Exflagellation of the malaria parasite microgametocyte usually occurs in the gut cavity of Anopheles mosquitoes following an infective blood meal. Exflagellation is a very rare event in human blood. Due to its rarity, the appearance of this structure in a peripheral blood smear will easily create a diagnostic dilemma. We report a case of malaria with exflagellated microgametes in human blood that was initially mistaken for a double infection of Plasmodium and another blood flagellate. The patient was a 29-year-old Parkistani man presenting with fluctuating fever accompanied by chills and fatigue for 4 days. Initial peripheral blood smear examination showed a number of Plasmodium ring forms, trophozoites, and gametocytes. Additionally, several filamentous structures resembling blood flagellates were seen. With these features, an initial diagnostic impression of combined infection of malaria and blood flagellate was made. Later, we determined that these structures resembling blood flagellates were exflagellated microgametes of malarial parasite. Therefore, the knowledge that exflagellation may appear in human blood with Plasmodium species infection and being more familiar with differentiation of the morphologic features of other species infection can prevent further possible misinterpretation.
Anopheles ; Chills ; Culicidae ; Fatigue ; Fever ; Humans ; Malaria ; Meals ; Parasites ; Plasmodium ; Trophozoites

To evaluate the effectiveness of I-131 in ablation of residual thyroid tissue, we analyzed 350 patients with thyroid cancer who were treated with various doses of I-131 after surgery for thyroid cancer. Two hundred fifty five patients were treated with l.lGBq(30mCi) of I-131 for ablation of remnant thyroid and one hundred seventeen patients received more than 2.8GBq(75mCi) of I-131. We determined the effectiveness of ablation by following I-131 whole body scan. Absent visible uptake or minimal uptake in thyroid tissue were considered as successful ablation. Of 255 patients who received doses of 30mCi I-131 therapy, 131 patients(51%) showed successful ablation of residual thyroid tissue with 2.6+/-1.7 times of I-131 therapy. Of 117 patients who received doses of the more than 75mCi I-131, 84 patients(72%) had successful remnant thyroid ablation with 1.6+/-1.1 times of I-131 therapy. According to the extent of surgery, successful ablation rates were 78%, 62%, 54%, 33% in patients who underwent total thyroidectomy, subtotal thyroidectomy, lobectomy and isthmectomy, lobectomy or tumorectomy, respectively. This study showed that ablation of remnant thyroid after surgery with 30mCi I-131 was successful only in 50%. Therefore, in cases of patients with high risk for recurrence, we recommend high dose I-131 for ablation of remnant after total thyroidectomy.
Humans ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Whole Body Imaging

Laboratory values change with age and interpreting laboratory results from elderly people using the reference intervals for younger adults may not be appropriate. The authors investigated the distribution patterns of routine chemistry values from elderly people to determine whether current reference intervals are also valid for elderly people. A total of 1,215 persons older than 65 years and 1,827 healthy adults below 65 years of age were evaluated. Blood samples were collected after an overnight fast and analyzed for chemistry tests. Computing the central 95th percentile showed that the total protein, albumin, ALP, LD, creatinine, uric acid, triglyceride, HDL-cholesterol, and electrolytes of elderly people were within the standard reference intervals used in our laboratory. For AST and ALT, the upper range of the central 95th percentile in the elderly population was found to be outside the common reference interval. However, the central 90th percentile values of AST and ALT were compatible with the common reference intervals. GGT, BUN, total cholesterol, LDL-cholesterol, and glucose showed higher values than the upper limits of the reference intervals. For common clinical chemistry tests, the common reference values in general should be applicable to elderly people, even though some parameters showed wider distributions in the elderly.
Adult ; Aged ; Chemistry, Clinical ; Cholesterol ; Clinical Chemistry Tests ; Creatinine ; Electrolytes ; Glucose ; Humans ; Reference Values ; Uric Acid

Congenital accessory limbs are very rare anomalies with many causative factors. We describe the case of a 1-day-old female neonate-born to a healthy, 27-year-old mother-who presented with an accessory limb (foot) attached to the buttock and an imperforate anus. We also provide a review of the relevant literature.
Adult ; Anus, Imperforate* ; Buttocks ; Extremities* ; Female ; Humans

The purpose of this study is to determine that YMCA step-test is useful method of cardiovascular fitness field-test for large scale study of epidemiology. 57 adults participated in this study. They are recruited considering subject's clinic status and gender proportion. Cardiorespiratory fitness of each participant was determined by grade exercise testing(GXT) with gas analysis and YMCA step-test. There are at least more two days an interval between the tests. Data were analyzed with a statistics program, SPSS version 14.0, by applying Spearman correlation coefficient and independent t-test and Fisher's exact test with a statistical significant level of alpha<.05. The results of this study were as followed. VO2max value exhibited significant correlation with YMCA step test scale(male : r =-.611, p=.001 ; female: r=-.656, p>.001). Our result is that validity of YMCA step-test is acceptable. YMCA step test is vary efficient as dimension of investigator's and subject's effort then the other field-test for assessment of cardiorespiratory. Therefore, Step test is useful for large scale study of epidemiology.
Adult ; Exercise Test ; Humans ; Oxygen ; Oxygen Consumption

Arterial canuulation is generally used to monitor blood pressure and sample blood for gas analysis. Radial and dorsalis pedis arteries are commonly used for arterial cannulation. It is a simple, safe, and uncomplicated procedure, but some complications have been reported, including bleeding, hematoma, infection, pseudoaneurysm, and thromboembolism. Although thromboembolism is not common, it could be serious because it can lead to digital ischemia and necrosis. We present a case of foot necrosis following dorsalis pedis artery cannulation in a 65-year-old patient who underwent small bowel resection.
Aged ; Aneurysm, False ; Arteries ; Blood Pressure ; Catheterization ; Foot ; Hematoma ; Hemorrhage ; Humans ; Ischemia ; Necrosis ; Organothiophosphorus Compounds ; Thromboembolism

PURPOSE: This study was conducted to evaluate clinical validity of a zirconia full-coverage crown by comparing zirconia's wear capacity over antagonistic teeth with that of feldspathic dental porcelain. MATERIALS AND METHODS: The subject groups were divided into three groups: the polished feldspathic dental porcelain group (Group 1), the polished zirconia group (Group 2), and the polished zirconia with glazing group (Group 3). Twenty specimens were prepared from each group. Each procedure such as plasticity, condensation, and glazing was conducted according to the manufacturer's manual. A wear test was conducted with 240,000 chewing cycles using a dual-axis chewing simulator. The degree of wear of the antagonistic teeth was calculated by measuring the volume loss using a three-dimensional profiling system and ANSUR 3D software. The statistical significance of the measured degree of wear was tested with a significant level of 5% using one-way ANOVA and the Tukey test. RESULTS: The degrees of wear of the antagonistic teeth were 0.119 +/- 0.059 mm3 in Group 1, 0.078 +/- 0.063 mm3 in Group 3, and 0.031 +/- 0.033 mm3 in Group 2. Statistical significance was found between Group 1 and Groups 2 and between Group 2 and 3, whereas no statistical significance was found between Group 1 and Group 3. CONCLUSION: Despite the limitations of this study on the evaluation of antagonistic teeth wear, the degree of antagonistic tooth wear was less in zirconia than feldspathic dental porcelain, representing that the zirconia may be more beneficial in terms of antagonistic tooth wear.
Analysis of Variance ; Ceramics ; Crowns ; Dental Porcelain ; Mastication ; Plastics ; Tooth ; Tooth Wear ; Zirconium

BACKGROUND: Recently, myeloproliferative leukemia (MPL) W515 mutations have been reported to be molecular markers for myeloproliferative neoplasms (MPNs). We studied the association between MPL W515 mutations and the clinico-hematological features of patients with MPNs. METHODS: Our study included 154 consecutive patients diagnosed with MPNs (31 had polycythemia vera [PV]; 106, essential thrombocythemia [ET]; and 17, primary myelofibrosis [PMF]). MPL W515 mutations were detected by real-time PCR and direct sequencing methods. RESULTS: The MPL W515L mutation was found in 4 patients and the MPL W515A mutation was detected in 1 patient. These 5 patients were diagnosed with JAK2 V617F-negative ET, and they accounted for 12.5% of patients with JAK2 V617F-negative ET. The patients with MPL W515-positive ET showed significantly lower hemoglobin levels and WBC counts than did patients with MPL W515-negative ET or JAK2 V617F-positive ET. CONCLUSIONS: MPL W515 mutation is a useful diagnostic marker for JAK2 V617F-negative MPNs and it is associated with specific hematologic characteristics such as lower hemoglobin levels and WBC counts.
Humans ; Janus Kinase 2 ; Leukemia ; Polycythemia Vera ; Primary Myelofibrosis ; Real-Time Polymerase Chain Reaction ; Thrombocythemia, Essential

OBJECTIVES: The purpose of this study was to evaluate the effectiveness of a seniors' oral health promotion program for establishing a cooperation model between public and private sectors. METHODS: This study was carried out targeting the seniors frequenting a community center in the Sosa-gu district of Bucheon-si in the Gyeonggi-do province of South Korea. Data were obtained from self-administered questionnaires or personal interviews with elders after they participated in the oral health promotion program. Their perceived satisfaction with their oral health before and after the oral health program was compared. The data were analyzed by t-tests, ANOVA, paired t-tests, and logistic regression using SPSS to assess the effects of explanatory factors on the seniors' satisfaction of the oral health promotion program. RESULTS: In total, 22.7% of participants had a positive idea about the oral health promotion program before their participation. The mean score of change in and difference of satisfaction with oral health tended to increase in each of the following groups: women, aged 80-84 years, number of permanent teeth, full denture wearers, and those who did not require dentures. Satisfaction notably increased 0.4 points in the group of full denture wearers (P<0.05). Moreover, after 1 month, the satisfaction level of the subjects who participated in the oral health promotion program increased 5.2 times (95% CI, 1.04-25.49) compared to dissatisfaction levels. Ultimately, satisfaction with oral health shows a major impact on the satisfaction with an oral health promotion program. CONCLUSIONS: The subjects who received the oral health promotion program responded very positively, but this program needs overall consideration about work processes and further reliable evaluations.
Dental Restoration Wear ; Dentures ; Female ; Gyeonggi-do ; Humans ; Korea ; Logistic Models ; Oral Health* ; Private Sector* ; Surveys and Questionnaires ; Tooth

BACKGROUND: 5-hydroxytryptamine 3 (5-HT3) receptors have been known to be associated with the modulation of nociceptive transmission. However, it is uncertain whether 5-HT3 plays a role in the antinociceptive or pronociceptive pathway for incisional pain. In this study, we evaluated the effects of palonosetron, a 5-HT3 receptor antagonist, on incisional pain in rats when administered intrathecally or intraplantarly. METHODS: An intrathecal catheter was implanted through the cisterna magna and placed in the intrathecal space of rats. An incision in the plantaris muscle of the right hind paw was done under anesthesia with sevoflurane. Withdrawal thresholds were evaluated with the von Frey filament after 2 hours. Palonosetron (0.5 and 0.1 microg intrathecally; 0.5 microg intraplantarly) was administered and the thresholds were observed for 4 hours. RESULTS: Mechanical hypersensitivity developed after the incision. Intrathecal palonosetron (0.5 microg and 0.1 microg) did not alter the paw withdrawal threshold. Intraplantar palonosetron (0.5 microg) also did not change the paw withdrawal threshold. CONCLUSIONS: Intrathecal and intraplantar palonosetron (0.5 microg) had no effect on modulating the mechanical hypersensitivity in the incisional pain model of rats.
Anesthesia ; Animals ; Catheters ; Cisterna Magna ; Hyperalgesia ; Hypersensitivity ; Isoquinolines ; Methyl Ethers ; Muscle, Skeletal ; Nociceptive Pain ; Pain Threshold ; Pain, Postoperative ; Quinuclidines ; Rats ; Rats, Sprague-Dawley ; Receptors, Serotonin, 5-HT3 ; Serotonin