PURPOSE: To evaluate the usefulness of dynamic contrast-enhanced T2*-weighted MR imaging for assessing cerebral hemodynamics in acute cerebral infarction. MATERIALS AND METHODS: We performed dynamic T2*-weighted imaging(TR/TE/flip angle : 40/26/10 degrees, 64 x 128 matrix, 5 sec scan time) in conjunction with conventional T1- andT2-weighted imaging and MR angiography in 20 patients with acute cerebral infarction. The regions of ischemia seenon T2-weighted image(high signal intensity), MR angiogram(vascular stenosis or occlusion) and dynamic contrast-enhanced T2*-weighted image(perfusion defect) were topographically compared with each other. Relative cerebral blood volumes(rCBVs) of the ischemic regions and of contralateral normal regions were calculated fromsignal intensity data measured on dynamic contrast-enhanced T2*-weighted images, and were compared. RESULTS: Regions of ischemia were topographically well correlated on T2-weighted image, MR angiogram and dynamic contrast-enhanced T2*-weighted image in all but two patients, of whom one had recanalization of the occluded artery and the other had a small infarction. rCBVs were asymmetrically reduced in the ischemic regions in all butone patient who had recanalization of the occluded artery. CONCLUSION: Dynamic contrast-enhanced T2*-weighted imaging is a useful method in the qualitative and quantitative assessment of cerebral hemodynamics in acutecerebral infarction. The use of this imaging technique along with conventional MR imaging and MR angiography provides better hemodynamic information in acute cerebral infarction.
Angiography ; Arteries ; Cerebral Infarction* ; Constriction, Pathologic ; Hemodynamics* ; Humans ; Infarction ; Ischemia ; Magnetic Resonance Imaging

OBJECTIVES: The aim of study was to investigate the effect of flow, specimen geometry and adhesion on the measurement of linear polymerization shrinkage of light cured composite resins using linear shrinkage measuring device. METHODS: Four commercially available composites - an anterior posterior hybrid composite Z100, a posterior packable composite P60 and two flowable composites, Filtek flow and Tetric flow - were studied. The linear polymerization shrinkage of composites was determined using 'bonded disc method' and 'non-bonded' free shrinkage method at varying C-factor in the range of 1~8 by changing specimen geometry. These measured linear shrinkage values were compared with free volumetric shrinkage values. The viscosity and flow of composites were determined and compared by measuring the dropping speed of metal rod under constant load. RESULTS: In non-bonded method, the linear shrinkage approximated one third of true volumetric shrinkage by isotropic contraction. However, in bonded disc method, as the bonded surface increased the linear shrinkage increased up to volumetric shrinkage value by anisotropic contraction. The linear shrinkage value increased with increasing C-factor and approximated true volumetric shrinkage and reached plateau at about C-factor 5~6. The more flow the composite was, reduced linear shrinkage was measured by compensation radial flow.
Anisotropy ; Compensation and Redress ; Composite Resins ; Polymerization* ; Polymers* ; Viscosity*

OBJECTIVES: The purpose of this study was to investigate the clinical characteristics and neurocognitive functions in schizophrenia patients with treatment-resistant auditory hallucination. METHODS: The 30 patients with treatment-resistant hallucination (hallucinating patients) were compared with 31 patients without hallucination (non-hallucinating patients) and 30 normal controls. The hallucinating patients included the schizophrenic patients who reported not-remitting hallucinations for 2 years in spite of appropriate treatments. The non-hallucinating patients included schizophrenic patients who had chronic illness course, and not reporting hallucination within 2 years. The hallucination characteristics and neurocognitive were measured by self report questionnaires on hallucination: functions Wisconsin card sorting test (WCST), Continuous performance test (CPT) and Sentence repetition test (SRT) among three groups. Psychopathology, depressive symptomps and extrapyramidal symtomps were measured by Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Beck depression Inventory (BDI) and Extrapyramidal Symptom Rating Scale (ESRS), separately. RESULTS: The auditory hallucinations 1 or 2 times a day (33%), with the contents of criticising and cursing (26%) were most frequent. Hallucinating patients did not feel uncomfortable with their hallucinations. WCST performances were significantly decreased in hallucinating patients than non-hallucinating patients, especially on total error (35.2+/-7.6 vs 25.3+/-10.0), perseverative error (54.8+/-14.9 vs 38.5+/-13.0). In CPT, hallucinating patients showed more error response (11.9+/-8.1 vs 8.9+/-7.5) and more prolonged reaction time to incorrect answers (552.4+/-433.2 ms vs 492.7+/-358.5 ms). CONCLUSION: Integrating these observations, it can be said that schizophrenic patients with treatment-resistant auditory hallucination have more neurocogntive functional deficits implying frontal lobe dysfunction than non-hallucinating schizophrenic patients.
Chronic Disease ; Depression ; Frontal Lobe ; Hallucinations* ; Humans ; Psychopathology ; Surveys and Questionnaires ; Reaction Time ; Schizophrenia* ; Self Report ; Wisconsin

A soft tissue injury can cause the formation of a pseudocyst in the subcutaneous tissue due to a hematoma, seroma, or liquefied fat. These cysts are Morel-Lavallée lesion. A 30-year-old male patient had previously received a large-volume Liposuction. After a couple of years, Morel-Lavallée lesion has formed on the abdomen. So after the two communicating massive sacs were resected, we advanced the upper flap inferiorly and resected a margin of the redundant tissue.
Abdomen ; Adult ; Hematoma ; Humans ; Lipectomy* ; Male ; Seroma ; Soft Tissue Injuries ; Subcutaneous Tissue

Endometriosis affects up to 5 million women in the united states. The number of cases observed at any time is 1 in 15(7%) women in the reproductive age range. Infertility occurs in as many as 30% to 40% of cases. Anatomical compromise with failure of oocyte capture and transport is an eviednt explanation for infertility in women suffering from advanced(stageIII/IV) endometriosis. In contrast, the pathophysiology in couples suffening from mild to moderate endometriosis as a sole infertility diagnosis is poorly understood. Research over the last decade indicates that women with endometriosis suffer from excessive activstion of immunocompetent cells within the pelvis. In experimental paradigms, adversd effects of a peritoneal fluid on the reproductive process of the endometriosis patients can be demonstrated and include:(1) Phagocytosis of sperm(2) Decreased sperm motility(3) Alteration of sperm-egg interactions(4) Failure of oocytes capture by the fimbria and(5) Impeded embryo development. These data raise the possibility that the intraperitoneal inflammatory process observed in women with endometriosis may be responsible for the associated infertility. The purpose of this study was to evaluate the effect of peritoneal fluid(PF) from patient with moderate endometriosis on mouse embryo development.PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free superantant was not heat-inactivated and not filtered. Fifty percent PF in human tubular fluid(HTF) media was prepared as a study group. The control group consisted of PF with a nonendometriosis and of 0.5% bovine serum albumin and HTF. The in vitro fertilization was performed with these culture media. We were observed distribution of embryo under the microscopy at 24 hours, 72 hours, 92 hours and 120 hours after insemination. The 2-cell embryonic stages in the study group(254 ovums) and those in the control group(247 ovums) at 24 hours were 50.4%, 70.4%, respectively. At 72 hours, the embryonic stages of both groups were reached the morula stage. At 72 hours, only 7.0% of the embryos in the study group reached the hatching, versus 55.7% in the control group. (p < 0.001). At the 120 hours, 100% of embryos in study group were degenerating, versus only 13.2% in the control group. As a result, the peritoneal fluid of the endometriosis patients exert an adverse influence on early reproductive performance, especially inhibiting embryo development. The peritoneal fluid may be as a mediator in the pathogenesis of endometriosis associated subfertility.
Animals ; Ascitic Fluid* ; Culture Media ; Diagnosis ; Embryonic Development* ; Embryonic Structures* ; Endometriosis* ; Family Characteristics ; Female ; Fertilization in Vitro ; Humans ; Infertility ; Insemination ; Laparoscopy ; Mice* ; Microscopy ; Morula ; Oocytes ; Pelvis ; Phagocytosis ; Pregnancy ; Serum Albumin, Bovine ; Spermatozoa ; United States

Endometriosis affects up to 5 million women in the united states. The number of cases observed at any time is 1 in 15(7%) women in the reproductive age range. Infertility occurs in as many as 30% to 40% of cases. Anatomical compromise with failure of oocyte capture and transport is an eviednt explanation for infertility in women suffering from advanced(stageIII/IV) endometriosis. In contrast, the pathophysiology in couples suffening from mild to moderate endometriosis as a sole infertility diagnosis is poorly understood. Research over the last decade indicates that women with endometriosis suffer from excessive activstion of immunocompetent cells within the pelvis. In experimental paradigms, adversd effects of a peritoneal fluid on the reproductive process of the endometriosis patients can be demonstrated and include:(1) Phagocytosis of sperm(2) Decreased sperm motility(3) Alteration of sperm-egg interactions(4) Failure of oocytes capture by the fimbria and(5) Impeded embryo development. These data raise the possibility that the intraperitoneal inflammatory process observed in women with endometriosis may be responsible for the associated infertility. The purpose of this study was to evaluate the effect of peritoneal fluid(PF) from patient with moderate endometriosis on mouse embryo development.PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free superantant was not heat-inactivated and not filtered. Fifty percent PF in human tubular fluid(HTF) media was prepared as a study group. The control group consisted of PF with a nonendometriosis and of 0.5% bovine serum albumin and HTF. The in vitro fertilization was performed with these culture media. We were observed distribution of embryo under the microscopy at 24 hours, 72 hours, 92 hours and 120 hours after insemination. The 2-cell embryonic stages in the study group(254 ovums) and those in the control group(247 ovums) at 24 hours were 50.4%, 70.4%, respectively. At 72 hours, the embryonic stages of both groups were reached the morula stage. At 72 hours, only 7.0% of the embryos in the study group reached the hatching, versus 55.7% in the control group. (p < 0.001). At the 120 hours, 100% of embryos in study group were degenerating, versus only 13.2% in the control group. As a result, the peritoneal fluid of the endometriosis patients exert an adverse influence on early reproductive performance, especially inhibiting embryo development. The peritoneal fluid may be as a mediator in the pathogenesis of endometriosis associated subfertility.
Animals ; Ascitic Fluid* ; Culture Media ; Diagnosis ; Embryonic Development* ; Embryonic Structures* ; Endometriosis* ; Family Characteristics ; Female ; Fertilization in Vitro ; Humans ; Infertility ; Insemination ; Laparoscopy ; Mice* ; Microscopy ; Morula ; Oocytes ; Pelvis ; Phagocytosis ; Pregnancy ; Serum Albumin, Bovine ; Spermatozoa ; United States

BACKGROUND: A pharyngocutaneous fistula is a common and difficult-to-manage complication after head and neck reconstruction. It can lead to serious complications such as flap failure, carotid artery rupture, and pharyngeal stricture, and may require additional surgery. Previous radiotherapy, a low serum albumin level, and a higher T stage have been proposed as contributing factors. We aimed to clarify the risk factors for pharyngocutaneous fistula in patients who underwent flap reconstruction and to describe our experiences in treating pharyngocutaneous fistula. METHODS: Squamous cell carcinoma cases that underwent flap reconstruction after cancer resection from 1995 to 2013 were analyzed retrospectively. We investigated several significant clinical risk factors. The treatment modality was selected according to the size of the fistula and the state of the surrounding tissue, with options including conservative management, direct closure, flap surgery, and pharyngostoma formation. RESULTS: A total of 127 cases (18 with fistulae) were analyzed. A higher T stage (P=0.048) and tube-type reconstruction (P=0.007) increased fistula incidence; other factors did not show statistical significance (P>0.05). Two cases were treated with conservative management, 1 case with direct closure, 4 cases with immediate reconstruction using a pectoralis major musculocutaneous flap, and 11 cases with direct closure (4 cases) or additional flap surgery (7 cases) after pharyngostoma formation. CONCLUSIONS: Pharyngocutaneous fistula requires global management from prevention to treatment. In cases of advanced-stage cancer and tube-type reconstruction, a more cautious approach should be employed. Once it occurs, an accurate diagnosis of the fistula and a thorough assessment of the surrounding tissue are necessary, and aggressive treatment should be implemented in order to ensure satisfactory long-term results.
Carcinoma, Squamous Cell ; Carotid Arteries ; Constriction, Pathologic ; Cutaneous Fistula ; Diagnosis ; Fistula* ; Free Tissue Flaps ; Head ; Humans ; Hypopharynx* ; Incidence ; Myocutaneous Flap ; Neck ; Oropharynx* ; Postoperative Complications ; Radiotherapy ; Retrospective Studies ; Risk Factors* ; Rupture ; Serum Albumin

No abstract available.

Many radiopharmaceuticals have been developed and wildy used in the imaging cardiac function. Myocardial perfusion imaging (MPI) is a well established noninvasive method of assessing coronary blood flow and has been widely used in patients diagnosed or suspected with coronary artery diseases. The innovation of radiopharmaceuticals used in the cardiac imaging is one of the most important contributors to the development of nuclear cardiology. Thallium-201 and various technetium-99m agents have been globally used for myocardial perfusion SPECT, and N-13 ammonia (13NH3), rubidium-82 (82Rb), O-15 water (H215O) for myocardial perfusion PET. As well as the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. Useful information can be obtained for diagnosing coronary artery disease, evaluating patients' condition, or assessing therapeutic effects. In this review, we describe the characteristics and clinical usefulness of radiopharmaceuticals used for cardiac SPECT and PET.
Ammonia ; Cardiology ; Coronary Artery Disease ; Humans ; Myocardial Perfusion Imaging ; Perfusion ; Radiopharmaceuticals ; Sympathetic Nervous System ; Tomography, Emission-Computed, Single-Photon ; Water