Objective To investigate the factors that influence the occurrence of hemorrhagic transformation (HT) in patients with acute massive cerebral infarction,and to provide references for clinical treatment.Methods The clinical data of 60 patients with acute ischemic stroke were retrospectively analyzed.All the 60 patients were divided into HT group and non-hemorrhagic transformation (NHT) group.Risk factors associated with cerebrovascular disease,such as general data (gender,age,histories of drink and smoke),history of past illness (hypertension,diabetes,coronary disease,atrial fibrillation and cerebral stroke) and clinical data (infarction location,therapeutic methods,blood pressure,blood glucose,blood fat,cholesterol,fibrinogen and et al),were compared between the two groups.Results Of all the 60 patients,HT rate was 35％ (21/60).Incidence of HT was higher in patients with past and present hypertension and hyperglycemia(P =0.009,0.013,0.005,0.008,0.017),and in patients with atrial fibrillation,anti-platelet therapy,infarction in cortex,and hypocholesterolemia (P =0.020,0.037,0.003,0.009).But gender,age,histories of drink and smoke and history of coronary disease were not significantly different between the two groups(P=0.935,0.309,0.196,0.717,0.058).Conclusion Hypertension,hyperglycemia,atrial fibrillation,hypocholesterolemia,anti-platelet therapy could be independent risk factors for HT in patients with acute massive cerebral infarction.

Objective To investigate the efficacy and feasibility of segment-orientated anatomical liver resection for the treatment of hepatic alveolar echinococcosis (HAE) in the middle lobe of the liver.Methods The clinical data of a female patient with HAE in the middle lobe of the liver who was admitted to the First Affiliated Hospital of Xi'an Jiaotong University in September 2013 were retrospectively analyzed.Before operation,various surgical plannings were facilitated by a three-dimensional reconstruction system,and then the surgical planning was determined with the assistance of the multivariate analysis (volume measurement of liver,resectability of remnant functional liver,evaluation of vascular resection and reconstruction,Child-Pugh score and indocyanine green retention at 15 minutes).Segment-orientated anatomical liver resection(segment Ⅴ,Ⅷ and Ⅳb) was performed on the patient.There was a close relationship between the HAE and the first and the second hepatic portal during operation,and the anatomical liver resection of segment Ⅴ,Ⅷ and Ⅳb was precisely carried out.The patient was followed up by outpatient examination and telephone interview every month up to April 2014.The condition of the liver was observed by B ultrasound and computed tomography examinations.Results The three-dimensional reconstruction of the CT data of the patient clearly displayed the anatomical structure and adjacent relationship between the tumor,abdominal organs and major abdominal vessels.The preoperative evaluation of the anatomy of tumor based on three-dimensional images was confirmed with operative findings.The operation time and volume of blood loss were 410 minutes and 1 000 mL,respectively.The patient did not receive blood transfusion.The intraoperative vital signs of the patient were stable.There were no complications such as hepatic insufficiency.The duration of postoperative hospital stay was 15 days.Surgical incision was healed at discharge.The results of blood routine and blood biochemistry test,daily diet and basic self-care ability were in normal condition.HAE was diagnosed based on the result of pathological examination.Albendazole was administered with 1 200 mg/d after operation.The patient was followed up for 6 months and returned to work.The weight of the patient increased by 5 kilograms than that at discharge,without complaint of discomfort.There was no recurrence of HAE and hepatic echinococcosis of organs.Conclusions Segment-orientated anatomical liver resection is not only a method for complete resection,but also maximizes the functional remnant of liver on the basis of intraoperative three-dimensional reconstruction system together with selective hepatic inflow occlusion and vessel reconstruction technique.The patient gets a full recovery with satisfactory outcome.

Objective To compare the differences of lifestyle factors between patients with functional constipation (FC)and constipation-predominant irritable bowel syndrome (IBS-C).Methods From February 2011 to December 2014,255 patients with chronic constipation were enrolled.Among them,there were 170 FC patients and 85 IBS-C patients.At the same period,170 healthy volunteers without symptoms of digestive diseases within one year were recruited as control.The data of demographic information and lifestyle factors were collected.First,single variant analysis was performed for statistical analysis and then the statistically significant variants were analyzed by multivariate logistic regression. Then the factors of FC and IBS-C patients were analyzed by decision tree model and the effects of factors under different categories were analyzed.Results The results of single variant analysis indicated that there was no difference in lifestyle factors between FC group and IBS-C group (all P >0.05).The results of multivariate logistic regression analysis showed that no independent protective or risk factors were found in IBS-C group compared with FC group.According to decision tree model analysis,body mass index (BMI),water intake per day and constipation family history were finally enrolled.The incidence of FC was higher in patients with BMI < 23.56 kg/m2 (except 18.74 to < 19.83 kg/m2 )(79.75 %).The incidence of FC was higher in patients with BMI from 18.74 to <19.83 kg/m2 and water intake <1 L
(66.67%).The incidence of FC was highest in patients with BMI≥23.56 kg/m2 and family history of constipation (70.00%).The total prediction accuracy of this model was 64.6% (42/65 )and area under curve (AUC)value was 0.688.Conclusions FC and IBS-C are related with many lifestyle factors.Low BMI and less water intake per day are influence factors of FC,while higher BMI and family history of constipation are influence factors of IBS-C.

Objective:To evaluate the accuracy of ultrasonography in determining the laryngeal mask airway position using three-dimensional CT reconstruction (3D-CTR) images as the standard.Methods:One hundred and thirty-four patients, aged 18-64 yr, weighing 30-100 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective cerebral vascular interventional stent surgery in our hospital, were selected.Cervical ultrasonography was performed before and after laryngeal mask airway placement, and digital subtraction angiography was performed during operation to obtain 3D-CTR images.Neck ultrasound and 3D-CTR images were analyzed and graded.Results:A total of 125 patients completed the study.At the vertical position of the laryngeal mask airway, ultrasonic grading was positively correlated to 3D-CTR grading ( r=0.742, P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound in determining the rotation of the laryngeal mask airway was 73.0% (95% CI: 62.0%-84.4%), 92.8% (95% CI: 86.9%-98.7%), 89.1% (95% CI: 80.5%-97.7%), 81.0% (95% CI: 72.6%-89.4%), and 74.2% (95% CI 65.2%-81.1%), respectively.In terms of laryngeal mask airway depth grading, the correlation between ultrasonic grading was positively correlated to 3D-CT grading ( r=0.332, P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound in determining the depth of the laryngeal mask airway was 58.5% (95% CI: 46.9%-70.1%), 93.3% (95% CI: 87.2%-99.4%), and 90.5% (95% CI: 82.0%-99.0%), 67.5% (95% CI: 57.7%-77.3%), and 33.2% (95% CI: 16.8%-47.8%), respectively.The positive predictive value of ultrasound in determining the optimal placement of the laryngeal mask airway was 61.1% (95% CI: 48.6%-73.6%). Conclusion:Although ultrasound cannot measure the depth of the tip of the laryngeal mask airway into the esophagus, it has higher accuracy in determining the rotation and can be used as a reliable tool for clinical detection of the position of the laryngeal mask airway, especially the rotation.

No abstract available.
Estradiol* ; Female ; Humans ; Plasma* ; Progesterone*

Acanthopanax koreanum Nakai, a well known traditional herb grown in Jeju Island, South of Korea, has been used as a tonic and sedative agent, as well as in the treatment of diabetes and immune diseases. Mutagenicity of two lignans, syringaresinol and tortoside A isolated from A. koreanum, was assessed using Salmonella/microsome (Ames) test. Tester strains used were Salmonella typhimurium TA98, TA100, TA1535, and Escherichia coli WP2uvrA. The mutagenic activity was determined both in the absence or presence of S9 mixture. As a result, tortoside A did not cause any increase in the number of his+ revertants in S. typhimurium and E. coli WP2uvrA strains in the presence or absence of S9 mix, compared to the controls. Similarly, low concentrations of syringaresinol (750 and 1,500 microg/plate) did not show any mutagenic properties in all bacterial strains, in the presence or absence of S9 mixture. However, in the high concentration of syringaresinol (3,000 microg/plate), the number of revertants were increased in TA1535 strains, in the absence of S9 metabolic activation. Therefore, in vivo experiments such as comet assay are needed to further determine the genotoxic/carciogenic potential of syringaresinol isolated from A. koreanum.
Eleutherococcus* ; Biotransformation ; Comet Assay ; Escherichia coli ; Immune System Diseases ; Korea ; Lignans* ; Salmonella typhimurium

We analyzed an astigmatism and an uncorrected visual acuity in 235 eyes for 6 months following sutureless cataract surgery(167 eyes) with 5 mm(Group 1), 6 mm(Group 2), and 7 mm(Group 3) incision lengths at 2.5 mm posteriorly from the corneoscleral limbus, and shoelace sutured cataract surgery(68 eyes) with 7 mm(Group 4) incision length at 1 mm posteriorly from the corneoscleral limbus performed by one surgeon. In three groups of sutureless cataract surgery, the surgically induced corneal astigmatisms were stable after one month postoperatively, but decreasing the length of incision substantially reduced the astigmatic changes(p>0.05), the astigmatic swings(p>0.05) and the astigmatic ranges. In comparison to sutured cataract surgery with 7 mm incision length, sutureless cataract surgery with same incision length reduced the astigmatic changes(p<0.01), reduced the astigmatic swings(p<0.01) and narrowed the astigmatic ranges and also was stabilized earlier. The shorter the length of incision in sutureless cataract surgery, the higher the incidence of an uncorrected visual acuities of 20/40 or better(p>0.05) was noted. In comparison to sutured catarct surgery with 7 mm incision length, suture less cataract surgery with same incision length had higher incidence of an uncorrected visual acuities of 20/40 or better(p<0.01). The tesults indicate that smaller incision length in sutureless cataract surgery was associated with a lower surgically induced astigmatism(p>0.05) and a better uncorrected visual acuity(p>0.05). And sutureless cataract surgery rather than sutured cataract surgery was associated with a lower surgically induced astigmatism(p<0.01), an earlier stability, and a better uncorrected visual acuity(p<0.01).
Astigmatism ; Cataract* ; Incidence ; Sutures ; Visual Acuity

BACKGROUND: In this study, we have investigated the effect of Korean red ginseng (KRG) extracts on the production of TNF-alpha and IL-8 in human keratinocytes. Also, to examine the antioxidative effect of red ginseng extracts, free radical scavenging activity and superoxide dismutase (SOD) activity in human dermal fibroblasts was measured. METHODS: To investigate the effect of KRG in atopic dermatitis, we measured the level of TNF-alpha and IL-8 secretion in LPS-stimulated human keratinocytes after the treatment of KRG extracts using enzyme-linked immunosorbent assay. Anti-oxidative activity was investigated by measuring 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging and SOD activity. RESULTS: The stimulation of human keratinocytes with KRG extracts shifted the LPS-induced cytokine secretion toward a more immunosuppressive response. KRG dose-dependently decreased TNF-alpha and IL-8 production in HaCaT cells and a significant inhibition of TNF-alpha was shown when cells were treated with 500 and 1,000 microg/ml of KRG extracts. Additionally, KRG extracts showed DPPH radical scavenging and SOD activity in a dose-dependent manner. Particularly, SOD activities of concentrations higher than 60 microg/ml of KRG extracts were significantly different in human dermal fibroblast cells. CONCLUSION: Based on this study, KRG extracts may be a useful immunosuppressive agent in the treatment of atopic dermatitis.
Biphenyl Compounds ; Dermatitis, Atopic ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; Humans ; Interleukin-8 ; Keratinocytes ; Panax ; Picrates ; Superoxide Dismutase ; Tumor Necrosis Factor-alpha

Multiple cerebral infarction developed in a 36-year-old woman with adenocarcinoma of the right lung with direct cardiac invasion. Neurological examination and brain MRI showed findings of ordinary infarction. Transesophageal echocardiography showed left atrial pedunculated mass which was the potential source of embolism. We report a rare case who had such multiple spontaneous tumor emboli large enough to result in clinically detectable cerebral infarction.
Adenocarcinoma ; Adult ; Brain ; Cerebral Infarction* ; Echocardiography, Transesophageal ; Embolism ; Female ; Humans ; Infarction ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Neoplastic Cells, Circulating ; Neurologic Examination

No abstract available.
Rhabdomyosarcoma*