PURPOSE: We evaluated the usefulness of quantitative spiral CT to predict postoperative lung function in patients undergoing pulmonary resection. MATERIALS AND METHODS: Fourteen patients in whom pneumonectomy or segmentectomy were performed underwent preoperative chest spiral CT and pulmonary function test(PFT). Six patients underwent postoperative follow-up PFT. Ten patients underwent preoperative radioisotope(RI) lung perfusion scan. Preoperative CT data were postprocessed with contiguous pixel method ranged from -9107HU to -500HU to quantify total functional lung volume(TFLV) and regional volume to be resected(RFLV). Postoperative lung function was predicted by following formula;Predicted postoperative PFT value=preoperative PFT x 1-RFLV/TFLV). CT predicted value was compared with postoperative measured PFT value and those value of RI perfusion scan. RESULTS: CT predicted values were very close to postoperative measured value and RI predicted value, and were correlated well with postoperative measured values (FVC: r=0.988, P<0.001 ;FEV1: r=0.994, P<0.001) and RI predicted values (FVC :r=0.976, P<0.001 ;FEVl: r=0.974, p<0.001). CONCLUSION: Quantitative spiral CT was useful to predict postoperative lung function and could be an effective alternative to RI perfusion scan.
Follow-Up Studies ; Humans ; Lung* ; Mastectomy, Segmental ; Perfusion ; Pneumonectomy ; Thorax ; Tomography, Spiral Computed*

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip*

Objective: The purpose of this study was to evaluate and compare the association of job stress and working with video display terminal (VDT) to musculoskeletal symptoms of the neck-shoulder which were most common in white-collar workers. METHODS: From 122 workplaces, 1,790 white-collar workers with no trauma, and no history of musculoskeletal disease were selected for the study. The questionnaire survey included general characteristics, work related characteristics, Job Content Questionnaire (JCQ) and musculoskeletal symptoms. Multiple logistic regression, adjusted for age, smoking status, drinking habit, housekeeping, work time, job tenure, and work-load change, were used to evaluate the effects of job stress and VDT-work on the symptoms. RESULTS: The prevalence of neck-shoulder symptoms was overall 24.3% overall. The prevalence odds ratio of job demand (high/low) to neck-shoulder symptoms, adjusted for general and work-related factors, was 1.56 (95% confidence interval 1.12~2.17), and that of job strain (high strain/low strain) was 1.72 (1.07~2.79). However, VDT-work was not associated with neck-shoulder symptoms in the multiple logistic regression model. CONCLUSIONS: To prevent musculoskeletal disorders in white-collar workers, it is important to consider psychosocial factors such as job demand and job strain, as well as VDT-work.
Computer Terminals ; Drinking ; Housekeeping ; Logistic Models ; Musculoskeletal Diseases ; Neck* ; Odds Ratio ; Prevalence ; Psychology ; Questionnaires ; Shoulder* ; Smoke ; Smoking

OBJECTIVE: This study was performed to evaluate relationship of burdened work and musculoskeletal symptoms in small-to-medium sized enterprises. METHOD: After a questionnaire survey was administered to 9,950 workers in 122 workplace, 7,626 workers(76.6%) were finally selected for the study analysis. Industrial hygienists visited 122 small-to-medium sized enterprises to investigate the presence of burdened works within the workplace. The selection of jobs with significant burden was based on the Ministry of Labor's recent notification in 11 types of job description associated with musculoskeletal disorders. The subjects of this study were then divided into three categories. 1) non-burdened white collar workers, 2) non-burdened blue collar workers, and 3) burdened workers (include some VDT workers). Multiple logistic regression was used to evaluate the relationship between burdened work and musculoskeletal symptoms. RESULTS: The burdened workers reported significantly more musculoskeletal symptoms than non-burdened white collar workers and non-burdened blue collar workers(OR:1.57, 95% CI: 1.314-1.875). There was no significant difference in reports of musculoskeletal symptoms between non-burdened white and blue collar workers. CONCLUSION: To prevent or diminish musculoskeletal disorders in small-to-medium sized enterprises, we need to better manage burdened works.
Job Description ; Logistic Models ; Questionnaires

Anticonvulsant hypersensitivity syndrome (AHS) is a rare and potentially life-threatening drug reaction, which has been associated with aromatic anticonvulsants such as phenytoin, carbamazepine, and phenobarbital. It is characterized by the triad of fever, rash and internal organ involvement, which mostly includes hepatitis. Histopathological findings usually show characteristic erythema multiforme. Lamotrigine is a new antiepileptic drug, chemically distinct from other anticonvulsant medication, however, AHS has recently been documented in patients treated with lamotrigine. We report a case of AHS in a 29-year-old man, thought to have been caused by the use of lamotrigine.
Adult ; Anticonvulsants ; Carbamazepine ; Erythema Multiforme ; Exanthema ; Fever ; Hepatitis ; Humans ; Hypersensitivity* ; Phenobarbital ; Phenytoin

Angiolipoma is a rare benign soft tissue tumor, an unusual variant of lipoma,consisting of fatty and vascular components and located in the subcutis, usually in the trunk and extremities. We report a case of posterior mediastinal angiolipo-ma extending into the spinal canal and showing both fat and angiomatous fea-tures on CT scan.
Aged ; Angiolipoma/pathology/*radiography ; Case Report ; Female ; Human ; Mediastinal Neoplasms/pathology/*radiography ; Spinal Canal/*pathology ; Tomography, X-Ray Computed

PURPOSE: Even though adipose tissue-derived stem cells (ADSCs) have been spotlighted as a possible alternative for liver transplantation in an experimental setting, the mechanism by which ADSCs improve liver dysfunction remains poorly characterized. The objective of this study was to evaluate the therapeutic ability of undifferentiated ADSCs, and find a few clues on how ADSCs alleviate liver damage by comparing the transplantation routes. METHODS: In vitro generated human ADSCs were checked for surface markers and stage-specific genes for characterization. Afterwards, they were transplanted into C57BL/6 mice with CCl4-induced liver injury. The transplantations were made via tail vein, portal vein, and direct liver parenchymal injection. At 1 and 3 post-transplantation days, serum biochemical parameters and/or liver specimens were evaluated. RESULTS: We have shown here that ADSCs have the characteristics of mesenchymal stem cells, and belong to endodermal and/or early hepatic differentiation stage. After transplantation into the mice with acute liver failure, markers of liver injury, such as alanineaminotransferase, aspartateaminotransferase, as well as ammonia, decreased. Of these transplantation routes, transplantation via tail vein rendered the most prominent reduction in the biochemical parameters. CONCLUSION: Undifferentiated ADSCs have the ability to improve hepatic function in mice with acute liver injury. Moreover, our transplantation route study supports the theory that ADSCs in systemic circulation can exert endocrine or paracrine effects to ameliorate the injured liver.
Ammonia ; Animals ; Endoderm ; Humans ; Liver ; Liver Diseases ; Liver Failure ; Liver Failure, Acute ; Liver Transplantation ; Mesenchymal Stromal Cells ; Mice ; Portal Vein ; Stem Cell Transplantation ; Stem Cells ; Transplants ; Veins

The residual tense false lumen following surgical repair of aortic dissection remains one of the most difficult and challenging postsurgical problems. Percutaneous fenestration of the dissecting membrane under the guidance of intravascular ultrasound has been recently introduced to depressurize the tense false lumen. A 63-year-old woman who underwent repair of acute type I dissection was readmitted because of claudication and numbness of the left lower extremity. Angiography, computed tomography, and magnetic resonance imaging clearly showed a dissection flap starting from the thoracic aorta distal to the left subclavian artery. Compressed true lumen by the markedly enlarged tense false lumen was also noted in the double-channeled descending thoracoabdominal aorta. Under intravascular ultrasound guidance, the intimal flap was punctured with a Brockenbrough needle advanced to the true lumen through a femoral artery, and then, a balloon catheter was introduced over the guidewire which was placed across the dissection flap. Desired fenestration was obtained successfully by inflation of the balloon without complications. After procedure, symptoms resolved promptly and she is currently(clinical follow-up of 12 months postfenestration) ambulating without claudication. In conclusion, percutaneous fenestration of the intimal flap is a technically feasible and an effective alternative procedure to surgical repair for restoration of perfusion to an ischemic extremity in selected patients complicated with aortic dissection.
Angiography ; Aorta ; Aorta, Thoracic ; Catheters ; Extremities* ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Hypesthesia ; Inflation, Economic ; Ischemia* ; Lower Extremity ; Magnetic Resonance Imaging ; Membranes ; Middle Aged ; Needles ; Perfusion ; Subclavian Artery ; Transcutaneous Electric Nerve Stimulation ; Ultrasonography

PURPOSE: We evaluated the influence of urinary stone components on the outcomes of ureteroscopic removal of stones (URS) by electrohydraulic lithotripsy (EHL) in patients with distal ureteral stones. MATERIALS AND METHODS: Patients with a single distal ureteral stone with a stone size of 0.5 to 2.0 cm that was completely removed by use of EHL were included in the study. Operating time was defined as the time interval between ureteroscope insertion and complete removal of ureteral stones. Ureteral stones were classified into 5 categories on the basis of their main component (that accounting for 50% or more of the stone content) as follows: calcium oxalate monohydrate (COM), calcium oxalate dihydrate, carbonate apatite (CAP), uric acid (UA), and struvite (ST). RESULTS: A total of 193 patients (131 males and 62 females) underwent EHL. The mean operating time was 25.1+/-8.2 minutes and the mean stone size was 1.15+/-0.44 cm. Calcium oxalate stones accounted for 64.8% of all ureteral stones, followed by UA (19.7%), CAP (8.3%), and ST (7.2%) stones. The mean operating time was significantly longer in the UA group (28.6+/-8.3 minutes) than in the COM group (24.0+/-7.8 minutes, p=0.04). In multivariate analyses, the stone size was negatively associated with the odds ratio (OR) for successful fragmentation. UA as a main component (OR, 0.42; 95% confidence interval, 0.20 to 0.89; p=0.023) was also found to be significantly important as a negative predictive factor of successful fragmentation after adjustment for stone size. CONCLUSIONS: The results of the present study suggest that successful fragmentation by URS with EHL could be associated with the proportion of the UA component.
Accounting ; Apatites ; Calcium Oxalate ; Carbon ; Humans ; Lithotripsy ; Magnesium Compounds ; Male ; Multivariate Analysis ; Odds Ratio ; Phosphates ; Ureter ; Ureteroscopes ; Ureteroscopy ; Uric Acid ; Urinary Calculi

Primary central nervous system atypical teratoid/rhabdoid tumors are rare and extremely aggressive malignancies of early childhood. These tumors are most common in infants less than 2 years of age. Diagnosis is based on distinctive light microscopic and immunohistochemical findings, coupled with a molecular genetic analysis. A histologic features of these tumors are epithelial and/or mesenchymal components in addition to rhabdoid, with or without neuroepithelial fields. The expression of the epithelial membrane antigen, vimentin, and the smooth muscle actin are characteristic of these tumors. Treatment includes surgery, chemotherapy, and radiotherapy. Prognosis is poor despite of an aggressive therapy. We report one case of an atypical teratoid/rhabdoid tumor in a young child. She is an 18 month-old-girl who presented with central type facial palsy. After extensive surgery she improved transiently but relapsed immediately. Her condition was not permitted to receive radiotherapy or chemotherapy. Thereafter, with phrenic nerve palsy, she suffered from recurrent episodes of pneumonia and respiratory difficulties. Finaly, she was expired three months after the diagnosis and treatment.
Actins ; Central Nervous System ; Cerebellum* ; Child ; Diagnosis ; Drug Therapy ; Facial Paralysis ; Humans ; Infant ; Molecular Biology ; Mucin-1 ; Muscle, Smooth ; Paralysis ; Phrenic Nerve ; Pneumonia ; Prognosis ; Radiotherapy ; Vimentin