No abstract available.
Fingers*

Colorectal cancer is second only to lung cancer as a cause of cancer death in the United States. Studies have shown that fecal occult blood (FOB) tests are effective in detecting colorectal cancer in its early stages. To increase the participation in the FOB test among the working population, a randomized controlled trial was conducted. A total 278 federal employees 40 years or older in Washington State were randomly divided into a intervention group which received a Colorectal Cancer Risk Appraisal and a control group which received a simple information letter. After three months a follow-up questionnaire was sent to all participants to measure the effectiveness of the intervention. As a result of the study, the intervention group had a 4.3% higher compliance rate with the FOB test during the three month follow-up period (p = .10). The largest effect of the intervention was on the employees' intention to get a FOB test within the next year (62.6% in the intervention group vs. 36.2% in the control group, OR = 3.18, p less than .001).
Adult ; Colorectal Neoplasms/*diagnosis/etiology ; Female ; Follow-Up Studies ; Human ; Male ; Middle Aged ; *Occult Blood ; Occupational Health ; Patient Compliance ; Risk Factors ; Support, U.S. Gov't, P.H.S. ; United States ; Washington

Pseudo-Bartter syndrome is a rare medical disease of the kidney characterized by normal blood pressure, hypokalemic metabolic alkalosis, hyperreninemia and hyperaldosteronism with drug history of diuretics. We report US, CT and MRI findings of a patient with clinically proved pseudo-Bartter syndrome. The patient was a 37-year-old woman with a history of long term ingestion of the diuretics(furosemide) for 20 years. Renal US revealed hyperechoic renal medulla at both kidneys. The resistive index(RI), calculated from the duplex doppler waveform is 0.61. Unenhanced CT revealed faint high attenuation along the medulla. Tl-weighted MRI revealed indistinct corticomedullary differentiation.
Adult ; Alkalosis ; Blood Pressure ; Diuretics ; Eating ; Female ; Humans ; Hyperaldosteronism ; Kidney ; Magnetic Resonance Imaging

Thirty-six patients (24 with oral cavity or oropharynx cancers and 12 larynx cancers) were prospectively examined with computed tomography (CT) to determine its value in staging the primary tumor and to compare with the clinical staging. The CT staging agreed with the clinical staging in 50% (12/24) of the oral cavity or oropharynx cancers and in 67% (8/12) of the larynx cancers. The CT upgraded the clinical staging in 29% (7/24) of the oral cavity or oropharynx tumors and in 33% (4/12) of the larynx cancers, whereas the CT downgraded the clinical staging in 21 % (5/24) of the oral cavity or oropharynx cancers. There is no downgrade on CT in larynx cancer. The post-surgical confirmation was not made in most of the cases. The possible causes of disagreement between the CT and the clinical staging, and the diagnostic value of the CT in evaluation of the primary tumor in oral cavity, oropharynx and larynx were discussed.
Head and Neck Neoplasms ; Head ; Humans ; Laryngeal Neoplasms ; Larynx ; Mouth ; Oropharyngeal Neoplasms ; Oropharynx ; Prospective Studies

Hepatoid adenocarcinoma of the stomach is a gastric carcinoma with both adenocarcinomatous and hepatocellular carcinomatous differentiation. It usually produces large amount of serum alpha-fetoprotein. It often occurs in aged person, commonly located in the gastric antrum. Because of early lymph node and liver metastasis, prognosis is poor. A case of hepatoid adenocarcinoma of the stomach in a 49-year-old man is reported. The patient's serum alpha-fetoprotein level was high(3380ng/ml). Liver function test was normal, otherwise. A mass was observed in right lobe of the liver on US and CT. It was hypervascular with increased uptake of lipiodol on hepatic arteriography. A large ulcerative tumor involving the gastric antrum and body was also found at barium study of the stomach. Subtotal gastrectomy and right Iobectomy of the liver resulted in rapid decrease in serum alpha-fetoprotein. Histopathologically the diagnosis was hepatoid adenocarcinoma of the stomach with liver metastasis.
Adenocarcinoma* ; alpha-Fetoproteins ; Angiography ; Barium ; Diagnosis ; Ethiodized Oil ; Gastrectomy ; Humans ; Liver ; Liver Function Tests ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Pyloric Antrum ; Stomach* ; Ulcer

Hepatoid adenocarcinoma of the stomach is a gastric carcinoma with both adenocarcinomatous and hepatocellular carcinomatous differentiation. It usually produces large amount of serum alpha-fetoprotein. It often occurs in aged person, commonly located in the gastric antrum. Because of early lymph node and liver metastasis, prognosis is poor. A case of hepatoid adenocarcinoma of the stomach in a 49-year-old man is reported. The patient's serum alpha-fetoprotein level was high(3380ng/ml). Liver function test was normal, otherwise. A mass was observed in right lobe of the liver on US and CT. It was hypervascular with increased uptake of lipiodol on hepatic arteriography. A large ulcerative tumor involving the gastric antrum and body was also found at barium study of the stomach. Subtotal gastrectomy and right Iobectomy of the liver resulted in rapid decrease in serum alpha-fetoprotein. Histopathologically the diagnosis was hepatoid adenocarcinoma of the stomach with liver metastasis.
Adenocarcinoma* ; alpha-Fetoproteins ; Angiography ; Barium ; Diagnosis ; Ethiodized Oil ; Gastrectomy ; Humans ; Liver ; Liver Function Tests ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Pyloric Antrum ; Stomach* ; Ulcer

PURPOSE: The purpose of this study was to examine the social determinants of health (SDH) associated with health-related quality of life (HQOL) among the community-dwelling elderly, based on the conceptual framework of the Commission on Social Determinants of Health (CSDH). METHODS: A survey was conducted with 199 elders aged 65 years or older sampled through convenient sampling. Data were collected through face to face interviews by trained interviewers using a structured questionnaire, which included scales of the residential area, social support, sense of community, social network, health behaviors, and HQOL. Data were analyzed by ANOVA and stepwise multivariate regression. RESULTS: Major SDH affecting HQOL included the participants' residential area, sense of community, and health behavior. The HQOL of the elderly residing in the B area with a low rate of basic livelihood security recipients was higher than that of those residing in other areas. CONCLUSION: CSDH framework was useful to determine the factors associated with HQOL among the community-dwelling elderly. In addition to their health behavior, their sense of community was found to be a SDH of HQOL, indicating the need of health promotion programs tailored to the characteristics of residential areas and strategies to enhance involvement in community activities.
Aged* ; Health Behavior ; Health Promotion ; Humans ; Quality of Life* ; Social Determinants of Health* ; Weights and Measures ; Surveys and Questionnaires

Opacification of the gallbladder after parenteral administration of contrast material usually indicates diminished renal function but can occur with normal renal function. The authors recently experienced 13 cases of such vicarious excretion of contrast media. Among 13 patients. 9 patients had renal disease unilateral ureteral stone(n=3), staghorn calculi(n=2), acute renal failure from sepsis(n=1), renal contusion(n=2) and unilateral renal artery involvement by dissecting aortic aneurysm(n=1). Of these 9 patients, 3 patients showed abnormal serum creatinine levels at the time of presentation or shortly thereafter. In 6 patients, injection of a large amount of contrast media was possibly the additional cause of vicarius excretion. There was no detectable cause in the remaining 4 patients. Heterotopic excretion of contrast media is clearly a complex phenomenon, the reason for which it is difficult to establish with certainty in each individual case. Anyhow, vicarius excretion of contrast media occurs more frequently than previously thought, and it can occur not only with abnormal renal function but with normal function also.
Acute Kidney Injury ; Contrast Media ; Creatinine ; Gallbladder* ; Humans ; Renal Artery ; Ureter

PURPOSE: Classically air in the portal vein has been detected on plain radiography, but computed tomography and ultrasonography have been shown to be more sensitive. We report a case of air in the PV in a 10-day-old infant with pneumatosis intestinalis with its ultrasonographic and Doppler findings. MATERIAL AND METHODS: The patient was a 10-day-old infant born by cesarean section at 41 weeks. Simple abdomen film revealed branching pattern of radiolucent air shadows within the contour of liver, gas distention of bowel loops and thickenod bowel walls with lincar intraluminal air shadows in abdomcn, suggesting neerotizing enterocolitis. So we performed Doppler ultrasonography. RESULTS: Ultrasonography showed branching pattern of hyperechogenic dots along the lumen of left portal vein. The color Doppler study revcaled an aliasing duo to increased velocity and whirling pattern of blood flow, and the Duplex Doppler spectral display showed sharp, vertical bidirectional spikes by air in portal vein. CONCLUSION: Air in the portal voin can be easily diagnosed by the followign signs:hyperechogenic dots in the portal vein on ultrasonography and vertical, sharp bidirectional spikes superimposod on the usual Doppler tracing of the portal vein on Duplex ultrasonography.
Abdomen ; Cesarean Section ; Enterocolitis ; Female ; Humans ; Infant ; Liver ; Portal Vein* ; Pregnancy ; Radiography ; Ultrasonography ; Ultrasonography, Doppler

PURPOSE: To evaluate the radiologic characteristics of axillary lymph nodes which are found on mediolateral oblique(MLO) view of mammography and to assess their clinical significance. MATERIALS AND METHODS: We retrospectively evaluated 119 cases axillary lymph nodes on MLO view of 410 cases of mammography in 205 patients regarding the size, bilaterality, number, grade of density, presence of central lucency, calcification of lymph nodes and presence of associated parenchymal pathologic lesions in breast. RESULTS: Axillary lymph nodes on MLO view were demonstrated in 119 (29%) among 410 cases. Axillary lymph nodes(112 cases) in cases without breast parenchymal lesions or with benign breast lesions showed; unilaterality in 68 cases(61%), smaller than 1.5cm in 100 cases(89%), lower density than breast parenchyma in 99 cases(88%), presence of central lucency in 99 cases(88%) and calcification in 3 cases(2.7%). Axillary lymph nodes(7 cases)in cases with breast cancer showed small size of less than 1.5cm in 4 cases(57%), absence of central lucency in 7 cases(100%) and iso-to higher density than breast parenchyma in 7 c&ses(100%). CONCLUSION: Axillary lymph nodes noted on MLO view of mammography, more than 1.5cm in diameter, absence of central lucency and iso to higher density than breast parenchyma could be suggested as clinically significant.
Breast ; Breast Neoplasms ; Humans ; Lymph Nodes* ; Mammography ; Retrospective Studies