Currently transcatheter arterial embolization(TAE) is widely used in Korea as a palliative treatment inpatients with inoperable heptocellular carcinoma. Embolization of cystic artery is frequently unavoidable in TAE but the effect on gallbladder, its significance and sonographic findings have not yet been fully as certained. We analyzed 29 cases of gallbladder in post TAE state by means of sonographic evaluation. The results were as follows. 1. Initial change was observed on the 1st day of TAE. 2. Maximum enlargement of the gallbladder occurred within 3 days. 3. Relief of pain was mostly noted in one week. 4. Ultrasonographic findings are: a) Enlargement ofthe gallbladder: 27 cases b) Sonolucent layer within the wall: 5 cases c) Thickening of the wall: 27 cases d)Sludge formation: 6 cases e) Pericholecystic anechoic area: 3 cases 5. No surgical intervention was necessary for complication of gallbladder, if ever: some medical treatment was sufficient. 6. Non-visualization of gallbladder was experienced, possibly due to atrophic changes. 7. Even in the case of cystic artery salvation, mild gallbladder changes were still observed. 8. No significant difference as sonographic findings was descernable inuse of various embolic materials
Arteries ; Gallbladder* ; Humans ; Inpatients ; Korea ; Palliative Care ; Ultrasonography

OBJECTIVE: The object of this study was to assess the accuracy of dipyridamole stress intravenous (IV) myocardial contrast echocardiography (MCE) using pulse inversion harmonic imaging and PESDA in the detection of perfusion defect in the patients with coronary artery disease in comparison with dipyridamole stress Tc-99m sestamibi SPECT. METHODS: Total 46 patients (29 males, mean age 64 years old) were consecutively enrolled. Patients with prior myocardial infarction were excluded. MCE and Tc-99m sestamibi SPECT were performed at the same day during rest and after 0.56 or 0.84mg/Kg dipyridamole infusion. Continuous IV infusion of PESDA (2-5 mL/min) was administered while obtaining triggered (1:1) end-systolic apical 2, 4 chamber and long axis views. Tc-99m sestamibi was injected 3 minutes after dipyridamole. Tc-99m sestamibi SPECT images were obtained one hour later. Coronary angiography was followed within two days in all patients. Tc-99m sestamibi SPECT images were matched to the sixteen segments of left ventricle according to American Society of Echocardiography for segmental comparison. Both images were analyzed visually. Results Using coronary angiography as the standard, MCE showed overall sensitivity of 70.7%, specificity of 95.8%, positive predictive value (PPV) of 87.8% and negative predictive value (NPV) of 88.5% in the detection of coronary atherosclerosis (70% stenosis). Tc-99m sestamibi SPECT showed sensitivity of 75.6%, specificity of 98.9%, PPV of 96.8% and NPV of 90.6%. The overall concordance rate between MCE and Tc-99m sestamibi SPECT for the detection of perfusion defects was 86.9% (Cohen's kappa value 0.63) according to the coronary territory and 86.8% (Cohen's kappa value 0.55) according to segmental analysis. CONCLUSION: Dipyridamole stress IV MCE using pulse inversion harmonic imaging and PESDA is feasible and comparable to Tc-99m sestamibi SPECT in identifying significant coronary stenosis and inducible myocardial perfusion defects in the patients with coronary artery disease. MCE using pulse inversion harmonic imaging seems to be a promising modality for assessing myocardial perfusion in the patients with suspected coronary artery disease.
Axis, Cervical Vertebra ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Dipyridamole ; Echocardiography* ; Heart Ventricles ; Humans* ; Male ; Myocardial Infarction ; Perfusion* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

Since the early discovery of H-reflex by Hoffmann in 1918 there have been a great number of articles in the literature suggesting its clinical used by Magladery in the early 1950. Our experiments about measurement of latent time in H-reflex were performed on 40 normal male adult(composed of medicos and medical officers) and 82 patients(lumbago 40, lumbar disc 42) admitted at CAFGH from January '79. to August '79. The result about normal adult are as follows: 1) The mean value and the standard deviation of the latent time in normal adult(height 171+/-5.14 cm) is 27.74+/-1.86 msec at right leg, 27.77+/-1.64 msec at left one respectively. 2) There may be a linear relationship between latency and the height of normal adult and the difference between right and left is revealed 0.15+/-0.19 msec. We compare the measurementon the 82 patients group with the normal adult experimental groups in addition literatures review.
Adult* ; H-Reflex ; Humans ; Leg ; Male

Growth Patterns of cranium measured directly as head circumference have been well documented. With the recent progress in CT, it is easy to measure the size and cross sectional area of the structure. The author chose themidvnetricular level of brain CT scan and measured the product of maximum anteroposterior and lateral dimension and cross sectional area. The age of infants ans children was 0 to 2 years old. The author obtained the following results through statistical analysis; 1. The maximum anteroposterior dimension and the cross sectional area were obtained through the computerized program of CT scanner. Using these measurements, monthly growth curve was obtained and which shows accelarated growth in the initial 12 months especially during the first four months, and followd by reduced rate of growth in the next 12 months. 2. Comparing the size of the calvarium between sexed,females' were somewhat larger than males', but there was no statistical significance. 3. Comparing the crosssectional area with the head circumference, high correlation was seen(correlation coefficient=0.96). Similarelationship was also seen between the product of cranial linear dimensions and the head circumference(correlationcoefficient=0.93). Also statistically significant relationship was noted between the cross sectional area and theproduct of the cranial linear dimensions(correlation coefficient=0.97). 4. Using the cross sectional area and theproduct of cranial linear dimenstions, monthly average value and the 95% significant range were obtained which canbe used as indices for the growth and development of cranium. Of these, the product of cranial linear dimensionscan eadily be measured by brain CT images, which may be useful on practical basis.
Brain ; Child ; Growth and Development ; Head ; Humans ; Infant ; Skull ; Tomography, X-Ray Computed

OBJECTIVES: The spontaneous spinal epidural hematoma (SSEH) is a rare clinical entity. Patients typically present with sudden onset back pain followed by neurological deficits. METHODS: Diagnosis of SSEH is usually made with MRI and standard treatment is surgical evacuation. In 1996, Groen published the most comprehensive review on the SSEH in which he analyzed 333 cases. We review 104 cases of SSEH presented in the English literature since the last major review and add three of our own cases, for a total of 107 cases. RESULTS: Our patients presented with back pain and neurologic deficits. Two made excellent functional recovery with prompt surgical decompression while one continued to have significant deficits despite evacuation. Better postoperative outcome was associated with less initial neurological dysfunction, shorter time to operation from symptom onset and male patients. CONCLUSION: We discuss the etiology of SSEH and report current trends in diagnosis, treatment, and outcome.
Back Pain ; Decompression, Surgical ; Hematoma, Epidural, Spinal ; Humans ; Male ; Neurologic Manifestations ; Retrospective Studies

The present study was conducted to examine the morphology and antigenicity of Photobacterium damselae subsp. piscicida by culturing the bacterium in vivo in the peritoneal cavity of sea bass (Dicentrarchus labrax) within dialysis bags with either a low molecular weight (LMW) cut-off of 25 kDa or a high molecular weight (HMW) cut-off of 300 kDa. Differences were observed in the growth rate between the bacteria cultured in vivo or in vitro. Bacteria cultured in vivo were smaller and produced a capsular layer, which was more prominent in bacteria cultured in the HMW bag. Antigenicity was examined by Western blot analysis using sera from sea bass injected with live Ph. d. subsp. piscicida. The sera recognised bands at 45 and 20 kDa in bacteria cultured in vivo in the LMW bag. Bacteria cultured in vivo in the HMW bag did not express the 45 kDa band when whole cell extracts were examined, although the antigen was present in their extracellular products. In addition, these bacteria had a band at 18 kDa rather than 20 kDa. Differences in glycoprotein were also evident between bacteria cultured in vitro and in vivo. Bacteria cultured in vitro in LMW and HMW bags displayed a single 26 kDa band. Bacteria cultured in the LMW bag in vivo displayed bands at 26 and 27 kDa, while bacteria cultured in vivo in the HMW bag possessed only the 27 kDa band. These bands may represent sialic acid. The significance of the changes observed in the bacterium's structure and antigenicity when cultured in vivo is discussed.
Animals ; Antigenic Variation/*genetics ; Antigens, Bacterial/genetics/*immunology ; Bass/*immunology/microbiology ; Blotting, Western ; Carbohydrates/analysis ; Electrophoresis, Polyacrylamide Gel ; Membranes, Artificial ; Microscopy, Electron, Transmission ; N-Acetylneuraminic Acid/genetics/*immunology ; Photobacterium/genetics/*immunology/ultrastructure

The antigenicity of Photobacterium damselae (Ph. d.)subsp. piscicida, cultured in four different growth media[tryptone soya broth (TSB), glucose-rich medium (GRM),iron-depleted TSB (TSB+IR-), and iron-depleted GRM(GRM+IR-)] was compared by enzyme-linked immuno-sorbent assay (ELISA) and Western blot analysis usingsera obtained from sea bass (Dicentrarchus labrax) raisedagainst live or heat-killed Ph. d. subsp. piscicida. Theantigenic expression of Ph. d. subsp. piscicida was found todiffer depending on the culture medium used. A significantlyhigher antibody response was obtained with iron-depletedbacteria by ELISA compared with non-iron depletedbacteria obtained from the sera of sea bass raised againstlive Ph. d. subsp. piscicida. The sera from sea bass raisedagainst live bacteria showed a band at 22kDa in bacteriacultured in TSB+IR- or GRM+IR- when bacteria thathad been freshly isolated from fish were used for thescreening, while bands at 24 and 47kDa were observedwith bacteria cultured in TSB or GRM. When bacteriawere passaged several times on tryptic soya agar prior toculturing in the four different media, only bands at 24 and47kDa were recognized, regardless of the medium used toculture the bacteria. It would appear that the molecularweight of Ph. d. subsp. piscicida antigens change in thepresence of iron restriction, and sera from sea bassinfected with live bacteria are able to detect epitopes onthe antigens after this shift in molecular weight.
Animals ; Antibodies, Bacterial/blood ; Antigens, Bacterial/immunology/*metabolism ; Bass/blood/*immunology ; Blotting, Western/veterinary ; Cell Count/methods ; Culture Media ; Enzyme-Linked Immunosorbent Assay/veterinary ; Fish Diseases/immunology/*microbiology ; Molecular Weight ; Pasteurella Infections/immunology/microbiology/*veterinary ; Photobacterium/*immunology

Locally advanced non-small cell lung cancer (NSCLC) is a heterogeneous disease, and we have embarked on an era where patients will benefit from individualized therapeutic strategies based on identifiable molecular characteristics of the tumor. The landmark studies demonstrating the importance of molecular characterization of tumors for NSCLC patients, the promising molecular pathways, and the potential molecular targets/agents for treatment of this disease will be reviewed. Understanding these issues will aid in the development of rationally designed clinical trials, so as to determine best means of appropriately incorporating these molecular strategies, to the current standard of radiation and chemotherapy regimens, for the treatment of locally advanced NSCLC.
Carcinoma, Non-Small-Cell Lung ; Combined Modality Therapy ; Humans ; Precision Medicine ; Lung Neoplasms ; Receptor, Epidermal Growth Factor

OBJECTIVE: This study aimed to describe the occupational hazards perceived by sanitary inspectors (SIs) from the City of Manila (Manila) and Quezon City (QC) as they perform their administrative and technical roles.

METHODS: Hazards and control measures were identified using self-administered questionnaires distributed among Sls of Manila and QC from November to December 2010.

RESULTS: The most frequently perceived hazards are slips, trips and falls, and verbal assault seen consistently present among 8 out of 9 roles. Harsh climatic condition on the other hand is the hazard perceived to be the riskiest as seen consistently in 8 out of 9 roles. Of the respondents, 28% did not receive formal training in the field of sanitary inspection and 64% did not have work shifts as administrative control measures; 90% said that personal protective equipment (PPE) were not made available to them and were not used by them.

CONCLUSION AND RECOMMENDATIONS: The most frequently perceived hazards encountered by SIs are slips, trips and falls, harsh climatic conditions, unwarranted complaints, and verbal assault. On the other hand, harsh climatic conditions, unwarranted complaints, and slips, trips and falls are the occupational hazards which are consistently present and perceived to pose the most risk in more than five roles. Provision of PPE and improvement in the implementation of administrative control measures is recommended. Moreover, further studies involving SIs' actual experiences, SIs from rural areas and control measures present in the workplace are suggested.

Purpose: This study aimed to examine the prevalence of surgery for postprostatectomy incontinence (PI) following minimally invasive surgery compared to conventional open surgery for prostate cancer. Methods: This retrospective cohort study used the Florida State Ambulatory Surgery and State Inpatient Databases, 2008 to 2010, radical prostatectomy (RP) patients were identified using International Classification of Diseases (ICD)-9/10 procedure codes and among this cohort, PI was identified also using ICD-9/10 codes. Surgical approaches included minimally invasive (robotic or laparoscopic) versus open (retropubic or perineal) RP. The primary outcome was the overall prevalence of surgery for PI. The secondary outcome was the association of PI requiring anti-incontinence surgery with the surgical approach for RP. Results: Among the 13,535 patients initially included in the study (mean age, 63.3 years), 6,932 (51.2%) underwent open RP and 6,603 (49.8%) underwent minimally invasive RP. The overall prevalence of surgical procedures for PI during the observation period among the all patients who had received RP was 3.3%. The rate of PI surgery for patients receiving minimally invasive surgery was higher than that for patients receiving open surgery (4.8% vs. 3.0%; risk difference, 1.8%; 95% confidence interval, 0.3%–3.4%). The adjusted prevalence of PI surgery for patients who had undergone laparoscopic RP was higher than that for those with retropubic RP (8.6% vs. 3.7%). Conclusions Among patients undergoing RP for prostate cancer, the prevalence of PI surgery is not negligible. Patients undergoing minimally invasive RP had higher adjusted rates for PI surgery compared to open approaches, which was attributed to high rate of PI surgery following laparoscopic approach and low rate of PI surgery following perineal approach. More studies are needed to establish strategies to reduce the rate of PI surgery after RP.