The clinical features and lung CT findings of 174 heart failure patients,including 85 cases with normal left ventricular ejection fraction (LVEF) and 89 cases with reduced LVEF were reviewed.Patients with normal LVEF had a higher proportion of hypertension,diabetes and obesity than patients with normal LVEF; and cough and dyspnea were more common.The lung CT findings in patients with normal LVEF were frequently presented as interstitial lung edema,increased pulmonary texture,subpleural line,Kerley lines and diffuse ground-glass opacity.Patients with reduced LVEF had a higher proportion of coronary heart disease and clinical manifestations of acute left heart failure,and central alveolar edema presented in lung CT images.Results suggest that heart failure patients with normal LVEF usually have longer clinical history and occult symptoms,and have a different lung CT imaging features from those in heart failure patients with reduced LVEF.

In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.
Anal Canal ; Counseling ; Depression* ; Foreign Bodies ; Genitalia, Male ; Humans ; Korea ; Laparotomy ; Male ; Peritonitis ; Rectum ; Schizophrenia ; Sepsis

BACKGROUND: Traumatic brain injury (TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, pre-hospital service can significantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China. DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure (CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identified articles. RESULTS: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions. CONCLUSION: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.

No abstract available.
Colon, Ascending* ; Neurilemmoma*

The infection of Metagonimus yokogawai has been known to be present nationwidely and endemic in some parts in Korea. In order to select a highly effective compound against Metagonimus infections, the therapeutic effects were observed in 156 cases who were treated with several anthelmintic i.e. bithionol, niclosamide, niclofolan and praziquantel. All of the above drugs showed highly effective to the treatment of metagonimiasis by a single or two medication days. The egg reduction rates were in the range of 80.2 to 100 per cent. However, relatively low cure rates(8.3 to 37.5 percent) were observed in the groups treated by two doses of 30 mg/kg of bithionol, a single day treatment with 100 mg/kg of niclosamide and two doses of 1.0 mg/kg of niclofolan. On the other hand, the high cure rates were observed at the following dose rates of each drugs, i.e. the cure rate of 66.7 percent was obtained at two doses of 100 mg/kg of niclosamide, 88.9 percent of cure rate was observed at two doses of 2.0 mg/kg of niclofolan and a single dose of 10 and 20 mg/kg of praziquantel were shown as 85.0 percent and 88.0 percent of cure rates respectively. But the complete radical cure was obtained in the group treated by two doses of 20 mg/kg of praziquantel in 10 metagonimiasis cases. From the above results praziquantel was shown as the most highly effective against metagonimiasis and it was well tolerated without any side effect. Therefore, praziquantel is a very promising drug for mass treatment against metagonimiasis.
parasitology-helminth-trematoda ; Metagonimus yokogawai-metagonimiasis ; bithionol ; niclosamide ; niclofolan ; praziquantel ; chemotherapy

OBJECTIVE: Neuroleptic Induced Akathisia(NIA) often occurs in neuroleptic treated patients. Cyproheptadine, an antiserotonergic agent, was used to treat neuroleptic induced akathisia. METHOD: In an open trial 21 neuroleptic-treated patients with akathisia were administrated Cyproheptadine(16mg/day) over 4 days. Assessment of akathisia was evaluated using Barnes' rating scale(BAS) for neuroleptic induced akathisia. The degree of depression and psychosis were assessed by brief psychiatric rating scale(BFRS) and Hamilton rating scale for depression(HAM-D). RESULT: Most patients(20 of 21) with neuroleptic induced akathisia(NIA) showed improvement under the treatment of cyproheptadine. There was no aggravation of psychosis or depression during the treatment. Symptoms of akathisia aggravated when cyproheptadine was discontinued. CONCLUSION: Cyproheptadine may be useful in the treatment of neuroleptic induced akathisia(NIA).
Cyproheptadine* ; Depression ; Humans ; Psychomotor Agitation* ; Psychotic Disorders

OBJECTIVETo examine the activation and cytotoxicity of human peripheral blood T lymphocyte induced in vitro by human 4-1-BB ligand (4-1-BBL) gene transfected into tumor Tca8113 cells.

METHODSThe eukaryotic expression vector pEGFP-h4-1-BBL was transfected into human oral carcinoma cell line Tca8113 by Lipofectamine 2000. The transfected cells were then selected in medium containing G-418, cloned by limited dilution and named as Tca8113-4-1-BBL. Human 4-1-BBL mRNA and protein expression of transfected cells was detected by reverse transcriptase-polymerase chain reaction (RT-PCR) and western blotting respectively. The tumor cell vaccines (TCV) were obtained by treatment with mitomycin (MMC). Human peripheral blood mononuclear cells (PBMC) were prepared from lymphoprep, and then stimulated with anti-CD-3 mAb and incubated with non-transfected or transfected TCV-Tca8113 cells, respectively. The proliferation of T cells was evaluated by trypan blue exclusion; the CCK-8 was used to detect the cytotoxic effect of T lymphocytes. Meanwhile, the secretion of interferon-gamma (IFN-gamma) and interleukin (IL)-2 in culture supernatant was detected by enzyme-linked immunosorbent assay (ELISA).

RESULTSThe Tca8113 cells transfected by pEGFP-h4-1-BBL could express human 4-1-BBL efficiently. As compared with wild type Tca8113 cells, the transfected Tca8113 cells could markedly promote proliferation, IL-2 and IFN-gamma production and cytotoxic activity of lymphocytes.

CONCLUSIONSThe transfection of human 4-1-BBL gene in Tca8113 cells is effective in enhancing its immunogenicity and inducing antitumor immune response in vitro.

4-1BB Ligand ; genetics ; Carcinoma, Squamous Cell ; genetics ; immunology ; Cell Line, Tumor ; Cell Proliferation ; Genetic Vectors ; Humans ; Interferon-gamma ; immunology ; Interleukin-2 ; immunology ; Lymphocyte Activation ; Mouth Neoplasms ; genetics ; immunology ; T-Lymphocytes, Cytotoxic ; immunology ; Transfection

AIMTo isolate and identify a glucuronide metabolite of SFZ-47 [3H-1,2-dihydro-2-(4-methyl-phenylamino)methyl-1-pyrrolizinone], which is difficult to synthesize because it undergoes hydrolysis and intramolecular acyl migration at physiological pH, in rabbit urine.

METHODSTwo rabbits were ig 200 mg doses of SFZ-47. Urine was collected for 24 h, adjusted to pH 4.0 with acetic acid and lyophilized. The residues were reconstituted in 25 mL methanol and centrifuged at 5,000 r.min-1 for 10 min. The supernatant was filtered (0.45 micron) and then isolated with semi-preparative reversed phase HPLC. The eluent collected from individual peaks was evaporated by rotary evaporation and freeze-drying. Compounds were then identified with electrospray ion trap mass spectrometry and 1HNMR spectroscopy.

RESULTSThe 1HNMR and ESI-MSn results indicate that the metabolite is the 1-O-acyl beta-D-glucuronide conjugate of 4-(3H-1,2-dihydro-1-pyrrolizinone-2-methylamino) benzoic acid.

CONCLUSIONThis method was shown to be rapid and simple and gave excellent resolution from endogenous constituents in urine, and it is suitable for preparation of the glucuronide metabolites of SFZ-47 and its analogues.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; metabolism ; urine ; Chromatography, High Pressure Liquid ; Male ; Molecular Structure ; Pyrroles ; chemistry ; metabolism ; urine ; Rabbits ; Spectrometry, Mass, Electrospray Ionization

Pneumoparotitis is a rare cause of enlargement of the parotid gland. Hence, it is often misdiagnosed and therefore incorrectly treated. We report, with the clinical presentation and radiographic findings, a case of pneumoparotitis due to trumpet playing. Swelling of the parotid gland was initiated by air being forced through the Stensen`s duct, resulting in the insufflation of air into the acini of the parotid gland. Recurrent parotid insufflation is not entirely benign and may predispose the parotid gland to sialectasia, recurrent parotitis, subcutaneous emphysema, and even mediastinal emphysema.
Insufflation ; Mediastinal Emphysema ; Parotid Gland ; Parotitis ; Subcutaneous Emphysema ; Wind*

OBJECTIVETo understand the demography changes and behaviors in drug users.

METHODSelf-reported questionnaires was used and longitudinal investigation was conducted in one of the detoxication centers in Beijing in 1998 and 2000. Drug users were randomly chosen.

RESULTSResults showed that age of drug users tend to become younger with the numbers of drug users aged below 25, increased from 18.7% in 1998 to 28.2% in 2000. Majority of drug users remained males, but the proportion of females seemed to increase. Distribution of occupation showed that the largest increase fell among individual enterprisers, from 15.2% in 1998 to 25.9% in 2000. With educational back-ground, the proportion of lower than elementary education level, including illiterate, increased. Fifty percent of drug users were unmarried which increased from 40.8% in 1998 to 53.2% in 2000. Needle sharing was quite common, 16.5% in 1998 and 11.9% in 2000, but the decrease was not statistically significant (P > 0.05). Fifty-seven point three percent of the injecting drug users did not have constant partners to share equipments. Proportion of extra-marriage sexual practice increased from 12.5% in 1998 to 27.5% in 2000, and significant difference (Chi-square = 12.50, P < 0.001). Multiple partners in extra-married drug users was also found (mean = 2). Compared to 1998, condom use during every sexual practice increased in 2000, but 47.7% drug users still never used condom.

CONCLUSIONIn summary, as the quick increase of drug users, sharing of injecting equipment and high-risk sexual behavior, including multiple partners and unprotected sex, were quite common, with the possibility of HIV epidemic in drug users.

Adult ; China ; epidemiology ; Demography ; Female ; HIV Infections ; epidemiology ; Humans ; Longitudinal Studies ; Male ; Needle Sharing ; adverse effects ; Prevalence ; Risk Factors ; Safe Sex ; statistics & numerical data ; Substance Abuse, Intravenous ; epidemiology ; Surveys and Questionnaires