PURPOSE: This study was designed to determine whether transabdominal ultrasound can detect different hepatic stiffness between patients with cirrhosis and control subjects. MATERIALS AND METHODS: Sevent-three patients (Child-Pugh class A stage) with liver cirrhosis and 57 control subjects were included in this study. All patients were subdivided arbitrarily into two groups: early cirrhosis (n = 53) and overt cirrhosis (n = 20). Two sagittal images of the left lobe of the liver were obtained in the left hepatic vein level during the resting state and at full inspiration while pushing their belly out, by abdominal US (i.e., resting and stress image). The length between the inferior hepatic angle and the midpoint of the liver dome was measured in all images for the evaluation of liver distortion. The elongation was calculated by a formula: (L2-L1/L1) x 100(%); where L1 and L2 are the length of the liver for both the resting and stress image. The calculated elongated length (L2-L1, EL) and elongation rate were compared between cirrhotic patients and control subjects. RESULTS: For the control subjects, early cirrhosis, and overt cirrhosis groups, the mean ELs (elongation rate) were 2.34+/-0.98 cm (30.2+/-13.2%), 1.18+/-0.73 cm (14.9+/-9.5%) and 0.53+/-0.54 cm (6.3+/-6.6%), respectively. This difference among the three groups was statistically significant (p < 0.05). A possible best cut-off value of liver elongation rate is 17% for the prediction of cirrhosis (sensitivity: 90%, specificity: 75.3%). CONCLUSION: The liver of patients with liver cirrhosis is stiffer than that of control subjects. Calculation of the elongation rate in the left lobe of the liver during a respiratory maneuver may be used as an ancillary method of US for the evaluation of liver cirrhosis.
Fibrosis ; Hepatic Veins ; Humans ; Liver ; Liver Cirrhosis ; Respiration

No abstract available.
Pregnancy*

OBJECTIVES: The objective of this study was to investigate the relationship of the Comprehensive Attention (CAT), Stoop Color-Word (STROOP), Children's Color Trails (CCTT), and Wisconsin Card Sorting Tests (WCST) in evaluating the executive function in attention-deficit/hyperactivity disorder (ADHD). METHODS: A total of 197 children and adolescents with ADHD (mean age 10.4+/-3.2 years, 173 boys) and 62 without ADHD (mean age 11.8+/-3.5 years, 48 boys) have completed the Swanson, Nolan, and Pelham-IV questionnaire (SNAP-IV), and also the CAT, STROOP, CCTT and WCST. RESULTS: The selective, sustained, divided attention and Flanker tests of the CAT significantly discriminated between the ADHD and non-ADHD groups. The results of the CCTT were significantly correlated with the results of the CAT only in the ADHD group. The results of the STROOP were associated with selective, sustained, divided attention and Flanker tests. The results of the WCST were significantly correlated with the scores of the Working Memory subtest of the CAT only in the non-ADHD group. CONCLUSION: The results of this study suggest that the CAT has strong discriminant validity and moderate concurrent validity. The CAT could be a tool for the evaluation of the executive function of ADHD.
Adolescent ; Animals ; Cats ; Child ; Executive Function ; Humans ; Memory, Short-Term ; Surveys and Questionnaires ; Stroop Test ; Wisconsin

PURPOSE: To develop optimal microbubble contrast agents (MBCAs) for performing ultrasound microscopy when examining small animals. MATERIALS AND METHODS: We prepared three types of MBCAs. First, a mixture of three parts of 40% dextran and one part of 5% human serum albumin were sonicated with perfluorocarbon (PFC) (MB1-D40A5P). Second, three parts of 40% dextran and one part of 1% human serum albumin were sonicated with PFC (MB2-D40A1P). Third, all parts of 1% bovine serum albumin were sonicated with PFC (MB3-A1P). We measured the microbubbles' sizes and concentrations with using image analysis software. The acoustic properties of the microbubbles were assessed both in vitro and in vivo. RESULTS: The majority of the MB1-D40A5Ps had a diameter of 2-5 um, the mean diameter of the MB2-D40A1Ps was 2.5 um, and the mean diameter of the MB3-A1Ps was less than 2.0 um. Among the microbubbles, the MB1-D40A5Ps and MB2-D40A1Ps showed increased echogenicity in the abdominal vessels, but the duration of their contrast effect was less than 30 sec. On the contrary, the MB3-A1Ps exhibited strong enhancement in the vessels and their duration was greater than 120 sec. CONCLUSION: A microbubble contrast agent consisting of all parts of 1% serum albumin sonicated with PFC is an effective contrast agent for ultrasound microscopy.
Acoustics ; Animals ; Contrast Media* ; Dextrans ; Humans ; Microbubbles* ; Microscopy* ; Microspheres ; Serum Albumin ; Serum Albumin, Bovine ; Ultrasonography*

No abstract available.
Alcoholism* ; Humans

BACKGROUND: We prospectively evaluated the performance of blood culture resin media, FA Plus and FN Plus, of the BacT/Alert 3D System (bioMérieux Inc., USA) in a tertiary university-affiliated hospital. METHODS: We obtained 2,994 blood culture sets. The positivity and time to detection (TTD) were compared between FA Plus and FN Plus for clinically significant microorganisms. We then categorized patients into two groups based on antibiotic treatment before blood culture to observe the difference of positivity between two groups. RESULTS: Among 2,994 sets received, 371 (12.4%) yielded 385 clinically significant pathogens. Comparing FA Plus to FN Plus media, lactose non-fermenters (18 vs. 1; P<0.001) and yeasts (15 vs. 0; P<0.001) were recovered at a significantly higher rate using FA Plus, whereas gram-positive cocci (10 vs. 26; P=0.011) and gram-negative anaerobes (0 vs. 10 P=0.002) were isolated at a higher rate using FN Plus. In terms of detection time in FA Plus compared to that in FN Plus, Staphylococcus aureus (13.8 hr vs. 18.1 hr) and gram-positive cocci (14.1 hr vs. 20.3 hr) were detected significantly earlier in FA Plus (each, P<0.001). There was no statistically significant difference in positivity based on prior antibiotic use (13.1%, 65/498) compared to antibiotic naïve patients (12.3%, 306/2,496) (P>0.05). CONCLUSIONS: Complementary detection of microorganisms was observed between FA Plus and FN Plus. Gram-positive cocci including S. aureus grew faster in FA Plus. In addition, the rate of positivity was not affected by prior antibiotic therapy in BacT/Alert 3D resin media.
Gram-Positive Cocci ; Humans ; Lactose ; Prospective Studies ; Sepsis ; Staphylococcus aureus ; Yeasts

A 73-year-old male presented a six-month history of buttock pain radiating into his thigh. The MRI revealed a large enhancing mass lesion involving the sacrum, with extension into the sacral canal. The tumor markers were measured to distinguish skeletal metastasis of carcinoma from primary bone tumor. The CA 19-9 was elevated. Despite the investigation, the primary site of cancer could not be found. Sacral bone biopsy was done. The pathologic examination revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells, consistent with tuberculosis. Sacral tuberculosis is rare in patients with no history of tuberculosis. Such solitary osteolytic lesions involving the subarticular region of large joints may mimic bone neoplasms and may be called "tuberculous pseudotumors." This case report intends to emphasize that bone tuberculosis should be a differential diagnosis in the presence of atypical clinical and radiological features. As tuberculous lesions may be mistaken for neoplasms, a small amount of fresh tissue should be sent for culture even if clinical diagnosis of a tumor seems likely. Described herein is a case of sacral tuberculosis mimicking metastatic bone tumor with elevated CA 19-9.
Aged ; Biopsy ; Bone Neoplasms ; Buttocks ; Diagnosis, Differential ; Giant Cells ; Humans ; Hydrazines ; Inflammation ; Joints ; Male ; Necrosis ; Neoplasm Metastasis ; Sacrum ; Thigh ; Tuberculosis ; Tuberculosis, Osteoarticular ; Biomarkers, Tumor

PURPOSE: The purpose of this study was to identify the degree of satisfaction of part-time work of the mentally disabled and the factors affecting their job satisfaction. METHODS: The subjects of this study were 106 part-time workers with mental illness in the city of B and Y. The data were collected from February 1, 2012 to May 30, 2012 using self-report questionnaires including the measurement scales of job satisfaction, family support, work volition and the degree of satisfaction with work environment. The data were analyzed using t-test, ANOVA, Pearson correlation coefficients, multiple regression with the SPSS/WIN 18.0 program. RESULTS: The mean of score for job satisfaction was 61.8+/-13.84. Job satisfaction was highly related to family support, work environment and work volition. The associated factor of the subjects job satisfaction were family support, work environment, work volition, and the period of employment. The combination of these four factors showed an explanation for job satisfaction at the rate of 80.2%. CONCLUSION: The results imply that job satisfaction needs to be increased for the job continuity of employees with mental illness. In addition to this, work environment, work volition and family support should first be improved for the increase of job satisfaction.
Employment ; Humans ; Job Satisfaction ; Mentally Disabled Persons ; Surveys and Questionnaires ; Rehabilitation, Vocational ; Volition ; Weights and Measures

OBJECTIVE: To assess the intra-rater and inter-rater reliability for measuring femoral anteversion angle (FAA) by a radiographic method using three-dimensional computed tomography reconstruction (3D-CT). METHODS: The study included 82 children who presented with intoeing gait. 3D-CT data taken between 2006 and 2014 were retrospectively reviewed. FAA was measured by 3D-CT. FAA is defined as the angle between the long axis of the femur neck and condylar axis of the distal femur. FAA measurement was performed twice at both lower extremities by each rater. The intra-rater and inter-rater reliability were calculated by intraclass correlation coefficient (ICC). RESULTS: One hundred and sixty-four lower limbs of 82 children (31 boys and 51 girls, 6.3±3.2 years old) were included. The ICCs of intra-rater measurement for the angle of femoral neck axis (NA) were 0.89 for rater A and 0.96 for rater B, and those of condylar axis (CA) were 0.99 for rater A and 0.99 for rater B, respectively. The ICC of inter-rater measurement for the angle of NA was 0.89 and that of CA was 0.92. By each rater, the ICCs of the intrarater measurement for FAA were 0.97 for rater A and 0.95 for rater B, respectively and the ICC of the inter-rater measurement for FAA was 0.89. CONCLUSION: The 3D-CT measures for FAA are reliable within individual raters and between different raters. The 3D-CT measures of FAA can be a useful method for accurate diagnosis and follow-up of femoral anteversion.
Axis, Cervical Vertebra ; Bone Anteversion ; Child ; Diagnosis ; Female ; Femur ; Femur Neck ; Follow-Up Studies ; Gait ; Humans ; Imaging, Three-Dimensional ; Lower Extremity ; Retrospective Studies

BACKGROUND: Unfractionated heparin (UFH) has unstable pharmacokinetics and requires close monitoring. The activated partial thromboplastin time (aPTT) test has been used to monitor UFH therapy for decades in Korea, but its results can be affected by numerous variables. We established an aPTT heparin therapeutic range (HTR) corresponding to therapeutic anti-Xa levels for continuous intravenous UFH administration, and used appropriate monitoring to determine if an adequate dose of UFH was applied. METHODS: A total of 134 ex vivo samples were obtained from 71 patients with a variety of thromboembolisms. All patients received intravenous UFH therapy and were enrolled from June to September 2015 at Gyeongsang National University Hospital. All laboratory protocols were in accordance with the Clinical and Laboratory Standards Institute guidelines and the College of American Pathologist requirements for aPTT HTR. RESULTS: An aPTT range of 87.1 sec to 128.7 sec corresponded to anti-Xa levels of 0.3 IU/mL to 0.7 IU/mL for HTR under our laboratory conditions. Based on their anti-Xa levels, blood specimen distribution were as follows: less than 0.3 IU/mL, 65.7%; 0.3–0.7 IU/mL (therapeutic range), 33.6%; and more than 0.7 IU/mL, 0.7%. No evidence of recurring thromboembolism was observed. CONCLUSION: Using the conventional aPTT target range may lead to inappropriate dosing of UFH. Transitioning from the aPTT test to the anti-Xa assay is required to avoid the laborious validation of the aPTT HTR test, even though the anti-Xa assay is more expensive.
Heparin* ; Humans ; Korea ; Partial Thromboplastin Time ; Pharmacokinetics ; Thromboembolism