No abstract available.
Gastroenteritis* ; Humans* ; Rotavirus*

No abstract available.
Dwarfism*

PURPOSE: To evaluate CT findings which may help differentiate benign from malignant parotid tumors. MATERIALS AND METHODS: The CT findings of seventy-one cases with surgically-proven parotid tumors were retrospectively analysed for size, location, margin, internal density, adjacent tissue plane and lymphadenopathy. RESULTS: The margin of the mass was smooth and sharp in most benign tumors (89.5%), and irregular or indistinct in twelve which were malignant (75%, p<0.01). With regard to internal density, 70.2% of benign tumors were homogeneous (similar to muscle) and 81.3% of malignant tumors were heterogeneous (p<0.01). When analysing low density patterns within the mass, focal low densities in benign tumors (11/17) and diffuse or scattered multifocal low densities in those which were maligant (8/13) were frequently seen. Three malignant tumors invaded adjacent muscles, the parapharyngeal space, and bones, each in one case, and twelve malignant and one benign tumor infiltrated the adjacent fascia or subcutaneous fat layer. In five patients with a malignant tumor, obliteration by the mass of the fat plane between the mastoid tip and styloid process was noted, suggesting facial nerve invasion, while in three cases of malignancy, lymphadenopathy greater than 1cm was seen. CONCLUSION: In differentiating malignant and benign parotid tumors, the presence of irregular or indistinct margin of the mass, and invasion of adjacent structures, are important. Lymph node enlargement greater than 1cm and diffuse internal low densities, which may suggest necrosis or cystic change were also helpful in differential diagnosis.
Diagnosis, Differential* ; Facial Nerve ; Fascia ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Mastoid ; Muscles ; Necrosis ; Retrospective Studies ; Subcutaneous Fat

GMH/IVH(Germinal martrix-Intraventricular hemorrhage ) is an inportant factor that influences on the mortality rate of low-birth-weight infants. The real-time high resolution sonography with a mechanical sector scanner is a convenient and useful method for the detection and follow-up study of intracranial hemorrhage in low-birth-weight infants. Authors analysed 112 cases of neurosonographic findings in low-birth-weight infants, weighing less than 2,500gm. The incidence of GMH/IVH was 54.5%. The severity of GMH/IVH was classified into 4 grades(I-IV) and their percentages were 41%, 41% 8.1%, and 9.9%, respectively. The onset of GMH/IVH was within the first week after birth in 75.4% of cases. The overall mortality rate of low-birth-weight infants with GMH/IVH was 18% (4% for grade I, 12% for grade II, 40% for grade III and 83% for grade IV). In the follow-up study of 61 cases, complete absorption was seen in 25 cases, rebleeding in 5 cases, cystic change in 24 cases, ventriculomegaly in 9 cases and hydrocephalus in 7 cases. The incidence of GMH/IVH in neonates with pathologic lung conditions was 82.5% and that with normal lung conditions was 39%. In conclusion, sonography is very useful in the diagnosis and follow-up of GMH/IVH in low-birth-weight infants. Our study is the first step in the further study of the relationship between GMH/IVH and neuromotor outcome.
Absorption ; Diagnosis ; Follow-Up Studies* ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Intracranial Hemorrhages ; Lung ; Methods ; Mortality ; Parturition

Background/Aims: Median arcuate ligament syndrome (MALS) is known as chronic recurrent abdominal pain related to compression of the celiac artery by the median arcuate ligament. We aim to seek the specific mechanism of the pain by evaluating symptoms and radiological characteristics on abdominal CT scans. Methods: We analyzed 35 patients who visited the emergency room for recurrent abdominal pain after cholecystectomy. We classified the characteristics of patients as 4 clinical components and 2 radiological components. We defined the sum of weighted clinical scores and weighted radiological scores as nutcracker ganglion abdominal pain syndrome (NCGAPS) scores. We categorized the patients into 3 groups classified by the degree of NCGAPS scores. The 3 patients with top-3 NCGAPS scores were recommended for CT angiography. Results: When the suspicion was graded by NCGAPS scores, post stenotic dilatation was significantly different among all groups (P < 0.001).The clinical components of pain varied positional or respirational change and continuous pain were significantly different among all the groups (P < 0.01). NCGAPS scores can remarkably differentiate highly suspicious patients in comparison to simply combined scores. Only 1 patient in the highly suspicious group by NCGAPS scores took the CT angiography and was confirmed with NCGAPS. Conclusions We suggest renaming MALS as NCGAPS, nutcracker celiac ganglion abdominal pain syndrome, to better explain the mechanism of the recurrent abdominal pain. Further studies on the diagnostic cutoff of clinical and radiological scores of NCGAPS are needed not to miss the diagnosis of NCGAPS.

BACKGROUND: This study was conducted to investigate the optimal angle of needle insertion during caudal epidural injection in chronic low back pain patients using ultrasound imaging. METHODS: One hundred eight patients (40 male and 68 female patients) with low back pain and sciatica were studied.Soft tissue ultrasonography was performed to identify the sacral hiatus. The optimal angle of the needle to the skin was measured with an imaginary line drawn parallel to the sacral base using a protractor on a longitudinal plane. A 22-gauge caudal epidural needle was inserted and was guided by ultrasound to the sacral hiatus and into the caudal epidural space. RESULTS: The mean +/- SD for the intercornual distance, depth of the caudal space and the thickness of the sacrococcygeal membrane were 19.0 +/- 3.2 mm, 3.6 +/- 0.9 mm and 1.8 +/- 0.8 mm, respectively. The optimal angle showed a significant correlation with the depth of the caudal space and the thickness of the sacrococcygeal membrane. The mean +/- SD for the optimal angle of the needle insertion was 23.5 +/- 6.9 degrees. CONCLUSIONS: We conclude that the needle should be inserted at an angle of approximately 23.5 degrees to the skin in order to avoid injury to the periosteum and an inadvertent intra-osseous injection.
Adult ; Female ; Humans ; Injections, Epidural ; Low Back Pain ; Male ; Membranes ; Needles ; Periosteum ; Sciatica ; Skin

Hajdu-Cheney syndrome is a rare, autosomal dominant skeletal dysplasia marked by acro-osteolysis of the distal phalanges and severe osteoporosis. Although there are more than 60 reports published to date, proper treatment and subsequent outcome have been scarce. Herein, we report a progress of anti-resorptive therapy with zoledronic acid, in a woman with Hajdu-Cheney syndrome. Results suggest that anti-resorptive therapy may be important in delaying the progress of osteoporosis and preventing fractures, but not necessarily acro-osteolysis itself.
Acro-Osteolysis/complications/*drug therapy ; Adult ; Bone Density Conservation Agents/*therapeutic use ; Diphosphonates/*therapeutic use ; Female ; Hajdu-Cheney Syndrome/complications/*drug therapy ; Humans ; Imidazoles/*therapeutic use ; Osteoporosis/complications/*drug therapy

BACKGROUND/AIMS: The rate of internet utilization has been gradually increased especially due to recent introduction of mobile devices. In 2005, we evaluated the quality of medical information on the internet about endoscopy under conscious sedation. In the present study, we tried to find out whether there was a significant change in the quality of medical information between 2005 and 2012. MATERIALS AND METHODS: Using the five most frequently used internet search engines, we found top 20 internet sites with the key word 'sleeping endoscopy' and 'endoscopy under conscious sedation'. The quality of information was evaluated by the same checklist used in the previous study. RESULTS: With the key word 'sleeping endoscopy', 69 sites were found. Among them, 58 sites (84.1%) were made by general hospitals or private clinics. The definition of sleeping endoscopy was accurately mentioned in 50.7% (n=35) of the sites, whereas the rate was 57.1% in 2005. In 2012, information on sedative agents were mentioned in only 16 sites (23.2%) which was lower than 42.9% in 2005 (P<0.05). There were more information on complications of endoscopy in 2012. Using the key word 'endoscopy under conscious sedation', only 13 sites were found, and the quality of information in these sites was generally better than sites found with 'sleeping endoscopy'. CONCLUSIONS: Between 2005 and 2012, the quantity of information on endoscopy under sedation has increased. However, there were no definite improvement in the quality of information.
Checklist ; Conscious Sedation ; Endoscopy ; Hospitals, General ; Internet ; Quality Improvement ; Search Engine

BACKGROUND/AIMS: The rate of internet utilization has been gradually increased especially due to recent introduction of mobile devices. In 2005, we evaluated the quality of medical information on the internet about endoscopy under conscious sedation. In the present study, we tried to find out whether there was a significant change in the quality of medical information between 2005 and 2012. MATERIALS AND METHODS: Using the five most frequently used internet search engines, we found top 20 internet sites with the key word 'sleeping endoscopy' and 'endoscopy under conscious sedation'. The quality of information was evaluated by the same checklist used in the previous study. RESULTS: With the key word 'sleeping endoscopy', 69 sites were found. Among them, 58 sites (84.1%) were made by general hospitals or private clinics. The definition of sleeping endoscopy was accurately mentioned in 50.7% (n=35) of the sites, whereas the rate was 57.1% in 2005. In 2012, information on sedative agents were mentioned in only 16 sites (23.2%) which was lower than 42.9% in 2005 (P<0.05). There were more information on complications of endoscopy in 2012. Using the key word 'endoscopy under conscious sedation', only 13 sites were found, and the quality of information in these sites was generally better than sites found with 'sleeping endoscopy'. CONCLUSIONS: Between 2005 and 2012, the quantity of information on endoscopy under sedation has increased. However, there were no definite improvement in the quality of information.
Checklist ; Conscious Sedation ; Endoscopy ; Hospitals, General ; Internet ; Quality Improvement ; Search Engine

V. vulnificus is an estuarine bacterium which causes septicemia and shock in susceptible patients. The organism produces a hemolytic cytolysin (VvH), which has a membrane damaging effect on erythrocytes. To clarify the mechanisms by which VvH might contribute to virulence, we examined its effect on macrophages. When mouse peritoneal macrophages were harvested and co-cultured with hemolysin-positive V. vulnificus strains (100 bacteria/ cell), about 60% of the macrophages were killed; macrophages were not killed when co-cultured V. vulnificus strain CVD 707, a VvH-negative deletion mutant. Exposure of macrophages to filtered culture supernatants (2.5 HU/ml) and purified VvH (3 HU/ml) resulted in an increase in dead cells (80 and 90%, respectively), as determined by the trypan blue dye exclusion method and LDH release from macrophages was also increased (70 and 65.5%, respectively). The cytotoxic effect of VvH on macrophages was both the dose- and time-dependent. The VvH caused damage to the macrophage membrane and was blocked significantly by preincubation with cholesterol (p<0.01). Fetal bovine serum showed remarkable inhibition of VvH synthesis by V. vulnificus and inhibited VvH activity in culture supernatant. Cell viability was increased by 35% (p<0.01) and LDH release decreased by 28% (P<0.01) when macrophages were incubated with V. vulnificus (100 bacteria/ cell) in DMEM-10% FBS for 2 hr. Bacterial clearance activity of mice against V. vulnificus CVD 707 was decreased by pretreatment with 10 HU of VvH. This result suggests that the VvH can impair the membrane of macrophages and may play a role in the pathogenesis of V. vulnificus septicemia.
Animals ; Cell Survival ; Cholesterol ; Erythrocytes ; Humans ; Macrophages ; Macrophages, Peritoneal* ; Membranes ; Mice* ; Perforin ; Sepsis ; Shock ; Trypan Blue ; Vibrio vulnificus* ; Vibrio* ; Virulence