For the purpose to define the clinical usefulness of fasting serum total bile acid, the authors carried out to measure the serum total bile acid in 18 cases of acute hepatitis, 10 cases of chronic active hepatitis, 21 cases of liver cirrhosis, 7 cases of hepatocellular carcinoma and 35 cases of adult healthy control. Diagnosis were confirmed histopathologically in all the patients. Blood samples were obtained usually in the morning before meals from th anterior cubital vein of all the patients and adult healthy control in Pusan National University Hospital during the periods from January to August, 1984. Total bile acid was measured fluorome cally by means of an enzymatic technique. The results obtained were as follows: 1) The mean value of serum total bile acid in adult healthy subject in fasting was 2.6+/-2.3 umol/L. 2) The mean values of serum total bile acid were significantly higher in the patients with various liver diseases, as compared with those in adult healthy subjects. 3) In acute hepatitis and chronic active hepatitis, the percentages of abnormal values were significantly higher or tended to be higher in total bile acid, as compared with those in total bilirubin, ALP, LDH and GGT activity and tended to be lower in total bile acid, as compared with those in AST and ALT activity. 4) In liver cirrhosis and hepatocellular carcinoma, the percentages of abnormal values of total bile acid were significantly higher in the patients with above 100IU/L of AST activity, compared with those in the patients with 50~100IU/L of AST activity. 5) Total bile acid showed a significant correlation with total bilirubin and ALP in acute hepatitis, with total bilirubin in chronic active hepatitis and hepatocellular carcinoma, and with ALP in liver cirrhosis. On the basis of the results obtained, it was suggested the measurement of serum total bile acid is clinically a highly sensitive, useful test in diagnosis of various liver diseases.
Adult ; Male ; Female ; Humans ; Carcinoma, Hepatocellular

Objective: This study aimed at providing a critical review of the overall benefits of the chin-tuck maneuver through a systematic review of its effects when used in the treatment of dysphagia, as well as to provide basic data for a comparative analysis in future studies. Methods: To identify academic papers on the chin-tuck maneuver published from January 2000 to January 2021, a literature search on three databases was performed using keywords, including chin-tuck, dysphagia, and head flexion. Out of the 712 related papers identified, the methodological characteristics and results of 12 selected studies were reviewed. Results: Nine of the 12 studies found that the chin-tuck position not only helped in the opening of the upper esophageal sphincter (UES) but also reduced pharyngeal residues and prevented aspiration and penetration. In addition, three studies analyzed the position of the neck flexion angle and the changing angle when performing the chin-tuck maneuver. Conclusion This shows that the chin-tuck maneuver is an effective strategy in the treatment of dysphagia. In future studies, further investigation of the posture, angles, and effects of the chin-tuck maneuver, could help identify additional benefits of this treatment.

BACKGROUND: Aging can serve as an underlying mechanism of chronic obstructive pulmonary disease (COPD). Also, smoking, which is the most common cause of COPD, is responsible for the systemic manifestations of the disease, independently from the lung function alterations. The purpose of this study was to analyze the effect of aging on the occurrence of cigarette smoking induced COPD. METHODS: For this analysis, we evaluated smoking status by a lifestyle intervention program and measured the occurrence of COPD by the Korea National Health and Nutrition Examination Survey (KNHANES) from 2005 to 2015. RESULTS: Aging and smoking were significantly effected on the lung function of COPD patients. Especially, the smoking duration is exaggerated in the presence of old age for older COPD patients. CONCLUSION The result showed that COPD patients exhibit aging and smoking duration related severity. The prevalence of COPD kept increasing internationally. Knowing the risk factor of COPD quantitatively and finding out the interaction among risk factors could be valuable predictors for preventing COPD.

Incisional metastases following surgery for cervical cancer are extremely rare. We report a case of a recurrence which occurred at a incisional site following radical hysterectomy and pelvic lymphadenectomy for squamous cell carcinoma of the cervix. The recurrence was found at the incisional site just below umbilicus that was not included for post-operative adjuvant radiotherapy. We performed wide local excision and postoperative adjuvant radiotherapy for 5 weeks. She has been under follow up until now, and there is no evidence of recurrence.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Follow-Up Studies ; Hysterectomy ; Lymph Node Excision ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence* ; Umbilicus ; Uterine Cervical Neoplasms

Cri-du-chat syndrome is a rare genetic disorder in which the patient presents with a characteristic high-pitched monotonous cry and recurrent aspiration pneumonia, attributed to abnormalities in the larynx, epiglottis, and nervous system. The most prominent brain MRI findings are the presence of pontine and cerebellar hypoplasia, which primarily involve posterior cranial fossa structures. Although atrophy of supratentorial structures were also a common radiological finding, it was considered to be a secondary change due to pontine hypoplasia. Here, we present the case of a three-month-old patient presenting with cri-du-chat at our institution. The patient also showed the presence of prominent pontine hypoplasia similar to previously reported cases; however, contrary to other cases, there was a general delayed myelination of brain instead of decreased myelination of anterior limb of internal capsule. Since the larynx, pons, and cerebellum all originated from similar notochord level, which suggests anomaly in early stage of development, laryngeal, and brain anomaly characteristically observed in the cridu- chat syndrome.

Fentanyl intoxication has occasionally been reported since fentanyl patches became available for medical use. Delayed post-hypoxic leukoencephalopathy is a complication of hypoxia. However, its neuropsychiatric symptoms can be delayed, and it can progress to leukoencephalopathy even after full recovery from coma due to acute intoxication. Herein, we report a case of fentanyl intoxication in a 65-year-old man who was presented to the hospital because of unconsciousness for 13 hours after using ten fentanyl patches simultaneously. Initial brain CT findings were non-specific. Twenty days later, delayed neuropathologic symptoms manifested, and MRI showed bilaterally symmetrical, heterogeneous, confluent high signal intensities on T2-weighted/fluid attenuated inversion recovery MRI in the cerebral white matter with diffusion restriction. This was followed by rapid exacerbation of neuropathological symptoms with diffuse severe cerebral atrophy over 1 year.

Tearing of the acetabular labrum is a common cause of chronic hip pain. MR arthrography (MRA) of the hip is the imaging procedure of choice for the evaluation of acetabular labrum. Familiarity with the various imaging findings of MRA of the hip allows recognition of normal variants and differentiation from true pathologic conditions. This article comprehensively reviews the technical aspects and interpretation of MRA of the hip. The appearances of normal and abnormal labra in MRA are discussed. Potential pitfalls in labral tear interpretation, such as sulci around the hip, normal variants of the labrum and plicae, and osseocartilaginous and soft tissue lesions identified on MRA of the hip are also described.

Tearing of the acetabular labrum is a common cause of chronic hip pain. MR arthrography (MRA) of the hip is the imaging procedure of choice for the evaluation of acetabular labrum. Familiarity with the various imaging findings of MRA of the hip allows recognition of normal variants and differentiation from true pathologic conditions. This article comprehensively reviews the technical aspects and interpretation of MRA of the hip. The appearances of normal and abnormal labra in MRA are discussed. Potential pitfalls in labral tear interpretation, such as sulci around the hip, normal variants of the labrum and plicae, and osseocartilaginous and soft tissue lesions identified on MRA of the hip are also described.

The purpose of this study was to identify the effect of providing toothbrushing by professionals as part of oral hygiene education for the elderly. We randomly visited 12 centers in the metropolitan city and analyzed the data of 114 participants among 310 early registrants aged >65 years, who participated in the study at all 3 time points. The subjects were categorized into an experimental group (odd-numbered visits) and a control group (even-numbered visits). Oral hygiene practices were provided for both experimental and control groups, but professional toothbrushing was performed in a different manner in the experimental group. Differences in plaque index (PI) according to the subjects' general characteristics and oral health status were assessed using the t-test, and the effect of PI difference between the experimental and control groups was assessed by repeated measure two-way analysis of variance. A stepwise multiple regression analysis was used to analyze factors affecting the PI. At baseline, the mean overall PI was 61.82. In both experimental and control groups, the PI significantly reduced from the baseline (p <0.01). At 5 weeks, the experimental group showed a decrease of 27.16 points from the baseline, and the 10-week PI was similar to the 5-week PI. The control group showed a decrease of 14.87 points from the baseline, and the PI increased by 5.74 points at 10 weeks. PI-related factors were gender and self-xerostomia. The PI was lower in the female group and the group with self-xerostomia (p <0.01). It is important to select an appropriate method to educate elderly subjects on proper removal of dental plaque and to habituate correct behavior, which requires inclusion of a direct toothbrushing intervention by a specialist.
Aged* ; Dental Plaque ; Education ; Female ; Humans ; Methods ; Oral Health ; Oral Hygiene ; Specialization ; Toothbrushing*

In this study, 110 adults aged 40 to 69 years were surveyed from April 28, 2016, to May 28, 2016 to analyze their periodontal status according to daily stress, coping methods, and oral health behavior. The collected data were analyzed using the t-test, one-way analysis of variance, and hierarchical multiple regression. Daily stress levels of all subjects were most frequent potential risk 64.5% of the subjects, the high risk 19.1% and 16.4% of the health group. Regarding stress coping methods, active methods recorded 2.46, passive methods recorded 2.32. Regarding oral health behaviors, subjects brushed an average of 2.45 times daily, for an average of 2 minutes. Futhermore, 69.1% of subjects brushed before bedtime and 89.1% practiced scaling. Regarding periodontal status, the O'Leary index was 73.45, gingivitis index was 1.30, an average of 2.83 quadrants possessed a periodontal pocket. The hierarchical multiple regression analysis identified, type of employment (β=−0.348), scaling (β= −0.253), and age (β=0.244) as factors that influence the number of quadrants possessing a periodontal pocket. These results confirmed that the oral health behavior of scaling, but not stress levels of coping methods, strongly influenced periodontal status.
Adult ; Employment ; Gingivitis ; Humans ; Oral Health* ; Periodontal Pocket