PURPOSE: To investigate the relation between retinal nerve fiber layer (RNFL) defect and grade of diabetic retinopathy in diabetic patients with normal intraocular pressure (IOP). METHODS: The medical records of 260 patients with nonproliferative diabetic retinopathy (NPDR) were reviewed retrospectively. Patients with diseases and congenital anomaly were excluded. According to the results of visual acuity, IOP, slit lamp examination and fluorescein angiography, patients were classified into 3 groups, mild, moderate, severe NPDR. RNFL photography was also performed in all patients. RESULTS: Average age of 260 patients (520 eyes) was 60 year-old, and average IOP was 16.8mmHg. 372 eyes were mild NPDR, 76 were moderate, and 72 were severe. 136 eyes (25.2%) had RNFL defects including wedge-shaped defect (107 eyes; 78.7%) and diffuse atrophy (29 eyes; 21.3%). RNFL defects were observed in patients with mild NPDR (84 eyes), moderate (24 eyes), and severe (28 eyes) and there were a significant correlation between RNFL defect and severity of diabetic retinopathy (p=0.008). CONCLUSIONS: Careful examination and continuous follow-up are necessary in patients with diabetic retinopathy because RNFL defect was common in diabetic patients and increased according to the degree of diabetic retinopathy.
Atrophy ; Diabetic Retinopathy* ; Fluorescein Angiography ; Humans ; Intraocular Pressure ; Medical Records ; Middle Aged ; Nerve Fibers* ; Photography ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity

Intramural hematoma of the duodenum is a relatively unusual complication associated with the endoscopic treatment of bleeding peptic ulcers. Intramural hematomas are typically resolved spontaneously with conservative treatment alone. We report a case of an intramural duodenal hematoma following endoscopic hemostasis with epinephrine injection therapy, which was associated with transient obstructive jaundice in a patient undergoing hemodialysis. The patient developed biliary sepsis due to obstruction of the common bile duct secondary to the huge hematoma. He was treated with fluoroscopy-guided drainage catheter insertion, which spontaneously resolved the biliary sepsis through conservative treatment in 6 weeks. Fluoroscopy-guided drainage may impact the treatment of intramural hematomas that involve life-threatening complications.
Catheters ; Cholestasis ; Common Bile Duct ; Drainage ; Duodenal Ulcer ; Duodenum ; Epinephrine ; Hematoma* ; Hemorrhage ; Hemostasis, Endoscopic* ; Humans ; Jaundice, Obstructive* ; Peptic Ulcer ; Renal Dialysis ; Sepsis

INTRODUCTION: The aim of the present study was to investigate the effect of mechanical irrigation in combination with mouthwash of antimicrobial agents on salivary bacterial counts. MATERIALS AND METHODS: This study was performed with a randomized study employing a panel of 40 healthy volunteers (20 males and 20 females) between the age of 26 and 32 years. Volunteers were randomly put in one of four treatment groups. In the first group, 0.2 mL of non-stimulatory saliva was collected from every subjective person. Then, saliva was collected after rinsing with chlorhexidine (CHX) for 1 minute. In the second group, non-stimulatory saliva was collected, and then saliva was collected after rinsing with CHX and irrigation with saline. In the third and fourth groups, the same procedures as the first and second groups were performed with povidone iodine (PVI) instead of CHX. All of these samples were cultured for 48 hours aerobically. The reduction rates of colony-forming units (CFU) were calculated for each group. The reduction rate between each group was tested statistically using student t-test. RESULTS: Using CHX in combination with saline irrigation showed a significant decrease of the salivary bacterial CFU when compared with only using CHX.(P<0.01) And using PVI with saline irrigation showed a little decrease of the CFU when compared with only using PVI, but there was no statistical significance.(P>0.01) CONCLUSION: It was concluded that the CHX or PVI used with saline irrigation made the salivary bacterial counts reduced more than when CHX or PVI was used alone as an oral antiseptic agent.
Anti-Infective Agents ; Bacterial Load ; Chlorhexidine ; Humans ; Male ; Mouthwashes ; Povidone-Iodine ; Saliva ; Stem Cells

Purpose: To develop a denoising convolutional neural network-based image processing technique and investigate its efficacy in diagnosing breast cancer using low-dose mammography imaging. Materials and Methods: A total of 6 breast radiologists were included in this prospective study. All radiologists independently evaluated low-dose images for lesion detection and rated them for diagnostic quality using a qualitative scale. After application of the denoising network, the same radiologists evaluated lesion detectability and image quality. For clinical application, a consensus on lesion type and localization on preoperative mammographic examinations of breast cancer patients was reached after discussion. Thereafter, coded low-dose, reconstructed full-dose, and full-dose images were presented and assessed in a random order. Results: Lesions on 40% reconstructed full-dose images were better perceived when compared with low-dose images of mastectomy specimens as a reference. In clinical application, as compared to 40% reconstructed images, higher values were given on full-dose images for resolution (p < 0.001); diagnostic quality for calcifications (p < 0.001); and for masses, asymmetry, or architectural distortion (p = 0.037). The 40% reconstructed images showed comparable values to 100% full-dose images for overall quality (p = 0.547), lesion visibility (p = 0.120), and contrast (p = 0.083), without significant differences. Conclusion Effective denoising and image reconstruction processing techniques can enable breast cancer diagnosis with substantial radiation dose reduction.

The aim of this study was to provide a basis for the molecular mechanism underlying the pharmacological action of ethanol. We studied the effects of 1-propanol on the location of n-(9-anthroyloxy)palmitic acid or stearic acid (n-AS) within the phospholipids of synaptosomal plasma membrane vesicles (SPMV). The SPMV were isolated from the bovine cerebral cortex and liposomes of total lipids (SPMVTL) and phospholipids (SPMVPL). 1-Propanol increased the rotational mobility of inner hydrocarbons, while decreasing the mobility of membrane interface, in native and model membranes. The degree of rotational mobility varied with the number of carbon atoms at positions 16, 12, 9, 6 and 2 in the aliphatic chain of phospholipids in the neuronal and model membranes. The sensitivity of increasing or decreasing rotational mobility of hydrocarbon interior or surface by 1-propanol varied with the neuronal and model membranes in the following order: SPMV, SPMVPL and SPMVTL.
1-Propanol* ; Carbon ; Cell Membrane ; Cerebral Cortex ; Ethanol ; Hydrocarbons ; Liposomes ; Membranes* ; Neurons* ; Phospholipids

PURPOSE: To identify the incidence of new vertebral compression fractures in women after kyphoplasty and to analyze influential factors in these patients. MATERIALS AMD METHODS: One hundred and eleven consecutive female patients with osteoporotic vertebral compression fractures (VCFs) underwent kyphoplasty at 137 levels. These patients were followed for 15.2 months postoperatively. For the survey of new vertebral compression fractures, medical records and x-rays were reviewed, and telephone interviews were conducted with all patients. RESULTS: During that time 20 (18%) patients developed new VCFs. The rate of occurrence of new VCFs in one year was 15.5% using a Kaplan-Meier curve. Body mass index (BMI), symptom duration and kyphoplasty level were the statistically significant factors between the patient groups both with and without new VCFs after kyphoplasty. In the comparison between the adjacent and remote new VCF groups, the adjacent new VCF group showed a larger amount of polymethyl methacrylate (PMMA) use during kyphoplasty (p<0.05). Before kyphoplasty, 9.9% of the patients had been prescribed medication for osteoporosis, and 93.7% of the patients started or continued medication after kyphoplasty. The development of new VCFs was affected by the number of vertebrae involved in the kyphoplasty. However, the lower incidence rate (15.5%) of new compression fractures might be due to a greater percentage (93.7% in our study) of patients taking anti-osteoporotic medication before and/or after kyphoplasty. CONCLUSION: When kyphoplasty is planned for the management of patients with osteoporotic VCFs, the application of a small amount of PMMA can be considered in order to lower the risk of new fractures in adjacent vertebrae. The postoperative use of anti- osteoporotic medication is recommended for the prevention of new VCFs.
Aged ; Aged, 80 and over ; Bone Cements ; Female ; Follow-Up Studies ; Fractures, Compression/epidemiology/*surgery ; Humans ; Incidence ; Middle Aged ; Orthopedic Procedures ; Postoperative Complications ; Recurrence ; Risk Factors ; Spinal Fractures/epidemiology/*surgery ; Surgical Procedures, Minimally Invasive ; Treatment Outcome

Malignant fibrous histiocytoma (MFH), a type of sarcoma, is a malignant neoplasm with uncertain origins that arise from both the soft tissues and the bone. The occurrence of MFH on the chest wall is extremely rare. We hereby report a case of a 72-year-old woman who was incidentally detected with MFH after a traffic accident.
Accidents, Traffic ; Aged ; Female ; Hemothorax* ; Histiocytoma, Malignant Fibrous* ; Humans ; Sarcoma ; Thoracic Wall*

Peritoneal mesothelioma is an unusual disease which diffusely involves the peritoneal surface. The incidence is approximately one per 1,000,000, and one fifth to one third of all mesothelioma are peritoneal in origin. Asbestos exposure is linked to the development of peritoneal mesothelioma as a significant etiology, but further investigation shoud be conducted. Abdominal sonography, abdominal CT and cytologic examination of ascitic fluid are used to confirm the diagnosis, but rarely provides proper diagnosis. Laparoscopy with biopsy is the most common diagnostic method for definite diagnosis of mesothelioma. Cytoreductive surgery and intraperitoneal chemotherapy have been suggested for better survival since the median survival after the initial diagnosis is near to 50 months. This report describes a case of 73-years-old male patient presented with abdominal pain and distension. This patient had not been exposed to asbestos. Abdominal sonography and CT showed massive ascites, multiple omental masses and peritoneal thickening. It was difficult to distinguish peritoneal mesothelioma from carcinomatosis. Laparoscopy and peritoneal biopsy was conducted and immunostaining examination confirmed the diagnosis of peritoneal mesothelioma.
Aged ; Humans ; Male ; Mesothelioma/*diagnosis/etiology/surgery ; Peritoneal Neoplasms/*diagnosis/etiology/surgery

PURPOSE: The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS). MATERIALS AND METHODS: Radiographic data, Scoliosis Research Society (SRS) patient-based outcome questionnaires, and operative records were reviewed for forty-nine patients undergoing surgical treatment of scoliosis. The study group was divided into a 4.5 mm thin rod group (n = 24) and a 5.5 mm thick rod group (n = 25). The radiographic parameters that were analyzed included coronal curve correction, the most caudal instrumented vertebra tilt angle correction, coronal balance, and thoracic kyphosis. RESULTS: The major curve was corrected from 49.8degrees and 47.2degrees pre-operatively to 24.5degrees and 18.8degrees at the final follow-up for the thin and thick rod groups, respectively (50.8% vs. 60.2% correction). There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up. The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group. There were no major intraoperative complications in either group. CONCLUSION: Significant correction loss was observed in the thin rod system at the final follow-up though both groups had comparable correction immediately post-operative. Therefore, the thick rod with poly axial screw system helps to maintain post-operative correction.
Adolescent ; Adult ; *Bone Screws ; Female ; Humans ; Male ; Retrospective Studies ; Scoliosis/radiography/*surgery ; Thoracic Surgery, Video-Assisted/*methods ; Treatment Outcome

Ascidian soft tunic syndrome (AsSTS) caused by Azumiobodo hoyamushi (A. hoyamushi) is a serious aquaculture problem that results in mass mortality of ascidians. Accordingly, the early and accurate detection of A. hoyamushi would contribute substantially to disease management and prevention of transmission. Recently, the loop-mediated isothermal amplification (LAMP) method was adopted for clinical diagnosis of a range of infectious diseases. Here, the authors describe a rapid and efficient LAMP-based method targeting the 18S rDNA gene for detection of A. hoyamushi using ascidian DNA for the diagnosis of AsSTS. A. hoyamushi LAMP assay amplified the DNA of 0.01 parasites per reaction and detected A. hoyamushi in 10 ng of ascidian DNA. To validate A. hoyamushi 18S rDNA LAMP assays, AsSTS-suspected and non-diseased ascidians were examined by microscopy, PCR, and by using the LAMP assay. When PCR was used as a gold standard, the LAMP assay showed good agreement in terms of sensitivity, positive predictive value (PPV), and negative predictive value (NPV). In the present study, a LAMP assay based on directly heat-treated samples was found to be as efficient as DNA extraction using a commercial kit for detecting A. hoyamushi. Taken together, this study shows the devised A. hoyamushi LAMP assay could be used to diagnose AsSTS in a straightforward, sensitive, and specific manner, that it could be used for forecasting, surveillance, and quarantine of AsSTS.
Animals ; Euglenozoa Infections/diagnosis/veterinary ; Kinetoplastida/*classification/genetics/*isolation & purification ; Nucleic Acid Amplification Techniques/*methods ; Predictive Value of Tests ; RNA, Ribosomal, 18S/*genetics ; Sensitivity and Specificity ; Urochordata