PURPOSE: Thoracic ultrasonography (US) is an emerging tool for diagnosing pneumothorax (PTX), and the possible application of color Doppler to ultrasonography is another new development. The aim of this study is to analyze the possible contribution of color Doppler to thoracic US and to the estimation of pneumothorax volume. METHODS: Patients who were admitted to emergency department underwent chest X-ray and thoracic US with color Doppler. They were also evaluated by computed tomography, if needed, US was performed at four chest sites by emergency medicine faculty and resident, and concordance between color Doppler and lung sliding was analyzed. The number of sites with abnormal findings was correlated with the volume of PTX at each sites. Statistical analysis was performed with Pearson correlation. RESULTS: Sixty-three of 151 PTX cases were included in our study. The sensitivity of US was for PTX detection was 92.1% (58 of 63), and the concordance between color Doppler and lung sliding was 99.4%. The number of sites per patient with abnormal findings increased with the average volume of the PTX. The average PTX volume in the 5 cases with normal findings was 7.0%, which is a smallsized PTX. CONCLUSION: The use of color Doppler is not more accurate than lung sliding, but it may helpful in diagnosing PTX. The volume of a PTX is proportional to a patient's number of sites with abnormal US findings.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Lung ; Pneumothorax* ; Thorax ; Ultrasonography

BACKGROUND/AIMS: The rapid urease test (RUT) is an invasive method to diagnose Helicobacter pylori infection, which relies on the acquisition and examination of gastric antrum and body tissues. We determined and compared the efficacy of RUT when the tissues were examined separately or after being combined. METHODS: Two hundred and fourteen patients were included and underwent esophagogastroduodenoscopy from July 2008 to June 2010. The separate test was defined as evaluating the status of infectivity of H. pylori from the antrum and body separately; whereas the united test was carried out putting both tissues from the antrum and body in the same RUT kit. All RUTs were read by a single observer 1, 3, 6, 12, and up to 24 hours later. We also got two biopsy specimens stained with hematoxylin and eosin and quantified H. pylori density was calculated on a scale of 0 to 3. RESULTS: Overall positivity for H. pylori was 137 (64%) for the separate test and 148 (69.2%) for the united test (p<0.01). The mean time to a positive test was 3.58 hours for the separate test and 1.69 hours for the united test (p<0.01). The correlation between the time to positive RUT and the severity of histology showed r=+0.556 for the antrum (p<0.01) and r=+0.622 for the body (p<0.01). CONCLUSIONS: Combining tissues prior to RUT enhances the detection of H. pylori, as compared with the examination of separate tissues, and shortens the time to develop a positive reaction by approximately 50%. These diagnostic advantages are also accompanied by increased cost-savings.
Biopsy ; Endoscopy, Digestive System ; Eosine Yellowish-(YS) ; Helicobacter ; Helicobacter pylori ; Hematoxylin ; Humans ; Pyloric Antrum ; Urease

The publisher wishes to apologize for incorrectly displaying the author (Sung Woon Moon) name. We correct his name from Sung Woon Moon to Sung Won Moon.

OBJECTIVE: To identify factors associated with massive postpartum bleeding in pregnancies complicated by incomplete placenta previa located on the posterior uterine wall. METHODS: A retrospective case-control study was performed. We identified 210 healthy singleton pregnancies with incomplete placenta previa located on the posterior uterine wall, who underwent elective or emergency cesarean section after 24 weeks of gestation between January 2006 and April 2016. The cases with intraoperative blood loss (≥2,000 mL) or transfusion of packed red blood cells (≥4) or uterine artery embolization or hysterectomy were defined as massive bleeding. RESULTS: Twenty-three women experienced postpartum profuse bleeding (11.0%). After multivariable analysis, 4 variables were associated with massive postpartum hemorrhage (PPH): experience of 2 or more prior uterine curettage (adjusted odds ratio [aOR], 4.47; 95% confidence interval [CI], 1.29 to 15.48; P=0.018), short cervical length before delivery (<2.0 cm) (aOR, 7.13; 95% CI, 1.01 to 50.25; P=0.049), fetal non-cephalic presentation (aOR, 12.48; 95% CI, 1.29 to 121.24; P=0.030), and uteroplacental hypervascularity (aOR, 6.23; 95% CI, 2.30 to 8.83; P=0.001). CONCLUSION: This is the first study of cases with incomplete placenta previa located on the posterior uterine wall, which were complicated by massive PPH. Our findings might be helpful to guide obstetric management and provide useful information for prediction of massive PPH in pregnancies with incomplete placenta previa located on the posterior uterine wall.
Case-Control Studies ; Cesarean Section ; Curettage ; Emergencies ; Erythrocytes ; Female ; Hemorrhage* ; Humans ; Hysterectomy ; Odds Ratio ; Placenta Diseases ; Placenta Previa* ; Placenta* ; Postpartum Hemorrhage ; Postpartum Period* ; Pregnancy* ; Retrospective Studies ; Risk Factors* ; Uterine Artery Embolization

PURPOSE: To assess the causes of periportal low attenuation, as seen on CT, in patients with blunt abdominaltrauma. MATERIALS AND METHODS: From among 812 patients who underwent abdominal CT after blunt abdominal trauma,we retrospectively analysed the findings in 124 with evidence of periportal low attenvation. Among these, hepaticinjury was noted in only 87. The presence or absence, and extent of hepatic injury, and of periportal lowattenuation, as seen on CT, were carefully evaluated. In each case, the ratio of the transverse diameter of theinferior vena cava(IVC) to the aorta at the level of the right adrenal gland provided an indirect measurement ofcentral venous pressure; for control purposes, the ratio was also obtained in 21 non-traumatic patients with noabnormal abdominal CT findings. RESULTS: Of the 87 patients with hepatic injury, 46 showed no periportal lowattenuation, and the average value of the ratio between the IVC and aorta was 1.16+/-0.12, while the remaining 41patients showed periportal low attenuation with a ratio of 1.51+/-0.21(p<0.05). In the 37 patients with periportallow attenuation but no evidence of concomitant hepatic injury, the average ratio was 1.52+/-0.25, while in 21non-traumatic patients it was 1.15+/-0.16. For resustication, all patients had received 0.5-5.0l of IV fluidtherapy before CT, and at the time of CT, were normotensive. CONCLUSION: Rapidly elevated central venous pressurefollowing massive IV infusion therapy in patients with blunt abdominal trauma can be one of the causes ofperiportal low attenuation, as seen on CT.
Adrenal Glands ; Aorta ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed ; Venous Pressure

There is increasing evidence that dietary factors in plant-based diets are important for the prevention of chronic disease. Especially, phytonutrients in fruits and vegetables have been recognized as major contributors for the decreased level of oxidative stress. In this study, the effect of switching the dietary habit to high consumption of fruits and vegetables were evaluated on the parameters of serum antioxidant status in healthy high school students. Forty one students participated in a randomized controlled trial and were assigned to the control group (n = 18) or the intervention group (n = 23). The intervention group was provided for 8 weeks with the main food source being whole grain and vegetables. Anthropometric measurements, blood parameters and dietary intakes were measured, and compared before and after study. After 8 weeks, weight and BMI were significantly decreased in the intervention group (p = 0.000). The serum diacron reactive oxygen metabolites (d-ROMs) test resulted in a significantly decreased level only in the intervention group (p < 0.05) after 8 weeks, but serum biological antioxidant potential (BAP) was increased significantly in both groups (p < 0.001). Intake of energy, total fat, cholesterol and sodium in the intervention group were significantly decreased after 8 weeks (p < 0.05). Also, the intervention group had significantly increased vitamin and phytonutrient intakes of all-trans-beta-carotene, alpha-carotene, alpha-tocopherol, ascorbic acid, and total phenols (p < 0.05). Overall, the results of this study suggest that whole grain, fruits, and vegetables supplementation showed improvement of the adolescent health.
Adolescent ; alpha-Tocopherol ; Ascorbic Acid ; Carotenoids ; Cholesterol ; Chronic Disease ; Diet ; Edible Grain ; Food Habits ; Fruit ; Humans ; Oxidative Stress ; Oxygen ; Phenol ; Phenols ; Sodium ; Vegetables ; Vitamins

BACKGROUND: The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance. METHODS: Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients. Femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization were assessed in all patients. Relationship of these parameters with the TT-TG distance was investigated to evaluate their effects on the TT-TG distance. RESULTS: We observed that the patellar dislocation group, compared to the control group, had increased TT-TG distance (mean, 19.05 mm vs. 9.02 mm) and greater tuberosity lateralization (mean, 64.1% vs. 60.7%) and tibial external rotation in relation to the femur (mean, 7.9° vs. −0.81°). CONCLUSIONS: Tuberosity lateralization and knee rotation were factors affecting patellar dislocation. These factors should be considered in addition to the TT-TG distance to determine the need for tibial tubercle osteotomy in patients with patellar dislocation.
Femur ; Humans ; Knee ; Osteotomy ; Patella ; Patellar Dislocation* ; Retrospective Studies

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) can develop in chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels. Therefore, methods that can stratify an individual's HCC risk are needed. METHODS: A simple HCC risk score was developed from 971 patients with CHB who had elevated hepatitis B virus DNA levels (>2,000 IU/mL) with normal or mildly elevated ALT levels (<80 U/L). The score was validated from an independent cohort of 507 patients. RESULTS: A 4-point risk scale was developed, with HCC risk ranging from 0% to 17.8% at 5 years for the lowest and highest risk scores. The D2AS score had high area under the receiver operating curves (AUROCs) for predicting development of HCC at 3/5 years (0.895/0.884). The calculated AUROCs to predict the development of HCC at 3/5 years were 0.889/0.876 in the validation cohort, with 5-year HCC incidence rates ranging from 0% to 13.8% at 5 years for the lowest and highest risk scores. CONCLUSIONS: The D2AS risk score can play a valuable role in risk stratification and may be useful for guiding clinical decisions for enhanced surveillance or treatment to reduce the HCC risk in CHB patients with normal or mildly elevated ALT levels.
Alanine Transaminase* ; Alanine* ; Carcinoma, Hepatocellular* ; Cohort Studies ; DNA ; Hepatitis B ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Incidence ; Liver Function Tests

PURPOSE: Hashimoto's thyroiditis (HT) is an important cause of hypothyroidism caused by autoimmune chronic lymphocytic thyroiditis. In order to attain a better understanding for use in treatment of papillary thyroid carcinoma (PTC) coexisting with HT, we conducted an analysis of the clinicopathologic features, as well as the importance of HT as a prognostic factor. METHODS: In this retrospective study, we analyzed 341 patients who were histopathologically diagnosed with PTC following surgery. RESULTS: PTC coexisting with HT was observed in 19.6% (67 patients) of all PTC patients. A statistically significant gender difference was observed in the group with HT (two male vs. 65 female), with a higher positive rate of anti-thyroglobulin antibody and smaller tumor size, compared to the PTC group without HT. When tumor size increased, a lower coexistence rate of HT was observed. No significant differences were observed in multifocality, cervical lymph node (LN) metastasis, coexistence of benign nodule, and extent of LN dissection. However, frequency of extrathyroidal extension was significantly lower and total thyroidectomy rate was higher in the group with HT. TNM stage and AMES stage were similar in both groups; frequency of high MACIS score showed a significant decrease in the group with HT. The recurrence rate and disease- free survival in patients with PTC were not significantly affected by coexistence of HT. CONCLUSION: We found a significant relationship with gender, extrathyroidal extension, and tumor size in PTC coexisting with HT. However, no significant differences in recurrence rate and disease-free survival were observed between groups. Therefore, coexistence in PTC could not be applicable as a prognostic factor of PTC.
Disease-Free Survival ; Hashimoto Disease ; Humans ; Hypothyroidism ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyroiditis*

OBJECTIVE: Malnutrition and nutritional disorder may cause problem of fertility and therefore adequate nutrition is very important during pregnancy. In this study, we investigated effects of supplemental diet contained folic acid, zinc, calcium, Iron, DHA and taurine on fertility outcome in the female rats and learning ability of their offsprings. METHODS: The female rats at 4 week were fed by two group divided control (AIN-76 diet) and supplement diet. The male rats were taken pellet type diet. After 3 weeks, female rats and male rats were mated. Then, at 3 weeks after mating, parturition was begun. After paturition, sex and birth weight of offsprings were examined for their offsprings. When the offsprings were 3 weeks of age, position reversional test in a water maze was done for 4 weeks. After female rats were fed experimental diet for 4 weeks, their follicle, corpus luteum, corpus albicans, progesterone, estradiol and ovary weight were measured. RESULTS: 22 rats of 30 in supplemental diet group succeeded on parturition, and 11 rats of 30 in control group succeeded. Pregnancy outcome was fine in both group. There was no significant difference in weight of major bowels and femur length of their offspring. The position reversional test of offsprings in a water maze showed a significant difference between control group and supplement group. Elapsed time and errorneous response to reach the escape platform were significantly lowered in supplemental group than control group. CONCLUSION: This result suggest that supplementation contained folic acid, multivitamins, DHA and taurine may increase fertility rate in the maternal rats and also learning ability in offsprings.
Animals ; Birth Rate* ; Birth Weight ; Calcium ; Child ; Corpus Luteum ; Diet ; Estradiol ; Female ; Femur ; Fertility* ; Folic Acid* ; Humans ; Iron ; Learning* ; Male ; Malnutrition ; Nutrition Disorders ; Ovary ; Parturition ; Pregnancy ; Pregnancy Outcome ; Progesterone ; Rats* ; Taurine ; United Nations ; Zinc