Twenty-one cases of mitral valve prolapse (MVP) diagnosed by M-mode echocardiograms were studied in regard to the underlying or associated conditions, types of MVP, and dimensions of the cardiac structures and parameters reflecting cardiac performance determined by echocardiograms. In 9 cases, MVP was thought to be idiopathic origin. Associated conditions in the remainder were 5 cases of congenital heart disease, 2 cases of rheumatic myocarditis, 1 case each of aortic valve disease, ischemic heart disease and hyperthyroidism, and 2 cases of undiagnosed cardiac conditions. There were 2 cases of buckling type of MVP and in the remainder hammock type. In these 2 patients with hammock type of MVP, mitral valve echoes were seen in the left atrium during systole in 1 case, and diastolic anterior displacement of posterior mitral leaflet in the other. In 9 cases of idiopathic MVP, cardiac dimensions and parameters reflecting cardiac performance as determined from echocardiograms showed no significant differences from those of 27 normal controls.
Aortic Valve ; Echocardiography* ; Heart Atria ; Heart Defects, Congenital ; Humans ; Hyperthyroidism ; Mitral Valve Prolapse* ; Mitral Valve* ; Myocardial Ischemia ; Myocarditis ; Systole

Ossifications of the ligamentum flavum(OLF) and the posterior longitudinal ligament(OPLL) are uncommon clinical entities as a cause of the progressive compression myelopathy or radiculopathy. Although there are considerable literatures concerning OPLL or OLF in cervical and thoracic spine, there are only a few references about OPLL or OLF in the lumbar spine. OLF and OPLL have been reported that they may lead to severe complication only with a minor trauma or even without trauma, such as paraplegia. The authors have experienced 2 cases of OLF accompanied by OPLL In the lumbar spine, who were treated with decompressive laminectomy and excision of ossified ligaments. For its rarity of OLF and OPLL in the lumbar region, we report here with review of literature.
Laminectomy ; Ligaments ; Ligamentum Flavum* ; Longitudinal Ligaments* ; Lumbosacral Region ; Paraplegia ; Radiculopathy ; Spinal Cord Diseases ; Spine*

PURPOSE: Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy. METHODS: Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses. RESULTS: At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function. CONCLUSION: These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.
Adult ; Analysis of Variance ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use ; Attention/drug effects ; Breast Neoplasms/*drug therapy ; Chemotherapy, Adjuvant ; Cognitive Dysfunction/epidemiology/*etiology ; Female ; Humans ; Longitudinal Studies ; Memory/drug effects ; Middle Aged

No abstract available.
Goldenhar Syndrome*

N,N-Diethylnitrosamine (DEN) has been proved to have carcinogenic potential in the initiation or promotion stage and the transformed cells proliferate to form preneoplastic nodules which are positive for placental form of glutathione S-transferase (GST-P). E-Cadherin, a member of the cadherin family, is expressed in epithelial cells. To evaluate the role of adhesion molecules (E-Cadherin, alpha-catenin, and beta-catenin), which have not been well understood in carcinogenesis, we investigated the changes of E-cadherin, alpha-Catenin and beta-Catenins by immunohistochemistry and immunoblotting in DEN-induced hepatocarcinogenesis of rat liver. In addition, the sequential analysis of histopathology and the expression of GST-P were also examined. Immunoreactive areas for GST-P were gradually increased from early period of carcinogenesis and strong GST-P positive foci were noted in various lesions, especially in the clear cell and eosinophilic cell nodules. Immunohistochemically, the E-Cadherin expression was increased in DEN-treated preneoplastic nodules in 4 and 10 weeks and hepatocellular carcinomas displayed relatively reduced expression compared with the hyperplastic nodules. But alpha- and beta-catenin expression was increased in hyperplastic nodules and hepatocellular carcinomas. Immunoblotting studies revealed that the level of alpha-catenin (cytosol and membranous fraction) was overexpressed in hyperplastic nodules as well as hepatocellular carcinomas, which showed markedly increased expression. The membranous fraction of beta-catenin was markedly increased in 10 weeks of DEN treatment and slightly reduced in hepatocellular carcinomas. These findings suggest that during DEN-induced hepatocarcinogenesis, the clear cell and eosinophilic cell nodules expressing GST-P in their cytoplasm are early transformed cell nodules. The altered expression of E-Cadherin and catenins is closely related with tumor propagation. Loss or reduced expression of E-cadherin may play a role in the progression of late hyperplastic nodule to hepatocellular carcinoma in DEN-induced rat hepato carcinogenesis.
alpha Catenin ; Animals ; beta Catenin ; Cadherins* ; Carcinogenesis ; Carcinoma, Hepatocellular ; Catenins* ; Cytoplasm ; Eosinophils ; Epithelial Cells ; Glutathione Transferase* ; Glutathione* ; Humans ; Immunoblotting ; Immunohistochemistry ; Liver* ; Rats*

No abstract available.
Child* ; Humans ; Humerus*

A 50-year-old woman visited the hospital with persistent watery rhinorrhea which she had for 2 months. Endoscopic examination revealed a mass in the right nasal cavity and rdiological findings revealed a bony defect on the lateral wall of the sphenoid sinus associated with the protrusion of the mass lesion. Endoscopic skull base reconstruction was performed via transpterygoid approach, including a watertight closure of the dural defect with both underlay and overlay repairs. Cerebrospinal fluid (CSF) leakage persisted after reconstruction. The right lateral lamella was identified as a secondary CSF leakage site. CSF leakage is common among patients with meningoencephalocele. However, a secondary CSF leakage accompanied with meningoencephalocele in other areas is uncommon. The present patient experienced CSF leakage from multiple sites—one associated with the original meningoencephalocele and another from a secondary defect at the skull base. This complication is rare in clinical practice. Here, we describe this rare case with a brief literature review.

Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu disease, is a rare autosomal dominant vascular disorder involving arteriovenous malformation. HHT is characterized by recurrent epistaxis, cutaneous telangiectasia, and visceral arteriovenous malformations. Hepatic arteriovenous malformation can lead to high output heart failure. We report a case of hereditary hemorrhagic telangiectasia patient who complained dyspnea and edema on both lower extremity.
Arteriovenous Malformations ; Dyspnea ; Edema ; Epistaxis ; Heart Failure* ; Heart* ; Humans ; Lower Extremity ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis

OBJECTIVE: In processing high dimensional clinical data, choosing the optimal subset of features is important, not only for reduce the computational complexity but also to improve the value of the model constructed from the given data. This study proposes an efficient feature selection method with a variable threshold. METHODS: In the proposed method, the spatial distribution of labeled data, which has non-redundant attribute values in the overlapping regions, was used to evaluate the degree of intra-class separation, and the weighted average of the redundant attribute values were used to select the cut-off value of each feature. RESULTS: The effectiveness of the proposed method was demonstrated by comparing the experimental results for the dyspnea patients' dataset with 11 features selected from 55 features by clinical experts with those obtained using seven other classification methods. CONCLUSION: The proposed method can work well for clinical data mining and pattern classification applications.
Data Mining ; Dyspnea

OBJECTIVES: Congenital muscular torticollis, a common disorder that refers to the shortening of the sternocleidomastoid in infants, is sensitive to correction through physical therapy when treated early. If physical therapy is unsuccessful, surgery is required. In this study, we developed a support vector regression model for congenital muscular torticollis to investigate the prognosis of the physical therapy treatent in infants. METHODS: Fifty-nine infants with congenital muscular torticollis received physical therapy until the degree of neck tilt was less than 5degrees. After treatment, the mass diameter was reevaluated. Based on the data, a support vector regression model was applied to predict the prognoses. RESULTS: 10-, 20-, and 50-fold cross-tabulation analyses for the proposed model were conducted based on support vector regression and conventional multi-regression method based on least squares. The proposed methodbased on support vector regression was robust and enabled the effective analysis of even a small amount of data containing outliers. CONCLUSIONS: The developed support vector regression model is an effective prognostic tool for infants with congenital muscular torticollis who receive physical therapy.
Humans ; Infant ; Least-Squares Analysis ; Neck ; Prognosis ; Torticollis