No abstract available.
Infectious bursal disease virus*

Posterior cervical foraminotomy is an attractive therapeutic option in selected cases of cervical radiculopathy that maintains cervical range of motion and minimize adjacent-segment degeneration. The focus of this procedure is to preserve as much of the facet as possible with decompression. Posterior cervical inclinatory foraminotomy (PCIF) is a new technique developed to offer excellent results by inclinatory decompression with minimal facet resection. The highlight of our PCIF technique is the use of inclinatory drilling out for preserving more of facet joint. The operative indications are radiculopathy from cervical foraminal stenosis (single or multilevel) with persistent or recurrent root symptoms. The PCIFs were performed between April 2007 and December 2009 on 26 male and 8 female patients with a total of 55 spinal levels. Complete and partial improvement in radiculopathic pain were seen in 26 patients (76%), and 8 patients (24%), respectively, with preserving more of facet joint. We believe that PCIF allows for preserving more of the facet joint and capsule when decompressing cervical foraminal stenosis due to spondylosis. We suggest that our PCIF technique can be an effective alternative surgical approach in the management of cervical spondylotic radiculopathy.
Constriction, Pathologic ; Decompression ; Female ; Foraminotomy ; Humans ; Male ; Mandrillus ; Radiculopathy ; Range of Motion, Articular ; Spondylosis ; Zygapophyseal Joint

OBJECTIVE: To compare current perception threshold with nerve conduction study, we measured current perception threshold (CPT) in healthy control and patients with carpal tunnel syndrome (CTS). METHOD: Twenty control subjects and twenty patients with CTS were included. Latency and amplitude of median and ulnar motor and sensory nerves were measured. The sensory current perception threshold was measured at the distal interphalangeal joint of third and fifth fingers and the palm with electrical current of 5 Hz, 250 Hz, and 2,000 Hz in frequency. We compared the results of the nerve conduction study with the data of the CPT. RESULTS: We found that measuring of the sensory threshold might detect carpal tunnel syndrome, especially with 2,000 Hz and 250 Hz stimulation and that CPT data correlated to sensory latency and amplitude of the median nerve. CONCLUSION: The sensory threshold test might be useful for diagnosis and follow up test in carpal tunnel syndrome.
Carpal Tunnel Syndrome* ; Diagnosis ; Fingers ; Humans ; Joints ; Median Nerve ; Neural Conduction ; Sensory Thresholds

OBJECTIVES: We aimed to investigate the relationship between subjective memory complaints and cognition in the elderly. METHODS: Data obtained from 1,496 subjects (510 men and 986 women) aged above 60 years was analyzed from the Gwangju Dementia and Mild Cognitive Impairment Study (GDEMCIS). All subjects completed the study questionnaire including demographic characteristics, history of current and past illnesses, drug history, Korean version-Mini Mental State Examination (K-MMSE), and Short Form Korean version of Geriatric depression scale (SGDS-K). Subjective memory complaints were defined in two different ways; worse than others (SMC-O) and worse than one's past (SMC-P). RESULTS: On analysis of covariance, there was significant difference of estimated marginal means of K-MMSE score among five SMC-P groups (much improve:18.0, little improve:21.3, not changed:21.2, little worse:21.1, much worse:20.2) after adjusting age, sex, educational level and depression (F=9.63, df=4, p<0.0001, adjusted R2=0.375). There was significant difference of estimated marginal means of K-MMSE score among three SMC-O groups (below peer's average:20.4, peer's average:20.9, above peer's average:21.8) after adjusting age, sex, educational level and depression (F=4.89, df=2, p=0.043, adjusted R2=0.0.361). CONCLUSION: These results suggest that subjective memory complaints may be an indicator of objective cognitive impairment in the elderly.
Aged ; Cognition ; Dementia ; Depression ; Humans ; Male ; Memory ; Mild Cognitive Impairment ; Surveys and Questionnaires

PEG is a simple, safe and rapid method for the placement of feeding gastrostomy tube because of its low morbidity and mortality. Also, exchange of gastrostomy tube can be easily performed because several types of exchange tube, suich as replacement balloon gastrostomy tube are available. But, less has been known about complications of exchange tube. The authors experienced a case of severe gastric ulcer bleeding in seventy one years old male patient who had been suffered from melena after exchange of old PEG tube for replacement balloon gastrostomy tube. Gastroscopy showed bleeding from acute, large and deep ulcer on the body of stomach, and replacement tube tip directed to the center of ulcer. Bleeding was thought to be caused by gastric ulcer due to replacement balloon gastrostomy tube, After removal of tube and conservative management with H2 receptor antagonist, bleeding ceased
Gastroscopy ; Gastrostomy* ; Hemorrhage* ; Humans ; Male ; Melena ; Mortality ; Stomach ; Stomach Ulcer* ; Ulcer

No abstract available.
Pancreatitis*

BACKGROUND AND OBJECTIVES: Dobutamine stress echocardiography (DSE) with 2D echocardiography (2DE) is one of the time-consuming procedures in the diagnosis of coronary artery disease (CAD). Moreover, the accuracy of DSE with 2DE depends on the operator's skill or bias during the image acquisition. This study was conducted to determine the feasibility and accuracy of DSE with real-time 3D echocardiography (RT3DE) for the diagnosis of CAD. SUBJECT AND METHODS: 62 patients (RT3DE: 36, 2DE: 26), suspected of angina pectoris and post-revascularization ischemia, underwent DSE and coronary angiography (CAG). Image acquisition was performed at the baseline, and at 4 times during the dobutamine infusion and recovery stages. The procedure time (from the baseline to the end of the peak dose stage) was recorded. Off-line analyses of the volumetric images acquired with RT3DE were performed using 3D computer software (TomTec, Co.). Digitized quad-screen images acquired with 2DE were analyzed using the 2DE review system (ProSolv 4.0). >50% luminal diameter stenosis of any coronary artery on CAG was defined as significant coronary artery stenosis. RESULTS: The procedure time of DSE with RT3DE was significantly shorter than that of DSE with 2DE (25+/-4 vs. 37+/-4 mins, p<0.001). There was no significant difference in the sensitivity (p>0.05) or specificity (p>0.05) between the two procedures. CONCLUSION: DSE with RT3DE seems to be a feasible and less time consuming diagnostic procedure, probably providing comparable sensitivity and specificity for the detection of coronary artery stenosis, than DSE with 2DE.
Angina Pectoris ; Bias (Epidemiology) ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Dobutamine* ; Echocardiography* ; Echocardiography, Stress* ; Echocardiography, Three-Dimensional* ; Humans ; Ischemia ; Phenobarbital ; Sensitivity and Specificity

PURPOSE: To evaluate the usefulness of echo-planar FLAIR imaging in various cerebral lesions as compared with fast FLAIR imaging. MATERIALS AND METHODS: We obtained consecutive fast FLAIR and echo-planar FLAIR images in 33patients in whom MR imaging had revealed ischemic infarction (n=11), acute infarction (n=5), brain tumor (n=3), other conditions (n=3) or no abnormality (n=11). On both sets of images, percentage contrast and contrast to noise ratio (CNR) were calculated for white matter-gray matter and white matter-lesion. RESILTS: White matter-gray matter percentage contrast and CNR were lower on echo-planar FLAIR imaging than on fast FLAIR imaging (percentage contrast, 19 +/- 2 % vs 28 +/- 3 %, CNR, 2.77 +/- 0. 5 vs 4.86 +/- 0.7). White matter-lesion percentage contrast on echo-planar FLAIR imaging was similar to or greater than that on fast FLAIR imaging; 75 +/- 12 % vs 45 +/- 11 % in ischemic infarction, 80 +/- 12 % vs 78 +/- 11% in acute infarction, and 121 +/- 25 % vs 102 +/- 15 % for tumors. White matter-lesion CNR was similar on both sets of images: 8.3 +/- 0.9 vs 7.9 +/- 0.8 in ischemic infarction, 11 +/- 1.5 vs 9.5 +/- 1.2 in acute infarction, and 24 +/- 4 vs 27 +/- 3 for tumors. Due to high susceptibility to magnetization, echo-planar FLAIR imaging showed image degradation at the interface of the paranasal sinus and adjacent to the temporal bone. CONCLUSION: Echo-planar FLAIR imaging may be a useful pulse sequence in the diagnosis of various cerebral lesions.
Brain Neoplasms ; Diagnosis ; Infarction ; Magnetic Resonance Imaging ; Noise ; Temporal Bone

Toxic megacolon is a devastating complication of colitis, which is commonly caused by inflammatory bowel disease. Frequently reported complications of toxic megacolon are bleeding, sepsis, colon perforation, and shock. Herein, we report a rare case of cardiac arrest that was likely caused by toxic megacolon in a 49-year-old male, who experienced 3 months of intermittent dyspnea and abdominal distension that abruptly worsened before presentation. Our case suggests that severe colon dilation complicated by toxic megacolon, especially accompanied by cardiopulmonary symptoms and signs, has the potential to progress to an abdominal compartment syndrome, which is a rare but life-threatening complication.
Colitis ; Colon* ; Critical Care ; Dyspnea ; Heart Arrest* ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Intra-Abdominal Hypertension ; Male ; Megacolon ; Megacolon, Toxic ; Middle Aged ; Sepsis ; Shock

PURPOSE: To determine the effect of iron on proton MR spectra (1H-MRS) by evaluating changes in 1H-MRS of the liver according to changes in hepatic parenchymal iron content. MATERIALS AND METHODS: We evaluated serial changes in 1H-MRS of the liver after intravenous infusion of SPIO in 40 rabbits. These were divided into eight groups of five, and in each group, respectively, 1H-MRS and T2WI MR images were acquired prior to SPIO infusion, just after infusion, and at 15 minutes and 1, 2, 4, 24 and 96 hours after infusion. MR spectra were evaluated with particular attention to the curve pattern observed at specific times after the infusion of SPIO, and the results were correlated with the signal intensity observed on T2W1 images and the histologic giade of ilon content of samples of resected liver parenchyma. RESULTS: As observed on T2WI, the mean signal intensity of rabbit liver in its pre-SPIO infusion state, just after infusion, at 15 minutes, and at 1, 2, 4, 24 and 96 hours after SPIO infusion was 121.3 +/-15.5, 41.5 +/-12.7, 30.3 +/-7.9, 31.3 +/-3.5, 33.6 +/-9.4, 45.5 +/-10.9, 80.3 +/-15.7 and 110.4 +/-22.9, respectively(p<0.05). Mean standard deviation of the ratio of the area of the peak (3.9-4.1 ppm) / lipid peak (1.3 ppm) peak at each of the above times except for the pre-infusion state was 1.10 +/-0.13, 1.86 +/-0.21, 1.80 +/-0.30, 1.76 +/-0.27, 1.74 +/-0.20, 0.07 +/-0.02 and 0.03 +/-0.01, respectively(p<0.05). The hepatic parenchymal iron content increased rapidly from just after SPIO infusion, reaching its maximal level (as revealed by histologic specimens) at 15 minutes, sustaining this for up to 4 hours, and then decreasing gradually over periods of 24 and 96 hours. These results show that serial changes in patterns of MR spectra and the signal intensity seen on T2WI images correlate closely with changes in hepatic parenchymal iron content. CONCLUSION: Elevated hepatic parenchymal iron content leads to increases in the relative intensity of unknown peaks at around 4.0 ppm and decreases in the relative intensity of lipid peaks.
Infusions, Intravenous ; Iron* ; Liver ; Protons* ; Rabbits