This study evaluated pulsed TDI variables including the isovolumic time interval and duration of the major wave in a population of large healthy dogs. Longitudinal myocardial motion at the septal mitral annulus was evaluated with pulsed TDI in 45 healthy adult dogs. Maximal myocardial velocities, isovolumic time intervals, and duration of the myocardial waves were measured. The correlation between time intervals and velocity variables was also investigated. The mean maximal systolic velocity was 6.92 +/- 1.78 cm/sec, the mean early diastolic velocity (Em) was 6.58 +/- 1.81 cm/sec, the mean late diastolic velocity (Am) was 5.10 +/- 2.00 cm/sec, the mean isovolumic contraction time (IVCT) was 53.61 +/- 95.13 msec, and the mean isovolumic relaxation time (IVRT) was 26.74 +/- 57.24 msec. The early diastolic mitral inflow velocity (E)/Em ratio was 10.94 +/- 3.27 while the Em/Am ratio was 1.40 +/- 0.40. There was a negative correlation between Am duration and Am amplitude, and a positive correlation between the IVRT and Em/Am ratio (p < 0.05). The normal LV parameter using pulsed TDI method could be used as the reference range for identifying myocardial dysfunction in dogs.
Animals ; Dogs/*anatomy & histology ; Female ; Heart Ventricles/*ultrasonography ; Male ; Mitral Valve/*ultrasonography ; Ultrasonography, Doppler, Pulsed/methods/*veterinary

Downstaging of hepatocellular carcinoma (HCC) is typically defined as the reduction in size or number of viable tumors through locoregional therapy (LRT), aiming to meet the established criteria for liver transplantation (LT). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, a subgroup of patients with BCLC-B may benefit most from downstaging therapies. The United Network Organ Sharing downstaging protocol identifies potential candidates for downstaging by setting out ‘inclusion criteria’ and defining ‘successful downstaging.’ Additionally, the protocol considers factors related to tumor biology, such as an alphafetoprotein level <500 ng/mL after LRT. Reports indicate that successful downstaging rates following LRT are about 50%, with post- LT recurrence rates comparable to those of patients within the Milan criteria. A comprehensive multicenter US study on 10-year outcomes post-LT after downstaging showed 10-year post-LT survival and recurrence rates of 52.1% and 20.6%, respectively, for patients whose disease was downstaged; this compares to 61.5% and 13.3% for those consistently within the Milan criteria. Recently, the development of effective systemic treatments for HCC, such as immuno-oncologic agents, has provided additional opportunities for downstaging. Numerous clinical trials are exploring a multidisciplinary approach (MDA) combining LRT and systemic therapy. Although concrete evidence of the superiority of MDA for HCC downstaging is lacking, some retrospective studies and phase I and II trials have shown promising results regarding the efficacy and safety of MDA for this purpose. In this review, we will also discuss the future of MDA protocols in downstaging for improved clinical outcomes.

A Yorkshire terrier (case 1) and a Miniature Schnauzer (case 2) were diagnosed with pylorogastric intussusceptions (PGIs). Both cases showed acute vomiting and had previous histories of laparotomy. In case 1, the invaginated pyloric wall was thickened unevenly containing multiple hypoechoic areas and had indistinct wall layering on ultrasonography. PGI with diffuse gastric edema and necrosis was confirmed on laparotomy. The dog recovered completely after gastrectomy and a Y-U plasty. Case 2 had uniformly thickened walls of invaginated gastric pylorus with the distinct wall layering. PGI was reduced spontaneously the next day.
Animals ; Dog Diseases/pathology/surgery/*ultrasonography ; Dogs ; Female ; Intussusception/surgery/ultrasonography/*veterinary ; Pylorus/*pathology/surgery

OBJECTIVES: In order to establish prevalence and characteristics of tinnitus and hearing thresholds according to tinnitus, this study was carried out. METHODS: Nine hundred and thirty two subjects, undergone human dock or general health check-up and been in college, were surveyed to the questionnaire on the general characteristics, past medical histories, life styles, subjective symptoms about hearing, taking ototoxic drugs and were conducted on the hearing thresholds by pure tone audiometry. RESULTS: Of the total population, 98 reported tinnitus, giving an overall prevalence of 10.5%, prevalence of tinnitus in the subjects with the factors infuencing hearing thresholds were 17.4 %, prevalence without the factors influencing hearing thresholds were 7.5 %. Frequency of tinnitus of the total population was the highest in 'once per several months'(39.6 %) and followed by' once per several days'(29.7 %), 'all day long'(16.5 %) and' several times per day'(14.3 %). Complaint site of tinnitus was 41.8 % in left ear or right ear 39.6 % in both ear and 18.7 % in head. The 13.6% of the total subjects complained sleep disturbance. Hearing thresholds in the subjects without the factors influencing hearing thresholds tended to increase or decrease in 20 and 30 years old according to tinnitus, but those with, tinnitus tended to increase more than chose without tinnitus in 40 and 50 years old. CONCLUSIONS: Results also provide evidence that reports of tinnitus at the time of annual audiometric testing may be useful in identifying workers at greater risk for developing significant shifts in hearing thresholds. Awareness of the possible occurrence of tinnitus may encourage worker to cooperate more actively in a company hearing conservation programme.
Adult ; Audiometry ; Ear ; Head ; Hearing* ; Humans ; Life Style ; Middle Aged ; Prevalence* ; Questionnaires ; Tinnitus*

Although the standard treatment of abdominal aortic aneurysm has shifted from open surgery to endovascular repair, open surgery has remained the standard of care for complex aneurysms involving the visceral arteries and in patients unsuitable for endovascular aneurysm repair. Postoperative renal insufficiency may occur after open surgical repair of suprarenal abdominal aortic aneurysm. Methods of minimizing renal ischemic injury include aortic cross-clamping and renal reconstruction techniques. This report describes the use of renal autotransplantation for renal reconstruction during open surgical repair of a suprarenal abdominal aortic aneurysm. This technique was successful, suggesting its feasibility for open suprarenal abdominal aortic aneurysm repair, minimizing renal ischemic injury and optimizing postoperative renal function.
Aneurysm ; Aorta ; Aortic Aneurysm, Abdominal* ; Arteries ; Autografts* ; Humans ; Kidney ; Renal Insufficiency ; Standard of Care ; Transplantation

Endocrine test data from a 13-year old intact female Maltese was indicative of the presence of an insulinoma, however ultrasonography identified a pancreatic mass only after 10 months after the first admission. Following identification of both pancreatic tumor and hepatic metastasis on computed tomography (CT), surgical excision of the mass was attempted. However, total excision failed because of tumor adhesion to adjacent large vessels. The pancreatic mass was monitored over the next 25 months via ultrasonography, CT, and positron emission tomography-computed tomography (PET-CT). Histopathological and immunohistochemical data confirmed the diagnosis of insulinoma with hepatic metastasis.
Animals ; Diagnostic Imaging ; Dogs ; Electrons ; Female ; Humans ; Insulinoma ; Neoplasm Metastasis ; Positron-Emission Tomography

Radiography, ultrasonography with hydrogram, and contrast studies using radiopaque markers were applied to evaluate alimentary lymphoma in two cats. The hydrogram facilitated the differentiation of pseudo-thickening from true wall thickening, and enabled an evaluation of wall layering and lymph nodes. In case 1, mechanical obstruction of the duodenum was confirmed with barium-impregnated polyethylene spheres (BIPS), a radiopaque marker; however, results obtained in case 2 were not as definitive. We expect that hydrograms and BIPS can be used as valuable alternative methods to evaluate the gastrointestinal (GI) tract although further studies in cases involving GI tumors are needed.
Animals ; Cats ; Duodenum ; Lymph Nodes ; Lymphoma ; Polyethylene

PURPOSE: The aim of this study was to determine the possible predictors of primary arteriovenous fistula (AVF) failure and examine the impact of a preoperative evaluation on AVF outcomes. METHODS: A total of 539 patients who underwent assessment for a suitable site for AVF creation by physical examination alone or additional duplex ultrasound were included in this study. Demographics, patient characteristics, and AVF outcomes were analyzed retrospectively. RESULTS: AVF creation was proposed in 469 patients (87.0%) according to physical examination alone (351 patients) or additional duplex ultrasound (118 patients); a prosthetic arteriovenous graft was initially placed in the remaining 70 patients (13.0%). Although the primary failure rate was significantly higher in patients assessed by duplex ultrasound (P = 0.001), ultrasound information changed the clinical plan, increasing AVF use for dialysis, in 92 of the 188 patients (48.9%) with an insufficient physical examination. Female sex and diabetes mellitus were risk factors significantly associated with primary AVF failure. Because of different inclusion criteria and a lack of adjustment for baseline differences, Kaplan-Meier survival analysis showed better AVF outcomes in patients assessed by physical examination alone; an insufficient physical examination was the only risk factor significantly associated with AVF outcomes. CONCLUSION: Routine use of duplex ultrasound is not necessary in chronic kidney disease patients with a satisfactory physical examination. Given that female gender and diabetes mellitus are significantly associated with primary AVF failure, duplex ultrasound could be of particular benefit in these subtypes of patients without a sufficient physical examination.
Arteriovenous Fistula* ; Demography ; Diabetes Mellitus ; Dialysis ; Female ; Humans ; Kidney Failure, Chronic ; Physical Examination ; Renal Dialysis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors ; Transplants ; Treatment Outcome ; Ultrasonography

OBJECTIVE: Previous studies showing the association of exposure to peer (PeVA) and parental verbal abuse in childhood with structural alterations in the young adult brain suggest functional changes in adolescence. In this functional MRI study, we investigated the effects of exposure to PeVA, during elementary and middle school periods, on brain response to emotional words, in high school students. METHODS: An emotional Stroop task consisting of swear, negative, positive, and neutral words was performed during functional MRI scan for 23 subjects who were divided into low- and high exposure groups to PeVA. RESULTS: High-PeVA group had a higher depression score, greater left ventrolateral prefrontal cortex (VLPFC) activity, and higher left VLPFC-left hippocampus connectivity in swear word conditions. The VLPFC activity and left VLPFC-left hippocampus connectivity was negatively related to the severity of anxiety and depressive symptoms, respectively. CONCLUSION: These preliminary findings support the hypothesis that exposure to PeVA, during childhood, is an aversive stimulus associated with meaningful functional change in emotional regulation network, showing hypersensitivity to swear words, at middle adolescence.
Adolescent* ; Anxiety ; Brain ; Depression ; Hippocampus ; Humans ; Hypersensitivity ; Magnetic Resonance Imaging ; Parents ; Prefrontal Cortex* ; Young Adult

BACKGROUND: Technique failure is an important issue for peritoneal dialysis (PD) patients. In this study, we aimed to analyze technique failure rate in detail and to determine the predictors for technique failure in Korea. METHODS: We identified all patients who had started dialysis between January 1, 2005, and December 31, 2008, in Korea, using the Korean Health Insurance Review and Assessment Service database. A total of 7,614 PD patients were included, and the median follow-up was 24.9 months. RESULTS: The crude incidence rates of technique failure in PD patients were 54.1 per 1,000 patient-years. The cumulative 1-, 2-, and 3-year technique failure rates of PD patients were 4.9%, 10.3%, and 15.6%, respectively. However, those technique failure rates by Kaplan–Meier analysis were overestimated compared with the values by competing risks analysis, and the differences increased with the follow-up period. In multivariate analyses, diabetes mellitus and Medical Aid as a crude reflection of low socioeconomic status were independent risk factors in both the Cox proportional hazard model and Fine and Gray subdistribution model. In addition, cancer was independently associated with a lower risk of technique failure in the Fine and Gray model. CONCLUSION: Technique failure was a major concern in patients initiating PD in Korea, especially in diabetic patients and Medical Aid beneficiaries. The results of our study offer a basis for risk stratification for technique failure.
Diabetes Mellitus ; Dialysis ; Follow-Up Studies ; Humans ; Incidence ; Insurance, Health ; Korea ; Multivariate Analysis ; Peritoneal Dialysis* ; Proportional Hazards Models ; Risk Factors ; Social Class