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.

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*

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

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

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

BACKGROUND: Although patients with end-stage renal disease (ESRD) experience excess mortality compared with the general population, the standardized mortality ratio (SMR) for Korean patients on dialysis has not yet been investigated. In this study, we evaluated the SMR among all Korean ESRD patients on maintenance ialysis in 2009 and 2010, and compared it according to age categories, sex, and dialysis modality. METHODS: We used data from all patients on maintenance dialysis between January 1, 2009 and December 31, 2010 in Korea using the database of the Korean Health Insurance Review and Assessment Service, and the SMR was determined by calculating of the ratio between the number of actual deaths and expected deaths. RESULTS: A total of 45,568 patients in 2009 and 48,170 patients in 2010 were included in the analysis. The overall age- and sex-adjusted SMR was 10.3 [95% confidence interval (CI), 10.0-10.6] in 2009 and 10.9 (95% CI, 10.7-11.2) in 2010. The SMR for females was much higher than for males. The SMR gradually decreased with increasing age groups. The overall SMR for maintenance hemodialysis patients was lower than that of peritoneal dialysis patients. CONCLUSION: The SMR among Korean ESRD patients is likely to be higher than in other countries. Further evaluation is needed to attempt to improve the outcomes.
Dialysis* ; Female ; Humans ; Insurance, Health ; Kidney Failure, Chronic ; Korea ; Male ; Mortality* ; Peritoneal Dialysis ; Renal Dialysis

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

BACKGROUND: Risk factors for bone avascular necrosis (AVN), a common late complication after kidney transplantation (KT), are not well known. METHODS: Patients that underwent living-donor KT at Asan Medical Center between January 2009 and July 2016 were included in this retrospective study to determine the incidence and risk factors for AVN after KT. RESULTS: Among 1,570 patients that underwent living-donor KT, 33 (2.1%) developed AVN during a mean follow-up of 49.8±25.0months. Additionally, AVN was diagnosed at a mean of 13.9±6.6 months after KT. The mean cumulative corticosteroid dose during the last follow-up in patients without AVN (9,108±3,400 mg) was higher than that that in patients with AVN (4,483±1,114 mg) until AVN development (P < 0.01). More patients among those with AVN (n=4, 12.1%) underwent steroid pulse treatment because of biopsy-proven rejections during the first 6 months after KT than patients without AVN (n=68, 4.4%; P=0.04). Female (hazard ratio [HR], 2.29; P=0.04) and steroid pulse treatment during the first 6 months (HR, 2.31; P=0.02) were significant AVN risk factors as revealed by the Cox proportional multivariate analysis. However, no significant differences in rejection-free graft survival rates were observed between the two groups (P=0.67). CONCLUSIONS: Steroid pulse treatment within 6 months of KT and being female were independent risk factors for AVN development.
Chungcheongnam-do ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Immunosuppression ; Incidence ; Kidney Transplantation* ; Kidney* ; Multivariate Analysis ; Necrosis* ; Osteonecrosis ; Retrospective Studies ; Risk Factors