PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients’ hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155–2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152–3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070–5.561) at living alone patients. Conclusion This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.

BACKGROUND AND OBJECTIVES: Compared to other target cells examined for gene therapy, vascular smooth muscle cells (VSMCs) have the unique advantages including proximity to blood stream and relative abundance in vasculature. With an ultimate goal of developing VSMC-based therapies for cardiovascular disorders, we explored the utility of VSMC as a target cell for ex vivo gene therapy using a set of retroviral vectors. MATERIALS AND METHODS: Cultured VSMCs were transduced with replication-defective recombinant retroviruses harboring LacZ, nlsLacZ, mVEGF, mGM-CSF or bacterial CAT reporter. The VSMCs were examined for G418-selection, transduction efficiency, the level of transgene expression, and longevity of gene expression. ResultsVSMCs were readily transduced with different kinds of retroviral vectors. The bacterial neo r gene-transduced VSMCs were successfully selected with G418. The G418-selected VSMCs could express the transduced genes at a level comparable to NIH3T3. The level of transgene expression did not appear to be affected by the increasing number of passages. CONCLUSION: The results demonstrate an efficient transduction of VSMCs by retroviral vectors in vitro and an sustained expression of retrovirally transduced genes in VSMCs. VSMCs could be one of the ideal target cells for ex vivo cardiovascular gene therapy employing retroviral vector.
Animals ; Cats ; Gene Expression ; Genetic Therapy* ; Longevity ; Muscle, Smooth, Vascular* ; Retroviridae ; Rivers ; Transgenes ; Zidovudine

PURPOSE: The purpose is to correlate computed tomographic findings classified according to the degree of disease severity(grading A-E) with clinical course of acute pancreatitis. MATERIALS AND METHODS: in a retrospective review of 42 patients with acute pancreatitis, computed tomographic scans were classifed according to the degree of disease severity, and were correlatd with the clinical course. RESULTS: Pancreatic abscesses were seen in 14.3% and occured in 35.7% of grade D and E patients. Three patients with abscess died. Fatty infiltration of the liver was noted in 16.7%, pleural effusion in 21.4%.. stones and thickened wall of the gallbladder were present in 7.1% and in 9.5%, respectively. CONCLUSION: Our data indicate that phlegmonous extrapancreatic spread on initial CT scan had a high predictive value of the patients, prognosis.
Abscess ; Cellulitis ; Gallbladder ; Humans ; Liver ; Pancreatitis* ; Pleural Effusion ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study is to evaluate the normal anatomy of the lymphatic system draining the biliary trees and the prevalence of variable lymphatic spread of primary biliary carcinoma into these extrahepatic planes. MATERIALS AND METHODS: We reviewed 46 pathologically confirmed among 116 cases underwent abdominal CT. RESULTS: Of 17 patients with gallbladder cancer, nodal metastsis was proved in 10(59%) cases, direct organ invasion in 3(18%) cases, and peritoneal spread in 2(12%) cases. After a radicaloperation, nodal invasion was developed in 4 patients and peritoneal spread in 5 patients. Of 11 patients with hilar cholangiocarcinoma, nodal metastasis was proved in 6(55%) patients. Four patients developed paritoneal dissemination later. Of 18 patients with extrahepatic cholangiocarcinoma, however, nodal metastasis was proved in only 6(33%), but 5 among 12 patients who took a radical operation showed recurrence. CONCLUSION: The lymph node of the foramen of Winslow and pancreaticoduodenal lymph node were prevalent sites in the nodal metastasis of biliary carcinoma and CT was helpful in the indentification of this lymphadenopathy and extrabiliary spread on both initial and follow-up studies.
Cholangiocarcinoma ; Follow-Up Studies ; Gallbladder Neoplasms ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphatic System ; Neoplasm Metastasis* ; Prevalence ; Recurrence ; Tomography, X-Ray Computed

PURPOSE: Radiofrequency ablation (RFA) of lung cancer in animals and humans has been described in previously published reports. The aim of this study was to present our preliminary experience of treatment of lung cancer involving this approach. MATERIALS AND METHODS: Eight patients with lung malignancies [stage IIIB or IV bronchogenic adenocarcinoma (n=6), metastatic squamous cell carcinoma (n=1), metastatic hepatocellular carcinoma (n=1)] underwent RFA treatment. In all cases LeVeen-type electrodes were employed and CT was used to monitor the procedure. One-day and one-month follow-up CT scans were obtained and analyzed. RESULTS: Prior to treatment, tumor diameter ranged from 2.5 to 5 cm; afterwards, low attenuation consistent with coagulative necrosis was observed. Complications included a small amount of pneumothorax (n=4), pleural effusion (n=8), and subcutaneous emphysema (n=1). Tumor size decreased in five patients, was unchanged in two, and increased in one. CONCLUSION: Radiofrequency ablation of lung cancer is safe and may result in a reduced tumor burden.
Adenocarcinoma ; Animals ; Carcinoma, Hepatocellular ; Carcinoma, Squamous Cell ; Catheter Ablation* ; Electrodes ; Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Necrosis ; Pleural Effusion ; Pneumothorax ; Subcutaneous Emphysema ; Tomography, X-Ray Computed ; Tumor Burden

PURPOSE: To compare the effect of humidified high flow nasal cannula (HHFNC) with that of nasal continuous positive airway pressure (NCPAP) as the mode of extubation in very low birth weight infants (VLBWI). METHODS: Medical records were retrospectively reviewed for 219 VLBWI who were admitted to the neonatal intensive care unit of Ajou University Hospital from January 2009 through December 2012; 87 were supported by noninvasive ventilation (NIV) after extubation (HHFNC n=47, NCPAP n=40). Extubation failure was defined as the need for reintubation within 1 week of extubation. RESULTS: (1) There were no significant differences between the groups in demographic data such as gestational age, birth weight, and age at extubation. (2) There were no significant differences in fraction of inspired oxygen (FiO2) (HHFNC 0.23+/-0.03 vs. NCPAP 0.23+/-0.03, P-value .937) and peak inspiratory pressure (HHFNC 11+/-6.6 cmH2O vs. NCPAP 10.3+/-3.4 cmH2O, P-value .559) before extubation. (3) The rate of extubation failure and FiO2 values after extubation were similar in the 2 groups (extubation failure, HHFNC 5/47 vs. NCPAP 5/40, P-value 1.000; FiO2, HHFNC 0.24+/-0.05 vs. NCPAP 0.25+/-0.04, P-value .399). (4) Among patients who received NIV after extubation once but did not receive further intubation, the duration of NIV or duration of oxygen supply were not significantly different between the groups (NIV, HHFNC 12.4+/-9.1 days vs. NCPAP 8.7+/-12.3 days, P-value .159, oxygen supply, HHFNC 49.0+/-40.3 days vs. NCPAP 50.9+/-41.3 days, P-value .844) or bronchopulmonary dysplasia rate (HHFNC 24.3% vs. NCPAP 34.4%, P-value .430). CONCLUSION: HHFNC is as effective as NCPAP for weaning VLBWIs from invasive mechanical ventilation.
Airway Extubation ; Birth Weight ; Bronchopulmonary Dysplasia ; Catheters* ; Continuous Positive Airway Pressure ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Intubation ; Medical Records ; Noninvasive Ventilation ; Oxygen ; Respiration, Artificial ; Retrospective Studies ; Weaning

The STRATUS CS200 (Siemens Healthcare Diagnostics Inc., USA) has recently been developed as an on-site diagnostic instrument for assaying several kinds of cardiac markers within a short duration. The precision, linearity, comparison, limit of quantification, and turnaround time (TAT) were evaluated for troponin I, creatine kinase-MB (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), and myoglobin assays according to guidelines provided by the Clinical and Laboratory Standards Institute. The total coefficients of variation of the four items were between 1.90% and 4.25%. All markers showed a linearity that was ≥0.99, and the values were within the manufacturer's range. All items showed a close correlation with E170 (Roche Diagnostics, Germany). The limits of quantification for troponin I, CK-MB, myoglobin, and NT-proBNP were 0.03 ng/mL, 0.3 ng/mL, 1 ng/mL, and 15 pg/mL, respectively. The TAT was 14 minutes. The performance of the STRATUS CS200 for assaying cardiac markers was highly satisfactory in terms of the precision, linearity, limit of quantification, and TAT, and it showed a good correlation with the comparative method.
Creatine ; Delivery of Health Care ; Methods ; Myoglobin ; Troponin I

BACKGROUND: Early detection of moderately increased albuminuria using the albumin-creatinine ratio (ACR) test is very important for preventing renal insufficiency and cardiovascular disease in patients with diabetes. The purpose of this study was to analyse the clinical usefulness of the Afinion AS100 Analyzer (Alere Technologies AS, Norway) for determining the ACR by evaluating its precision and linearity and comparing it with another conventional device. METHODS: Urine samples of patients and quality control materials were used for evaluation. The Afinion AS100 was used to measure albumin and creatinine, and the ACR was automatically calculated. The Cobas Integra 800 (Roche Diagnostics, Germany) was used as a reference instrument for correlation analysis. In accordance with the Clinical and Laboratory Standards Institute guidelines, precision, linearity, and turnaround time were evaluated, and the Afinion AS100 was compared with another device. RESULTS: The total coefficients of variation of albumin and creatinine were 2.8% and 2.9% for high concentration and 2.9% and 2.5% for low concentration, respectively. Both albumin and creatinine showed coefficients of determination of 0.999 or higher in linearity. Correlation coefficients of albumin, creatinine, and ACR were higher than the Clinical and Laboratory Standards Institute recommended value of 0.975, suggesting a high correlation as well as showing significant correlation with a 24-hour urinary albumin level obtained using the Cobas Integra 800. Mean turnaround time was 5 minute 35 seconds. CONCLUSIONS: The albumin, creatinine, and ACR tests performed with the Afinion AS100 showed satisfactory performance in terms of precision and linearity and showed good correlation with the central laboratory instrument and a 24-hour urine albumin quantitative test using a conventional instrument.
Albuminuria ; Cardiovascular Diseases ; Creatinine* ; Humans ; Quality Control ; Renal Insufficiency

PURPOSE: To compare the three-dimensional gadolinium-enhanced MR angiography with digital subtraction angiography (DSA) for evaluation of the pedal artery. MATERIALS AND METHODS: In 12 extremities of 11 patients, both digital subtraction angiography (DSA) and contrast-enhanced MR angiography (CE-MR angiography) were performed during the same week. Among ten of the 11 patients, the following conditions were present: atherosclerosis (n=4), diabetic foot (n=3), Buerger's disease (n=1), calciphylactic arteriopathy (n=1) and arteriovenous malformation of the foot (n=1). The remaining patient underwent angiography prior to flap surgery. For MR angiography, a 1.5T system using an extremity or head coil was used. A three-dimensional FISP (fast imaging with steady state precession) sequence was obtained before enhancement, followed by four sequential acquisitions (scan time, 20 secs; scan interval time, 10 secs) 10 seconds after intravenous bolus injection of normal saline (total 10 cc), following intravenous adminstration of gadolinium (0.02 mmol/kg, 3 ml/sec). Arterial segments of the ankle and foot were classified as the anterior or posterior tibial artery, the distal peroneal artery, the medial or lateral plantar artery, the pedal arch, and the dorsalis pedis artery. Two radiologists independently analysed visualization of each arteraial segment and the mean of visible arterial segments in one extreminty using CE-MR angiography and DSA. RESULTS: Among 84 arterial segments, 16 were invisible at both CE-MR angiography and DSA, while 39 were demonstrated by both modalities. Twenty-six segments were visible only at CE-MR angiography and three only at DSA. CE-MR angiography displayed a higher number of arterial segments than DSA (mean, 5.42 vs. mean 3.50, respectively), a difference which was statistically significant (p<0.000). The difference between each arterial segment was not statistically significant, except for the dorsalis pedis artery (t test, p<0.000). CONCLUSION: In that it provides additional information for the planning of treatment of lower-extremity arterial disease, three-dimensional CE-MR angiography is superior to DSA for evaluation of the pedal artery.
Angiography* ; Angiography, Digital Subtraction* ; Ankle ; Arteries* ; Arteriovenous Malformations ; Atherosclerosis ; Diabetic Foot ; Extremities ; Foot ; Gadolinium ; Head ; Humans ; Thromboangiitis Obliterans ; Tibial Arteries