PURPOSE: For the production and evaluation of the tissue-equivalent phantom. MATERIALS AND METHODS: We used agarous gel and oil as a basic component of the mixture and added Tween 80 for the stabilization of phantoms. We did the test for homogeneity and measured T1 and T2 relexation times of each phantom tube. RESULTS: T1 relaxation time ranged from 642 to 2781 msec and T2 relaxation times from 42 to 157 msec. Each phantom was significantly different in T1 relaxation time and T2 relaxation time (p < .0001). CONCLUSION: Tissue equivalent phantom may provide good information on the optimal sequence before MR imaging of patients and may be valuable if it is used with the patients' MR imaging.
Agar ; Humans ; Magnetic Resonance Imaging* ; Polysorbates ; Relaxation

The reliability of emergency ultrasonographic(US) detection of hemoperitoneum and solid organ injury in blunt abdominal trauma was evaluated retrospectively. From October 1,1995 to August 31,1996,90 patients were included in the study. Ultra- sonographic findings showed a sensitivity, specificity, and accuracy of 97.6%, 97.9%, and 98.1%, respectively, in detecting intraabdominal fluid collection. We believe that US in an emergency center is a quick, safe screening method in the evaluation of blunt abdominal trauma. In our department, US has replaced diagnostic peritonaeal lavage(DPL) and computed tomography(CT) as the screening study of first choice.
Emergencies* ; Hemoperitoneum* ; Humans ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

No abstract available.
Thyrotropin*

BACKGROUND: Reports on serum thyroglobulin(Tg) levels being used to predict recurrence or distant metastasis during the follow-up of patients with differentiated thyroid cancer(DTC) has been inconsistent. In addition, there have been few reports that attempt to define the cut-off value of Tg for recurrence or distant metastasis obtained by a receiver operating characteristic(ROC) curve. As well, there are differences in opinions on what the value should be on the first serum Tg level measured just before radioactive iodine(RAI) ablation(Tg-RAI), during thyroxine administration (Tg-on), and after thyroxine withdrawal(Tg-off) during the follow-up. Reports on the positive predictive values(PPVs) and negative predictive values(NPVs) of these Tg values are rare. METHODS: A total of 205 patients(42 males, 163 females) with DTC were studied. All patients had undergone total or near-total thyroidectomy. After surgery and RAI ablation, annual thyroxine withdrawal 131I-whole body scan(WBS) with Tg measurements was performed. The mean duration of follow-up was 5.0 (1.4~7.4) years. The most sensitive and specific Tg values(cut-off values) for tumor recurrence and/or distant metastasis were selected by using ROC curves. We also calculated the PPVs and NPVs for recurrence and/or distant metastasis using two-by-two tables. RESULTS: Cut-off values of Tg-RAI, Tg-on, and Tg-off for recurrence were 11.8, 1.4, and 3.3ng/mL, respectively. For these values, the sensitivities were 85.4, 82.2, and 93.3%, with the specificitiesat 89.2, 92.4, and 88.0%. PPVs were 71.9, 77.1, and 77.0% while NPVs were 95.0, 94,4, and 97.8%. The cut-off values for distant metastasis were 27.4, 2.5, and 7.9ng/mL, respectively. For these cut-off values, the sensitivities were 86.7, 87.5, and 92.3%, with the specificities being 86.2, 90.8, and 80.2%. PPVs were 34.2, 46.7, and 25.0% and NPVs were 98.7, 98.8, and 99.3%. CONCLUSION: All three serum Tg levels were sensitive and specific markers for recurrence and distant metastasis. Their PPVs were low in contrast to the high NPVs. In comparison with Tg-on, Tg-off showed higher sensitivity and NPV as well as lower specificity and PPV. Therefore, in the case of higher Tg-on during the follow-up period, efforts to find recurrence and distant metastasis,such as 131I-WBS, should be done. In addition, regular measurement of Tg-off or Tg after stimulation with recombinant human TSH is recommended as a screening test.
Follow-Up Studies ; Humans ; Male ; Mass Screening ; Neoplasm Metastasis* ; Recurrence* ; ROC Curve ; Sensitivity and Specificity ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin Alfa ; Thyroxine

No abstract available.
Closing Volume* ; Humans ; Posture* ; Pulmonary Ventilation*

OBJECTIVES: The purpose of this study was to investigate the characteristics of psychosocial factors related to functional dyspepsia(FD) and their effects on quality of life(QOL) in firefighters. METHODS: This study examined data collected from 1,217 firefighters. We measured psychological symptoms by Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder questionnaire(GAD-7), Korean Occupational Stress Scale(KOSS), Ways of Coping checklist(WCCL), Rosenberg's Self-Esteem Scale(RSES) and World Health Organization Quality of Life Scale abbreviated version(WHOQOL-BREF). Chi-square test, independent t-test, Pearson's correlation test, logistic regression analysis, and hierarchical regression analysis were used as statistical analysis methods. RESULTS: For the group with FD, the male participants showed significantly higher frequency(p=0.006) compared to the female participants. The group with FD had higher scores for depressive symptoms(p<.001), anxiety (p<.001), and occupational stress(p<.001), and did lower scores for self-esteem(p=.008), quality of life(p<.001) than those without FD. The FD risk was higher in the following KOSS subcategories: job demand(OR 1.94, 95% CI : 1.29-2.93), lack of reward(OR 2.47, 95% CI : 1.61-3.81), and occupational climate(OR 1.51, 95% CI : 1.01-2.24). In the hierarchical regression analysis, QOL was best predicted by depressive symptoms, self-esteem, and occupational stress. Three predictive variables above accounts for 42.0% variance explained of total variance. CONCLUSIONS: The psychosocial factors showed significant effects on FD, and predictive variables for QOL were identified based on regression analysis. The results suggest that the psychiatric approach should be accompanied with medical approach in future FD assessment.
Anxiety ; Anxiety Disorders ; Depression ; Dyspepsia* ; Female ; Firefighters* ; Humans ; Logistic Models ; Male ; Psychology* ; Quality of Life* ; World Health Organization

OBJECTIVE: Survivin is an inhibitor of apoptosis protein(IAP), which inhibits apoptosis through a pathway distinct from the Bcl-2 family members. Overexpression of survivin and Bcl-2 have been commonly reported in human neoplasms. The authors investigate whether there is a synergistic effect on the anti-apoptosis rate of primary brain tumors "in situ" based on the co-expression of survivin and Bcl-2. METHODS: One hundred and two brain tumor patients who had been resected were included in this study. Survivin and Bcl-2 were detected by Western blotting analysis, while apoptosis was examined by DNA fragmentation analysis. An anti-apoptotic rate was assessed in these brain tumor samples based on the expression of survivin and Bcl-2 or co-expression of both. RESULTS: Survivin and Bcl-2 were expressed in 57(55.9%) and 53(52.0%) of 102 brain tumor samples studied respectively, and co-expressed in 31(30.4%). The percentage of astrocytic and meningeal tumors expressing survivin was significantly correlated with histological grades; however, Bcl-2 was not correlated (p=0.106). The anti-apoptotic rate in primary brain tumors with survivin, Bcl-2, and both was detected in 49(86.0%) of 57 samples, 42(79.9%) of 53 samples, and 27(87.1%) of 31 samples, respectively. Their difference in the frequency of anti-apoptosis was not significant. CONCLUSION: Survivin or Bcl-2 is involved in the anti-apoptosis. However, it suggests that co-expression of survivin and Bcl-2, together, have no synergistic effect on the anti-apoptotic properties of the primary brain tumors.
Apoptosis ; Blotting, Western ; Brain Neoplasms* ; DNA Fragmentation ; Humans ; Meningeal Neoplasms

Sodium picosulfate/magnesium citrate (Picolight Powder), which is used as a bowel preparation for the colon and the rectum, can cause a severe electrolyte imbalance like hyponatremia. When hyponatremia gets severe or occurs rapidly, it can lead to death due to associated complications. We have experienced a case of hyponatremia associated with seizure and loss of consciousness in a 76-year-old woman, who took sodium picosulfate/magnesium citrate as a bowel preparation for colonoscopy. She was taking thiazide and synthroid for the treatment of hypertension and hypothyroidism, respectively, and she had other underlying medical conditions such as a history of seizure and dementia. Following the diagnosis of hyponatremia, we used an intravenous injection of 3% NaCl to normalize the sodium level in her serum, and her associated symptoms soon disappeared.
Aged ; Citric Acid* ; Colon ; Colonoscopy ; Dementia ; Diagnosis ; Female ; Humans ; Hypertension ; Hyponatremia* ; Hypothyroidism ; Injections, Intravenous ; Rectum ; Seizures* ; Sodium* ; Thyroxine ; Unconsciousness

PURPOSE: Uncontrolled bleeding is a leading cause of death in multiple-injury patients. It is very difficult to control hemorrhage due to microvascular injury in soft tissue by surgery or vascular intervention. Thus, hemostatic agents such as recombinant activated coagulation factor VII (rFVIIa) have become popular with regard to reducing transfusion volumes and correcting the hemorrhage-associated coagulopathy. METHODS: From March 2007 to January 2010 we used rFVIIa in 15 multiple-injury patients. Transfused packed red blood cell (pRBC) volume was compared before and 6 h after administration of rFVIIa. Complete blood count, prothrombin time and activated partial thromboplastin time were also checked. RESULTS: Mortality rate correlated strongly with initial severity of coagulopathy. Transfused pRBC volumes per hour were reduced significantly after rFVIIa (p=0.01), and coagulopathy was also significantly corrected. Thromboembolic events such as acute myocardial infarction and cerebrovascular attack, a fatal complication of rFVIIa, did not occur. CONCLUSION: The administration of rFVIIa can correct hemorrhage associated coagulopathy and reduce pRBCs transfusion volume. A quick decision regarding the administration of rFVIIa is needed for a more favorable outcome in multiple-injury patients with hemorrhagic shock.
Blood Cell Count ; Cause of Death ; Erythrocytes ; Factor VII ; Factor VIIa ; Hemorrhage ; Hemostasis ; Humans ; Multiple Trauma ; Myocardial Infarction ; Partial Thromboplastin Time ; Prothrombin Time ; Recombinant Proteins ; Shock, Hemorrhagic

PURPOSE: Uncontrolled bleeding is a leading cause of death in multiple-injury patients. It is very difficult to control hemorrhage due to microvascular injury in soft tissue by surgery or vascular intervention. Thus, hemostatic agents such as recombinant activated coagulation factor VII (rFVIIa) have become popular with regard to reducing transfusion volumes and correcting the hemorrhage-associated coagulopathy. METHODS: From March 2007 to January 2010 we used rFVIIa in 15 multiple-injury patients. Transfused packed red blood cell (pRBC) volume was compared before and 6 h after administration of rFVIIa. Complete blood count, prothrombin time and activated partial thromboplastin time were also checked. RESULTS: Mortality rate correlated strongly with initial severity of coagulopathy. Transfused pRBC volumes per hour were reduced significantly after rFVIIa (p=0.01), and coagulopathy was also significantly corrected. Thromboembolic events such as acute myocardial infarction and cerebrovascular attack, a fatal complication of rFVIIa, did not occur. CONCLUSION: The administration of rFVIIa can correct hemorrhage associated coagulopathy and reduce pRBCs transfusion volume. A quick decision regarding the administration of rFVIIa is needed for a more favorable outcome in multiple-injury patients with hemorrhagic shock.
Blood Cell Count ; Cause of Death ; Erythrocytes ; Factor VII ; Factor VIIa ; Hemorrhage ; Hemostasis ; Humans ; Multiple Trauma ; Myocardial Infarction ; Partial Thromboplastin Time ; Prothrombin Time ; Recombinant Proteins ; Shock, Hemorrhagic