No abstract available.
Doxorubicin* ; Drug Therapy, Combination* ; Etoposide* ; Fluorouracil* ; Mitomycin* ; Retrospective Studies* ; Stomach Neoplasms*

Hypertrophic olivary degeneration (HOD) is regarded as a secondary degenerative change subsequent to the formation of lesions in the "Guillain-Mollaret Triangle," and this is the result of the loss of transsynaptic neurologic input to the inferior olivary nucleus. HOD usually occurs unilaterally, but bilateral hypertrophic olivary degeneration is known to be rare. We experienced one case of this lesion, and we report here on the bilateral HOD that was secondary to infarction of the brainstem and cerebellum.
Brain Stem* ; Cerebellum* ; Infarction* ; Olivary Nucleus*

PURPOSE: The most important step for patients who come to the emergency department with ureter stones is acute pain management. There have been insufficient studies on what factors affect acute pain management for ureteral colic the most. In this study, patients with ureteral colic were divided into two groups: one group, in which the pain was first managed with an analgesic, and another group with unmanaged pain, to find factors that most affect additive analgesics administration for ureter stones. METHODS: There were 121 patients, eventually confirmed for the presence of ureter stones through a computed tomography CT scan, included in this study. When ureter stones were suspected after the initial patient evaluation, initial pain was assessed through numerical rating scale (NRS) and the first analgesic was administered once. Pain was reassessed through NRS after 30 minutes. At that time, if the pain was managed, the patient was assigned to Group 1. If the pain persisted, another analgesic was administered for the second and third time, and the patient was assigned to Group 2. Finally, ureter stones were identified through CT scan. RESULTS: There were 58 patients (47.9%) in Group 1 and 63 patients (52.1%) in Group 2. There were no statistically significant differences in average age, serum creatinine, size of ureter stone, and severity of hematuria between the two groups. The differences in NRS measured initially and after 30 minutes were statistically significant (7.6+/-1.4 vs. 8.6+/-1.2, p<0.001; 1.4+/-1.3 vs. 6.6+/-1.9, p<0.001, respectively). The presence of hydronephrosis and perirenal edema were also statistically significant (p<0.001, p=0.007). The affecting factor for the administration of additive analgesics was hydronephrosis (odds ratio 7.213, p<0.001). CONCLUSION: Hydronephrosis is an important factor in the treatment of patients with additive analgesics. It can also be used as a predictive index to assess the severity of pain in patients with ureter stones.
Acute Pain ; Analgesics ; Creatinine ; Edema ; Emergencies ; Hematuria ; Humans ; Hydronephrosis ; Renal Colic ; Ureter ; Urolithiasis

We evaluated the relationship between preoperative risk factors[gestational age, birth weight, postconceptual age and weight at operation, duration of operation, duration of anesthesia, abnormalities in neurosonogram, bronchopulmonary dysplasia]and apnea with or without bradycardia, for which mechanical ventilation was necessary after general anesthesia in the surgical treatment of retinopathy of prematurity[ROP]. Thirty-eight patients [21%]developed apnea and thirteen patients[7%]had bradycardia out of 183 patients. Retrospective study was performed and risk factors were analyzed by logistic regression. Gestational age, birth weight, postconceptual age and weight at operation and bronchopulmonary dysplasia showed the positive correlation with postanesthetic apnea and bradycardia. Duration of operation showed the positive correlation with postanesthetic apnea but not with postanesthetic bradycardia. In logistic regression without confoundings, weight at operation and bronchopulmonary dysplasia were correlated with postanesthetic apnea. Receiver operating characteristic curve analysis revealed that patients with weight under 2, 600gm at operation suffered from apnea more frequently than those with weight over 2, 600gm. In conclusion, patients with weight under 2600gm or bronchopulmonary dysplasia are at greater risk for postanesthetic apnea and optimal pre-and postanesthetic management should be prepared for these patients.
Anesthesia ; Anesthesia, General* ; Apnea* ; Birth Weight ; Bradycardia ; Bronchopulmonary Dysplasia ; Gestational Age ; Humans ; Infant, Newborn ; Logistic Models ; Respiration, Artificial ; Retinopathy of Prematurity* ; Retrospective Studies ; Risk Factors* ; ROC Curve

BACKGROUND: Laser therapy for various skin conditions is one of the most common procedures in dermatology. Recently, several articles described the use of 1064 nm Q-switched Nd:YAG lasers for the treatment of benign skin lesions. Such treatment is known to trigger its therapeutic effect through a photoacoustic effect and selective photothermolysis effect. However, only a limited number of articles have dealt with the theoretical base of the photoacoustic effect of the 1064 nm Q-switched Nd:YAG laser. OBJECTIVE: To compare the wound repair process and nonselective tissue heat damage induced by three different laser modalities: the CO2 laser, Er:YAG laser, and 1064 nm Q-switched Nd:YAG laser. METHODS: We irradiated the skin of an albino rat (Sprague Dawley(R), 200~250 g) with CO2, Er:YAG, and 1064 nm Q-switched Nd:YAG lasers. Skin biopsy specimens of the irradiated areas were collected on the first, fifth, and tenth day after laser exposure. For histologic analysis, the specimens were stained with the H&E, Verhoff-Van Gieson, and Masson's trichrome protocols. RESULTS: Compared with other laser modalities, rat skin irradiated by the 1064 nm Q-switched Nd:YAG laser showed the least amount of heat damage and the quickest tissue repair response to the damage. CONCLUSION: A 1064 nm Q-switched Nd:YAG laser with a photoacoustic effect capable of ablating the epidermis and dermis can be a proper treatment modality for the removal of benign skin lesions. The 1064 nm Q-switched Nd:YAG laser may be considered as an alternative treatment option for the treatment of benign skin lesions.
Animals ; Biopsy ; Dermatology ; Dermis ; Epidermis ; Hot Temperature ; Laser Therapy ; Lasers, Gas ; Rats* ; Skin* ; Wounds and Injuries*

Uterine leiomyosarcoma is a rare malignant tumor, and distant metastasis to skull bone is very uncommon. We experienced a case of parietal skull bone metastasis from uterine leiomyosarcoma in a 52-year-old woman who had undergone simple total hysterectomy and bilateral salpingoophorectomy with the diagnosis of uterine myoma. We treated this patient with combination chemotherapy using cisplatin and adriamycin and radiotherapy after craniectomy. She is alive now without particular symptoms. We report this case with a brief review of some literatures.
Cisplatin ; Diagnosis ; Doxorubicin ; Drug Therapy, Combination ; Female ; Humans ; Hysterectomy ; Leiomyoma ; Leiomyosarcoma* ; Middle Aged ; Neoplasm Metastasis* ; Rabeprazole ; Radiotherapy ; Skull*

OBJECTIVES: To integrate the results of studies which assess an association between blood lead and blood pressure. METHODS: We surveyed the existing literature using a MEDLINE search with blood lead and blood pressure as key words, including reports published from January 1980 to December 2000. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers exposed to lead, and 2) both blood pressure and blood lead must have been measured and presented with sufficient details so as to estimate or calculate the size of the association as a continuous variable. Among the 129 articles retrieved, 13 studies were selected for quantitative meta-analysis. Before the integration of each regression coefficient for the association between blood pressure and blood lead, a homogeneity test was conducted. RESULTS: As the homogeneity of studies was rejected in a fixed effect model, we used the results in a random effect model. Our quantitative meta-analysis yielded weighted regression coefficients of blood lead associated with systolic blood pressure and diastolic blood pressure results of 0.0047 (95% confidence interval [CI]: -0.0061, 0.0155) and 0.0004 (95% CI: -0.0031, 0.0039), respectively. CONCLUSIONS: The published evidence suggested that there may be a weak positive association between blood lead and blood pressure, but the association is not significant.
Blood Pressure*

BACKGROUND AND OBJECTIVES: It has been known that MMP-9, TIMP-1, and VEGF play an important role in the formation of nasal polyps (NPs). The aim of this study is to investigate the effect of smoking on the expression of MMP-9, TIMP-1 and VEGF in the epithelial cells and fibroblasts of NPs. MATERIALS AND METHODS: The epithelial cells and fibroblasts of NPs obtained from 10 patients who underwent endoscopic sinus surgery were cultured and used. The prepared CSE concentrations were 5%, 1%, 0.5% and 0.1%. In the control group, cells were cultured for 9 hours in the media containing 1 ml of AEGM and DMEM/F-12K. In the CSE group, cells were treated with 5%, 1%, 0.5% and 0.1% CSE for 9 hours. After washing with PBS, cells were cultured in medium for 24 hours. ELISA was performed to measure the secretion of MMP-9, TIMP-1 and VEGF proteins and real-time PCR was performed to assay their mRNAs. RESULTS: The production of MMP-9, TIMP-1 and VEGF proteins did not change significantly in comparison with the control group in epithelial cells and fibroblasts after exposure to CSE. CONCLUSION: These results suggest that CSE does not appear to have an effect on the expression of MMP-9, TIMP-1 and VEGF for developing and growth of nasal polyposis.
Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Fibroblasts ; Humans ; Nasal Polyps ; Proteins ; Real-Time Polymerase Chain Reaction ; Smoke ; Smoking ; Tissue Inhibitor of Metalloproteinase-1 ; Tobacco Products ; Vascular Endothelial Growth Factor A

PURPOSE: This study investigated the clinical presentations of symptomatic Clostridium difficile infection (CDI) in children. METHODS: We reviewed the medical records of 43 children aged <20 years who showed either positive C. difficile culture or C. difficile toxin test results between June 2010 and April 2014. RESULTS: Of the 43 patients (mean age 6.7 years), 22 were boys. Sixteen patients (37.2%) showed both positive C. difficile culture and toxin test results. Seventeen out of 43 children (39.5%) had preexisting gastrointestinal diseases, and 26 children had other medical conditions that were risk factors for CDI. Twenty-eight children had a history of antibiotic treatment for >3 days, and the most frequently prescribed antibiotic was amoxicillin-clavulanate (35.7%). Twenty-eight patients were diagnosed with CDI despite taking probiotic supplements, most commonly Lactobacillus acidophilus (53.6%). The most common symptom was diarrhea (72.1%) at the time CDI was diagnosed. C. difficile was eradicated in 11 patients (25.6%) after treatment with oral metronidazole for 10-14 days, and in the two patients (4.6%) who required two courses of oral metronidazole. Sixteen patients (37.2%) showed clinical improvement without any treatment. CONCLUSION: This study showed the various clinical characteristics of CDI in children and that preexisting clinical conditions favored the development of CDI. In addition, CDI was found to occur in a number of patients even after probiotic prophylaxis given in conjunction with antibiotic therapy.
Child* ; Clostridium difficile* ; Diarrhea ; Gastrointestinal Diseases ; Humans ; Lactobacillus acidophilus ; Medical Records ; Metronidazole ; Probiotics* ; Risk Factors

Purpose: To compare the per-patient diagnostic performance of simulated abbreviated MRI (AMRI) to that of conventional MRI (CMRI) with full-sequence dynamic gadoxetic acid (GA) enhancement for early-stage hepatocellular carcinoma (HCC) screening in high-risk patients. Materials and Methods: A total of 201 consecutive patients at high-risk for HCC, who underwent 3T liver MRI, were included in this retrospective study. The AMRI protocol comprised T2-weighted imaging, hepatobiliary phase imaging after GA injection, and diffusion-weighted imaging. For each patient, two AMRI and CMRI image sets were independently reviewed by two radiologists.Inter-reader agreement was assessed using Cohen’s kappa value. A composite reference standard was used to determine the diagnostic performance of each image set for each reader. Results: A total of 93 HCCs were detected in 79 patients. The inter-reader agreement was almost perfect for both image sets (κ = 0.839, 0.948). In AMRI, the per-patient sensitivity and negative predictive values (NPV) were 94.9% and 96.4%, respectively. In CMRI, the per-patient sensitivity and NPV were 96.2% and 97.5%, respectively. Conclusion AMRI, using only three sequences, had a comparable diagnostic performance to CMRI in screening early-stage HCC. AMRI could be an alternative HCC screening tool for highrisk HCC patients.