Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

OBJECTIVE: The purpose of this retrospective study is to determine the accuracy of maximum intensity projection (MIP) images of computed tomographic angiography (CTA) for diagnosis of cerebral vasospasm (CV) following subarachnoid hemorrhage (SAH) compared with that of digital subtraction angiography (DSA). MATERIALS AND METHODS: For patients admitted to our hospital for SAH, MIP images of CTA and DSA were checked at admission, and images were taken again 1 week later. This protocol was used in 39 cases. MIP images of CTA and DSA examinations were reviewed by two independent readers. RESULTS: Accuracy of MIP images of CTA in various arterial segments, using DSA as the gold standard: the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for different segments varied from 84 to 97, 33–100, 84–100%, 25–85, and 79–97%, respectively, for readers. Accuracy of CTA in various vasospasm severity, using DSA as the gold standard: the sensitivity, specificity, PPV, NPV, and accuracy for different vasospasm severity varied from 44 to 100, 69–100, 36–100%, 61–100, and 88–100%, respectively, for readers. Accuracy of CTA in central segments versus peripheral segments, using DSA as the gold standard: the sensitivity, specificity, PPV, NPV, and accuracy for central segments and peripheral segments varied from 90 to 94, 68–83, 93–97%, 56–69, and 87–93%, respectively, for readers. CONCLUSION: MIP imaging of CTA is a useful modality when diagnosing CV after SAH.
Angiography* ; Angiography, Digital Subtraction* ; Diagnosis* ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Subarachnoid Hemorrhage* ; Vasospasm, Intracranial*

The aim of this study was to determine if a 457 nm blue laser could effectively polymerize dental composite resins. After light curing 6 dental composite resins using a laser or a LED light-curing unit at 530 mW/cm2 and 900 mW/cm2, respectively, degree of conversion and microhardness were evaluated. Degree of conversion of specimens by the laser and LED was similar (on top surface 54.4–67.7% and 55.2–67.1%, respectively; on bottom surface 35.1–53.8% and 45.4–53.1%, respectively). Microhardness was also similar (on top surface 28.5–83.6 Hv and 19.1–82.4 Hv, respectively; on bottom surface 22.5–65.4 Hv and 16.8–74.4 Hv, respectively), although, in some cases, laser-treated specimens showed slightly lower microhardness than the LED-treated on bottom surface. The present study shows that the 457 nm laser can polymerize dental composite resins to the same level as LED achieved.
Composite Resins ; Polymerization ; Polymers

PURPOSE: To determine adequate timing of acquisition of contrast-enhanced fluid attenuated inversion recovery (FLAIR) by using multiphasic contrast-enhanced FLAIR magnetic resonance imaging (MRI) and to evaluate added value in detecting small intracerebral metastases 5 mm or less. MATERIALS AND METHODS: Twenty-nine patients, that underwent multiphasic contrast-enhanced FLAIR MRI and contrast-enhanced T1 weighted image (T1WI) were included and total number of small intracerebral metastases was 131. Sensitivity, specificity and accuracy of lesion detection were evaluated. Contrast ratio (CR) and enhancement ratio of each lesion were compared and analyzed among each imaging sequence. RESULTS: Sensitivity, specificity and accuracy of lesion detection were increased when contrast-enhanced FLAIR was added to contrast-enhanced T1WI. Area of under receiver operating characteristic curve significantly increased by addition of contrast-enhanced FLAIR than using contrast-enhanced T1WI alone (p < 0.05). CR was significantly higher in contrast-enhanced T1WI than FLAIR (p < 0.001). All of the above results were not different according to time of acquisition of contrastenhanced FLAIR. CONCLUSION There was advantage of conducting contrast-enhanced FLAIR MRI, but multiphasic contrast-enhanced FLAIR did not provide additional information for detection of small intracerebral metastases compared with single-phase FLAIR MRI.

OBJECTIVES: The aims of this study were to explore ways in which social adjustment (SA) is enhanced and to investigate the structure of relationships among mental health state (MHS), the de-velopment of personal skills (DPS), and the development of environmental resources (DER) through structural equation modelling. METHODS: The research data were gathered by collecting self-administered questionnaires from 689 service users recruited from 62 mental health organizations in South Korea. RESULTS: Firstly, in the result of path estimates of measurement and theoretical model, especially MHS, the DER had a significant effect on the SA, the DER had a significant effect on the DPS, and the DPS had a significant effect on the SA. In contrast, MHS showed no significant effect on the DPS, and the DER showed no significant effect on the SA. Secondly, MHS and the DPS had direct effects on the SA, while the DER had indirect effects on the SA. Finally, the DER full mediating effects of between MHS and DPS ; another full mediating effects of DPS between DER and SA. CONCLUSION: Several intervention strategies for improving social adjustment were identified and presented. I found that much of your results section was difficult to understand without access to your full paper. For example, I have no details of your theoretical model and was unsure what form of structural equation modeling you used. My editing, especially of the way in which you reported your results, may therefore be inaccurate and certainly less helpful than I would have liked. Please accept my apologies for this.
Humans ; Mental Health ; Models, Theoretical ; Negotiating ; Surveys and Questionnaires ; Social Adjustment

BACKGROUND: Death from coronary heart disease is increasing and this study is to evaluate the effect of longitudinal changes of lifestyle and biological parameters on the blood lipid levels, as the risk factor of the coronary heart disease. METHODS: Total cholesterol and total cholesterol to HDL-cholesterol ratio (atherosclerogenic index) as an indicator for risk of coronary heart disease were examined longitudinally in a sample (n = 463) of middle-aged men by 2 years. The independent variables were body mass index, smoking, alcohol, exercise, diastolic blood pressure, uric acid. All data was drawn from questionnaire, blood chemistry, and review of chart. RESULTS: ANOVA test according to categorized variables revealed that for total cholesterol, uric acid (P<0.01) and diastolic blood pressure (P<0.01), and for atherosclerogenic index, and body mass index (P<0.001) were significant. In correlation analysis, total cholesterol was associated with uric acid (r=0.20, P<0.001), diastolic blood pressure (r=0.15, P <0.001) and body mass index (r=0.03, P<0.05), and for atherosclerogenic index so was body mass index (r=0.18, P<0.001). In regression, uric acid (beta=6.07, P <0.001), diastolic blood pressure (beta=0.36, P <0.01) for total cholesterol, and body mass index (beta=0.22, P <0.001) for atherosclerogenic index were significant. But changes in alcohol consumption, smoking, and exercise were not statistically significant. CONCLUSION: In order to reduce risks of coronary heart disease, the more aggressive medical intervention for the uric acid, DBP, and BMI, would be essential. This study was done without medical intervention. So, further study with intervention, adequate duration and intensity for parameters modification is required.
Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Chemistry ; Cholesterol ; Coronary Disease ; Humans ; Life Style* ; Male ; Middle Aged* ; Risk Factors ; Smoke ; Smoking ; Uric Acid ; Surveys and Questionnaires

No abstract available.
Diagnosis* ; Postpartum Period* ; Pregnancy* ; Thyroid Diseases*

BACKGROUND: Mitral valve repair for posterior mitral leaflet (PML) prolapse has been considered to be a standard treatment because of its high success rate and high level of patient satisfaction. The aim of this study was to evaluate the clinical results of two different techniques of PML prolapse, quadrangular resection (QR) and chordal replacement (CR). MATERIALS AND METHODS: The subjects consisted of 56 patients who had undergone mitral valve repair for PML prolapse between November 1997 and December 2010. The patients were divided into two groups according to surgical technique. Among them, 31 patients underwent QR (group QR) and 25 patients had CR (group CR). We reviewed the medical records of the patients retrospectively to compare the clinical outcomes of both groups. RESULTS: After mitral valve repair, the degree of mitral regurgitation (MR) in both groups decreased to the to a mild degree or less and the amount of remnant MR was slightly higher in the CR group but it was not statistically different. Three patients received mitral valve-related reoperation (2 in the QR group and 1 in the CR group). Freedom from mitral valve-related reoperation at 7 years was 93% for the QR group and 96% for the CR group and was not significantly different between the two groups. CONCLUSION: Both QR and CR showed excellent long-term results and were considered equally effective methods for PML prolapse.
Chordae Tendineae ; Freedom ; Humans ; Medical Records ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Patient Satisfaction ; Prolapse ; Reoperation ; Retrospective Studies

BACKGROUND: A ring implantation in the tricuspid annulus requires many interrupted mattress sutures for correction of tricuspid regurgitation (TR). In this study, tricuspid ring annuloplasty was performed by 2-0 polypropylene continuous suture instead of multiple interrupted 2-0 polyester mattress sutures, and the efficacy of the method was evaluated. MATERIALS AND METHODS: This study included 20 patients who underwent tricuspid ring annuloplasty by continuous suture between May 2009 and July 2010. Four of the patients had an isolated TR, and the rest had a left-sided cardiac lesion. The concomitant tricuspid annuloplasty was performed after the left-sided heart surgery was completed and a Duran flexible ring prosthesis was used. RESULTS: There was no perioperative mortality or conduction problem. More than a moderate degree of TR was improved to less than a mild degree after the procedure. After the ring annuloplasty, the right atrial volume decreased from 123.7+/-69.2 mL to 74.5+/-37.4 mL, and the mean right atrial pressure was lowered from 18.7+/-12.2 mmHg to 8.9+/-5.5 mmHg. CONCLUSION: The continuous "over and over" suture may be a useful procedure for fixing the ring to the annulus and making an intentional annular placation in performing tricuspid ring annuloplasty.
Atrial Pressure ; Humans ; Polyesters ; Polypropylenes ; Prostheses and Implants ; Sutures ; Thoracic Surgery ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Although cervical epidural abscess is rare, it should be strongly suspected in any patient with unexplainable neck pain and fever, especially when the patient has a predisposing factor for this infectious process. The authors report a case of cervical epidural abscess in a 39-yr-old man with an aorto-duodenal fistula, which complicated the interposition of artificial graft for abdominal aortic aneurysm rupture, which had undertaken 40 months before. Timely detection and intervention rendered him a full neurological recovery. This extremely rare case is presented with a literature review.
Adult ; Aneurysm, Dissecting/complications ; Aneurysm, Dissecting/surgery ; Aortic Aneurysm, Abdominal/complications ; Aortic Aneurysm, Abdominal/surgery ; Aortic Diseases/complications* ; Aortic Rupture/complications ; Aortic Rupture/surgery ; Blood Vessel Prosthesis Implantation ; Cervical Vertebrae* ; Duodenal Diseases/complications* ; Duodenal Ulcer/complications ; Enterococcus ; Epidural Abscess/etiology* ; Epidural Abscess/microbiology ; Epidural Abscess/surgery ; Fistula/complications* ; Gram-Positive Bacterial Infections/complications ; Human ; Male ; Peptic Ulcer Perforation/complications ; Salmonella Infections/complications ; Staphylococcal Infections/complications