HExDB is a database for analyzing exon and splicing pattern information in Homo sapiens. HExDB is useful for specific purposes: 1) to design primers for exon amplification from cDNA and 2) to understand the change of ORFs by alternative splicing. HExDB was constructed by integrating data from AltExtron which is the computationally predicted exon database, Ensemble cDNA annotation, and Affymetrix genome tile published recently. Although it may contain false positive data, HExDB is good starting point due to its sensitivity. At present, there are as many as 2,046,519 exons stored in the HExDB. We found that 16.8% of the exons in the database was constitutive exons and 83.1% were novel gene exons.
Alternative Splicing* ; Animals ; DNA, Complementary ; Ecthyma, Contagious ; Exons* ; Genome ; Humans* ; Open Reading Frames

Ocular symptoms related to orbital fracture occur immediately after the fracture in most cases. However, authors experienced a delayed onset diplopia occurred 16 months after orbital floor fracture. A 19-year-old man, who had right orbital floor fracture 16 months ago, presented with diplopia of upward gaze. At the time of the fracture, no surgery was performed because the fracture was minimal and there were no particular symptoms. Physical examinations revealed a minor ocular motility restriction of upward gaze, but orbital floor showed no definite interval change on computed tomography. Severe adhesion between the orbital fat tissue and orbital floor was noted intraoperatively and the adhesion was dissected. After the operation, the patient showed remarkable improvement in diplopia and restriction of the ocular motility.
Diplopia ; Floors and Floorcoverings ; Humans ; Orbit ; Orbital Fractures ; Physical Examination ; Young Adult

Peutz-Jeghers type hamartomatous polyp is known to be associated with Peutz-Jeghers syndrome, which shows characteristic multiple hamartomatous polyp involvement in the gastrointestinal tract, combined with mucocutaneous symptom, familial history of Peutz- Jeghers syndrome or STK11/LTB1 mutation. However, some cases showing histologic appearance of the polyps discovered in Peutz- Jeghers syndrome while lacking other diagnostic criteria of the syndrome have been reported, and these are called solitary Peutz- Jeghers type polyps. Herein, we report a case of solitary Peutz-Jeghers type polyp covered with heterotopic epithelium. The patient was 47-year-old female without any mucocutaneous symptoms nor familial history of Peutz-Jeghers syndrome. Microscopic examination revealed Peutz-Jeghers type hamartomatous polyp in duodenum covered with gastric type foveolar epithelium. Considering the definition of hamartomatous polyp, which is, the abnormal overgrowth of the indigenous epithelial component, the histological feature of current case is noteworthy in a point that it shows proliferation of heterotopic component, rather than the indigenous component.

No abstract available.
Central Nervous System* ; Humans ; Lymphoma* ; Methotrexate*

PURPOSE: The bedside lung ultrasound in emergency (BLUE) protocol is an excellent diagnostic tool for acute respiratory failures requiring admission to the intensive care unit. We incorporated cardiac ultrasound in the BLUE algorithm because cardiac origin is also necessary to examine in an emergency setting. We studied the usefulness of the emergency department (ED)-BLUE protocol for patients complaining of dyspnea in an emergency department. METHODS: At first, we assessed lung sliding, artifacts (Alines and B-lines), alveolar consolidation and pleural effusion on stage I and II evaluation. Then, we checked heart to detect 3Es (Effusion, Equality, and Ejection fractions). We divided all the possible conditions into 10 categories. We compared it with final diagnosis and examined the agreements using kappa statistics. We compared the physician's level of confidence for the first impression. The 10 categories were: 1) normal or inconclusive, 2) pulmonary embolism, 3) airway disease (chronic obstructive pulmonary disease or asthma), 4) pneumothorax, 5) large pleural effusion, 6) alveolar consolidation, 7) acute pulmonary edema due to systolic congestive heart failure, 8) acute respiratory distress syndrome, 9) chronic interstitial lung disease with exacerbation, and 10) pericardial effusion with/without tamponade. RESULTS: This prospective study was performed for 172 patients over 18-years-of-age with dyspnea during a 25-month period. Kappa value between the diagnosis after ED-BLUE and final diagnosis was 0.812(p<0.001). The mean of physician's full term for LOC for the first impression before and after ED-BLUE was 3.09+/-0.83 and 4.36+/-0.70 (paired t-test, p<0.001). CONCLUSION: ED-BLUE protocol could help the emergency physician make an accurate diagnosis in patients with dyspnea in the emergent setting.
Artifacts ; Dyspnea ; Emergencies ; Heart ; Heart Failure ; Humans ; Intensive Care Units ; Lung ; Lung Diseases, Interstitial ; Lung Diseases, Obstructive ; Pericardial Effusion ; Pleural Effusion ; Pneumothorax ; Prospective Studies ; Pulmonary Edema ; Pulmonary Embolism ; Respiratory Distress Syndrome, Adult

BACKGROUND: The prognosis of paraquat intoxication patients is poor and this makes the prediction of mortality important in administering aggressive treatment and admission. This article investigates the usefulness of simplified acute physiology score II (SAPS II), as a predictor of the mortality in paraquat intoxication. METHODS: We retrospectively reviewed 65 patients who were admitted in one hospital between January in 2005 and December in 2010. We calculated their SAPS II, serum paraquat level, and severity index of paraquat poisoning (SIPP) at the time of intensive care unit (ICU) admission. We investigated the relationship between each systems and the mortality. RESULTS: Overall mortality was 73.8%: 48 out of 65 patients died. Non-survived group (n = 48) had a higher SAPS II score (30.44 +/- 15.99) than survived group (n = 17 [15.7 +/- 6.26], p < 0.001). Serum paraquat level and SIPP were significantly higher in non-survived group than in survived group (p < 0.05, in all comparisons). By using the area under receiver operating characteristic curves (AUC), the SAPS II system yielded equal discriminative power (AUC = 0.82) with serum paraquat level (AUC = 0.896) and SIPP (AUC = 0.865). Hosmer-Lemeshow goodness-of-fit test C indicated SAPS II score validated well in paraquat intoxication group (p = 0.33). CONCLUSIONS: Serum paraquat level is the best way for prediction of mortality in patients with acute paraquat intoxication. If checking serum paraquat level is impossible or delayed, SAPS II score can be an alternative tool for evaluating the prognosis in paraquat intoxication.
Humans ; Intensive Care Units ; Paraquat ; Prognosis ; Research Design ; Retrospective Studies ; ROC Curve

OBJECTIVE: Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs.METHODS: Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures.RESULTS: Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months.CONCLUSION: We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.
Bone Density ; Fentanyl ; Fractures, Compression ; Fractures, Spontaneous ; Humans ; Incidence ; Retrospective Studies ; Vertebroplasty

Pseudoaneurysm formation in the profunda femoris artery (PFA) is a rare complication of femur shaft fractures or, more usually, a consequence of operative repair. Over the past few years, percutaneous transcatheter arterial embolization (TAE) has increasingly been considered the most effective treatment for pseudoaneurysms of the PFA. We report two cases with pseudoaneurysms of the PFA that were caused by femur shaft fractures and were successfully treated using TAE with n-butyl cyanoacrylate (NBCA). When a pseudoaneurysm of the PFA occurs due to a femur shaft fracture, early recognition and prompt radiologic intervention may prevent severe vascular injury without the need for additional surgery. The advent of TAE using NBCA enables minimally invasive treatment to be undertaken and it is effective for managing pseudoaneurysms of the PFA.

This study aimed to enhance the physicochemical properties of sodium iodide-based root filling materials, particularly solubility. In earlier developmental stages, the iodoformcontaining paste exhibited high antibacterial efficacy but failed to meet only the solubility requirement among the ISO 6876 criteria. Therefore, this study focused on enhancing the physicochemical properties of the paste under development, particularly centering on reducing its solubility. Four experimental groups were established, including three control group. The previously developed D30 paste was named the Oil 33 group, and the control group was named the Vitapex® group. The Oil 50 group, in which the oil content was increased, and the Oil 45L group, in which lanolin was incorporated. The physical properties (solubility, pH, flowability, and film thickness) of the four pastes were evaluated according to the ISO 6876 standards. No significant differences were observed between the Oil 45L and Vitapex® groups in any of the physical property evaluations. While the Oil 33 and Oil 50 groups met the ISO 6876 standards for flowability and film thickness, the Oil 45L group met all the physical properties. However, reducing the overall oil content may be necessary to enhance the antimicrobial properties. The result of the physicochemical experiments showed that the Oil 45L group with the newly formulated composition and incorporated lanolin exhibited low solubility meeting the ISO 6876 standard of ≤ 3%. We were able to develop a paste with more stable solubility than previous iodide-based root-filling materials. Therefore, the oil content must be further adjusted to improve its antimicrobial properties. If other physical properties also meet the ISO 6876 standards and demonstrate excellent results in cytotoxicity tests, this root filling material could potentially replace existing options.

Objectives: Endoscopic submucosal dissection (ESD) is a widely used approach for the resection of superficial gastric neoplastic lesions. Endoscopic mucosal resection (EMR) is acceptable for lesions <10–15 mm in size. Herein, we compared the clinical outcomes of ESD with those of EMR after circumferential precutting (EMR-P) for gastric adenomas ≤15 mm. Methods: We retrospectively analyzed the data of 213 patients with 228 gastric adenomas ≤15 mm in size who were treated endoscopically at a single tertiary hospital in Korea between November 2018 and October 2022. We evaluated the complete endoscopic resection rate, recurrence rate, procedurer-elated complications, and procedure time according to the procedure used. Results: Among the 228 gastric adenomas, 49 were treated with EMR-P and 179 with ESD. The histological complete resection rate was higher in the ESD group than in the EMR-P group (87% vs. 57%, p<0.001). No significant between-group differences were observed in endoscopic en bloc resection rates (ESD vs. EMR-P, 96% vs. 90%; p=0.081). The procedure time was significantly shorter in the EMR-P group than in the ESD group (28.9±19.7 min vs. 8.8±5.9 min, p<0.001). The local recurrence rate in patients with histologically incomplete resection did not differ between the two groups (ESD vs. EMR-P, 8.7% vs. 9.5%; p=0.924). Conclusions For gastric adenomas ≤15 mm, EMR-P may be the preferable treatment method considering the en bloc resection rate, procedure time, and local recurrence rate. However, considering the complete resection rate, ESD is recommended as the treatment of choice for high-grade adenomas and early gastric cancer lesions.