Lung volume reduction surgery, resecting the most severely affected regions of emphysema, was designed to improve quality of life for selected patients with severe emphysema. We report a case of a 72 year old severe emphysema patient who received bilateral lung volume reduction surgery and showed marked improvement of quality of life and lung function.
Aged ; Emphysema* ; Humans ; Lung* ; Pneumonectomy* ; Quality of Life

No abstract available.

Sweat gland carcinoma is the uncommon neoplasm, with few cases reported in the literatures. In a review of literatures, the most commonly used term is malignant nodular hidradenoma; however, similar cases also have been known as a malignant clear cell hidradenoma, malignant clear cell myoepithelioma, clear cell eccrine carcinoma and malignant clear cell acrospiroma. It is difficult to differentiate clinically between sweat gland carcinomas and other skin lesion, such as keloids, sebaceous cyst, dermatofibroma, lymphoma, and squamous cell carcinoma. Thus, a preoperative diagnosis of sweat gland carcinoma is rarely made and histologic examination is the only means of diagnosis. Most sweat gland carcinomas are found on the scalp, face, upper extremities, and axilla. The lesions are typically small, very slow growing, painless nodules. However, it is aggressive, infiltrative, and has highly recurrent rate. Lymph node metastases are frequent and overall survival is poor. So, that must be treated with wide local excision of the lesion and primary regional node dissection is recommended.We have experienced of a case of malignant nodular hidradenoma in cheek area. It was widely excised by total parotidectomy and covered by scapula fasciocutaneous free flap. We report this case with the review of the literature.
Acrospiroma* ; Axilla ; Carcinoma, Squamous Cell ; Cheek ; Diagnosis ; Epidermal Cyst ; Free Tissue Flaps ; Histiocytoma, Benign Fibrous ; Keloid ; Lymph Nodes ; Lymphoma ; Myoepithelioma ; Neoplasm Metastasis ; Scalp ; Scapula ; Skin ; Sweat Glands ; Upper Extremity

Sweat gland carcinoma is the uncommon neoplasm, with few cases reported in the literatures. In a review of literatures, the most commonly used term is malignant nodular hidradenoma; however, similar cases also have been known as a malignant clear cell hidradenoma, malignant clear cell myoepithelioma, clear cell eccrine carcinoma and malignant clear cell acrospiroma. It is difficult to differentiate clinically between sweat gland carcinomas and other skin lesion, such as keloids, sebaceous cyst, dermatofibroma, lymphoma, and squamous cell carcinoma. Thus, a preoperative diagnosis of sweat gland carcinoma is rarely made and histologic examination is the only means of diagnosis. Most sweat gland carcinomas are found on the scalp, face, upper extremities, and axilla. The lesions are typically small, very slow growing, painless nodules. However, it is aggressive, infiltrative, and has highly recurrent rate. Lymph node metastases are frequent and overall survival is poor. So, that must be treated with wide local excision of the lesion and primary regional node dissection is recommended.We have experienced of a case of malignant nodular hidradenoma in cheek area. It was widely excised by total parotidectomy and covered by scapula fasciocutaneous free flap. We report this case with the review of the literature.
Acrospiroma* ; Axilla ; Carcinoma, Squamous Cell ; Cheek ; Diagnosis ; Epidermal Cyst ; Free Tissue Flaps ; Histiocytoma, Benign Fibrous ; Keloid ; Lymph Nodes ; Lymphoma ; Myoepithelioma ; Neoplasm Metastasis ; Scalp ; Scapula ; Skin ; Sweat Glands ; Upper Extremity

PURPOSE: Chest compression is the corner stone of resuscitation. As a result, many studies insist on the importance of retention of skill performance. But there are weak points. First, a unique characteristic of skill is ignored, "the more practice, the better outcome". Second, no one knows when they have a proficiency in a skill. Learning curve-CUSUM analysis is a good tool to evaluate each trainee's performance. Hence, we designed this study to evaluate each trainee's proficiency in performing chest compression using LC-CUSUM analysis. METHODS: Four medical students were enrolled. We asked them to perform chest compression for two minutes per day without any intervention over six weeks. Data included the depth and rate of chest compression. Eventually, all trainees performed chest compression at least 30 times. We plotted the LC-CUSUM curve according to the results of attempts, successes or failures. RESULTS: According to median values of the depth and rate of chest compression through the 30th attempt, trainees had performances within the acceptable range, 40~49 mm (for depth) and 100~105 beats per minutes (for rate) of chest compression. Nonetheless, LC-CUSUM analysis indicated that two trainees no longer were proficient throughout, and even though the rest of them were once proficient, they appear to have lost that proficiency regarding depth of chest compression. LC-CUSUM analysis of rate of compression showed that all trainees had proficiency during the early phase. CONCLUSION: We propose that instructors can evaluate their trainees' proficiency easily, based on LC-CUSUM analysis.
Cardiopulmonary Resuscitation ; Clinical Competence ; Humans ; Learning ; Resuscitation ; Retention (Psychology) ; Students, Medical ; Thorax ; Training Support

Tumor endothelial marker 7 (TEM7) is a putative transmembrane protein that is highly expressed in the tumor endothelium. In the present study, the expression profile of TEM7 in the rat forebrain was investigated using immunohistochemistry with a specific polyclonal antibody against the extracellular region of TEM7. The immunohistochemical research revealed that TEM7 expressions were localized to specific neuronal areas such as cerebral cortex, hippocampus and hypothalamic magnocellular nuclei. The TEM7 protein was mainly present in the dendrite and cell body of the projection neurons. However, glial cells, vascular endothelial cells and meningeal cells did not show the expression of TEM7, indicating the specific roles of TEM7 in the neuronal cells in the vertebrate nervous system.
Animals ; Cerebral Cortex ; Dendrites ; Endothelial Cells ; Endothelium ; Hippocampus ; Immunohistochemistry ; Nervous System ; Neuroglia ; Neurons ; Prosencephalon* ; Rats* ; Vertebrates

Previous reports showed that age and socioeconomic factors mediated health-related unemployment. However, those studies had limitations controlling for confounding factors. This study examines age and socioeconomic factors contributing to health-related unemployment using propensity score matching (PSM) to control for various confounding variables.

Previous reports showed that age and socioeconomic factors mediated health-related unemployment. However, those studies had limitations controlling for confounding factors. This study examines age and socioeconomic factors contributing to health-related unemployment using propensity score matching (PSM) to control for various confounding variables.

Previous reports showed that age and socioeconomic factors mediated health-related unemployment. However, those studies had limitations controlling for confounding factors. This study examines age and socioeconomic factors contributing to health-related unemployment using propensity score matching (PSM) to control for various confounding variables.

PURPOSE: Metabolic encephalopathy is not an infrequent condition. However it is very difficult to diagnose and treat because of its various causes and clinical manifestations. Our purpose was to clarify the cause of metabolic encephalopathy by evaluation of MR findings and clinical features. METHODS: We reviewed MR images and clinical features for 25 patients with metabolic encephalopathy who showed abnormal signal changes on the MR images with neurologic deterioration. RESULTS: The 25 patients had underlying diseases such as chronic liver disease (n=16) or renal failure (n=9). The MR findings showed significant differences in the involved sites according to the underlying disease. In 10 of the 16 patients with liver disease, corpus callosal involvement was observed. Red nucleus involvement was seen in 6 patients, dentate nucleus involvement in 5 patients. These lesions were seen to have a high signal intensity on the diffusion weighted image. Contrary to liver disease, encephalopathy with renal disease showed typical central pontine myelinolysis in 6 of the 9 patients and a relatively benign clinical course. CONCLUSION: Our results showed that the typically involved site and clinical manifestations depended on the underlying disease. We think that involvement of the corpus callosum, the red nucleus, and the dentate nucleus is a typical pattern of injury in metabolic encephalopathy with chronic liver disease and that these findings will be helpful for diagnosing and treating metabolic encephalopathy.
Brain Diseases, Metabolic* ; Cerebellar Nuclei ; Corpus Callosum ; Diffusion ; Humans ; Liver Diseases ; Myelinolysis, Central Pontine ; Red Nucleus ; Renal Insufficiency