PURPOSE: To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access. MATERIALS AND METHODS: Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava. RESULTS: Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place. CONCLUSION: The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.
Arm* ; Catheters* ; Heart Atria ; Humans ; Ocimum basilicum ; Punctures ; Radiology, Interventional ; Silicones ; Subclavian Vein ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Superior

PURPOSE: To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access. MATERIALS AND METHODS: Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava. RESULTS: Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place. CONCLUSION: The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.
Arm* ; Catheters* ; Heart Atria ; Humans ; Ocimum basilicum ; Punctures ; Radiology, Interventional ; Silicones ; Subclavian Vein ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Superior

BACKGROUND/AIMS: The aim of this study was to evaluate the prevalence and risk factors for hepatitis B surface antigen (HBsAg) positivity in pregnant Ghanaian women. METHODS: We surveyed 1,500 pregnant women in Eastern region of Ghana. Direct interviews were performed by trained nurses using standardized questionnaires. Pregnant women were screened for human immunodeficiency virus (HIV) and hepatitis B infections, hemoglobin levels and sickle cell anemia as part of the antenatal check-up. RESULTS: The overall HBsAg positive rate was 10.6%, which varied among districts (13.8% for Kwahu West, 12.4% for Upper Manya, and 2.2% for Yilo Krobo). HBsAg positivity was significantly higher in women with depression (odds ratio [OR], 3.74; 95% confidence interval [CI], 2.13 to 6.57) and HIV (OR, 2.03; 95% CI, 1.06 to 3.89). Age, education, and gravidity were not related to HBsAg positivity. Anti-hepatitis B immunoglobulin for newborns of HBsAg-positive mothers is not provided at birth in public health facilities in Ghana. However, hepatitis B vaccination is provided as part of a routine vaccination schedule starting at 6 weeks of age. CONCLUSIONS: To prevent mother-to-child transmission of hepatitis B, screening tests for HBsAg in pregnant women and hepatitis B vaccination of newborns immediately after birth need to be performed in this region.
Anemia, Sickle Cell ; Appointments and Schedules ; Depression ; Female ; Ghana ; Gravidity ; Hemoglobins ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; HIV ; Humans ; Immunoglobulins ; Infant, Newborn ; Mass Screening ; Mothers ; Parturition ; Pregnant Women ; Prevalence ; Public Health ; Risk Factors ; Vaccination ; Surveys and Questionnaires

We have previously isolated a novel protein "B/K" that contains two C2-like domains. Here, we report the isolatioin and mRNA distribution of a human B/K isoform, and protein kinase A (PKA)-dependent phosphorylation of the B/K protein. The 1.5 kb human B/K cDNA clone exhibits 89% and 97% identities with rat B/K in the sequences of nucleotide and amino acid, respectively. Human B/K isoform encodes a 474 amino acid protein and shows structural features similar to the rat counterpart including two C2 domains, three consensus sequences for PKA, absence of a transmembrane region, and conservation of the N-terminal cysteine cluster. On Northern and dot blot analyses, a 3.0 kb B/K transcript was abundantly present in human brain, kidney, and prostate. Among the brain regions, strong signals were observed in the frontal and temporal lobes, the hippocampus, the hypothalamus, the amygdala, the substantia nigra, and the pituitary. Recombinant B/K proteins containing three consensus sites for PKA was very efficiently phosphorylated in vitro by PKA catalytic subunit. B/K protein which was overexpressed in LLC-PK1 cells was also strongly phosphorylated in vivo by vasopressin analog DDAVP, and PKA-specific inhibitor H89 as well as type 2 vasopressin receptor antagonist specifically suppressed DDAVP-induced B/K phosphorylation. These results suggest that B/K proteins play a role as potential substrates for PKA in the area where they are expressed.
Sequence Homology, Amino Acid ; Sequence Analysis, DNA ; Rats ; Protein Isoforms/genetics ; Phosphorylation ; Phosphoproteins/genetics/*metabolism ; Molecular Sequence Data ; Mice ; Male ; Humans ; Gene Expression Profiling ; Female ; DNA, Complementary/chemistry/genetics ; Cyclic AMP-Dependent Protein Kinases/*physiology ; Cloning, Molecular ; Cell Line ; Base Sequence ; Animals ; Amino Acid Sequence ; Adult

The cannabinoid (CB2) receptor type 2 has been proposed to prevent the degeneration of dopamine neurons in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated mice. However, the mechanisms underlying CB2 receptor-mediated neuroprotection in MPTP mice have not been elucidated. The mechanisms underlying CB2 receptor-mediated neuroprotection of dopamine neurons in the substantia nigra (SN) were evaluated in the MPTP mouse model of Parkinson's disease (PD) by immunohistochemical staining (tyrosine hydroxylase, macrophage Ag complex-1, glial fibrillary acidic protein, myeloperoxidase (MPO), and CD3 and CD68), real-time PCR and a fluorescein isothiocyanate-labeled albumin assay. Treatment with the selective CB2 receptor agonist JWH-133 (10 μg kg⁻¹, intraperitoneal (i.p.)) prevented MPTP-induced degeneration of dopamine neurons in the SN and of their fibers in the striatum. This JWH-133-mediated neuroprotection was associated with the suppression of blood-brain barrier (BBB) damage, astroglial MPO expression, infiltration of peripheral immune cells and production of inducible nitric oxide synthase, proinflammatory cytokines and chemokines by activated microglia. The effects of JWH-133 were mimicked by the non-selective cannabinoid receptor WIN55,212 (10 μg kg⁻¹, i.p.). The observed neuroprotection and inhibition of glial-mediated neurotoxic events were reversed upon treatment with the selective CB2 receptor antagonist AM630, confirming the involvement of the CB2 receptor. Our results suggest that targeting the cannabinoid system may be beneficial for the treatment of neurodegenerative diseases, such as PD, that are associated with glial activation, BBB disruption and peripheral immune cell infiltration.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine* ; Animals ; Blood-Brain Barrier ; Chemokines ; Cytokines ; Dopamine* ; Dopaminergic Neurons* ; Fluorescein ; Glial Fibrillary Acidic Protein ; Macrophages ; Mice ; Microglia ; Neurodegenerative Diseases ; Neuroprotection ; Nitric Oxide Synthase Type II ; Parkinson Disease* ; Peroxidase ; Real-Time Polymerase Chain Reaction ; Receptor, Cannabinoid, CB2* ; Receptors, Cannabinoid ; Substantia Nigra

BACKGROUND: Primary nodal marginal zone B-cell lymphoma (MZBL) is recently divided into mucosa-associated lymphoid tissue (MALT) type and splenic type. Herein, we analyzed clinicopathologic differences of those two types of nodal MZBL. METHODS: Histologic and clinical findings of eleven cases of primary nodal MZBL lymphoma were reviewed. Immunohistochemical stains for IgD, Ki-67, CD3, and CD20 were performed. RESULTS: The cases were classified as splenic type in four, MALT type in five, and unclassified in two. The age at presentation was 36.7 years old (range: 16-73) in splenic type and 48 years old (range: 31-68) in MALT type. Two patients with splenic type and one with MALT type had a long history of lymphadenopathy up to 9 years. Whereas tumors of splenic type showed nodular infiltration of tumor cells with follicular colonization and hyperplastic germinal center, tumors of MALT type showed mainly sinusoidal or parafollicular infiltration and atrophic germinal centers. All the patients with splenic type were alive at last follow-up and one patient with MALT type died of disease at 5 months after diagnosis. CONCLUSIONS:Although the number of cases we analyzed was small, splenic type seems to be distinct from MALT type and lower grade neoplasm.
Colon ; Coloring Agents ; Diagnosis ; Follow-Up Studies ; Germinal Center ; Humans ; Immunoglobulin D ; Lymphatic Diseases ; Lymphoid Tissue* ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Middle Aged ; Pathology

PURPOSE: To evaluate the MR imaging findings of intraosseous lipoma. MATERIALS AND METHODS: The MR imaging findings of 12 cases of intraosseous lipoma were retrospectively analyzed with regard to internal signal intensity, enhancement patterns, the presence of calcification and the status of the margin. The findings relating to these last two features were compared with those of plain films and CT. RESULTS: Six tumors were located in the calcaneus, three in the tibia, two in the ilium, and one in the carpal lunate. A fat component was clearly identified in all cases, but no lesion was purely fatty. Cyst formation was noted in four cases, and hyperintense portions different from the cystic area were seen on T2WI in ten. Contrast enhancement was observed in four patients, and although plain film and CT images revealed, in all cases, the presence of calcification, in two cases this was not demonstrated by MRI. In all cases, however, MRI showed well-defined tumoral margins. CONCLUSION: MRI clearly depicts fat and other components related to the involutional changes occurring in cases of intraosseous lipoma. The information these images provide is useful for the diagnosis and histologic classification of intraosseous lipoma.
Bone Neoplasms ; Calcaneus ; Classification ; Diagnosis ; Humans ; Ilium ; Lipoma* ; Magnetic Resonance Imaging* ; Retrospective Studies ; Tibia

RTOG proposed a multivariate modeling system predicting the response of head and neck cancers to radiation therapy in 1984. The aim of this study was to verify whether PPC (Probability of primary clearance calculated by a multivariate modeling system) had any correlation with the survival in the patients with carcinoma of the nasopharynx following radiation therapy. Analysing 81 patients with carcinoma of the nasopharynx treated with radiotherapy between January 1, 1971 and December 31, 1983 at Yonsei University College of Medicine, Yonsei Cancer Center, the actuarial 5 year survival rate was 36% and median survival was 39 months. The survivals for Group 1 (27 who had more than 80% of PPC), Group 2 (20 who had between 71 and 80% of PPC), and Group 3 (29 who had less than 71% of PPC) were 66% (median survival months: more than 72), 27% (31), and 4% (12) respectively. There was a definite correlation between PPC and survival among the three groups.
Head ; Humans ; Nasopharynx* ; Neck ; Radiotherapy ; Survival Rate

OBJECTIVETo investigate brain activity patterns during acupuncture in stroke patients, and to compare the result with normal subjects using functional magnetic resonance imaging (fMRI).

METHODSA total of 11 stroke patients with motor weakness and 10 healthy subjects were studied. fMRI was performed during acupuncture on the left side at points Quchi (LI11) and Zusanli (ST36). Data were analyzed using statistical parametric maps of brain activation induced by acupuncture stimulation.

RESULTSThe results showed that stimulation of both LI11 and ST36 produced significantly different brain activation patterns between the two groups. The normal group showed a greater overall activation than the stroke group. In the normal group, parts of the frontal lobe, parietal lobe, sub-lobar, cerebellum and midbrain regions were activated by acupuncture at the left LI11. On the other hand, only the right side of the inferior parietal lobule region was activated in the stroke patients. When the left ST36 was stimulated in the normal group, both sides of the frontal lobe, parietal lobe, temporal lobe, and sub-lobar, and the left side of occipital lobe, and the right side of cerebellum and midbrain regions were activated. For the same stimulation in the stroke group, only both sides of the inferior parietal lobule and cerebellum regions were activated (P<0.05, cluster level). Deactivation pattern was not noted during any acupuncture stimulation in both groups.

CONCLUSIONBrain signal activations during the same acupuncture were different between the healthy and the stroke patients, and the effects showed a correlation of different acupuncture points.

Acupuncture Therapy ; Aged ; Brain Mapping ; Case-Control Studies ; Demography ; Female ; Health ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Stroke ; physiopathology

This study explores the internal standards for hearing tests and benefits of implementing international standard protocols, including the International Organization for Standardization (ISO) and International Electrotechnical Commission (IEC), and discusses how ISO and IEC standards provide a framework for designing, calibrating, assessing hearing test instruments and methods, and exchanging and comparing data globally. ISO and IEC standards for hearing tests improve accuracy, reliability, and consistency of test results by applying standardized methods and environments. Moreover, they promote international harmonization and data interoperability, enabling information exchange and research collaboration. Those standards for hearing tests are beneficial but have challenges and limitations, such as variation in equipment and calibration, lag in updating standards, variation in implementation and compliance, and lack of coverage of clinical aspects, cultural diversity, and linguistic diversity. These affect the quality and interpretation of test results. Adapting ISO or IEC standards locally would improve their applicability and acceptability, while balancing customization and compatibility with global standards.