No abstract available.
Humans

Varieties of telepathology system had been developed and in use, but their functional capability and diagnostic accuracy are considered to be inferior to those of conventional optical microscope. This study is intended to find out: 1) the diagnostic accuracy and reproducibility rate according to the input devices and the video signals; 2) any potential technical problems of the telepathology system; 3) any possible physical and psychological impacts. We devised a virtual telepathology system using our existing microscope equipped with CCD camera unit that has no restriction of network speed. Total fifty-five surgical pathology cases from 11 different organs were selected. Three pathologists were involved in making diagnoses. The resulting diagnostic accuracies were: 1 CCD camera with composite video signal was 86.2%; 3 CCD camera with composite video signal was 93.1%; 3 CCD camera with component video signal was 95.0%. The 3 CCD camera with component video signal resulted in 95.0% diagnostic accuracy and was superior to 1 CCD camera with composite video signal. Some technical problems noted during this study were: the visual field of the virtual telepathology system was smaller by 43% than that of microscope; the difference of cell sizes between microscope and monitor; low resolution of image. Some physical and psychological symptoms were noted.
Cell Size ; Diagnosis ; Pathology, Surgical ; Telepathology* ; Visual Fields

PURPOSE: To investigate the shifting trends of pathogenic organisms, antibiotic resistance, and clinical characteristics of patients with Gram-positive bacterial keratitis and to elucidate the prognostic factors. METHODS: We performed a retrospective chart review of 152 isolates in 146 eyes with Gram-positive bacterial keratitis between January 1998 and December 2012. The study was divided into 5 periods for analysis of the bacteriological profiles and in vitro antibiotic resistance. The epidemiological and clinical characteristics were compared according to bacterial isolates. Logistic regression analysis was performed to determine the risk factors. RESULTS: Gram-positive bacterial keratitis tended to decrease and significant change in the distribution of isolates was not observed. Commonly isolated organisms were S. epidermidis (48.7%), S. aureus (25.0%), and S. pneumoniae (7.2%) in order of frequency. The resistance to fluoroquinolone tended to increase (p = 0.104) and resistance to gentamicin was significantly decreased (p = 0.01). S. epidermidis had the shortest corneal epithelium healing time (p = 0.035) and the most favorable visual outcome after treatment (p = 0.035) compared with the other species. Risk factors for poor visual outcomes included a best corrected visual acuity less than 0.1 at initial evaluation and an epithelial healing time greater than 10 days. CONCLUSIONS: Gram-positive bacterial keratitis tended to decrease and S. epidermidis was the most common isolate. The clinical prognosis was most favorable in S. epidermidis. The BCVA less than 0.1 at initial evaluation was an important risk factor for poor visual outcome and surgical treatment in Gram-positive bacterial keratitis.
Drug Resistance, Microbial ; Epithelium, Corneal ; Gentamicins ; Humans ; Keratitis* ; Logistic Models ; Pneumonia ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus ; Staphylococcus epidermidis ; Visual Acuity

Recently, many hospitals have been adopting clinical data warehouses (CDW) as well as electronic medical records. These new hospital information systems are inevitably introducing very large amounts of clinical data that might be useful for further analysis. However, the electronic clinical data in the CDW are usually byproducts of clinical practice rather than the product of research. Therefore, they include inconsistent and sometimes erroneous information that might not have the specific context of the clinical situations. Data miners usually have various academic backgrounds such as electronics, informatics, statistics, biomedicine, and public health. If the complex situations surrounding the clinical data are not well understood, investigators performing data mining in clinical fields may have problems assessing the information they are confronted with. Here, we would like to introduce some basic concepts on the principles of data mining in clinical fields including legal and ethical considerations as well as technical concerns.
Machine Learning ; Data Mining ; Electronic Health Records ; Electronics ; Electrons ; Hospital Information Systems ; Humans ; Informatics ; Public Health ; Research Personnel

OBJECTIVE: This study was carried out to evaluate the effect of the isolation methods of inner cell mass from mouse blastocyst, types of feeder cells and treatment time of mitomycin C on the formation rate of ICM colony. METHODS: The inner cells were isolated by conventional immunosurgery, partial trophoblast dissection with syringe needles and whole blastocyst co-culture method. Commercially available STO and primary cultured mouse embryonic fibroblast (pMEF) feeder cells were used, and mitomycin C was treated for 1, 2 or 3 hours, respectively. The formation rate of ICM colony was observed after isolation of ICM and culture of ICM on the feeder cells for 7 days. RESULT: The ICM colony formation rate on STO were significantly higher in partial trophoblast dissection group (58%) than that in immunosurgery (12%) or whole blastocyst culture (16%) group (p<0.05). The formation rate on pMEF feeder layer was higher in partial trophoblast dissection (88%) and whole blastocyst culture (82%) group than that in immunosurgery (16%) group (p<0.05). When mitomycin C treated to pMEF for 2 hours, the formation rate of 88% was significantly higher than those of other conditions. CONCLUSIONS: Above results showed that the efficient isolation method of ICM from blastocyst was the partial trophoblast dissection and the appropriate treatment time of mitomycin C was 2 hours. However, the subculture of ICM colony and characterization of stem cells should be carried out to confirm the efficacy of the partial trophoblast dissection method.
Animals ; Blastocyst ; Coculture Techniques ; Feeder Cells* ; Fibroblasts ; Mice* ; Mitomycin* ; Needles ; Stem Cells ; Syringes ; Trophoblasts

Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is a chronic inflammatory condition of the gastrointestinal tract, which is often accompanied by altered gut microbial composition. Gut dysbiosis in IBD is considered to be the reason for the high risk of Clostridioides difficile infection (CDI) in patients with IBD. Therefore, CDI should be evaluated in IBD patients with a symptom flare. Medical treatment of non-severe CDI in IBD is similar to that in non-IBD patients and includes oral vancomycin or fidaxomicin. The risk of recurrent CDI in IBD is higher than in non-IBD patients and this could be mitigated by fecal microbiota transplantation. As CDI may worsen the clinical outcomes of IBD, patients should be carefully monitored and an escalation of IBD therapy needs to be considered when there is no improvement seen with the antimicrobial treatment of CDI. This review discusses the risk, pathophysiology, diagnosis, and management of CDI in IBD.

Purpose: To report a case of continuously progressive abducens palsy after transarterial coil embolization.Case summary: A 42-year-old male was referred to the clinic due to binocular horizontal diplopia. The patient had a history of left direct carotid cavernous fistula (CCF) after head trauma, and his ocular symptoms developed 15 months after coil embolization for CCF. Visual acuity and pupil reaction of both eyes were normal. The ocular motility examination showed 14 prism diopters (PD) of left esotropia in the primary gaze with abduction limitation; therefore, the patient was diagnosed with left abducens palsy. There was no evidence of fistula recanalization or new abnormal lesions in follow-up brain imaging. After strabismus was stabilized with 35 PD of esotropia, strabismus surgery including left medial rectus muscle recession and lateral rectus resection was performed, and ocular alignment was normalized in the primary position. However, 2 years after surgery, left abducens palsy recurred and abduction limitation worsened to -4 over 10 months. Finally, the patient underwent superior rectus transposition and medial rectus re-recession, which improved his ocular alignment at primary position. Binocular diplopia was resolved at primary position. Conclusions Late-onset abducens palsy can occur after coil embolization and is likely to continue to progress. Because spontaneous regression is rare in late-onset palsy compared with acute-onset palsy, surgery should be considered when the strabismus becomes stabilized.

Purpose: To report a case of continuously progressive abducens palsy after transarterial coil embolization.Case summary: A 42-year-old male was referred to the clinic due to binocular horizontal diplopia. The patient had a history of left direct carotid cavernous fistula (CCF) after head trauma, and his ocular symptoms developed 15 months after coil embolization for CCF. Visual acuity and pupil reaction of both eyes were normal. The ocular motility examination showed 14 prism diopters (PD) of left esotropia in the primary gaze with abduction limitation; therefore, the patient was diagnosed with left abducens palsy. There was no evidence of fistula recanalization or new abnormal lesions in follow-up brain imaging. After strabismus was stabilized with 35 PD of esotropia, strabismus surgery including left medial rectus muscle recession and lateral rectus resection was performed, and ocular alignment was normalized in the primary position. However, 2 years after surgery, left abducens palsy recurred and abduction limitation worsened to -4 over 10 months. Finally, the patient underwent superior rectus transposition and medial rectus re-recession, which improved his ocular alignment at primary position. Binocular diplopia was resolved at primary position. Conclusions Late-onset abducens palsy can occur after coil embolization and is likely to continue to progress. Because spontaneous regression is rare in late-onset palsy compared with acute-onset palsy, surgery should be considered when the strabismus becomes stabilized.

No abstract available.
Thyroglobulin* ; Thyroid Gland*

The thioureylene drugs, propylthiouracil and methylmercaptoimidazol(MMI), exert their antithyroid effect primarily through inhibition of thyroid peroxidase-catalyzed iodination of thyroglobulin. Recently the interest about the effect to the thyroglobulin synthesis of these drugs have been increasing. So we studied the MMI effect to the thyroglobulin synthesis in cultured porcine thyroid cells. Porcine thyroid cells were isolated by sequential trypsinization in the presence of EGTA, seeded at high density(1X10^6 cells/cm^2) and cultured. One week later, MMI was added in different concentrations(0, 0.2, 1, 5mM) with TSH only or with 4H(b-TSH, Insulin, Transferrin, Hydrocortisone) or without hormone. Medias were collected after 24 hours and compared the amount of thyroglobulin secreted. And also pulse-labeling were performed with S^35 cysteine/methionine(1-2uCi/well) for 30, 60, 90min at the same conditions.There was no significant change in the amount of the secreted thyroglobulin by MMI, and there was no significant change in the pulse-labeled interacellular thyroglobulin by MMI. And also there was no significant change in the secretion of TSH-stimulated thyroglobulin by MMI. So we conclude that MMI has no effect on the thyroglobulin synthesis in cultured porcine thyroid cells and also MMI has no effect on the TSH-stimulated thyroglobulin synthesis in cultured porcine thyroid cell.
Antithyroid Agents ; Egtazic Acid ; Halogenation ; Insulin ; Methimazole ; Propylthiouracil ; Thyroglobulin ; Thyroid Gland ; Transferrin ; Trypsin