BACKGROUND: In patients with myocardial infarction, one needs to know the location, extent and severity of wall motion abnormalities to assess prognosis and guide therapy. Thus more precise quantatative estimates of regional ventricular function are required. Regional wall motion has generally been assessed by displaying the multiple cardiac images of RVG as endless-loop movie, but the cinematic display was not objective. We used the usefulness of the phase analysis in evaluating the global left ventricular function and regional wall motion abnormalities of patients with myocardial infarction. The accuracy of the RVG cinematic display in detecting regional wall motion abnormalities in patients with myocardial infarction was also evaluated. METHODS: Studied cases were 97 patients with myocardial infarction and 20 normals with low likelihood of coronary artery disease. Coronary angiography and contrast left ventriculography were performed in all patients with myocardial infarction. The regional wall myocardial infarction(presence) is defined when the EKG presented the evidence of myocardial infarction, left ventriculogram showed RWMA(regional wall motion abnormality) along with stenosis of 50% or greater of the regional supplying coronary artery. Each patient was imaged in 45 left anterior oblique(LAO) view, anterior(Ant) view and left lateral(Lt Lat) view. We evaluated Left ventricular ejection fraction(LVEF) from time-activity curve. We constructed the histogram for the left ventricle and both ventricle separately to obtain the global and total phase angle(GPA, TPA), standard deviation of phase angle(GSDPh, TSDPh), full width half maximum(GFWHM, TFWHM). The left ventricle was divided into 7 segments. LAO projection ; septal, apical, basal lateral, apical lateral, Ant projection ; anterolateral, Lt Lat projection ; inferior, posterior, Phase angle(RPA) and full width half maximum(RFWHM) from the histogram (regional 7 segments) were examined. On the RVG cinematic display, the standard 4 grading system was used, normal, hypokinesia, akinesia, dyskinesia. The observer evaluated regional wall motion abnormality of the 7 segments for all cases. The sensitivity of the above parameters and RVG cinematic display was evaluated. We analyzed the regional parameters among the patents with regional wall myocardial infarction(presence), those without regional wall myocardial infarction(absence) and control group using the t-test. The statistical analysis was done by one way ANOVA between regional phase analysis and RVG cinematic display. RESULTS: The sensitivity of LVEF was lowest(70.1%) and the GFWHM was highest among the global parameters(89.1%). But RFWHM showed even higher sensitivity(96.9%), thus regional phase analysis was also required. The RVG cinematic display was also sensitive(92.7%), but less sensitive than the RFWHM. On regional phase analysis the RPA of septal, apical, inferior, posterior walls of the left ventricle was able to separate presence group from absence group and also presence group from control group and the RPA of the apical lateral wall could separate presence group from absence group. The RPA of basal lateral and anterolateral wall was inaccurate in diagnosing the regional wall myocardial infarction, because basal lateral wall was overlapped by adjacent vascular structures, and the area of anterolateral wall dose not correlate completely beteen the RVG & the left ventriculogram, also the anterolateral wall can be supplied by the obtuse marginal branch of left circumflex artery. The RFWHM of all regional walls of left ventricle could separate presence group from absence group and presence group from control group. We found good correlation between regional phase analysis & left ventriculogram for detection of regional wall myocardial infartion. On RVG cinematic display, the RPA of the normal group was different from that of dyskinesia, akinesia and hypokinesia groups. The RPA of the dyskinesia group was also different from that of skinesia and hypokinesia groups by oneway ANOVA(p<0.05). The RFWHM of the dskinesia group was different from that of the normal group and hypokinesia group. RVG cinematic display correlated well with regional phase analysis and also quantitation of wall motion. CONCLUSIONS: Thus RVG cinematic display was useful and can not be replaced by phase analysis. But the regional phase analysis was sensitive and objective in diagnosing the wall motion abnormality in myocardial infarction.
Ants ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Dyskinesias ; Electrocardiography ; Heart Ventricles ; Humans ; Hypokinesia ; Myocardial Infarction* ; Prognosis ; Radionuclide Ventriculography ; Ventricular Function ; Ventricular Function, Left

OBJECTIVE: To study the incidence and degree of the cervical instability in the cerebral palsied patients and to investigate the cause of the high incidence of cervical myelopathy in these patients. METHOD: The static and dynamic radiography of the cervical spine in the sagittal plane was performed in seventy-two patients with athetoid and spastic cerebral palsy and the incidence of spondylolisthesis, range of motion(by the Penning Method), sagittal diameter of the cervical canal, and posture of the cervical spine were evaluated. RESULTS: The incidence of the cervical spondylolisthesis was fifty percent with athetoid cerebral palsy and twenty-seven percents with spastic cerebral palsy. The incidence of spondylolisthesis was especially high at the level of C3/4 and C4/5. The excessive range of motion in flexion/extension by the sagittal plane was observed in 66.7% of athetoid patients and 53.3% of spastic patients, especially at the C2/3 and C3/4 levels. The abnormal curvature was noted in 66.6% of athetoid and spastic patients. C-curve and S-curve were more common in athetoid patients and straightening of the C-spine was more common in spastic type. A sagittal diameter of the cervical spinal canal was significantly decreased in patients with athetoid patients with C3/4 spondylolisthesis and/or abnormal curvature such as a C-curve or S-curve(P<0.05). Height of the vertebral body was decreased in both athetoid and spastic patients. CONCLUSION: The combination of a cervical instability and a narrow spinal canal predisposes the neurological progression to a cervical myelopathy in cerebral palsied patients.
Adolescent* ; Cerebral Palsy* ; Humans ; Incidence ; Muscle Spasticity ; Posture ; Radiography ; Range of Motion, Articular ; Spinal Canal ; Spinal Cord Diseases ; Spine ; Spondylolisthesis

Purpose: Hepatitis E outbreaks are a serious public health concern in the world. The pilots or air traffic controllers can be incapacitated by severe hepatitis symptoms. If the symptoms of acute hepatitis do not improve, it is not suitable for aviation duties.In this study, we compare of incidence status of hepatitis E virus (HEV) infections, and epidemic aspects between South Korea (from here on, ‘Korea’) and Japan. Methods: The raw data on confirmed of HEV infection cases were obtained from the National Notified Disease Surveillance System of Korea Diseases Control and Prevention Agency, the Ministry of Health and Welfare in Korea, and the National Epidemiological surveillance of Infectious Diseases surveillance system, administered by the National Institute of Infectious Diseases in Japan. Statistically significant differences between the epidemiological aspects and risk factors were determined using the Pearson’s chi-squared test or paired t-test. All data analyses were performed in Microsoft Excel 2010 (Microsoft, Redmond, WA, USA). Results: There were 191 cases of HEV infected cases with a prevalence rate (PR) of 0.37 per 100,000 populations of Korea in 2020. During the same year in Japan, there were 454 cases with a PR of 0.36. When compared, there is statistically none significantly differences. Moreover, both PR per 100,000 populations of HEV infections in habitat of two countries were compared, in the provinces (0.39) of Korea were much higher than that in capital city of Seoul (0.27; P<0.01), but that in Japan were capital city of Tokyo (0.84) was higher than that of the provinces (0.30; P<0.01). Male to female morbidity ratio was 1.65 and 3.78 in Korea and Japan, respectively. The distribution by the age adjusted groups were similar in Korea and Japan that the total cases occurred in the over 40-years-old age bracket, clearly showing a higher incidence in the elderly. Conclusion We believed that the HEV are a zoonotic virus, and human occurs mainly through the fecal contamination of water and consumption of contaminated meat from infected animals. In addition, HEV infection can be a problem for pilots and air traffic controllers as well, requiring further investigation and research.

Purpose: Zika virus (ZIKV) infection is a mosquito-borne Flavivirus disease. we investigated the epidemiological aspects and status of imported ZIKV infection cases in Korea (Republic of) and Japan during 2016–2020. Methods: Raw data of ZIKV infection cases from the Korea Diseases Control and Prevention Agency, and the National Institute of infectious Diseases in Japan, 2016– 2020. Results: There were 33 cases of ZIKV infection in Korea and 21 cases in Japan between 2016 and 2020. Cumulative incidence rate per 1,000,000 overseas travelers (OTs) of Korea (0.30) did not substantially differ that of Japan (0.27), respectively.We observed the ZIKV infected cases of male (69.7% of total cases) were much more than that for female (30.3%) in OTs of Korea (P<0.05). However, while there was none significant differences level between males (52.4%) and females (47.6%) in OTs of Japan. On the other hands, the distribution by adjusted-age groups for ZIKV infections were similar between Korean and Japanese that total cases occurred in the over 20 to 59-years old age, clearly more showing a higher infected of ZIKV (P<0.01). The presumptive origin imported ZIKV infection cases in Korean were as follows; Southeast Asia (81.8% of total cases) and Central & South Americas (18.2%), and those in Japan, these were Southeast Asia (42.9%) and Central & South Americas (42.9%) and Oceania (4.7%), respectively. Conclusion This study demonstrates that there is a similar pattern of imported ZIKV disease cases in Korea and Japan. Therefore, to prevent ZIKV infections, greater attention should be paid to individuals who are planning to travel to the presumptive regions of ZIKV.

It is. commonly assumed that nasorespiratory function can exert a dramatic effect upon the development of the dentofacial complex. Specially, it has been stated that chronic nasal obstruction leads to mouth breathing, which causes altered tongue and mandibular positions. If this occurs during a period of active growth, :the .outcome is development of the "adenoid facies". Such patients characteristically: manifest a vertically long lower third facial height, narrow alar bases, lip incompetence, a long and narrow maxillary arch and a greater than normal mandibular plane angle. But several authors have reported that so-called adenoid facies is not always associated with adenoids and mouth breathing, and that a particular type of dentition is not alwarys found in mouth breathers with or without adenoids. Some authors have believed adenoids lead to mouth breathing in cases with particular facial characteristics and types of dentition. We assumed that the ability to adapt to individual's neuromuscular complex is various. So, we compared the difference of influence of mouth breathing between childrens who have different facial types. This study included 60 patients and they were divided into three groups by Rickett's facial type. Their dentition and tongue position were compared. The results are as follows. 1. There is a significant difference in arch width of upper molars between different facial types. Especially dolichofacial type patients have narrowest arch width. 2. There is a significant difference in tongue position between different facial types. Especially dolichofacial type patients have lowest positioned tongue.
Adenoids ; Child ; Dentition* ; Facies ; Humans ; Lip ; Molar ; Mouth ; Mouth Breathing ; Nasal Obstruction ; Respiration* ; Tongue

Mechanical obstruction of the common hepatic duct includes the following causes; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the “syndrome del conducto hepatico” in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mrizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a variant of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of 38℃, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/cm3; albumin 2.6 g/dl (normal 0-1) with the direct bilirubin, 4.4 mg/dl (normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction (Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.
Abdominal Pain ; Aged ; Biliary Tract ; Bilirubin ; Calculi ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Choledocholithiasis ; Common Bile Duct ; Constriction, Pathologic ; Cystic Duct ; Cytochrome P-450 CYP1A1 ; Gallbladder ; Gallstones ; Hepatic Duct, Common ; Humans ; Inflammation ; Jaundice, Obstructive ; Lymph Nodes ; Mirizzi Syndrome* ; Neck ; Physical Examination ; Sclera ; Sclerosis ; Ultrasonography

A Case of double pylorus, in 56 year old man, was diagnosed by fiberoptic gastroscopy and upper gastrointestinal series. Two ovoid large openings of pyloric canal divided by smooth thickened septum were observed endoscopically And the relevant literatures on tihe subject were reviewed.
Gastroscopy ; Humans ; Middle Aged ; Pylorus*

We obtained successful functional and esthetic results by grafting of iliac marrow-cancellous bone in 2 cases of alveolar-palatal cleft patients. Bone graft of alveolar-palatal clefts provide bony support to adjacent teeth of cleft area, prevented from relapse of orthodontic arch expansion, closure of oroantral fistula and improvement of speech problem. 1. In one case, extraction of upper right central incisor that was little bone support, alignment of rotated teeth and expansion of collapsed arch segment were done with pre-orthodontic treatment. The other case. Bone grafting was done after removal of prosthesis with no pre-orthodontic treatment. 2. After mucoperiosteal incision in cleft area, the mucosal flap of labial area, palate and nose were separation and the raised nasal mucosa was sutured for closure of oroantral fistula. Then, the iliac marrow-cancellous bones were grafted to cleft site. 3. After 6 months of operation, we had seen the new bone deposition to cleft site in dental radiograph and prosthetic treatment of missing teeth were done.
Bone Transplantation* ; Humans ; Incisor ; Nasal Mucosa ; Nose ; Oroantral Fistula ; Palate ; Prostheses and Implants ; Recurrence ; Tooth ; Transplants

There exists a need to develop strategies that promote neovascularization in virtually all tissue engineering and regenerative medicine efforts. While research typically focuses on understanding and exploiting the role of angiogenic factors and vascular cells on new blood vessel formation, the activity of the immune system is being recognized to impact vascular formation and adaptation. This review will provide both an overview of the relationship of angiogenesis and the immune system, and how biomaterials may be designed to promote favorable angiogenesis by interaction between these 2 systems to promote effective vascularization.
Angiogenesis Inducing Agents ; Biocompatible Materials ; Blood Vessels ; Immune System ; Inflammation* ; Regenerative Medicine ; Tissue Engineering

Purpose: The purpose of this paper is to study the epidemiologic series of Tsutsugamushi disease (TD), also known as scrub typhus in the Republic of Korea (Korea) and Japan. Methods: We investigated raw data of TD outbreaks from the National Notifiable Disease Surveillance System of the Korea Diseases Control and Prevention Agency in Korea, and the National Institute of Infectious Diseases in Japan, 2016 to 2020. Results: There were 36,785 cases of TD with a cumulative infectious rate (CIR) of 14.3 per 100,000 populations in Korea from 2016 to 2020. During the same period in Japan, there were 2,350 cases with a CIR of 0.4. When compared, Korea was much higher than that in Japan (P<0.01). In Korea, more females (60.2% of total cases) were infected than males (39.8%), while there was a significant difference between males (58.8%) and females (41.2%) in Japan, respectively (P<0.01). Conclusion These differences in TD risk factors reflect differences of vectors/hosts, climate, and geographical and cultural characteristics between the two countries. The surveillance of TD, primarily a zoonotic disease, should be continued in order to obtain a better understanding of its current status. Moreover, guidelines for the prevention of TD, and its control measures should be more established.