Purpose: The purpose of the study was to investigate the diagnostic value of SPECT, PET and PET/CT in the diagnosis of coronary artery disease, based on a systematic review. Material and Methods: A search of PubMed/Medline and Sciencedirect databases in the English-language literature published over the last 24 years was performed. Only studies with at least 10 patients comparing SPECT, PET or combined PET/CT with invasive coronary angiography in the diagnosis of coronary artery disease (50% stenosis) were included for analysis. Sensitivities and specificities estimates pooled across studies were analysed using a Chisquare test. Results: Twenty-five studies met the selection criteria and were included for the analysis. Ten studies were performed with SPECT alone; while another six studies were performed with PET alone. Five studies were carried out with both PET and SPECT modalities, and the remaining four studies were investigated with integrated PET-CT. The mean value of sensitivity, specificity and accuracy of these imaging modalities for the diagnosis of coronary artery disease was 82% (95%CI: 76 to 88), 76% (95%CI: 70 to 82) and 83% (95%CI: 77 to 89) for SPECT; 91% (95%CI: 85 to 97), 89% (95%CI: 83 to 95) and 89% (95%CI: 83 to 95) for PET; and 85% (95%CI: 79 to 90), 83% (95%CI: 77 to 89) and 88% (95%CI: 82 to 94) for PET/CT, respectively. The diagnostic accuracy of these imaging modalities was dependent on the radiotracers used in these studies, with ammonia resulting in the highest diagnostic value. Conclusion: Our review shows that PET has high diagnostic value for diagnosing coronary artery disease, and this indicates that it is a valuable technique for both detection and prediction of coronary artery disease.

OBJECTIVE: For the ubiquity of medical service, when user who has proper authority want to access medical data, user accessability should be assured. And the security of the disclosed medical data is important. This paper presents single user access interface on multiple patient reservoirs and elaborate access control using the Role-Based Access Control(RBAC) system. METHODS: Proposed system consists of 4-tier architecture that is client application, Access Control Central(ACC) agent, Local Access Control(LAC) agent and Hospital Information Systems(HIS). User requests medical data with client application. ACC notarizes user identity and controls access of user request and selectively encrypts medical data. LAC charges data conversion for communication between ACC and HIS. HIS has repositories of medical datum. System provides security service with digital certificate, X.509v3, of user. RESULTS: User requests medical data of several HIS approaching single ACC not by each HIS. Through conversion process of LAC, data that is described XML and is used for communication inter system enables information exchange with single common data format that is independent to several HIS. CONCLUSION: In the proposed system, user accesses medical datum of several HIS regardless of location and has consistent access interface. And using independent format against each HIS makes easy information exchange between several HIS. Transferred data maintains security about significant datum by selective encryption and increases encryption efficiency. Unified access control about multiple patient reservoirs that are scattered in other places provides unified and precise diagnosis of patient information. And it functions the portal of collaborate treatment in inter-HIS.
Computer Security ; Delivery of Health Care, Integrated ; Diagnosis ; Health Services Accessibility ; Hospital Information Systems ; Humans

A retrospective descriptive study on the relative frequency of surgical site infection (SSI) among 235 operated cancer patients at Chong Hua Hospital was done covering the period from January 1991 up to May 1993. SSI occurred in 9.4 percent (22/235). There was a significant increase in SSI as the population became older (p=0.01). Dirty operations had a significantly higher infection rate of 50 percent (2/4) compared to 8.7 percent (20/211) for the rest (p=0.45). Clean operations had a significantly lower infection rate of 2.5 percent (3/121) compared to 16.7 percent (19/114) for the rest. There was no difference in SSI between early and late stage cancer cases. Operations in the alimentary tract had a significantly higher infection rate of 19.3 percent (11/57) compared to 6.4 percent (11/172) for operations on the other sites (p=0.004). Operations on solf tissues, breast and thyroid had a signifanctly lower rate of 4.6 percent (4/87) compared to 12.7 percent (18/142) for operations on other sites (p=0.045).(Author)

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Surgical Wound Infection ; Thyroid Gland ; Hospitals ; Patients ; Neoplasm

Objective To study the effect of atorvastatin on the expressions of intercellular adhesion molecule-1 (ICAM-1) and transforming growth factor-β1 (TGF-β1) in the spinal cord of rats with experimental autoimmune encephalomyelitis (EAE).Methods Eighty healthy female Wistar rats were randomly divided into 4 groups:normal control group (n=20),EAE model group (n=20),low-dose treatment group (n=20) and high-dose treatment group (n=20).Each group was equally divided into 2 sub-groups:14-d group and 21-d group according to the day that they were sacrificed.EAE rat models were established by immunizing the rats with fresh guinea-pig spinal cord homogenate plus complete Freund's Adjuvat (CFA).Rats of the treatment groups were fed with atorvastatin at dasage of 2 mg/(kg·d)and 10 mg/ (kg·d),respectively; and rats of the normal control group and EAE model group were fed with physiological saline.The severity of EAE was scored according to the signs and symptoms,and NIHSS was performed.Pathological changes were observed with the aid of HE staining.The levels of ICAM-1 and TGF-β1 were detected by immunohistochemistry.Results The rats in the high-dose treatment group had significantly lower incidence of disease,decreased CNS inflammation focus,lower level of ICAM-1 and higher level of TGF-β1 as compared with rats of the EAE model group and low-dose treatment group (P＜0.05).Conclusion Atorvastatin could ameliorate EAE of rats in a dose-dependent manner,whose effect might be related to the decreased expression of ICAM-1 and increased expression of TGF-β1.

OBJECTIVESTo assess the association of socioeconomic indicators with various chronic and acute illnesses and the utilization of public health care in a new town in Hong Kong, China.

METHODSIllness experience and socioeconomic and demographic data of 7570 residents from 2022 randomly selected households were collected through telephone interviews. The relationships between socioeconomic indicators and illnesses/choice of health care were explored using stepwise logistic regressions after adjusting for sex and age.

RESULTSSignificant positive associations were noted between low household income and diabetes mellitus, any chronic illnesses among adults and flu among younger subjects; low educational level and accident-related illness among adults; being born in Chinese mainland and flu, any acute illness in adults. For the utilization of public health care, low household income was the most consistent risk factor.

CONCLUSIONThis study did not demonstrate a unidirectional socioeconomic gradient in health but supported the hypothesis that socioeconomic deprivation was associated with the utilization of public health care.

Acute Disease ; economics ; epidemiology ; Adolescent ; Adult ; Age Factors ; China ; Chronic Disease ; economics ; epidemiology ; Cities ; Cross-Sectional Studies ; Delivery of Health Care ; utilization ; Educational Status ; Employment ; Female ; Health Surveys ; Hong Kong ; epidemiology ; Housing ; Humans ; Income ; Male ; Prevalence ; Residence Characteristics ; Sex Factors ; Socioeconomic Factors

Objective Toanalyzetheimagingfeaturesofmedulloepitheliomaforfurtherunderstanding.Methods Theimaging findingsof12casesofmedulloepitheliomaprovedbypathologywereanalyzedretrospectively.Results Thelesionswerelocatedin cerebralhemisphere(6),cerebellum (3),ventricularsystem (3),andalloftheminvolvedbothgrayandwhitematter.Thefeatures includedlargegrosstumorvolume,clearboundaryandperitumoraledema(8/12).Othersincludedcystic-solidlesions(11/12),completelysolidlesion (1/12),andiso-orslightlyhyper-densitywithcalcificationonCTscan.ThetypicalfeatureofMRIwas "mid-lakeisland"sign,and solidcomponentshowediso-orhypo-intensityonT1WI,isoorhyper-intensityonT2WIwithhemorrhageandnecrosis,aswellasthe tumorshowedobviousheterogeneousenhancementaftercontrast.Cystcomponentshowedthin-wallring-enhancement.Conclusion Thetypicalfeatureofthemedulloepitheliomaisthe "mid-lakeisland"sign.Thetumorhasalargevolume,andthe majorityshow cystic-solidlesions.Aboveall,medulloepitheliomashouldbeconsideredifthereisasolid-cysticlesionwithclearboundaryatchildren andadolescents.

In eukaryotic cells, DNA damage triggers activation of checkpoint signaling pathways that coordinate cell cycle arrest and repair of damaged DNA. These DNA damage responses serve to maintain genome stability and prevent accumulation of genetic mutations and development of cancer. The p38 MAPK was previously implicated in cellular responses to several types of DNA damage. However, the role of each of the four p38 isoforms and the mechanism for their involvement in DNA damage responses remained poorly understood. In this study, we demonstrate that p38γ, but not the other p38 isoforms, contributes to the survival of UV-treated cells. Deletion of p38γ sensitizes cells to UV exposure, accompanied by prolonged S phase cell cycle arrest and increased rate of apoptosis. Further investigation reveal that p38γ is essential for the optimal activation of the checkpoint signaling caused by UV, and for the efficient repair of UV-induced DNA damage. These findings have established a novel role of p38γ in UV-induced DNA damage responses, and suggested that p38γ contributes to the ability of cells to cope with UV exposure by regulating the checkpoint signaling pathways and the repair of damaged DNA.
Animals ; Apoptosis ; Cell Cycle Proteins ; metabolism ; Cells, Cultured ; DNA Damage ; DNA Repair ; Enzyme Activation ; Fibroblasts ; metabolism ; radiation effects ; Gene Deletion ; Histones ; metabolism ; Mice ; Mitogen-Activated Protein Kinase 12 ; genetics ; metabolism ; Phosphorylation ; S Phase ; Tumor Suppressor Protein p53 ; metabolism ; Ultraviolet Rays

OBJECTIVE: Longitudinal studies may help elucidate the factors associated with Problematic Internet Use (PIU); however, little prospective research has been conducted on the subject. The aim of the current study was to prospectively examine PIU in children/adolescents and identify the possible risk factors associated with transitions in PIU severity. METHODS: 650 middle-school boys were surveyed at two points one year apart and assessed for PIU using the Internet Addiction Proneness Scale for Youth (KS-II) and on other psychological characteristics. RESULTS: We found that 15.3% at baseline and 12.4% at one year met the criteria for at-risk/high-risk PIU (ARHRPIU). Both the persistent-ARHRPIU and emerging-ARHRPIU groups revealed greater depressive, motor impulsive, and smart-phone-addiction tendencies than the remitting-ARHRPIU group or the persistent low-risk group. In addition, we found that individuals exhibiting higher hyperkinetic attention-deficit/hyperactivity disorder (ADHD) scores were less likely to remit from ARHRPIU, and that individuals exhibiting more ADHD-related cognitive dysfunction and reporting fewer Internet-game-free days were more likely to demonstrate an emergence of ARHRPIU. CONCLUSION: The present findings support previous studies in that specific negative-health features are linked to transitions in ARHRPIU. Furthermore, these findings suggest that intervention is needed and may be best targeted at specific groups of youths.
Adolescent ; Attention Deficit Disorder with Hyperactivity ; Humans ; Internet ; Longitudinal Studies ; Prospective Studies ; Risk Factors

In the 1960s, Sir John Charnley introduced to clinical practice his concept of low-friction total hip arthroplasty (THA). Although early designs were plagued by poor performance and even failure, there have been steady advances in implant designs, biomaterials, surgical techniques and an understanding of the biomechanical restoration of the hip; these advances have contributed to improvements in implant survival and clinical outcomes of THA in the past three decades. With improved wear resistance and mechanical reliability, a potential to last for at least 25 to 30 years are now available for THA. In this review, we focus on the evolution of THA and review current controversies and future directions of this procedure based on a single surgeon's 29-year of experience at a single institution.
Arthroplasty, Replacement, Hip ; Biocompatible Materials ; Hip

Objective: To explore the characteristics of distribution on Chinese adult body mass index (BMI) in different age groups and genders and to provide reference related to obesity and related chronic diseases. Methods: Data from the China Health and Nutrition Survey in 2009 were used. Sequential sample cluster method was used to analyze the characteristics of BMI distribution in different age groups and genders by SAS. Results: Our results showed that the adult BMI in China should be divided into 3 groups according to their age, as 20 to 40 years old, 40 to 65 years old, and> 65 years old, in females or in total when grouped by difference of 5 years. For groupings in male, the three groups should be as 20 to 40, 40 to 60 years old and>60 years old. There were differences on distribution between the male and female groups. When grouped by difference of 10 years, all of the clusters for male, female and total groups as 20-40, 40-60 and>60 years old, became similar for the three classes, respectively, with no differences of distribution between gender, suggesting that the 5-years grouping was more accurate than the 10-years one, and BMI showing gender differences. Conclusions: BMI of the Chinese adults should be divided into 3 categories according to the characteristics of their age. Our results showed that BMI was increasing with age in youths and adolescents, remained unchanged in the middle-aged but decreasing in the elderly.
Adolescent ; Adult ; Age Distribution ; Aged ; Asian People/statistics & numerical data* ; Body Mass Index ; China/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Nutrition Surveys ; Obesity/ethnology* ; Sex Distribution ; Sex Factors ; Young Adult