No abstract available.
Clinical Decision-Making/*methods ; *Evidence-Based Medicine ; *Practice Patterns, Physicians' ; *Uncertainty

No abstract available.
Lymphangioma, Cystic*

Objective To quantitatively assess severity of movement disability by analyzing physical activities recorded by an actigraph monitor in patients with neurology disorders.Methods Eighty-one patients with Parkinson' s disease(PD)and 61 patients with acute cerebral infarction(ACI)accompanying impaired upper limb motor function were included in the study.PD patients and ACI patients were treated using the international PD and ACI treatment guidelines,respectively.The patients were asked to wear an Actigraph monitor for 6 days before the treatment in both PD and ACI patient groups and at 24-38 days post-treatment in PD patients or at 28 days post-treatment in ACI patients.The recorded data was analyzed by power-law exponent(PLE)and detrended fluctuation analysis(DFA).Clinically,before and after the treatments,PD patients were evaluated using the conventional Unified Parkinson Disease Rating Scale (UPDRS),and ACI patients were evaluated by assessing upper limb motor function using Fugl-Meyer Assessment(FMA)and Functional Independence Measure(FIM).The correlation of the UPDRS scores with PLE was analyzed in PD patients,and the correlation of FMA or FIM with DFA in ACI patients.Results Both the UPDRS scores and the PLE values in PD patients were improved after the drug administration(UPDRS total:32.8 ± 16.2 and 28.8 ± 14.7,Z =2.080,P =0.038; UPDRS Ⅲ:18.6 ± 8.2 and 15.7±6.8,Z=2.155,P=0.031; PLE:0.98 ±0.25 and 0.82 ±0.21,Z=2.212,P=0.027,before and after the treatment,respectively).There were a linear correlation coefficient of 0.699 between the improvements of total UPDRS scores and the PLE values,and of 0.823 between the UPDRS Ⅲ and the PLE values.FMA,FIM scores and DFA were improved significantly than before treatment(FMA:12.39 ± 8.21 and 30.28 ±7.29,Z=3.016,P =0.004; FIM:8.98 ±7.29 and 13.21 ±7.6,Z =2.282,P=0.038; DFA:0.86 ±0.31 and 0.98 ±0.27,Z =2.360,P =0.036,before and after the treatment,respectively).It also showed linear correlations between the improvements of FMA scores and DFA(r =0.638),and between FIM scores and DFA(r =0.712,both P ＜0.05).There was no correlation between UPDRS scores and DFA values in PD patients,nor between FIM scores or FMA scores and PLE values in ACI patients.Conclusions Actigraph device can be used to monitor patients activity in movement disorders.Analysis of its PLE can provide a quantitative evaluation in PD while its DFA may provide useful specific assessment of impaired upper limb motor function in ACI patients.It can also be used in quantitatively assessing new drug efficacy.

OBJECTIVES: This study was designed to explore body-shape satisfaction and adjustment functions in 410 adolescent school girls. METHODS: After underweight, normal-weight and overweight groups were identified among 410 high school girls according to BMI(body mass index), we compared current weight & height, ideal weight & height, subtracted value of ideal weight from current weight, subtracted value of ideal height from current height, subtracted value of ideal BMI from current BMI, weight dissatisfaction, height dissatisfaction,body-shape dissatisfaction,and EAT-26(Eating attitude Test-26),OSIQ(Offer Self-Image Questionnaire for Adolescents), STAI(State-Trait Anxiety Inventory),BDI(Beck Depression Inventory),BITE(Bulimic Investigatory Test Edinburgh) among the three group. RESULTS: 1) The subjects consisted with overweight group(BMI > 25,N=27,6.6%), normal-weight group(19< or = BMI < or =25,N=278,67.8%),and underweight group(BMI<19, N=105, 25.6%). 2) In comparison to other groups, overweight group was significantly different in subtracted value of ideal weight from current weight and subtracted value of ideal height from current height. These results suggest that overweight group wants greater body-shape change than other groups. Overweight group was significantly shorter in height than underweight group there were no significant differences in ideal height among the groups. 3) Overweight group and normal-weight group showed significantly highter weight dissatisfaction than underweight group. There were no significant differences in height dissatisfaction and body-shape dissatisfaction among the three groups. All groups showed higher weight, height dissatisfaction and body-shape dissatisfaction except higher weight dissatisfaction in underweight group. 4) In comparison of overweignt group with other groups by mean difference of each scale, there was significant difference in superior adjustment subscale of the OSIQ and symptom subscale of the BITE between overweight group and other groups. There was also significant difference in symptom severity subscale of the BITE between overweight and underweight groups. There was no significant difference in EAT-26,STAI,BDI,other subscales of OSIQ among the groups. CONCLUSIONS: 1) The distribution rate of overweight group was lower than in western studies. 2) These results suggest that overweight group wants greater body-shape change than other groups, and overweight group may have binge-eating behavior and poor coping system.
Adolescent* ; Anxiety ; Depression ; Female* ; Humans ; Obesity ; Overweight ; Surveys and Questionnaires ; Thinness

BACKGROUND/AIMS: The p53 mutations have been described as the most common genetic alteration during development and progression of malignancy in a wide range of human cancers. Mutant p53 proteins have a prolonged half-life accounting for increased levels of p53 protein frequently detected in tumors. This can induce the production of anti-p53 in the senzn of patients with HCC. We determined the relationship of serum anti-p53 with p53 expression in the liver tissue of chronic liver disease and the correlation of serum anti-p53 with serum alpha- fetoprotein(AFP) in patients with HCC. METHODS: In sera of same patients, we analysed the anti- p53 using ELISA system As controls we tested 50 healthy individuals and 20 patients with chronic hepatitis. Immaiohistochemical study for the presence of mutant p53 was performed on liver tissue from 50 patients with cirrhosis and 30 patients with HCC using monoclonal antibody clone DO-7 and LSAB kit by ABC method. RESULTS: Anti-p53 was positive in 9(30%) of 30 patients with HCC. Among nine patients with positive anti-p53, only two patients had detectable p53 expression in their tumor tissues. Anti-p53 was positive in 5(10%) of 50 patients with liver cirrhosis. The AFP was elevated in 21(70%) of 30 patients with HCC. Among the 9 AFP- negative HCC patients, 4(44.4%) were found to be positive for anti-p53. P53 expression was detectable in 9(30%) of 30 HCCs and 1(3.3%) of RO surrounding non-tumorous cirrhotic tissues. CONCLUSION: Mese findings suggest that anti-p53 was not correlated with the status of p53 expression in liver tissue and serological testing for anti-p53 antibody may be complementary to serum AFP for diagnosing of HCC with normal serum AFP.
Carcinoma, Hepatocellular ; Chronic Disease* ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Half-Life ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases ; Liver* ; Serologic Tests

PURPOSE: External beam radiotherapy (EBRT) is a useful option to treat head and neck skin cancer patients who are not indicated for surgery. In this study, we evaluated the treatment outcomes of EBRT in an Asian population.MATERIALS AND METHODS: The records from 19 head and neck skin cancer patients (10 with squamous cell carcinoma and 9 with basal cell carcinoma) who were treated with definitive or adjuvant EBRT from 2009 to 2017 were retrospectively reviewed. The radiotherapy doses administered ranged from 50 to 66 Gy (median, 55 Gy) with 2.0–2.75 Gy per daily fraction (median, 2.5 Gy). The T stage at presentation was as follows: Tis (1 patient), T1 (11 patients), T2 (6 patients), and T3 (1 patient). None had regional lymph node disease or distant metastasis at presentation. The local failure-free survival (LFFS) rates, toxicity, and cosmetic results were analyzed.RESULTS: The median age was 75.5 years (range, 52.6 to 92.5 years). The median follow-up duration from the completion of radiotherapy was 44.9 months (range, 5.8 to 82.6 months). One local failure occurred in a patient with a 2.1-cm posterior neck squamous cell carcinoma at 32.5 months after radiotherapy (1/19, 5.3%). The 3-year LFFS rate was 91.7%. No patients died from skin cancer during follow-up, and no grade 3 complications occurred. The cosmetic outcomes were excellent for 16 (84.2%) and good for 3 (15.8%) of the 19 patients.CONCLUSION: EBRT offers good local control and cosmetic outcomes in patients with head and neck skin cancer, with no grade 3 complications.
Asian Continental Ancestry Group ; Carcinoma, Squamous Cell ; Follow-Up Studies ; Head ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Radiotherapy ; Retrospective Studies ; Skin Neoplasms ; Skin ; Treatment Outcome

Purpose: This study aimed to compare the surgical and oncological outcomes between totally laparoscopic pylorus-preserving gastrectomy (TLPPG) with intracorporeal anastomosis and laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) with extracorporeal anastomosis. Materials and Methods: A retrospective analysis was performed in 258 patients with cT1N0 gastric cancer who underwent laparoscopic pylorus-preserving gastrectomy using two different anastomosis methods: TLPPG with intracorporeal anastomosis (n=88) and LAPPG with extracorporeal anastomosis (n=170). The following variables were compared between the two groups to assess the postoperative surgical and oncological outcomes: proximal and distal margins, number of resected lymph nodes (LNs) in total and in LN station 6, operation time, postoperative hospital stay, and postoperative morbidity including delayed gastric emptying (DGE). Results: The average length of the proximal margin was similar between the TLPPG and LAPPG groups (2.35 vs. 2.73 cm, P=0.070). Although the distal margin was significantly shorter in the TLPPG group than in the LAPPG group (3.15 vs. 4.08 cm, P=0.001), no proximal or distal resection margin-positive cases were reported in either group. The average number of resected LN was similar in both groups (36.0 vs. 33.98, P=0.229; LN station 6, 5.72 vs. 5.33, P=0.399). The operation time was shorter in the TLPPG group than in the LAPPG (200.17 vs. 220.80 minutes, P=0.001). No significant differences were observed between the two groups in terms of postoperative hospital stay (9.38 vs. 10.10 days, P=0.426) and surgical complication rate (19.3% vs. 22.9%), including DGE (8.0% vs. 11.8%, P=0.343). Conclusions The oncological safety and postoperative complications of TLPPG with intracorporeal anastomosis are similar to those of LAPPG with extracorporeal anastomosis.

Fistula between coronary artery and pulmonary artery is a type of coronary artery anomalies. It can cause atypical chest pain and fatigue, angina pectoris, endocarditis, finally myocardial steal can result in heart failure and myocardial infarction. But only 0.1-0.2% of coronary angiographic studies reveal the communications between coronary artery and other spaces. (heart chamber, pulmonary artery etc.) It is frequently congenital, but acquired types are increasing because chest and heart manipulations such as opertion of tetralogy of Fallot, endomyocardial biopsy, radiation therapy, or penetrating blunt trauma are increasing. There are reports about repair of fistula using thrombogenic tips, coil embolization and surgical intervention. We report a connection between coronary artery and pulmonary artery in 79 years old female. She was 30 pack-years smoker and suffered from dyspnea several years with chronic obstructive pulmonary disease. She presented with atypical chest pain and palpitation after admission. Electrocardiography showed ST-T wave abnormality. Emergency coronary angiography and chest CT scan revealed coronary-pulmonary artery fistula. Transcatheter embolization was performed and she was relieved from discomforts.
Aged ; Angina Pectoris ; Arteries* ; Biopsy ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Dyspnea ; Electrocardiography ; Embolization, Therapeutic ; Emergencies ; Endocarditis ; Fatigue ; Female ; Fistula* ; Heart ; Heart Failure ; Humans ; Myocardial Infarction ; Pulmonary Artery ; Pulmonary Disease, Chronic Obstructive ; Tetralogy of Fallot ; Thorax ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: We assessed plaque erosion of culprit lesions in patients with acute coronary syndrome in real world practice. SUBJECTS AND METHODS: Culprit lesion plaque rupture or plaque erosion was diagnosed with optical coherence tomography (OCT). Intravascular ultrasound (IVUS) was used to determine arterial remodeling. Positive remodeling was defined as a remodeling index (lesion/reference EEM [external elastic membrane area) >1.05. RESULTS: A total of 90 patients who had plaque rupture showing fibrous-cap discontinuity and ruptured cavity were enrolled. 36 patients showed definite OCT-plaque erosion, while 7 patients had probable OCT-plaque erosion. Overall, 26% (11/43) of definite/probable plaque erosion had non-ST elevation myocardial infarction (NSTEMI) while 35% (15/43) had ST elevation myocardial infarction (STEMI). Conversely, 14.5% (13/90) of plaque rupture had NSTEMI while 71% (64/90) had STEMI (p<0.0001). Among plaque erosion, white thrombus was seen in 55.8% (24/43) of patients and red thrombus in 27.9% (12/43) of patients. Compared to plaque erosion, plaque rupture more often showed positive remodeling (p=0.003) with a larger necrotic core area examined by virtual histology (VH)-IVUS, while negative remodeling was prominent in plaque erosion. Overall, 65% 28/43 of plaque erosions were located in the proximal 30 mm of a culprit vessel-similar to plaque ruptures (72%, 65/90, p=0.29). CONCLUSION: Although most of plaque erosions show nearly normal coronary angiogram, modest plaque burden with negative remodeling and an uncommon fibroatheroma might be the nature of plaque erosion. Multimodality intravascular imaging with OCT and VH-IVUS showed fundamentally different pathoanatomic substrates underlying plaque rupture and erosion.
Acute Coronary Syndrome* ; Humans ; Membranes ; Myocardial Infarction ; Plaque, Atherosclerotic ; Rupture* ; Thrombosis ; Tomography, Optical Coherence ; Ultrasonography

Magnetic resonance imaging (MRI) has become a crucial tool for evaluating mediastinal masses considering that several lesions that appear indeterminate on computed tomography and radiography can be differentiated on MRI. Using a three-compartment model to localize the mass and employing a basic knowledge of MRI, radiologists can easily diagnose mediastinal masses. Here, we review the use of MRI in evaluating mediastinal masses and present the images of various mediastinal masses categorized using the International Thymic Malignancy Interest Group’s three-compartment classification system. These masses include thymic hyperplasia, thymic cyst, pericardial cyst, thymoma, mediastinal hemangioma, lymphoma, mature teratoma, bronchogenic cyst, esophageal duplication cyst, mediastinal thyroid carcinoma originating from ectopic thyroid tissue, mediastinal liposarcoma, mediastinal pancreatic pseudocyst, neurogenic tumor, meningocele, and plasmacytoma.