Authors reviewed mammographic ultrasonographic and MRI findings a patient with breast cysticerocosis, which was operated and pathologically proved. Mammography showed a 1 cm sized round radioopaque lesion with curvilinear calification, which was located near the pectoralis major muscle. Ultrasonograiphic findings showed heterogenous hypoechoic cystic lesion with internal hyperechoic nodule and posterior acoustic shadowing. T2Wl and proton density MR image showed low signal intensity with cresentic high signal intensity portion. 2D-FLASH dynamic MRI showed intermediate signal intensity and peripheral signal void area, which was not enhanced with Gd-DPTA. The possibility of cysticercosis can be considered be considered when a cytic lesion is discovered near the pectoralis muscle in a patient living in an endemic area.
Acoustics ; Breast* ; Cysticercosis* ; Humans ; Magnetic Resonance Imaging ; Mammography ; Pectoralis Muscles ; Protons ; Shadowing (Histology)

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy

Various hematologic and vascular complications from snakebites have been reported in the literature. Spontaneous bleeding causing hematoma, however, is not a common complication of snakebites. Here we report a case of spontaneous retroperitoneal hematoma in which a 72-year-old male visited the emergency department with sudden-onset left flank pain and dizziness. Computed tomography (CT) revealed high-attenuation fluid collection in the retroperitoneum and contrast extravasation. Conservative treatment was continued and he was discharged without any complications after 7 days.
Aged ; Bites and Stings ; Dizziness ; Emergencies ; Flank Pain ; Hematoma ; Hemorrhage ; Humans ; Male ; Retroperitoneal Space ; Snake Bites ; Vascular System Injuries

No abstract available.
Lichens* ; Mucinosis, Follicular*

BACKGROUND: The self-inflating bag-valve resuscitator is an useful breathing support equipment in the cardiopulmonary resuscitation, the transportation of patients who required ventilation assist, or respiratory therapy. The inspiratory oxygen concentration (FiO2) or tidal volume (VT) delivered to the patient depends on various conditions during bag-valve ventilation. METHODS: During bag-valve ventilation without a reservoir at oxygen flow rates of 10 l/min, we evaluated fifty six volunteers to determine the FiO2 and VT at ventilatory frequencies of 10, 12 and 15 cycles per minute and to observe the effect of hand size and grasp power on FiO2 and VT in two-hand compression methods. RESULT: The FiO2 at frequency of 10 cycles/min were 50.1% and it was higher than other ventilatory frequencies. However, the VT was not statistically different among the changes of ventilatory frequency. In the change of VT according to characteristics of the hand, the operator's hand size exerted influence on VT(larger vs. smaller ; 942ml vs. 885ml, p<0.05), but the grasp power of the hand did not significantly affect. Separate analyses with size or grasp power of the hand failed to reveal significant differences of the FiO2. CONCLUSION: The results suggest that a slowing of ventilatory frequency within the allowable ranges for adequate gas exchange increase the FiO2 during bag-valve ventilation without reservoir, and that hand size may exert influence on the VT without FiO2 changes but grasp power may not be a contributing factor to the VT or FiO2 changes.
Cardiopulmonary Resuscitation ; Hand Strength ; Hand* ; Humans ; Oxygen* ; Respiration ; Respiratory Therapy ; Tidal Volume* ; Transportation of Patients ; Ventilation* ; Volunteers

No abstract available.
Transposases*

BACKGROUND: Pain is one of the most common presenting complaints in the emergency department(ED) and adequate analgesia for painful conditions is an important goal of emergency medical practice. This study was designed to investigate on the actual condition regarding the use of analgesic injections for traumatized patients in the field of ED and to reconsider the concern and methods of pain management in the future. METHOD: We carried out a prospective, noninterventional observational clinical study of adult patients presenting with acute trauma in the ED. Using a numeric rating scale ranging from 0 to 10, patients quantified their pain intensity on arriving at the ED and on one hour after analgesic administrations in the cases of analgesic use or after initial Assessment in the cases of no analgesic use. They also were interviewed about the level of their satisfaction to pain relief before leaving the ED. RESULTS: Seventy eight percent of all patient received analgesic injections(nonsteroidal antiinflammatory drugs; 62%, opioids; 16%) and the remaining 22 patients(22%) were treated without analgesics. At the time of secondary assessment to pain, initial pain score in the cases of analgesic administration decreased. Patients who are beyond fair in the level of satisfaction were recorded for only 18% of all patient even though 78% of patients received analgesic injections. CONCLUSION: Our data illustrate that the patient of trauma commonly receive analgesic injections in the ED but their levels of satisfaction are under fair. This finding suggests that the concern and methods of pain management have to be reconsidered through the understanding of analgesic pharmacology and pattern of pain relief by analgesics.
Adult ; Analgesia ; Analgesics ; Analgesics, Opioid ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Pain Management* ; Pharmacology ; Prospective Studies

BACKGROUND: The present study investigated the efficacy and safety of vildagliptin-metformin treatment compared to those of glimepiride-metformin treatment for type 2 diabetes. METHODS: In a randomized, open-label, comparative study, 106 patients with type 2 diabetes were enrolled. The primary endpoint was a reduction in HbA1c from baseline and secondary endpoints included fasting plasma glucose (FPG) or 2-hour postprandial glucose (2h-PPG) reduction from baseline, as well as HbA1c responder rate and HbA1c reduction according to baseline HbA1c category. RESULTS: Comparable HbA1c reduction was observed with a mean+/-standard deviation change from baseline to the 32-week endpoint of -0.94+/-1.15% in the vildagliptin group and -1.00+/-1.32% in the glimepiride group. A similar reduction in 2h-PPG (vildagliptin group 3.53+/-4.11 mmol/L vs. the glimepiride group 3.72+/-4.17 mmol/L) was demonstrated, and the decrements in FPG (vildagliptin group 1.54+/-2.41 mmol/L vs. glimepiride group 2.16+/-2.51 mmol/L) were not different between groups. The proportion of patients who achieved an HbA1c less than 7% at week 32 was 50.1% in the vildagliptin group and 56.0% in the glimepiride group. An average body weight gain of 2.53+/-1.21 kg in the glimepiride group was observed in contrast with the 0.23+/-0.69 kg weight gain noted in the vildagliptin group. A 10-fold lower incidence of hypoglycemia was demonstrated in the vildagliptin group, in addition to an absence of severe hypoglycemia. CONCLUSION: Vildagliptin-metformin treatment provided blood glucose control efficacy comparable to that of glimepiride-metformin treatment and resulted in better adverse event profiles with lower risks of hypoglycemia and weight gain.
Adamantane ; Blood Glucose ; Body Weight ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Humans ; Hypoglycemia ; Incidence ; Metformin ; Nitriles ; Plasma ; Pyrrolidines ; Sulfonylurea Compounds ; Weight Gain

BACKGROUND: Victims of trauma in the emergency room(ER) suffer from kinds of discomforts derived from their physical injury and psychological instability. Although discomforts may be varied by the patient's characteristics and environmental factors such as medical personnel or facilities in ER, an active control for the discomfort should be required because it may affect an outcome of treatment and prognosis of illness. The purpose of this study is to analyze the distressing factors which traumatized patients have been experienced in the ER and to improve the management of trauma patients in the future. METHODS: From January 1, 1996 to June 30, 1996, we tried to interview patients about the painful experiences in ER before the decision of his or her discharge from ER. We analyzed the data on age, sex, religion, educational level, injury severity score(ISS), the most unpleasant experience, sleep deprivation, and friar for death. RESULTS: The 126 patients were enrolled in this study. The patients consisted of 93 male and 33 female, their mean age was 45 years old and mean ISS was 7.86. About seventy one percent of the patients complained unpleasant experiences during the stay in the ER. Of these, pain at the injury sites was the most frequent complaint (66.7%). The sleep deprivation was showed about sixty percent of the total patient and the most common cause of this was also due to pain(40%). Nineteen percent of the patients answered that they have felt the fear for death. There were statistically significant differences in degree of the ISS whether the fear for death and unpleasant experience were or not. When the patients demarked with whether the presence of pain, the occurrence of sleep deprivation, and fear for death were statistically related to the pain. However, the data was denoted no direct relationship with pain according to sex, educational level, or religion. CONCLUSION: The trauma patient admitted to ER suffered from various stressful conditions including not only their physical injury but care personnel or unstable environmental factors in ER. Therefore, emergency medical personnel has to understand some possible distresses of the patients and need to reduce them to provide more careful and proper managements.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Sleep Deprivation

BACKGROUND AND OBJECTIVE: AT-1 cells have been derived from the left atrial tissue in which the ANF promoter targeted SV40 large T antigen expression. When cultured, clusters of spontaneously contracting cells were observed after 4-5 days and contiguous sheets of synchronously beating cardiomyocytes were formed after 10 days. In this study, expression of several cell cycle regulatory genes were monitored through Northern blot analyses in AT-1 cells during beating and after formation of beating sheets (BS). MATERIALS AND METHOD: AT-1 RNAs were obtained in 3 days after plating, during beating and after formation of BS, and used for Northern blot analyses. RESULTS: alpha-Cardiac myosin heavy chain expression was prominent in beating cells, as would be expected for this contractile protein isoform but ANF was decreased after beating. Gax was not expressed in cultured AT-1 cells but in AT-1 tumor and murine heart. p53 and p21 were decreased after beating which indicate transcription level of p53 and p21 correlated well in AT-1 cells. In contrast, pRB and p107 were increased after beating but p68 (2.4 kb) which arose by alternative splicing of p107 and lacks the pocket domain B was decreased in beating cells. pTCS2, murine tuberous sclerosis gene, represented similar levels during beating but a little was decreased after formation of BS. mRAD50, the murine homologue of yeast DNA recombinational repair gene RAD50, was increased in beating cells, a similar pattern to p107 and pRB. But the p50 arose by alternative splicing of mRAD50 and has 3' half of mRAD50 had unexpectedly appeared and maintained after beating. CONCLUSION: The expression of cell cycle regulatory genes after beating and formation of BS in AT-1 cells showed gene-specific pattern and the p50 which has homology to the mRAD50 may participate in differentiation of cardiomyocytes.
Alternative Splicing ; Antigens, Viral, Tumor ; Atrial Natriuretic Factor ; Blotting, Northern ; Cell Cycle* ; Genes, Regulator* ; Heart ; Myocytes, Cardiac* ; Myosin Heavy Chains ; Recombinational DNA Repair ; RNA ; Tuberous Sclerosis ; Yeasts