We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*

PURPOSE: To evaluate the usefulness of MR urography(MRU) using Half-Fourier acquisition single-shot turbospin-echo(HASTE) sequence compared with conventional intravenous urography(IVU). MATERIALS AND METHODS: Thirtyfive lesions of 32 patients who underwent MRU because of delayed excretion or nonvisualization of the ureter wereincluded in this study. HASTE MR urography was performed with a 1.0 MR imaging unit. Coronal images includingthose of the kidney, ureter and bladder were obtained in every patient using the multislice technique, and werepostprocessed by means of the maximal intensity projection technique. Scan time was 17-19 seconds. We analyzed theresults of MRU, focusing on level of obstruction, incidence of stone, ureter dilatation, and motion artifact, andin each case compared MRU findings with those of IVU. RESULTS: In 12 of 35 lesions(34.2%), MRU more effectivelydiagnosed causes of obstruction than did IVU, while in seven lesions(20%), MRU and IVU were similar. In eightlesions(22.9%), all of which were caused by a stone, IVU was better than MRU, and in a further eight, neithermodality was able to diagnose the cause. For diagnosis of the level of obstruction, MRU was better than IVU in 20of 35 lesions(57.1%), and similar to IVU in seven(20%). In three lesions(8.6%), neither modality was able todetect the level of obstruction. Four lesions not related to obstruction were polycystic renal disease, cysticrenal change, vesicovaginal fistula and extra-renal pelvis. Dilatation of the ureter was seen in 23lesions(65.8%) on MRU and in seven lesions on IVU. Thus, MRU revealed dilatation of for the ureter more efectivelythan IVU. CONCLUSION: MRU using HASTE was valuable for the detection of underlying causes and levels ofobstruction in the urinary tract, and of abnormalities in surrounding structures in patients with non-visualization of the kidney or delayed contrast excretion of the ureter, as seen on delayed IVU urogram.
Artifacts ; Diagnosis ; Dilatation ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Magnetic Resonance Imaging ; Pelvis ; Polycystic Kidney Diseases ; Ureter ; Urinary Bladder ; Urinary Tract ; Urography* ; Vesicovaginal Fistula

No abstract available.
Adenocarcinoma in Situ ; Adenocarcinoma ; Neoplasm Metastasis ; Phenotype

PURPOSE: Most chemical transfection reagents are ineffective for the transfection of cells in suspension, such as leukemic cell and stem cell lineages. We developed two different types of viroplexes, cationic Sendai F/HN viroplexes (CSVs) and protamine sulfate-condensed cationic Sendai F/HN viroplexes (PCSVs) for the efficient transfection of T-leukemic cells. MATERIALS AND METHODS: The viroplex systems were prepared by reconstitution of fusogenic Sendai F/HN proteins in DMKE (O,O'-dimyristyl-N-lysyl glutamate) cationic liposomes. The viroplexes were further optimized for plasmid DNA and siRNA delivery to suspension cells. The particle size and surface charge of the viroplexes were analyzed with a zeta-sizer. Transfection of plasmid DNA (pDNA) and small interfering RNA (siRNA) by CSVs or PCSV was evaluated by measurement of transgene expression, confocal microscopy, FACS, and RT-PCR. RESULTS: The optimized CSVs and PCSVs exhibited enhanced gene and siRNA delivery in the tested suspension cell lines (Jurkat cells and CEM cells), compared with conventional cationic liposomes. In the case of pDNA transfection, the CSVs and PCSVs show at least 10-fold and 100-fold higher transgene expression compared with DMKE lipoplexes (or lipofectamine 2000), respectively. The CSVs showed more effective siRNA delivery to the suspension cells than cationic liposomes, as assessed by confocal microscopy, FACS, and RT-PCR. The effective transfection by the CSVs and PCSVs is presumably due to fusogenic activity of F/HN proteins resulting in facilitated internalization of pDNA and siRNA. CONCLUSION: This study suggests that Sendai F/HN viroplexes can be widely applicable for the transfection of pDNA and siRNA to suspension cell lines.
Cell Line, Tumor ; HN Protein/genetics ; Humans ; Jurkat Cells ; RNA, Small Interfering ; Sendai virus/genetics ; Transfection/*methods ; Viral Fusion Proteins/genetics ; Virosomes

Shigellosis may mimic acute appendicitis clinically, but Shigella species rarely cause appendicitis. We experienced acute appendicitis with perforation caused by Shigella sonnei in a 24-year-old woman who had traveled abroad.
Appendicitis ; Dysentery, Bacillary ; Female ; Humans ; Hydrazines ; Shigella ; Shigella sonnei ; Young Adult

Actinomyces is a normal flora of the oral cavity but lesions localized to the oral mucosa are very rare. We herein present a rare case of actinomycosis presenting as ulcers of hard palate which developed after esophagogastroduodenoscopy.
Actinomyces ; Actinomycosis ; Endoscopy, Digestive System ; Mouth ; Mouth Mucosa ; Oral Ulcer ; Palate, Hard ; Ulcer

Actinomyces is a normal flora of the oral cavity but lesions localized to the oral mucosa are very rare. We herein present a rare case of actinomycosis presenting as ulcers of hard palate which developed after esophagogastroduodenoscopy.
Actinomyces ; Actinomycosis ; Endoscopy, Digestive System ; Mouth ; Mouth Mucosa ; Oral Ulcer ; Palate, Hard ; Ulcer

Background: We used machine learning and population-based data for analyzing the determinants of sarcopenia in adult women and developing its decision support systems for various subgroups. Methods: All data was acquired from the Korea National Health and Nutrition Examination Survey, and women 18 years and older were included in this research. The variables were selected based on female characteristics and the ability to be acquired in a survey format, and were ranked by importance using Random Forest. From this ranking, four main variables were selected, age, menopause age, menarche age and number of pregnancy. A decision supporting system was constructed based on a tree randomly selected from Random Forest. Results: We defined sarcopenia as -2SD below the appendicular skeletal mass (ASM) index reference of 0.5136, and 89.87% (n = 8,610) were found non-sarcopenic and 10.13% (n = 971) were found sarcopenic. The subjects were divided into 6 groups based on menopausal status and BMI. The obese postmenopausal women had the highest number of sarcopenia, whereas the non-obese premenopausal women had the least number of sarcopenic subjects. In non-obese premenopausal women, which was considered to be at the lowest risk for sarcopenia, the most determining variable was the menarche age, followed by age and number of pregnancies. In obese and postmenopausal women, which was considered to be at the highest risk for sarcopenia, the most influential factor was the menopausal age, followed by age and menarche age. Conclusions We identified the major determinants of sarcopenia using machine learning and population-based data. This study demonstrated the strengths of the random forest as an effective decision support system for each stratified subgroup to find its own optimal cut-off points for the major variables of sarcopenia.

Objective: Severe acute cholecystitis is an infectious disease that requires immediate gallbladder drainage. Although percutaneous transhepatic gallbladder drainage (PTGBD) is the most common method of gallbladder drainage, the optimal timing remains unclear. Methods: This study is a retrospective analysis of patients diagnosed with severe acute cholecystitis who underwent PTGBD between July 2018 to June 2021. This study investigated the effect of time from emergency department arrival to PTGBD (tPTGBD) on patient prognosis. Results: Totally, 48 patients were included in this study. Based on the cutoff value calculated using the Youden index, the group with tPTGBD of <5.93 hours had a shorter hospital stay (10 vs. 13.5 days, P=0.021), lower portion of progression (27:5 [15.6%] vs. 7:9 [56.3%], P=0.004), even they had a higher initial SOFA score (6 vs. 4.6, P=0.049). However, no statistical difference was obtained for the length of ICU stay between both groups (1 vs. 2, P=0.617). Conclusion Executing PTGBD to severe acute cholecystitis patients within 5.93 hours after presenting at the emergency department is associated with reduced progression and hospital stay.

BACKGROUND/AIMS: MELD-Na (model for end-stage liver disease with incorporation of serum sodium) was suggested to provide better survival prediction than MELD alone for patients with end stage liver disease. However, there is no data verifying the usefulness of MELD-Na for predicting short term mortality of cirrhotic patients in Korea. This study was aimed to determine whether MELD-Na would be more accurate in predicting short term mortality than other scoring systems such as Child-Turcotte-Pugh (CTP) or MELD. METHODS: Data from 355 patients admitted due to liver cirrhosis were retrospectively reviewed. The cumulative survival rates were obtained. Prediction of mortality rate for three months and one year were analyzed using the area under the receiver's operating characteristics curve (AUC). RESULTS: One hundred patients (28%) died during the study period. All of the three systems showed significant differences in the cumulative survival rate according to the scores on admission (p<0.001). The AUC of CTP, MELD, and MELD-Na in predicting three-months mortality were 0.828, 0.845, and 0.862 (p>0.05), and the AUC of each score system for death within one year were 0.792, 0.800, and 0.831, respectively (p>0.05). The AUC of MELD-Na in predicting short term death were the highest, although it was not statistically significant. Multivariate analysis showed that only MELD-Na was significantly related to three-month mortality (p=0.012). CONCLUSIONS: MELD-Na is more appropriate in predicting short term mortality, but larger scale studies are needed to confirm the superiority of MELD-Na to MELD and CTP in patients with liver cirrhosis.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Liver Cirrhosis/*mortality ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; ROC Curve ; Retrospective Studies ; *Severity of Illness Index ; Survival Analysis ; Time Factors