This study was performed to demonstrate the effect of linear or nonlinear contrast enhancement on subtraction images. Three different textures were radiograped on dental film. The first radiograph was taken without the presence of an object. the second, which showed trabucular bone, was taken of the molar area of a human. the third radiograph was taken of the coronal part of molars. Each film was digitized into a 1312 X 1024 pixel X 8 bit depth matrix by means of a Nikon 35 mm film scanner(LS-3510AF, Japan) with fixed gain and internal dark current correction to maintain constant illumination. The scanner was interfaced to a Macintosh LC III computer(Apple Computer, Charlotte, N.C.). This resulted in three pairs of images, including different textures-plain, bone and enamel. Digital regular, linearly and nonlinearly enhanced subtraction was performed. Computer software was used to simulate lesions in the shape of a 2D-Gaussian curve on each of a pair of images. The each subtraction images were presented in a random sequence to two groups of 10 observers(students and dentists). ROC analysis was used to compare observer performance. The following results were obtained; 1. All of LCE subtraction, equalized subtraction and regular subtraction images of plain texture were diagnosed the best by far. 2. The data revealed a siginificant LCE effect in both the student group and the expert group. 3. Clinical expertise was a helphul factor for the observers in this study.
Dental Enamel ; Humans ; Lighting ; Molar ; ROC Curve

Anti-M antibodies are usually assumed to be naturally occurring and to consist of immunoglobulin M reacting at 4degrees C. They are not usually considered to be clinically significant, however, many of them have an immunoglobulin G component reacting at 37degrees C and can be correlated with hemolytic disease of the newborn (HDN). We report a moderate case of HDN by anti-M. A 2-days old baby born from a mother with preeclampsia as a second pregnancy was admitted due to anemia, hyperbilirubinemia and hypoxic encephalopathy. The blood type of mother was AB, ccDEE, NN, and the blood type of baby was A, D+, and MN. Antibody screening and identification identified anti-M antibody which was strong reactive at 37degrees C albumin and antiglobulin phase in both baby's and her mother's serum. The direct antiglobulin test of baby's red blood cells was negative. The infant was transfused with group O red cells which have negative to trace reaction with her mother's serum in antiglobulin phase. Two days later, the hemoglobin level elevated from 6.7 g/dL to 15.9 g/dL falled to below 11 g/dL quite soon. After all, newborn died of cardiac arrest due to her basic disease at age of 49 days; metabolic acidosis and hypernatremia.
Acidosis ; Anemia ; Antibodies ; Coombs Test ; Erythrocytes ; Heart Arrest ; Humans ; Hyperbilirubinemia ; Hypernatremia ; Hypoxia, Brain ; Immunoglobulin G ; Immunoglobulin M ; Infant ; Infant, Newborn* ; Mass Screening ; Mothers ; Pre-Eclampsia ; Pregnancy

Chromosomal abnormalities, which are valuable markers for diagnosis and prognosis of cancer, provide useful clues in characterizing cancer at molecular level. Gastric cancer is the major cause of cancer deaths in Asian countries, including Korea. Genetic changes during the progression and metastasis of gastric cancer remain unclear. Recently, technique of degenerate oligonucleotide primed (DOP) PCR-comparative genomic hybridization (CGH) permits genetic imbalances screening of the entire genome using only small amounts of tumor DNA. In non-metastatic gastric cancers the common sites of copy number increases were detected at 8q (64%), 4p12-q24 (64%), 5p13-q23 (64%), 13q21-q32 (64%), 6q11-q21 (55%), 7q(50%), 14q11.2-q21 (45%), 3q11-q13.3 (41%), and 2q23-q32 (41%). In metastatic gastric cancers, the frequent sites of gains were detected at 8p21-qter (60%), 5 (54%), 20 (42%), 6pter-q24 (51%), 1q21-qter (46%), 3p14-qter (46%), 22q (46%), and 4 (43%). Deletion or chromosomal loss was found to be less frequent in this study. The frequent sites of copy number decreases were detected at 1p34-pter (23%), 16q23-q24 (18%), and 19q13 (18%) in non-metastatic gastric cancers. In metastatic gastric cancers, chromosome losses were detected at X (37%), 1p33-pter (37%), and 16p (23%). The recurrent gains and losses of chromosomal regions identified in this study provide candidate regions that may contain oncogenes or tumor suppressor genes respectively involved in the tumorigenesis of gastric cancer.
Asian Continental Ancestry Group ; Carcinogenesis ; Chromosome Aberrations ; Comparative Genomic Hybridization* ; Diagnosis ; DNA ; Genes, Tumor Suppressor ; Genome ; Humans ; Korea ; Mass Screening ; Neoplasm Metastasis ; Nucleic Acid Hybridization ; Oncogenes ; Prognosis ; Stomach Neoplasms

PURPOSE: To investigate the relationship between the smart devices usage-related factors and self-regulation ability development in early childhood. METHODS: Parental questionnaires of 187 children aged 3–6 years were analyzed. The metrics included smart device usage frequency (times/week, scored as uFreq), smart device usage time (hours/day, scored as uTime), parental scale for appropriate smart device usage level (scored as uLevel), the Korean-developmental screening test (K-DST), and the scale for self-regulation ability in young children (scored as SRS, and including four sub-categories: self-appraisal, self-determination, behavior inhibition, and emotionality). The correlations were analyzed by total age group and by each age. RESULTS: In the total age group analysis, uFreq and uTime were negatively correlated with mean SRS (rs =−0.366, −0.330; P < 0.001) and sub-category SRS (rs =−0.186 to −0.370; P < 0.05). Mean uLevel score was positively correlated with mean SRS (rs =0.406; P < 0.001) and most of the mean sub-category SRS (rs =0.174 to 0.362; P < 0.05). In 3-year-old children, the mean SRS was strongly negatively correlated with uFreq (rs =−0.751; P < 0.001), negatively correlated with uTime (rs =−0.518; P < 0.001), and positively correlated with mean uLevel score (rs =0.533; P=0.013). Such correlations seemed to decrease at the age of 4–6 years. CONCLUSION: Self-regulation ability was significantly correlated with smart device-related factors and was the highest in the 3-year-old children. Encouraging appropriate smart device usage will be helpful for self-regulation development of young children.
Child ; Child, Preschool ; Diagnostic Self Evaluation ; Humans ; Mass Screening ; Parents ; Self-Control* ; Smartphone

The use of totally implantable central venous access devices (chemoport) has increased with the development of chemotherapeutic agents in oncologic patients, especially with no venous access site. However, there can be various complications such as port site infection, thromboembolism, injury of central vein, fracture of catheter, and migration of catheter. We report a rare case of migration of catheter to right atrium due to the separation of the catheter from the chemoport.
Catheters ; Heart Atria ; Humans ; Thromboembolism ; Veins

The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.
Asthma ; Bronchi ; Bronchoscopy* ; Delayed Diagnosis ; Dyspnea ; Early Diagnosis ; Incidence ; Lung ; Lung Abscess ; Membranes ; Pneumonia ; Pulmonary Atelectasis ; Rib Fractures ; Rupture* ; Thorax* ; Trees

Purpose: Radiation-induced lymphopenia is associated with worse outcomes in solid tumors. We assessed the impact of interleukin-7 (IL-7), a key cytokine in lymphocyte homeostasis, on radiation-induced lymphopenia. Materials and Methods: A post-hoc analysis was performed in a prospective cohort of 98 patients with hepatocellular carcinoma who were treated with radiotherapy in 2016-2018. Blood IL-7 levels were assayed before and at the end of radiotherapy. Acute severe lymphopenia (ASL) was defined as a total lymphocyte count of < 200/μL during radiotherapy. Cox and logistic regression analyses were performed to identify predictors of survival and ASL development, respectively. Results: Patients with ASL (n=41) had significantly poorer overall survival than those without (12.0 months vs. 25.3 months, p=0.001). Patients with lymphocyte recovery showed significantly longer overall survival than those without (21.8 months vs. 10.3 months, p=0.042). ASL was an independent predictor of poor survival (hazard ratio, 2.07; p=0.015). Patients with ASL had significantly lower pre-radiotherapy IL-7 levels (2.07 pg/mL vs. 3.01 pg/mL, p=0.010). A high pre-radiotherapy IL-7 level was an independent predictor of a reduced risk of ASL development (hazard ratio, 0.40; p=0.004). IL-7 levels reflected a feedback response to ASL, with a higher ΔIL-7 in patients with ASL and a lower ΔIL-7 in those without ASL (0.48 pg/mL vs. –0.66 pg/mL, p < 0.001). Post-radiotherapy IL-7 levels were significantly positively correlated with the total lymphocyte counts at 2 months. Conclusion IL-7 is associated with the development of and recovery from ASL, which may impact survival. To overcome radiation-induced lymphopenia, a novel strategy using IL-7 may be considered.

PURPOSE: This study aimed to identify changes in smart device usage trends of young children using two studies conducted in 2015-2016 and 2017 respectively. METHODS: We compared the data of the previous study of 130 children (Group A) and the new study of 162 children (Group B). The children and parents were recruited from kindergartens in Seoul and Guri/Namyangju cities. We used the “Parental questionnaire for smart device usage status.” RESULTS: There were some changes in the smart device usage in young children and parental perception. In the 2017 study, smart device usage time increased during weekends (P < 0.05) and the usage with siblings decreased (P < 0.05). In 2017, the smart device was mostly used when children had to be quiet without disturbing others (36.8%). No significant difference existed in the main purpose of use: watching video clips (79.3% vs 76.6%). Overall control of the usage was still largely exercised by mothers; however, when using applications, mothers still only helped the children on request (51.8% vs 49.7%). Regarding the effect of smart device on children, responses of “not knowing” decreased and “will be negative” and “will be positive” increased (P < 0.05). Additionally, most mothers thought that “Although the smart device is currently unnecessary, it will be needed in future” in 2017 (46.3%). CONCLUSION: Limiting the smart device usage time during the weekends and increasing parental involvements are recommended. Guidelines for smart devices usage in young children are also necessary considering the changes in parental attitudes in recognizing the smart device usage as unavoidable.
Child ; Humans ; Mothers ; Parents ; Seoul ; Siblings ; Smartphone

Oral anticoagulants are used for prophylaxis or treatment of both arterial and venous thromboembolisms, and their use has increased with the increment of the aged population and cardiovascular disease. Oral anticoagulants, such as warfarin, are associated with a risk for bleeding, but small bowel necrosis by hemorrhage is a very rare complication of warfarin therapy. The combination of warfarin and an antiplatelet agent increase the risk of bleeding. A 70-year-old man with no prior symptoms was admitted to the emergency department with periumbilical pain. He had been taking warfarin and aspirin due to valve replacement therapy. He underwent an exploratory laparotomy due to sustained abdominal pain and fever. A macroscopic examination of the resected jejunum showed transmural hemorrhagic necrosis. We report a rare case of small bowel necrosis as a complication of warfarin therapy.
Abdominal Pain ; Aged ; Anticoagulants ; Aspirin ; Cardiovascular Diseases ; Emergencies ; Fever ; Hemorrhage ; Humans ; Jejunum ; Laparotomy ; Necrosis ; Thromboembolism ; Warfarin

Hepatic portal venous gas (HPVG) is a rare disease presenting as acute abdomen. There were first described in children with necrotizing enterocolitis in 1955. HPVG is caused by mesenteric ischemia but may have various etiologies. Predisposing factors that develop mesenteric ischemia include gastric ulcer disease, bowel obstruction, diverticulitis and sepsis. The presence of the air in the portal and mesenteric vein on radiographics has been associated with a mortality rate of more than 75% in earlier studies. Abdominal computed tomography has proven useful for detecting portomesenteric venous gas and pneumatosis intestinalis. We report a case of the patient with hepatic portal venous gas with pneumatosis intestinalis, which showed rapid progress of the disease and eventually died within 24 hours of admission.
Abdomen, Acute ; Child ; Diverticulitis ; Enterocolitis, Necrotizing ; Humans ; Ischemia ; Mesenteric Veins ; Portal Vein ; Rare Diseases ; Sepsis ; Stomach Ulcer