PURPOSE: The Purpose of this study was to evaluate the usefulness of Helical CT in the preoperative staging of gastric carcinoma. MATERIALS AND METHODS: We performed Helical CT on 66 patients with pathologically proved gastric carcinoma. The findings were prospectively analyzed and correlated with surgical and histopathologic findings. RESULTS: The detection rate for gastric carcinoma was 88%(58/66). The rates of accuracy, understaging, and overstaging of Helical CT according to TNM staging in determining the depth of tumor invasion were 68%(45/66),23%(15/66), and 9%(6/66), respectively. In early and less advanced carcinomas(T1 & T2), the depth of tumor invasion was correctly determined in only 44%(11/25) of cases, whereas in more advanced carcinomas (T3 & T4), the corresponding figure was 83%(34/41). In lymph node staging, accuracy, understaging, and overstaging rates were 62%(41/66), 21%(14/66), and 17%(11/66), respectively. Helical CT showed a sensitivity of 48%, a specificity of97%, and an accuracy of 92% in assessing metastasis to lymph nodes. One of five cases of peritoneal carcinomatosis(20%) was correctly diagnosed by Helical CT. CONCLUSION: In the preoperative evaluation of gastriccarcinoma, Helical CT is useful in the detection of tumours and for determining the depth of tumor invasion, particularly in cases where there is serosal and adjacent organ invasion; for the evaluation of metastasis tolymph nodes and peritoneal carcinomatosis its usefulness is limited, however. Further resech will therefore be necessary.
Carcinoma ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Prospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed*

Hantavirus pulmonary syndrome(HPS) is a systemic disease that is caused by a newly discorved and characterized virus of the Hantavirus genus, which is most frequently referred to as the sin nombre virus. The clinical syndrome resembles other hantavirus syndromes worldwide, except that it is characterized by a brief prodromal illness followed by rapidly progressive, noncardiogenic edema, and that it is more deadly than any previously recognized hantavirus infection. The clinical manifestations of HPS are characterized by four clinical phases prodrome, pulmonary edema and shock, diuresis, and convalescence. Mortality is greatest in the first 24 hours of the pulmonary edema and shock phase of the illness. These phases are strikingly similar to the clinical phases of Hemorrhagic fever with renal syndrome(HFRS) induced by Hantaan virus, except that HPS has not been associated with renal failure and Disseminated intravascular coagulation(DIC). We here report a case of hantavirus pulmonary syndrome developed in a 58 year-old man. He had a flu-like illness followed by the rapid onset of respiratory failure due to noncardiogenic pulmonary edema. HPS was diagnosed by clinical manifestations, identification of high titer antibody to Hantaan virus antigen and histologic finding of transbronchial lung biopsy (TBLB) specimen. The patient was treated with mechanical ventilation and initial corticosteroid pulse therapy resulting in successful outcome.
Biopsy ; Convalescence ; Diuresis ; Edema ; Fever ; Hantaan virus ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Humans ; Lung ; Middle Aged ; Mortality ; Pulmonary Edema ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Insufficiency ; Shock ; Sin Nombre virus

Three patients development subdural pneumocephalus after undergoing posterior fossa surgery performed in sitting position. The mechanism for entry of air into the intracranial compartment is analogous to the entry of air into an inverted bottle. As the fluid pours out, air bubbles to the top of the container. A brow-up lateral skull radiograph with a horizontal beam provided prompt diagnosis and confirmed brain displacement as well as computerized tomography did. Tension pneumocephalus appears to be another potential complication of posterior fossa surgery in sitting position. This condition is easily diagnosed and treated, and should be considered whenever a patient fails to recover as expected following posterior fossa surgery.
Brain ; Diagnosis ; Humans ; Pneumocephalus* ; Skull

PURPOSE: The aim of this research was to establish the effect and variation in differing convergence angle and length of abutment on the retention of full veneer casted gold crown. MATERIALS AND METHODS: Two different length,5 mm and 10 mm in height with convergence angles of 5, 10, 15 and 25 degrees crowns were fabricated. Cementation was done using cements; zinc phosphate cement (Fleck's zinc phosphate cement), resin-modified glass ionomer cement (Vitremer) and resin cement (Panavia 21). These were tested for tensile force at the point of separation by using Instron Universal Testing Machine. Statistical analysis was done by SAS 6.04 package. RESULTS: In all cements the mean retention decreased with significant difference on increase of convergence angle (P<.05). Increase in every 5 degree-convergence angel the retention rate decreased with resin-modified glass ionomer cement of 15.9% and resin cement of 14.8%. With zinc phosphate cement, there was largest decreasing rate of mean retention of 25.5% between convergence angles from 5 degree to 10 degree. When the crown length increased from 5 mm to 10 mm, the retention increased with the significant difference in the same convergence angle and in all types of cement used (P<.05). CONCLUSION: The retention was strongly dependent on geometric factors of abutment. Much care is required in choosing cements for an optimal retention in abutments with different convergence angles and crown lengths.
Acrylic Resins ; Cementation ; Collodion ; Crowns ; Dental Cements ; Glass Ionomer Cements ; Phenothiazines ; Phosphates ; Resin Cements ; Retention (Psychology) ; Silicon Dioxide ; Zinc ; Zinc Compounds ; Zinc Phosphate Cement

BACKGROUND: It is known that HLA molecule can restrict specific IgE responses, but few studies have documented the association between HLA and sensitization to house dust mite(HDM). OBJECTIVE: To evaluate whether a specific HLA type can be a risk or protective factor for the development of HDM sensitivity. METHOD: Total 146 subjects were genotyped for HLA-DRB1 using PCR-SSP technique and HDM sensitivity, determined by skin prick test using two mite allergens, D. pteronyssinus (Dp) and D. farinae (Df). Subjects were grouped according to Dp or Df sensitivity and linkage analysis between HDM sensitivity and HLA-DRB1 genotype was performed. RESULTS: The data revealed higher allele frequencies of DRB1*07 in Dp or Df sensitive groups compared to insensitive groups (11.6% vs. 2.6% in Dp, 11.5% vs. 3.3% in Df group, p<0.05), but the other allele frequencies showed no difference. CONCLUSION: There was a significant association between HLA-DRB1*07 genotype and HDM sensitization. These results indicate that antigen presentation by HLA class II molecule restricts the development of specific IgE response to HDM.
Allergens ; Antigen Presentation ; Dust* ; Gene Frequency ; Genotype* ; HLA-DRB1 Chains* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Skin

Thirty two cases of the cervical spinal injury have been collected except those which associated with the injury on the other sites, such as head or internal organs. Nine cases of them were managed with surgery anterior and/or posterior approaches. The others were only immobilized by traction. Independent of operative method, we acquired slight to moderate improvement in all operative cases. Two cases with skeletal traction, however, became more aggravated. Indication of operation has much controversies as yet. A Major problem at present falls on the difficulty of functional recovery.
Head ; Immobilization ; Laminectomy ; Spinal Injuries ; Spine* ; Traction

OBJECTIVES: To prevent progression to fatal asthma it is essential to assess the severity of asthma and treat adequetely. But there was no objective index to evaluate the severity of airway inflammation in asthmatic patients, So we evaluated that serum ECP concentration is a objective parameter of airway inflammation in patients with acute severe asthmatic attack. METHODS: We measured the parameters of asthamtic severtity(clinical parameter, FEV1, arterial blood gas, peripheral blood eosinophil counts, and serum ECP levels) before and after antiasthmatic treatment in 9patients with acute severe asthmatic attack, And we compared serum ECP concentrations of severe asthmatic patients with those of control patients with mild to moderate severity. RESULTS: 1) The serum ECP levels in patients with acute asthmatic attacks compared to patients with mild to moderate, asthmatic severity were significantly increased. 2) The serum ECP levels and pheriperal blood eosinophil counts 2hours after antiasthmatic treatment were significantly lower than the value before treatment, but the total scores of clinical parameter, FEV1, and scores of arterial blood gases were not significantly different from the basal values, CONCLUSION: It is suggested that the serum ECP level is a objective parameter as a response to antiasthmatic treatment as well as a severity of airway inflammation in patients with acute asthmatic attack.
Asthma ; Eosinophil Cationic Protein* ; Eosinophils ; Gases ; Humans ; Inflammation

BACKGROUND: Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). METHODS: Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. RESULTS: The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was -4.1degrees before surgery, and increased to 2.5degrees after surgery. The mean nasolabial angle was 72.7degrees before surgery, and increased to 88.7degrees after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. CONCLUSIONS: Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.
Cleft Lip ; Humans ; Lip ; Mandible ; Maxilla ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Le Fort ; Osteotomy, Sagittal Split Ramus ; Palate

OBJECTIVE: The ras association domain family 1A (RASSF1A) gene plays an important part in carcinogenesis by inactivation via promoter hypermethylation in several cancers. We aimed to examine the effect of the RASSF1A Ala133Ser polymorphism on cervical carcinogenesis in reference to environmental factors, such as smoking and age at first sexual intercourse. METHODS: Seven hundred five patients who were diagnosed with cervical neoplasia and who had a positive results for human papillomavirus were enrolled to experimental group, and 641 of normal healthy women were enrolled as controls. All of the subjects were genotyped using the SNaPshot single base primer extension assay. RESULTS: Compared with RASSF1A TT/GT, the odds ratio (95% confidence interval) for RASSF1A GG was 1.4 (0.9-2.1) for invasive cervical cancer and 1.1 (0.7-1.7) for cervical intraepithelial neoplasia (CIN) II or III. The risks for cervical cancer were higher in patients under 40 years old at diagnosis (1.6, 1.0-2.6), than in patients over 40 years old at diagnosis (1.0, 0.7-1.5). Women with RASSF1A GG who currently smoke had a 2.7 (1.3-5.9) times higher risk of cervical cancer. Women with RASSF1A GG who had an early age of first intercourse, as compared with RASSF1A TT/GT, were also at increased risk. CONCLUSION: The RASSF1A Ala133Ser polymorphism is associated with a higher risk of cervical cancer and particularly with an early onset of cervical carcinogenesis.
Adult ; Carcinogenesis ; Cervical Intraepithelial Neoplasia ; Coitus ; Diagnosis ; Female ; Humans ; Odds Ratio ; Smoke ; Smoking ; Uterine Cervical Neoplasms*

PURPOSE: To compare intraoperative and postoperative flap complication rate between the Hansatome Excellus and Zyoptix XP microkeratomes for LASIK surgery. METHODS: The intra- and post-operative flap complication rate, in 323 eyes of 167 patients operated on using the Hansatome microkeratome were compared with 260 eyes of 132 patients that were operated on using the Zyoptix XP microkeratome. RESULTS: The Hansatome group showed an intraoperative complication incidence of 2.7% compared to 0.4% for the Zyoptix XP group (p<0.05), but the incidence of postoperative complication was 2.7% in the Zyoptix XP group compared to 0.6% in the Hansatome group (p>0.05). There was no incidence of visually significant complications in either group. CONCLUSIONS: The Zyoptix XP showed a significantly decreased intraoperative flap complication rate compared to the Hansatome Excellus microkeratome. The preoperative K value is an important factor for safe LASIK.
Eye ; Humans ; Incidence ; Intraoperative Complications ; Keratomileusis, Laser In Situ ; Postoperative Complications