Objective: To assess the relevance of electrodiagnosis (EDX) in the cross-sectional area (CSA) of the nerve root of patients with cervical radiculopathy (CR) by using high-resolution ultrasonography (HRUS). Methods: The CSAs of the cervical nerve roots at C5, C6, and C7 were measured bilaterally using HRUS in 29 patients with unilateral CR whose clinical symptoms, magnetic resonance imaging (MRI) findings, and EDX results: corresponded with each other (CR-A group), and in 26 patients with unilateral CR whose clinical symptoms and MRI findings matched with each other but did not correspond with the EDX findings (CR-B group). Results The CSA of the affected side in each nerve root was significantly larger than that of the unaffected side in both the CR-A and CR-B groups. The side-to-side difference in the bilateral CSAs of the nerve root and the ratio of the CSAs between the unaffected and affected sides were statistically larger in the CR-A group than in the CR-B group. Conclusion The increased CSAs in the CR-A group reflect the physiological changes of the cervical nerve root, which is supported by the EDX findings.

Objective: To assess the relevance of electrodiagnosis (EDX) in the cross-sectional area (CSA) of the nerve root of patients with cervical radiculopathy (CR) by using high-resolution ultrasonography (HRUS). Methods: The CSAs of the cervical nerve roots at C5, C6, and C7 were measured bilaterally using HRUS in 29 patients with unilateral CR whose clinical symptoms, magnetic resonance imaging (MRI) findings, and EDX results: corresponded with each other (CR-A group), and in 26 patients with unilateral CR whose clinical symptoms and MRI findings matched with each other but did not correspond with the EDX findings (CR-B group). Results The CSA of the affected side in each nerve root was significantly larger than that of the unaffected side in both the CR-A and CR-B groups. The side-to-side difference in the bilateral CSAs of the nerve root and the ratio of the CSAs between the unaffected and affected sides were statistically larger in the CR-A group than in the CR-B group. Conclusion The increased CSAs in the CR-A group reflect the physiological changes of the cervical nerve root, which is supported by the EDX findings.

PURPOSE: To evaluate the outcomes and prognostic factors of trabeculectomy with mitomycin C in Korean patients with juvenile open-angle glaucoma (JOAG). METHODS: A retrospective review was performed on 29 eyes with JOAG who had undergone trabeculectomy between January 2004 and January 2013. Intraocular pressure (IOP) and postoperative complications were monitored at 1 day preoperatively, at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively, and at final follow-up after postoperative 18 months. Surgical success was defined as a final IOP of <21 mm Hg or <80% of preoperative IOP, regardless of the use of anti-glaucoma medication. Prognostic factors for surgical success or failure were analyzed by the Cox proportional hazards model. RESULTS: Mean (+/- standard deviation) age at trabeculectomy was 24.6 (+/- 8.9) years, and mean follow-up period was 24.3 (+/- 20.8) months. The overall success rate was 82.8% at final follow-up. The Kaplan-Meier cumulative probabilities of surgical success were 100% at 1 year, 87.4% at 2 years, and 78.7% at 3 years postoperatively. The Cox proportional hazards model failed to determine any significant factors that were associated with surgical failure. The three most frequent postoperative complications were immediately postoperative hypotony (n = 19, 65.5%), hypotony maculopathy (n = 8, 27.6%), and encapsulated bleb (n = 8, 27.6%), most of which were resolved after a minor procedure or observation. Two of 8 eyes with encapsulated bleb required a second surgery. There were no vision-threatening severe complications. CONCLUSIONS: Trabeculectomy with MMC may be an effective treatment in Korean JOAG patients.
Blister ; Follow-Up Studies ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Mitomycin ; Postoperative Complications ; Proportional Hazards Models ; Retrospective Studies ; Trabeculectomy*

BACKGROUND: Three-dimensional (3D) echocardiography has been reported to be valuable for evaluating the geometry of cardiac chambers. We validated the accuracy of 3D transthoracic echocardiography for quantifying aortic root geometry in comparison with cardiac multi-detector computed tomography (MDCT). METHODS: Twenty-three patients who underwent cardiac MDCT and showed normal left ventricular ejection fraction (> 55%), as assessed by 2-dimensional transthoracic echocardiography, were enrolled (12 male, mean 53 +/- 9 years). We defined the aortic root volume as the volume from the aortic annulus to the sinotubular junction. The aortic root volume at end-diastole measured by both cardiac MDCT and 3D echocardiography was assessed. RESULTS: The cross-sectional area of the aortic root was asymmetric. At the annulus level, the cross-sectional area showed asymmetric triangle. From the aortic annulus to the most dilated point of the sinus of Valsalva, the asymmetric triangular shape was maintained. From the most dilated point of the sinus of Valsalva to the sinotubular junction, the cross-sectional shape of the aortic root changed to oval. The average aortic root volumes measured by 3D echocardiography (ARV-3DE) were 13.6 +/- 4.8 mL at end-diastole and 14.1 +/- 5.3 mL at end-systole, respectively. The average aortic root volume measured by MDCT at end-diastole (ARV-CT) was 14.1 +/- 5.7 mL. At end-diastole, the ARV-3DE correlated well with the ARV-CT (R2 = 0.926, difference = 0.5 +/- 1.7 mL), and the two methods were in excellent agreement (the percent difference was 0%). CONCLUSION: Our results demonstrate both the feasibility and accuracy of 3D echocardiography for the clinical assessment of the geometry of the aortic root.
Echocardiography ; Echocardiography, Three-Dimensional ; Humans ; Male ; Sinus of Valsalva ; Stroke Volume

PURPOSE: Papillary thyroid cancer (PTC) has a good prognosis, and it's known to be related to the apoptosis of papillary thyroid cancer. The expression of bcl-2 is thought to be associated with the inhibition of apoptosis. We evaluated the differences of bcl-2 and P53 between PTC and the control (normal tissue and benign lesion). We then analyzed the correlation between the bcl-2 and P53 expressions and the classic prognostic factors. METHODS: Between January 2001 and December 2005, 30 patients who underwent total thyroidectomy for the PTC were included in this study and immunohistochemical staining was performed on the tumors. RESULTS: bcl-2 was expressed in 18 cases (60%) in their PTC (P<0.05). The expression of P53 was not significantly related with the clinicopathological factors, but P53 was expressed in 9 cases (30%) of PTC (P<0.05). The positive staining for was noted in 18 cases (62.1%) of the PTC tissue among the 30 patients, and as the TNM stage progresses, the expression rate of was significantly decrease for 7 stage I cases (100%), for 4 stage ll cases (80%) and for 7 stage ll cases (38.9%). CONCLUSION: bcl-2 was expressed more as the TNM stage of PTC decreases. So bcl-2 is possibly useful as a prognostic factor for PTC, but further studies are needed for confirming its significance.

BACKGROUND/AIMS: Although diagnosis and surgical treatment for distal common bile duct cancer have enormously advanced, survival is not satisfactory and its prognostic factors are still being debated. Thus, we evaluated the outcomes and prognostic factors after major resection for distal extrahepatic cholangiocarcinoma (dCC). METHODS: One hundred and fifty-four patients who underwent major resection such as pancreaticoduodenectomy for dCC were retrospectively analyzed. We investigated clinical features, postoperative complications, survival, and prognostic factors of dCC. CONCLUSIONS: One hundred and three (66.9%) male and 51 (33.1%) female patients were enrolled and their mean age was 59.6 (31-78) years. Among them, 97 patients (63.0%) underwent Whipple's procedure, 45 (29.2%) pylorus-preserving pancreaticoduodenectomy, 7 (4.5%) total pancreatectomy, and 5 (3.3%) hepatopancreaticoduodenectomy, respectively. Mean follow-up duration was 26.6 (0.4-108.5) months. The postoperative morbidity and mortality were 42.2% and 1.3%, respectively. Five-year survival rate was 32.8% and mean survival duration was 47.2 (39.1-55.3) months. Type of biliary drainage (percutaneous transhepatic biliary drainage), lymph node status (positive), and cellular differentiation (moderate or poor) were significant indicators for death in multivariate analysis of resectable dCC. CONCLUSIONS: Moderate or poor cellular differentiation and lymph node metastasis may be independent poor prognostic factors for resectable dCC.
Adult ; Aged ; Bile Duct Neoplasms/mortality/*surgery ; *Bile Ducts, Extrahepatic ; Biliary Tract Surgical Procedures ; Cholangiocarcinoma/mortality/*surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Survival Rate

PURPOSE: Although splenectomy remains the most effective treatment of chronic idiopathic thrombocytopenia (ITP), the results after splenectomy vary, with the prognostic factors for the postoperative result being debatable. This study investigated the response and predictors of the outcome after splenectomy. METHODS: Forty five adult patients, older than 15 years of age, who underwent splenectomy for ITP between 1995 and 2004, were retrospectively reviewed. The clinical characteristics, therapeutic modality, response rate and predictive factors of the response were analyzed. RESULTS: There were 12 and 33 male and female patients, respectively, with a mean age of 48 years. The preoperative platelet count ranged between 1000 to 47, 000/mm3 (mean: 12, 600). Remission was accessed 6 months after the surgery. Complete remission was observed in 31 patients (65.9%), and a partial response in 4 (8.5%), 12 patients (25.5%) did not respond to the splenectomy. Patients with an elevation of the platelet count to more than 250, 000/mm3 within 2 weeks after the surgery had better responses (P=0.03). However, patients who had splenectomy more than 36 months after the initial diagnosis had poor responses (P=0.02). Age, sex, previous response to glucocorticoids and intravenous immunoglobulin, the initial platelet count and platelet transfusion showed no clinical significance for predicting the response. A single patient had pneumonia postoperatively, there was no mortality. There was no relapse in the complete response group during the follow up period (mean: 27.8 months). CONCLUSION: Splenectomy for patients with ITP was safe and effective treatment. The early recovery of the platelet count and early operation following diagnosis were related with better responses to splenectomy.
Adult* ; Diagnosis ; Female ; Follow-Up Studies ; Glucocorticoids ; Humans ; Immunoglobulins ; Male ; Mortality ; Platelet Count ; Platelet Transfusion ; Pneumonia ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Retrospective Studies ; Splenectomy* ; Thrombocytopenia

Holoprosencephaly is a developmental malformation complex of forebrain and midface which arises from incomplete cleavage of the embryonic forebrain. It is subdivided into alobar, semilobar and lobar types based on the degree of growth disturbance within the anterior wall of the telencephalon, particularly in the midline. Cyclopia is the most severe form of alobar holoprosencephaly presenting a single median eye and a blind-ending proboscis usually located above the eye. We report a case of alobar holoprosencephaly with cyclopia and proboscis in premature infant.
Holoprosencephaly* ; Humans ; Infant, Newborn ; Infant, Premature ; Prosencephalon ; Telencephalon

BACKGROUND: Subepithelial fibrosis plays a major role in the development of irreversible airway obstruction in asthma. Eosinophils are major effector cells in allergic inflammation, and it has been suggested that eosinophil-derived mediators such as transforming growth factor-beta (TGF-beta) play a role in the pathogenesis of airway remodeling. OBJECTIVE: The aim of this study was to evaluate whether eosinophils activated by IL-5 plays a major role in the collagen gel contraction by lung fibroblasts. METHOD: Various cell numbers of lung fibroblasts were cultured in collagen gels to determine the appropriate numbers of fibroblasts. Purified human peripheral blood eosinophils were activated by IL-5 for 3 days, and TGF-beta mRNA expression was evaluated using semiquantitative RT- PCR. The cultured supernatants with or without TGF-beta were added to the collagen gel media with lung fibroblasts, and collagen gel diameter was serially measured to evaluate collagen gel contraction. RESULTS: The amount of collagen gel contraction was significantly associated with the number of fibroblasts (p< 0.05), and TGF-beta significantly contracted the collagen gel to contract in a dose-dependent manner (p< 0.05). However, supernatants derived from IL-5-activated eosinophils did not contract the collagen gel compared to controls (p> 0.05). Moreover, expression of TGF-beta mRNA in eosinophils was the same before and after stimulus of IL-5. CONCLUSION: Activated eosinophils by IL-5 may play a minor role in the collagen gel contraction by lung fibroblasts.
Airway Obstruction ; Airway Remodeling ; Asthma ; Cell Count ; Collagen* ; Eosinophils* ; Fibroblasts* ; Fibrosis ; Gels ; Humans ; Inflammation ; Interleukin-5 ; Lung* ; Polymerase Chain Reaction ; RNA, Messenger ; Transforming Growth Factor beta

BACKGROUND: The aim of this study is to define the cardioprotective effects (functional and metabolic) of newly developed DelNido cardioplegic solution (containing plasma solution, mannitol, magnesium and lidocaine). MATERIAL AND METHOD: This study assessed the function of rat hearts after itermittent infusion of DelNido cardioplegia with different preserving methods(Air or Icebox) for 2hours and perfusing the hearts on a Langendorff apparatus. Heart rate, left ventricular developed pressure (LVDP) and coronary flow, were measured at pre-ischemic, post-reperfusion 15min, 30min and 45min. Coronary flow was standardized to dry heart weight. Each weight was weighted to calculate water content. Creatine kinase-MB isoenzyme release was measured and ultrastructural assessment was done with electron microscopes. DelNido group was better than St, Thomas group and Icebox group was better than Room-air group. CONCLUSION: DelNido cardioplegia have better myocardial protective effects than St. Thomas cardioplegia when they were preserved in the Room-air. But we can not tell the difference between Delnido cardiplegia with Air preserving method and St. Thomas cardioplegia with Icebox.
Animals ; Cardioplegic Solutions ; Creatine ; Heart ; Heart Arrest, Induced* ; Heart Rate ; Magnesium ; Mannitol ; Plasma ; Rats ; Water