STUDY DESIGN: Case study of two cases. OBJECTIVES: The aim of our study is to describe the rare MR imaging patterns of infectious spondylitis. SUMMARY OF LITERATURE REVIEW: It is generally accepted that the intravertebral cleft sign is not shown in cases of infection or malignancy, and thus, its recognition can obviate unnecessary imaging or biopsy because of its benign significance. MATERIALS AND METHODS: Two patients are presented who developed worsening back pain after a minor trauma. Preoperative MR images of these patients showed intravertebral fluid and benign vertebral compression fractures. Anterior decompression and fusion were done and the bacteria isolated from the intraoperative cultures were Listeria monocytogenes and Mycobacterium tuberculosis, respectively. RESULTS: After 2 years of follow-up, the patients were free of pain, without signs of infection, and showed correct fusion. CONCLUSIONS: MR findings in infectious spondylitis may simulate the patterns of osteoporotic VCFs.
Back Pain ; Bacteria ; Biopsy ; Decompression ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Listeria monocytogenes ; Magnetic Resonance Imaging ; Mycobacterium tuberculosis ; Spondylitis*

BACKGROUND/AIMS: Revaprazan (Revanex(R)) is a novel proton pump inhibitor (PPI) that has a somewhat different effect on proton pump compared with the other PPI's, also (called as 'acid pump antagonist'). We aimed to examine the false negative rate of 13C-urea breath test (UBT) in the patients with Helicobacter pylori (H. pylori) associated peptic ulcer disease who were treated with revaprazan and evaluate the anti-urease activity of revaprazan. METHODS: Total 55 patients were enrolled in this study. They received EGD examination between January 2009 and December 2009 and diagnosed histologically as H. pylori associated peptic ulcer disease. All patients took revaprazan only. Three patients were excluded because of underlying chronic disease and inappropriate breath sampling. The remaining 52 patients had UBT at 0, 2 and 4 weeks of revaprazan use. After 2 weeks of the cessation of revaprazan, they had the fourth UBT. RESULTS: At 2 and 4 weeks, the false negative rates of UBT were 5.8% and 23.1%, respectively (p=0.05). After 2 weeks of the cessation, the cases of the false negative result were five. Four out of five patients had prolonged negative results on two or three successive tests, and baseline 13C difference value did not predict the false negative results. CONCLUSIONS: False negative results of UBT were common and increased with prolonged use of acid pump antagonist. As PPI, it had also anti-urease activity and most patients (47/52, 90.4%) reverted to positive results by 2 weeks after the cessation of taking the medication.
*Breath Tests ; Carbon Isotopes ; False Negative Reactions ; Female ; Helicobacter Infections/complications/*diagnosis ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Peptic Ulcer/*drug therapy/microbiology ; Proton Pump Inhibitors/*therapeutic use ; Pyrimidinones/*therapeutic use ; Tetrahydroisoquinolines/*therapeutic use ; Urea/*diagnostic use

STUDY DESIGN: This is a retrospective study OBJECTIVES: This study compared the clinical outcomes of posterior lumbar interbody fusion (PLIF) using hydroxyapatite blocks with PLIF using a metal or poly-ether-ether-ketone (PEEK) cage. SUMMARY OF THE LITERATURE REVIEW: There are few reports on the clinical outcomes of PLIF using a hydroxyapatite block for treating lumbar degenerative disease. MATERIALS AND METHODS: The 27 PLIF cases (62 units, HA block) that were followed up for 1-year were compared with 13 cases using a metal cage and 13 cases using a PEEK cage. Pedicle screw fixation was performed for all the cases. If the local bone is deficient, then an additional bone graft with autogeous iliac bone or bone substitute was used. The visual analog scale(VAS) for low back pain and radiating pain, the Oswestry disability index (ODI), the intervertebral height and the halo sign around the cages and pedicle screws were comparatively analyzed. RESULTS: The mean VAS score for low back pain before PLIF and using the HA block, the metal cage and the PEEK cage was 7.5, 8.3 and 6.2, respectively, and this was 3.3, 2.9 and 4.8 after PLIF (P<0.05 with using the HA block and the metal cage (Wilcoxon test). The mean VAS score for radiating pain before PLIF was 7.9, 8.3 and 8.5, respectively, and the VAS score was 3.5, 3.1 and 3.9, respectively, after PLIF (P<0.05 for all cases, Wilcoxon test). For the ODI, the means before PLIF were 60.3, 51.2 and 53.8, respectively, and they changed to 30.5, 24.9 and 29.7, respectively, after PLIF (P<0 .05 for all cases, Wilcoxon test). On the X-ray images, there was no halo sign greater than 2 mm near the pedicle screws or greater than 1 mm near the cages and no breakage of the HA block. No additional bone graft was needed for the PLIF using the HA block and local bone. There was no statistically significant differences among the groups (P>0.05, One-way ANOVA). CONCLUSION: PLIF using a HA block showed improvements, including the back pain, and the ODI was satisfactory and this didn't fall below those ODIs of using metal or PEEK cages. Although a HA block may have higher tendency to break, there was no breakage at the 1-year follow up.
Back Pain ; Bone Substitutes ; Durapatite ; Follow-Up Studies ; Ketones ; Low Back Pain ; Polyethylene Glycols ; Retrospective Studies ; Transplants

PURPOSE: N-13 ammonia uptake and retention in the myocardium is related to perfusion and metabolism. There are several potential advantages of N-13 ammonia positron emission tomography (PET) to detect myocardial ischemia, such as higher spatial resolution, greater counting efficiencies, and robust attenuation correction. But there are few reports comparing Tc-99m myocardial perfusion single photon emission tomography (MPS) and N-13 ammonia PET. We thus compared adenosine stress N-13 ammonia PET/CT and Tc-99m sestamibi MPS in patients with suspected coronary artery stenosis. MATERIALS AND METHODS: Seventeen patients (male 13 : 63+/-11 years old) underwent adenosine stress N-13 ammonia PET/CT (Discovery ST, GE), Tc-99m sestamibi MPS (dual head gamma camera, Hawkeye, GE) and coronary angiography within 1 week. N-13 ammonia PET/CT and Tc-99m sestamibi MPS images were assessed with a 20-segment model by visual interpretation and quantitative analysis using automatic quantitative software (Myovation, GE). RESULTS: Both sensitivities and specificities of detecting an individual coronary artery stenosis were higher for N-13 ammonia PET/CT than Tc-99m sestamibi MPS (PET/CT: 91%/ 89% vs MPS: 65%/ 82%). N-13 ammonia PET/CT showed reversibility in 52% of segments that were considered non-reversibile by Tc-99m sestamibi MPS. In the 110 myocardial segments supplied by the stenotic coronary artery, N-13 ammonia PET/CT showed higher count densities than Tc-99m MPS on rest study (p<0.01), and the difference of count density between the stress and the rest studies was also larger on N-13 ammonia PET/CT. CONCLUSION: Adenosine stress N-13 ammonia PET/CT had higher diagnostic sensitivity and specificity, more reversibility of perfusion defects and greater stress/rest uptake differences than Tc-99m sestamibi MPS. Accordingly, N-13 ammonia PET/CT might offer better assessment of myocardial ischemia and viability.
Adenosine ; Ammonia ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Gamma Cameras ; Head ; Humans ; Myocardial Ischemia ; Myocardium ; Perfusion ; Positron-Emission Tomography ; Retention (Psychology) ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon

PURPOSE: The purpose of this study is to understand student recognition of CBT as well as its strengths and weaknesses, and to explore the improvement methodologies for the effective development and implementation of CBT. METHODS: A questionnaire survey was conducted twice (before and after implementation of CBT) with a total of 17 multiple-choice and 2 essay-type questions. The multiple-choice questions were analyzed by frequency analysis and the essay-type questions were coded by content analysis. RESULTS: The results are as follows. First, the overall satisfaction with CBT was shown to be high. Second, students listed the merits of CBT as follows: simple correction of answers (before: 89.4%; after: 80.8%), presentation of realistic materials (before: 72.9%; after: 84.7%), prompt feedback on grades (before: 60.3%; after: 71.1%), shortened exam time and effective time scheduling (before: 86.5%; after: 66.4%), accurate estimation of abilities (before: 70.2%; after: 36.6%), and assistance in academic improvement (before: 70.9%; after: 22.1%). Drawbacks of CBT were: inconvenience of review (before: 70.9%; after: 22.1%), inconvenient screen organizations (before: 0%; after: 48.1%), possibility of cheating (before: 73.9%; after: 31.8%), and equality issue of test (before: 47.3%; after: 17.3%). CONCLUSION: Assessment paradigms are currently shifting from summative evaluation to formative evaluation, from one-off assessment to continuous assessment, and from output assessment to process assessment. Therefore, CBT must be expanded to move from result-oriented summative evaluation to formative evaluation continuously monitoring the student learning process.
Education, Medical ; Humans ; Learning ; Process Assessment (Health Care) ; Surveys and Questionnaires

OBJECTIVE: The objective of this study was to elucidate the relationship between job stress and pulse wave velocity (PWV) as a cardiovascular risk factor. METHOD: The study design was cross-sectional, and a total of 234 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude) using a modified Karasek model. Cuffs were applied to the extremities and a microphone for phonocardiography was placed at the second intercostal space at the margin of the sternum. The subjects rested in a supine position for 5 min, and PWV was measured using a VP-1000(Colin Waveform analyzer). RESULTS: There were significant correlations between blood pressure, glucose, total cholesterol, coagulation factor and PWV. The group with low decision latitude and high decision latitude showed higher levels of PWV, but the differences were not significan. The PWV (left) was significantly higher in the high strain group than in the lower strain group. After adjustment for age and cardiovascular risk factors, job strain was still associated with PWV. CONCLUSION: These result suggest that the high strain group among workers is related to an increased risk of PWV as a marker of atherosclerosis.
Atherosclerosis ; Blood Coagulation Factors ; Blood Pressure ; Cholesterol ; Extremities ; Glucose ; Phonocardiography ; Pulse Wave Analysis* ; Risk Factors* ; Sternum ; Supine Position

OBJECTIVE: This study was conducted to compare the job characteristics (work demand, decision latitude, and job insecurity) and psychosocial stress levels of typical workers in the parent firm, to those of atypical workers in subcontracted firms. In addition the risk factors for psychosocial stress of atypical workers are evaluated. METHOD: The study design was cross-sectional, and 1,713 shipbuilding workers (681; typical workers, 1,032; atypical workers) were recruited. A structured-questionnaire was used to assess the general characteristics, job characteristics and psychosocial stress levels. We used the chi-square test for univariate and multiple regression analyses. RESULTS: In univariate analyses, there were significant differences in smoking, hobby, insufficient sleeping, work hours per week, quitting, unemployment, job demand, job decision latitude and job insecurity. The job strain was significantly higher in the atypical workers than in the typical workers. The proportion of iso-strain groups was significantly greater in the atypical workers than typical workers. Using psychosocial stress as the dependent variable, multiple regression models were estimated. After adjustment for sociodemographic factors, unemployment, quitting, employment type, job demand, job decision latitude and job insecurity were all found to be significantly associated with psychosocial stress. CONCLUSION: This result suggests that the psychosocial stress of atypical workers is related to job characteristics such as job insecurity and labor flexibility.
Employment ; Hobbies ; Humans ; Parents ; Pliability ; Risk Factors ; Smoke ; Smoking ; Unemployment

Protoplasts of the wild type strain of Pleurotus osteatus were mutagenized with UV light, and 3,000 colonies were examined for abnormal mycelial and fruiting phenotypes. Forty one strains displayed variant phenotypes in mycelia and fruiting processes. The variant phenotypes were classified into 6 groups: (1) auxotrophic strains, which are incapable of growing on minimal media and can only grow when provided with their specific requirements; (2) abnormal vegetative strains, which grow very slowly on minimal and complete media; (3) primordiumless strains, which fail to develop to the formation of primordia; (4) maturationless strains, which form primordia, but do not form mature fruiting bodies; (5) specifically colored strains, which have Specific bluish grey or bluish white pileus; (6) poorly spored strains, which fail to produce basidiospore or which produce few spores. These variant strains may be useful in genetic breeding programs and for the studies of fungal development and genetics.
Breeding ; Fruit ; Genetics ; Phenotype ; Pleurotus* ; Protoplasts ; Spores ; Ultraviolet Rays

BACKGROUND: The aim of this study is to define the cardioprotective effects (hemodynamic, cytochemical and ultrastructural of the newly developed Histidine-Tryptophan-Ketoglutarate (HTK) cardioplegia compared to DelNido cardioplegia. MATERIAL AND METHOD: Seventy-nine isolated rat hearts were divided into three groups on the basis of techniques of cardioplegia infusion. Twenty-eight hearts (Group 1) were flushed with cold DelNido cardioplegia with every 40 minutes for 2 hours. Twenty-seven hearts (Group 2) were flushed with cold HTK cardioplegia for once during the 2 hours. Twenty-four hearts (Group 3) were flushed with cold HTK cardioplegia with every 40 minutes for 2 hours. Heart rate, left ventricular developed pressure (LVDP), changes of +dp/dt max, coronary flow, and rate-pressure product value were measured at pre-ischemic, post-reperfusion 15 minutes, 30 minutes, and 45 minutes for hemodynamic study. Aspartate aminotransferase (AST), lactate dehydrogenase (LD), creatine kinase (CK), CK- MB, troponin-I, myoglobin, and lactate were measured at pre-ischemic and post-reperfusion 45 minutes for cytochemical parameters. Mitochondrial scores were counted in 3 cases from each group for ultrastructural assessment. RESULT: In hemodynamic study, there were no significant differences among group 1, group 2, and group 3. However, the decrease values of heart rate in group 2 and 3 exhibited significantly lower values than in group 1. In cytochemical study, there were no significant differences among group 1, group 2, and group 3. However, the increase values of lactate in group 2 and 3 exhibited significantly lower values than in group 1. In ultrastructural assessment, the mean myocardial mitochondria scores in group 1, group 2, and group 3 were 2.14+/-0.10, 1.52+/-0.57, and 2.10+/-0.16. CONCLUSION: HTK solution provides adequate myocardial protection with some advantages over DelNido solution in isolated rat hearts.
Animals ; Aspartate Aminotransferases ; Cardioplegic Solutions ; Creatine Kinase ; Heart Arrest, Induced* ; Heart Rate ; Heart* ; Hemodynamics ; L-Lactate Dehydrogenase ; Lactic Acid ; Mitochondria, Heart ; Myoglobin ; Rats* ; Troponin I

Tension pneumocephalus is a rare complication of craniotomy, however, it should be managed promptly due to rapid neurological deterioration. We report a case of tension pneumocephalus after transsphenoidal surgery for a giant pituitary tumor. It may have developed because of the cerebrospinal fluid rhinorrhea and presence of an external lumbar drain.
Cerebrospinal Fluid Rhinorrhea ; Craniotomy ; Pituitary Neoplasms* ; Pneumocephalus*