BACKGROUND: AND PURPOSE: The aim of this study was to determine the diagnostic performance and safety of a new ¹⁸F-labeled amyloid tracer, ¹⁸F-FC119S. METHODS: This study prospectively recruited 105 participants, comprising 53 with Alzheimer's disease (AD) patients, 16 patients with dementia other than AD (non-AD), and 36 healthy controls (HCs). In the first screening visit, the Seoul Neuropsychological Screening Battery cognitive function test was given to the dementia group, while HC subjects completed the Korean version of the Mini Mental State Examination. Individuals underwent ¹⁸F-FC119S PET, ¹⁸F-fluorodeoxyglucose (FDG) PET, and brain MRI. The diagnostic performance of ¹⁸F-FC119S PET for AD was compared to a historical control (comprising previously reported and currently used amyloid-beta PET agents), ¹⁸F-FDG PET, and MRI. The standardized uptake value (SUV) ratio (ratio of the cerebral cortical SUV to the cerebellar SUV) was measured for each PET data set to provide semiquantitative analysis. All adverse effects during the clinical trial periods were monitored. RESULTS: Visual assessments of the ¹⁸F-FC119S PET data revealed a sensitivity of 92% and a specificity of 84% in detecting AD. ¹⁸F-FC119S PET demonstrated equivalent or better diagnostic performance for AD detection than the historical control, ¹⁸F-FDG PET (sensitivity of 80.0% and specificity of 76.0%), and MRI (sensitivity of 98.0% and specificity of 50.0%). The SUV ratios differed significantly between AD patients and the other groups, at 1.44±0.17 (mean±SD) for AD, 1.24±0.09 for non-AD, and 1.21±0.08 for HC. No clinically significant adverse effects occurred during the trial periods. CONCLUSIONS ¹⁸F-FC119S PET provides high sensitivity and specificity in detecting AD and therefore may be considered a useful diagnostic tool for AD.

OBJECTIVE: Acute ischemic stroke (AIS) requires time-dependent reperfusion therapy, and early recognition of AIS is important to patient outcomes. This study was conducted to identify the clinical features and risk factors of AIS patients that are missed during the early stages of diagnosis. METHODS: We retrospectively reviewed AIS patients admitted to a hospital through the emergency department. AIS patients were defined as ischemic stroke patients who visited the emergency department within 6 hours of symptom onset. Patients were classified into two groups: an activation group (A group), in which patients were identified as AIS and the stroke team was activated, and a non-activation group (NA group), for whom the stroke team was not activated. RESULTS: The stroke team was activated for 213 of a total of 262 AIS patients (81.3%), while it was not activated for the remaining 49 (18.7%). The NA group was found to be younger, have lower initial National Institutes of Health Stroke Scale scores, lower incidence of previous hypertension, and a greater incidence of cerebellum and cardio-embolic infarcts than the A group. The chief complaints in the A group were traditional stroke symptoms, side weakness (61.0%), and speech disturbance (17.8%), whereas the NA group had non-traditional symptoms, dizziness (32.7%), and decreased levels of consciousness (22.4%). Independent factors associated with missed stroke team activation were nystagmus, nausea/vomiting, dizziness, gait disturbance, and general weakness. CONCLUSION: A high index of AIS suspicion is required to identify such patients with these findings. Education on focused neurological examinations and the development of clinical decision tools that could differentiate non-stroke and stroke are needed.
Cerebellum ; Consciousness ; Diagnosis ; Dizziness ; Education ; Emergencies* ; Emergency Service, Hospital* ; Gait ; Humans ; Hypertension ; Incidence ; National Institutes of Health (U.S.) ; Neurologic Examination ; Reperfusion ; Retrospective Studies ; Risk Factors* ; Stroke*

PURPOSE: This study was conducted to compare the levels of pain intensity and pain relief between cancer patients and nursing records, and to compare the barriers to pain control between cancer patients and their nurses. METHODS: Data were collected from 90 cancer patients who were admitted to three oncology wards and 90 oncology nurses in the same three wards at C University Hospital in G City from July to September, 2012. RESULTS: The most severe pain intensity reported by cancer patients was 6.59 points on the first day of analgesic treatment, while that of their nursing records was 3.98 points on the first day. There were significant changes in pain intensity over time between two groups (F=142.07, p<.001). The highest level of pain relief reported by patients was 2.87 points on the third day, while that of nursing records was 1.67 points on the first day. The score for the social system area of barriers to pain control among the nurses was higher than that of cancer patients (t=-3.69, p=.021). CONCLUSION: Nurses need to frequently check and to be sensitive to cancer pain. Furthermore, the administrative procedures of narcotic analgesics need to be simplified.
Comprehension ; Humans ; Narcotics ; Nursing Records

PURPOSE: The purpose of this study was to identify the compliance with the protocol, which was developed considering the emetogenic potential for prophylaxis of chemotherapy. METHODS: Data was collected from 144 patients who received chemotherapy from June 15 to August 31, 2010 in C University Hospital in Jeollanamdo, Korea. The level of chemotherapy-induced nausea and vomiting (CINV) and the compliance with the protocol for prophylaxis of CINV were measured. RESULTS: There was statistically significant difference of CINV in morning sickness and anticipatory nausea of general and clinical characteristics. Also, the compliance with the protocol developed according to emetogenic potential of chemotherapy was statistically significant. There was no difference in CINV in regard to the compliance with the protocol. CONCLUSION: There was a good compliance with the protocol for prophylaxis according to emetogenic potential. But it should be recommended to use antiemetics for prophylaxis aggressively to relieve CINV for the patients who already experienced morning sickness and anticipatory nausea. In addition, the oncology nurses should respond sensitively to the complaints of nausea and vomiting no matter what the emetogenic potentials of chemotherapy regimen are.
Antiemetics ; Antineoplastic Combined Chemotherapy Protocols ; Compliance ; Female ; Guideline Adherence ; Humans ; Korea ; Morning Sickness ; Nausea ; Pregnancy ; Vomiting

PURPOSE: Authors evaluated the effectiveness of pain relief of the femoral nerve block in multimodal pain control protocols for patients with total knee arthroplasty in early postoperative period. MATERIALS AND METHODS: Seventy-six patients who underwent TKA under general anesthesia were enrolled in this study. Preemptive analgesic medication, periarticular multimodal drug injection, and IV-PCA were used for pain control in all patients. This single-blind, randomized controlled trial included 43 patients in the nerve block group and 33 patients in the control group. In the former group, the femoral nerve block was done by one author with a nerve stimulator set using 0.5% bupivacaine 20 ml and 1% lidocaine 10 ml. Pain scale was measured at 6, 12, 24, 48, 72 hours and 7 days postoperatively. In addition, amount of IV-PCA consumption, numbers of using acute pain rescuer, range of motion, straight leg raising, first ambulation time, and complications related with drugs were evaluated. RESULTS: Pain scale and the amount of IV-PCA consumption were significantly lower in nerve block group until 48 hours (p=0.04, 0.03), and the range of motion was better compared to the control group (p< or =0.02). The number of pain rescue medicines was significantly low in nerve block group within the first 3 days postoperatively (1.36 vs 2.58). The ability to raise a straightened leg was recovered more rapidly in the control group than in the nerve block group; this difference was statistically significant (12 vs 27.9 hours, p=0.02). There were no differences in first ambulation time and incidence of complications between the 2 groups. CONCLUSION: Femoral nerve block in the early period after TKA under multimodal pain control protocols showed significant improvement in pain relief and in range of motion, as well as a significant decrease in the requirement of IV PCA and acute pain rescuers.
Acute Pain ; Anesthesia, General ; Arthroplasty ; Bupivacaine ; Femoral Nerve ; Humans ; Incidence ; Knee ; Leg ; Lidocaine ; Nerve Block ; Osteoarthritis ; Passive Cutaneous Anaphylaxis ; Range of Motion, Articular ; Walking

BACKGROUND/AIMS: The aim of our study was to define the potential role of virologic response at 12 months of treatment (VR12) in predicting subsequent virologic and clinical outcomes in adefovir (ADV)-treated lamivudine-resistant chronic hepatitis B. METHODS: Two hundred and four patients with lamivudine-resistant chronic hepatitis B virus (HBV) treated with ADV monotherapy were included. Serum HBV DNA was quantified by real-time polymerase chain reactions. VR12 was defined as a HBV DNA level of less than 4 log10 copies/mL after 12 months of ADV treatment. RESULTS: VR12 was observed in 110 of the 204 patients (54%). The mean HBV DNA reductions from baseline after 12 months of ADV treatment were 3.8 and 1.9 log10 copies/mL in patients with and without VR12, respectively (p<0.001). The hepatitis B "e" antigen (HBeAg) seroconversion rates in patients with and without VR12 were 32% and 14% at 12 months treatment, respectively (p=0.018), and 40% and 27% at 24 months of treatment (p=0.032). The genotypic mutation rates to ADV in patients with and without VR12 were 0% and 6% at 12 months of treatment, respectively (p=0.033), and 21% and 42% at 24 months (p=0.012). The rates of viral breakthrough in patients with and without VR12 were 0% and 7% at 12 months of treatment, respectively (p=0.072), and 9% and 25% at 24 months (p=0.006). CONCLUSIONS: Patients without VR12 may need to switch to or add on other potent antiviral drugs in their medical regimens.
Adenine ; Antiviral Agents ; DNA ; Drug Resistance ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Mutation Rate ; Organophosphonates ; Polymerase Chain Reaction ; Viruses

The hepatitis B virus (HBV) polymerase gene has overlapping reading frames with surface genes, which allows to alter the amino acid codon of the surface genes. In adefovir (ADV) treated chronic hepatitis B patients carrying rtA181T/rtA181V mutations, overlap with surface gene mutations such as sW172stop/sL173F has been reported. However, the clinical consequences of such surface mutations have not been determined. The aim of this study was to determine the surface gene sequence in ADV-resistant patients carrying the A181T/V mutation and to describe the clinical significance. Of the 22 patients included in this study, 13 were ADV-resistant with rtA181T/V mutations (polymerase mutation group, Group P) and nine were antiviral treatment-naive (control group, Group C). The Pre-S1 gene mutation, V60A, was detected in 11 patients (Group P=8, Group C=3). A start codon mutation in the Pre-S2 gene was found in five patients (Group P=3, Group C=2). An S gene mutation, sA184V, was found in nine patients, all of whom were in group P. Although sW172stop and sL173F mutations were detected, reduced HBsAg titer was not observed. Further study of these mutations and their clinical implications are needed.
Adenine/*analogs & derivatives/therapeutic use ; Adult ; Aged ; Amino Acid Sequence ; Amino Acid Substitution ; Antiviral Agents/*therapeutic use ; Codon, Initiator ; DNA-Directed DNA Polymerase/*genetics ; Demography ; Drug Resistance, Viral/genetics ; Female ; Genotype ; Hepatitis B Surface Antigens/*genetics/metabolism ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Organophosphonates/*therapeutic use ; Point Mutation ; Viral Proteins/*genetics

Major peritoneal catheter-related complications include pericatheter leaks, outflow failure, and infection of the exit site or tunnel. We experienced a rare spontaneous fracture of a silicone peritoneal catheter. A 39-year-old man undergoing continuous ambulatory peritoneal dialysis (CAPD) developed peripheral edema and peritoneal outflow failure. He had no signs of exit-site infection, trauma, or peritonitis. The kidney-ureter-bladder radiograph suggested a fractured peritoneal catheter. We removed the catheter in an emergency operation and inserted a new peritoneal catheter. No obvious reason could explain why the catheter had broken, although the patient's nephew was known to frequently jump on his abdomen Based on this case, mechanical stress should be avoided in CAPD patients with increased intra-abdominal pressure.
Abdomen ; Adult ; Catheters ; Edema ; Emergencies ; Fractures, Spontaneous ; Humans ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Silicones ; Stress, Mechanical

Angiosarcoma is a rare but highly malignant tumorthat usually arises in the scalp or face of elderly males. Distant metastases favor the lung, liver, lymph nodes and skin. Metastatic pulmonary angiosarcoma commonly takes the form of a nodule but can sometimes appear as a thin-walled cyst. We report a case of 65 years-old male with a spontaneous pneumothorax, who underwent excision and radiotherapy for an angiosarcoma of the scalp 2 years ago. A chest CT scan revealed multiple cysts in the lung. The video-assisted thoracoscopic lung biopsy demonstrated subpleural cysts without tumor cells. A skin biopsy of the scalp showed an angiosarcoma. This case was diagnosed as a recurrence of an angiosarcoma with a supposed lung metastasis. This case suggests that a spontaneous pneumothorax in elderly people may be secondary to a pulmonary metastasis from an angiosarcoma of the scalp.
Aged ; Biopsy ; Hemangiosarcoma ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Pneumothorax ; Recurrence ; Scalp ; Skin ; Thorax