OBJECTIVE: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. MATERIALS AND METHODS: We investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included. MET was performed in patients with or without injected intravenous tissue plasminogen activator. MET was considered in patients with a National Institute of Health Stroke Scale score of 4 or more, older than 18 years, with definite occlusion of the basilar artery or posterior cerebral artery (PCA), and who arrived at the hospital within 24 hours from onset. RESULTS: The direct catheter aspiration technique was used in five cases, and the stent retrieval technique was used in seven cases. The stent retrieval technique with the direct aspiration technique was used in three cases. Recanalization failed in two cases. Basilar occlusion without PCA involvement is the only effective factor of successful recanalization (p = 0.03). Successful recanalization (p = 0.005) and the presence of a posterior communicating artery (p = 0.005) affected the good outcome at discharge. CONCLUSION: An early diagnosis and active MET may improve the patient outcome. MET may help recanalization and good flow restoration and the potential for a good outcome.
Arteries ; Basilar Artery ; Catheters ; Early Diagnosis ; Humans ; Medical Records ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery* ; Stents ; Stroke ; Thrombectomy* ; Tissue Plasminogen Activator

BACKGROUND: The majority of patients undergoing stem cell transplantation (SCT) require a blood transfusion until the complete engraftment. Because blood transfusion rules for patients with ABO-incompatible SCT are complicated, we developed an ABO-incompatible transfusion management system (ABO-ITMS) for accurate blood transfusion and improved manageability. METHODS: A committee composed of medical doctors, technicians, and a programmer developed ABO-ITMS during the eight months from July 2013 to February 2014. The program has been linked with other databases, including clinical and laboratory databases and resulted in a new subsystem of the health information system. Server computer's operating system was Window Server 2008, and the database manager program was Oracle 11g. Programming language was ASP.Net (VBScript, C #), and the server and client computer were used to connect to the web server using a web browser. RESULTS: ABO-ITMS was designed to follow three main steps by hematologic oncology clinic, laboratory physician, and blood bank. In the first step, a hematologic-oncology clinic doctor inputs SCT recipients' data and appropriate ABO group for each phase of post-transplantation. Laboratory physician enters the isoagglutinin titer and ABO group at the second step. Finally, blood bank workers enter the results of type, screening, and antibody identification. The patient's SCT information and the previous immunohematologic test results are shown on the screen. CONCLUSION: ABO-ITMS can replace the existing complicated system and workflow. ABO-ITMS will contribute to reducing medical error and improving quality of SCT recipient care.
Blood Banks ; Blood Transfusion* ; Health Information Systems ; Humans ; Mass Screening ; Medical Errors ; Programming Languages ; Stem Cell Transplantation* ; Web Browser

BACKGROUND AND OBJECTIVES: Cardiac troponins are associated with increased mortality, even among patients with no coronary artery disease. Elevated cardiac troponin levels are frequently observed in patients without significant coronary lesions, although the mechanism underlying this finding is unclear. The aim of our study was to evaluate the association between the levels of cardiac troponin and coronary flow reserve (CFR). SUBJECTS AND METHODS: We evaluated serum cardiac troponin-I in 19 patients (9 female; age 61.9+/-10.9 year-old). All patients had an ejection fraction >40% and angiographically normal coronary arteries. Simultaneous measurements of fractional flow reserve (FFR), the index of microcirculatory resistance (IMR), and CFR measurements using an intracoronary temperature- and pressure-sensing guidewire under basal conditions and during maximal hyperemia were performed in three vessels: the left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery (RCA). RESULTS: All patients were followed for a median of 13 months. FFR, IMR, and CFR measurements were performed successfully in all subjects. Mean CFRs of LAD, LCX, and RCA were 1.98+/-1.20, 2.75+/-2.11, and 4.44+/-2.51, respectively. Mean IMRs of LAD, LCX and RCA were 33.28+/-18.78, 29.11+/-26.70, and 30.55+/-23.65, respectively. There was a poor correlation between CFR and troponin-I values in each vessel. In selecting the lowest value of CFR in each patient as the corresponding value, the lowest CFR was not associated with troponin-I levels (r=-0.219, p=0.367). CONCLUSION: In patients without significant coronary lesions, the correlation between CFR and troponin-I level was not significant using a thermodilution technique. Further study of a larger population with longer-term follow-up may be needed to more fully understand microvascular dysfunction.
Arteries ; Coronary Artery Disease* ; Coronary Vessels ; Female ; Follow-Up Studies ; Humans ; Hyperemia ; Microvessels ; Mortality ; Thermodilution* ; Troponin I ; Troponin* ; Vascular Resistance

Since oxidative stresses are involved in gastroenteritis and diarrhea, we investigated antioxidative and antidiarrheal activities of persimmon flesh extract (PFE) and persimmon calyx extract (PCE) in vitro and in vivo, respectively. PCE significantly scavenged 1,1-diphenyl-2-picrylhydrazyl hydrate and 2,2'-azinobis (3-ethylbenzthiazoline-6-sulfonic acid) from 500 microg/mL, although PFE was ineffective. In addition, PFE and PCE exhibited strong nitric oxide-scavenging effects from 1 microg/mL, in which PCE was superior to ascorbic acid (50 microM). Furthermore, PFE and PCE significantly inhibited FeCl3-induced lipid peroxidation as well as Cu2+/H2O2-induced protein oxidation from 10 microg/mL. In vivo charcoal-propulsion assay, in contrast to a negligible effect of PFE, treatment with PCE (160-500 mg/kg) markedly inhibited intestinal motility. The results indicate that extracts of persimmon, especially PCE, possess antioxidative, antiinflammatory and antidiarrheal activities. Therefore, it is suggested that persimmon extracts could be used for the relief of gastroenteritis and diarrhea.
Ascorbic Acid ; Biphenyl Compounds ; Diarrhea ; Diospyros ; Gastroenteritis ; Gastrointestinal Motility ; Lipid Peroxidation ; Oxidative Stress ; Picrates

Various venous approaches are available for chemoport insertion. The subclavian vein and jugular vein are commonly used. The cephalic vein has several advantages for chemoport insertion. The authors introduce chemoport insertion using cephalic vein. Operation methods were as follows: patient was placed in supine position. Under local anesthesia, the incision was made in the infraclavicular portion, dissection was performed along the deltopectoral groove and the cephalic vein was identified and isolated. Dissection was performed between the subcutaneous fat layer and the muscle layer to make space for chemoport placement. The cephalic vein was incised and the catheter was introduced to the cephalic vein directly and examined by fluoroscopy. Chemoport insertion using cephalic vein is a useful method of chemoport insertion.
Anesthesia, Local ; Catheters ; Fluoroscopy ; Humans ; Jugular Veins ; Muscles ; Subclavian Vein ; Subcutaneous Fat ; Supine Position ; Veins

PURPOSE: Free cancer cells exfoliated from cancer-invaded serosa contribute to peritoneal dissemination, the most frequent pattern of recurrence in patients with gastric cancer. To detect free cancer cells, CEA and CA19-9 were introduced as the markers of gastric cancer, and many methods, such as cytology, immunoassay, and reverse transcription polymerase chain reaction (RT-PCR), exist for detecting them. The aim of this study is to define the clinical significance of using immunoassay to measure the levels of CEA and CA19-9 in the peritoneal washings in patients with gastric cancer. MATERIALS AND METHODS: The peritoneal washing fluids were obtained from 130 patients with gastric cancer who received a curative gastrectomy, palliative gastrectomy or open and closure. The pCEA and pCA19-9 levels were measured by using immunoassay and cytology. The results were compared with the clinicopathological data. RESULTS: The pCEA and pCA19-9 levels were correlated with tumor invasion, lymph-node metastasis, and stage (P<0.05). CONCLUSION: A correlation was found between elevated pCEA and pCA19-9 levels measured by immunoassay and the TNM stage. Therefore, a combined pCEA and pCA19-9 assay could be a sensitive detector of peritoneal dissemination, as well as a predictor of postoperative prognosis. pCEA and pCA19-9 may also determine the adjuvant management strategy.
Gastrectomy ; Humans ; Immunoassay ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Prognosis ; Recurrence ; Reverse Transcription ; Serous Membrane ; Stomach Neoplasms*

Preadipocyte cell lines are useful models for investigating adipogenesis process. 3T3-L1 preadipocyte, which can be induced to differentiate into adipocyte in cell culture, is one of the most studied preadipocyte cell lines. When exposed to the appropriate differentiation inducer, including insulin, dexamethasone and 3-isobutyl- 1-methylxanthine, 3T3-L1 preadipocytes differentiate into adipocytes. This study was undertaken to evaluate the effect of epigallocatechin on differentiation of 3T3-L1 preadipocyte, and to test whether epigallocatechin can be useful to reduce fat deposition. Cell proliferation was determined by MTT(3,4,5-Dimethylthiazol-2,5-Diphenyl- Tetrazoliumbromide) spectro-photometry, fat content followed by cell differentiation was determined by Oil Red O staining, and the degree of differentiation into adipocytes were determined by measuring mRNA content and activity of glyceraldehydes 3-phosphate dehydrogenase (G3PDH). Epigallocatechin inhibited proliferation of preadipocytes, not into adipocytes. Fat storage during 3T3-L1 preadipocyte conversion into adipocyte was inhibited by epigallocathechin. Epigallocatechin decreased G3PDH, leptin mRNA and peroxisome proliferator-activated receptor(PPAR)gamma mRNA which were increased by differentiation of preadipocyte into adipocyte. These results suggest that epigallocatechin has a potential to serve as a fat-reducing drug.
Adipocytes ; Adipogenesis* ; Cell Culture Techniques ; Cell Differentiation ; Cell Line ; Cell Proliferation ; Dexamethasone ; Insulin ; Leptin ; Oxidoreductases ; Peroxisomes ; RNA, Messenger

According to the reports, the prevalence of anti-HCV is about 1%. In past, the results of the prevalence of HBs Ag & HBs Ab in the patients of Hansen's disease were reported. But we don't know about that of anti-HCV. So we study about the prevalence of serum anti-HCV of 60 patients & PALS of Hansen's disease. And we test about Alk. Phosp., ALT, AST, Gtlc HBs Ag & HBs Ab. 1. The prevalence of anti-HCV is 8.33%. It is higher than past reports(about 1-2%). 2. The prevalence of HBs Ag is 3.4% & that of HBs Ab is 36.3%. 3. Because of the high prevalence of anti-HCV in the patients of Hansen's disease & PALS, we think that more studies are need about it.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis* ; Humans ; Leprosy ; Prevalence

A 38-year-old woman with twin pregnancy was referred after detection of hydrocephalus in one fetus at 23+1 weeks' gestation. Sonography showed hydrocephalus, a scalloping of the frontal bone giving a lemon-like configuration, and meningocele. The affected twin was terminated by ultrasonographically guided intracardiac injection of 4 ml (8 mEq/L) potassium chloride solution at 24+5 weeks' gestation. Chromosomal analysis of the other fetus showed normal findings (46, XX). Serial ultrasound scans and coagulopathy tests were unremarkable. Preterm premature rupture of the membrane was developed at 33+3 weeks' gestation, and emergency Cesarian section was done. A healthy 1360 g female was born, with Apgar scores of 7 and 8 at one and five minutes, respectively.
Adult ; Arnold-Chiari Malformation* ; Emergencies ; Female ; Fetus ; Frontal Bone ; Humans ; Hydrocephalus ; Membranes ; Meningocele ; Pectinidae ; Potassium Chloride ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Twins, Dizygotic* ; Ultrasonography

Twenty eight patients with negative but technically satisfactory four-vessel angiography-admitted to our department from 1985 to 1995 were followed for long term evaluation. The aim of this retrospective study of patients with SAH of unknown etiology was to evaluate the clinical features, long-term prognosis in mortality rate and risk of rebleeding, and the daily functional capacity. Twenty eight out of 1035(2.7%) spontaneous subarachnoid hemorrhage patients were found to have subarachnoid hemorrhage(SAH) of unknown etiology. Twenty eight patients were confirmed as SAH, by computed tomography or lumbar puncture. CT scan was undertaken in all cases(in 28 cases within 5 days of hemorrhage). SAH of unknown etiology classified as Hunt and Hess grade I was 60.7% of cases, but there were no patients with Grade V. Arterial hypertension was present on admission in 35.7% of cases. We only performed the angiogram once in 16 of 28 patients, but there were no rebleedings caused by aneurysm. The period of follow-up ranged from 2 to 11 years, with the mean of 4.3 years. Only one of 28 patients(3.6%) experienced late rebleeding, and again had normal cerebral panangiography. Two patients(7.1%) showed a moderate disability in activities of daily living, one patient(3.6%) was mild disabled, and two(7.1%) had died of pneumonia. Based on the ADL grade, Grade I was 28.6% at the time of discharge however, during follow-up, increased up to 81.5%.
Activities of Daily Living ; Aneurysm ; Follow-Up Studies* ; Humans ; Hypertension ; Mortality ; Pneumonia ; Prognosis ; Retrospective Studies ; Spinal Puncture ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed