Ultrasound-guided insertion of peripherally inserted central catheter after anesthetic induction in children undergoing surgery for moyamoya disease - Thirty cases report-

Background@#Pediatric patients with moyamoya disease are vulnerable to ischemic attacks following physical or emotional stress, such as those experienced during blood sampling. A central venous catheter might be beneficial for blood sampling, and a peripherally inserted central catheter (PICC) is a considerable option for central venous access. However, PICC insertion during anesthetic management is relatively rare.Case: Thirty cases of ultrasound-guided PICC insertion were performed in children undergoing surgery for moyamoya disease after anesthetic induction. Positioning was successful in 22 cases, and 5 were malpositioned. In three cases, the peripheral insertion failed. Adjustment of the insertion depth was performed in nine cases. No complications related to catheterization were observed during the procedure or the catheter indwelling period. @*Conclusions@#We report the successful use of PICC in children undergoing surgery for moyamoya disease with a considerable success rate and low incidence of malpositioning or complications.

The Trend in Incidence and Case-fatality of Hospitalized Acute Myocardial Infarction Patients in Korea, 2007 to 2016

Changes in Language Function and Recovery-Related Prognostic Factors in First-Ever Left Hemispheric Ischemic Stroke

OBJECTIVE: To investigate longitudinal changes in language function in left-hemispheric ischemic stroke patients as well as factors that influence language recovery until 1 year after stroke onset.METHODS: We analyzed data from 235 patients with first-ever left-hemispheric ischemic stroke. All patients completed the Korean version of the Frenchay Aphasia Screening Test (K-FAST) at 7 days (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after stroke onset. Repeated measures analysis of variance (ANOVA) was used to investigate changes in language function between time points. Subgroup analysis was performed according to the K-FAST scores at T1. Stroke lesion volume was assessed using diffusion tensor images, and involvement of language-related brain regions was examined. Multiple regression analysis was used to analyze factors influencing improvement of K-FAST score.RESULTS: The K-FAST scores at T1, T2, T3, and T4 differed significantly (p < 0.05). In the subgroup analysis, only the severe group showed continuous significant improvement by 1 year. Factors that negatively influenced improvement of language function were the age at onset, initial National Institutes of Health Stroke Scale (NIHSS) score, and initial K-FAST score, whereas education level and stroke lesion volume positively affected recovery. Involvement of language-related brain regions did not significantly influence long-term language recovery after ischemic stroke.CONCLUSION: Recovery of language function varied according to the severity of the initial language deficit. The age at stroke onset, education level, initial severity of aphasia, initial NIHSS score, and total stroke lesion volume were found to be important factors for recovery of language function.

¹⁸FFET PET is a useful tool for treatment evaluation and prognosis prediction of anti-angiogenic drug in an orthotopic glioblastoma mouse model / 한국실험동물학회지

O-2-¹⁸F-fluoroethyl-l-tyrosine ([¹⁸F]FET) has been widely used for glioblastomas (GBM) in clinical practice, although evaluation of its applicability in non-clinical research is still lacking. The objective of this study was to examine the value of [¹⁸F]FET for treatment evaluation and prognosis prediction of anti-angiogenic drug in an orthotopic mouse model of GBM. Human U87MG cells were implanted into nude mice and then bevacizumab, a representative anti-angiogenic drug, was administered. We monitored the effect of anti-angiogenic agents using multiple imaging modalities, including bioluminescence imaging (BLI), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT). Among these imaging methods analyzed, only [¹⁸F]FET uptake showed a statistically significant decrease in the treatment group compared to the control group (P=0.02 and P=0.03 at 5 and 20 mg/kg, respectively). This indicates that [¹⁸F]FET PET is a sensitive method to monitor the response of GBM bearing mice to anti-angiogenic drug. Moreover, [¹⁸F]FET uptake was confirmed to be a significant parameter for predicting the prognosis of anti-angiogenic drug (P=0.041 and P=0.007, on Days 7 and 12, respectively, on Pearson's correlation; P=0.048 and P=0.030, on Days 7 and 12, respectively, on Cox regression analysis). However, results of BLI or MRI were not significantly associated with survival time. In conclusion, this study suggests that [¹⁸F]FET PET imaging is a pertinent imaging modality for sensitive monitoring and accurate prediction of treatment response to anti-angiogenic agents in an orthotopic model of GBM.

Establishment of a mouse model of 70% lethal dose by total-body irradiation / 한국실험동물학회지

Whereas increasing concerns about radiation exposure to nuclear disasters or side effects of anticancer radiotherapy, relatively little research for radiation damages or remedy has been done. The purpose of this study was to establish level of LD70/30 (a lethal dose for 70% of mice within 30 days) by total-body γ irradiation (TBI) in a mouse model. For this purpose, at first, 8-week-old male ICR and C57BL/6N mice from A and B companies were received high dose (10, 11, 12 Gy) TBI. After irradiation, the body weight and survival rate were monitored for 30 days consecutively. In next experiment, 5-week-old male ICR and C57BL/6N mice from B company were received same dose irradiation. Results showed that survival rate and body weight change rate in inbred C57BL/6N mice were similar between A and B company. In ICR mice, however, survival rate and body weight change rate were completely different among the companies. Significant difference of survival rate both ICR and C57BL6N mice was not observed in between 5-week-old and 8-week-old groups receiving 10 or 12 Gy TBI. Our results indicate that the strain and age of mice, and even purchasing company (especially outbred), should be matched over experimental groups in TBI experiment. Based on our results, 8-week-old male ICR mice from B company subjected to 12 Gy of TBI showed LD70/30 and suitable as a mouse model for further development of new drug using the ideal total-body irradiation model.

An acoustic analysis on the pronunciation of Korean vowels in patient with class III malocclusion

The purpose of the study was to investigate the characteristics of the pronunciation of Korean vowels in patients with class III malocclusion. 11 adult male patients with class III malocclusion(mean ages 22.3 years) and four adult males with normal occlusion(mean ages 26.5 years) were selected for the analysis of eight Korean monophthongs /i, e, e, a, eo, o, eu, u/. The values and relationships of F1, F2 and F3 were derived from the stable section of target vowel in each sentence, and the analysis using formant plots and vowel triangles' distance and area was conducted to find the features of two groups' vowel distributions. Consequently, it was identified that the pronunciation of males patients with class III malocclusion showed high values of F1 in the low vowels, high values of F2 in the back vowels, and remarkably low position of /a/. The vowel triangle suggested that the triangle areas of male patients with class III malocclusion were shown wider vertically and narrower horizontally than those of males with normal occlusion. These characteristics could reflect the structural features of class III malocclusion such as the prognathic mandible, low tongue position, and advancement of back position of the tongue.

Effects of Fiber Supplements on Functional Constipation

This study aimed to evaluate the effect of dietary fiber supplementation with snack type on functional constipation. We conducted a double blind case-control study with 3 groups; placebo, low dose group (LD: insoluble fiber 7 g/d + soluble fiber 1.2 g/d) and high dose group (HD: insoluble fiber 14 g/d + soluble fiber 2.4 g/d), which were randomly assigned out of subjects with functional constipation, defined by modified Rome II criteria. We measured anthropometric parameters and evaluated the bowel movement frequency, stool type, straining, sense of complete evacuation, abdominal discomfort/pain, abdominal inflation, relief and colon transit time before, during the supplementation. Both LD and HD groups had significant improvement in straining, sense of complete evacuation and satisfactory relief compared with placebo group (p<0.05). When subdivide by baseline colon transit time (less than 24 hrs/24 hrs or more and less than 72 hrs/72 hrs or more) , only HD group had significantly improvement; colon transit time recovered near by 24 hrs in subjects of 'less than 24 hrs' (from 7.57+/-1.40 hrs to 25.2+/-3.91 hrs, p<0.01) and reduced in those of '24hr or more and less than 72 hr' (from 47.0+/-3.36 hrs to 31.3+/-4.31 hrs, p<0.01) and '72 hr or more' (from 106.7+/-10.7 hrs to 85.0+/-13.1 hrs, p<0.05) subjects. Particularly, positive effect of fiber supplementation on straining and sense of complete evacuation in test groups seemed to be greater in subjects of '24 hrs or less' and '24 hrs or more and less than 72 hrs' than those of '72 hrs or more'. In conclusion, subjects with functional constipation, particularly those having colon transit time less than 72 hrs can significantly improve, at least in part, symptom related to constipation by fiber supplementation of snack type without serious side effects.

Immunohistochemical Demonstration of C-erbB-2 Oncoprotein Expression in Transitional Cell Carcinoma of the Bladder: Correlative Study with Tumor Grade, Stage, Proliferating Cell Nuclear Antigen Expression, Nucleolar Organizer Regions Per Nucleus, and Flow / 대한비뇨기과학회지

C-erbB-2 oncoprotein has been known to act as growth factor receptor responsible for the regulation of cellular growth, proliferation and differentiation and has been demonstrated in a number of cancers by immunohistochemical as well as matrix blotting techniques. Breast and ovarian cancer patients, whose tumor cells have amplification or overexpression of this oncoprotein, have been suggested to have worse prognosis. Yet, there are only a few studies on c-erbB-2 oncoprotein expression in transitional cell carcinoma(TCC) of the bladder. The aim of this study was to examine c-erbB-2 oncoprotein expression in bladder cancer to assess its potential as a useful prognostic marker in transitional cell carcinoma of the bladder. Deparaffinized tumor specimens from 42 patients with TCC of the bladder and 3 normal bladder tissue specimens were utilized. C-erbB-2 oncoprotein expression was detected by immunohistochemical analysis and then correlated with conventional prognostic variables such as histologic tumor grade, stage and DNA ploidy. In addition, we related the expression of c-erbB-2 oncoprotein to indicators of cellular proliferative activities such as proliferating cell nuclear antigen(PCNA), mean number of silver nucleolar organizer regions(AgNORs) per nucleus, flow cytometric S-phase fraction(CPF) and proliferation index(PI). The incidence of c-erbB-2 oncoprotein expression in Ash grade IV TCC of bladder was higher than that in Ash grade II and III (Chi-square test, p<0.05). The incidence of positive immunoreaction was higher in cases with muscle invasion and metastasis than in superficial tumors with statistical significance(p<0.05). In addition, statistical significant correlation was noted between c-erbB-2 oncoprotein expression and PCNA expression rate. But there were no significant differences in c-erbB-2 oncoprotein expression to DNA ploidy, PI nor SPF by flow cytometry and mean number of AgNORs per nucleus. The results of this study suggests that the c-erbB-2 oncoprotein together with other predictive parameters may serve to provide a phenotypic profile which permits more accurate forecasting of bladder cancer behavior and may prove to be useful in the future as an important guide to specific anti-tumor therapy.

A case of transitional cell carcinoma of bladder, metastasis to ovary / 대한비뇨기과학회지

The incidence of ovarian metastasis of transitional cell carcinoma is very rare and its prognosis appears to be poor. We have experienced a unique case of ovarian metastasis from transitional cell carcinoma of the bladder in 59 year old female whose complaint was palpable abdominal mass. The patient previously underwent partial cystectomy due to perforation during transurethral resection of the bladder tumor. During the course of evaluation, left distal ureteral tumor was identified with cystic abdominal mass. On exploration, the palpable abdominal mass was confirmed as ovarian mass. She eventually underwent left oophorectomy and distal ureterectomy. The final diagnosis was confirmed as metastatic ovarian transitional cell carcinoma.

Interrelationships between nuclear DNA ploidy, tumor grade and stage in upper tract transitional cell carcinoma / 대한비뇨기과학회지

DNA ploidy analysis by flow cytometry is a well established method to characterize urinary tract tumors in the diagnosis, monitoring of treatment efficacy, and predicting progression and recurrences. We analyzed a total of 34 paraffin embedded specimens from 26 upper urinary tract transitional cell carcinoma patients who were operated upon between 1984 and 1991. 1. DNA diploid histogram patterns were detected in 14 patients (54%) and the remaining 12 (46%) showed aneuploid patterns. 2. DNA diploid tumors tend to be associated with superficial tumors (9/11) and the aneuploidy with invasive tumors (10/15). 3. DNA ploidy and histological grade were closely associated; Aneuploidy was identified more frequently in higher grades (8/11) than in lower grades (4/15). In conclusion, our data indicate that DNA ploidy, grade and stage are closely associated with each other in upper urinary tract transitional cell carcinoma. The DNA ploidy analysis of the upper tract transitional cell carcinoma may be utilized as an additional prognostic factor.

Leiomyosarcoma of the penis / 대한비뇨기과학회지

Leiomyosarcoma of the penis is an extremely rare disease. We have encountered a case of leiomyosarcoma of the penis in a 45 year old man. On staging work up. local invasion to corpus cavernosum. but no evidence of lymph node metastasis was evident. After the confirmation of leiomyosarcoma by excisional biopsy, the patient underwent partial penectemy. Herein we report this case with the review of literatures.

The results of modified double layer vasovasostomy / 대한불임학회지

No abstract available.