Ramifications of coronary angiography with effect to time comparing two groups: undergoing off pump coronary artery bypass grafting within or more than seven days of coronary angiography

Background: Acute kidney injury (AKI) following off pump coronary artery bypass grafting (OPCABG) within short interval from coronary angiography (CAG) has been well documented. This prospective study is aimed to delineate perioperative effects and effects of elective 7 days interval between CAG and off pump CABG, to observe its outcome on renal functions.Methods: The present study was conducted in a total of 1102 consecutive patients who underwent coronary angiography following coronary artery bypass surgery in Fortis hospital, Mohali. Patients were divided into 2 groups - group A (patients undergoing CABG within 7 days of CAG) and group B (patients undergoing CABG beyond 7 days of CAG). Comparison was made between the two groups, in relation to the timing between CAG and CABG, with its impact on perioperative renal functions.Results: Statistically it was found highly significant higher values of 1st and 3rd day serum creatinine and high incidence of postoperative AKI in patients of group A in comparison to patients of group B.Conclusions: Thus, our study confirms that patients with a shorter interval between CAG and subsequent OPCAB are more likely to present higher peak creatinine level as well as lower minimum eGFR. A gap of 7 days for elective cases is more likely to present less postoperative AKI.

Interval between entry of mainland China and diagnosis in imported COVID-19 cases and factors contributing to delayed diagnosis in Guangdong Province / 南方医科大学学报

OBJECTIVE@#To understand the distribution patterns and the factors influencing the interval between entry of mainland China and diagnosis in imported COVID-19 cases in Guangdong Province to provide evidence for formulating and implementing effective control measures.@*METHODS@#We collected the data of imported COVID-19 cases from March 1st to April 10th, 2020 published on the official websites of Health Commission of Guangdong Province and local government of the cities in Guangdong Province for epidemiological analysis. Descriptive statistical methods were used to analyze the distribution patterns of the interval between entry of mainland China and diagnosis of the imported cases, and multivariate logistic regression was used to analyze the factors influencing the interval.@*RESULTS@#A total of 179 imported cases were reported in Guangdong by April 10th, 2020. The average interval between entry of mainland China and diagnosis was 4.21 days with a median of 2 days. The interval was between 1 and 3 days in 69.8% of the cases. Multivariate logistic regression analysis showed that a negative result of the initial nucleic acid test (OR=5.205, 95% : 1.100-24.640, =0.038) and interval between entry of mainland China and a positive diagnosis >2 days (OR=85.654, 95%: 24.569-298.615, < 0.001) were risk factors for the finding delay.@*CONCLUSIONS@#The results of initial nucleic acid detection and the interval between entry of mainland China and a positive diagnosis of COVID-19 are the major contributing factors of delayed case detection. This finding suggests that strict quarantine and detection measures should be carried out for the personnel entering China to accurately and quickly identify the cases.

Role and significance of anterior cruciate ligament injury in the development of post-traumatic knee osteoarthritis / 中国组织工程研究

BACKGROUND: Anterior cruciate ligament has the function of stabilizing the knee joint and restricting the tibiofemoral joint in the translation and rotation of the tibia. Most patients with anterior cruciate ligament reconstruction have an increased risk of knee pain and knee instability. Knee osteoarthritis after trauma is a serious complication of anterior cruciate ligament injury. Knee osteoarthritis is a chronic progressive disease, and the mechanism of osteoarthritis after anterior cruciate ligament injury remains unclear. OBJECTIVE: To review the relationship between anterior cruciate ligament injury and the risk factors of post-traumatic knee osteoarthritis, so as to provide guidance for the treatment of post-traumatic knee osteoarthritis. METHODS: The first author searched related articles in PubMed database from the establishment of the database to October 2019. The key words were “ACL injury, traumatic knee osteoarthritis, ACL reconstruction, meniscus status, body mass index, cartilage injury, age, graft selection, time interval between injury and surgery”. A total of 123 articles were retrieved, and 66 articles were eligible for the inclusion criteria. RESULTS AND CONCLUSION: (1) Meniscus status, body mass index, cartilage damage, age, graft selection, and time between injury and surgery may influence the development of post-traumatic knee osteoarthritis. (2) Although anterior cruciate ligament reconstruction is primarily performed to restore stability after anterior cruciate ligament rupture, a long-term goal of the process is to reduce the risk of knee osteoarthritis and maintain long-term joint health. (3) Meniscus resection in patients with anterior cruciate ligament rupture accompanied by meniscus injury is also the cause of knee osteoarthritis, which is likely to be caused by weakened endurance and kinematic changes of the joint.

The Effect of Emergency Medical Service Use and Inter-hospital Transfer on Prehospital Delay among Ischemic Stroke Patients: A Multicenter Observational Study

The time between symptom onset and arrival at an emergency department (ED) (S2D) is a crucial time for optimal intravenous reperfusion care for ischemic stroke. We aimed to analyze the effect of emergency medical services (EMS) utilization and inter-hospital transfer on S2D in Korea. Ischemic stroke patients were prospectively enrolled from November 2007 to December 2012 in 23 tertiary and teaching hospital EDs in Korea. Of 31,443 adult ischemic stroke patients, 20,780 were categorized into 4 groups based on modes of EMS utilization and inter-hospital transfer: direct transport to destination ED by EMS (EMS direct; n=6,257, 30.1%), transfer after transport to another ED by EMS (EMS indirect; n=754, 3.6%), direct transport to the ED without using EMS (non-EMS direct; n=8,928, 43.0%), and transfer after visiting another hospital without using EMS (non-EMS indirect; n=4,841, 23.3%). Our primary outcome variable was of S2D within 2 hr (S2D < or =2 hr) and found that 30.8% of all patients and 52.3%, 16.4%, 25.9%, and 13.9% of EMS direct, EMS indirect, non-EMS direct, and non-EMS indirect, respectively, achieved S2D < or =2 hr. Adjusted odds ratio for S2D < or =2 hr were 6.56 (95% confidence interval [CI], 5.94-7.24), 2.27 (95% CI, 2.06-2.50), and 1.07 (95% CI, 0.87-1.33) for EMS direct, non-EMS direct, and EMS indirect, respectively. Patients directly transported to destination hospitals by the EMS show the highest proportion of therapeutic time window for optimal care in ischemic stroke.

Relación entre el intervalo de nacimiento entre gemelos y el pH de cordón umbilical: ¿existe asociación entre la acidosis del primer gemelo y el segundo? / Relationship between the birth interval between twins and umbilical cord pH: is there an association between acidosis of the first twin and the second?

OBJETIVOS: Determinar si el intervalo de nacimiento vía vaginal entre gemelos, se relaciona con un descenso de pH arterial/venoso de cordón umbilical del segundo gemelo respecto al primero, y establecer si el pH acidótico del primer gemelo predice la acidosis del segundo. MÉTODO: Estudio de cohortes retrospectivo en 77 pares de gemelos realizado en el Hospital de Getafe, España, en el periodo 2008-2013. Se relacionó el tiempo transcurrido entre el nacimiento de los gemelos con el resultado del pH de cordón y el exceso de bases. Estudiamos la correlación entre el tiempo transcurrido entre ambos nacimientos y la diferencia entre los valores de pH del primer y segundo gemelo, y la correlación con la diferencia de exceso de base. RESULTADOS: Hubo correlación lineal significativa entre el tiempo transcurrido entre el nacimiento de los gemelos y la diferencia de pH venoso del segundo gemelo respecto del primero (R=0,560; p=0,0001), así como con el pH arterial (R=0,502; p=0,0001). El pH <7,20 del primer gemelo se asoció con acidosis en el cordón del 2° gemelo (<7,20, p=0,000; <7,15, p=0,0001; <7,10, p=0,0001; <7,05, p=0,001; <7,00, p=0,0001). CONCLUSIONES: El pH del segundo gemelo siempre fue igual o menor que el del primer gemelo, hubo una correlación lineal entre el intervalo de nacimiento entre gemelos y el descenso del pH venoso y arterial del segundo gemelo respecto al primero. El pH acidótico del primer gemelo predice la acidosis del segundo.

OBJETIVOS: Determinate if the twin-to-twin vaginal delivery time interval, is related with a decline of the arterio-venous cord blood pH of the second twin regarding to the first twin, and to evaluate if the acidotic pH of first twin can predict the acidosis status of the second one. METHOD: A retrospective descriptive cohort study was performed at the Hospital of Getafe, Spain, in the period 2008-2013, with 77 pairs of twins that were registered and met the inclusion criteria. The twin-to-twin delivery time interval and the cord blood status results were registered. A statistical analysis was performed to study the relation of the twin-to-twin delivery time interval with the pH value differences between first and second twins, and with the base excess. RESULTS: A positive linear correlation between the twin-to-twin delivery time interval and the difference of venous pH of the second twin respect to the first one was found (R=0.560; p=0.0001), and also with the difference on arterial pH (R=0.502; p=0.0001). A pH value <7.20 of the first twin was associated with blood cord acidosis of the second twin (<7.20, p=0.000; <7.15, p=0.0001; <7.10, p=0.0001; <7.05, p=0,001; <7.00, p=0.0001). CONCLUSIONS: The second twin pH was equal to or less than the first twin pH in all cases. There is a linear relation between twin-to-twin delivery time interval and the decrease of the pH value of the second twin regarding to the first one. The acidosis of first twin could predict the acidosis status of the second twin.

Study of impact of operation time interval after neoadjuvant chemoradiotherapy for locally progressed rectal patients’ outcome / 中国癌症杂志

Neoadjuvant chemoradiotherapy (nCRT) is used to downstage locally advanced rectal cancer before surgery, in order to increase the chance of radical resection, reduce local recurrence, and improve overall survival. Accumulating data suggest that tumor response to nCRT is time dependent. A delay between nCRT and surgery may increase the proportion of patients that achieve a favorable response, and 4-6 weeks are considered to be a universal interval. However, delayed surgery beyond 6-8 weeks may increase the technical dififculty, and the risks of surgical complications and recurrence or metastasis. This article brielfy reviews the relevant literature to evaluate the efifciency and safety of delayed surgery.

A comparison of systolic and diastolic time variation with pulse pressure variation as a predictor of fluid responsiveness during pediatric liver transplantation

BACKGROUND: In pediatric patients, dynamic preload indices to predict fluid responsiveness remain controversial. Because each beat of blood pressure (BP) - waveform - contains evidence of a systolic and diastolic time interval (STI, DTI), we compared pulse pressure variation (PPV) with respiratory STI and DTI variation (STV, DTV) as predictors of fluid responsiveness during pediatric liver transplantation. METHODS: A total of 61 datasets from 16 pediatric liver transplant patients (age range one month to seven years), before and after an inferior vena cava clamp was applied, were retrospectively evaluated from electronically archived BP and central venous pressure (CVP) waveforms. STI and DTI were separated by a beat-to-beat blood pressure waveform. STV, DTV and PPV were calculated by averaging three consecutive respiratory cycles. Averaged CVP was used as a static preload index. A PPV threshold of > or =16%, a known cutoff value in pediatric surgery, was used to discriminate fluid responsiveness in the receiver operating characteristic (ROC) curve analysis. RESULTS: PPV showed correlations with STV and DTV (r = 0.65 and 0.57, P < 0.001, respectively), but not with CVP (r = -0.30, P = 0.079). The area under the ROC curves (AUC) of STV, DTV and CVP were 0.834, 0.872, and 0.613, respectively. Cut-off values of STV and DTV were 7.7% (sensitivity/specificity, 0.80/0.83) and 7.7% (sensitivity/specificity, 0.70/0.88), respectively. CONCLUSIONS: This study demonstrates that STV and DTV from a BP waveform showed the potential to predict fluid responsiveness as a surrogate of PPV during pediatric surgery.

Intervalos de monitoreo para la medición en la glándula tiroides de los radionucleidos 125I y 129I / Monitoring intervals for the measurement of the radionuclides 125I and 129I in the thyroid gland

El trabajo muestra los intervalos de monitoreo que se pueden utilizar en el Laboratorio de Contaminación Interna del Centro de Protección e Higiene de las Radiaciones para medir directamente en la glándula tiroides los radionúclidos y . Se emplearon dos sistemas de medición, uno con un detector de centelleo y otro con un detector Phoswich. Ambos detectores se ubicaron dentro de una cámara de bajo fondo de 2.5 x 2.5 x 2.5 m de dimensión recubierta con 15 cm de acero, 3 mm de plomo, 1.8 mm de estaño, y 1.5 mm de cobre. Se calculó la actividad mínima detectable para cada sistema y en función de esta se determinaron los intervalos de monitoreo aplicables, de forma tal que una incorporación correspondiente al 5 % del límite anual de incorporación se pueda detectar. Se obtuvo que para el , todos los intervalos evaluados (120, 90, 60, 30, 14, y 7 días) se pueden utilizar en el monitoreo con ambos sistemas. En el caso del radionúclido , con la instalación del detector de centelleo solo se pueden aplicar los intervalos de 120, 90, y 60 días, y para la instalación con el Phoswich, todos los evaluados.

This paper shows the monitoring intervals that can be used in the Internal Contamination Laboratory of the Center for Radiation Protection and Hygiene for direct measurement of the radionuclides I-125 and I-129 in the thyroid gland. Two measuring systems were used, one of them with a scintillation detector and the other one with a Phoswich detector. Both detectors were placed inside a low background shielding chamber (2.5 x 2.5 x 2.5 m) coated with 15 cm of steel, 3 mm of lead, 1.8 mm of tin and 1.5 mm of copper. The minimum detectable activity for each system was calculated, and based on this, the applicable monitoring intervals were determined, so that an intake corresponding to 5 % of the Annual Intake Limit can be detected. The results showed that for the radionuclide I-125 all the intervals tested (120, 90, 60, 30, 14 and 7 days) can be used in monitoring both systems. In the case of the radionuclide I-129, only the intervals of 120, 90 and 60 days can be implemented by using the scintillation detector whereas for the Phoswich detector, all the tested intervals can be used.

Importance of the Time Interval between Bowel Preparation and Colonoscopy in Determining the Quality of Bowel Preparation for Full-Dose Polyethylene Glycol Preparation

BACKGROUND/AIMS: The quality of bowel preparation (QBP) is the important factor in performing a successful colonoscopy. Several factors influencing QBP have been reported; however, some factors, such as the optimal preparation-to-colonoscopy time interval, remain controversial. This study aimed to determine the factors influencing QBP and the optimal time interval for full-dose polyethylene glycol (PEG) preparation. METHODS: A total of 165 patients who underwent colonoscopy from June 2012 to August 2012 were prospectively evaluated. The QBP was assessed using the Ottawa Bowel Preparation Scale (Ottawa) score according to several factors influencing the QBP were analyzed. RESULTS: Colonoscopies with a time interval of 5 to 6 hours had the best Ottawa score in all parts of the colon. Patients with time intervals of 6 hours or less had the better QBP than those with time intervals of more than 6 hours (p=0.046). In the multivariate analysis, the time interval (odds ratio, 1.897; 95% confidence interval, 1.006 to 3.577; p=0.048) was the only significant contributor to a satisfactory bowel preparation. CONCLUSIONS: The optimal time was 5 to 6 hours for the full-dose PEG method, and the time interval was the only significant contributor to a satisfactory bowel preparation.

Practice and discussions on the reform of time-interval outpatient clinic appointment registration at Shenzhen Eye Hospital / 中华医院管理杂志

Shenzhen Eye Hospital took the lead to launch the time interval outpatient clinic appointment registration,for easing the difficulty of seeing doctors and shortening outpatient waiting time.With 30min as a registration interval,the hospital calls into play a variety of means to provide this service to outpatients.This service benefits the outpatients with comfortable hospital environment and promotes hospital efficiency.On this basis,the paper probed into existing problems in the appointment system and proposed improvement suggestions.

Simulation study of the outpatients queuing system under the time-interval controlled appointment registration mode / 中华医院管理杂志

Objective To build a simulation model for outpatients queuing,using data from a general outpatient cardiovascular clinic of a general hospital in Shanghai and different rules in the process.The study employs time-interval controlled mode for appointment registration,for the purpose of analyzing characteristics of different queues.Methods Extraction of data of the clinic in a given month by means of HIS system to determine the parameters of the queuing models.Building the simulation model with Matlab to develop the plan of mixed queues and that of discrete queues,for analyzing the waiting time variations,with different number of doctors on duty and different number of appointments in one time interval.Resnlts In the Monday mornings for example,the mean waiting time of appointments or no-appointments are calculated by simulation with different queuing rules,different number of doctors on duty and different appointment quantities of one time interval.Conclusion The mean waiting times of appointments and no-appointments can be both sizably cut short by means of time-interval controlled appointment; different queuing plans are recommended for different departments; the simulation model should be further verified and optimized in practice.

Uso do procedimento de bissecção temporal na avaliação de idosos com doença de Alzheimer: uma revisão sistemática / Using the temporal bisection procedure in the evaluation of elderly with Alzheimer's disease: a systematic review

OBJETIVO: Realizar revisão sistemática de artigos que utilizaram o método de bissecção, para avaliar a percepção de tempo em idosos com doença de Alzheimer e analisar seus parâmetros. MÉTODO: As buscas dos artigos foram conduzidas no período de março a maio de 2011, nas seguintes bases de dados: Web of Science, Science Direct on Line, Biological Abstracts, PsychoInfo e Medline. As palavras-chave e operadores booleanos foram: "interval timing" ou "perception of time" ou "time discrimination" ou "reproduction of time" e "Alzheimer's disease". Também foram realizadas buscas manuais nas referências dos artigos selecionados. RESULTADOS: Quatro artigos contemplavam todos os critérios de inclusão, nos quais foram encontradas grandes variações nos parâmetros utilizados no método. CONCLUSÃO: Pacientes com doença de Alzheimer apresentam prejuízos nas tarefas de bissecção de tempo, que podem ser explicados pelo declínio gradual nas habilidades que são utilizadas no teste de percepção de tempo. Há grandes variações nos intervalos de tempo utilizados. Neste contexto, há necessidade de mais estudos, controlados e randomizados, para investigar potenciais efeitos das variações nos intervalos de tempo do método de bissecção. Os resultados de tais estudos poderão contribuir para o estabelecimento de parâmetros mais adequados e fidedignos.

OBJECTIVE: Perform a systematic review of articles that used the bisection time method to assess the perception of time in patients with Alzheimer's disease by means of the bisection-of-time method, and to analyze its parameters. METHOD: Searches were conducted from March to May, 2011, in the following databases: Web of Science, Science Direct On Line, Biological Abstracts, Medline and PsychoInfo. Keywords and boolean operators were: "interval timing" or "perception of time" or "time discrimination" or "reproduction of time" and "Alzheimer's disease". Additionally, a manual search was conducted in the references of the selected articles. RESULTS: Four studies fulfilled all inclusion criteria, and large variations in the parameters of the method were found. CONCLUSION: Patients with Alzheimer's disease show difficulty in performing the task of bisection of time, which can be explained by the gradual decline on the abilities required in the perception of time test. There are large variations regarding the time intervals applied in the method. In such context, controlled-and-randomized future studies are required, in order to investigate the potential effects of time-intervals variations in the bisection-of-time method. The results of such studies would contribute to establish most suitable and reliable parameters.

The Post-operative Outcomes of Spinal Epidural and Subdural Hematoma Patients Without Spinal Fracture

OBJECTIVE: Spinal epidural hematoma (SEDH) and spinal subdural hematoma (SSDH) are rare diseases and they may have various causes such as trauma, lumbar puncture, anticoagulant therapy, tumor, blood dyscrasia and vascular malformation. In general, SEDH and SSDH are regarded as surgical emergency. We reviewed our cases with patients with SEDH or SSDH. They were surgically treated or conservatively treated. We examined the relationship between the surgical timing and the neurological outcome. METHODS: Twelve patients (8 cases for SEDH, 4 cases for SSDH) were included in our study. There were seven male and five female patients (mean age: 50.2 yrs, ranged from 18 to 87 years). Ten patients were surgically treated (7 cases for SEDH, 3 cases for SSDH) and two patients were conservatively treated (1 case for SEDH, 1 case for SSDH). We checked preoperative Frankel grade, time interval between onset of symptom and operation and post-operative neurologic change of each case. We investigated relationship between surgical timing and neurological outcome and also relationship between pre-operative Frankel grade and post-operative outcome. RESULTS: In seven cases (70%) of operated cases, there were postoperative improvements in clinical symptoms. Two cases had time interval within 6 hours from onset of symptoms to operations and their neurologic deficits were not improved. There were 2 cases with time interval of more than 6 hours and within 12 hours. And there were 6 cases with time interval over 12 hours. Seven of eight cases with time interval over 6 hours were improved after surgical treatments. CONCLUSION: There are various factors which may affect post-operative neurologic prognosis. Surgical timing is generally regarded as one of the most critical factors. However, in our study, preoperative neurologic status of patients functioned as the most important factor in clinical outcomes. We thought that the initial neurologic status of patient, as well as the surgical timing, may predict the prognosis.

Study on Operational Reliability of Astronaut in Spacecraft Cabin / 航天医学与医学工程

Objective To analyze human operational reliability,and to provide suggestions for design of controllers in spacecraft cabin.Method Twenty-two male subjects participated in 924 person-times of experiments.The experiments were divided into 6 groups to study the effect of space suit glove,time interval and task on human operational reliability in spacecraft cabin.Result 1)Task had obvious effects on operational reliability and time(P

Correlation of post-operative morbidity and various time intervals between large loop excision of transformation zone and total abdominal hysterectomy / 대한산부인과학회잡지

OBJECTIVE: This study was aimed to detail the effects of various time intervals between large loop excision of transformation zone (LLETZ) and total abdominal hysterectomy (TAH) upon post-operative morbidity. METHODS: The charts of 169 patients selected among 306 patients who had underwent LLETZ followed by type 1 extended abdominal hysterectomy from Jan. 1996 to Dec. 2001 at Yonsei University Medical Center were retrospectively reviewed for post-operative morbidity. The patients were categorized into three groups according to time interval: within 48 hours, within 48 hours to 6 weeks, longer than 6 weeks. Correlation of post-operative morbidity and time interval was evaluated. One way ANOVA and chi-square test were used for statistical analysis. RESULTS: There were no significant differences in demographic and obstetric characteristics among three groups. There were no significant differences in operative time (104.3 min, 99.6 min, 102.4 min), blood loss (190 ml, 182 ml, 160 ml), hemoglobin change (1.12 g/dl, 0.92 g/dl, 1.28 g/dl), febrile morbidity (6.7%, 6.8%, 0.0%), wound problems (6.7%, 9.1%, 10.0%) and urinary difficulty (2.9%, 0.0%, 5.0%). CONCLUSION: We found no significant differences in post-operative morbidity according to various time intervals between LLETZ and TAH. It could be recommended for TAH after LLETZ to be performed regardless of the intervening interval because there is no specific suitable time for the patients.

Correlation of post-operative morbidity and various time intervals between large loop excision of transformation zone and total abdominal hysterectomy / 대한산부인과학회잡지

OBJECTIVE: This study was aimed to detail the effects of various time intervals between large loop excision of transformation zone (LLETZ) and total abdominal hysterectomy (TAH) upon post-operative morbidity. METHODS: The charts of 169 patients selected among 306 patients who had underwent LLETZ followed by type 1 extended abdominal hysterectomy from Jan. 1996 to Dec. 2001 at Yonsei University Medical Center were retrospectively reviewed for post-operative morbidity. The patients were categorized into three groups according to time interval: within 48 hours, within 48 hours to 6 weeks, longer than 6 weeks. Correlation of post-operative morbidity and time interval was evaluated. One way ANOVA and chi-square test were used for statistical analysis. RESULTS: There were no significant differences in demographic and obstetric characteristics among three groups. There were no significant differences in operative time (104.3 min, 99.6 min, 102.4 min), blood loss (190 ml, 182 ml, 160 ml), hemoglobin change (1.12 g/dl, 0.92 g/dl, 1.28 g/dl), febrile morbidity (6.7%, 6.8%, 0.0%), wound problems (6.7%, 9.1%, 10.0%) and urinary difficulty (2.9%, 0.0%, 5.0%). CONCLUSION: We found no significant differences in post-operative morbidity according to various time intervals between LLETZ and TAH. It could be recommended for TAH after LLETZ to be performed regardless of the intervening interval because there is no specific suitable time for the patients.

Prognostic factors in bilateral breast cancer / 中国癌症杂志

Purpose:To study the determining prognostic factors that affect the survival of patients with bilateral breast cancer. Methods:The records of 21 women with bilateral breast cancer were analyzed.4(19%) presented simultaneous bilateral tumor.17(81%)developed bilateral breast cancer with interval in between. Patients were treated with surgery, radiation treatment and chemotherapy. Analysis of high risk factors of breast cancer and possible relation to postoperative survival was carried out.Results:The size of the tumor, the number of involved axillary nodes, and the adequacy of the initial treatment still remain the major prognostic factors ,correlated with the time interval between two cancers. 2 year, 5 year, 10 year, survival was recorded to be 90%, 71.4%, 66.7%. Conclusions:If treatment is correct for bilateral breast cancers, its 5 year survival rate still rather high. Time interval between two breast cancers was the most prominent prognostic factor, correlated with the overall survival. The early diagnosis and prompt adequate treatment of the seconed primary breast cancer are still the key to longer survival rates of bilateral breast cancer.

Correlation of the Time Interval from the Peak of Mitral E Wave to the Peak of Pulmonary Venous D Wave with Mitral Doppler Indexes

BACKGROUND: Pulmonary venous diastolic flow follows the pattern of mitral flow and is dependent on the pressure difference between the pulmonary vein and the left atrium (LA). The magnitude of the decrease in LA pressure in early diastole depends on both the volume of the blood leaving the LA and the stiffness of the left ventricle (LV) and the LA. Relaxation process is known to govern early diastolic compliance. We hypothesized that in patients with decreased early diastolic compliance due to LV relaxation abnormality, there may be rapid rise in LV and LA pressure, resulting in early peak of pulmonary venous D wave as early LV diastolic filling progress. This study was undertaken to define this hypothesis and to examine the relation of the time interval between E wave peak and D wave peak to mitral doppler indexes. METHOD: Patients with significant mitral or aortic valvular disease, or patients with LV ejection fraction below 60%, or patients who have pseudonormal or restrictive LV filling pattern on mitral and pulmonary venous Doppler, were excluded from this study. Mitral Doppler indexes including peak E velocity, peak A velocity, E wave acceleration time (EAT) and deceleration time (EDT) were measured. E/A ratio was calculated. The isovolumic relaxation time from aortic valve closure (Ac) to the onset of E wave , the time interval from Ac to the peak of E wave (AcE), the time interval from Ac to the peak of D wave, and the diastolic time from Ac to R of electrocardiogram (AcR) were measured by the pulsed wave Doppler and phonocardiography. The time interval from the peak of E wave to the peak of D wave (ED) was calculated by the subtraction of AcE from AcD. RESULTS: 1) ED is significantly shorter in patients with E/A or =1 (58.9+/-27.4 msec versus 74.7+/-17.2 msec, p<0.05). 2) ED correlated with IVRT (r=-0.400, p<0.01), AcR (r=0.414, p<0.01), but not with E/A ratio, EDT, or EAT. 3) Multivariate linear regression analysis with all the previously mentioned variables showed that IVRT, AcR, and EAT were independent determinants of the ED. CONCLUSION: This study demonstrates that the ED is shortened in patients who are regarded as having LV relaxation abnormality and that ED is affected by IVRT, AcR, and EAT.

The estimation of the skeletonized bone and teeth: A case report of a victim of 5.18 Kwang Ju democratic movement / 대한법의학회지

We report here estimating a victim who might be involved 5.18 Kwang Ju democratic movement in 1980. One skeletonized skull and mandible were sent for examination to see if any information could be elicited which might aid in search for the missing person. The examination was made on the usual lines, first to ascertain the sex, age, etc., then any particular features which might lead to identification, the circumstances of death and the length of time since the death took place. From the examination of the specimen it could reasonably be assumed (1) that the fracture of teeth and alveolar bone due to trauma which was speedily and strong (2) that the skull and mandible were belong to one person, (3) that the specimen was an adult man about 42 years old, (4) that he was dead before 6 years ago as a result of racemization. This paper indicates that forensic odontology examination have another valuable means of identification, i.e. dental age estimation, time interval since death, analysis of trauma in oral and facial region. This information can help in attempting to establish not only the personal identification but also the circumstances of death.

Doppler Echocardiographic Assessment of the Changes in Pulmonary Arterial Pressure in Preterm Infants with Respiratory Distress Syndrome

PURPOSE: The ratio of time to peak velocity(AT) and right ventricular ejection time(ET) as measured from the pulmonary artery Doppler waveform showed a close inverse correlation with pulmonary arterial pressure. The purpose of this study was to see the pattern of change in pulmonary arterial pressure assessed by AT/ET in preterm infants with respiratory distress syndrome (RDS). METHODS: The changes in pulmonary arterial pressure were assessed by serial AT/ET measurements in 18 preterm infants with RDS. RESULTS: The mean AT/ET was significantly lower in the acute phase of RDS. The pattern of change in AT/ET during recovery from RDS fell into three groups. In group 1(n=11), there was a normalization of AT/ET. Four infants showed a rapid normalization of the ratio within 24 hours of the oxygen requirements falling and the remaining 7 showed a delayed normalization. In group 2(n=4), AT/ET did not rise into the normal range during the time of study. All of the infants developed bronchopulmonary dysplasia(BPD). In 2 of the 4 infants, the ratio rose towards the normal range in the early recovery phase, but fell as the recovery period continued whereas in the remaining 2, the ratio remained at a consistent low level throughout the recovery period. One infant died of severe BPD at 36 days of age and 3 were breathing air at the time of discharge. In group 3(n=3), AT/ET decreased during a relatively short period, leading to death in all infants. CONCLUSION: Pulmonary hypertension in the acute phase of RDS is usually normalized during the recovery period. In infants who develop BPD, however, pulmonary pressure persistently remains high and in those with mortality, it is aggravated during a short-term interval.