Predictors for the need for endoscopic therapy in patients with presumed acute upper gastrointestinal bleeding

BACKGROUND/AIMS@#Selecting patients with an urgent need for endoscopic hemostasis is difficult based only on simple parameters of presumed acute upper gastrointestinal bleeding. This study assessed easily applicable factors to predict cases in need of urgent endoscopic hemostasis due to acute upper gastrointestinal bleeding.@*METHODS@#The consecutively included patients were divided into the endoscopic hemostasis and nonendoscopic hemostasis groups. We reviewed the enrolled patients’ medical records and analyzed various variables and parameters for acute upper gastrointestinal bleeding outcomes such as demographic factors, comorbidities, symptoms, signs, laboratory findings, rebleeding rate, and mortality to evaluate simple predictive factors for endoscopic treatment.@*RESULTS@#A total of 613 patients were analyzed, including 329 patients in the endoscopic hemostasis and 284 patients in the non-endoscopic hemostasis groups. In the multivariate analysis, a bloody nasogastric lavage (adjusted odds ratio [AOR], 6.786; 95% confidence interval [CI], 3.990 to 11.543; p < 0.0001) and a hemoglobin level less than 8.6 g/dL (AOR, 1.768; 95% CI, 1.028 to 3.039; p = 0.039) were independent predictors for endoscopic hemostasis. Significant differences in the morbidity rates of endoscopic hemostasis were detected between the group with no predictive factors and the group with one or more predictive factors (OR, 2.677; 95% CI, 1.920 to 3.733; p < 0.0001).@*CONCLUSIONS@#A bloody nasogastric lavage and hemoglobin < 8.6 g/dL were independent predictors of endoscopic hemostasis in patients with acute upper gastrointestinal bleeding.

The value of 64 row CT low dose scanning in thyroid enhanced scan / 中华内分泌外科杂志

Objective To investigate the value of 64 row CT low dose scanning technique in thyroid enhancement scanning.Methods From Jan.2016 to Dec.2017,152 patients with thyroid occupying lesions were studied in our hospital.All the patients underwent multislice spiral CT enhanced scan and pathological examination.The patients were divided into four groups according to the different current and voltage of multislice spiral CT.The significance of multi slice spiral CT scanning in the 4 groups was compared.Results There were no significant differences (U=0.1825,P=0.351 8＞0.05)among the four groups of multi-slice spiral CT in the detection rate of nodular thyroid lesions (96.21％,94.38％,85.71％,87.50％) or the detection rate of diffuse thyroid lesions (77.78％,83.33％,80.00％,83.33％).There were significant differences in CTDIvol,DLP and ED among the four groups (P＜0.05),and the radiation dose of group D was lower than that of group A and C.There were significant differences in thyroid CT value,background noise and background signal among the four groups (P＜0.05).The thyroid CT value,background noise and background signal in group D were higher than those in group A,B and C (P＜0.05).There was no significant difference in SNR and CNR among the four groups (P＞0.05).There was no significant difference in subjective evaluation of CT scan images between the four groups (P＞0.05).Conclusion The multislice spiral CT low-dose scanning technique used in thyroid enhanced scan can obtain satisfying scanning images,which is not only beneficial to the quality of the images,but also can improve the accuracy of the diagnosis and reduce the ionizing radiation damage to the patients.

A comparative study on MRI appearance and pathological grading for pancreatic neuroendocrine tumors / 中华内分泌外科杂志

Objective To explore the value of conventional and functional MRI image parameter in preoperative grade of pancreatic neuroendocrine tumours (pNET).Methods Data of 35 cases of pNET were retrospectively analyzed,including tumor size,intensity of T1WI's and T2WI's signal,enhancement feature,and apparent diffusion coefficients (ADC)value.All kinds of tumors were classified into G1 to G3 according to WHO's classification in 2010.Results There were 40 pNETs (mean size(4.2±2.9)cm) among the 35 patients (20 male,and 15 female).By WHO's tumor grading,the number of patients from G1 to G3 was 18(45％),12(30％),and 10(25 ％),respectively.A higher grade was associated with larger tumor size (P＜0.05).Intensity of T1WI and T2WI signal has no significance for predicting tumor grade.Enhancement feature had statistical significance on tumor's grade (P＜0.05).ADC value decreased with the increase of tumor's grade,(2.23±0.80) × 10-3,(1.80±0.73) × 10-3,(0.92±0.24) ×10-3 mm2/s respectively for tumors from grade G1 to G3.Conclusion Enhancement features of MRI image and ADC value are conducive to preoperative grading of pNET.

Value of MR 3D CUBE T2 WI Sequence in Displaying Anatomical Structure of Knee Joint / 医学研究杂志

Objective To investigate the value of MR 3D CUBE T2WI sequence in displaying anatomical structure of knee joint.Methods Sixty cases of knee joints (30 cases in lesion group and 30 cases in control group) were scanned with conventional 2D and 3D CUBE T2WI sequence by HDXt 3.0T superconducting magnetic resonance of GE Signa imaging system and hased-array coil.The meniscus,articular cartilage,anterior and posterior cruciate ligaments demonstrated by two sequences were evaluated as excellent,good and poor grade,the results were comparatively analyzed by statistics.Results 3D CUBE T2WI was superior to conventional 2D sequence in displaying of articular cartilage,anterior and posterior cruciate ligaments,and inferior to conventional 2D sequence in displaying of meniscus(all P =0.000).When we put excellent and good levels of image quality as according with diagnostic requirement.The satisfaction rate demonstrating anterior and posterior cruciate ligaments by 3D CUBE T2WI sequence in lesion and control group were 100％,articular cartilage was 93.33％ in control group and 90.00％ in lesion group,while the meniscus was 30.00％ in control group and 33.33％ in lesion group.Conclusion MR 3D CUBE T2WI sequence is a sensitive technique in demonstrating ligaments and articular cartilage of knee joint,but it was inferior to conventional 2D sequence in displaying of meniscus.We should adopt it according to clinical diagnosis.

The effects of 2-hydroxyethyl methacrylate on the proliferation and migration of human dental pulp cells / 实用口腔医学杂志

Objective:To assess the effects of HEMA on the proliferation and migration of human dental pulp cells(hDPCs).Meth-ods:hDPCs were obtained using tissue explant culture technique in vitro,and then cells of the 3rd -5th passages were treated by differ-ent concentrations of HEMA for 24,48 and 72 h respectively.Cell proliferation was examined by MTT assay.Cell migration was ob-served by Transwell method.Results:The proliferation ability of hDPCs decreased when exposed to HEMA in both time and concentra-tion dependent manner(vs control,P <0.05).Cell proliferation at 24 h expossure was statistically higher than that at 48 h and 72 h(P<0.05).The migration of hDPCs was significantly reduced in HEMA groups at different concentrations(vs control,P <0.05).Con-clusion:HEMA inhibits the proliferation and migration of human dental pulp cells in vitro.

Clinical efficacy review on cases of laparoscopic myomectomy / 대한산부인과내시경학회지

OBJECTIVE: To report the safety and clinical efficacy of laparoscopic myomectomy. METHODS: We analyzed retrospectively the data for 74 laparoscopic myomectomy performed at Inje University Busan Paik Hospital beween 2005 and 2009. With medical records, we analyzed data on the patient's age, parity, BMI, size, weight and location of myoma, previous operative history, preoperative indication, operating time, blood loss, change of hemoglobin concentration from preoperative to postoperative state, hospital stay. RESULTS: The mean age of the patients was 39.5+/-6.9 years, parity was 1.4+/-1.0 and BMI was 22.1+/-2.6 kg/m2. The size of myoma by preoperative ultrasonography was 5.2+/-1.9 cm, the weight of removed myoma was 95.1+/-88.1 g. Most myomas were subserosal and intramural type. The operating time was 95.9+/-34.4 minutes, the change of hemoglobin concentration was 1.3+/-0.78 g/dL, and the hospital stay was 4.7+/-1.1 days. Postoperatively, transfusion was done in 2 cases, one patient was pregnant and underwent an cesarean section delivery during follow-up. CONCLUSION: Laparoscopic myomectomy was performed regardless of the size, the location of the myoma or the previous operative history and had good outcomes without complications in our hospital. Laparosocpic myomectomy is considered safe and reliable procedure in various types of myoma.

A Case of Septic Shock by Prevotella Species associated with Acute Periapical Abscess / 감염과화학요법

A healthy 34-year-old man was admitted to the intensive care unit through the emergency room with a drowsy mentality and severe chilling. Following a diagnosis of septic shock of unknown origin, the patient was treated with broad spectrum antibiotics and massive hydration. After recovery of consciousness, he complained of a severe toothache that originated from the right lower teeth. Under dental consultation, he was diagnosed as having an acute periapical abscess of the right mandibular first molar. The patient underwent extraction and cyst enucleation. Gram negative bacilli isolated from blood culture on day 5 after admission were identified as Prevotella species. After receiving antibiotic treatment and undergoing dental procedures, the patient made a full recovery. We report on a case of septic shock due to infection by Prevotella species in association with an acute periapical abscess.

A Case of Acetone Intoxication Misdiagnosed as Diabetic Ketoacidosis / 임상당뇨병

Diabetic ketoacidosis (DKA) is one of the most serious acute metabolic complications of diabetes. The triad of uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration characterizes DKA. Not all patients with ketoacidosis have DKA, and other situations can result in metabolic acidosis and ketonemia, like starvation ketosis, alcoholic ketoacidosis or ingestion of drugs such as salicylate, methanol, ethylene glycol. We report a case of acetone intoxication that was misdiagnosed as diabetic ketoacidosis.

The Comparison between 6th and 7th International Union Against Cancer/American Joint Committee on Cancer Classification for Survival Prognosis of Gastric Cancer / 대한소화기학회지

BACKGROUND/AIMS: The tumor-node-metastasis (TNM) staging is an useful system to assess the prognosis of any solid cancer. As new TNM staging classification of 7th stomach cancer was revised in 2009, we evaluated the prognostic predictability of the 7th International Union Against Cancer/American Joint Committee on Cancer (UICC/AJCC) TNM classification compared to 6th UICC/AJCC TNM classification in gastric cancer. METHODS: From January 2000 to December 2009, 5-year survival rates of 266 patients with gastric cancer were calculated by the 6th and 7th UICC/AJCC TNM classification. RESULTS: Using the 7th UICC/AJCC TNM classification, there was no significant difference in the 5-year cumulative survival rates (5 YSR) between stage IIA and IIB, IIB and IIIA, and IIIA and IIIB (70% vs. 71%, p=0.530; 71% vs. 80%, p=0.703; 80% vs. 75%, p=0.576, respectively) though significant differences of the survival rates were observed among stages of 6th edition. Using T stage of 7th edition, 5 YSR was not different between T2 and T3 (86% vs. 82%, p=0.655). Using N stage of 7th edition, 5 YSR were not different between N1 and N2, N3a and N3b (79% vs. 81%, p=0.506; 41% vs. 17%, p=0.895, respectively). CONCLUSIONS: The 7th UICC/AJCC TNM classification had poor prognostic predictability in gastric cancer compared to the 6th edition.

Comparison of the BACTEC Blood Culture and Conventional Culture Methods for Isolation of Microorganisms Causing Peritonitis in CAPD Patients / 대한내과학회지

BACKGROUND/AIMS: Peritonitis is the most frequent complication of continuous ambulatory peritoneal dialysis (CAPD). Prompt recognition and treatment of peritonitis is important. The purpose of this study was to compare the effectiveness of isolation of the microorganisms causing CAPD peritonitis by the BACTEC blood culture and conventional methods. METHODS: We retrospectively reviewed 38 episodes of peritonitis in 34 CAPD patients between September 2007 and February 2010. Two methods of processing dialysate from patients on CAPD were used. Blood culture was performed using two 10-mL effluents, which were inoculated into a pair of BACTEC culture bottles. The conventional method was performed using 50 mL of centrifuged dialysate. The sedimented dialysate was inoculated onto blood agar and MacConkey agar plates or into thioglycollate broth. To evaluate effectiveness, we compared the rate of positive culture results and the time to identify the causative organism of the two culture methods. RESULTS: Use of the BACTEC bottle method resulted in more positive culture results than did conventional culture (86.8 vs. 57.9% p = 0.003). The time taken to identify the causative organism from culture-positive peritonitis was more rapid using the blood culture compared with the conventional culture method (90 vs. 109 hr, p = 0.03). CONCLUSIONS: Blood culture using the BACTEC bottle is more effective than the conventional culture technique for detection of causative microorganisms in CAPD peritonitis.

A study on clinicopathological characteristics of ovarian masses / 대한산부인과학회지

OBJECTIVE: The aim of this study was to know the clinicopathological characteristics that help to make a decision about diagnosis and treatment of ovarian masses in Korean women. METHODS: Women who were undergone operations and histopathologically confirmed as ovarian masses at Inje University Busan Paik Hospital and Donrae Paik Hospital from January of 1997 to June of 2009 were enrolled in this study. Distribution according to histopathological types and ages were analyzed. RESULTS: Of the 2875 cases, there were 1078 cases (37.5%) of non neoplastic masses and 1797 cases (62.5%) of neoplastic masses. In the neoplatic masses, there were 1286 cases (44.7%) of benign tumors, 140 cases (4.9%) of borderline tumors and 371 cases (12.9%) of malignant tumors. Endometriomas were most common tumors (644 cases, 59.7%) among non-neoplastic masses. Mature cystic teratomas were the most common tumors (598 cases, 46.5%) among benign tumors. Mucinous cystadenomas were the most common types (105 cases, 75.0%) among borderline tumors. Epithelial ovarian cancers were the most common types (267 cases, 72.0%) among malignant tumors. As the result of age distribution, mature cystic teratomas were the most common types of the women of the first and second decade, endometriomas were the most common types of the women of the third and fourth decade, and benign epithelial tumors were the most common types of the women of fifth and after sixth decade. CONCLUSION: Taken as a whole, neoplastic ovarian masses were more common than non-neoplastic masses, but most common ovarian mass was endometrioma which is non-neoplastic mass.

Amount of polymerization shrinkage and shrinkage stress in composites and compomers for posterior restoration / 대한치과보존학회지

The purpose of present study was to evaluate the polymerization shrinkage stress and amount of linear shrinkage of composites and compomers for posterior restoration. For this purpose, linear polymerization shrinkage and polymerization stress were measured. For linear polymerization shrinklage and polymerization stress measurement, custom made Linometer (R&B, Daejon, Korea) and Stress measuring machine was used (R&B, Daejon, Korea). Compositers and compomers were evaluated; Dyract AP (Dentsply Detrey, Gumbh. German) Z100 (3M Dental Products, St. Paul, USA) Surefil (Dentsply Caulk, Milford, USA) Pyramid(Bisco, Schaumburg, USA) Synergy Compact (Coltene, Altstatten, Switzerland), Heliomolar (Vivadent/Ivoclar, Liechtenstein), and Compoglass (Vivadent Ivoclar/Liechtenstein) were used. 15 measurements were made for each material. Linear polymerization shrinkage or polymerization stress for each material was compared with one way ANOVA with Tukey at 95% levels of confidence. For linear shrinkage; Heliomolar, Surefil

The amounts and speed of polymerization shrinkage and microhardness in LED cured composites / 대한치과보존학회지

This study evaluated the effectiveness of the light emitting diode(LED) units for composite curing. To compare its effectiveness with conventional quartz tungsten halogen (QTH) light curing unit, the microhardness of 2mm composite, Z250, which had been light cured by the LEDs (Ultralume LED2, FreeLight, Developing product D1) or QTH (XL 3000) were compared on the upper and lower surface. One way ANOVA with Tukey and Paired t-test was used at 95% levels of confidence. In addition, the amount of linear polymerization shrinkage was compared between composites which were light cured by QTH or LEDs using a custom-made linometer in 10s and 60s of light curing, and the amount of linear polymerization shrinkage was compared by one way ANOVA with Tukey. The amount of polymerization shrinkage at 10s was XL3000 > Ultralume 2, 40, 60> FreeLight, D1 (P Ultralume 2, 60> Ultralume 2,40> FreeLight, D1 (P<0.05) It was concluded that the LEDs produced lower polymerization shrinkage in 10s and 60s compared with QTH unit. In addition, the microhardness of samples which had been cured with LEDs was lower on the lower surfaces than the upper surfaces whereas there was no difference in QTH cured samples.

The Expression of LH/CG receptor, alpha and Beta-hCG mRNA in the trophoblast of spontaneous abortion / 대한산부인과학회잡지

OBJECTIVE: To investigate the mechanisms involved in the mRNA expressions of hCG, LH/CG receptor and in hormone secretion in the trophoblast of normal and abnormal early pregnancy. METHODS: hCG, free Beta-hCG, and progesterone concentrations were measured in serum and the mRNA expressions of alpha,Beta-hCG and LH/CG receptor were measured in the placental trophoblast of 22 spontaneous abortion patients (spontaneous abortion group), 20 normal pregnancy women (normal pregnancy group) and 6 hydatidiform mole patients (hydatidiform mole group). RESULTS: 1. Mean values of serum hCG and free Beta-hCG concentrations were the lowest in spontaneous abortion group (46343.63+/-40404.18 mIU/ml, p<0.001; 31.34+/-61.57 mIU/ml, p<0.01 respectively) among the three groups. Mean progesterone concentration was the lowest in spontaneous abortion group (11.84+/-7.60 ng/ml, p<0.01), too.2. The expression levels of alpha,Beta-hCG were the highest in spontaneous abortion group (4.64+/-5.47, p=0.015; 4.57+/-4.42 p=0.002 respectively). The expression levels of LH/CG receptor were not different statistically among the three groups and they were high at the 5th week of gestation, reaching nadir at the 10th week of gestation when the concentrations of serum hCG showed peak values in normal pregnancy group.3. The correlations between serum hCG and progesterone concentrations were positive in both spontaneous abortion (r=0.827, p<0.001) and normal pregnancy (r=0.438, p=0.054) group. Though they were not significant statistically, the correlations between progesterone concentrations and the levels of alpha,Beta-hCG expressions were negative in both spontaneous abortion (r=-0.237, p=0.289; r=-0.211, p=0.347) and normal pregnancy (r=-0.270, p=0.250; r=-0.235, p=0.318) group. In hydatidiform mole group, the correlation between progesterone concentrations and the levels of Beta-hCG expression was positive (r=0.968, p=0.002). CONCLUSION: Our results suggest that the mechanisms involved in the secretion of hCG, progesterone and the expression of alpha,Beta-hCG, LH/CG receptor be normal in spontaneous abortion as in normal pregnancy and in the both groups, hCG stimulate the secretion of progesterone by autocrine function and control the secretion of itself, through the suppression of the expressions of alpha,Beta-hCG and LH/CG receptors. So the cause of spontaneous abortion in early pregnancy may be not placental dysfunction but the defect of embryo itself with poor placental growth.

Axis-line-distance technique:a new method in scoliosis measurement / 中华放射学杂志

Objective To investigate the clinical significance of a new method,axis-line-distance technique(ALDT),in scoliosis measurement.Methods Thirty cases with idiopathic scoliosis were measured on two separate occasions by six observers with the Cobb technique and the ALDT on PACS workstation.The interval time between two measurement occasions were three weeks.The data were analyzed statistically with the paired-sample t-test.Results(1)Concerning intraobserver variance in two measurement occasions,the minimum variance,the maximum variance and the average variance were 0, 24.00?,5.71??1.54?for Cobb technique and 0,12.00 mm,(1.95?0.58)mm for ALDT.There were significant measurement differences for four observers with Cobb method 39.00??10.69?versus 36.50?? 10.63?,31.73??10.96?versus 37.30??9.65?,32.03??7.49?versus 27.86??9.00?,29.77??8.87? versus 34.20??7.26?,all P0.05].(2)Concerning interobserver variances in six observers,the average measurement variance was 5.07??0.35?for Cobb method,and(2.32?0.26)mm for ALDT. There were significant measurement differences for every observer using with Cobb method(36.63??10.30? versus 33.27??10.10?,39.00?10.69?versus 31.73??10.96?,32.03??7.49~ versus 29.78?? 8.87?,36.63??10.30?versus 39.00??10.69?versus 32.03??7.48?,39.00??10.69?versus 32.03?? 7.49?,all P

The killing activity of IL-6+CD3AK cells against the MGC-803 gastric carcinoma cell in vitro / 中国免疫学杂志

Objective:The killing activity of tumor killer cells against the MGC-803 gastric carcinoma cells was investigated Methods:The IL-6+CD3AK cells were prepared from the peripheral blood mononuclear cells (PBMCs) from the culture media containing rIL-6 with rIL-2 and anti-CD3Ab The other control groups were cultivated in rIL-6 only, in rIL-6 with anti-CD3ab, in rIL-2 only Each group was divided into four groups by the ratio of effect and target cells After 24 h and 48 h, the death rate of cancer cells was determined by MTT assay and trypan-blue exclusion, the morphologic changes were observed by various microscope Results:The killing activity of rIL-6+CD3AK cells was higher than those of the other groups(P

A study on the urinary estriol levels in the preeclamptic women / 대한산부인과학회잡지

No abstract available.