Background: Pulmonary paragonimiasis is caused by consumption of raw or improperly cooked crabs infected by a laval stage (metacercaris) of the parasite. In our country it had been a highly prevalent endemic disease until th late 1960s, and after then it's prevalence has been markedly decreased. But because some people have continued to ingest undercooked crabs, this disease have yet occured sporadically. Methods: We reviewed the clinical and radiological findings retrospectively in seventy-four patients of pulmonary paragonimiasis including familial infestation in 7 familes (20 cases) who were confirmed by food history, clinical and radiological findings, and labaratory data. Results: The male: female ratio was 2.2:1 and most prevalent age was 40-49 years old. Twen6ty nine patients (39%) had ova-positive infection. The detection sites were sputum (48%), pleural fluid (17%), fine needle aspiration biopsy of nodular or cystic lesion (17%), pleural biopsy (7%), skin nodule biopsy (7%), and stool (3%). The patients had pulmonary symptoms in 63 cases (85%) but 9 cases did not have any symptoms. The 53 cases (72%) had abnormal radiological findings in lung parenchyme (75%) and pleura (63%). However 21 cases (28%) showed no specific findings in their chest X-ray. Serum titers (ELISA) of specific IgG for paragonimiasis in 13 cases were followed for average 9.8 months after treatment, which showed slow decreasement. In the evaluation of family member (7 family, 20 cases), all members having the common dietary history together with a proven patients were confirmed this disease by serological test, regardless of the presence or the abscence of clinical or radilogical symptoms. Conclusion: We evaluated the clinical and radiological findings in 74 cases of pulmonary paragonimiasis including 7 family members who had a history of ingestion of improperly cooked crabs together with patients. The paients of pulmonary paragonimiasis have various findings in clinical and radiological findings. Common diet exposure history and laboratory findings including specific IgG were important in earlier diagnosing and treating in family members of patients.
Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.
Park, Kun-Hyun;Park, Su-Hyun;Lee, Sung-Hwy;Pyo, Sung-Woon
Maxillofacial Plastic and Reconstructive Surgery
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v.32
no.5
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pp.389-395
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2010
Purpose: Although it is generally accepted that patients with controlled diabetes have similar rates of success for dental implants as healthy individuals, the use of dental implants in diabetic patients is controversial. In addition, the impact of diabetes on the healing of bone associated with immediately place dental implants is not completely understood. The purpose of this study was to measure bone response to implants radiologically in uncontrolled and insulin-controlled diabetic rats. Materials and Methods: Twenty rats were divided into control, insulin-treated and diabetic groups. The rats received streptozotocin (60 mg/kg) to induce diabetes; animals in the insulin-treated group also received three units of subcutaneous slow-release insulin. Two titanium implants ($1.2{\times}3$ mm) were placed in the extraction socket of the maxillary first molars of the animals and were harvested at 3 days, 1, 2 and 4 weeks. The bone density was measured by digital radiography using gray-level analysis (histogram) in the regions of interest (ROI) at four points: two mesial and two distal to both sides of the implant. Results: The results showed that the osseointegration of the implants was impaired in the diabetic rats compared to the control and the insulin-treated rats. The radiographic evidence demonstrated marked destruction of bone around the implants in the diabetic group. Both the control and the insulin-treated groups had a significantly higher bone density on radiograph than the diabetic group from the 1 week of the experiment (P<0.05 for each comparison). Conclusion: The present study revealed that the immediate placement of titanium implants in the maxilla of diabetic rat lead to delay in the maturation of bone adjacent to implants. It is expected that the reduced predictability of success of immediate implantation in patient with the uncontrolled diabetes.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.1
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pp.445-452
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2015
Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. A single-center, single-blinded, randomized trial was conducted to determine the effect of a single session (August 4 to August 29) of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies (NCS) were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1mA for 15 minutes under two different conditions, with 25 subjects in each group. The conditions were as follows: tDCS on the dorsolateral prefrontal cortex (DLPFC) and sham tDCS on DLPFC. The parameters of the CPT was recorded with a Neurometer$^{(R)}$ at frequencies of 2000, 250 and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure the CPT values of the DLPFC in the anodal tDCS group, the values increased significantly in all of 250 and 5 Hz. All CPT values decreased for the sham tDCS. These results showed that DLPFC anodal tDCS can modulate the sensory perception and pain thresholds in healthy adult volunteers. This study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.
Background: The most common type of ocular lymphoma is non-Hodgkin lymphoma (NHL), categorized into two groups: indolent (slow growing) and aggressive (rapid growing). Differentiating benign reactive lymphoid hyperplasia (RLH) from malignant ocular adnexal lymphoma (OAL) is challenging. Histopathology, immunohistochemistry (IHC) and flow cytometry have been used as diagnostic tools in such cases. Materials and Methods: In this retrospective case series, from 2002 to 2013 at Farabi Eye Center, 110 patients with ocular lymphoproliferative disease were enrolled. Prevalence, anatomical locations, mean age at diagnosis and the final diagnosis of the disease with IHC were assessed. Comparison between previous pathologic diagnoses and results of IHC was made. Immunoglobulin light chains and B-cell and T-cell markers and other immuno-phenotyping markers including CD20, CD3, CD5, CD23, CD10, CYCLIND1 and BCL2 were evaluated to determine the most accurate diagnosis. The lymphomas were categorized based on revised European-American lymphoma (REAL) classification. Results: Mean age ${\pm}$ SD (years) of the patients was $55.6{\pm}19.3$ and 61% were male. Patients with follicular lymphoma, large B-cell lymphoma or chronic lymphocytic leukemia/small cell lymphoma (CLL/SLL) tended to be older. Nine patients with previous diagnoses of low grade B-cell lymphoma were re-evaluated by IHC and the new diagnoses were as follows: extranodal marginal zone lymphoma(EMZL) (n=1), SLL(n=1), mantle cell lymphoma (MCL) (n=3), reactive lymphoid hyperplasia RLH (n=2). Two cases were excluded due to poor blocks. Flow cytometry reports in these seven patients revealed SLL with positive CD5 and CD23, MCLwith positive CD5 and CyclinD1 and negative CD23, EMZL with negative CD5,CD23 and CD10. One RLH patient was negative for Kappa/Lambda and positive for CD3 and CD20 and the other was positive for all of the light chains, CD3 and CD20. Orbit (49.1%), conjunctiva (16.1%) and lacrimal glands (16.1%) were the most common sites of involvement. Conclusions: Accurate pathological classification of lesions is crucial to determine proper therapeutic approaches. This can be achieved through precise histologic and IHC analyses by expert pathologists.
This study assessed the feasibility of a dual-channel (DC) compound method for film dosimetry. The red channel (RC) is usually used to ensure dosimetric quality using a conventional fraction dose because the RC is more accurate at low doses within 3 Gy than is the green channel (GC). However, the RC is prone to rapid degradation of sensitivity at high doses, while degradation of the GC is slow. In this study, the DC compound method combining the RC and GC was explored as a means of providing accurate film dosimetry for high doses. The DC compound method was evaluated at various dose distributions using EBT3 film inserted in a solid-water phantom. Measurements with $10{\times}20cm^2$ radiation field and $60^{\circ}$ dynamic-wedge were done. Dose distributions acquired using the RC and GC were analyzed with root-mean-squares-error (RMSE) and gamma analyses. The DC compound method was used based on the RC after correcting the GC for high doses in the gamma analysis. The RC and GC produced comparatively more accurate RMSE values for low and high doses, respectively. Gamma passing rates with an acceptance criterion of 3%/3 mm revealed that the RC provided rapid reduction in the high dose region, while the GC displayed a gradual decrease. In the whole dose range, the DC compound method had the highest agreement (93%) compared with single channel method using either the RC (80%) or GC (85%). The findings indicate that the use of DC compound method is more appropriate in dosimetric quality assurance for radiotherapy using high doses.
Anumber of prior studies have reported eye movement dysfunction in patients with dementia. The eye movement test which is non-invasive can evaluate the local brain function quantitatively. Therefore, it can be a useful method for characterizing regional brain abnormalities of patients with dementia. The aim of this paper is to review the literatures on eye movement abnormalities in dementia patients. Saccade system dysfunctions in Alzheimer disease include increased latency, reduced accuracy, and increased antisaccade error rates. Patients with frontotemporal dementia showed impaired reflexive saccade inhibition and increased latency and errors of antisaccade task. And delayed initiation of voluntary saccades, slow saccades, and increased errors and latency on antisaccade task were found in Huntington's disease. Patients with Parkinson’s disease dementia and dementia with Lewy bodies have characteristics of impaired in both reflexive saccade execution and complex saccade performance. However, there were few reports of abnormal eye movements in Creutzfeldt-Jakob disease; they could be found at the later stages after symptoms of dementia came to be evident, and secondary to cerebellar and vestibular involvement. Slowing of saccades and hypometric saccades might precede the supranuclear limitation of vertical gaze in PSP. Dysfunction of voluntary eyelid movements was a characteristic finding of PSP as well. In conclusion, patients with dementia can show various abnormal eye movements and they are related with cortial and subcortical brain dysfunctions. The research on localization of brain relevant to each symptom can promise more clinical implications of eye movement of dementia.
Background: Buprenorphine, a new synthetic thebaine derivative, is a partial agonist of the opioid $\mu$-receptor with high receptor affinity, great lipid solubility, and slow rate of opiate receptor association and dissociation. Continuous epidural infusion of opioid can possibly produced undesirable effects, such as respiratory depression, pruritus, etc, in spite of effective postoperative analgesia. Methods: The present study was undertaken to compare the analgesic properties and side effects of continuous epidural infusion of buprenorphine combined with bupivacaine, and morphine combined with bupivacaine in 90 patients following elective gynecologic lower abdominal surgery. At the end of surgery, the initial bolus doses were 3 mg morphine (M group), 0.15 mg buprenorphine (0.15B group), 0.3 mg buprenorphine (0.3B group) combined with 0.25% bupivacaine 10ml, and subsequent continuous infusion doses were 6 mg morphine plus 0.125% bupivacine 100 ml (M group) and 0.6mg buprenorphine plus 0.125% bupivacaine 100 ml (0.15B, 0.3B, group) during 48 hours. The assessment of analgesic efficacy and side effects were made at arrival of recovery room, 1 hr, 4 hr, 8 hr, 24 hr, 36 hr, and 48 hr after the epidural injection. Results: The pain score during 48 hours was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05), and the number of patients requiring additional analgesics was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05). Signs of respiratory depression were not noted, and the incidence of pruritus, nausea, and vomiting was slightly lower in the 0.15B group and 0.3B group than in the M group, and the incidence of sedation and urinary retention was similar in three group. The subjective rating of satisfaction was better in the 0.3B group than in the M group and 0.15B group (P<0.05). Conclusion: The above results suggest that continuous epidural infusion of buprenorphine combined with low-dose bupivacaine is an advisable method of postoperative analgesia.
Kim, Eun-jung;Yun, Hyo-in;Park, Seung-chun;Oh, Tae-kwang;Cho, Chun-hyung
Korean Journal of Veterinary Research
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v.34
no.2
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pp.259-266
/
1994
The study was carried out to determine the pharmacokinetic parameters after intravenous(iv) and intramuscular(im) administration (10mg/kr) in healthy rabbits. The results obtained through the experiments were summarized as follows: 1. Bioassay (Bacillus cereus 11778) was evaluated very useful for the determination of oxytetracycline(OTC) in the rabbit serum and tissues, with the detection limit of $0.125{\mu}g/ml$. 2. The pharmacokinetic profiles of OTC (10mg/kg, iv) in rabbits were best described with a two compartment open model $(C=29.5e^{-4,3t}{\pm}3.6^{-0.2t})$, whereas that of OTC (10mg/kg, im) showed a one compartment curve fitting. 3. Following iv administration, a rapid distribution phase was predominant [$t_{\frac{1}{2}}({\alpha}):1.43{\pm}0.98hr$ (♂), $0.5{\pm}0.1hr$(♀)], and then more slow elimination phase ensued [$t_{\frac{1}{2}}({\beta}):4.52{\pm}0.76hr$(♂), $7.32{\pm}2.52hr$(♀)]. Other computer generated pharmacokinetic values were as follows:C1 [$67.76{\pm}18.59ml/kg/h$(♂), $76.03{\pm}22.98ml/kg/h$ (♀)] Vd [$257.74{\pm}180.47ml/kg$ (♂), $92.33{\pm}23.62$ (♀)] AUC [$25.6{\pm}4.44mgh/L$ (♂), $39.6{\pm}12.13mgh/l$ (♀)]. There were no statistical significance between both sexes for all the parameters at the confidence level of 95%. 4. After im administaration, the absorption from the injection sites was very rapid [ Ka:$0.18{\pm}0.03h^{-1}$ (♂), $0.24{\pm}0.02h^{-1}$ (♀)] followed by a monoexponential elimination fashion. The time to peak blood level (Tmax) were calculated $1.64{\pm}0.15hr$ and $1.34{\pm}0.24hr$, in the male and female, respectively. The peak levels (Cmax) at the corresponding time were $1.69{\pm}0.23{\mu}g/ml$ (♂) and $2.08{\pm}0.16{\mu}g/ml$ (♀), with no statistical differences (p>0.05).
In this study, we describe a novel function of TNNC1 (Troponin C1, Slow Skeletal and Cardiac Type), a component of actin-bound troponin, as a tumor suppressor of lung adenocarcinoma (LUAD). First, the expression of TNNC1 was strongly down-regulated in cancer tissues compared to matched normal lung tissues, and down-regulation of TNNC1 was shown to be strongly correlated with increased mortality among LUAD patients. Interestingly, TNNC1 expression was enhanced by suppression of KRAS, and ectopic expression of TNNC1 in turn inhibited KRASG12D-mediated anchorage independent growth of NIH3T3 cells. Consistently, activation of KRAS pathway in LUAD patients was shown to be strongly correlated with down-regulation of TNNC1. In addition, ectopic expression of TNNC1 inhibited colony formation of multiple LUAD cell lines and induced DNA damage, cell cycle arrest and ultimately apoptosis. We further examined potential correlations between expression levels of TNNC1 and various clinical parameters and found that low-level expression is significantly associated with invasiveness of the tumor. Indeed, RNA interference-mediated down-regulation of TNNC1 led to significant enhancement of invasiveness in vitro. Collectively, our data indicate that TNNC1 has a novel function as a tumor suppressor and is targeted for down-regulation by KRAS pathway during the carcinogenesis of LUAD.
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