Recently, a variety of arthroscopic techniques have been reported for the treatment of the displaced tibial eminence fracture. The purpose of this study was to describe details of arthroscopic technique using pull-out wire and to evaluate the results. Eleven patients with irreducible type II and type III tibial eminence fractures underwent the arthroscopic reduction and internal fixation using double strand pull-out wiring. The anterior cruciate ligament tibial drill guide was utilized for the reduction of fracture and passage of the guide pins. The tibial eminence fracture was firmly fixed with double strand 26-gauge pull-out wire(0.45mm diameter). Fracture union was achieved at 7.2 weeks (range, six to eight weeks) after operation. All cases were united at the last follow-up. Subjectively, nine patients had no pain and no restriction of daily activities. Two patients with combined injuries had limitation of knee motion(10 to 130 degrees, respectively) and one patient showed mild anterior laxity. Early rehabilitation was enabled without loss of reduction and breakage of pull-out wire. The arthroscopic reduction and internal fixation using pull-out wire showed good results including early rehabilitation, early fracture union, minimal morbidity, and no requirement of the second operation for hard ware removal.
PET or PET/CT detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after diagnosis of gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivity for lymph node staging, the specificity of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FOG uptake of primary tumor is low, distant metastasis also tends to show low FDG uptake reducing its detection on PET. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET or PET/CT.
Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatment outcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL). Materials and Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPL during the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed. Results: Of 331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-risk factors without high-risk factors. All studied patients had an initial complete response. At median follow-up time of 40.9 months (range 1-103.3 months) and mean follow-up time of$ 43.3{\pm}25.3$ months, 37 women had disease recurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Five-year and 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overall survival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic node metastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI, 1.483-9.549). Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be considered and disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primary surgical treatment for early-stage cervical carcinoma were found to be excellent.
Objective: The benefits of screening and early detection of breast cancer, including reduced morbidity and mortality, have been well-reported in the literature. In 2011, a breast cancer screening program was launched in Meknes-Tafilalt region of Morocco. The aim of this study was to evaluate the early performance indicators of this program. Materials and Methods: This retrospective evaluative study was conducted between April 2012 and December 2014, in Meknes-Tafilalt region of Morocco. Several performance indicators of the breast cancer screening program were calculated: the compliance rate, the positivity rate, the referral rate, the cancer detection rate and the organizational indicators. Results: During 2012-2014, a total of 184,951 women participated in the breast cancer screening program. The compliance rate was 26%, the positive rate was 3.3%, the referral rate was 36.7%, and the cancer detection rate was 1.2 per 1,000 women. The median time between the date of clinical breast examination and the date of biopsy (or cyto-puncture) was 36 days. The median time between the date of positive mammography and the date of biopsy (or cyto-puncture) was 6 days. The median time between the date of clinical breast examination and the date of the first received treatment was 61 days. Conclusions: The program needs better monitoring, as well as implementation of quality assurance tools to improve performance in our country.
The objective of this study was to evaluate Biocom (a protein source containing a high level of glutamine and alanyl-glutamine) as a replacement for glutamine (Gln) in nursery pig diets. Forty-two pigs (fourteen pigs per treatment) weaned at 28 d of age were used in a 28-d performance trial using three dietary treatments: control (no Gln), control supplemented with Gln or Biocom. The control diet was composed of corn, soybean meal, whey and fish meal. Individual body weight, pen feed disappearance and diarrhea were monitored. On d 0, 2, 7 and 14 postweaning, respectively, five pigs per treatment were selected and bled from the anterior vena cava to obtain five replicate samples of blood on each dietary treatment for determination of blood biochemical index. Dietary supplementation of Gln and Biocom did not influence performance, plasma Gln and total serum protein concentration (p>0.05). However, the addition of Gln and Biocom could prevent serum urea nitrogen and serum cortisol from increasing on d 2 postweaning (p<0.05). There were no significant differences (p>0.05) in any of the examined parameters between Gln- and Biocom-supplemented diets. In conclusion, dietary Gln did not influence the performance of early-weaned piglets owing to the complex diet containing whey, but could prevent the increase of serum urea and cortisol. Biocom could be used as a replacement for free pure Gln without any negative effect on early-weaned piglets.
Hallux valgus has been characterized by a valgus deformity of the great toe at the metatarsophalangeal joint, along with medial deviation of the first metatarsal, and by three components. First, there is a valgus angle more than $20^{\circ}$ at the first, metatarsophalangeal joint. Second, there is a greater angle than $9^{\circ}$ between the first. and second metatarsals. Third, there is bursal hypertrophy at the medial eminence of the first metatarsals head. The etiology is multifactorial and many procedures have been reported in the treatment of hallux valgus. Most of the procedures are directed towards pain relief, correction of deformity, and preservation of dorsiflexion in the first metatarsophalangeal joint. One such treatment is the Modified chevron osteotomy. It is technically simple, and provides greater stability than a standard osteotomy, and allows early ambulation after surgery. We a reviewed 19 cases with 13 patients of hallux valgus deformity. They were all treated with the Modified chevron osteotomy at the Department of Orthopedic Surgery, Choong ang Gil Hospital, between June 1988 and May 1994. The results of the study were as follows; 1. The mean age was 36 years. Three patients(5 case) were male and ten patients(14 cases) were female. 2. The mean value of the hallux valgus angle was $34.1^{\circ}$, and the first to second intermetatarsal angle was $12.1^{\circ}$, preoperatively. These angles were corrected to $15.8^{\circ}$ and $8.5^{\circ}$, respectively. 3. The metatarsalgia subsided in 17 cases (89.5%). avascular necrosis, non union, and dorsal angulation complicatious were nonexistant. Early bone healing occurred in all cases. 4. The Modified chevron osteotomy is technically simple. It provides excellent pain relief, early ambulation, increased mechanical stability, and many avoids many complications such as AVN, non-union, and dorsal angulation.
Dental caries is the most common oral disease. There are many factors contributing to its development, but complete understanding and prevention are not fully known. However, it is possible to remineralize the early enamel curious lesion by fluoride containing remineralization solution. Recently the pH-cycling model has been used to examine the effect of fluoride solution on remineralization of artificial caries in vitro as it can closely simulate the conditions encountered in vivo within a carefully controlled environment. The aim of this study was to evaluate the remineralizing effects of supersaturated buffer solutions under pH-cycling model. The specimen with 3mm-diameter was made using mature bovine incisors which has no caries and has sound enamel surface. Early curious lesions were produced by suspending each specimens into demineralization solution at pH 5.0 for 33 hours and the specimen whose surface hardness value ranged from 25 to 45 VHN were used. The pH cycling treatment regimen consisted of 5 min soaks of three treatment solutions four times per days for 15 days and the continuous cycling of demineralization and remineralization were carried out for 15 days. Following the pH-cycling treatment regimen, the specimens' surface microhardness were measured by the Vickers hardness test (VHN) and analyzed by ANOVA and Duncan's multiple-range test. 1. The surface microhardness value of supersaturated solution, Senstime, and Gagline groups were increased after pH cycling, and that of supersaturated solution was significantly Increased compared to saline group(P<0.05). 2. The surface remineralization effect of fluoride containing solutions was accelerated by saliva under pH-cycling mode 3. The pH cycling model was considered appropriate to mimic the intra-oral pH changes when evaluating demineralization and remineralization in vitro. Under the results of above study, salivary remineralization effect can be improved by fluoride containing remineralization solution. The pH-cycling model was considered appropriate to mimic the intra-oral pH changes when evaluating demineralization and remineralization in vitro.
Sarcoidosis is a multisystem disease characterized by noncaseating granulomas. Cardiac involvement is known to have poor prognosis because it can manifest as a serious condition such as the conduction abnormality, heart failure, ventricular arrhythmia, or sudden cardiac death. Although early diagnosis and early treatment is critical to improve patient prognosis, the diagnosis of CS is challenging in most cases. Diagnosis usually relies on endomyocardial biopsy (EMB), but its diagnostic yield is low due to the incidence of patchy myocardial involvement. Guidelines for the diagnosis of CS recommend a combination of clinical, electrocardiographic, and imaging findings from various modalities, if EMB cannot confirm the diagnosis. Especially, the role of advanced imaging such as cardiac magnetic resonance (CMR) imaging and positron emission tomography (PET), has shown to be important not only for the diagnosis, but also for monitoring treatment response and prognostication. CMR can evaluate cardiac function and fibrotic scar with good specificity. Late gadolinium enhancement (LGE) in CMR shows a distinctive enhancement pattern for each disease, which may be useful for differential diagnosis of CS from other similar diseases. Effectively, T1 or T2 mapping techniques can be also used for early recognition of CS. In the meantime, PET can detect and quantify metabolic activity and can be used to monitor treatment response. Recently, the use of a hybrid CMR-PET has introduced to allow identify patients with active CS with excellent co-localization and better diagnostic accuracy than CMR or PET alone. However, CS may show various findings with a wide spectrum, therefore, radiologists should consider the possible differential diagnosis of CS including myocarditis, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy, amyloidosis, and arrhythmogenic right ventricular cardiomyopathy. Radiologists should recognize the differences in various diseases that show the characteristics of mimicking CS, and try to get an accurate diagnosis of CS.
Soybean cultivars susceptible to Phytophthora root and stem rot are vulnerable to seed rot and damping-off of seedlings and young plants following an infection by Phytophthora sojae. In this study, the disease responses of Japanese soybean cultivars including currently grown main cultivars during the early growth stages were investigated following infections by multiple P. sojae isolates from Japanese fields. The extent of the resistance to 17 P. sojae isolates after inoculations at 14, 21, and 28 days after seeding varied significantly among 18 Japanese and two US soybean cultivars. Moreover, the disease responses of each cultivar differed significantly depending on the P. sojae isolate and the plant age at inoculation. Additionally, the treatment of 'Nattosyo-ryu' seeds with three fungicidal agrochemicals provided significant protection from P. sojae when plants were inoculated at 14-28 days after seeding. These results indicate that none of the Japanese soybean cultivars are completely resistant to all tested P. sojae isolates during the first month after sowing. However, the severity of the disease was limited when plants were inoculated during the later growth stages. Furthermore, the protective effects of the tested agrochemicals were maintained for at least 28 days after the seed treatment. Japanese soybean cultivars susceptible to Phytophthora root and stem rot that are grown under environmental conditions favorable for P. sojae infections require the implementation of certain practices, such as seed treatments with appropriate agrochemicals, to ensure they are protected from P. sojae during the early part of the soybean growing season.
The Journal of the Society of Stroke on Korean Medicine
/
v.21
no.1
/
pp.67-76
/
2020
■ Objectives The purpose of this case is to report the effectiveness of Korean medicine in the treatment of early stage multiple system atrophy-cerebellar ataxia(MSA-C) ■ Methods The patient was treated with acupuncture, bee venom, and herbal medicine. The clinical symptoms was assessed using unified multiple system atrophy rating scale(UMSARS) and 20M gait time and steps. ■ Results After treatment, UMSARS score and 20M gait time and steps showed improvement. ■ Conclusion This study suggested that Korean medical treatment could be an effective option for treating early stage MSA-C.
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