Long-Term Outcomes of Patients with Stent Tips Embedded into Internal Carotid Artery Branches during Aneurysm Coiling.

BACKGROUND AND PURPOSE: During stent-assisted coiling of ICA aneurysms, stent tips are sometimes unintentionally embedded into ICA branches. Stent tips can be visualized because they have radiopaque markers. Concerns regarding stent tip misplacement include risks of artery perforation and occlusion. The aim of this study was to evaluate the long-term outcomes of ICA branches with embedded stent tips. MATERIALS AND METHODS: ICA branches with embedded stent tips were identified among 35 patients with unruptured ICA aneurysms treated with stent-assisted coiling between November 2003 and November 2014. Patient clinical and angiographic outcomes associated with the embedded stent tip were analyzed. RESULTS: Most of the 35 studied aneurysms were paraclinoid ICA aneurysms (n = 30). The most commonly involved ICA branch was the posterior communicating artery (26 patients, 74.3%), followed by the anterior choroidal artery (8 patients, 22.9%) and ophthalmic artery (1 patient, 2.9%). During the follow-up period (38.6 ± 17.9 months), no new neurologic deficits developed. Neither hemorrhagic nor thromboembolic events occurred. Angiography was performed during the final follow-up evaluation at a mean of 32.7 ± 18.0 months, and all ICA branches with embedded stent tips showed patent blood flow without severe luminal narrowing. CONCLUSIONS: In our experience, placement of a stent tip into ICA branches during stent-assisted coiling was not associated with any major adverse events.

Apparent treatment-resistant hypertension among elderly Korean hypertensives: an insight from the HIT registry.

The aim of this study was to determine the clinical characteristics of patients with resistant hypertension (RH) and predictors among elderly Korean hypertensives. This prospective, multi-center, observational study evaluated 2439 elderly hypertensive patients between December 2008 and November 2011, who visited secondary hypertension clinics for high blood pressure (BP). Patients were categorized as resistant if their BP was ≥140/90 mm Hg and if they reported using antihypertensive medications from three different drug classes, including a diuretic or drugs from ≥4 antihypertensive drug classes, regardless of BP. Characteristics of patients with RH were compared with those of patients who were controlled with one or two antihypertensive medications after 6-month antihypertensive treatment. In comparison with 837 patients with non-RH, 404 patients with RH were more likely to be aware of their status of high BP before enrollment and have a high baseline systolic BP ≥160 mm Hg, microalbuminuria, high body mass index (BMI) ≥24 kg m(-2) and diabetes mellitus (DM). In drug-naive patients, awareness of hypertension at baseline was the only independent predictor for RH. In elderly Korean hypertensives, BMI (≥24 kg m(-2)), baseline systolic BP (≥160 mm Hg), microalbuminuria, DM and awareness of hypertension showed an association with RH.

Clinical outcomes of multicenter domino kidney paired donation.

Domino kidney paired donation (KPD) is a method by which an altruistic living nondirected donor (LND) is allocated to a pool of incompatible donor-recipient pairs (DRP) and a series of KPDs is initiated. To evaluate the feasibility and clinical outcomes of multicenter domino KPD, we retrospectively analyzed a cohort of DRPs who underwent domino KPD between February 2001 and July 2007 at one of 16 transplant centers. One hundred seventy-nine kidney transplants were performed, with 70 domino chains initiated by altruistic LND. There were 45 two-pair chains, 15 three-pair chains, 7 four-pair chains, 2 five-pair chains and 1 six-pair chain. A majority of donors were spouses (47.5%) or altruistic LNDs (39.1%). DRPs with a blood type O recipient or an AB donor comprised 45.9% of transplanted DRPs. HLA mismatch improved in transplanted donors compared to intended donors in pairs enrolled to improve HLA mismatch (3.4 +/- 0.7 vs. 4.8 +/- 1.0, p < 0.001). One-year and 5-year graft survival rates were 98.3% and 87.7%, respectively, with a median follow-up of 46 months. One-year and 5-year patient survival rates were 97.2% and 90.8%, respectively. In conclusion, multicenter domino KPD could multiply the benefits of donation from LNDs, with patients and graft survival rates comparable to those seen with conventional KPD.

Stability of green tea catechins in commercial tea leaves during storage for 6 months.

To help meet the needs of consumers, producers of dietary tea products, and researchers for information on health-promoting tea ingredients, we determined by HPLC 7 catechins [(-)-epigallocatechin (EGC), (-)-catechin (C), (+)-epicatechin (EC), (-)-epigallocatechin 3-gallate (EGCG), (-)-gallocatechin 3-gallate (GCG), (-)-epicatechin 3-gallate (ECG), and (-)-catechin 3-gallate (CG)] in samples of 8 commercial green tea leaves of unknown history sold as tea bags in the United States, Korea, and Japan. The samples were stored at 20 degrees C and sampled at 1 wk and 1, 2, 4, and 6 mo. The following ranges in the initial values (0 controls) were observed (in mg/g tea leaves): EGC and C, 0 to trace amounts; EC, 1.9 to 21.1; EGCG, 13.3 to 113.0; GCG, 0.2 to 1.6; ECG, 5.7 to 50.5; CG 0.5 to 3.7; total catechins 36.5 to 169.7. Statistical analysis of the results and plots of changes in individual and total catechin levels as a function of storage time indicate a progressive decrease in the content in the total levels, most of which is due to losses in the most abundant catechins, EGCG and ECG. Possible mechanisms of degradations of catechins during storage and the possible significance of the results to consumers of tea are discussed.

Cerebral lipiodol embolism during transcatheter arterial chemoembolization.

Cerebral lipiodol embolism (CLE) is a rare complication that may occur during chemoembolization. The authors present three cases of CLE during transcatheter arterial chemoembolization for hepatocellular carcinoma. Multiple small nonconfluent hyperintense intracerebral lesions were found on the diffusion-weighted and fluid-attenuated inversion recovery MRI. Clinical signs completely resolved and MRI lesions markedly improved on follow-up evaluation within a 3-week period.

Effect of cold air therapy in relieving spasticity: applied to spinalized rabbits.

STUDY DESIGN: Before-After trial measured prior to cold air therapy, immediately following, after 30 and 60 min. OBJECTIVE: To determine the effect of cold air therapy in relieving spasticity, the optimal intramuscular temperature, and the duration of spasticity relief attained by cold air therapy. SETTING: Clinical research laboratory, Seoul, Korea. SUBJECT: Forty-six spastic paraplegic rabbits with spinal cord injury. METHODS: Spastic paraplegia was induced by transection of spinal cord in 46 rabbits. Cold air was applied to triceps surae muscles for 30 min at three different intramuscular temperatures (25, 30 and 32.5 degrees C). Clinical parameters of spasticity (muscle tone, Babinski's sign, muscle stretch reflex and ankle clonus) and electrophysiologic parameters (F/M ratio and H/M ratio) were measured immediately following, after 30 and 60 min. RESULTS: In the 32.5 degrees C group, relief in spasticity lasted less than 30 min. In the 30 and 25 degrees C groups, the decrease in spasticity lasted for at least 30 min clinically. The spasticity relief was observed only immediately following treatment when measured electrophysiologically. However, six out of 16 cases (37.5%) in the 25 degrees C group showed complete motor conduction block. CONCLUSION: To relieve spasticity with cold air therapy, the intramuscular temperature should be maintained at 30 degrees C. The duration of spasticity relief lasted from between 30-60 min after cold air therapy. We certify that all applicable institutional and governmental regulations concerning the ethical use of animals were followed during the course of this research.

Identity of activation molecule 3 on superantigen-stimulated bovine cells is CD26.

Most CD8(+) T cells in cultures of bovine mononuclear cells stimulated with staphylococcal enterotoxin C1 develop an unusual phenotype characterized by expression of activation molecule 3 (ACT3). This superantigen-dependent phenotype may be relevant to immunopathogenesis mediated by certain microbial toxins. The size and N-terminal sequence of immunoprecipitated ACT3 indicate that ACT3 is the bovine orthologue of CD26.

Epidemiological significance of sero-positive inhabitants against sparganum in Kangwon-do, Korea.

Sparganum is a plerocercoid of pseudophyllidean tapeworms, Diphyllobothrium or Spirometra spp. Human sparganosis is endemic mainly in East and Southeast Asian countries where the custom of eating raw snake or frog meat, or poulticing with snake's skin exists. From January 1995 to November 1999, an epidemiological survey was undertaken to evaluate the serum levels of anti-sparganum specific IgG antibodies in Whachon-gun residents, Korea. An enzyme- linked immunosorbent assay (ELISA) and immunoblot analysis of the sera from 316 subjects were used. In addition, a stool examination from 416 inhabitants and questionnaires regarding the consumption of raw meat were given. Out of 416 inhabitants examined coprologically, one was infected with Clonorchis sinensis and two were infected with Metagonimus spp. The sera from 36 inhabitants (11.4 %) showed a positive reaction to the sparganum antigen. Out of these 36 inhabitants, the sera from 25 people were examined 7, 19, and 50 months later. The sera were found to still show positive reactions without any remarkable changes of anti-sparganum specific antibody titers except for one. An analysis of the questionnaires suggested that a history of eating of raw snakes or frogs was important risk factor for clinical or covert sparganosis (odd ratio=15.6 and 3.1, respectively).

A case of torsade de pointes associated with hypopituitarism due to hemorrhagic fever with renal syndrome.

We describe a 51-yr-old man presenting with syncope due to torsade de pointes. The torsade de pointes was refractory to conventional medical therapy, including infusion of isoproterenol, MgSO4, potassium, lidocaine, and amiodarone. His past history, physical findings, and hormone study confirmed that QT prolongation was caused by anterior hypopituitarism that developed as a sequela of hemorrhagic fever with renal syndrome. The long QT interval with deep inverted T wave was completely normalized 4 weeks after starting steroid and thyroid hormone replacement. Hormonal disorders should be considered as a cause of torsade de pointes, because this life-threatening arrhythmia can be treated by replacing the missing hormone.

Short-term effect of mitomycin-C augmented trabeculectomy on axial length and corneal astigmatism.

PURPOSE: To evaluate the short-term effect of trabeculectomy with adjunctive mitomycin-C (MMC) on corneal astigmatism and axial length. SETTING: Asan Medical Center, University of Ulsan, Department of Ophthalmology, Seoul, Korea. METHODS: Eighteen consecutive eyes of 16 patients having trabeculectomy with adjunctive MMC were prospectively analyzed. Intraocular pressure (IOP) and axial length were evaluated preoperatively and 1, 3, 6, and 12 months postoperatively. Postoperative changes in corneal astigmatism were evaluated using vector analysis. RESULTS: The overall mean induced astigmatism showed with-the-rule change up to 3 months postoperatively followed by an against-the-rule shift. The mean axial length was significantly less postoperatively and changed throughout the 12 month follow-up. There was a positive correlation between postoperative axial length and IOP. Eyes with higher preoperative IOP had a greater decrease in axial length after trabeculectomy with MMC. CONCLUSION: The induced corneal astigmatism after trabeculectomy with MMC was long lasting, although less than that in previous studies. The change in axial length after surgery was significant, especially in eyes with a high preoperative IOP. The decrease in axial length persisted throughout the follow-up.

Changes in posterior disc bulging and intervertebral foraminal size associated with flexion-extension movement: a comparison between L4-5 and L5-S1 levels in normal subjects.

BACKGROUND CONTEXT: No previous study has used magnetic resonance imaging (MRI) to evaluate changes of posterior disc bulging and intervertebral foraminal size in the normal spine with flexion-extension movement, comparing L4-5 versus L5-S1 intervertebral levels. PURPOSE: To determine changes in posterior disc bulging and intervertebral foraminal size with flexion-extension movement, comparing L4-5 versus L5-S1 intervertebral levels. STUDY DESIGN: An in vivo study of magnetic resonance kinematics with spine flexion extension. METHODS: Spines of three volunteers with no history of low back pain were scanned in neutral, flexion, and extension positions in a vertically open MRI system. MRI was repeated after 6 hours of normal activity and an additional 4 hours of heavy activity with a weighted vest. Posterior bulging of the intervertebral disc and the size of intervertebral foramen were measured at the L4-5 and L5-S1 levels. RESULTS: With spine flexion, posterior bulging of the discs increased at L4-5 in eight of nine measurements (three different spine-loading states for each of three subjects) and L5-S1 discs in six of nine measurements. In most cases, posterior bulging decreased with extension. No significant difference was noted in the degree of disc bulge between levels. Foraminal size at L4-5 increased with flexion and decreased with extension, and the extent of these changes was greater at the L4-5 level than at L5-S1. CONCLUSIONS: This pilot study demonstrates two distinct behavior characteristics of the normal spine with flexion-extension movement.

MR and MR arthrography to identify degenerative and posttraumatic diseases in the shoulder joint.

MR imaging provides a comprehensive evaluation of a wide spectrum of both intraarticular and extraarticular pathology of the shoulder. MR imaging enables the detection or exclusion of degenerative and posttraumatic diseases of the shoulder with a reasonable accuracy. MR arthrography is useful in the visualization of subtle anatomic details and further improves the differentiation. In this article, findings of MR imaging and MR arthrography of degenerative and posttraumatic shoulder diseases (impingement syndrome, rotator cuff tears, and glenohumeral instability) has been reviewed.

Stereochemical requirement at 4-position of 4-phenyl-1-arylsulfonylimidazolidinones for their cytotoxicities.

In order to investigate the stereochemical requirements of planar structure at 4-position of 4-phenyl-1-arylsulfonylimidazolidinones (1) for their cytoxicities against human cancer cell lines, the size, the distance from imidazolidinone ring, and the conformation of this moiety were variegated. Replacement of phenyl moiety with naphthyl in compounds 2 and 3 or benzyl moiety in compound 4 sharply reduced activity of 1. Conformational restriction on phenyl ring in compound 5 also resulted in the loss of activity of 1. Therefore, phenyl moiety without any substituents directly attached to imidazolidinone ring of 1 should be considered as an essential pharmacophore for this analog.

Five cases of ocular toxocariasis confirmed by serology.

We report 5 cases of ocular toxocariasis in Korean adults complaining of visual impairment along with floating or bubbling sensation. Fundoscopic examination revealed a retinal detachment along with exudate in 4 cases. They all showed typical reaction by ELISA and immunoblot against Toxocra excretory-secretory antigen. One case showed high level of anti-Toxocara IgE antibodies (34,000 Toxocara units/L) as well as increased level of serum total IgE antibodies and the specific IgE antibodies for 3 inhalant antigens, suggesting that high level of anti-Toxocara IgE antibodies was associated with an atopic status. Clinical manifestations were improved after the sequential use of steroids then mebendazole. We also suggest that ocular toxocariasis should be thoroughly investigated even when an evocative uniocular inflammatory lesion is encountered in peripheral retina without a systematic disease.

Enterobius vermicularis egg positive rate of pre-school children in Chunchon, Korea (1999).

Pre-school children were examined for the presence of Enterobius vermicularis egg by perianal swab method. We visited 67 nurseries and 25 kindergartens between January, 1999 and April, 1999 in Chunchon, Korea. Of the 4,711 children examined, 434 (9.2%) were found to be positive for E. vermicularis egg. The egg positive rates of boys and girls were 10.1% and 8.1%, respectively. The rates were 7.8% in kindergartens and 9.7% in nurseries. Positive rate of 50 institutions was less than 10%. Rate in 35 institutions was from 10% to less than 20%. Rate in 7 institutions was equal to or over 20%. Out of 1,113 children examined twice, 28 (2.5%) children were positive consecutively, 53 (4.8%) were positive with negative conversion, 47 (4.2%) were negative with positive conversion, and 985 (88.5%) were consecutively negative. It means that in the low endemic area of enterobiasis with around 10% positive rate, the two consecutive examinations may increase the egg detection rate of 4.2-4.8%. The small number of consecutive egg positive children also suggests that the worm burden of the positive children might be low. Since the egg positive rate of that age group in this City increased from 1.85% (1997), and 3.0% (1998), the more intensive regular control should be executed.

An error detection and recovery algorithm for compressed video signal using source level redundancy.

The motion compensation-discrete cosine transform (MC-DCT) coding is an efficient compression technique for a digital video sequence. However, the compressed video signal is vulnerable to transmission errors over noisy channels. In this paper, we propose a robust video transmission algorithm, which protects the compressed video signal by inserting redundant information at the source level. The proposed algorithm encodes every lth frame in the semi-intra frame (S-frame) mode, in which the redundant parity-check DC coefficients (PDCs) are systematically inserted into the compressed bitstream. Then, the decoder is capable of recovering very severe transmission errors, such as loss of an entire frame, in addition to detecting the errors effectively without requesting any information from external devices. The proposed algorithm is implemented based on the H.263 coder, and tested intensively in realistic error prone environment. It is shown that the proposed algorithm provides much better objective and subjective performances than the conventional H.263 coder in the error prone environment.

Infection status of dragonflies with Plagiorchis muris metacercariae in Korea.

Plagiorchis muris has been found in both house and field rats as well as in humans. The infection status of the second intermediate hosts of P. muris is prerequisite in understanding their biological features in an ecosystem. Six species of dragonflies were caught in a wide range of areas in Korea; and they were Sympetrum darwinianum, S. eroticum, S. pedomontanum, S. infuscatum, Pantala flavoscens, Calopteryx atrata, and Orthetrum albistylum speciosum. The occurrence of P. muris metacercariae in dragonflies was nationwide with various infection rates. The metacercarial burden of P. muris in the surveyed areas was the highest in S. eroticum followed by S. darwinianum, S. pedomontanum, and C. atrata. The highest infection rate by P. muris metacercariae was found in S. darwinianum followed by S. eroticum. The metacercarial burden was particularly heavy in the dragonflies found in Hamyang-gun and Kosong-gun, Kyongsangnam-do. It is, therefore, likely that dragonflies play a significant role as the second intermediate host in the life cycle of P. muris in Korea.

Variation of antigenicity and serological reaction to Pneumocystis carinii in Korea.

The present study observed the variation of antigenicity of Pneumocystis carinii and serum IgG antibody reaction to the antigens from different localities in Korea. Antigens of rat P. carinii and sera of inhabitants were collected at Chunchon. Chungju, Kwangju, and Seoul during 1995-1996. Enzyme-linked Immunosorbent Assay and immunoblot were used for immune reaction. Absorbance of 1,294 human sera ranged between 0.01 and 0.93. Sera from Chunchon showed higher absorbances than those from other areas. Immunoblotting revealed IgG antibody reactions to 116, 100, and 45-55 kDa antigenic bands of rat P. carinii, but the frequencies of positive reaction to individual bands were variable by localities. Total 62.6% of the sera showed the reaction to 116 kDa band while 37.7% reacted to 100 kDa band and 32.0% to 45-55 kDa bands. For the reaction to 116 kDa, the reaction rate was 60.0% to 82.6% by localities. It is found that the reaction rates of the human sera to rat P. carinii antigen are variable according to the localities. Also, the high molecular antigen of 116 kDa of rat P. carinii is the most frequent antigenic band reacting to human sera.

A cytogenetic study on human intestinal trematodes of the genus Metagonimus (Digenea: Heterophyidae) in Korea.

In order to analyze chromosome numbers and karyotypes of intestinal trematodes belonging to the genus, Metagonimus, the gonad tissues of M. takahashii, M. miyatai, and M. yokogawai were prepared and examined. The number of bivalents in the first meiotic division of M. takahashii was nine (n = 9). The diploid number of M. miyatai was observed to be eighteen (2n = 18) and their chromosomes consisted of one pair of metacentric, 7 pairs of submetacentric, and one pair of telocentric chromosomes. The diploid number of M. yokogawai was thirty-two (2n = 32) and the chromosome complements were composed of two pairs of metacentric, 11 pairs of submetacentric, and three pairs of subtelocentric chromosomes. These results could be a supporting evidence for the validity of the new species, M. miyatai, distinct from M. yokogawai.

Hybrid estimation of navigation parameters from aerial image sequence.

This work presents a hybrid method for navigation parameter estimation using sequential aerial images, where navigation parameters represent the position and velocity information of an aircraft for autonomous navigation. The proposed hybrid system is composed of two parts: relative position estimation and absolute position estimation. Computer simulation with two different sets of real aerial image sequences shows the effectiveness of the proposed hybrid parameter estimation algorithm.