Adaptation of the Score for Allergic Rhinitis in the Chinese Population: Psychometric Properties and Diagnostic Accuracy.

BACKGROUND: Allergic rhinitis (AR) is a worldwide health problem with rising prevalence. To enhance the estimation of AR prevalence in epidemiological studies, the Score for AR (SFAR), a screening tool, has been developed and widely used. An 8-item SFAR is a handy, self-administered instrument assessing the information on nasal and eye symptoms, seasonal increase in symptoms, skin test results, and previous AR diagnoses. This study aimed to adapt the SFAR to the Chinese population (CSFAR) and validate it by testing its psychometric properties and diagnostic accuracy. METHODS: This methodological study involved translation and validation phases. Different batches of participants were recruited for the above purposes. RESULTS: In phase 1, the CSFAR obtained satisfactory item (80-100%) and scale level (97.8%) semantic equivalence, content validity index (96.7%), comprehensibility (100%), cross-language testing (κ = 0.44-0.83 for item-to-item agreement; intraclass correlation coefficient [ICC] = 0.95, p < 0.05-0.001). In phase 2, CSFAR showed satisfactory internal consistency (α = 0.83), 1-month (ICC = 0.88) and 1-year stability (ICC = 0.85), and construct validity (significant correlation between CSFAR and impairments induced by AR: r = 0.47, p < 0.001). Based on the receiver-operating characteristic curve, comparing the CSFAR with diagnosis made by specialists, an optimal cutoff value was 6 (sensitivity 81.8% and specificity 80.3%). CONCLUSION: SFAR was translated into a Chinese version, the CSFAR. Satisfactory results were obtained for its equivalence, appropriateness, comprehensibility, and relevance, as well as its reliability and validity. A cutoff value of 6 was recommended to increase the diagnostic accuracy in environments with less pollen. This study provides evidence that the SFAR we adapted for the Chinese population is a valuable tool in AR screening.

Centers for Disease Control and Prevention Funding for HIV Testing Associated With Higher State Percentage of Persons Tested.

OBJECTIVES: To assess the association between state per capita allocations of Centers for Disease Control and Prevention (CDC) funding for HIV testing and the percentage of persons tested for HIV. SETTING AND PARTICIPANTS: We examined data from 2 sources: 2011 Behavioral Risk Factor Surveillance System and 2010-2011 State HIV Budget Allocations Reports. Behavioral Risk Factor Surveillance System data were used to estimate the percentage of persons aged 18 to 64 years who had reported testing for HIV in the last 2 years in the United States by state. State HIV Budget Allocations Reports were used to calculate the state mean annual per capita allocations for CDC-funded HIV testing reported by state and local health departments in the United States. DESIGN: The association between the state fixed-effect per capita allocations for CDC-funded HIV testing and self-reported HIV testing in the last 2 years among persons aged 18 to 64 years was assessed with a hierarchical logistic regression model adjusting for individual-level characteristics. MAIN OUTCOME: The percentage of persons tested for HIV in the last 2 years. RESULTS: In 2011, 18.7% (95% confidence interval = 18.4-19.0) of persons reported being tested for HIV in last 2 years (state range, 9.7%-28.2%). During 2010-2011, the state mean annual per capita allocation for CDC-funded HIV testing was $0.34 (state range, $0.04-$1.04). A $0.30 increase in per capita allocation for CDC-funded HIV testing was associated with an increase of 2.4 percentage points (14.0% vs 16.4%) in the percentage of persons tested for HIV per state. CONCLUSIONS: Providing HIV testing resources to health departments was associated with an increased percentage of state residents tested for HIV.

No Evidence of Cross-Orientation Suppression Differences in Migraine with Aura Compared to Healthy Controls.

It has been suggested that there may be an imbalance of excitation and inhibitory processes in the visual areas of the brain in people with migraine aura (MA). One idea is thalamocortical dysrhythmia, characterized by disordered oscillations, and thus disordered communication between the lateral geniculate nucleus and the cortex. Cross-orientation suppression is a visual task thought to rely on inhibitory processing, possibly originating in the lateral geniculate nucleus. We measured both resting-state oscillations and cross-orientation suppression using EEG over occipital areas in people with MA and healthy volunteers. We found evidence of cross-orientation suppression in the SSVEP responses, but no evidence of any group difference. Therefore, inhibitory processes related to cross-orientation suppression do not appear to be impaired in MA.

One-Year Clinical Outcomes of Subcutaneous Infliximab Maintenance Therapy Compared With Intravenous Infliximab Maintenance Therapy in Patients With Inflammatory Bowel Disease: A Prospective Cohort Study.

BACKGROUND: Although the pharmacokinetic profile of subcutaneous (SC) infliximab (IFX) is superior to conventional intravenous (IV) IFX, long-term efficacy and safety of SC IFX in patients with inflammatory bowel disease (IBD) have not been reported yet. This study aimed to evaluate long-term clinical outcomes of IBD patients treated with SC IFX compared with those of IBD patients treated with IV IFX during maintenance therapy. METHODS: This prospective cohort study enrolled 61 IBD patients in clinical remission who received scheduled IFX maintenance therapy. Of them, 38 patients were switched to SC IFX, while 23 patients continued IV IFX with dose optimization. Enrolled patients were followed up for 1 year. The primary outcome was durable remission defined as clinical remission (Crohn's disease, Harvey-Bradshaw index <5; ulcerative colitis, partial Mayo score <2) and biochemical remission (C-reactive protein <0.5 mg/dL) with IFX trough level ≥3 µg/mL throughout the follow-up period. RESULTS: One-year clinical remission, 1-year biochemical remission, and mucosal healing did not differ between the IV and SC IFX groups (n = 20 of 23 vs 33 of 38; P = 1.000; n = 22 of 23 vs 34 of 38; P = .641; and n = 10 of 18 vs 17 of 25; P = .414, respectively). During follow-up, the number of patients with IFX trough level <3 µg/mL was significantly lower in the SC IFX group (n = 0 of 38, 0%) than in the IV IFX group (n = 10 of 23, 43%) (P < .001). The SC IFX group showed higher 1-year durable remission than the IV IFX group (n = 31 of 38, 82% vs n = 11 of 23, 48%; P = .013). The incidence of IFX-related adverse events did not differ significantly between both groups (26% vs 39%; P = .446). CONCLUSION: The SC IFX switch induced a higher 1-year durable remission rate than continuing IV IFX in patients with IBD during scheduled maintenance therapy, showing similar safety.

Long-term efficacy and safety of subcutaneous infliximab in patients with inflammatory bowel diseases have not been reported yet. Switching from intravenous to subcutaneous infliximab showed higher 1-year durable remission than continuing intravenous infliximab during scheduled maintenance therapy, with similar safety.

Brief Report: HIV Testing, Diagnosis of HIV Infection, Linkage to Medical Care, and Interview for Partner Services Among Transgender Persons-United States, 2012-2017.

BACKGROUND: Transgender persons are at high risk for HIV infection. Testing is a key component of the national effort to end the HIV epidemic in the United States. SETTING: Sixty-one local and state health departments and 150 community-based organizations funded by the Centers for Disease Control and Prevention to conduct HIV testing programs. METHODS: We analyzed HIV testing data submitted to the Centers for Disease Control and Prevention by funded health departments and community-based organizations during 2012-2017. Descriptive analysis examined patterns of HIV testing and key outcomes (diagnosis of HIV infection, linkage to HIV medical care, and interview for partner services) among transgender persons. Multivariate robust Poisson regression was used to assess associations between HIV testing outcomes and demographic characteristics, census region, and test setting. RESULTS: A total of 82,818 HIV tests were provided to transgender persons. Of these, 2280 (2.8%) transgender persons were diagnosed with HIV infection; 1556 (1.9%) received a new and 724 (0.9%) a previous diagnosis with HIV infection. The highest percentage of new HIV diagnosis was found among persons tested in correctional settings (4.6%), non-Hispanic Blacks (3.5%) and transgender women (2.4%). Among newly diagnosed persons, 85.0% were linked to HIV medical care ≤90 days after diagnosis and 63.5% were interviewed for partner services. CONCLUSIONS: HIV positivity was high, and the delivery of partner services was low, among transgender persons. HIV testing outcomes among transgender persons varied significantly by demographic characteristics and test setting. HIV prevention programs that are responsive to the needs of transgender persons may address gender-related disparities in HIV testing outcomes.

Enhancement of preimplantation mouse embryo development with optimized in vitro culture dish via stabilization of medium osmolarity / 대한생식의학회지

Objective@#We evaluated the efficacy of the newly developed optimized in vitro culture (OIVC) dish for cultivating preimplantation mouse embryos. This dish minimizes the need for mineral oil and incorporates microwells, providing a stable culture environment and enabling independent monitoring of individual embryos. @*Methods@#Mouse pronuclear (PN) zygotes and two-cell-stage embryos were collected at 18 and 46 hours after human chorionic gonadotropin injection, respectively. These were cultured for 120 hours using potassium simplex optimized medium (KSOM) to reach the blastocyst stage. The embryos were randomly allocated into three groups, each cultured in one of three dishes: a 60-mm culture dish, a microdrop dish, and an OIVC dish that we developed. @*Results@#The OIVC dish effectively maintained the osmolarity of the KSOM culture medium over a 5-day period using only 2 mL of mineral oil. This contrasts with the significant osmolarity increase observed in the 60-mm culture dish. Additionally, the OIVC dish exhibited higher blastulation rates from two-cell embryos (100%) relative to the other dish types. Moreover, blastocysts derived from both PN zygotes and two-cell embryos in the OIVC dish group demonstrated significantly elevated mean cell numbers. @*Conclusion@#Use of the OIVC dish markedly increased the number of cells in blastocysts derived from the in vitro culture of preimplantation mouse embryos. The capacity of this dish to maintain medium osmolarity with minimal mineral oil usage represents a breakthrough that may advance embryo culture techniques for various mammals, including human in vitro fertilization and embryo transfer programs.

Anaphylaxis to Chlorhexidine-Impregnated Central Venous Catheters in Spine Surgery / 대한정형외과학회잡지

Attempts to lower rates of catheter-related bloodstream infection have led to the adoption of chlorhexidine-coated central venous catheters (CVCs) in several orthopedic surgeries. On the other hand, there is still some controversy regarding the advantage of reducing catheterrelated infections. This paper reports a case of severe anaphylaxis to chlorhexidine-coated CVCs when used in spine surgery. Before exposing the patients to chlorhexidine-coated CVCs, the risk of complications including anaphylaxis should be considered.

Changing Features of Liver Injury in COVID-19 Patients: Impact of Infection with the SARS-CoV-2 Delta (B.1.617.2) Variants / 감염과화학요법

Background@#There is growing evidence that abnormal liver function tests (LFTs) are common in patients with coronavirus disease 2019 (COVID-19). However, it is not known whether viral involvement in the liver differs according to the strain. We investigated the impact on liver injury in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta (B.1.617.2) variants. @*Materials and Methods@#We conducted a single-center, retrospective cohort study, including 372 patients admitted during the pre-Delta period (PDP: between February 1 and November 30, 2020) and 137 patients admitted during the Delta period (DP: between August 1 and August 31, 2021). Initial liver injury was defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels ≥3 × the upper limit of normal (ULN) or alkaline phosphatase (ALP) or total bilirubin ≥2 × the ULN within 3 days from admission. @*Results@#Of 509 patients with COVID-19 included in our study, 38 (7.5%) patients had initial liver injury. The DP group had a significantly higher rate of initial liver injury than the PDP group (PDP: 5.9% vs. DP: 11.7%, P = 0.028). The DP group (adjusted odds ratio [aOR]: 2.737, 95% confidence interval [CI]: 1.322 – 5.666) was independently associated with initial liver injury. During hospitalization, 160 (31.4%) patients had severe COVID-19. The DP group and initial liver injury had higher odds of progressing to severe COVID-19 (aOR: 2.664, 95% CI: 1.526 - 4.648, and aOR: 4.409, 95% CI: 1.816 - 10.707, respectively). The mediation analysis suggested that initial liver injury mediates the relationship between SARS-CoV-2 Delta variant infection and severe COVID-19 (unstandardized beta coefficient = 0.980, Standard error = 0.284, P = 0.001). @*Conclusion@#Initial liver injury is more common in COVID-19 patients with Delta variants. Also, Delta variants and initial liver injury are associated with poor clinical outcomes.

Prasugrel-based De-Escalation of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With STEMI

Background and Objectives@#De-escalation of dual-antiplatelet therapy through dose reduction of prasugrel improved net adverse clinical events (NACEs) after acute coronary syndrome (ACS), mainly through the reduction of bleeding without an increase in ischemic outcomes. Whether the benefits of de-escalation are sustained in highly thrombotic conditions such as ST-elevation myocardial infarction (STEMI) is unknown. We aimed to assess the efficacy and safety of de-escalation therapy in patients with STEMI or non-STsegment elevation ACS (NSTE-ACS). @*Methods@#This is a pre-specified subgroup analysis of the HOST-REDUCE-POLYTECH-ACS trial. ACS patients were randomized to prasugrel de-escalation (5 mg daily) or conventional dose (10 mg daily) at 1-month post-percutaneous coronary intervention. The primary endpoint was a NACE, defined as a composite of all-cause death, non-fatal myocardial infarction, stent thrombosis, clinically driven revascularization, stroke, and bleeding events of grade ≥2 Bleeding Academic Research Consortium (BARC) criteria at 1 year. @*Results@#Among 2,338 patients included in the randomization, 326 patients were diagnosed with STEMI. In patients with NSTE-ACS, the risk of the primary endpoint was significantly reduced with de-escalation (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.48– 0.89; p=0.006 for de-escalation vs. conventional), mainly driven by a reduced bleeding. However, in those with STEMI, there was no difference in the occurrence of the primary outcome (HR, 1.04; 95% CI, 0.48–2.26; p=0.915; p for interaction=0.271). @*Conclusions@#Prasugrel dose de-escalation reduced the rate of NACE and bleeding, without increasing the rate of ischemic events in NSTE-ACS patients but not in STEMI patients.

Clinical Results of Drug-Coated Balloon Treatment in a Large-Scale Multicenter Korean Registry Study

Background and Objectives@#The aim of this study was to demonstrate the efficacy and safety of treatment with drug-coated balloon (DCB) in a large real-world population. @*Methods@#Patients treated with DCBs were included in a multicenter observational registry that enrolled patients from 18 hospitals in Korea between January 2009 and December 2017. The primary outcome was target lesion failure (TLF) defined as a composite of cardiovascular death, target vessel myocardial infarction, and clinically indicated target lesion revascularization at 12 months. @*Results@#The study included 2,509 patients with 2,666 DCB-treated coronary artery lesions (1,688 [63.3%] with in-stent restenosis [ISR] lesions vs. 978 [36.7%] with de novo lesions).The mean age with standard deviation was 65.7±11.3 years; 65.7% of the patients were men.At 12 months, the primary outcome, TLF, occurred in 179 (6.7%), 151 (8.9%), 28 (2.9%) patients among the total, ISR, and de novo lesion populations, respectively. A history of hypertension, diabetes, acute coronary syndrome, previous coronary artery bypass graft, reduced left ventricular ejection fraction, B2C lesion and ISR lesion were independent predictors of 12 months TLF in the overall study population. @*Conclusions@#This large multicenter DCB registry study revealed the favorable clinical outcome of DCB treatment in real-world practice in patient with ISR lesion as well as small de novo coronary lesion.

Whole Lumbar Spinal Subdural Hematoma with Progressive Paraplegia after Lumbar Spinal Epidural Injection / 대한정형외과학회잡지

Spinal hematomas are a rare but serious complication that is typically observed in the epidural space. Spinal subdural hematomas are a dangerous clinical situation because of their potential to cause significant compression of the neural elements and can be mistaken easily for spinal epidural hematomas. This paper reports a case of a severe whole lumbar subdural hematoma after a simple epidural injection that was treated with surgical decompression with excellent clinical results.

Radiological Assessment of the Effects of Anterior Cervical Discectomy and Fusion on Distraction of the Posterior Ligamentum Flavum in Patients with Degenerative Cervical Spines

Background@#This study aimed to assess the effects of anterior cervical discectomy and fusion (ACDF) on distraction of the posterior ligamentum flavum (LF) by increasing the intervertebral disc height and positioning a graft in patients with degenerative cervical spine disease. @*Methods@#Sixty-eight patients with degenerative cervical diseases who underwent single-level ACDF were included in the analysis. The intervertebral disc height, Cobb angle, and transverse thickness of the LF were measured, and magnetic resonance imaging was performed both preoperatively and 6 weeks postoperatively on each patient. Correlation analyses were performed to evaluate the relationships between age, sex, change in intervertebral disc height, Cobb angle, and position of the intervertebral implant according to the postoperative change in LF thickness. The position of the intervertebral implant was categorized as anterior, middle, or posterior. We also evaluated radiological effects according to the implant position. @*Results@#The mean intervertebral disc height increased from 5.88 mm preoperatively to 7.49 mm postoperatively. The Cobb angle was 0.88° preoperatively and 1.43° postoperatively. Age (p = 0.551), sex (p = 0.348), position of cage (p = 0.312), pre- and postoperative intervertebral disc height (p = 0.850, p = 0.900), Cobb angle (p = 0.977, p = 0.460), and LF thickness (p = 0.060, p = 1.00) were not related to changes in postoperative LF thickness. Postoperative increase in disc height was related to Cobb angle (r = 0.351, p = 0.038). No other factors were significantly related. The position of the cage was not related with the change of Cobb angle (p = 0.91), LF thickness (p = 0.31), or disc height (p = 0.54). @*Conclusions@#Change in the intervertebral disc height and the position of the intervertebral implant after ACDF did not affect the thickness of the LF after surgery in patients with degenerative cervical spine disease.

Health Department HIV Prevention Programs That Support the National HIV/AIDS Strategy: The Enhanced Comprehensive HIV Prevention Planning Project, 2010-2013.

OBJECTIVE: The Enhanced Comprehensive HIV Prevention Planning project was the first initiative of the Centers for Disease Control and Prevention (CDC) to address the goals of the National HIV/AIDS Strategy (NHAS). Health departments in 12 U.S. cities with a high prevalence of AIDS conducted comprehensive program planning and implemented cost-effective, scalable HIV prevention interventions that targeted high-risk populations. We examined trends in health department HIV prevention programs in these cities during the project. METHODS: We analyzed the number of people who received partner services, condoms distributed, and people tested for HIV, as well as funding allocations for selected HIV prevention programs by year and by site from October 2010 through September 2013. We assessed trends in the proportional change in services and allocations during the project period using generalized estimating equations. We also conducted thematic coding of program activities that targeted people living with HIV infection (PLWH). RESULTS: We found significant increases in funding allocations for HIV testing and condom distribution. All HIV partner services indicators, condom distribution, and HIV testing of African American and Hispanic/Latino populations significantly increased. HIV tests associated with a new diagnosis increased significantly among those self-identifying as Hispanic/Latino but significantly decreased among African Americans. For programs targeting PLWH, health department activities included implementing new program models, improving local data use, and building local capacity to enhance linkage to HIV medical care, retention in care, and treatment adherence. CONCLUSIONS: Overall, these findings indicate that health departments in areas with a high burden of AIDS successfully shifted their HIV prevention resources to scale up important HIV programs and make progress toward NHAS goals.

Apparent treatment-resistant hypertension among ambulatory hypertensive patients: a cross-sectional study from 13 general hospitals

Background/Aims@#To examine the prevalence and clinical characteristics of apparent treatment-resistant hypertension among ambulatory hypertensive patients. @*Methods@#We enrolled adult ambulatory hypertensive patients at 13 well-qualified general hospitals in Korea from January to June 2012. Apparent resistant hypertension was defined as an elevated blood pressure > 140/90 mmHg with the use of three antihypertensive agents, including diuretics, or ≥ 4 antihypertensives, regardless of the blood pressure. Controlled hypertension was defined as a blood pressure within the target using three antihypertensives, including diuretics. @*Results@#Among 16,915 hypertensive patients, 1,172 (6.9%) had controlled hypertension, and 1,514 (8.9%) had apparent treatment-resistant hypertension. Patients with apparent treatment-resistant hypertension had an earlier onset of hypertension (56.8 years vs. 58.8 years, p = 0.007) and higher body mass index (26.3 kg/m2 vs. 24.9 kg/m2, p < 0.001) than those with controlled hypertension. Drug compliance did not differ between groups. In the multivariable analysis, earlier onset of hypertension (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p < 0.001) and the presence of comorbidities (OR, 2.06; 95% CI, 1.27 to 3.35; p < 0.001), such as diabetes mellitus, ischemic heart disease, heart failure, and chronic kidney disease, were independent predictors. Among the patients with apparent treatment-resistant hypertension, only 5.2% were receiving ≥ 2 antihypertensives at maximally tolerated doses. @*Conclusions@#Apparent treatment-resistant hypertension prevalence is 8.9% among ambulatory hypertensive patients in Korea. An earlier onset of hypertension and the presence of comorbidities are independent predictors. Optimization of medical treatment may reduce the rate of apparent treatment-resistant hypertension.

Apparent treatment-resistant hypertension among ambulatory hypertensive patients: a cross-sectional study from 13 general hospitals

Background/Aims@#To examine the prevalence and clinical characteristics of apparent treatment-resistant hypertension among ambulatory hypertensive patients. @*Methods@#We enrolled adult ambulatory hypertensive patients at 13 well-qualified general hospitals in Korea from January to June 2012. Apparent resistant hypertension was defined as an elevated blood pressure > 140/90 mmHg with the use of three antihypertensive agents, including diuretics, or ≥ 4 antihypertensives, regardless of the blood pressure. Controlled hypertension was defined as a blood pressure within the target using three antihypertensives, including diuretics. @*Results@#Among 16,915 hypertensive patients, 1,172 (6.9%) had controlled hypertension, and 1,514 (8.9%) had apparent treatment-resistant hypertension. Patients with apparent treatment-resistant hypertension had an earlier onset of hypertension (56.8 years vs. 58.8 years, p = 0.007) and higher body mass index (26.3 kg/m2 vs. 24.9 kg/m2, p < 0.001) than those with controlled hypertension. Drug compliance did not differ between groups. In the multivariable analysis, earlier onset of hypertension (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p < 0.001) and the presence of comorbidities (OR, 2.06; 95% CI, 1.27 to 3.35; p < 0.001), such as diabetes mellitus, ischemic heart disease, heart failure, and chronic kidney disease, were independent predictors. Among the patients with apparent treatment-resistant hypertension, only 5.2% were receiving ≥ 2 antihypertensives at maximally tolerated doses. @*Conclusions@#Apparent treatment-resistant hypertension prevalence is 8.9% among ambulatory hypertensive patients in Korea. An earlier onset of hypertension and the presence of comorbidities are independent predictors. Optimization of medical treatment may reduce the rate of apparent treatment-resistant hypertension.

Epidemiology of HIV/AIDS among Asians and Pacific Islanders in the United States.

Although the percentage of overall AIDS diagnoses remains low among Asian and Pacific Islanders (APIs) in the United States compared with other racial/ethnic groups, research on API risk behaviors and health status suggest that the low number of AIDS cases may not provide a full picture of the epidemic and issues faced by this understudied and underserved population. Data from national HIV/AIDS surveillance systems and the Behavioral Risk Factor Surveillance System (BRFSS) were examined to delineate the magnitude and course of the HIV/AIDS epidemic among APIs in the United States. Same-sex sexual activity is the main HIV risk for API men, whereas heterosexual contact is for API women. APIs are significantly less likely to report being tested for HIV despite the fact that a similar proportion of APIs and other racial/ethnic groups reported having HIV risk in the past 12 months. Given the enormous diversity among APIs in the United States it is important to collect detailed demographic information to improve race/ethnicity and HIV risk classification, conduct better behavioral and disease monitoring for informing prevention planning, and addressing cultural, linguistic, economic and legal barriers to HIV prevention among APIs.

Relationships and Usefulness of Cervical Lateral Radiographs Compared with Whole-Spine Lateral Radiographs for Evaluating Cervical Sagittal Alignment

Objectives@#This study was conducted to identify the correlations and usefulness of lateral cervical radiographs compared with wholespine sagittal lateral radiographs for evaluating cervical sagittal alignment.Summary of Literature Review: Few reports have compared cervical lateral radiographs with whole-spine sagittal radiographs. @*Materials and Methods@#We retrospectively analyzed 181 patients with both cervical standing lateral radiographs and whole-spine standing lateral radiographs. The radiographs were evaluated using the following sagittal alignment parameters: C2-7 lordosis, C2-7 sagittal vertical axis (SVA), T1 slope, spino-cranial angle (SCA), and whole-spine SVA. We evaluated the relationships between the two radiographs. The patients were divided into four groups according to age and the measured sagittal parameters were compared across groups. An analysis according to clinical symptoms was also done. @*Results@#C2-7 lordosis was 16.86° and 15.76°, C2-7 SVA was 15.76° and 16.86°, T1 slope was 29.03° and 22.49°, and SCA was 74.74° and 74.5°, respectively, on the cervical and whole spine radiographs. The whole-spine SVA was -2.64 mm. Correlation analysis between the two types of radiographs showed significant relationships for each sagittal parameter. The whole-spine SVA was related with wholespine C2-7 lordosis, T1 slope, and SCA. Cervical C2-7 lordosis and the whole-spine SVA increased with age. A decrease of C2-7 lordosis on whole-spine radiographs was shown in patients with neck pain. @*Conclusions@#Cervical SVA and T1 slope were lower on whole-spine standing lateral radiographs than on simple cervical lateral radiographs. The cervical sagittal parameters measured on cervical radiographs were correlated with those measured on whole-spine radiographs. Cervical radiographs can be used to replace whole-spine radiographs with due consideration of these findings.

Primary Angiosarcoma of the Mesentery: A Case Report

Angiosarcoma is a malignant endothelial cell tumor of lymphatic or vascular origin and is most commonly found in the skin and soft tissue. Primary mesenteric angiosarcoma has rarely been reported. Here, we present a case of primary mesenteric angiosarcoma manifesting as a gradually enhancing mass along with necrosis and hemorrhage.

Primary Angiosarcoma of the Mesentery: A Case Report

Angiosarcoma is a malignant endothelial cell tumor of lymphatic or vascular origin and is most commonly found in the skin and soft tissue. Primary mesenteric angiosarcoma has rarely been reported. Here, we present a case of primary mesenteric angiosarcoma manifesting as a gradually enhancing mass along with necrosis and hemorrhage.

Efficacy of Dynamic Radiographs in Routine Evaluations for Degenerative Cervical Spine Disease

Objectives@#To analyze the usefulness of flexion-extension radiographs in the diagnosis of degenerative cervical disease.Summary of Literature ReviewThere is little information about the efficacy of flexion-extension radiographs in the diagnosis of degenerative cervical disease. @*Methods@#and MaterialsWe analyzed 1,062 patients with cervical degenerative disease who underwent flexion-extension radiographs and computed tomography (CT) or magnetic resonance imaging (MRI). The range of motion of the cervical joints was measured. Segmental instability was evaluated using the sagittal translation (≥3.5 mm) between C2 and T1, the sagittal angulation (≥3.5°), the vertebral slip angle (≥ 10°), and the dynamic spinal canal stenosis (≤12 mm). The relationship between canal compromise on CT or MRI and radiological instability was also evaluated. @*Results@#Cervical range of motion was 36.45°±17.63° (range, 2.1°–106.6°). Segmental instability was observed in 484 patients (nine cases of sagittal translation, 79 cases of sagittal plane rotation, 415 cases of a vertical slip angle, and 21 cases of dynamic spinal stenosis). Segmental instability was related with pathology in 218 patients with available CT or MRI (42%, including five cases of sagittal translation, 32 cases of sagittal plane rotation, 171 cases of vertical slip angle, and 10 cases of dynamic spinal stenosis. @*Conclusions@#Flexion-extension radiographs of the cervical spine were useful in diagnosing and evaluating subaxial segmental instability.