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  • 1
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Although asthma is a common cause of morbidity in adults, relatively few objectively measured population studies of asthma prevalence in adult populations have been conducted.Objective To evaluate the prevalence of asthma, based on both a questionnaire and methacholine bronchial provocation test, and to determine the risk factors of asthma prevalence in an adult population.Methods A total of 2467 adults, who were randomly selected from metropolitan urban, non-metropolitan urban and rural areas, responded to the modified ISAAC questionnaire, and underwent methacholine bronchial provocation tests and skin prick tests to locally common aeroallergens.Results The prevalence of current asthma based on the questionnaire and the methacholine challenge was 2.0% in adults younger than 40, 3.8% in 40- to 54-year-olds, 7.7% in 55- to 64-year-olds and 12.7% in those aged 65 or higher. For subjects of 55–64 years, active smoking was found to be significantly related with the prevalence of current asthma and bronchial hyper-responsiveness, although smoking was positively associated with percentage predictive value of forced expiratory volume of 1 s (FEV1).Conclusion The prevalence of current asthma is common among the elderly, and active smoking may play an important role in the development of asthma and bronchial hyper-responsiveness among the elderly.
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  • 2
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Urticaria/angioedema is a common aspirin-induced allergy; however, its pathogenic mechanism is not understood.Objective In order to uncover the genetic mechanism, we studied the associations of the human leucocyte antigen (HLA) genotypes in patients with aspirin-induced urticaria compared with aspirin-intolerant asthma and normal control in a Korean population.Methods Ninety-four aspirin-induced urticaria patients presenting urticaria/angioedema-induced by both ASA and NSAID (50 had underlying chronic urticaria) and showing positive responses on oral aspirin challenge test, 76 aspirin-intolerant asthmatics with positive responses on lysine–aspirin bronchoprovocation test, and 185 normal healthy controls were enrolled. HLA-DRB1, DQB1, and DPB1 genotypings were performed by direct DNA sequencing analysis.Results The allele frequencies of HLA-DRB1*1302 (18.1%) and HLA-DQB1*0609 (10.1%) in aspirin-induced urticaria were significantly higher than in aspirin-intolerant asthma (5.3%, P=0.0004; 2.0%, P=0.0024) and in normal controls (8.1%, P=0.0005; 3.2%, P=0.0008), and they remained significant after correcting for multiple comparisons. The patients with these two HLA markers had a significantly younger age than patients without, while no associations were found in with respect to atopic status, a history of previous allergic diseases, total IgE level, or presence of underlying chronic urticaria (P〉0.05, respectively). In haplotype analysis, the HLA-DRB1*1302-DQB1*0609-DPB1*0201 was significantly higher in the aspirin-induced urticaria (8.0%) than in the aspirin-intolerant asthma (0.7%, P=0.0014) and normal controls (2.0%, P=0.0006).Conclusion These findings suggest that the HLA-DRB1*1302-DQB1*0609-DPB1*0201 may be a strong genetic marker to determine the aspirin-induced urticaria phenotype.
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  • 3
    ISSN: 0304-3991
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Electrical Engineering, Measurement and Control Technology , Natural Sciences in General , Physics
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  • 4
    ISSN: 0378-4371
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
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  • 5
    ISSN: 1433-0350
    Keywords: Key words Infant ; Spinal epidural abscess ; Anterior approach
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Spinal epidural abscess (SEA) is rare in children, especially in newborns and infants, groups in which only very few cases have been reported. Because of the nonspecificity of presenting symptoms in children the diagnosis may be delayed, resulting in major permanent neurological deficits. In this paper, we report a case of cervical SEA in a 6-week-old infant who initially presented with fever and developed quadriparesis 19 days prior to admission. After emergency anterior decompression of the abscess the neurological function was improved immediately. Five months after surgery the neurological status was normal, an MR study showing disappearance of the epidural abscess and spinal cord indentation, and progressive fusion of the C3, C4 and C5 vertebral bodies. Anterior decompression without bone graft can provide an excellent prognosis in case of an anterior cervical SEA in infants.
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  • 6
    ISSN: 1432-2218
    Keywords: Key words: Tumor localization — Laparoscopic surgery — Colon tumors — Rectal tumors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Because of the inability to palpate colonic tumors during laparoscopy, their location must be precisely identified before resection is undertaken. Method: A retrospective study was performed of 58 patients in order to be able to describe our methods of tumor localization for laparoscopic colorectal operations and to review their effectiveness. Results: In all patients, the entire colon was examined preoperatively by colonoscopy. In one patient, preoperative colonoscopic localization was inaccurate. In 31 patients, tumors were easily detectable at surgery. In five patients with the tumor in the right colon, even though the lesion was not detectable at surgery, right colectomy was performed without marking because preoperative colonoscopy reliably identified the lesion adjacent to the ileocecal valve. Twenty-two patients required some type of procedure to localize the tumor. The procedures and their problems were as follows: preoperative tattoo (five)—tattoo not visualized (one); intraoperative colonoscopy alone (six), combined with intraoperative tattoo (four) or clip (three)—poor operative exposure due to bowel distension (nine), hard to see the clip (three), dislodged clip (two), inadequate resection margin (one); intraoperative proctoscopy alone (two), combined with laparoscopic stitch (two)—no problems. In no patient was tumor present at a resection line and in no patient was the wrong segment resected. Conclusions: Reliable preoperative identification of the tumor adjacent to the ileocecal valve can permit right colectomy without marking. Lesions in the upper rectum can be approached via intraoperative proctoscopy ± suture placement. If the surgeon anticipates intraoperative localization may be difficult, lesions other than rectal or cecal ones should probably be marked by preoperative tattooing. Further studies regarding the technique of tattooing are warranted.
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  • 7
    ISSN: 1432-0509
    Keywords: Key words: Appendix—Mucocele—Tumor—US—CT.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Background: Mucocele of the appendix is a rare disease entity, but preoperative diagnosis is very important. With the advent of ultrasonography (US) and computed tomography (CT), it has been possible to preoperatively diagnose mucocele of the appendix. We describe the spectrum of US and CT findings of mucocele of the appendix and the differential points from mimicking diseases. Methods: We evaluated 17 patients with pathologically proven mucocele of the appendix by using US and CT. Pathologic diagnoses of 17 patients were mucinous cystadenoma in 11 patients, mucinous cystadenocarcinoma in two, and mucosal hyperplasia in four. We analyzed morphologic characteristics of mucocele of the appendix at US and CT. Results: The typical US finding were a cystic mass with variable internal echogenicity, layered wall, and calcification in the wall. The CT finding was a well-encapsulated cystic mass with a wall of variable thickness. Both cases with focal nodular solid enhancing portion in the wall on CT were pathologically proven as mucinous cystadenocarcinoma. Conclusion: US and CT were useful methods in diagnosing mucocele of the appendix and differentiating this condition from mimicking diseases. Nodular enhancing lesion in the wall of the mucocele may be a finding suggestive of malignant cause of mucocele.
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  • 8
    ISSN: 1432-0509
    Keywords: Key words: Contrast media—Computed tomography—Small bowel allergy.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report three cases of small bowel angioedema that showed circumferential wall thickening of the small bowel loops during infusion of iodinated contrast media. Follow-up small bowel series or computed tomography confirmed the normalized small bowel loops. When significant wall thickening of the long segment of the small bowel during infusion of contrast media is seen, radiologists should consider the possibility of isolated small bowel angioedema in spite of its rarity.
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  • 9
    ISSN: 1432-0509
    Keywords: Key words: Liver, infection—Liver, US—Liver, CT—Liver, MRI—Parasites.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of necrotic granuloma of the liver by human fascioliasis. The lesion showed unusual findings at sonography, computed tomography, and magnetic resonance imaging that have not been reported previously.
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  • 10
    ISSN: 1432-0509
    Keywords: Key words: Liver neoplasms—Biopsies, percutaneous—Biopsies, complications—Computed tomography.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Needle-tract implantation is an important complication of cutting biopsy of hepatocellular carcinoma (HCC). This study was performed to evaluate the frequency of needle-tract implantation after ultrasound (US)-guided percutaneous biopsy of HCC and to describe triple-phase helical computed tomographic (CT) findings of implanted nodules. Methods: Between April 1994 and December 1997, 205 patients underwent US-guided percutaneous biopsy for HCC. Review of medical records and the pathology database disclosed seven patients who were found to have needle-tract implantation of HCC. Among these patients, five underwent triple-phase helical CT examination. We analyzed the frequency of needle-tract implantation and triple-phase helical CT findings of implanted nodules, with particular attention to the morphology and enhancement pattern. Results: Seven of 205 patients (3.4%) had tumor implantation along the needle tract at histologic examination after surgical resection. Eight implanted nodules in five patients were found on triple-phase helical CT images (one nodule in three patients, two nodules in one patient, and three nodules in one patient). All implanted nodules has well-circumscribed margins and were ovoid or lobulated in contour. On triple-phase helical CT, six (75%) implanted nodules were isodense compared with abdominal wall muscle on all triple-phase CTs, and two (25%) nodules were hyperdense on hepatic arterial and portal venous phases and isodense on equilibrium phase. Conclusions: The frequency of needle-tract implantation of HCC after percutaneous needle biopsy was higher than reported previously, and careful attention should be paid during interpretation of CT images in patients with a history of previous percutaneous biopsy.
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