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Sepsis and Meningitis due to Listeria Monocytogenes
Orhan Yildiz,Bilgehan Aygen,Duygu Esel,Uner Kayabas,Emine Alp,Bulent Sumerkan,Mehmet Doganay 연세대학교의과대학 2007 Yonsei medical journal Vol.48 No.3
Purpose: This study focused on the effect of immuno-compromising conditions on the clinical presentation of severe listerial infection. Patients and Methods: Nine human listeriosis cases seen from 1991-2002 were reviewed. All adult patients, from whose blood, peritoneal fluid or cerebrospinal fluid (CSF) the L. monocytogenes was isolated, were included in this retrospective study. Results: Listeriosis presented as primary sepsis with positive blood cultures in 5 cases and meningitis with positive CSF cultures in 4 cases. All of these patients had at least one underlying disease, most commonly, hematologic malignancy, diabetes mellitus, amyloidosis and hepatic cirrhosis; 55.6% had received immunosuppressive or corticosteroid therapy within a week before the onset of listeriosis. The patients were adults with a mean age of 60 years. Fever, night sweats, chills and lethargy were the most common symptoms; high temperature (>38℃), tachycardia, meningeal signs and poor conditions in general were the most common findings on admission. The mortality rate was 33.3% and was strictly associated with the severity of the underlying disease. Mortality differences were significant between sepsis (20%) and meningitis (50%) patients. Conclusion: Listeriosis as an uncommon infection in our region and that immuno- suppressive therapy is an important pre-disposing factor of listeriosis. Sepsis and meningitis were more common in this group of patients and had the highest case-fatality rate for food-borne illnesses.
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Aysegul Oz,Figen Basaran Demirkazik,Meltem Gulsun Akpinar,Isıl Soygur,Atac Baykal,Sevgen Celik Onder,Aysegul Uner 한국유방암학회 2012 Journal of breast cancer Vol.15 No.2
Purpose: We performed this study to detect preoperative axillary metastases with ultrasound (US)-guided fine needle aspiration biopsy (FNAB), to eliminate the need for time-consuming and costly sentinel lymph node (SLN) scintigraphy and biopsy steps in the treatment of breast cancer patients, and in that of with suspicious US findings, and to evaluate the accuracy of preoperative US-guided FNAB for patients with suspicious lymph node metastases on US. Methods: Patients with a suspicious breast lump or histopathologically proven breast cancer underwent breast-axillary US. Increase in lymph node size, cortical thickening, non-hilar cortical flow, and hilar changes were evaluated with gray scale-color Doppler US. FNAB was performed if US results were suspicious for malignancy. Results: Thirty-eight axillary lymph nodes (ALN) underwent FNAB. ALN dissection, SLN scintigraphy, and biopsy steps were bypassed in 23 axillas with positive ALN FNAB (60.5%). The sensitivity of ALN FNAB was 88.46%; specificity and positive predictive value were 100%; and negative predictive value was 66.6% (inadequate cytology included; 76.7%, 100%, 100%, 53.3%, respectively). Asymmetrical cortical thickening, non-hilar cortical flow, and increase in hypoechogenity were only detected in metastatic nodes. Cortical thickening, and lymph node and breast mass size was higher in the metastatic group. Conclusion: By performing FNAB on suspicious lymph nodes, the routine, high-cost SLN scintigraphy and intraoperative gamma probe steps may be skipped, and axilla dissection can be performed directly. This leads to the elimination of the need for SLN investigation in more than half of the patients. The assessment of ALN metastases with preoperative US-guided FNAB is a cost-effective method with high specificity, that eliminates the need for costly and time-consuming SLN scintigraphy and biopsy steps, and helps in preoperative staging.
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Beyond the Arms Embargo: EU Transfers of Defense and Dual-Use Technologies to China
Oliver Bräuner 동아시아연구원 2013 Journal of East Asian Studies Vol.13 No.3
China has largely been cut off from direct transfers of military systems and technologies since the announcement of the EU arms embargo in 1989. Nevertheless, the EU and its member states remain a major source of high technologies for China, namely, by means of trade, investment, and scientific cooperation. This is mainly because the EU-China relationship continues to be dominated by the economic interests of individual member states, both in trade and increasingly in investments. Furthermore, due to a lack of direct security interests in the Asia-Pacific, Europeans do not generally see China as a security threat or a strategic competitor. Therefore, the EU has so far failed to develop a strategic approach toward the potential security implications of transfers of European militarily sensitive technologies that goes beyond the existing arms embargo and currently lacks effective mechanisms to control the flow of such technologies to China.
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