No abstract available.
Carcinoma, Hepatocellular* ; Diagnosis*

The lateral margin of the psoas muscle, contrasted by retroperitoneal fat, is usually visualized o plainabdominal radiography. Failure to visualize all or segment of lateral margin of the psoas muscle, so called psoassing, has been emphasized as reliable finding of retroperitoneal pathology. But the significance of psoas sign hasbeen controversial. The authors reevaluated ‘psoas sign’ by comparing 160 abdominal radiography with CT. Theresults were as follows: 1. In 160 supine radiographys, good visualization was present in 106 cases(66.3%), faintvisualizatin in 24(15.0%), segmental nonvisualization in 18(11.3%), and completer nonvisualization in 12(7.5%). In113 erect radiographs, good visualization was present in only 36 cases(31.9%). 2. Asymmetric visualization waspresent in 84 out of 160 cases. In patient with scoliosis, lateral margin of convex side was seen more clearlythan concave side, and this finding was statistically significant (p<0.005). 3. Ascites did not directly influenceto psoa visualization contrary to common belief. 4. In 54 cases of faint or nonvisualization, normal was16(29.6%), intraperitoneal pathology was 16(29.6%), and retroperitoneal pathology was 22(40.7%). 1) In normalpatient, psoas contact with kidney or intestine and deformed psoas muscle were responsible for poor visualization. 2) The major cause of poor visualization in intraperitoneal pathology were psoas contact with displaced kidney byhepatomegaly, ascites with scanty retroperitoneal fat and derformed psaos muscle. 3) The major cause of poorvisualization in retroperitoneal pathology were psoas invasion by tumor or inflammation, psoas conntact withenlarged kidney or perirenal lesion. 5. In summary, the mechanism of faint or nonvisualization of psoas marginwere: 1) psoas contact with normal or pathologic organs 2) psoas invasion by tumor or inflammation 3) deformedpsoas muscle 4) scanty retroperitoneal fat
Ascites ; Humans ; Inflammation ; Intestines ; Intra-Abdominal Fat ; Kidney ; Pathology ; Psoas Muscles ; Radiography ; Radiography, Abdominal ; Scoliosis

PURPOSE: We studied a clinical analysis of pediatric patients who visited the emergency medical center of Yeungnam University Hospital to compare the characteristics of pediatric emergency patients after year 2000 with the previous studies. METHODS: We reviewed 7, 034 children under the age of 15 years who visited the emergency medical center of Yeungnam University Hospital during the 2 year period from January 2001 to December 2002, and then we performed a clinical and statistical analysis. We analyzed the pediatric patients according to gender, age, season, day of the week, time of the visit, the disease classification and the final disposition of the patients. RESULTS: Among the patients who visited the emergency room, 15.6% of the total emergency patients were under the age of 15. The male to female ratio was 1.6: 1. Among the 7, 034 pediatric patients, the most common age group was between 1 year and under 3 years of age (26.9%). The peak seasonal incidence was early summer and spring, especially during June (11.2%) and May (10.6 %). The peak incidence day of the week was Sunday (24.8%) and the peak time when the emergency pediatric patients visited the emergency room was between 20 and 24 o'clock (28.8%). The distribution of diseases, according to ICD-10 system, were injury and poisoning (30.4%), diseases of the respiratory system (22.8%), and diseases of the digestive system (14.6%). 30% of total pediatric patients were admitted to the hospital. CONCLUSION: After year 2000, as compared with the previous studies, the proportions of emergency pediatric patients has decreased. The distribution of diseases was not much different from the previous studies and the proportions of non-urgent diseases, such as acute nasopharyngitis or acute gastroenteritis, were still high. These result have come about due to the declining birth rate and changes of the medical system in Korea.
Birth Rate ; Child ; Classification ; Digestive System ; Emergencies* ; Emergency Service, Hospital ; Female ; Gastroenteritis ; Humans ; Incidence ; International Classification of Diseases ; Korea ; Male ; Nasopharyngitis ; Poisoning ; Respiratory System ; Seasons

No abstract available.
Behcet Syndrome* ; Renal Insufficiency*

Ghrelin is a newly discovered peptide, which is released from the stomach and neurons in the hypothalamic arcuate nucleus (ARC), and potently stimulates growth hormone release and food intake. In the present study, we investigated the effect of ghrelin on [Ca2+]i in thyroid FRTL-5 cells. Ghrelin (5 nM) increased [Ca2+]i and TSH (1 unit/l) had an additive effect on [Ca2+]i when extracellular normal solution was 1.1mM Ca2+ containing Coon's modified Ham's F12 medium. When Ca2+-free medium containing 2 mM EGTA replaced the above normal solution, ghrelin also induced a similar rise in [Ca2+]i. In the middle of [Ca2+]i increment by ghrelin, nifedipine (1 micrometer), nickel (100micrometer) and La3+ (100micrometer) had no effect on [Ca2+]i. After endoplasmic reticulum was depleted by cyclopiazonic acid (CPA; 10micrometer), ghrelin caused no visible change on [Ca2+]i in Ca2+-free/2 mM EGTA solution. These results suggest that ghrelin can increase [Ca2+]i through endoplasmic reticulum in thyroid FRTL-5 cells.
Arcuate Nucleus ; Eating ; Egtazic Acid ; Endoplasmic Reticulum ; Ghrelin* ; Growth Hormone ; Neurons ; Nickel ; Nifedipine ; Stomach ; Thyroid Gland*

OBJECTIVE: This study was conducted to evaluate scorecards for early recognition of high-risk patients of delirium in the emergency department (ED). METHODS: Data from 399 consecutive patients aged 65 years or older between January 1, 2015 and December 31, 2015 were retrospectively analyzed. Delirium was identified by reviewing medical records and was confirmed by a psychiatrist. The study population was divided into a training and validation group. Predisposing factors were evaluated and validated by multivariate logistic regression analysis and a calibration plot, after which a scorecard was constructed using these factors and applying points to double odds to each regression coefficient. RESULTS: Dementia, transfer from a long-term care facility, acute acid-base imbalance, moderate pain, and stroke were independent predisposing factors for delirium in ED, with assigned scores in the scorecard of 3, 2, 2, 2, and 2, respectively. The total score of the scorecard for delirious patients was significantly higher than that for non-delirious patients in both the training and validation groups. The coefficient of determination (R²) of the calibration plot was 0.74 and 0.68 in the training and validation group, respectively. In the receiver operation characteristic curve, the cut-off point of the scorecard for delirium was 2.5 and the sensitivity, specificity, and accuracy were 75.0%, 87.8%, and 86.7% in training group, while they were 76.9%, 85.1%, and 84.2% in the validation group, respectively. CONCLUSION: The scorecard was a useful screening tool for early recognition of patients with a high-risk of developing delirium in the ED.
Acid-Base Imbalance ; Calibration ; Causality ; Delirium ; Dementia ; Emergencies ; Emergency Service, Hospital ; Humans ; Logistic Models ; Long-Term Care ; Mass Screening ; Medical Records ; Psychiatry ; Retrospective Studies ; Sensitivity and Specificity ; Stroke

Ganglioneuroma of the gastrointestinal tract is a rare tumor that consists of ganglion cells, nerve fibers, and supporting cells of the enteric nervous system. Ganglioneuromas are usually associated with genetic disorders such as the multiple endocrine neoplasia syndrome or neurofibromatosis. Ganglioneuromas of the gastrointestinal tract predominantly involve the colon and rectum, and reports about duodenal ganglioneuromas are few. Herein, we report a case of duodenal ganglioneuroma treated with endoscopic resection. A 56-year-old female patient visited our hospital because of a subepithelial tumor in the second portion of the duodenum. She had no remarkable medical or family history and revealed no history of genetic disorders. Endoscopic ultrasonography and abdominal computed tomography revealed a tumor located mainly in the submucosal layer, without any regional lymph node involvement. Endoscopic resection of the lesion was performed, and the pathological examination confirmed a duodenal ganglioneuroma.
Colon ; Duodenum ; Endosonography ; Enteric Nervous System ; Female ; Ganglion Cysts ; Ganglioneuroma ; Gastrointestinal Tract ; Humans ; Lymph Nodes ; Middle Aged ; Multiple Endocrine Neoplasia ; Neurofibromatoses ; Neurons ; Rectum

BACKGROUND: Neuropsychiatric systemic lupus erythematosus (NPSLE) shows some similarities to neuroBehcet's disease (NBD) in that both conditions have some analogous clinical features and they are both pathologically associated cerebral vasculopathy. This study compared the clinical manifestations, brain MRI findings and prognosis of NPSLE and NBD patients. METHODS: Forty three patients with NPSLE (n = 25) or NBD (n = 18), who were monitored at a single center, were enrolled in this study. We retrospectively analyzed the clinical and brain MRI data. The neuropsychiatric manifestations were classified in both groups according to the new American College of Rheumatology nomenclature for NPSLE. RESULTS: The diffuse symptoms that included mood disorders, psychosis, confusion, cognitive dysfunctions, generalized seizures and headaches other than migraine or cluster headaches were more commonly observed in the NPSLE patients, while the frequency of focal diseases such as cranial neuropathy tended to be higher in the NBD patients. The brain MRI revealed that the NBD patients had more abnormalities in the brain stem than did the NPSLE patients. Most of the patients improved, at least partially, after being treated with glucocorticoid and/or immune suppressants. However, the disease course differed significantly between the two groups. There were more episodic cases in the NPSLE group of patients, while there were more remittent cases in the NBD group of patients. CONCLUSION: NPSLE had a tendency to cause diffuse neuropsychiatric manifestations, and it has a different predilection of brain lesions compared with NBD. The NBD patients showed a poorer outcome than did the NPSLE patients, suggesting that different therapeutic strategies for the two diseases need to be considered.
Adult ; Behcet Syndrome/complications/*diagnosis/pathology ; Brain/*pathology ; Female ; Humans ; Lupus Erythematosus, Systemic/complications/diagnosis/pathology ; Lupus Vasculitis, Central Nervous System/complications/*diagnosis/pathology ; *Magnetic Resonance Imaging ; Male ; Prognosis ; Retrospective Studies ; Risk Factors

The association of nephrotic syndrome with a hypercoagulable state and vascular thrombosis is well recognized. In all adult series of nephrotics, venous thrombosis are much more common than arterial thrombosis, which has been mainly reported in children. Intracoronary thrombus is among the rarest arterial thromboses. We present a case of acute myocardial infarction in a 39-year-old women with nephrotic syndrome secondary to membranous glomeluronephritis, in which subsequent coronary angiography showed no evidence of atherosclerotic change and thrombotic occlusion in the left main coronary artery which was successfully treated with intracoronary stent and intravenous abciximab.
Adult ; Child ; Coronary Angiography ; Coronary Vessels ; Female ; Glomerulonephritis, Membranous* ; Humans ; Myocardial Infarction ; Nephrotic Syndrome ; Stents* ; Thrombosis* ; Venous Thrombosis

Bovine coronavirus (BCoV) is a causative agent of entero-pathogenic diarrhea in young calves and winter dysentery (WD) in adult cattle. In this study, we conducted a nationwide sero-epidemiological survey of BCoV infection in Korea. In total, 3,029 bovine sera collected between October and December 2005 were screened for the presence of antibodies against BCoV using a hemagglutination inhibition (HI) test. Half (50.0%) of individual cattle tested were positive for BCoV. The regional distribution of the seroprevalence of positive HI antibodies was 55.7% (234/420) in Gyeonggi, 53.0% (316/596) in Jeonra, 51.9% (374/720) in Chungcheong, 48.5% (401/827) in Gyeongsang, 43.9% (79/180) in Jeju, and 38.1% (109/286) in Gangwon Province. Analyzing the distribution of HI titer according to the age of the cattle showed the highest BCoV seropositive rate in 5-year-old cattle, and the incidence of cattle with an HI antibody titer of 1:160 or above was 12.1%.
Adult ; Animals ; Antibodies ; Cattle ; Child, Preschool ; Coronavirus, Bovine* ; Diarrhea ; Dysentery ; Gangwon-do ; Gyeonggi-do ; Hemagglutination ; Humans ; Incidence ; Korea* ; Seroepidemiologic Studies