External ventricular drainage (EVD) is a common procedure performed in neurosurgical field. The purpose of this study was to introduce the linear intracranial calcification formed along EVD tract and to investigate its incidence, predisposing factors, and clinical impact. A total of 59 patients who underwent EVD insertion over a 1-year period were included in this study. The clinical factors and radiographic features between the occurrence and the non-occurrence groups were analyzed to investigate the predisposing factors and clinical impact related to the linear intracranial calcification in EVD tract. The linear intracranial calcification following EVD insertion occurred in 7 patients (11.9%). Among various risk factors assessed, only usage of bone dust (p =0.003) had contributed to linear intracranial calcification with statistical significance in univariate logistic regression analysis. Housefield unit (HU) scale was different between calcification (872.57 ± 46.15 HU) and EVD catheter (169.00 ± 61.35 HU). This study indicates that using bone dust for sealing a burr hole is the only predisposing factor for linear intracranial calcification formed in EVD tract.
Catheters ; Causality* ; Drainage* ; Dust ; Humans ; Incidence ; Logistic Models ; Risk Factors

To evaluate the predisposing factors and characteristics of the steinstrasse after ESWL and to suggest the proper management of it, we analyzed 1,144 urolithiasis patients who were managed by ESWL with the second generation lithotripter, Siemens Lithostar, at Seoul National University Hospital from March 1989 to October 1995. Steinstrasse developed in 72 patients with the incidence of 6.3% after ESWL. As the risk factor for developing steinstrasse after ESWL, stone size and volume significantly influenced the development of steinstrasse (p<0.01, by student t-test), and multiple stones induced steinstrasse more frequently than single stones (p<0.05, by chi-square test). Stones located at renal pelvis induced more steinstrasse after ESWL than calyceal stones or ureter stones t<0.05, by chi-square test). Clinically, 61.1% of the patients who developed steinstrasse didn't have any symptoms or upper tract changes. Nineteen steinstrasse (26.4%) were resolved spontaneously without any intervention, with the median duration of 12 days after detection of the steinstrasse. In 51 steinstrasse which was not resolved spontaneously or with severe symptoms, ESWL was performed resulting in successful resolution in 94.1% of the patients. These results suggest that expectancy could be the first line strategy of the management of steinstrasse, and repeated ESWL could be recommended for patients refractory to expectancy and patients with severe symptoms.
Causality ; Humans ; Incidence ; Kidney Pelvis ; Risk Factors ; Seoul ; Ureter ; Urolithiasis

We expirenced multiple hepatocellular adenomatosis, which was proved by pathology, in 38 years old man who had no prior history of predisposing factors. The radiologic findings were different by the size of tumor mass and intratumoral hemorrhage. Ultrasound demonstrated inhomogeneous hyperechoic large mass in segment 5 of right lobe and hyperechoic or isoechoic multiple small nodules in right lobe. Computed tomography demonstrated low density mass without contrast enhacement. Central high density is noted in hemorrhagic portion. Magnetic resonance T1-weighted image demonstrated high signal intensity in mass and hemorrhagic portion. T2-weighted image demonstrated slightly high signal intensity in mass portion, high signal intensity in hemorrhagic portionand double-layered peripheral rim. Gradient echo image well demonstrated inhomogenesity of mass.
Causality ; Hemorrhage ; Pathology ; Ultrasonography

Diarrhea ; Cities ; Epidemiologic Causality

BACKGROUND: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. MATERIAL AND METHOD: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. RESULT: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients (80%), dyspnea in 5 patients (33%), and throat discomfort in 4 patients (26%). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients (77%). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients (100%) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. CONCLUSION: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them (77%) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.
Adult ; Asthma ; Bronchoscopy ; Causality ; Chest Pain ; Dyspnea ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Mediastinal Emphysema* ; Mediastinum ; Pharynx ; Precipitating Factors ; Radiography ; Recurrence ; Retrospective Studies ; Subcutaneous Emphysema ; Thorax ; Tomography, X-Ray Computed ; Vomiting ; Young Adult

No abstract available.
Arthritis, Rheumatoid* ; Causality* ; Humans ; Methotrexate*

No abstract available.
Causality* ; Humans ; Infant, Newborn* ; Pneumothorax*

Estimating the actual real-world effectiveness of the vaccine is an essential part of the post-marketing evaluation. This regression discontinuity design (RDD) using observational data is designed to quantify the effect of an intervention when eligibility for the intervention is based on a defined cutoff as age, making it suited to estimate vaccine effects. This approach can avoid the high cost and ethical issues; overcome difficulties in the organization and practice process in randomized controlled trials, which leads to a higher level of causal inference evidence and more realistic results. Here, we describe key features of RDD in general, and then specific scenarios, with examples, to illustrate that RDD are an essential tool for advancing our understanding of vaccine effects.
Causality ; Humans ; Vaccine Efficacy ; Vaccines

Candida arthritis is a rare joint infection. Its predisposing factors include prosthetic joint, intraarticular injection of corticosteroid and immunosuppression. Clinical diagnosis may be difficult because of the absence of specific signs and symptoms. Hence the presence of Candida species in synovial fluid should never be interpreted as laboratory contamination in patients with a risk factor, and therapy should be initiated promptly. We experienced a case of Candida arithritis secondary to repeated intraarticular corticosteroid injection in chronic tophaceous gout. We report the case with review of relevant literature.
Arthritis* ; Candida* ; Causality ; Diagnosis ; Gout* ; Humans ; Immunosuppression ; Injections, Intra-Articular ; Joints ; Risk Factors ; Synovial Fluid

Chronic subdural hematoma (CSDH), which rarely happens in the young, is thought to be a disease of the elderly. Whereas unspecific symptoms and insidious onset in juveniles and young adults, as a result of its relative low morbidity, CSDH is usually neglected even undertreated in the young. Through the three cases and review of the current literature on this subject, we tried to illustrate the clinical and etiopathological characteristics of this entity and find out the most appropriate treatment strategy. We report three young CSDH patients with different but similar symptoms. The present histories, tests and examinations revealed different predisposing factors accounting for the genesis of CSDH. Their preoperative symptoms were all resolved with burr hole and drainage operation. Juveniles and young adults suffering from CSDH differ from that of their elderly counterparts in their clinical and etiopathological characteristics. Although trauma is the most important risk factor in young and old CSDH patients, some other predisposing factors may exist. Burr hole and drainage surgery could resolve the problem most of the time. But further tests and examinations even specific management should be made in some cases.
Aged ; Causality ; Drainage ; Hematoma, Subdural, Chronic* ; Humans ; Intracranial Hypotension ; Risk Factors ; Young Adult