OBJECTIVE: This study is undertaken to review the characteristics, risk factors and the surgical outcomes in long term follow-up of brain abscesses. METHODS: We had reviewed medical records and radiological findings in patients with brain abscess who underwent operations in our hospital from January 1992 to June 2003. RESULTS: Observed 11 cases were comprised of 8 men and 3 women with 42 years old average age ranging from 17 to 66. Lesions were located at frontal lobe in 5 cases, parietal in 4 cases, temporal in 1 case, and occipital in 1 case. The mean follow-up period was 23.8 months and ranged from 5 to 33 months. The microbial sources of infection had been found in 5 cases (45%). The organisms were identified by using the microbial culture obtained from the excisional biopsy. We had applied all cases with surgical excision. Empirical antibiotic treatment started soon after diagnosis in all cases. The mortality and morbidity of surgical excision were low. Nine patients were neurologically improved. One patient had died after the operation due to acute respiratory distress syndrome (ARDS). CONCLUSION: The single and large abscess located in an accessible lesion is a good candidate for surgical excision because of it's low morbidity, mortality, and favorable outcome after surgical excision. Further study is required to compare the surgical excision with other treatment modalities of brain abscess.
Abscess ; Adult ; Anti-Bacterial Agents ; Biopsy ; Brain Abscess* ; Brain* ; Diagnosis ; Female ; Follow-Up Studies ; Frontal Lobe ; Humans ; Male ; Medical Records ; Mortality ; Rabeprazole ; Respiratory Distress Syndrome, Adult ; Risk Factors

PURPOSE: To evaluate the precipitating factors of amputation as initial treatment in diabetic foot patients. MATERIALS AND METHODS: Between March, 1994 and February 2003, 41 cases (37 patients) diabetic foot patients who had diabetic ulcer, pyogenic inflammation and gangrene and followed up over 1 year were collected. Among them, We evaluate the precipitating factors of amputation for average 39.6months (12-118months). RESULTS: Among many factors, Wagner classification, pulse volume recording of toes, Ankle-Brachial Index and Albumin level are statistically significant in amputation patients. CONCLUSION: In determining the amputation of diabetic foot as initial treatment, the trauma history, circulation of foot and serum albumin level are important precipitating factors. So the education about preventing even minor trauma and maintaining good nutrition state decrease the amputation rate in diabetic foot patients.
Amputation* ; Ankle Brachial Index ; Classification ; Diabetic Foot* ; Education ; Foot ; Gangrene ; Humans ; Inflammation ; Precipitating Factors* ; Serum Albumin ; Toes ; Ulcer

PURPOSE: To evaluate the precipitating factors of amputation as initial treatment in diabetic foot patients. MATERIALS AND METHODS: Between March, 1994 and February 2003, 41 cases (37 patients) diabetic foot patients who had diabetic ulcer, pyogenic inflammation and gangrene and followed up over 1 year were collected. Among them, We evaluate the precipitating factors of amputation for average 39.6months (12-118months). RESULTS: Among many factors, Wagner classification, pulse volume recording of toes, Ankle-Brachial Index and Albumin level are statistically significant in amputation patients. CONCLUSION: In determining the amputation of diabetic foot as initial treatment, the trauma history, circulation of foot and serum albumin level are important precipitating factors. So the education about preventing even minor trauma and maintaining good nutrition state decrease the amputation rate in diabetic foot patients.
Amputation* ; Ankle Brachial Index ; Classification ; Diabetic Foot* ; Education ; Foot ; Gangrene ; Humans ; Inflammation ; Precipitating Factors* ; Serum Albumin ; Toes ; Ulcer

The aim of this study is to determine whether full-mouth disinfection therapy(FMT) in our clinical setting would show better improvement of clinical parameters than partial mouth disinfection therapy(PMT) in chronic periodontitis and aggressive periodontitis patients. Among 12 patients, 6 were treated FMT and other 6 were treated PMT. Clinical parameters were calculated 3 months and 6 months after initial therapy. 1. There were no statistically significant differences between FMT and PMT in the reduction rate of bleeding on probing after 3 months, 6 months 2. Initial probing depth was 4-6mm, the mean probing depth after 3 months was 2.2mm vs 2.5mm(FMT vs PMT), after 6 months was 2.4mm vs 2.8mm. This was significantly lower in the FMT groups. 3. Initial probing depth was > or = 7mm, the reduction rate of mean probing depth during first 3 months was 4.8mm vs 4.1mm(FMT vs PMT), and 3 to 6 months was 0.5mm vs 0.3mm. This was significantly larger in the FMT groups. 4. Initial probing depth was 4-6mm, the mean clinical attachment level after 3 months was 2.3mm vs 2.7mm(FMT vs PMT), after 6 months was 2.7mm vs 3.0mm. This was significantly lower in the FMT groups. 5. Initial probing depth was > or = 7mm, the reduction rate of mean probing depth during first 3 months was 4.0mm vs 3.0mm(FMT vs PMT), and 3 to 6 months was 0mm vs -0.1mm. This was significantly larger in the FMT groups. Although the results provided us with succeccful clinical improvement in aggressive periodontitis, further research is needed to prove its additional benefit in the treatment of chronic periodontitis

The aim of this study is to determine whether full-mouth disinfection therapy(FMT) in our clinical setting would show better improvement of clinical parameters than partial mouth disinfection therapy(PMT) in chronic periodontitis and aggressive periodontitis patients. Among 12 patients, 6 were treated FMT and other 6 were treated PMT. Clinical parameters were calculated 3 months and 6 months after initial therapy. 1. There were no statistically significant differences between FMT and PMT in the reduction rate of bleeding on probing after 3 months, 6 months 2. Initial probing depth was 4-6mm, the mean probing depth after 3 months was 2.2mm vs 2.5mm(FMT vs PMT), after 6 months was 2.4mm vs 2.8mm. This was significantly lower in the FMT groups. 3. Initial probing depth was > or = 7mm, the reduction rate of mean probing depth during first 3 months was 4.8mm vs 4.1mm(FMT vs PMT), and 3 to 6 months was 0.5mm vs 0.3mm. This was significantly larger in the FMT groups. 4. Initial probing depth was 4-6mm, the mean clinical attachment level after 3 months was 2.3mm vs 2.7mm(FMT vs PMT), after 6 months was 2.7mm vs 3.0mm. This was significantly lower in the FMT groups. 5. Initial probing depth was > or = 7mm, the reduction rate of mean probing depth during first 3 months was 4.0mm vs 3.0mm(FMT vs PMT), and 3 to 6 months was 0mm vs -0.1mm. This was significantly larger in the FMT groups. Although the results provided us with succeccful clinical improvement in aggressive periodontitis, further research is needed to prove its additional benefit in the treatment of chronic periodontitis

We report on an unusual case with infiltrating extradural spinal angiolipoma. Most spinal angiolipomas involve the thoracic spine and infiltrating ones are also located mainly at the thoracic levels rather than lumbar lesion. In particular, there are few cases of lumbar extradural infiltrating type spinal angiolipoma. One case is that of a 52-year-old female with infiltrating extradural spinal angiolipoma involving lumbar 4 (L4) vertebra, who underwent a L4-5 laminectomy and surgical removal of the tumor. We achieved satisfactory results with surgical treatment of the patient. Spinal angiolipoma has a benign course with a good postoperative outcome.
Angiolipoma* ; Female ; Humans ; Laminectomy ; Middle Aged ; Spine*

Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis owing to its desmoplastic stroma. Therefore, therapeutic strategies targeting this tumor stroma should be developed. In this study, we describe the heterogeneity of cancer-associated fibroblasts (CAFs) and their diverse roles in the progression, immune evasion, and resistance to treatment of PDAC. We subclassified the spatial distribution and functional activity of CAFs to highlight their effects on prognosis and drug delivery. Extracellular matrix components such as collagen and hyaluronan are described for their roles in tumor behavior and treatment outcomes, implying their potential as therapeutic targets. We also discussed the roles of extracellular matrix (ECM) including matrix metalloproteinases and tissue inhibitors in PDAC progression. Finally, we explored the role of the adaptive and innate immune systems in shaping the PDAC microenvironment and potential therapeutic strategies, with a focus on immune cell subsets, cytokines, and immunosuppressive mechanisms. These insights provide a comprehensive understanding of PDAC and pave the way for the development of prognostic markers and therapeutic interventions.

PURPOSE: While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. METHODS: All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. RESULTS: There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/ bed). CONCLUSION: Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.
Asthma ; Bronchiolitis ; Child ; Day Care, Medical ; Developed Countries ; Diagnosis ; Emergency Service, Hospital ; Epilepsy ; Gastroenteritis ; Humans ; Inpatients ; Korea* ; Length of Stay ; Medical Records ; Otitis Media ; Outpatients ; Pediatrics ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Seizures, Febrile

Few cases of macrophage activation syndrome (MAS) or reactive hemophagocytic lymphohistiocytosis (HLH) during the acute febrile phase of Kawasaki disease (KD) have been reported. We report on a case of a 19 month-old girl with MAS or reactive HLH during the course of KD. Despite immunoglobulin and steroid therapy, she showed persistent fever with hepatosplenomegaly and evidence of hemophagocytosis in the bone marrow. A high index of suspicion for clinical features associated with MAS is necessary for KD patients in order to provide appropriate treatment.
Bone Marrow ; Fever ; Humans ; Immunoglobulins ; Lymphohistiocytosis, Hemophagocytic ; Macrophage Activation ; Macrophage Activation Syndrome ; Macrophages ; Mucocutaneous Lymph Node Syndrome ; Organic Chemicals

PURPOSE: To date, it has been impossible to relate the occurrence of ventricular arrhythmia to survival in hyperkalemia. QT dispersion is thought to reflect the inhomogeneity of ventricular repolarization and to be related to ventricular-arrhythmia-induced sudden cardiac death in various medical conditions. Therefore, the purpose of this study was to investigate to use QT dispersion as a prognostic marker in hyperkalemia and to suggest treatment guidelines for hyperkalemia by analyzing the correlations between the QT dispersion on the initial ECG and the treatment outcomes. METHODS: This study's population was comprised of 104 patients with serum potassium concentrations > or =5.5 mEq/L, who were divided into 2 groups; group 1 was the survival group (n=81), group 2 was the death group (n=23). We reviewed retrospectively the underlying diseases, electrolytes, treatment outcomes and the clinical and ECG findings during the initial and the recovery states. The QT interval for each lead was measured manually on an enlarged (X1.5) ECG. The QT interval was measured from the first deflection of the QRS complex to the point of the T wave offset, and the corrected QT interval was obtained by using B a z e t t's formula. The QT dispersion and the corrected QT dispersion were defined as the differences between the minimal and the maximal QT values and between the corresponding corrected QT values for each of the 12 leads, respectively. RESULTS: The treatment outcomes were not related to the initial serum potassium and the hourly serum potassium change rates. For hyperkalemia > or =7.0 mEq/L, the death group had significantly larger QT dispersion than the survival group (death group = 95.6+/-15.4 msec, survival group = 51.8+/-17.5 msec, p<0.01). However, the QT dispersions of the two groups were not different for serum potassium levels <7.0 mEq/L. For hyperkalemia > or =7.0mEq/L, QT dispersion above 65 msec had a 93.8% sensitivity, a 79.4% specificity, and a 68.2% positive predictive value for death. CONCLUSION: For hyperkalemia > or =7.0 mEq/L, QT dispersion above 65 msec should be considered to be a prognostic marker for prediction of the treatment outcome.
Arrhythmias, Cardiac ; Death, Sudden, Cardiac ; Electrocardiography ; Electrolytes ; Humans ; Hyperkalemia* ; Potassium ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Treatment Outcome