Tuberculous spondylitis is not rare disease. Today the posterior instrumentation and posterior or posterolateral fusion concomitant with the anterior decompression and anterior interbody fusion have been used for the treatment of spinal tuberculosis. The authors experienced a case of tuberculous spondylitis complicated with descending aortic pseudoaneurysm. An aneurysm is defined as a localized dilatation of an artery that is at least one-half the size greater than is expected for that artery. Pseudoaneurysm occurring after previous operation, trauma, and infection. Erosion of the thoracic aorta with the development of an fistula in the presence of infection is an unusual and difficult problem to manage. We report a case and review related articles briefly.
Aneurysm ; Aneurysm, False* ; Aorta, Thoracic ; Arteries ; Decompression ; Dilatation ; Fistula ; Rare Diseases ; Spondylitis* ; Tuberculosis, Spinal

PURPOSE: The residual intrahepatic stones with biliary strictures are difficult to remove percutaneously via T-tube tract after surgery in patients with recurrent pyogenic cholangitis. We evaluated the effectiveness of percutaneous balloon dilatation of benign biliary strictures. MATERIALS AND METHODS: The balloon dilatations with 6-12mm angioplasty balloon catheter and stone extractions were performed via a T-tube tract after surgical treatment in 15 patients with recurrent pyogenic cholangitis. The balloons were inflated for 3-4minutes under 5 atm. until disappearance of waist of the stricture site, from one to seven session. After balloon dilatation, residual stones were extracted with saline irrigation or stone basket. RESULTS: Among total 42 strictures, the balloon dilatation was succesful in 27 strictures(64.3%), partially successful in 12 strictures(28.6%), and failed in three strictures(7.1%). Single or central biliary strictures were dilated easily rather than multiple ductal strictures. Of 26 sites with residual intrahepatic stones, stone extraction was complete in 17 sites(65.4%), incomplete in seven sites(26.9%) due to impacted or large stone and acute ductal angulation, and failed in two sites(7.7%). CONCLUSION: Percutaneous balloon dilatation of benign biliary strictures is an effective procedure for extraction of residual intrahepatic stones associated with recurrent pyogenic cholangitis.
Angioplasty ; Catheters ; Cholangitis ; Constriction, Pathologic* ; Dilatation* ; Humans

PURPOSE: Motion effects in parallel magnetic resonance imaging (MRI) are investigated. Parallel MRI is known to be robust to motion due to its reduced acquisition time. However, if there are some involuntary motions such as heart or respiratory motions involved during the acquisition of the parallel MRI, motion artifacts would be even worse than those in conventional (non-parallel) MRI. In this paper, we defined several types of motions, and their effects in parallel MRI are investigated in comparisons with conventional MRI. MATERIALS AND METHODS: In order to investigate motion effects in parallel MRI, 5 types of motions are considered. Type-1 and 2 are periodic motions with different amplitudes and periods. Type-3 and 4 are segment-based linear motions, where they are stationary during the segment. Type-5 is a uniform random motion. For the simulation, Cartesian and spiral grid based parallel and non-parallel (conventional) MRI are used. RESULTS: Based on the motions defined, moving artifacts in the parallel and non-parallel MRI are investigated. From the simulation, non-parallel MRI shows smaller root mean square error (RMSE) values than the parallel MRI for the periodic (type-1 and 2) motions. Parallel MRI shows less motion artifacts for linear (type-3 and 4) motions where motions are reduced with shorter acquisition time. Similar motion artifacts are observed for the random motion (type-5). CONCLUSION: In this paper, we simulate the motion effects in parallel MRI. Parallel MRI is effective in the reduction of motion artifacts when motion is reduced by the shorter acquisition time. However, conventional MRI shows better image quality than the parallel MRI when fast periodic motions are involved.
Artifacts ; Computer Simulation ; Heart ; Magnetic Resonance Imaging

OBJECTIVE: To assess long term outcomes of aggressive rehabilitative treatment on canalicular sequestered lumbar disc herniations METHOD: Clinical outcomes of twenty four patients with sequestered disc herniation with symptomatic radicular pain were evaluated prospectively and longitudinally for one year. All patients received aggressive rehabilitative treatment including transforaminal epidural steroid injection, pelvic stabilization exercise, physical therapy, and back school. Clinical outcomes were measured by visual analogue scale (VAS) for back and radicular pain, Oswestry Disability Index (ODI) for back pain before treatment, posttreatment one, three, six, and twelve months. After twelve months, we categorized patients' satisfaction. Four patients were dropp RESULTS: The averages of VAS for lower extremity and back pain reduced significantly from 6.6 and 5.8 at pretreatment to 0.7 and 0.9 at 12 months posttreatment, respectively (p<0.001). The averages of ODI reduced significantly from 73.5% at pretreatment to 22.3% at posttreatment 12 months (p<0.001). Sixteen of twenty patients (80.0%) were satisfied with their current status posttreatment 12 months. CONCLUSION: Sequestered disc herniations could be treated successfully by aggressive rehabilitative treatment. Clinical improvement was achieved from posttreatment one month and persisted for twelve months. Operation might be delayed until aggressive rehabilitation treatment fail to treat sequestered disc herniations.
Back Pain ; Exercise ; Follow-Up Studies* ; Humans ; Lower Extremity ; Prospective Studies ; Rehabilitation

Carnobacterium is a genus of gram-positive bacilli belonging to the family Lactobacillaceae.Generally, Carnobacterium species are considered nonpathogenic to humans and are mostly found in the natural environment, food, and food packaging. Furthermore, some Carnobacterium species play a bioprotective role in the food industry. Isolation of Carnobacterium from human blood or other sites, such as skin or abscess, has rarely been reported—there are only four published case reports worldwide, and none of them is from Korea. In all the reported cases, the patients reported contact with an aqueous environment or were administered nutrition via a parenteral route. Herein, we report the detection of Carnobacterium divergens bacteremia in an immunocompromised patient by using mass spectrometry in Korea.

BACKGROUND: Rheumatoid arthritis(RA) is a systemic disease not infrequently involing the heart. It has been known that pericardial effusion, most commonly observed cardiac abnormality in patients with RA, and other cardiac manifestations such as conduction disturbances, valve thickenings, and enlargement of left atrium or aorta are associated with RA. We have determined the nature and extent of cardiac manifestations of RA in comparison with those of control group by echocardiographic examination. METHOD: 27 patients with RA(4 males and 23 females, mean age=47 +/-13 years) and 22 control subjects(3 males and 19 females, mean age+43 +/- 11 years) were randomly selected. Standard two-dimensional, M-mode and doppler echocardiographic examination were done on each group of subjects. RESULTS: 1) Pericardial effusions were more commonly detectd in patients with RA than control group(55.6% vs 22.7%, p<0.01). There were no significant differences in the amount of pericardial effusion according to the duration and the stage of RA. 2) Thickness of each cardiac valve was thicker in patients with RA than control group. But, there were no statistical significance between them. 3) The left ventricular mass index(LVMI) and the diameter of aorta showed a trend to increase in patients with RA(109.5 +/-28.0 g/m(2) vs 94.2 +/-24.6 g/m(2), p=0.054). 4) The diameter of left atrium was more lager in patients with RA(35.1 +/- 4.0mm vs 31.6 +/- 4.5mm, p=o.005). 5) The E/A ratio of mitral valve was statistically significantly lower in patients with RA(RA:control=1.2 +/- 0.5 : 1.7 +/- 0.4, p=0.01). CONCLUSION: The asymptomatic patients with RA more frequently show cardiac abnormalities such as pericardial effusion, valve thickening, decrease of E/A ratio than control group. So two-dimensional echocardiography is necessary for early, noninvasive and accurate evaluation of asymptomatic cardiac abnormalities in patients with RA.
Aorta ; Arthritis, Rheumatoid ; Echocardiography ; Female ; Heart ; Heart Atria ; Heart Valves ; Humans ; Male ; Mitral Valve ; Pericardial Effusion

BACKGROUND: The purpose of this study was to investigate whether brain AT1 receptor stimulation contributes as a hypertensive mechanism to deoxycorticosterone acetate (DOCA)-salt hypertension. METHODS: 1) Acute injection:Losartan (1 mg/4 uL) or artificial cerebrospinal fluid (aCSF) was injected into the lateral cerebral ventricle (icv) of conscious control uninephrectomized Wistar rats or rats with DOCA-salt at 2 or 4 weeks, and mean arterial pressure (MAP) and heart rates (HR) were recorded. 2) Chronic injection:Using osmotic minipump, losartan (1 mg/kg/d) or aCSF was injected to a sham group or three DOCA-salt rat groups [icv-aCSF, icv-losartan, sc-losartan (subcutaneous) groups] for 4 weeks, after which the MAP and HR were recorded in addition to the weights of the left (LV) and right ventricles (RV) and kidneys. RESULTS: 1) Acute injection: In rats treated with DOCA-salt, resting MAP significantly increased compared to the control group [144+/-6 mmHg (2 weeks), 170+/-5 mmHg (4 weeks) vs 115-120 mmHg (controls)]. MAP decreased significantly (2 weeks, 4 weeks) at 4, 8, 24 hours after icv injection of losartan to the level of the control group. 2) Chronic injection: The general trend showed that MAP decreased more in the icv-losartan group than in the icv-aCSF group (127+/-15.2 mmHg vs 141.1+/-5.5 mmHg, p=0.0578). In all DOCA-salt groups, no differences in RV weight were found. In the icv-aCSF and sclosartan groups, the kidney weight increased compared to the control group, but there was no difference in LV and kidney weight between the icv-losartan group and the control group. CONCLUSION: Normalization of MAP after acute or chronic icv administration of the AT1 receptor antagonist suggests that the stimulation of the brain AT1 receptor plays a significant role in the development and maintenance of hypertension in the DOCA-salt hypertensive rat model. Losartan icv injection appeared to have a protective effect on the heart and kidney.
Angiotensin II ; Animals ; Arterial Pressure ; Brain ; Cerebral Ventricles ; Cerebrospinal Fluid ; Desoxycorticosterone ; Heart ; Heart Rate ; Heart Ventricles ; Hypertension* ; Kidney ; Losartan* ; Models, Animal ; Rats* ; Rats, Wistar ; Receptor, Angiotensin, Type 1 ; Weights and Measures

PURPOSE: Barriers to cardiopulmonary resuscitation (CPR) education are magnified by relative cost and course availability. E-learning has emerged as a viable solution for continuous, on-demand training and organizational learning. We assessed the hypothesis that E-learning is a viable strategy for CPR training of the general public and sought to evaluate its effects on CPR quality compared to traditional classroom-based methods. METHODS: The E-learning program was specifically designed to teach basic life support skills, and consisted of 50 minutes internet lectures and simulation videos. The training session was freely available to twenty two officers in rural South Korea. The trainees were able to practice with a mannequin and an automated external defibrillator (AED) trainer at their place of employment over the course of 3 days. The control group was trained at a hospital by certified instructors using the same equipment during a 2 hour period. At the end of the course, the participant's skills were evaluated using a checklist and a skill performance test. RESULTS: Forty two subjects were enrolled finally with 19 and 23 belonging to the E-learning and the control groups, respectively. One E-learning trainee was excluded because he was absent from the skills test. The mean time to learn CPR and AED techniques was 29.0+/-24.5 minutes in the elearning group. The mean age of the E-learning group was significantly older than that of the control group (32.4+/-4.0 vs. 26.0+/-1.5, p<0.001). However, we did not find any significant differences in their weight, height or CPR educational status. Before the education sessions, the willingness to perform CPR and their confidence in performing CPR were not significantly different among the two groups. Regarding skill performance, there were no significant differences between the groups except the volume of ventilation. The control group showed a higher volume of ventilation than the elearning group (1,031.7+/-521.6 vs. 548.8+/-303.3, p=0.004). CONCLUSION: E-learning accompanied with appropriate practice can be a helpful tool for public CPR training. The demand for E-learning will increase, and this study shows that e-learning programs can be successful, yielding similar results as traditional, classroom-based training.
Cardiopulmonary Resuscitation ; Checklist ; Defibrillators ; Education, Distance ; Educational Status ; Employment ; Hypogonadism ; Internet ; Learning ; Lectures ; Life Support Care ; Manikins ; Mitochondrial Diseases ; Ophthalmoplegia ; Republic of Korea ; Ventilation

PURPOSE: Barriers to cardiopulmonary resuscitation (CPR) education are magnified by relative cost and course availability. E-learning has emerged as a viable solution for continuous, on-demand training and organizational learning. We assessed the hypothesis that E-learning is a viable strategy for CPR training of the general public and sought to evaluate its effects on CPR quality compared to traditional classroom-based methods. METHODS: The E-learning program was specifically designed to teach basic life support skills, and consisted of 50 minutes internet lectures and simulation videos. The training session was freely available to twenty two officers in rural South Korea. The trainees were able to practice with a mannequin and an automated external defibrillator (AED) trainer at their place of employment over the course of 3 days. The control group was trained at a hospital by certified instructors using the same equipment during a 2 hour period. At the end of the course, the participant's skills were evaluated using a checklist and a skill performance test. RESULTS: Forty two subjects were enrolled finally with 19 and 23 belonging to the E-learning and the control groups, respectively. One E-learning trainee was excluded because he was absent from the skills test. The mean time to learn CPR and AED techniques was 29.0+/-24.5 minutes in the elearning group. The mean age of the E-learning group was significantly older than that of the control group (32.4+/-4.0 vs. 26.0+/-1.5, p<0.001). However, we did not find any significant differences in their weight, height or CPR educational status. Before the education sessions, the willingness to perform CPR and their confidence in performing CPR were not significantly different among the two groups. Regarding skill performance, there were no significant differences between the groups except the volume of ventilation. The control group showed a higher volume of ventilation than the elearning group (1,031.7+/-521.6 vs. 548.8+/-303.3, p=0.004). CONCLUSION: E-learning accompanied with appropriate practice can be a helpful tool for public CPR training. The demand for E-learning will increase, and this study shows that e-learning programs can be successful, yielding similar results as traditional, classroom-based training.
Cardiopulmonary Resuscitation ; Checklist ; Defibrillators ; Education, Distance ; Educational Status ; Employment ; Hypogonadism ; Internet ; Learning ; Lectures ; Life Support Care ; Manikins ; Mitochondrial Diseases ; Ophthalmoplegia ; Republic of Korea ; Ventilation

OBJECTIVE: To examine the incidence of the depressive symptoms during pregnancy and the socio-demographic and obstetric factors associated with depression. METHODS: Two hundred five women who had received antenatal care at Kangnam St. Mary's Hospital from March 2008 to May 2008 completed the questionnaire related to socio-demographic characteristics and Edinburgh Postnatal Depression Scale (EPDS). Statistics were performed using chi-square test and Fisher's extract test (SPSS 12.0). Results were considered statistically significant for P-values<0.05. RESULTS: Of 205 pregnant women, the mean score of EPDS was 7.3+/-4.2.54 of 205 women (26.5%) scored more than 10 point which is the cutoff value to define depressive symptoms. The incidences of depressive symptoms were not significantly different by the trimester (25.7% vs. 29.0% vs. 25.0%, P<0.844). There were no significant socio-geographic factors associated with depressive symptoms. In cases of unexpected pregnancies, the incidence of depressive symptoms was significantly high (34.6% vs. 21.0%, P=0.036), and the women who have problems of previous pregnancies scored significantly higher EPDS (56.3% vs. 23.8%, P=0.014). CONCLUSION: This study was the first report about the depression symptoms during pregnancy. Based on this study, we have to focus on and manage depression symptoms related to pregnancy.
Depression ; Depression, Postpartum ; Female ; Humans ; Incidence ; Pregnancy ; Pregnant Women ; Surveys and Questionnaire