No abstract available.
Drug Therapy*

Adenosquamous carcinoma in the duodenum is extremely rare disease entity and only 6 cases were reported all over the world so far. Recently we encountered a 62 year-old female patient with duodenal adenosquamous carcinoma. The patient subsequently underwent Whipple's operation. Histopathologic examination revealed two pathologic components composed of adenocarcinoma and squamous cell carcinoma. The metastatic foci of lymph nodes were composed of pure squamous cell carcinoma. For differential diagnosis, we performed several special stains including high molecular weight cytokeratin(HMWCK), low molecular weight cytokeratin(LMWCK), carcinoembryogenic antigen( CEA), mucicarmine, periodic acid-Schiff(PAS). Immunohistochemical stains demonstrated LMWCK, CEA, mucicarmine positivity for glandular component and HMWCK for squamous component. Weak positivity for squamous component was observed with PAS stain. The pathogenesis of adenosquamous carcinoma is controversial issue and not resolved yet, so we discussed the histogenesis of adenosquamous carcinoma.
Adenocarcinoma ; Carcinoma, Adenosquamous* ; Carcinoma, Squamous Cell ; Coloring Agents ; Diagnosis, Differential ; Duodenum ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Molecular Weight ; Rare Diseases

Treatment of Rupture of Achilles tendon was first reported by Pare, 1575 and thereafter the various causes, diagnostic & therapeutic method of the ruptured tendon have been described by many authors. The two options of treatment are conservative management and surgical treatment and currently surgical intervention has been more popular. There are various surgical techniques which have been reported by many surgeons to treat the acute rupture of the Achilles tendon. In this report, 18 cases ( 11 male & 7 female ) of injuried Achilles tendon had been treated by the modified Lindholm method and follow-up study of 18 cases had been made during 28 months from august. 1993 to december, 1995. The results as follows; 1. After repair by the modified Lindholm method, a long leg cast was applied, and then aweight bearing was started average 8 weeks postoperatively. It can be demonstrated to shorten hospitalization and early ambulation compared to other surgical techniques 2. Postoperative power of triceps surae muscle was improved to normal in 15 patients ofthe 18 patients, and muscle power was good in 3 patients, but, all cases was improved to nearly normal whithin the last follow up. 3. Heel to floor distance was 0.6cm less on the operated side than on the normal side, and the difference decreased to 0.2cm at the last follow up. 4. The calf atrophy was minimal, and active range of motion of ankle was within normal limit. 5. We suggest that the procedure is recommended for one of the methods of the treatment of acute rupture of the Achilles tendon, because it is easy to do and permits early weight bearing and the complication is less.
Achilles Tendon* ; Ankle ; Atrophy ; Early Ambulation ; Female ; Follow-Up Studies ; Heel ; Hospitalization ; Humans ; Leg ; Male ; Range of Motion, Articular ; Rupture* ; Tendons ; Weight-Bearing

It is important to follow strict indications for surgery and recognize prognostic factors in order to get good results in the surgical treatment of herniated nucleus pulposus. 55 patients with herniated nucleus pulposus were studied who had had laminectomy and discectomy and were followed up for more than 1 year in order to analyze the correlation between various factors including history, physical examination and radiologic finding and surgical results. Age, sex, symptom duration, location of the herniation, smoking, occupation, physical examination, disc height change, MRI findings, operation time and bleeding volume were evaluated as prognostic factors that seemed to influence surgical result. The results are as follow 1. Female had significantly better surgical results than male (P<0.05). 2. Non-smokers had significantly better surgical result than smokers (P<0.01). 3. In MRI finding, protruded disc had significantly better surgical result when it had involved spinal canal posterolaterally than centrally (P<0.01). 4. The less bleeding volume, the better surgical result (P<0.05).
Diskectomy ; Female ; Hemorrhage ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Occupations ; Physical Examination ; Smoke ; Smoking ; Spinal Canal

The coagulation cascade and inflammatory process are known to be associated with the pathophysiology of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). We retrospectively investigated laboratory values indicating coagulopathy obtained within 24 hr from diagnosis of ALI/ARDS in 79 children who received mechanical ventilation between 2008 and 2009 and their final outcomes. Prothrombin time (PT) (P = 0.001) and activated partial thromboplastin time PTT (APTT) (P = 0.001) were more prolonged in non-survivors than survivors (mean; 1.57 vs 1.33; 63 vs 57). In multivariate analysis with stratification by oxygenation-index (< 14.5, > or = 14.5), prolonged PT (> or = 1.46 international normalized ratio, [INR]) (hazard ratio; 2.043, 1.027-4.064) was associated with lower non-pulmonary-organ-failure-free survival rate (FFS), and prolonged APTT (> or = 50 seconds) (2.062, 1.031-4.121; 2.422, 1.227-4.781) was associated with lower overall survival rate (OS) and lower FFS. In stratification by ventilation-index (< 40, > or = 40), prolonged PT (2.232, 1.095-4.540; 2.177, 1.092-4.342) and prolonged APTT (2.574, 1.230-5.386; 3.089, 1.500-6.360) were associated with lower OS and lower FFS. Prolonged PT and APTT are associated with mortality in mechanically ventilated children with ALI/ARDS. We suggest PT and APTT as prognostic factors of ALI/ARDS in children.
Acute Lung Injury/*etiology/mortality ; Adolescent ; Blood Coagulation Disorders/*complications ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Multivariate Analysis ; Partial Thromboplastin Time ; Prognosis ; Prothrombin Time ; Respiratory Distress Syndrome, Adult/*etiology/mortality ; Retrospective Studies ; Survival Rate ; Young Adult

INTRODUCTION: Human attachment is known to be closely associated with psychophysiological phenomenon. However, there have not been enough researches on the relationship of the attachment with sleep, especially with insomnia. The objective of the present study was to investigate the relationship between adult attachment styles and insomnia in community-dwelling population. METHODS: One hundred seventy seven community-dwelling adults (74 males and 103 females ;mean age 41.23+/-8.44) participated in the current study. To assess the attachment styles (secure, dismissing, preoccupied and fearful), self-reporting Relationship Style Questionnaires (RSQ) were completed by the participants. Presence, type, frequency and duration of insomnia in the last month were also investigated. RESULTS: Compared to subjects without insomnia, subjects with insomnia had higher fearful attachment scores (t =2.87, p=0.005). Higher fearful attachment score were found in all subtypes of insomnia (sleep-onset insomnia, t =2.33, p=0.021;maintenance insomnia, t=2.92, p=0.004;terminal insomnia, t=2.89, p=0.004). Subjects with frequent (>or =3 per week) insomnia had higher fearful attachment scores than subjects with infrequent (or =6 months) had higher preoccupied attachment scores relative to subjects with transient insomnia (<6 months), (t=2.57, p=0.012). CONCLUSION: In the current study, attachment styles were different depending on the characteristics of insomnia. The fearful attachment was associated with the presence of insomnia, while the preoccupied attachment was associated with the chronicity of insomnia. These findings suggest that there may be some relationship between the adult attachment styles and the clinical features of insomnia.
Adult ; Female ; Humans ; Male ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Dipyridamole* ; Perfusion*

No abstract available.
Cryptococcosis* ; Lung Neoplasms* ; Lung*

No abstract available.
Cryptococcosis* ; Lung Neoplasms* ; Lung*

OBJECTIVE: To identify predictive factors of depressive mood in patients with isolated cerebellar stroke. METHODS: A retrospective chart review was performed in patients who had experienced their first isolated cerebellar stroke during 2002-2014. The patients were classified into two groups by the Geriatric Depression Scale (GDS) (non-depressive group, 0≤GDS≤16; depressive group, 17≤GDS≤30). Data on demographic and socioeconomic factors, comorbidities, functional level, cognitive and linguistic function, and stroke characteristics were collected. Significant variables in univariate analysis were analyzed using logistic regression. RESULTS: Fifty-two patients were enrolled, of whom 55.8% had depressive mood, were older (p=0.021), and had higher hypertension rates (p=0.014). Cognitive and linguistic functions did not differ between the two groups. The depressive group had higher ischemic stroke rates (p=0.035) and showed a dominant right posterior cerebellar hemisphere lesion (p=0.028), which was independently associated with depressive mood in the multiple logistic regression analysis (odds ratio, 5.081; 95% confidence interval, 1.261-20.479). CONCLUSION: The risk of depressive mood after cerebellar stroke was increased in patients at old age, with a history of hypertension, ischemic stroke, and lesion of the right posterior cerebellar hemisphere. The most significant determining factor was stroke lesion of the right posterior cerebellar hemisphere. Early detection of risk factors is important to prevent and manage depressive mood after cerebellar stroke.
Cerebellum ; Comorbidity ; Depression ; Humans ; Hypertension ; Linguistics ; Logistic Models ; Retrospective Studies* ; Risk Factors ; Socioeconomic Factors ; Stroke*