PURPOSE: Kimura's disease is an inflammatory condition of unknown etiology which usually occurs in salivary glands and cervical lymph nodes. This study was undertaken to evaluate the radiologic characteristics of Kimura's disease using CT and MRI. MATERIALS & METHODS: We evaluated CT & MR of 10 patients with histologically proved Kimura's disease in the head and neck. Six males and four females between 16 and 58 years old (mean age, 37.6 years) were included. Contrast enhanced CT scan was performed in all, and spin-echo MRI was performed in 2 patients. RESULTS: Both CT and MRI demonstrated the distinctive sites of involvement that were major salivary glands (4 cases) and lacrimal gland (1 case), periglandular soft tissue (8 cases), and cervical lymph nodes (8 cases). Majority of soft tissue lesions were ill-defined with infiltration to adjacent fascial planes, but nodal lesions were relatively well-defined and homogenous. The lesions were iso-intense on Tl-weighted image and hyper-intense on T2-weighted image. All but a few nodal lesions showed variable degree of contrast enhancement on CT and MRI. CONCLUSION: In diagnosis of Kimura's disease, CT & MRI of head & neck, especially salivary glands, are useful. In cases of recurrent periglandular soft tissue mass with contrast-enhancing cervical lymphadenopathy in adult patients, Kimura's disease should be included in the differential diagnosis.
Adult ; Diagnosis ; Diagnosis, Differential ; Female ; Head* ; Humans ; Lacrimal Apparatus ; Lymph Nodes ; Lymphatic Diseases ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck* ; Salivary Glands ; Tomography, X-Ray Computed

PURPOSE: To evaluate high-resolution CT(HRCT) findings of the miliary tuberculosis and their significancy. MATERIAL AND METHOD: We retrospectively studied clinical records, HRCT and chest radiographs of 14 patients with miliary tuberculosis. RESULTS: On HRCT, nodules were seen in all 14 cases, 10 of them evenly, and 4 were irregularly distributed. The size of each nodule was less than 1 mm in 7 cases, 1 --2ram in 6 cases, and 3mm or more in 1 case. The ground - glass opacity was accompanied in 8 cases, and fine reticular opacity was also noted in 8 cases. Other associated findings were pleural effusion (n=4), hilar and mediastinal lymphadenopathy (n=3), consolidation of the exudative tuberculosis (n=4). CONCLUSION: HRCT findings of miliary tuberculosis are diffusely distributed micronodules of variable size, less than 5mm in diameter. The ground-glass opacity can be combined.
Glass ; Humans ; Lymphatic Diseases ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Miliary*

Neurovascular surgeons have been trying to find a solution to the problem of surgical invasiveness by applying minimally invasive keyhole approaches. A superciliary keyhole approach can be a reasonable alternative to a pterional approach for selected cases of small aneurysms arising at the supraclinoid internal carotid artery, A1 segment, anterior communicating artery, and M1 segment, including the middle cerebral artery bifurcation. The authors describe the surgical technique in detail in addition to the indications, limitations, and advantages of this minimally invasive keyhole approach.
Aneurysm ; Arteries ; Carotid Artery, Internal ; Intracranial Aneurysm ; Middle Cerebral Artery ; Surgical Procedures, Minimally Invasive

PURPOSE: This study was done to identify the differences nursing needs and satisfaction with medications in patients admitted to hospital. METHOD: The participants were 258 patients admitted for 3days or more to D hospital. The data were analyzed using frequencies, percentages, means, standard deviations, t-test and ANOVA. SPSS-WIN 11.0 was used to assist analysis. RESULTS: The results are as follow: 1. Variables effecting nursing needs were education and economic level. All scores of nursing needs were higher in the group with less than middle school education compared to those with high school education or higher. 2. The scores for nursing needs were higher than the score for satisfaction in common item and injection domains. The scores for nursing satisfaction were higher than nursing needs in the oral medication domain. 3. The item with the highest difference between the scores for nursing needs and satisfaction was 'I want to know the side effect of the drugs'. CONCLUSION: Patients admitted to hospital want to know the therapeutic effect, side effect and reason for their drugs. However satisfaction with medication was not equal to needs. It is necessary to emphasize clinical pharmacology in nursing education programs.
Education ; Education, Nursing ; Humans ; Nursing* ; Pharmacology, Clinical

Radiation and drug resistance remain the major challenges and causes of mortality in the treatment of locally advanced, recurrent and metastatic breast cancer. Dysregulation of phospholipase D (PLD) has been found in several human cancers and is associated with resistance to anticancer drugs. In the present study, we evaluated the effects of PLD inhibition on cell survival, cell death and DNA damage after exposure to ionizing radiation (IR). Combined IR treatment and PLD inhibition led to an increase in the radiation-induced apoptosis of MDA-MB-231 metastatic breast cancer cells. The selective inhibition of PLD1 and PLD2 led to a significant decrease in the IR-induced colony formation of breast cancer cells. Moreover, PLD inhibition suppressed the radiation-induced activation of extracellular signal-regulated kinase and enhanced the radiation-stimulated phosphorylation of the mitogen-activated protein kinases p38 and c-Jun N-terminal kinase. Furthermore, PLD inhibition, in combination with radiation, was very effective at inducing DNA damage, when compared with radiation alone. Taken together, these results suggest that PLD may be a useful target molecule for the enhancement of the radiotherapy effect.
Breast Neoplasms/*drug therapy/*enzymology/pathology ; Cell Death/drug effects/radiation effects ; Cell Line, Tumor ; Cell Proliferation/drug effects/radiation effects ; DNA Damage ; Enzyme Activation/drug effects/radiation effects ; Enzyme Inhibitors/*pharmacology/*therapeutic use ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Female ; Humans ; JNK Mitogen-Activated Protein Kinases/metabolism ; Phospholipase D/*antagonists & inhibitors/metabolism ; Radiation Tolerance/*drug effects ; Radiation, Ionizing ; p38 Mitogen-Activated Protein Kinases/metabolism

Objective: If empirical antibiotics must be administered, the pharmacy needs to deliver the drug to emergency patients as soon as possible. The purpose of this study was to investigate the impact of the installation of an automated dispensing cabinet system in an emergency center. Methods: A retrospective study was conducted through the analysis of medical records in an emergency medical center for 12 months before and after the installation of the system. The order-to-antibiotic time and door-to-antibiotic time were collected retrospectively through a system log analysis. For the satisfaction survey, nursing providers who use the dispensing system were administered a survey questionnaire related to the system. Results: This study covered 1,292 prescriptions before and 1,377 after the introduction of the system in the emergency center. It was observed that the average time from the order-to-drug administration decreased (48.7±57.9 vs. 41.1±52.3, P=0.001) after the introduction of the system. The door-to-drug administration time also showed a decrease (293.6±260.2 vs. 267.4±221.1, P=0.006). A satisfaction survey was conducted on 38 users of the system who agreed to participate and respond. The score of the satisfaction survey was 3.63±0.44. The user response showed that they were most satisfied with the prevention of medication errors (4.00±0.62) and system control (4.00±0.57). Conclusion The automated dispensing cabinet system in an emergency center can shorten the order-to-drug time and door-to-drug time. In addition, it helps to improve the satisfaction and work efficiency of emergency medical workers related to medication dispensation.

Inflammation is the basis of severe acute and chronic diseases. This study investigated the anti-inflammatory property of a crude methanol extract (MeOH-ex) and the solvent fractions of Ixeris dentata Nakai (IDN) in LPS-stimulated murine macrophage-like cell line RAW264.7. Here, we showed that the ethyl acetate fraction (EtOAc-fr) had the most potent inhibitory activity on LPS-induced nitric oxide (NO) production among the tested samples, i.e., IDN MeOH-ex and the three different solvent fractions (chloroform, n-hexane, and EtOAc). We further found that the EtOAc-fr significantly inhibited LPS-induced prostaglandin PGE2 (PGE2) generation in RAW264.7 cells. Furthermore, the treatment with EtOAc-fr effectively suppressed the expression of inducible NO synthase (iNOS) and cyclooxygenase 2 (COX-2). These results suggest that the EtOAc-fr of IDN MeOH-ex exhibits an anti-inflammatory activity in vitro by inhibiting LPS-induced NO production and PGE2 generation via suppression of iNOS and COX-2 expression.
Asteraceae* ; Cell Line ; Chronic Disease ; Cyclooxygenase 2 ; Dinoprostone* ; Inflammation ; Methanol ; Nitric Oxide Synthase ; Nitric Oxide*

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS. METHODS: We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group. RESULTS: From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock. CONCLUSIONS: In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.
Acute Kidney Injury ; Aged* ; Extracorporeal Membrane Oxygenation ; Humans ; Intensive Care Units ; Medical Records ; Patients' Rooms ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Shock, Septic ; Ventilator-Induced Lung Injury

There are few reports analyzing the results of intensive care for children in Korea. A total of 40 critically ill pediatric patients were evaluated in terms of Therapeutic Intervention Scoring System (TISS), The group was composed of patients from 4 services: cardiothoracic surgery, pediatric surgery, pediatrics and other surgeries. We evaluated duration of stay and cost in pediatric intensive care unit (PICU), Seoul National University Hospital, and TISS related to departments. The patients with higher TISS showed longer duration of stay and higher cost in PICU than those with lower TISS. The duration of stay of the patients with high TISS more than 50 was 5.0 days, but it was 2.8 days in 40-49, 2.4 days in 30-39, 2.1 days in 20-29 and 1.9 days in 10-19 of TISS's, respectively. The postoperative first day cost of intensive care was approximately 2,210,000 Won in the patients with high TISS more than 50, but it was 1,060,000 Won in 40-49, 220,000 Won in 30-39, 460,000 Won in 20-29, 120,000 Won in 10-19 of TISS's, respectively. The patients in cardiothoracic surgery showed higher values in maximum, minimum and discharge TISS than other services. Maximum, minimum and discharge TISS of the patients in cardiothoracic surgery were 41, 28 and 23, respectively. TISS's of patients in pediatric surgery and neurosurgery were similar, but durations of stay in PICU were 3.5 days in pediatric surgery and 1.2 days in neurosurgery. In this study, we conclude that duration of stay in PICU and cost of intensive care might be proportional to TISS.
Child ; Critical Illness* ; Humans ; Critical Care ; Intensive Care Units ; Korea ; Neurosurgery ; Pediatrics ; Seoul