Objective: This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided minimally invasive treatment in patients with parathyroid lesions. Materials and Methods: This study included 27 patients who had undergone US-guided radiofrequency ablation (RFA) or ethanol ablation (EA) for parathyroid lesions between January 2010 and 2018. RFA was performed in 19 patients with primary hyperparathyroidism (PHPT, n = 11) or secondary hyperparathyroidism (SHPT, n = 8), and EA was performed in eight patients with symptomatic nonfunctioning parathyroid cysts (SNPCs). Nodule size, volume, serum parathyroid hormone (PTH) and calcium levels were recorded before and after treatment. Complications were evaluated during and after treatment. Results: In patients with PHPT, significant reductions in size and volume were noted after RFA at 6- and 12-month follow-up (all, p < 0.05). Seven nodules nearly completely disappeared (residual volume < 0.1 mL); serum PTH and calcium levels were reduced to normal ranges (7/11, 63.6%). Four patients experienced partial reductions of serum PTH and calcium levels (4/11, 36.4%). In patients with SHPT, three experienced therapeutic response of serum PTH (3/8, 37.5%), while five showed persistent hyperparathyroidism (5/8, 62.5%) within 6 months after RFA. In patients with SNPCs, EA resulted in significant reductions in cyst size and volume (all, p < 0.05) at the last follow-up. A total of four complications (two transient hypocalcemia [RFA], one permanent [RFA], and one transient [EA] hoarseness) were observed. Conclusion Minimally invasive treatments, such as RFA and EA, may serve as therapeutic alternatives for patients with PHPT or SNPCs; they may have limited usefulness in patients with SHPT.

Objective: This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided minimally invasive treatment in patients with parathyroid lesions. Materials and Methods: This study included 27 patients who had undergone US-guided radiofrequency ablation (RFA) or ethanol ablation (EA) for parathyroid lesions between January 2010 and 2018. RFA was performed in 19 patients with primary hyperparathyroidism (PHPT, n = 11) or secondary hyperparathyroidism (SHPT, n = 8), and EA was performed in eight patients with symptomatic nonfunctioning parathyroid cysts (SNPCs). Nodule size, volume, serum parathyroid hormone (PTH) and calcium levels were recorded before and after treatment. Complications were evaluated during and after treatment. Results: In patients with PHPT, significant reductions in size and volume were noted after RFA at 6- and 12-month follow-up (all, p < 0.05). Seven nodules nearly completely disappeared (residual volume < 0.1 mL); serum PTH and calcium levels were reduced to normal ranges (7/11, 63.6%). Four patients experienced partial reductions of serum PTH and calcium levels (4/11, 36.4%). In patients with SHPT, three experienced therapeutic response of serum PTH (3/8, 37.5%), while five showed persistent hyperparathyroidism (5/8, 62.5%) within 6 months after RFA. In patients with SNPCs, EA resulted in significant reductions in cyst size and volume (all, p < 0.05) at the last follow-up. A total of four complications (two transient hypocalcemia [RFA], one permanent [RFA], and one transient [EA] hoarseness) were observed. Conclusion Minimally invasive treatments, such as RFA and EA, may serve as therapeutic alternatives for patients with PHPT or SNPCs; they may have limited usefulness in patients with SHPT.

BACKGROUND: We evaluated the effectiveness of isolation measures using cohorting rooms and antimicrobial use in reducing the isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Acinetobacter baumannii (MDR-AB). METHODS: Four cohorting rooms (16 beds) for patients colonized or infected with multidrug-resistant organisms (MDRO) have been created in the general wards of our 894-bed hospital since October 2003. We prospectively evaluated the isolation rates of MRSA and MDR-AB, and amount of antimicrobial use during the 8-year study period. We also investigated the relationship between antimicrobial use density (AUD) and the isolation rates of MRSA and MDR-AB. RESULTS: After creating cohorting rooms, the isolation rates of MRSA decreased from 1.56 cases per 1,000 patient-days from 2004-2005 to 1.24 from 2006-2007 (P=0.57). The isolation rates of MDR-AB also decreased from 0.72 from 2004-2005 to 0.36 from 2010-2011 (P<0.01). The mean quarterly AUDs of glycopeptides and carbapenems were 30.17+/-6.80 and 19.5+/-7.10, respectively. There were no significant correlations between AUD values and the isolation rate of MRSA or MDR-AB. CONCLUSION: This study suggests that isolation measures using cohorting rooms to help limit the transmission of MDRO infection and colonization, especially MDR-AB, in resource-limited settings is feasible and efficacious.
Acinetobacter ; Acinetobacter baumannii ; Carbapenems ; Cohort Studies ; Colon ; Drug Resistance ; Glycopeptides ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Patient Isolation ; Patients' Rooms ; Prospective Studies

Uterine arteriovenous malformation is a rare gynecologic condition, which is sometimes accompanied torrential vaginal bleeding and it can be aggravated with diagnostic dilatation and curettage. For proper management of vaginal bleeding, accurate diagnosis should be achieved before the intervention. In the past, the diagnosis was made retrospectively after hysterectomy, however recently it may be made by noninvasive method such as Doppler ultrasonogram before management. We have experienced 3 cases of uterine arteriovenous malformation, of which 2 cases were diagnosed with Doppler ultrasonogram.
Arteriovenous Malformations* ; Diagnosis ; Dilatation and Curettage ; Female ; Hysterectomy ; Retrospective Studies ; Ultrasonography ; Uterine Hemorrhage

No abstract available.
Syphilis, Congenital*

BACKGROUND: Epidural anesthesia is becoming an increasingly important aspect of anaesthetic practice because it has many advantages. To achieve the appropriate sedation, various methods have been described. The authors applied the ketamine for this purpose in subanesthetic dose and compared with the midazolam that has been most commonly used for intravenous sedation. METHODS: Fifty-seven adult patients undergoing lower abdominal and extremity surgery who were receiving epidural anesthesia were randomely enrolled into this clinical study. They were allocated to three groups to receive only normal saline (group C), midazolam 0.05 mg/kg (group M) and ketamine 0.5 mg/kg midazolam 0.05 mg/kg (group K) in normal saline 10ml, respectively. Hemodynamic and respiratory measurements were recorded at baseline, 1 minute, 3 minute, 5 minute, 10 minute, 20 minute and 30 minute after sedation. The degree of sedation was assessed by a blinded observer using sedation score. RESULTS: There were no significant differences for hemodynamic and respiratory parameters, but decrements of arterial pressure at 1 minute after sedation were most remarkable in the group M. Sedation was satisfactorily achieved by combination of ketamine and midazolam without significant emergence reaction. CONCLUSIONS: The combination of ketamine and midazolam was judged to be suitable alternative for sedation during epidural anesthesia.
Adult ; Anesthesia, Epidural* ; Arterial Pressure ; Extremities ; Hemodynamics ; Humans ; Ketamine* ; Midazolam*

Various cancer types have been associated with cancer-related cerebral infarction. In this study, we describe the first case of cancer-related cerebral infarction in which the underlying disease was primary bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke, we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL). Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in patients with abnormal hematologic findings.

The purpose of this study is to evaluate the flow ability of the thermoplasticized Gutta Percha in different temperatures. Four Gutta Percha products were classified by its hardness (soft, medium, and hard) and were experimented by the Rheometer (Melt flow indexer MFI-10, DAVENPORT, England) measuring apparatus, in (23 ± 2) ℃, and in a relative humidity of (50 ± 5) %, following the guidelines of ISO 1133-1:2011. The heating temperature ranged from 108℃, 160℃ to 200℃, and the load at 2.16 kg and 3.8 kg. The Gutta Percha was cut in 5 mm to be suitable for the rheometer pressurization process. After the experiment was conducted with a preheating time of 5 minutes, a cutting time of 5–240 seconds, and a sample of 10 grams, the Gutta Percha did not show any changes in fluidity for 108℃, 160℃, but showed a change in its flow ability in 200℃. Also, the Gutta Percha did not show any changes in its fluidity when it was pressurized by 2.16 and 3.8 kilograms. Therefore, this experiment shows that the heating temperature and the cut-off time showed a significance while measuring the melt flow rate.
Gutta-Percha ; Hardness ; Heating ; Hot Temperature ; Humidity

BACKGROUND: Anesthetic requirements are affected by the preoperative levels of some hormones. This study investigated to identify the hormonal status such as plasma level and maximal secretary capacity correlating with propofol and remifentanil requirements in pituitary adenoma patients who show various hormonal secretory states perioperatively. METHODS: From 51 adult female pituitary adenoma patients, preoperative basal values and maximal stimulated levels of various hormones related to the axis of hypothalamus-pituitary-target organs on combined pituitary function test were recorded. Total intravenous anesthesia using target controlled infusion with propofol and remifentanil was administered. The effect-site concentration (Ce) of propofol reaching anesthetic induction and the consumed dosages of propofol and remifentanil during operation were measured. Anesthetic maintenance was controlled within 30% of preanesthetic hemodynamic variables by remifentanil and within ranges of BIS 45 +/- 10 by propofol. Spearman correlations between hormonal status and anesthetic requirements such as propofol Ce for induction, total consumed doses of propofol and remifentanil were performed with a statistical significance at P of 0.05. RESULTS: The preoperative basal level of ACTH was correlated positively with propofol induction Ce and maintenance dose, and the maximal secretory capacity of prolactin also correlated positively with propofol induction Ce. Remifentanil consumption dose was not related with any hormones measured regardless of either preoperative basal levels or maximal secretory levels. CONCLUSIONS: Propofol requirements may be related with preoperative plasma level of ACTH or maximal secretory capacity of prolactin.
Adrenocorticotropic Hormone ; Adult ; Anesthesia, Intravenous ; Axis, Cervical Vertebra ; Female ; Hemodynamics ; Humans ; Piperidines ; Pituitary Function Tests ; Pituitary Neoplasms ; Plasma ; Prolactin ; Propofol

PURPOSE: This study was conducted to suggest direction and strategy of safety education proper to elementary school children. METHOD: The subject of this survey consisted of 313 3rd-5th grade from 4 elementary schools in Kyungi-Do and Kwangwon-Do. Data were collected from March to May, 2002 using a questionnaire about "safety education needs", "knowledge about injury prevention", "attitude about injury prevention. RESULT: 1. The degree of safety education needs showed averaged 77.50 on the basis of 100 points. 2. The degree of knowledge and attitude about injury prevention showed averaged 72.81 and 81.74 seperately on the basis of 100 points. 3. With the respect to the demographic characteristics, there were stastically significant differences in safety education need according to children's grade(F=8.692, p=.003), sex(t=-2.059, p=.040), family type(t=-2.229, p=.027) and in knowledge & attitude about injury prevention, there statiscally significant difference according to experience of injury prevention education(t=3.058, p=.003; t=5.308, p=.000) each. 4. The level of safety education needs is correlated at signficant level with knowledge and attitude about injury prevention of childrens(r=.166, p=.048; r=.265, p=.001) and between knowledge and attitude about injury prevention, there was significant correlation (r=.427, p=.000). CONCLUSION: From this results, nurses can plan safety education program appropriate to children's needs, level of knowledge and attitude about injury prevention.
Child* ; Education* ; Gangwon-do ; Humans ; Child Health ; Surveys and Questionnaires