Magnetic resonance image of INFH were correlated with histologic sections. Seventeen patients withe eighteen hips were included in this study. reoperative radiographs and MRI were taken for the patients. Three hips were in stage II, nine hips were in stage III, and remaining six were in stage IV respectively(Ficat and Alert). These hips were replaced with artificial joint and resected heads were examined. The specimens were bisected along the imaging plane, and studied histologically and matched with respective MR images of T1 and T2. Specimen MRI was performed on three femoral head immediately after femoral head removal. Necrotic portion of the femoral head in earlier stage showed higher signal intensity in T1-weighted image. Subchondral void, necrotic bone and saponified fat were responsible for low signal intensity in necrotic portion. Low signal band adjacent to the necrotic foci represented inner fibrous tissue and outer reactive sclerotic bone. Outside the fibrous band, the signal intensity diminished compared with normal fatty marrow. these findings were attributed by cellular infiltration and trabecular bony proliferation. MRI patterns were variable in various stages, but corresponded well with histologic findings.
Bone Marrow ; Head ; Hip ; Humans ; Joints ; Magnetic Resonance Imaging ; Necrosis

OBJECTIVES: The purpose of this study was to evaluate the relationship betseen attachment style and somatization in patients with somatoform disorder. METHODS: Data was collected by self-report questionnaires. 134 normal subjects and 30 patients with somatoform disorder were enrolled in this study. All subjects completed a psychometric assessment that consisted the Revised Adults Attachment Scale (RAAS), Inventory of Parent and Peer Attachment (IPPA), Sungshin Self-concept Inventory (SSCI), and SCL-90-R. RESULTS: 1) Somatoform patients showed more anxious attachment style than normal control. 2) Anxious attachments were combined with mistrust of their parents, emotional instability, and interpersonal mistrust which may play a significant portion of variance in somatization. CONCLUSION: We found that patients with somatoform disorder had more anxious attachment style than normal subjects. Insecure attachment patterns may significantly explain the phenomenon of somatization.
Adult ; Humans ; Parents ; Psychometrics ; Surveys and Questionnaires ; Somatoform Disorders*

Sarcoidosis is an inflammatory disease involving multiple-organs with an unknown cause. The new onset of sarcoidosis associated with therapeutic agents has been observed in 3 clinical settings; tumor necrosis factor antagonists in autoimmune rheumatologic diseases, interferon alpha with or without ribavirin in patients with chronic hepatitis C or melanoma, and antineoplastic agent-associated sarcoidosis in patients with hematologic malignancies. Here, we report a female patient who developed sarcoidosis after capecitabine treatment as an adjuvant chemotherapy for sigmoid colon cancer. To our knowledge, this is the first report of a capecitabine-induced sarcoidosis.
Chemotherapy, Adjuvant ; Deoxycytidine ; Female ; Fluorouracil ; Hematologic Neoplasms ; Hepatitis C, Chronic ; Humans ; Interferon-alpha ; Melanoma ; Ribavirin ; Sarcoidosis ; Sigmoid Neoplasms ; Tumor Necrosis Factor-alpha ; Capecitabine

OBJECTIVES: Electroconvulsive therapy (ECT) is the important treatment method which has a good effect on refractory depression, schizophrenia at acute stage, patients with suicidal ideation. Although ECT results in better effects and less adverse effects in acute stage of illnesses as compared with pharmacotherapy, clinical implications are decreasing. Thus, authors surveyed a view of Korean psychiatrists about ECT to find whether there are prejudices and/or misconceptions for ECT. METHODS: Authors made survey questionaire for the attitudes of ECT, based on the APA task force 14, a clinical study in Korea, Hermann et al's report, and questioned Korean psychiatrists on their opinions for ECT through the internet E-mail, who are the members of Korean Neuropsychiatric Association (KNPA) serving in hospitals with psychiatric inpatient units. RESULTS: 122 psychiatrists answered to survey questionnaire. 89.4% have positive attitude about ECT. They thought that ECT has relatively safe and potent therapeutic effects, and less adverse effects. The rate of psychiatrists who have been no experience to perform ECT was 13.9% (n=16). Interestingly all of them had been trained serve in university hospitals now. The rate of psychiatrists who had experienced practicing ECT past but, not experienced within 2 years recently was 48.7% (n=56). While psychiatrists who have been no experience of ECT were more worried about adverse effects, doctors who experienced practicing ECT thought preferably the aspect of safety and potent effects of ECT. Psychiatrists who prefer psychotherapy were more likely to concern about adverse effect of ECT, but there were no differences in other aspects when compared with others. Most psychiatrists participated in this survey had positive attitudes about application of ECT to geriatric patients, but negative at child&adolescent patients. CONCLUSION: Authors recognized that many Korean psychiatrists agreed with performing ECT, and expected good results, but in reality, it is difficult to expect for them to perform ECT. Several factors may be associated for that: the changes in trend of psychiatric treatment, production of novel psychotropic drugs, researches trends which pharmacotherapy is prevailing in the fields of psychiatry, and problems of education, that is, lack of standard educational curriculums and systemic training course at residency for ECT.
Advisory Committees ; Curriculum ; Depressive Disorder, Treatment-Resistant ; Drug Therapy ; Education ; Electroconvulsive Therapy* ; Electronic Mail ; Hospitals, University ; Humans ; Inpatients ; Internet ; Internship and Residency ; Korea ; Prejudice ; Psychiatry* ; Psychotherapy ; Psychotropic Drugs ; Surveys and Questionnaires ; Schizophrenia ; Suicidal Ideation

BACKGROUND/AIMS: In head and neck squamous cell carcinoma, second primary gastrointestinal tumors are not uncommon. However, it is unclear whether a screening endoscopy is needed for detecting gastrointestinal neoplasm in patients with head and neck cancer. Therefore, we analyzed the prevalence and independent risk factors for second primary gastrointestinal neoplasm in head and neck squamous cell carcinoma. METHODS: A consecutive series of 328 patients with primary head and neck squamous cell carcinoma that underwent esophagogastroduodenoscopy or colonoscopy were included using our registry. An age- and sex-matched group of 328 control subjects was enrolled. We assessed risk factors of synchronous gastrointestinal cancer. RESULTS: The prevalence of esophageal cancer with head and neck squamous cell carcinoma was significantly higher than that of the control group (1.5% vs. 0.0%, p=0.011). An age of 54 years or more (OR, 1.033; 95% CI, 1.008-1.059; p=0.009) and male gender (OR, 4.974; 95% CI, 1.648-15.013; p=0.004) were risk factors for concomitant colorectal cancer or adenomas in the head and neck squamous cell carcinoma patients. CONCLUSIONS: Preoperative colonoscopy can be recommended for detecting synchronous second primary colorectal lesions in head and neck squamous cell carcinoma patients with male sex regardless of age, and esophagogastroduodenoscopy is necessary in all head and neck squamous cell carcinoma patients for detecting esophageal cancer.
Adenoma ; Carcinoma, Squamous Cell ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis ; Endoscopy ; Endoscopy, Digestive System ; Endoscopy, Gastrointestinal* ; Esophageal Neoplasms ; Gastrointestinal Neoplasms ; Head and Neck Neoplasms* ; Head* ; Humans ; Male ; Mass Screening ; Neck ; Neoplasms, Second Primary* ; Prevalence ; Risk Factors

No abstract available.
Lymphadenitis*

The B-type gamma knife unit was installed at Kyung-Hee University Hospital in March 1992. The selective beam plugging method can be used to reduce the low percentage isodose profiles of normal sensitive organ and to codify the isodose cuties of treatment volume for better shaping of the target volume. For representing the changes of the law percentage isodose profiles, the variations of dose distribution for several cases were discussed in this paper. The film dosimetry was performed for the evaluation of calculated isodose profiles predicted by KULA dose planning system. The results were verified by RFA-3 automatic densitometry. The clinical application of selective beam shielding method was performed in 17 patients in 100 patients who have undergone gamma knife radiosurgery for a year. The calculated and the measured isodose profiles for the high percentage regions were well consistent with each other. When the target of pituitary tumor is macro-size, the selective beam shielding method is the most applicable method. When the target size, however, is small, the correct selection of the proper helmet size is very important. All patients were exposed almost about 3~12 Gy for brain stem, and 3~11.2 Gy for optic apparatus. It is recommended that the same or other plugging patterns with multiple isocenters should be used for protection of the radiosensitive normal structures with precise treatment of CNS lesions.
Brain Stem ; Densitometry ; Film Dosimetry ; Head Protective Devices ; Humans ; Jurisprudence ; Pituitary Neoplasms ; Radiosurgery

BACKGROUND: We evaluated the usefulness of a newly developed molecular typing method of infrequent restriction site polymerase chain reaction (IRS-PCR) as an epidemiological DNA fingerprinting tool for Candida tropicalis. METHODS: Thirty-two strains of C. tropicalis comprising eight sporadic strains and 24 clonal strains belonging to six clones, of which clonal type were previously confirmed by pulsed-field gel electrophoresis (PFGE), were tested by IRS-PCR to evaluate the usefulness of this technique. Twenty strains of Candida species, including C. glabrata, C. krusei, C. albicans, and C. parapsilosis, were also tested to assess the ability of IRS-PCR to discriminate among species of Candida. RESULTS: Using the IRS-PCR assay, sporadic strains of C. tropicalis could not be differentiated from clonal strains. Most strains belonging to the same clones were classified as different IRS-PCR types or clusters, and some different sporadic strains were classified as the same IRS-PCR types. When pattern variation was examined for different strains of C. tropicalis using IRS-PCR, pairwise similarity measured by the Dice coefficient was 75.4~100%. In contrast, pairwise similarity among isolates of five different species of Candida was 25~69.2%. Therefore, five different species of Candida were easily differentiated. CONCLUSION: The IRS-PCR typing assay appears to be an inadequate tool for the epidemiological typing of C. tropicalis, because the typing result of IRSPCR is not comparable to that of PFGE. To our knowledge, this is the first evaluation study for IRSPCR as an epidemiological typing tool for C. tropicalis.
Candida tropicalis* ; Candida* ; Clone Cells ; DNA Fingerprinting ; Electrophoresis, Gel, Pulsed-Field ; Epidemiologic Studies ; Molecular Typing ; Polymerase Chain Reaction* ; Technology Assessment, Biomedical

BACKGROUND: Rapid detection of pathogens in blood is important in patient management, because the mortality rate associated with bloodstream infections is very high. We evaluated the efficiency of a 16S rDNA PCR assay for the detection of various pathogens in blood culture broth in METHODS: 16S rDNA PCR was performed on 221 blood culture bottles consisting of 99 culturepositive and 122 culture-negative samples. The results were compared with conventional culture methods. We also compared the efficiency of three DNA extraction and purification methods using proteinase K, triton X-100, and benzyl alcohol-guanidine DNA extraction of blood culture broths. RESULTS: The 16S rDNA PCR method detected 95 (12 Staphylococcus aureus, 27 coagulase negative staphylococci, 10 enterococci, 5 streptococci, 37 gram negative bacilli, 4 corynebacteria) of 99 positive culture bottles. Four false-negative results were obtained for bottles containing 2 Corynebacterium, 1 Escherichia coli, and 1 S. aureus species. All 122 bottles that showed no blood culture growth were negative by 16S rDNA PCR. Overall, the sensitivity, specificity, positive predictive values and negative predictive values of 16S rDNA PCR relative to the culture results were 96.0%, 100%, 100%, and 96.8%, respectively. Among the three DNA extraction methods, the benzyl alcohol-guanidine method was most effective. CONCLUSION: The 16S rDNA PCR assay is a rapid and efficient means of detecting various pathogens in the blood and has great potential for use in the clinical microbiology laboratory.
Coagulase ; Corynebacterium ; DNA ; DNA, Ribosomal* ; Endopeptidase K ; Escherichia coli ; Humans ; Mortality ; Octoxynol ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sepsis ; Staphylococcus aureus

In clinical practice, pharmacological treatment is mostly focused on behavioral symptoms in everyday life. Nevertheless, persistent effort continues to develop medication for causal treatment. Recent changes in diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) to DSM-5 would affect not only diagnosing approaches, but also therapeutic approaches. Because previous pervasive developmental disorders have been integrated into a single entity, the autism spectrum disorder (ASD), we have to prepare for what medications are valuable for the ASD. In this article, we reviewed the following etiological treatment: acetylcholine and glutamate related medicine; amino acid medicine such as secretin, endogenous opioid, and oxytocin; complementary and alternative medicine such as chelating agents, vitamins, and omega-3; promising drugs related to the scope of pharmacogenetics currently under study.
Acetylcholine ; Behavioral Symptoms ; Chelating Agents ; Child ; Autism Spectrum Disorder* ; Complementary Therapies ; Diagnostic and Statistical Manual of Mental Disorders ; Drug Therapy* ; Glutamic Acid ; Oxytocin ; Pharmacogenetics ; Secretin ; Vitamins