PURPOSE: To evaluate several risk factors related to re-ulceration of diabetic foot including psychosocial aspects such as familial support and degree of independence of patients' activity. MATERIALS AND METHODS: We reviewed medical records and performed telephone interview with eighty-five patients who had a history of hospitalization in our hospital due to diabetic foot ulceration from year 2002 to 2010. Based on the collected data, we analyzed several factors such as age, gender, prevalence duration, accompanying diseases, HbA1c level, degree of independence and familial support. RESULTS: The mean age was 61.4 years and most common in the 4th decade. There were 57 cases (67%) of recurrence, predominance of male. Eleven patients with recurrent diabetic foot ulceration had undergone major amputations. Psychosocial problems such as depression, insufficient familial support and mortality were more frequently observed in recurrent group. CONCLUSION: This study shows that psychosocial factor such as familial support for patient with diabetic foot could be important to reduce the recurrence rate of diabetic foot ulceration. Therefore, we should pay attention to strategic plans for prevention, screening, treatment, and aftercare through the prospective studies including psychosocial risk factor in diabetic foot ulceration.
Aftercare ; Amputation ; Depression ; Diabetic Foot ; Foot ; Hospitalization ; Humans ; Interviews as Topic ; Male ; Mass Screening ; Medical Records ; Prevalence ; Recurrence ; Retrospective Studies ; Risk Factors ; Ulcer

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.
Acetazolamide* ; Arteriovenous Malformations* ; Brain* ; Humans ; Perfusion* ; Prognosis* ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

Paragonimus westermani can cause extrapulmonary parasitism in various sites such as abdominal organ, brain, eye, periorbital tissue, heart and pericardium, mediastinum, and subcutaneous tissue. We experienced a case of subcutaneous paragonimiasis involving the breast. The lesion exhibited chronic granuloma with scattered eggs of paragonimus westermani. The adult worm was not found within the lesion which should be disintegrated a year ago by praziquantel treatment. This relatively rare involvement of ectopic paragonimiasis should be differentiated from breast malignancy.
Adult ; Male ; Female ; Humans

OBJECTIVE: To find out the changes of the plantar pressure distribution of foot and the pathway of center of pressure (COP) in normal preschool children with age. METHOD: Thirty-eight normal children aged 1 to 6 were participated in this study. We divided into three groups according to the age. Foot contact area, pressure of the foot and pathway of COP were measured using F-scan in-shoe measuring system (Tekscan Inc.) during the gait. RESULTS: The ratio of midfoot contact width to forefoot contact width was decreased with age (p<0.05). And the relative pressure of the medial midfoot was decreased with age (p<0.05). In the analysis of COP, the ratio of anteroposterior length of COP to total contact length was significantly increased (p<0.05), and the ratio of mediolateral width of COP to forefoot contact width was tend to decrease. CONCLUSION: We can identify the characteristics and changes of the foot pressure distribution and the pathway of COP in preschool children with normal foot using F-scan system. These quantitative data of foot scan are useful for evaluating the foot pathology in preschool children during the gait.
Child ; Child, Preschool* ; Foot* ; Gait* ; Humans ; Pathology

Axon guidance molecules (AGMs), such as Netrins, Semaphorins, and Ephrins, have long been known to regulate axonal growth in the developing nervous system. Interestingly, the chemotactic properties of AGMs are also important in the postnatal period, such as in the regulation of immune and inflammatory responses. In particular, AGMs play pivotal roles in inflammation of the nervous system, by either stimulating or inhibiting inflammatory responses, depending on specific ligand-receptor combinations. Understanding such regulatory functions of AGMs in neuroinflammation may allow finding new molecular targets to treat neurodegenerative diseases, in which neuroinflammation underlies aetiology and progression.
Axons ; Ephrins ; Inflammation ; Nervous System ; Neurodegenerative Diseases ; Neuroglia ; Semaphorins

An intussusception was first reported by Barbette in 1674, but an intussusception of the appendix was first reported in London, in 1858. Of all intussusceptions, 5% occur in adults, and of these 90% are as a result of a primary cause. Therefore, treatment is usually based on the primary cause. An intussusception of the appendix can be treated by barium or air reduction, or by an appendectomy, with manual reduction in pediatrics, but these are very uncommon in adult, and can be treated by various methods, according to the underlying cause. A 74 years old woman was preoperatively diagnosed, by radiological examination, to have an intussusception of the appendix. An exploratory laparotomy was performed, and the lesion confirmed as an intussusception caused by an appendix mass, which was cystic and filled with mucin. Therefore, a right hemicolectomy was performed, with the pathological results confirming a mucinous cystadenocarcinoma of the appendix. Here, we report a case of an adult intussusception of the appendix in a 74 years old woman.
Adult ; Aged ; Appendectomy ; Appendix ; Barium ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Intussusception* ; Laparotomy ; Mucins* ; Pediatrics

PURPOSE: The tunneled hemodialysis catheter has been widely used for a temporary or an alternative permanent vascular access in patients requiring hemodialysis. The tunneled hemodialysis catheter is also widely used for a reliable vascular access in children who need stem cell transplantation. METHOD: We reviewed the results of 150 catheters inserted in 108 patients for the duration of the indwelling catheter, the complication rate and the reasons for insertion and removal. RESULT: The mean duration of the indwelling catheter was 5.7 months (1 d~52.2 mo). In the stem cell transplantation group, the mean duration of the indwelling catheter was significantly longer than for the hemodialysis group (mean: 9.9 mo vs. 3.6 mo, P<0.05). Fifty-one catheters (39.8%) were removed due to complications. The most common complications were infection (n=23: 17.9%) and dislocation (n=15: 11.7%). In the hemodialysis group, the complication-related catheter removal was more frequent than in the stem cell transplantation group (43.9% vs. 32.6%, P<0.05). CONCLUSION: The tunneled hemodialysis catheter remains a reliable short-term vascular access for hemodialysis and a good vascular access in stem cell transplantation.
Catheterization, Central Venous ; Catheters* ; Catheters, Indwelling ; Child* ; Dislocations ; Humans ; Renal Dialysis* ; Stem Cell Transplantation

Postburn sternomental contractures (PBSMC) of the neck can cause difficulties in endotracheal intubation when the cervical hyperextension and lifting of the mandible are impaired. Ten patients with a healed burn of the neck were assessed prior to surgery using the modified Mallampati test, and by measuring the sternomental distance, interincisor gap with their mouth fully open, and using Onah's classification system for PBSMC. Difficult endotracheal intubation was predicted. The patients were intubated successfully with a fiberoptic bronchoscope. The fiberoptic bronchoscope was found to be a useful device for managing patients with PBSMC. Moreover, Onah's classification system can be used for assessing postburn contractures.
Airway Management* ; Anesthesia* ; Bronchoscopes ; Burns ; Classification ; Contracture* ; Humans ; Intubation, Intratracheal ; Lifting ; Mandible ; Mouth ; Neck

BACKGROUND/AIMS: The invasiveness of a liver biopsy and its inconsistent results have prompted efforts to develop noninvasive tools to evaluate the severity of chronic hepatitis. This study was intended to assess the performance of serum biomarkers for predicting liver fibrosis in patients with chronic viral hepatitis. METHODS: A total of 302 patients with chronic hepatitis B or C, who had undergone liver biopsy, were retrospectively enrolled. We investigated the diagnostic accuracy of several clinical factors for predicting advanced fibrosis (F≥3). RESULTS: The study population included 227 patients with chronic hepatitis B, 73 patients with chronic hepatitis C, and 2 patients with co-infection (hepatitis B and C). Histological cirrhosis was identified in 16.2% of the study population. The grade of porto-periportal activity was more correlated with the stage of chronic hepatitis compared with that of lobular activity (r=0.640 vs. r=0.171). Fibrosis stage was correlated with platelet count (r=-0.520), aspartate aminotransferase to platelet ratio index (APRI) (r=0.390), prothrombin time (r=0.376), and albumin (r=-0.357). For the diagnosis of advanced fibrosis, platelet count and APRI were the most predictive variables (AUROC=0.752, and 0.713, respectively). CONCLUSIONS: In a hepatitis B endemic region, platelet count and APRI could be considered as reliable non-invasive markers for predicting fibrosis of chronic viral hepatitis. However, it is necessary to validate the diagnostic accuracy of these markers in another population.
Aspartate Aminotransferases ; Biomarkers* ; Biopsy ; Blood Platelets ; Coinfection ; Diagnosis ; Fibrosis* ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Liver ; Liver Cirrhosis ; Platelet Count ; Prothrombin Time ; Retrospective Studies

OBJECTIVES: Pregnanolone is a potent positive modulator of the gamma-aminobutyric acid(GABA) response that enhances the binding of [3H]flunitrazepam to the GABA A receptor. Recently, it was reported that chronic treatment with pregnanolone uncouples allosteric interactions between steroid and benzodiazepine recognition sites. The present study was designed to assess the effect of repeated stress on the modulation of neuroactive steroids on the GABA A receptor. METHODS: The effect of steroids on the ligands binding to GABA A receptor was investigated using cerebral cortices of unstressed and repeatedly immobilized rats. Male Sprague-Dawley rats, weighing 200-250g were forced to suffer an immobilization stress for 2 hours. RESULTS: Pregnanolone enhanced the binding of [3H]flunitrazepam to GABA A receptor in both of unstressed and repeatedly stressed rats. However, repeatedly stressed rats showed significantly higher values in EC50 and lower values in E max of enhancement binding of [3H]flunitrazepam than those of unstressed rats. CONCLUSIONS: From these findings, it can be concluded that repeated stress reduced the positive modulation of neuroactive steroid on the GABA A-receptor complex.
Animals ; Benzodiazepines ; Cerebral Cortex ; gamma-Aminobutyric Acid ; Humans ; Immobilization ; Ligands ; Male ; Pregnanolone ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A ; Steroids*