Though the incidence of paragonimiasis has been remarkably decreased since 1970, it is still not a rare disease in Korea. Major problems in the diagnosis of pulmonary paragonimiasis on chest radiography are its differentiation from pulmonary tuberculosis and lung cancer. Chest radiographic findings have been described in detail, but little have been reported on CT findings. We reviewed CT findings of 10 patients with pulmonary paragonimiasis. The characteristic CT findings were similar to those on chest radiography, such as air-space consolidation (70%), nodular mass (50%), pleural effusion (40%), cystic lesion (30%), small low density within the mass (30%), linear density (20%), pneumothorax(20%), and burrow track (20%). CT depicted the cystic lesions and the burrow tracks more clearly and showed the small worm-retaining cysts within the mass that were not detectable on chest radiography. In conclusion, all of these CT findings are useful in the diagnosis of pulmonary paragonimiasis especially when differentiation from tuberculosis or lung canceris difficult on chest radiography.
Diagnosis ; Humans ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Paragonimiasis* ; Pleural Effusion ; Radiography ; Radiography, Thoracic ; Rare Diseases ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

OBJECTIVE: This study was conducted to assess the current status of experiential education, by analyzing pharmacy students' satisfaction and evaluation for practice sites and preceptors for 3 years from 2014 through 2016. METHODS: Students evaluated the practice sites and preceptors using a 5-point and a 4-point Likert scale, respectively. Analysis was performed based on the types of curriculums and practice sites. In addition, sub-analysis was conducted based on the types of health-system pharmacy and the community pharmacy. RESULTS: Total 203 students responded to the survey questionnaires. The 3-year average score of students' satisfaction with practice sites was 4.25. In the sub-analysis conducted based on the types of health-system pharmacy, the score was higher in the tertiary hospital pharmacies than that of the general hospital pharmacies (4.49 vs. 4.06, P<0.001). For community pharmacy, the difference in the score of the 3-year analysis was not significant, depending on the types (4.51 vs. 4.33, P=0.054). The average score of students' evaluation on the preceptors was 3.37 in the 3-year analysis. The score was significantly higher for the preceptors of tertiary hospital pharmacies than those of general hospital pharmacies (3.61 vs. 3.25, P<0.001). For community pharmacy, no significant differences were found, depending on the types of pharmacy (3.53 vs. 3.43, P=0.309). CONCLUSION: The students' satisfaction with practice sites and preceptors in pharmacy experiential education was high. However, it varied greatly depending on the types of educational institutions. Mutual effort between university and educational institutions is required, to narrow the gap in the degree of students' satisfaction.
Curriculum ; Education* ; Hospitals, General ; Humans ; Pharmacies ; Pharmacy* ; Students, Pharmacy ; Tertiary Care Centers

No abstract available.
Autopsy* ; Endocarditis* ; Thromboembolism

Understanding of brain morphology and magnetic resonance image(MRI) is essential for accurate diagnosis and treatment of the brain diseases. As education tools, the cadaver dissection, plastic models, and neuroanatomy books have been used for understanding brain morphology; and the MRI films and radiology books have been used for understanding brain MRI. Recently, due to the popularization of powerful personal computers, computer programs compensating the conventional education tools have been used. But these computer programs have a disadvantage that it is not possible to visualize the details of brain morphology or to compare the corresponding sectioned specimens and MRI. Therefore, we attempted to make a computer program which could visualize not only the details of brain morphology but also the corresponding sectioned specimens and MRI by using the brains removed from Korean cadavers. Three brains were removed from Korean cadavers. With a brain, 122 MRI and 122 serially-sectioned specimens with an 1.4mm interval were acquired and inputted into the computer. Ten brain structures were segmented, and 83 fine structures were designated on the images. With two brains, 27 dissected specimens were acquired and inputted into the computer. One-hundred two fine structures were designated on the images. Based on these images, a computer program for understanding brain morphology and MRI was made. The computer program, which was made in this study, visualized the corresponding sectioned specimens, MRI, and segmented images after sectioning a brain horizontally or at any angles. In addition, the computer program visualized the images of dissected brain. This computer program is helpful to understand brain morphology and MRI. This computer program is expected to be used through CD-title or Internet as an educational tool for medical students and doctors.
Brain Diseases ; Brain* ; Cadaver ; Diagnosis ; Education ; Humans ; Internet ; Magnetic Resonance Imaging ; Microcomputers ; Neuroanatomy ; Plastics ; Students, Medical

Although shock in sepsis is usually managed successfully by conventional medical treatment, a subset of cases do not respond and may require salvage therapies such as veno-arterial extracorporeal membrane oxygenation (VA ECMO) support as well as an attempt to remove endotoxins. However, there are limited reports of attempts to remove endotoxins in patients with septic shock on VA ECMO support. We recently experienced a case of septic shock with severe myocardial injury whose hemodynamic improvement was unsatisfactory despite extracorporeal membrane oxygenation (ECMO) support. Since the cause of sepsis was acute pyelonephritis and blood cultures grew gram-negative bacilli, we additionally applied polymyxin B direct hemoperfusion (PMX-DHP) to the ECMO circuit and were able to successfully taper off vasopressors and wean off ECMO support. To the best of our knowledge, this is the first adult case in which PMX-DHP in addition to ECMO support was successfully utilized in a patient with septic shock. This case indicates that additional PMX-DHP therapy may be beneficial and technically feasible in patients with septic shock with severe myocardial injury refractory to ECMO support.
Adult ; Cardiomyopathies* ; Endotoxins ; Extracorporeal Membrane Oxygenation ; Hemodynamics ; Hemoperfusion* ; Humans ; Membranes* ; Oxygen* ; Polymyxin B* ; Polymyxins* ; Pyelonephritis ; Salvage Therapy ; Sepsis ; Shock ; Shock, Septic*

No abstract available.
Animals ; Glycogen Synthase ; Glycogen ; Insulin ; Rats

No abstract available.
Bismuth* ; Gentamicins* ; Mercuric Chloride*

OBJECTIVES: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. METHODS: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. RESULTS: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. CONCLUSIONS: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.
Drug-Eluting Stents/*economics ; Emergency Service, Hospital/economics ; Female ; Humans ; Male ; Metals ; Middle Aged ; Myocardial Infarction/economics/*therapy ; Republic of Korea ; Retrospective Studies ; Stents/*economics

PURPOSE: To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. MATERIALS AND METHODS: We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6 -4.1ppm to lipid (0.9 - 1.6ppm) [P (1.6 -4.1ppm)/P (0.9 -1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of 1 H-MRS. RESULTS: Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6 -4.1ppm)/P (0.9 -1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6 -4.1ppm)/P (0.9 -1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were 2.71 +/-1.48 and 0.29 +/- 0.11, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were 100% (11/11, and 14/14). CONCLUSION: Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and 1 H-MRS can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.
Biopsy ; Diagnosis, Differential ; Fibrosis* ; Magnetic Resonance Spectroscopy* ; Protons* ; Rectal Neoplasms* ; Sensitivity and Specificity

We report a case of rectal teratoma coexistent with an ovarian teratoma. To our knowledge, this is the first radiologic report of rectal teratoma. Computed tomography (CT) showed a sharply demarcated cystic and fatty mass with amorphous calcification in the rectum. A double-contrast barium study showed a well-defined intraluminal rectal mass without mucosal destruction. Imaging findings of rectal teratoma allow for correct preoperative diagnosis. CT was helpful in differentiating rectal teratoma from other rectal lesions.
Barium ; Diagnosis ; Rectum ; Teratoma*