The MR images of 13 patients with brain abscesses were retrospectively reviewed. The abscesses were solitary in 11 patients and multiple in 2 patients. They were located in the corticomedullary junction of the cerebral hemispheres(11) and cerebellum (2).: The sizes of the abscesses were variable, ranging from 1 cm to 5 cm in diameter. They were round (5), oblong (4) or multilobulated (4) in shape. Massive surrounding edema was found in 12 patients. The signal intensity of the abscess contents was hypointense to gray matter and hyperintense to CSF on T1-weighted images, and hyperintense to gray matter on both proton-density-and T2-weighted images. In 5 patients the abscess contents were heterogeneous on both T1-and T2-weighted images. The signal intensity of the abscess walls was isointense(11), slightly hyperintense (1) or hypointense (1) relative to gray matter on T1-weighted images, whereas they were isointense (4) or hypointense (9) on T2-weighted images. Of 10 patients with Gd-enhanced-T1-weighted images, 5 patients(50%) showed thin, smooth, rim enhancement, while the other 5 patients revealed somewhat irregular thick wall enhancement Satellite or daughter abscesses were found in 6 patients. Meningeal or ventricular wall enhancement suggesting meningitis or ventriculitis was associated in 3 and 1 patient, respectively. In conclusion, the characteristic morphology and intensity of the abscess capsule, massive surrounding edema, satellite abscess and associated meningitis or ventriculitis are characteristics of the brain abscess, even though they are not entirely specific to allow for accurate diagnosis in all patients.
Abscess ; Brain Abscess* ; Brain* ; Cerebellum ; Diagnosis ; Edema ; Gray Matter ; Humans ; Magnetic Resonance Imaging* ; Meningitis ; Nuclear Family ; Retrospective Studies

OBJECTIVE: Excessive worry about minor matters and a state in which this worry is experienced as uncontrollable are known to be key symptoms of generalized anxiety disorder (GAD). Given the importance of pathological worry in GAD, the need for psychometrically sound measures of this construct has increased. The purpose of this study was to investigate the usefulness of the Korean version of Penn State Worry Questionnaire (K-PSWQ) for screening GAD. METHODS: Two hundred and forty six patients were initially screened, from which 102 GAD patients and 118 patients with anxiety disorder not otherwise specified (anxiety disorder NOS) were finally enrolled. Patients were diagnosed by a structured clinical interview for the DSM-IV Axis I. We also enrolled 114 control subjects who had no medical or psychiatric history. Pathological worry in both patients and control subjects were assessed at baseline using the PSWQ and we estimated optimal cutoff score by the receiver operating characteristic (ROC) analysis. RESULTS: We found that in the first ROC analysis, a score of 53 could simultaneously optimize sensitivity and specificity in order to discriminate GAD patients from control subjects. From the second receiver operating characteristic analysis, when both sensitivity and specificity were optimized, we can suggest a score of 61 as being the cutoff for differentiating GAD patients from patients with anxiety disorder NOS. CONCLUSION: The Korean version of PSWQ is a useful method for screening GAD patients, although ethnic and cultural differences may affect the cutoff score of PSWQ for GAD.
Anxiety Disorders* ; Anxiety* ; Axis, Cervical Vertebra ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening* ; Methods ; Surveys and Questionnaires* ; ROC Curve* ; Sensitivity and Specificity

Congenital diverticula of the cardiac ventricle have been reported as arising either from the left ventricule or, rarely from both ventricules. A diverticulum arising from the right ventricle alone is very rare. Double chambered right ventricle(DCRV) was first described in 1962 by Lucas et al, and account for 1.5% of congenital heart disease. Right ventricular diverticulum are associated with right ventricle outlet obstructive disease, tetralogy of fallot, double outlet right ventricle, pulmonic stenosis, ventricular septal defect, left ventricule-right atrium communication, persistant truncus arteriosus. DCRV are freqently associated with ventricular septal defect(80%), pulmonic stenosis(33%), renal anormaly(43%). Treatment consist of suture of diverticulum and resection of septum. We report a case of double chambered right ventricle with congenital right ventricular true diverticulum in 62 years of female patients admitted due to anterior chest pain and mild exertional dyspnea.
Chest Pain ; Diverticulum* ; Double Outlet Right Ventricle ; Dyspnea ; Female ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Heart Ventricles* ; Humans ; Pulmonary Valve Stenosis ; Sutures ; Tetralogy of Fallot ; Truncus Arteriosus

OBJECTIVE: Although specific temperaments have been known to be related to autonomic nervous function in some psychiatric disorders, there are few studies that have examined the relationship between temperaments and autonomic nervous function in a normal population. In this study, we examined the effect of temperament on the sympathetic nervous function in a normal population. METHODS: Sixty eight healthy subjects participated in the present study. Temperament was assessed using the Korean version of the Cloninger Temperament and Character Inventory (TCI). Autonomic nervous function was determined by measuring skin temperature in a resting state, which was recorded for 5 minutes from the palmar surface of the left 5th digit using a thermistor secured with a Velcro(R) band. Pearson's correlation analysis and multiple linear regression were used to examine the relationship between temperament and skin temperature. RESULTS: A higher harm avoidance score was correlated with a lower skin temperature (i.e. an increased sympathetic tone; r=-0.343, p=0.004) whereas a higher persistence score was correlated with a higher skin temperature (r=0.433, p=0.001). Hierarchical linear regression analysis revealed that harm avoidance was able to predict the variance of skin temperature independently, with a variance of 7.1% after controlling for sex, blood pressure and state anxiety and persistence was the factor predicting the variance of skin temperature with a variance of 5.0%. CONCLUSION: These results suggest that high harm avoidance is related to an increased sympathetic nervous function whereas high persistence is related to decreased sympathetic nervous function in a normal population.
Anxiety ; Blood Pressure ; Cloning, Organism ; Linear Models ; Skin ; Skin Temperature ; Temperament

PURPOSE: To evaluate the effect of plugging the biopsy tract in rabbit liver and the pathologic changes caused by plugging materials. MATERIALS AND METHODS: Thirty-two New Zealand White rabbits were divided into four groups(eight rabbits in each) and compared with one another. They were labeled group A(control), B(gelfoam),C(fibrin sealant) or D(NBCA). The liver was exposed and biopsied with an 18G disposible biopsy gun. The inner Tru-cut needle was withdrawn and plugging was undertaken through the outer cannula of the biopsy gun. Bleeding times of each material were compared. The rabbits were sacrificed and pathologically evaluated for 17 days. RESULTS: Mean bleeding times were 46.7+/-34.5 sec in group A, 42.9+/-54.7 sec in group B, 12.6+/-15.0 sec in group C, and 0 sec in group D. In groups C and D, these results were statistically significant(p<0.01). Pathologically, fibrin sealant was lowest in foreign body reaction and fibrosis. NBCA was effective for the prevention of hemorrhage. CONCLUSION: NBCA and fibrin sealant effectively plug the biopsy tract through the outer cannula of an18 G biopsy gun.
Biopsy* ; Bleeding Time ; Catheters ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibrosis ; Foreign-Body Reaction ; Gelatin Sponge, Absorbable* ; Hemorrhage ; Liver* ; Needles ; Rabbits

Multiple myeloma is lethal plasma cell proliferation that produces monoclonal M-protein and presents bone pain, pathologic fractures, anemia, hypercalcemia, renal failure, abnormalities of the coagulation system, and dysfunctions of the nervous system. About 1% of the multiple myeloma have more than one such protein (monoclonal M-protein). We experienced a case of mutiple myeloma presented as biclonal gammopathy. Protein electrophoresis and immunoelectrophoresis showed biclonal band that consisted of IgG-landa and IgA-k.
Anemia ; Electrophoresis ; Fractures, Spontaneous ; Hypercalcemia ; Immunoelectrophoresis ; Multiple Myeloma* ; Nervous System ; Plasma Cells ; Renal Insufficiency

BACKGROUND: We present here the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2010 through June 2011. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 130 ICUs in 72 hospitals using KONIS. Nosocomial infection (NI) rates were calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: A total of 3,757 NIs were found: 1,978 UTIs (1,949 cases were urinary catheter-associated), 1,092 BSIs (with 932 being central line-associated), and 687 PNEUs (410 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTIs) was 3.87 cases per 1,000 device-days (95% confidence interval, 3.70-4.05), and the urinary catheter utilization ratio was 0.86 (0.859-0.861). The rate of central line-associated BSIs was 3.01 per 1,000 device-days (2.82-3.21), and the utilization ratio was 0.53 (0.529-0.531). The rate of ventilator-associated PNEUs (VAPs) was 1.75 per 1,000 device-days (1.59-1.93), and the utilization ratio was 0.40 (0.399-0.401). Although both the ventilator utilization ratiosand the urinary catheter utilization ratios were lower in hospitals with 400-699 beds than thosein hospitals with 700-899 beds ormore than 900 beds, the rates of VAPsand CAUTIs were higher in hospitals with 400-699 beds than thosein hospitals with 700-899 beds or more than 900 beds. CONCLUSION: The risk of acquiring VAP and CAUTI is higher in the ICUs of 400-699 bed hospitals than in ICUs oflarger hospitals. Therefore, ongoing targeted surveillance and implementation of proven infection control strategies are needed especially for hospitals having fewer than 700 beds.
Benzamides ; Cross Infection ; Infection Control ; Critical Care ; Intensive Care Units ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

BACKGROUND: In this report, we present the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2009 through June 2010. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTIs), bloodstream infections (BSIs), and pneumonia (PNEU) at 116 ICUs in 63 hospitals by using KONIS. Nosocomial infection (NI) rates were calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: We identified 3,965 NIs during the study period: 2,156 cases of UTIs (2,119 were urinary catheter-associated), 1,110 cases of BSIs (948 were central line-associated), and 699 cases of PNEU (410 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTIs) was 4.75 cases per 1,000 device-days (95% confidence interval, 4.55-4.95), and urinary catheter utilization ratio was 0.86 (range, 0.859-0.861). The rate of central line-associated BSIs was 3.28 (range, 3.07-3.49), and the utilization ratio was 0.56 (range, 0.559-0.561). The rate of ventilator-associated PNEUs (VAPs) was 1.95 (range, 1.77-2.15), and the utilization ratio was 0.41 (range, 0.409-0.411). Although ventilator utilization ratio was lower in the hospitals with 400-699 beds than in the hospitals with 700-899 beds and more than 900 beds, the rate of VAPs were higher in the hospitals with 400-699 beds than in hospitals with 700-899 beds and more than 900 beds. The incidence of infections due to imipenem-resistant Acinetobacter baumannii increased from 43.6% to 82.5% since July 2006. CONCLUSION: The risk of acquiring VAP and CAUTI is highest in the ICUs of hospitals with 400-699 beds than that in hospitals with more beds. Imipenem-resistant A. baumannii was identified as an emerging gram-negative pathogen of nosocomial infections.
Acinetobacter baumannii ; Cross Infection ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

This cohort study is a collaborative effort of 8 institutions. The goal is to establish a large scale cohort that can be followed for 10 or more years to assess the relationship between life-styles and cancer occurrence, and to evaluate the role of environmental exposures in the development of six major sites of cancers(stomach, liver, lung, colorectum, uterine cervix and female breast) in the rural population. Since 1993, 11,304 men and women aged over 35 living in four areas have been recruited. The number of target population is 30,000 persons, which is expected to be successfully recruited until 1999. Each subject has completed a detailed questionnaire on general life-styles, reproductive factors, and agricultural chemical exposures through the interview. Anthropometric measurements with body fat composition and the routine clinical laboratories were examined. For the cancer-free cohort, physical examination by the physicians and serologic tests for hepatitis markers, some tumor markers, and lipid profile have been done, but not all. In order to provide an opportunity to incorporate barious biomarkers of exposure and effect as well as genetic susceptibility, a biologic tissue bank has been established from blood and urine sample(plasma, WBC buffy-coat, RBC clots, and urine supernatant) stored at-70degrees C. Re-examination of changes in exposere to risk factors will be done periodically. Disease occurrence will be ascertained by the active(mainly through diagnosis by physicians) and the passive surveillance(through both death certificate and screening of medical utilization records).
Adipose Tissue ; Biomarkers ; Cervix Uteri ; Cohort Studies* ; Death Certificates ; Diagnosis ; Environmental Exposure ; Female ; Genetic Predisposition to Disease ; Health Services Needs and Demand ; Hepatitis ; Humans ; Korea* ; Liver ; Lung ; Male ; Mass Screening ; Physical Examination ; Risk Factors ; Rural Population ; Serologic Tests ; Tissue Banks ; Biomarkers, Tumor ; Surveys and Questionnaires

OBJECTIVE: Panic disorder is characterized by recurrent panic attacks, persistent concerns about additional attacks, and worry about the implications of the attack or significant changes in behavior related to the attacks. We examined the efficacy of 24-week naturalistic, open-label escitalopram treatment in terms of the response and remission rates and functional disability in 119 adult Korean patients with panic disorder from 6 clinical centers in South Korea. METHODS: Clinical severity and functional impairment were assessed at baseline and at 4, 12, and 24 weeks after the treatment using the Panic Disorder Severity Scale and Sheehan Disability Scale. Ninety-six patients (80.7%) showed a treatment response, and 87 patients (73.1%) had attained remission after 24 weeks of escitalopram treatment. RESULTS: Continuous improvement in the Panic Disorder Severity Scale and Sheehan Disability Scale scores was found over the 24 weeks of treatment. CONCLUSION: These findings suggest that escitalopram treatment is very effective for panic disorder in terms of both response and remission rates and that long-term pharmacotherapy with escitalopram continuously improved panic symptoms and functional disability in Korean patients with panic disorder.
Adult ; Antidepressive Agents ; Citalopram ; Humans ; Panic ; Panic Disorder ; Prospective Studies