Background and purpose: This study evaluated the changes in blood flow velocity in the anterior and posterior intracranial circulations according to the progression of moyamoya disease in adult patients. Methods: We evaluated Suzuki's angiographic stage and mean blood flow velocity (MBFV) changes in intracranial vessels from both sides in 19 adult moyamoya patients. We then analyzed the linearity of MBFV changes from early to late moyamoya stages in each intracranial vessel using piecewise linear regression models. Results: The MBFV in the middle cerebral artery, terminal internal carotid artery, and anterior cerebral artery increased non linearly until stage III, and then decreased progressively up to stage VI. The ophthalmic artery also showed nonlinear velocity changes, with an increase in MBFV up to stage IV, followed by a decrease in MBFV up to stage VI. The MBFV of the basilar artery increased linearly from a normal velocity at an early moyamoya stage to a stenotic velocity at a late stage. There was no statistically significant regression model for the relationship between the MBFV in the posterior cerebral artery and moyamoya stage. Conclusions: The nonlinear and/or linear MBFV changes associated with variable intracranial vessels might be useful in initial and follow-up evaluations of different stages of moyamoya disease.
Adult ; Anterior Cerebral Artery ; Basilar Artery ; Blood Flow Velocity ; Carotid Artery, Internal ; Glycosaminoglycans ; Hemodynamics ; Humans ; Linear Models ; Middle Cerebral Artery ; Moyamoya Disease ; Ophthalmic Artery ; Posterior Cerebral Artery

Intracranial venous infarction and drainage alteration are rare clinical events developing after intracranial operation. Immediate anticoagulation has been recommended to restore the alteration of the intracranial venous drainage. However, for the venous drainage alteration or infarction developed just after intracranial operation, the bleeding tendency induced by the anticoagulation should be considered. We report a case of successfully managed cortical venous infarctions developed immediately after intracranial operation using low molecular weight heparin.
Drainage* ; Hemorrhage ; Heparin, Low-Molecular-Weight* ; Infarction

BACKGROUND AND PURPOSE: Periodic lateralized epileptiform discharges (PLEDs) are defined as spikes or sharp waves occurring at an approximately regular interval. PLEDs are subdivided into PLEDs proper and PLEDs plus in Reiher's classification, but since this does not sufficiently reflect the pleomorphism of PLEDs, we propose a new subclassification scheme of PLEDs, and discuss the relationship between them and clinical prognoses. METHODS: Thirty-seven patients who had at least two available EEGs were included in this study. Each patient had structural brain lesions identified in brain CT/MRI: 237 EEGs from 37 patients were reviewed and the patterns of PLEDs were classified by electroencephalographic characteristics based on Reiher's classification. PLEDs proper of class 3 were subclassified into four categories: (1) simple, (2) benign, (3) vigorous, and (4) suppressed. RESULTS: Most of the PLEDs that started with the vigorous or suppressed pattern of class 3 evolved into the simple or benign pattern of class 3 and subsequently changed into class 1 or class 2, finally intermingling with the neighboring background waves. PLEDs that started with the benign or simple pattern of class 3 rapidly changed into class 1 or 2. Patients showing the benign or simple pattern of class 3 exhibited a better clinical prognosis. CONCLUSIONS: PLEDs have five distinctive classes, and over time they evolve from malignant PLEDs plus to benign PLEDs proper before finally disappearing. It appears that those of class 3 have more diverse patterns, with the vigorous and suppressed patterns being the more malignant forms of PLEDs in this class.
Brain ; Classification* ; Electroencephalography ; Humans ; Prognosis

BACKGROUND: This study evaluated the relationships between endogenous estrogen levels and vascular risk factors in healthy men and women. METHODS: Demographics and laboratory data were collected from normotensive subjects (123 men and 154 women) in their thirties, forties and fifties who had normal laboratory profiles and no cardiovascular risk factors. Initially, estradiol, low-density lipoprotein (LDL)-cholesterol, triglyceride, and high-density lipoprotein (HDL)-cholesterol, systolic and diastolic blood pressure (SBP and DBP), NO2/NO3, homocysteine, and body mass index (BMI) were measured. Then, the relationships between estradiol and the evaluated items were analyzed with comparison of means and correlation, and stepwise multiple regression analysis based on genders and age-groups. RESULTS: Estradiol levels decreased with aging in women. Lower LDL and triglyceride, higher HDL levels, and lower SBP and DBP observed in women were correlated with decreasing age as well as increasing estradiol level. On the multivariate analysis, however, estradiol levels were negatively correlated with the changes in SBP, DBP, and triglyceride among the lipid variables. BMI was positively related with the increase of SBP and DBP and the estradiol levels. Although higher NO2/NO3 and lower homocysteine levels were observed in women than men, the NO2/NO3 and homocysteine levels had no significant correlation with estradiol changes. CONCLUSION: The study observed the beneficial relationships between endogenous estrogen, and blood pressures and lipids in healthy women. The estrogen-related benefits observed in this study were lower TG levels, SBP, and DBP in young women than those in older women or in men.
Aging ; Blood Pressure ; Body Mass Index ; Cholesterol ; Demography ; Estradiol ; Estrogens ; Female ; Homocysteine ; Humans ; Lipoproteins ; Male ; Multivariate Analysis ; Nitric Oxide ; Risk Factors ; Vascular Diseases

PURPOSE: This research study explores the job stress, job satisfaction, and health of women who works in the professional work place and identify the influence of the job stress and job satisfaction on the mental health status focused on the social and psychological structure of the workplace. METHOD: 535 participants of registered nurses and teachers from 10 General Hospitals and 15 Middle and High School located in Seoul, Korea were completed the modified version of the short form Work-family stress inventory of questionnaire as used for job stress and mental health problems and perceived overall health status and job satisfaction. RESULT: Job stress was significantly correlated with job satisfaction, overall health, and mental health. There were also significant group differences in job stress and job satisfaction between nurses and teachers. Multiple regression only moderately supported the effect of job stress and job satisfaction on the mental health of professional working women. Also marital status demonstrated a significant factor of group differences in job stress, work-family stress, job satisfaction, and mental health problem. CONCLUSION: These results suggest that job stress in the work place has profound impact on job satisfaction and health of women who work in the professional job. This study also identified major sources and types of work-related stress on women's health which should be considered in a management for health promotion.
Female ; Health Promotion ; Hospitals, General ; Humans ; Job Satisfaction* ; Korea ; Marital Status ; Mental Health ; Surveys and Questionnaires ; Seoul ; Women's Health ; Women, Working ; Workplace

Here, we present a case of lung cancer in a 48-year-old male horse trainer. To the best of our knowledge, this is the first such case report to include an exposure assessment of respirable crystalline silica (RCS) as a quartz. The trainer had no family history of lung cancer. Although he had a 15 pack/year cigarette-smoking history, he had stopped smoking 12 years prior to his diagnosis. For the past 23 years, he had performed longeing, and trained 7-12 horses per day on longeing arena surfaces covered by recycled sands, the same surfaces used in race tracks. We investigated his workplace RCS exposure, and found it to be the likely cause of his lung cancer. The 8-hour time weight average range of RCS was 0.020 to 0.086 mg/m3 in the longeing arena. Horse trainers are exposed to RCS from the sand in longeing arenas, and the exposure level is high enough to have epidemiological ramifications for the occupational risk of lung cancer.
Continental Population Groups ; Crystallins ; Horses ; Humans ; Lung ; Lung Neoplasms ; Male ; Quartz ; Risk Assessment ; Silicon Dioxide ; Smoke ; Smoking ; Track and Field

PURPOSE: The purpose of this study was to analyze changes in the work patterns of nurses working in tertiary hospitals in Seoul, Korea. METHOD: Structured self-administered questionnaires were sent to the nursing department of each hospital, and distributed to nurses. The questionnaires were designed to identity changes in work patterns, frequency of contact inside & between departments, and interpersonal relationship inside & between departments. And also variables for analysis included the followings; acknowledgement of convenience, information applicability, willingness to participate in, and job satisfaction after implementation of a Hospital Information System. A total of 249 nurses from 13 hospitals replied. RESULTS: Changes in direct nursing time showed the most improvement and the frequency of contact was decreased while interpersonal relationships among coworkers was improved. As most nurses expressed a positive opinion of the HIS including its convenience, and information applicability, their willingness to participate in it and job satisfaction, it can be concluded that the implementation of the HIS has resulted in positive influences in the work patterns of clinical nurses.
Hospital Information Systems ; Information Systems* ; Job Satisfaction ; Korea ; Nursing ; Surveys and Questionnaires ; Seoul* ; Tertiary Care Centers*

Duplicated gallbladder (GB) is a rare congenital disease. Surgical management of a duplicated GB needs special care because of concurrent bile duct anomalies and the risk of injuring adjacent arteries during surgery. An 80-year-old man visited an emergency room with right upper quadrant abdominal pain. Computed tomography (CT) revealed cholecystitis with a 2-bodied GB. Because of this unusual finding, magnetic resonance choledochopancreatography was performed to detect possible biliary anomalies. The 2 GB bodies were unified at the neck with a common cystic duct, a so-called V-shaped duplicated GB. The patient's right posterior hepatic duct joined the common bile duct (CBD) near the cystic duct. The patient underwent laparoscopic cholecystectomy without adjacent organ injury, and was discharged uneventfully. Surgeons should carefully evaluate the patient preoperatively and select adequate surgical procedures in patients with suspected duplicated GB because of the risk of concurrent biliary anomalies.
Abdominal Pain ; Aged, 80 and over ; Arteries ; Bile Ducts ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute* ; Common Bile Duct ; Cystic Duct ; Emergency Service, Hospital ; Gallbladder* ; Hepatic Duct, Common ; Humans ; Laparoscopy ; Neck ; Patient Rights ; Surgeons