No abstract available.
Encephalomyelitis, Acute Disseminated* ; Vaccination*

BACKGROUND: The evaluation of behavioral and psychological symptoms (BPS) in ALS is important because its existence may serve as a prognostic factor and suggest a shared pathology with frontotemporal dementia (FTD) in ALS. In this study, we sought to identify the prevalence of the BPS of ALS patients and evaluate its relationship with the clinical profiles and survival of ALS patients. METHODS: One hundred sixty-six patients were enrolled in a cross-sectional cohort analysis from September 2008 to February 2012. All patients had sporadic ALS without a genetic mutation and were collected clinical profiles. The t-test and chi-square test were used to assess differences in the clinical characteristics and caregiver-administered neuropsychiatric inventory (CGA-NPI) scores. The Kaplan-Meier method and Cox proportional hazard model were used for the survival analysis. RESULTS: Forty-two patients had clinically significant BPS (42/166, 25.3%). ALS patients with BPS had worse clinical dementia rating (CDR), ALS Functional Rating Scale-Revised (ALSFRS-R) score, and progression rate of disease than those without BPS. Among CGA-NPI subscales, depression, irritability, apathy, and agitation were higher prevalent than the others. There was a trend for ALS patients with BPS having short survival time than those without BPS in the Kaplan-Meier analysis (p=0.006). However, in the Cox proportional hazard model, BPS in ALS patients were not associated with poor survival. CONCLUSION: These results support the presence of an overlapping spectrum between ALS and FTD and emphasize the importance of neuropsychiatric evaluations in ALS. Although the association between BPS and prognosis are not explained clearly, these results could be used to stratify ALS patients according to neuropsychiatric symptoms and help investigators to evaluate the BPS in ALS patients.
Amyotrophic Lateral Sclerosis* ; Apathy ; Cohort Studies ; Dementia ; Depression ; Dihydroergotamine ; Frontotemporal Dementia ; Humans ; Kaplan-Meier Estimate ; Pathology ; Prevalence ; Prognosis ; Proportional Hazards Models ; Research Personnel

BACKGROUND: Arteriovenous malformations (AVMs) are increasingly treated by radiologists using various embolic materials. Because of pain and significant hemodynamic changes that may be associated with this treatment, anesthesiologists are frequently asked to provide anesthesia and supportive care. We evaluated the hemodynamic changes that occurred after absolute alcohol embolization. METHODS: Fourteen patients between 15 and 50 years of age who had arteriovenous malformation were included in this study. 2 to 4 ml of alcohol was injected each time. The hemodynamic parameters were measured before alcohol injection (control) and after 1st to 10th alcohol injection. RESULTS: Blood pressure, heart rate, and cardiac output were significantly increased after 1st to 10th alcohol injection compared with control value. Central venous pressure, pulmonary capillary wedge pressure and systemic vascular resistance were not significantly changed. But pulmonary vascular resistance was significantly increased after 9th and 10th alcohol injection. Systolic pulmonary artery pressure was significantly increased after 4th, 8th, 9th and 10th alcohol injection. CONCLUSIONS: Bolus injection of absolute ethyl alcohol induces short-term significant increases in blood pressure, heart rate and cardiac output probably by severe pain and sympathetic activation that appear to be centrally mediated. The underlying mechanism of cardiovascular event and other systemic effects of intravascular ethanol in this setting need further study.
Anesthesia ; Arteriovenous Malformations* ; Blood Pressure ; Cardiac Output ; Central Venous Pressure ; Ethanol ; Heart Rate ; Hemodynamics* ; Humans ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Sclerotherapy* ; Vascular Resistance

BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires

BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires

BACKGROUND: Smoking is universally recognized as the foremost preventable cause of cancer. And smoking behavior causes many negative effects in cancer patients. Based on the mounting evidence that smoking affects cancer treatment outcomes and survival, we studied whether the cancer diagnosis affects smoking behavior. METHODS: During August 2007, 279 patients who were hospitalized with the diagnosis of cancer were surveyed by a questionnaire and a follow up survey was performed at 3 months and 7 months afterwards. Follow up survey was performed via telephone and finally 246 patients were enrolled. Questions in the survey included smoking history, nicotine dependence, stage of change and the reason for quit smoking or keep smoking. In the follow up survey at 7 month, we asked whether they needed smoking cessation interventions. RESULTS: At the end of the study, the subjects who kept smoking were 27 patients, but the degree of nicotine dependence was decreased compared to the preceding 2 surveys and contemplation as well as preparation stage turned out to be the most prevalent stage of change. The main reasons to keep smoking were behavioral habits and stress. Regardless of their smoking history, almost all cancer patients wanted smoking cessation interventions. CONCLUSION: Smoking is a critical variable that affects cancer treatment and outcome. We surely found there is a smoking subgroup after cancer diagnosis and we should advise them to quit smoking.
Follow-Up Studies ; Humans ; Smoke ; Smoking ; Smoking Cessation ; Telephone ; Tobacco Use Disorder

The therapeutic effectiveness and safety of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) have been clinically established, and the procedure is now generally accepted as a curative treatment for very early or early stage HCC. Recently, we observed an aggressive recurrence after RFA for HCC in 50 year-old female. RFA was performed for a 2.7 cm sized HCC, which was completely ablated. However, 7 months later, aggressive intrahepatic recurrence was observed. Herein, we report a case with a discussion.
Ablation Techniques ; Carcinoma, Hepatocellular* ; Catheter Ablation* ; Female ; Humans ; Recurrence

BACKGROUND/AIMS: The aim of this study was to elucidate the antiviral efficacy of lamivudine (LMV)-adefovir (ADV) combination therapy in chronic hepatitis B patients who showed resistance to LMV and ADV consecutively. METHODS: A retrospective review was performed in eighteen patients with chronic hepatitis B who developed virologic breakthroughs during LMV-ADV sequential mono-therapy and treated with LMV-ADV combination therapy. RESULTS: The median duration of follow up was 17 months (range, 6-27) after the start of LMV-ADV combination therapy. Mean HBV DNA level in log10 IU/mL was 6.08+/-0.95, 4.05+/-1.66, 3.17+/-1.58, 3.18+/-2.16, and 2.35+/-1.52 at 0, 3, 6, 12, and 24 months, respectively. Sixteen patients (88.9%) showed HBV DNA reduction below detection limit (<20,000 IU/mL). HBeAg seroconversion was observed in one patient (7.1%) after 8 months of combination therapy. Virologic breakthrough occurred in only one patient after 21 months of combination therapy. Viral rebound occurred in two patients at 12 months and 14 months of combination therapy. Normalization of serum ALT was achieved in twelve patients (66.7%). Primary non-response was observed in two cases (11.1%). CONCLUSIONS: LMV-ADV combination treatment was effective in 88.9% of patients with resistance to LMV and ADV in a short-term follow up. It may be applied as a bridge therapy until another effective antiviral regimen becomes available.
Adenine/*analogs & derivatives/therapeutic use ; Adult ; Antiviral Agents/*therapeutic use ; DNA, Viral/analysis ; Drug Resistance, Viral ; Drug Therapy, Combination ; Female ; Genotype ; Hepatitis B, Chronic/*drug therapy ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Phosphonic Acids/*therapeutic use ; Time Factors

To preserve scientific integrity, Journal of Liver Cancer agreed with the authors that this paper be retracted.

BACKGROUND/AIMS: We investigated the effect of low dose corticosteroid therapy on HBV reactivation in patients with chronic HBV infection. METHODS: From August 1998 to March 2007, the HBsAg-positive patients who received oral or intravenous corticosteroid therapy for more than 1 week at Samsung Medical Center were included in this retrospective study. We included those patients who received anticancer chemotherapy or organ transplantation, or concurrent antiviral therapy or other immunosuppressive agents. HBV reactivation was defined as a 10-fold increase in the HBV DNA levels compared with baseline. RESULTS: A total of 16 patients were included. They were 45.4+/-16.7 years of age, and the male:female ratio was 14:2. Their combined diseases included bronchial asthma, allergic urticaria, allergic rhinitis, etc. The corticosteroid doses were converted to prednisolone equivalent doses and these varied from 2.5 mg to 50 mg per day. Eleven patients used less than 20 mg of prednisolone per day. The mean medication duration was 60.1 days (range: 7-364 days). Among the patients, only one patient showed HBV reactivation. This ankylosing spondylitis patient was a 31-year old man who took prednisolone 5 mg/day for 364 days. He displayed HBeAg-positivity before corticosteroid treatment. There was no aggravation of the levels of ALT, albumin, bilirubin, and PT between the pre-and post-medication in this patient. CONCLUSIONS: The short term use of low dose corticosteroid is not likely to be related with HBV reactivation in those patients with chronic HBV infection, yet long term use may lead to viral reactivation. Further large scaled, prospective studies on this subject are needed.
Asthma ; Bilirubin ; DNA ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Immunosuppressive Agents ; Organ Transplantation ; Prednisolone ; Retrospective Studies ; Rhinitis ; Rhinitis, Allergic, Perennial ; Spondylitis, Ankylosing ; Transplants ; Urticaria