Persistent trigeminal artery is an embryonic remnant of the anastomotic channel linking the internal carotid artery and the basilar artery. Cases of vertebrobasilar insufficiency caused by the persistent trigeminal artery with internal carotid artery stenosis has been described previously, but vertebrobasilar insufficiency entirely due to in situ stenosis of the persistent trigeminal artery has not been reported. A 71-year-old man presented with frequent dizzy episodes. The brain MRI showed no parenchymal lesions. MR angiography showed poor visualization of vertebrobasilar system. He was diagnosed as having vertebrobasilar insufficiency. Cerebral angiography revealed that there was complete occlusion at the vertebrobasilar junction, and the basilar artery was supplied by the persistent trigeminal artery which had severe stenosis at its origin. There was no stenosis of the internal carotid artery of both sides. We believe that this is the first report of vertebrobasilar insufficiency due to stenosed persistent trigeminal artery, without internal carotid artery stenosis.

Mural nodules in ovarian mucinous tumors, whether benign, borderline, or malignant, have been described by several authors since Prat and Scully first described sarcoma or sarcoma-like mural nodules occurring in association with mucinous epithelial neoplasia in 1979. Three distinct types of the mural nodule have been identified; i. e., 1) sarcoma-like lesion, 2) true mesenchymal sarcome, and 3) anaplastic carcinoma simulating a sarcoma. Mural nodules of sarcomatous and carcinomatous foci associated with mucinous ovarian tumors should be separated from sarcoma-like nodules because of the poor prognosis of the former compared to the favorable prognosis of the latter. We experienced a case of ovarian mucinous cystadenocarcinoma with sarcoma-appearing mural nodule of anaplastic carcinoma occurred in a 59-year-old woman and reported with brief review of the literatures.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Middle Aged ; Mucins* ; Ovary ; Prognosis ; Sarcoma

No abstract available.
Amniotic Fluid* ; Female ; Pregnancy*

OBJECTIVES: The objective of this study is to assess the prevalence and risk factors of metabolic syndrome (MS) among inpatients with schizophrenia, and to compare with general population. METHODS: Nine hundreds seventy inpatients were included to assess the prevalence of MS from two mental hospitals in Yong-in city. Assessment of MS was performed based on modified American Heart Association criteria with abdominal obesity threshold of 90cm for men, 85cm for women. Comparative analysis was performed using age- and gender matched sample from Korea Health and Nutritional Examination Survey III. For evaluating risk factors, analysis included 766 inpatients taking consistent medications at least for 30 days. RESULTS: The prevalence of MS of inpatients with schizophrenia was 26.2%, in females it was 33.2%, compared to 20.2% in males(p < 0.001). Compared to general population, the prevalence of MS was significantly lower in male and higher in female patients. In terms of criteria prevalence, who met abdominal circumference criterion were more prevalent in patient group(p < 0.001). After multivariate analysis, female gender and old age remained as risk factors of MS. CONCLUSIONS: The prevalence of MS of inpatients with schizophrenia was 26.2% and significantly low compared to general population. Female gender and old age were risk factors of MS.
American Heart Association ; Female ; Hospitals, Psychiatric ; Humans ; Inpatients ; Korea ; Male ; Multivariate Analysis ; Obesity, Abdominal ; Prevalence ; Risk Factors ; Schizophrenia

OBJECTIVES: The aims of this study are to estimate the prevalence of polydipsia and water intoxication and to identify risk factors of polydipsia and water intoxication in psychiatric inpatient. METHODS: 1,108 Psychiatric inpatients at 2 mental hospitals in Yongin city were studied from September, 2008 to January, 2009. We diagnosed'polydipsia' using staff reports(fluid intake>3L/day) or by specific gravity of urine(SPGU<1.008) and diagnosed'at risk for water intoxication' using normalized diurnal weight gain (NDWG>4%). We attempted to identify clinical characteristics of patients by reviewing their medical records. RESULTS: Two hundred forty seven patients(22.3%) were polydipsic. Sixty eight patients(6.1%) were at risk for water intoxication. The factors associated with polydipsia were lithium, smoking, younger age and increased smoking amounts. The factors associated with risk for water intoxication were valproic acid and polydipsia. CONCLUSION: Polydipsia and water intoxication in psychiatric inpatients are not rare conditions. Therefore, clinicians' attention should be paid to these conditions.
Hospitals, Psychiatric ; Humans ; Inpatients ; Lithium ; Polydipsia ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Specific Gravity ; Valproic Acid ; Water Intoxication ; Weight Gain

PURPOSE: Single-port laparoscopic surgery is a rapidly advancing technique in laparoscopic surgery. However, there is currently limited evidence on the learning curve for this procedure. The aim of this study was to estimate the number of single port laparoscopic cholecystectomies required until improvement in the performance of the technique ceases. METHODS: This is a descriptive, single-center study using routinely collected clinical data from 70 patients who underwent single port laparoscopic cholecystectomy between May 2009 and June 2010 at Dong-A University Medical Center in Busan, Korea. The review includes the mean operating time, conversion cases, intra-operative GB perforation, post-operative wound infection and mean hospital stay. RESULTS: The mean operating time of the first 30 cases (the learning period) was 91.83 minutes. After 30 operations (the experience period), it plateaued to an average of 75.25 minutes, which remained steady in the next 40 operations - a reduction of more than 16%. Reduction in the operating time was significant (P<0.001) between the learning period and the experience period. Other factors including additional ports, intraoperative gall bladder perforation, mean hospital stay, post-operative wound infection were not significantly different between the two periods. CONCLUSION: We suggest that the learning curve for single port laparoscopic cholecystectomy should be around thirty cases for a surgeon with prior conventional laparoscopic cholecystectomy experience and for self-taught single port technique.
Academic Medical Centers ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Humans ; Korea ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Urinary Bladder ; Wound Infection

No abstract available.
Administration, Oral* ; Animals ; Carbon Disulfide* ; Carbon* ; Rats*

PURPOSE: To evaluate the early ERG (electroretinogram) changes in N-methyl-N-nitrosourea (MNU)-induced retinal degeneration in rats. METHODS: Thirty-six 6-week-old male rats were injected intraperitoneally with 60mg/kg MNU and divided into 6 groups. Histology and ERG were recorded for the rats of each group before treatment and at 3, 6, 12, 18, and 24 hours after MNU injection. Promptly after the ERG recording, rats were sacrificed and the eyeballs prepared for histologic sectioning. The Tdt-mediated dUTP-digoxigenin nick end labeling (TUNEL) method was used to detect photoreceptor cell death. RESULTS: The first decreases of ERG responses were noticed maximally at 3 hours after the treatment. Thereafter, the amplitude of the responses was partially recovered at 12 hours post-treatment. The second decrease of ERG amplitudes was observed in the 18-hour recordings, and those changes progressed to 24 hours after the treatment. In the histologic findings, TUNEL (+) cells in the Outer Nuclear Layer (ONL) were not detected at 3 hours after MNU injection, but were initially noticed at 6 hours post-injection. CONCLUSIONS: The first decreases of ERG amplitudes proceeded the appearance of TUNEL (+) cells in ONL, and these electrophysiological changes seemed to not be related to photoreceptor cell death. We propose that electrophysiological changes observed might be related to the MNU-induced activity enhancement of guanylate cyclase in the phototransduction pathway. We also show that photoreceptor cell death in the MNU-induced retinal degeneration model occurs at 6 hours after the treatment, which is earlier than the results of previous reports.
Animals ; Guanylate Cyclase ; Humans ; In Situ Nick-End Labeling ; Light Signal Transduction ; Male ; Methylnitrosourea ; Photoreceptor Cells ; Rats* ; Retinal Degeneration* ; Retinaldehyde*

The purpose of this study was to compare the occupational health concerns and opinions among 4 groups: workers, employers and managers, government officials, and health & safety managers. It could help establishing occupational health plans efficiently and providing the way to solve health problems in workplaces in the Inchon area. The delphi technique which is used for deciding group opinion was adopted for this study. Questionnaires regarding health problems and their priorities in the workplaces were sent to four groups three times. All items were measured by five degree ordinal scales. The four groups agreed with questionnaire items, improvement of working environment, occupational health concerns of the employers, the health concerns of workers, and measurement and analysis of working environment, as the upper five priorities for solving the occupational health problems. Besides with the first five priorities, health examinations, health education, and occupational diseases were suggested as important health problems in workplace.
Delphi Technique ; Health Education ; Health Priorities ; Humans ; Incheon* ; Occupational Diseases ; Occupational Groups ; Occupational Health* ; Surveys and Questionnaires ; Weights and Measures

PURPOSE: To report two cases of tsutsugamushi disease, showing ocular manifestations with eschars on the lower eyelids. METHODS: Two patients who have tsutsugamushi disease with ocular manifestations were examined by standard ophthalmic procedures. Eschars were observed in both patients on the medial canthal lower lid. Conjunctival injection and episcleral vessel dilations were also observed in both patients. One patient had limbal vasculitis with pannus. RESULTS: It is possible that eschars, which are the pathognomonic sign in tsutsugamushi disease, can occur on the eyelid, as well as on the axilla, perineum, abdomen, and extremities, which have been commonly observed sites. Ocular manifestations, including conjunctival injection, episcleral vessel dilation, or limbitis may be observed. These conditions may respond well to treatment with 0.1% Fluorometholone.
Abdomen ; Axilla ; Extremities ; Eyelids* ; Fluorometholone ; Humans ; Perineum ; Scrub Typhus* ; Vasculitis