BACKGROUND AND PURPOSE: This study was undertaken to determine the knowledge that people with epilepsy (PWE) have regarding the nature of epilepsy and its management, and also to identify the factors contributing to their knowledge of epilepsy. METHODS: We studied 79 consecutive PWE who visited the outpatient clinic of Seoul National University Hospital using a structured questionnaire consisting of 27 questions in 3 categories. The mean correct response rate was 61%, with 81% believing that brain cells die during a seizure, 29% considering it dangerous to take a bath or shower alone, and more than 70% believing that taking antiepileptic drugs (AEDs) will impair memory and damage the liver and kidneys. RESULTS: The mean overall correct-answer rate was significantly related to gender, length of education, type of seizures, and regularity of hospital visits (all p<0.05). CONCLUSIONS: The level of knowledge deviated significantly from the scientific data, especially in the causes of epilepsy, safety issues, and side effects of AEDs. A large-scale study should identify those PWE with the lowest knowledge of epilepsy, and then develop and implement suitable educational intervention programs to improve their knowledge.
Ambulatory Care Facilities ; Anticonvulsants ; Baths ; Brain ; Education ; Epilepsy* ; Kidney ; Liver ; Memory ; Seizures ; Seoul ; Surveys and Questionnaires

PURPOSE: To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access. MATERIALS AND METHODS: Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava. RESULTS: Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place. CONCLUSION: The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.
Arm* ; Catheters* ; Heart Atria ; Humans ; Ocimum basilicum ; Punctures ; Radiology, Interventional ; Silicones ; Subclavian Vein ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Superior

PURPOSE: To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access. MATERIALS AND METHODS: Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava. RESULTS: Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place. CONCLUSION: The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.
Arm* ; Catheters* ; Heart Atria ; Humans ; Ocimum basilicum ; Punctures ; Radiology, Interventional ; Silicones ; Subclavian Vein ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Superior

Observational studies and laboratory research support cardioprotective effects of menopausal hormone treatment (MHT). However, cardioprotective effects of MHT were not confirmed by randomized clinical studies that were made up of subjects who were well-beyond the time of menopausal symptoms and were of advanced chronological age when they began hormone treatment (HT). The differences in study outcomes most likely reflect age-related differences in cardiovascular risk factors such as hypertension and metabolic syndromes. As well, data from the randomized clinical trial (RCT)s confirmed the presence of actual cardiovascular disease (CVD) in many of the RCT subjects prior to beginning HT. Therefore, beginning MHT early seems crucial since older women are at greater risk for the presence of risk factors and sub-clinical CVD. Older women also are possible targets of hormonally related thrombosis because of their underlying vascular disease. The need for early prophylaxis is convenient since most women seek treatment for symptoms within the first few years of menopause. This review addresses issues regarding optimization of the initiation of MHT for cardioprotection.
Aging ; Atherosclerosis ; Cardiovascular Diseases ; Estrogens ; Female ; Humans ; Hypertension ; Menopause ; Risk Factors ; Thrombosis ; Vascular Diseases

Observational studies and laboratory research support cardioprotective effects of menopausal hormone treatment (MHT). However, cardioprotective effects of MHT were not confirmed by randomized clinical studies that were made up of subjects who were well-beyond the time of menopausal symptoms and were of advanced chronological age when they began hormone treatment (HT). The differences in study outcomes most likely reflect age-related differences in cardiovascular risk factors such as hypertension and metabolic syndromes. As well, data from the randomized clinical trial (RCT)s confirmed the presence of actual cardiovascular disease (CVD) in many of the RCT subjects prior to beginning HT. Therefore, beginning MHT early seems crucial since older women are at greater risk for the presence of risk factors and sub-clinical CVD. Older women also are possible targets of hormonally related thrombosis because of their underlying vascular disease. The need for early prophylaxis is convenient since most women seek treatment for symptoms within the first few years of menopause. This review addresses issues regarding optimization of the initiation of MHT for cardioprotection.
Aging ; Atherosclerosis ; Cardiovascular Diseases ; Estrogens ; Female ; Humans ; Hypertension ; Menopause ; Risk Factors ; Thrombosis ; Vascular Diseases

Gastric intestinal metaplasia (GIM) is a known premalignant condition of the human stomach along the pathway to gastric cancer (GC). Histologically, GIM represents the replacement of normal gastric mucosa by mucin-secreting intestinal mucosa. Helicobacter pylori infection is the most common etiologic agent of GIM development worldwide. The prevalence of GIM is heterogeneous among different regions of the world and correlates with the population endemicity of H. pylori carriage, among other environmental factors. GC remains the third leading cause of cancer-related mortality globally. GIM is usually diagnosed by upper endoscopy with biopsy, and histologic scoring systems have been developed to risk-stratify patients at highest risk for progression to GC. Several recent endoscopic imaging modalities may improve the optical detection of GIM and early GC. Appropriate surveillance of GIM may be cost effective and represents an opportunity for the early diagnosis and therapy of GC. Certain East Asian nations have established population-level programs for the screening and surveillance of GIM; guidelines regarding GIM surveillance have also recently been published in Europe. By contrast, few data exist regarding the appropriateness of surveillance of GIM in the United States. In this review, we discuss the pathogenesis, epidemiology, diagnosis, and management of GIM with an emphasis on the role of appropriate endoscopic surveillance.
Asian Continental Ancestry Group ; Biopsy ; Diagnosis ; Early Diagnosis ; Endoscopy ; Epidemiology ; Europe ; Gastric Mucosa ; Helicobacter pylori ; Humans ; Intestinal Mucosa ; Mass Screening ; Metaplasia ; Mortality ; Prevalence ; Stomach ; Stomach Neoplasms ; United States

This paper reports on issues relating to the optimal use of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (Gd-EOB-DTPA MR imaging) together with the generation of consensus statements from a working group meeting, which was held in Seoul, Korea (2010). Gd-EOB-DTPA has been shown to improve the detection and characterization of liver lesions, and the information provided by the hepatobiliary phase is proving particularly useful in differential diagnoses and in the characterization of small lesions (around 1-1.5 cm). Discussion also focused on advances in the role of organic anion-transporting polypeptide 8 (OATP8) transporters. Gd-EOB-DTPA is also emerging as a promising tool for functional analysis, enabling the calculation of post-surgical liver function in the remaining segments. Updates to current algorithms were also discussed.
Algorithms ; Contrast Media/*diagnostic use/metabolism ; Diagnosis, Differential ; Gadolinium DTPA/*diagnostic use/metabolism ; Humans ; Liver Diseases/*diagnosis/metabolism/surgery ; Liver Function Tests ; *Magnetic Resonance Imaging ; Organic Anion Transporters, Sodium-Independent/metabolism ; Postoperative Complications/diagnosis ; Practice Guidelines as Topic

It has been shown that iodinated fatty acid esters such as Ethiodol(*) or Lipiodol(**) are selectively retained in hypervascular hepatic tumors following intrahepatic arterial admininstration. Such agents have been utilized in the detection and treatment of hepatocellular carcinoma (HCC) along with anticancer drug emulsions. Radioildination of Lipiodol(1-131-Lipiodol) was achieved by using a simple exchange method and the agent was used in the treatment of HCC following intrahepatic arterial-injection via superselective catheterization of tumor feeding vessels. Forty patients with HCC (massive 18; multinodular 12; infiltrative 10) were treated in an attempt to deliver a high dose of internal radiation; a cumulative tumor dose of 12,000 rad(120 GY) or higher was aimed in single or multiple procedures. Following therapy, the patients were divided into 2 groups, responsive or nonresponsive. Patients classfied as massive type responded to this treatment best (72.3%) followed by multinodular type (33.3%) and infiltrative type(10.0%). According to the size of tumor there was an 80.0% response for tumors of less than 5cm in diameter, 60.0%, between 5 to 8cm and 9.0% larger than 10cm in diameter. The clinical results of this treatment modality appear to be quite promising in the management of HCC, especially in the less than 8cm sized massive type of HCC. Also this method was able to not only provide long term local control but also a good quality of life without complications.
Adult ; Aged ; Carcinoma, Hepatocellular/blood supply/*radiotherapy ; Case Report ; Clinical Trials ; Female ; Hepatic Artery ; Human ; Injections, Intra-Arterial ; Iodine Radioisotopes/administration and dosage/*therapeutic use ; Iodized Oil/administration and dosage/*therapeutic use ; Liver Neoplasms/blood supply/*radiotherapy ; Male ; Middle Age ; Support, Non-U.S. Gov't

Chewing lice (Phthiraptera) that parasitize the globally threatened swan goose Anser cygnoides have been long recognized since the early 19th century, but those records were probably biased towards sampling of captive or domestic geese due to the small population size and limited distribution of its wild hosts. To better understand the lice species parasitizing swan geese that are endemic to East Asia, we collected chewing lice from 14 wild geese caught at 3 lakes in northeastern Mongolia. The lice were morphologically identified as 16 Trinoton anserinum (Fabricius, 1805), 11 Ornithobius domesticus Arnold, 2005, and 1 Anaticola anseris (Linnaeus, 1758). These species are known from other geese and swans, but all of them were new to the swan goose. This result also indicates no overlap in lice species between older records and our findings from wild birds. Thus, ectoparasites collected from domestic or captive animals may provide biased information on the occurrence, prevalence, host selection, and host-ectoparasite interactions from those on wild hosts.
Animals ; Bias (Epidemiology) ; Birds ; Far East ; Geese* ; Lakes ; Mastication* ; Mongolia ; Phthiraptera* ; Population Density ; Prevalence

Chewing lice (Phthiraptera) that parasitize the globally threatened swan goose Anser cygnoides have been long recognized since the early 19th century, but those records were probably biased towards sampling of captive or domestic geese due to the small population size and limited distribution of its wild hosts. To better understand the lice species parasitizing swan geese that are endemic to East Asia, we collected chewing lice from 14 wild geese caught at 3 lakes in northeastern Mongolia. The lice were morphologically identified as 16 Trinoton anserinum (Fabricius, 1805), 11 Ornithobius domesticus Arnold, 2005, and 1 Anaticola anseris (Linnaeus, 1758). These species are known from other geese and swans, but all of them were new to the swan goose. This result also indicates no overlap in lice species between older records and our findings from wild birds. Thus, ectoparasites collected from domestic or captive animals may provide biased information on the occurrence, prevalence, host selection, and host-ectoparasite interactions from those on wild hosts.
Animals ; Bias (Epidemiology) ; Birds ; Far East ; Geese* ; Lakes ; Mastication* ; Mongolia ; Phthiraptera* ; Population Density ; Prevalence