PURPOSE: to assess the role of MR imaging in determining of the atrial situs in complicated congenital heart disease with situs ambiguus. MATERIALS AND METHODS: In order to classify the situs, the morphology of atrial appendages, on bronchial length ratio, the superior-inferior relation of the pulmonary artery (PA) and main bronchi on each side, and splenic abnormality were evaluated by MR imaging in 22 patients (12 boys and 10 girls), and the results were compared. RESULTS: In all patients, the superior-inferior relation of the PA and main bronchi tended to lateralize, and in one, bronchial length ratio was not consistent with the relation between the PA and bronchus. Bronchial and atrial situs, as determined by appendage morphology, were consistent in ten of 13 right isomerism patients, and in only three of nine of these with left isomerism. All 13 right isomerism patients, classified by the relation of the PA and main bronchi, showed asplenia, whereas eight of nine of these with left isomerism had polysplenia. CONCLUSION: In the assessment of atrial situs by MR imaging, the positional relation of a bronchus and the PA, bronchial length ratio, and splenic abnormality are constant and reliable. The accuracy of classification of situs on the basis of atrial appendage morphology is, however, limited.
Atrial Appendage ; Bronchi ; Classification ; Heart Defects, Congenital* ; Heterotaxy Syndrome* ; Humans ; Isomerism ; Magnetic Resonance Imaging* ; Pulmonary Artery

PURPOSE: To evaluate the feasibility, safety and effectiveness of a newly designed percutaneously implanted separate stent-graft (SSG) for the treatment of aortic aneurysms and dissections. MATERIALS AND METHODS: Using a percutaneous technique, SSG placement (in the descending thoracic aorta in 26 cases and infrarenal abdominal aorta in 24) was attempted in 50 patients with aortic aneurysms (n=27) or dissection (n=23). All SSGs were individually constructed using self-expandable nitinol stents and a Dacron graft, and were introduced through a 12 F sheath and expanded to a diameter of 20-34 mm. In all cases, vascular access was through the femoral artery. The clinical status of each patient was monitored, and postoperative CT was performed within one week of the procedure and at 3-6 month intervals afterwards. RESULTS: Endovascular stent-graft deployment was technically successful in 49 of 50 patients (98%). The one failure was due to torsion of the unsupported graft during deployment. Successful exclusion of aneurysms and the primary entry tears of dissections was achieved in all but three patients with aortic dissection. All patients in whom technical success was achieved showed complete thrombosis of the thoracic false lumen or aneurysmal sac, and the overall technical success rate was 92%. In addition, sixteen patients demonstrated complete resolution of the dissected thoracic false lumen (n=9) or aneurysmal sac (n=7). Immediate post-operative complications occurred at the femoral puncture site in one patient with an arteriovenous fistula, and in two, a new saccular aneurysm developed at the distal margin of the stent. No patient died, and there was no instance of paraplegia, stroke, side-branch occlusion or infection during the subsequent mean follow-up period of 9.4 (range, 2 to 26) months. CONCLUSION: In patients with aortic aneurysm and dissection, treatment with a separate percutaneously inserted stent-graft is technically feasible, safe, and effective.
Aneurysm ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm* ; Arteriovenous Fistula ; Femoral Artery ; Follow-Up Studies ; Humans ; Paraplegia ; Polyethylene Terephthalates ; Punctures ; Stents ; Stroke ; Thrombosis ; Transplants

Sweet’s syndrome (SS) is an autoimmune-mediated acute febrile neutrophilic dermatosis with a number of possible etiologies, including infection, malignancy, and drug reactions. In contrast to its original description, it can rarely involve extracutaneous organs, including the central nervous system, cardiovascular system, lung, liver, gastrointestinal tract, spleen, and bone. To our knowledge, there have been only three cases of SS accompanied by acute kidney injury worldwide, and this is the first report in which the patient recovered completely from acute kidney injury as well as cutaneous lesions with early steroid administration. Here, we report a case of SS with acute kidney injury in a patient with myelodysplastic syndrome (MDS) whose skin lesions and renal function recovered fully with early diagnosis and steroid therapy along with a review of the relevant literature.

PURPOSE: The aim of this study was to investigate any difference of ultrasound findings for palpable and nonpalpable breast cancers. METHODS: Two hundred breast cancer patients that had undergone preoperative ultrasound and surgery were enrolled in the study. A total of 126 cancers were palpable, and the remaining 74 cancers were nonpalpable. We compared lesion characteristics using ultrasound images according to the BI-RADS(R)-Ultrasound guidelines of the American College of Radiology. A crude odds ratio (OR) and 95% confidence interval (CI) were calculated for a comparison of the palpable and nonpalpable breast cancers. RESULTS: Nonpalpable cancers displayed more often an oval shape (OR=0.35, 95% CI=0.17-0.70), no posterior acoustic features (OR=0.50, 95% CI=0.28-0.89), and a parallel orientation (OR=0.50, 95% CI=0.28-0.89). An irregular shape (OR=2.98, 95% CI=1.60-5.54), a spiculated margin (OR=2.66, 95% CI=1.23-5.74), and a combined pattern of posterior acoustic features (OR=7.20, 95% CI=1.64-31.66) were more commonly observed in the palpable cancers. CONCLUSION: Palpable and nonpalpable breast cancers were found to have different ultrasound characteristics.
Acoustics ; Breast ; Breast Neoplasms ; Humans ; Odds Ratio ; Orientation ; Palpation

OBJECTIVES: The purposes of the study were to assess the unmet needs of the chronic mental ill in low income class living in community and to provide basic data for developing services and programs in community mental health. METHODS: Face to face interviews were done for the subjects (n=320) who were diagnosed as schizophrenia, major depressive disorder, and bipolar I disorder. The Korean version of Camberwell Assessment of Need Short Appraisal Scale (CANSAS) was used as the assessment tool of the needs. Frequencies and rates of met needs and unmet needs of each 22 items of CANSAS were estimated. We classified 22 items into six need areas by operational definition, and then estimated mean percentages of unmet needs and met needs for each 6 need areas. We also classified subjects into 2 groups by the presence of psychiatric care needs, and then estimated mean percentage of unmet needs for other 5 need areas according to psychiatric care needs. RESULTS: Among the respondents, 77.7% of them had no spouses, and 66.4% had the education of six years and over. Of the respondents, 53.8% were males, 46.2% females. And 74.3% used medical aid in social security. Most respondents did not have present occupations and persons who were living with their parents were 48.3% and persons living alone reached 8%. The diagnosis of schizophrenia was 60.9%, major depressive disorder 15.2%, respectively. Most respondents (73.6%) had been admitted to the hospitals, but they hardly used rehabilitation services or programs during the daytimes. In estimating the unmet needs for each 22 items of CANAS, the need of company of others was the highest and that of welfare benefit and daytime activity were next. Information for treatment, intimate relationship, psychological distress, money, and psychotic symptoms follow the order. The mean percentages of unmet needs for each 6 needs area were 29.5% for income needs, 26.9% for social relation needs, 17.0% for physical care needs, 14.2% for psychiatric care needs, 11.6% for daily living skill needs, and 9.6% for residency needs. We classified subjects into 2 groups by the presence of psychiatric care needs: 49% of the subjects had no psychiatric care needs and 51% had psychiatric care needs. The group that had psychiatric care needs also had higher mean percentage of unmet need in 5 other needs areas than group that had no psychiatric care needs. And these results showed statistically significant except residency needs area. CONCLUSION: When preparing services or programs in community mental health, occupational rehabilitation and social support should be included as basic services. Other services such as physical treatment, psychiatric treatment, social skill training, and residency could be considered as optional.
Surveys and Questionnaires ; Depressive Disorder, Major ; Diagnosis ; Education ; Female ; Humans ; Internship and Residency ; Male ; Mental Health ; Mentally Ill Persons* ; Needs Assessment* ; Occupations ; Parents ; Rehabilitation ; Schizophrenia ; Social Security ; Spouses

No abstract available.
Extremities ; Ischemia ; Magnetic Resonance Imaging ; Oxygen ; Perfusion

Somatics refers to body work and movement study that emphasize internal perception and experience. Recently, a new perspective has emerged that views somatics-based techniques as a kind of mindful movement. Somatic techniques as contemplative movement can improve emotional regulation ability through improvement of body awareness or interoception. Based on this background, the present study attempts to develop a somatics based program suitable for a group of clinical patients suffering from emotional dysregulation. This study plans to collect quantitative and qualitative data in order to clarify how interoception and the related emotional regulation ability change after the program. These findings will help to explore whether the somatics technique has potential as an emotion regulation program in the future. In addition, the results are expected to contribute to finding an alternative treatment modality for patients who have not achieved a sufficient effect with conventional psychotherapy.

Somatics refers to body work and movement study that emphasize internal perception and experience. Recently, a new perspective has emerged that views somatics-based techniques as a kind of mindful movement. Somatic techniques as contemplative movement can improve emotional regulation ability through improvement of body awareness or interoception. Based on this background, the present study attempts to develop a somatics based program suitable for a group of clinical patients suffering from emotional dysregulation. This study plans to collect quantitative and qualitative data in order to clarify how interoception and the related emotional regulation ability change after the program. These findings will help to explore whether the somatics technique has potential as an emotion regulation program in the future. In addition, the results are expected to contribute to finding an alternative treatment modality for patients who have not achieved a sufficient effect with conventional psychotherapy.

OBJECTIVES: Recently high dose chemotherapy with autologous peripheral blood stem cell transplantation (APBSCT) has been investigated with the hope of maximizing tumor response and increasing survival. The purpose of this study is to evaluate the effect, feasibility, and toxicity of high-dose cyclophosphamide, thiotepa, and carboplatin (CTCb) with APBSCT in patients with metastatic or high risk primary breast cancer. METHODS: Four cases of high-risk primary breast cancer (with more than 10 involved axillary nodes) and three cases of metastatic disease in complete or partial response were enrolled. Peripheral blood stem cells were mobilized by G-CSF plus chemotherapy, and median number of collected mononuclear cells was 5.44 X 108/kg(range, 1.95-7.08 X 108/kg). High-dose chemotherapy of cyclophosphamide (1,500mg/m2/day), thiotepa (125mg/m2/day) and carboplatin (200mg/m2/day) was administered for 4 days and peripheral blood stem cells were reinfused to the patients 72 hours after the completion of chemotherapy. RESULTS: The median days of recovery for neutrophil (over 500/mm3) and for platelet (over 50,000/mm3) were 10 (range, 8 to 33) and 30 (range, 10 to 40). One patient suffered from seizure attack and grade 3 hepatotoxicity during high dose chemotherapy, There were no treatment-related death. Four patients with high-risk primary breast cancer remained disease-free at 2, 8, 12 and 19 months post-transplant. In one patient with bone metastasis, complete response was induced following APBSCT. All three patients with metastatic disease remained progression-free at 8, 18 and 19 months post-transplant. CONCLUSION: High-dose chemotherapy and autologous peripheral blood stem cell transplantation was feasible and would be a potentially effective treatment modality in high risk and metastatic breast cancer.
Blood Platelets ; Breast Neoplasms* ; Breast* ; Carboplatin* ; Cyclophosphamide* ; Drug Therapy* ; Granulocyte Colony-Stimulating Factor ; Hope ; Humans ; Neoplasm Metastasis ; Neutrophils ; Peripheral Blood Stem Cell Transplantation* ; Seizures ; Stem Cells ; Thiotepa*