PURPOSE: To evaluate the effectiveness and safety of the modified pulse-spray method using Urokinase (UK) in subacute and chronic thrombotic arterial occlusion. MATERIALS AND METHODS: Modified pulse-spray methods using UKwere performed in seven patients with subacute (1week-1month) to chronic (1 month-5years) occlusive sysmptoms suchas limb pain, claudication and impotence. Angiographic examination revealed thrombotic occlusion of the aorta, common iliac arteries, brachial arterio-venous hemodialysis graft and femoro-popliteal bypass graft. The patients underwent thrombolysis using modified pulse-spray and additional constant infusion of UK. In the presence of underlying stenosis or organized clots, balloon angioplasty or stent placement was performed. RESULTS: Completelysis was obtained in five of seven patients. For initial lysis, the mean dose of UK was 420,000 units, and the mean modified pulse-spray time was 50 minutes. Mean total dose of UK and mean total time for complete lysis were 800,000 units and 161 minutes, respectively. Thrombolysis of the femoro-popliteal bypass graft failed due to severe occlusion of the distal anastomosis. Partial lysis was achieved in one patient with aorto-iliac occlusion, but further thrombolysis was stopped due to bleeding at the puncture site. CONCLUSION: The modified pulse-spraymethod using UK is effective in treating subacute and chronic arterial thrombotic occlusion. It augments the speed, safety and efficacy of thrombolysis. When underlying stenosis or organized clots remain after thrombolysis, balloon angioplasty or stent placement would be helpful.
Angioplasty ; Angioplasty, Balloon ; Constriction, Pathologic ; Erectile Dysfunction ; Extremities ; Hemorrhage ; Humans ; Iliac Artery ; Male ; Punctures ; Renal Dialysis ; Stents ; Transplants ; Urokinase-Type Plasminogen Activator*

No abstract available.
Hepatocyte Growth Factor* ; Hepatocytes* ; Placenta* ; Pre-Eclampsia*

Adenomyosis of the uterus is a relatively common gynecologic disease characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Small cystic spaces (not larger than several mil-limeters) are invariably present, and these are filled with blood. Extensive hemorrhagic cystic adenomyosis,however, is rare, and there have been very few radiologic reports of this condition. We describe the CT and MRI features of three cases of histologically confirmed huge cystic adenomyosis.
Adenomyosis* ; Animals ; Female ; Genital Diseases, Female ; Magnetic Resonance Imaging* ; Mice ; Myometrium ; Uterus*

The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment. The total treatment duration was 15 years and 10 months. Class I canine and Class II molar relationships and normal overbite and overjet were achieved at the end of treatment. Although the long-term use of facemask therapy resulted in significant protraction of the retrusive maxilla, the patient exhibited Class III profile because of continued mandibular growth. However, the treatment result was well maintained after 2 years of retention. The findings from this case suggest that interdisciplinary and customized approaches are mandatory for successful management of maxillary hypoplasia, bony defect, and dental problems in Tessier number 0 cleft. Moreover, considering the potential of orthognathic surgery or distraction osteogenesis, meticulous monitoring of mandibular growth until growth completion is important.
Bone Transplantation ; Child, Preschool ; Humans ; Incisor ; Male ; Maxilla ; Molar ; Open Bite ; Orthognathic Surgery ; Orthopedics* ; Osteogenesis, Distraction ; Overbite ; Transplants

Background: Biogenetic causal explanations of mental disorders are commonly used for public education and campaigns. However, the influence of biogenetic explanations on the ideas about and attitudes toward mental illness is unclear. We examined the influence of biogenetic explanations on attitudes toward mental disorders using a meta-analytic method accompanied by subgroup analyses. Methods: The protocol for this meta-analysis was registered in PROSPERO (CRD42020158656) in March 2020. Experimental and correlational studies were analyzed separately. Five outcome measures related to attitudes toward mental disorders were included: ‘attitude toward helpseeking,’ ‘blame,’ ‘perceived dangerousness,’ ‘prognostic pessimism,’ and ‘social distance.’ Subgroup analyses were performed for the type of mental disorder, population, and geographic region for which a biogenetic explanation was provided. Results: A total of 44 studies were included, of which 24 were experimental and 20 were correlational. A positive attitude toward help-seeking was associated with having a biogenetic concept (d = 0.43; 95% confidence interval [CI], 0.18 to 0.67; P < 0.001) in general population and in Eastern countries in particular. Although a biogenetic explanation was associated with a decreased level of blame (d = −0.20; 95% CI, −0.38 to −0.02; P = 0.029) in the general population, it was also associated with significantly higher levels of perceived dangerousness (d = 0.13; 95% CI, 0.03 to 0.23; P = 0.008). A tendency toward a higher level of prognostic pessimism and social distance was associated with a biogenetic concept of mental disorders although there was no statistical significance. Conclusion Having a biogenetic concept of the cause of mental disorders was related with a positive attitude toward help-seeking, particularly in the general population and individuals living in Eastern countries. Providing a biogenetic explanation decreased blame toward individuals with mental illness but was associated with increased perceived dangerousness and prognostic pessimism. Therefore, although a biogenetic explanation use of mental health services, it should be carefully applied to avoid an increase in negative thoughts, such as that mental illness is biologically irreversible and untreatable.promotes public

Finite Element Analysis ; Humans ; Mandible ; Stress, Mechanical

PURPOSE: To investigate change of CT attenuation of biliary stones in water soluble contrast media with time as well as the factors contributing to this change. MATERIALS AND METHODS: Thirty biliary stones were placed within cone-shaped plastic tubes, and as a control study, spiral CT scanning was performed 50 minutes after immersion in normal saline. The stones were rescanned at 5, 10, 20, 30, 45, 60, 90 and 120 minutes after immersion in water soluble contrast media. Mean CT attenuation value and volume of the stones were measured after three-dimensional reconstruction of images. Physical factors such as porosity[(wet weight - dry weight) / wetweight]x100, volume, and cholesterol as a chemical factor were measured. RESULTS: The pattern of change of CT attenuation was classified as one of three types. Fifteen stones (50%) were classified as type 1, in which attenuation increased with immersion time; in ten stones, this increase was rapid, particularly within the first 5 minutes. Twelve (40%) were classified as type 2, in which attenuation showed no significant change. Three stones showed no regular pattern, and these were classified as type 3. The mean porosity of type 1 (median; 32.7, mean+/-SD; 52.83+/-34.48) was greater than that of type 2 (median; 6.7, mean+/-SD; 30.58+/-48.25)(p<.05). The volume and cholesterol fraction of stones were not significantly different between type 1 and 2. CONCLUSION: In some biliary stones, CT attenuation value increases in water-soluble contrast media with time, and porosity is the most important factor in attenuation change.
Cholesterol ; Contrast Media* ; Immersion ; Plastics ; Porosity ; Tomography, Spiral Computed

BACKGROUND: von Willebrand disease (VWD) is the most common inherited bleeding disorder with a prevalence of up to 1%. However in Korea, only 126 VWD patients were registered in Korea Hemophilia Foundation (KHF). The aim of this study was to determine the status of VWD patients in Korea. We analyzed VWD patients by age, gender, blood group, family history and bleeding history.METHODS: One hundred twenty-six VWD patients registered in the KHF by December 2016, and 74 patients diagnosed at six university hospitals were enrolled in this study. We evaluated the medical records from the KHF and the questionnaires from six university hospitals retrospectively.RESULTS: Seventeen patients misdiagnosed and ten patients duplicated were excluded. One hundred nine patients registered in the KHF and 64 patients diagnosed at six university hospitals met the criteria for VWD. The blood type O accounts for 72 (51.8%). VWF mutation was detected in 30 patients (17.3%). Median age at diagnosis was 10.5 yr. The bleeding score of adults was higher than that of children (P < 0.001). The most common bleeding symptom was epistaxis (48.5%). The distribution of VWD types was: 67% of type 1, 30.1% of type 2, and 2.9% of type 3.CONCLUSION: Even though only six hospitals responded to the survey, 64 patients not registered in the KHF were diagnosed with VWD. Our results suggest the prevalence of Korean VWD might be higher than previously reported. A nationwide registration system is warranted in order to accurately identify the national prevalence of VWD.
Adult ; Child ; Diagnosis ; Epistaxis ; Hemophilia A ; Hemorrhage ; Hospitals, University ; Humans ; Korea ; Medical Records ; Prevalence ; Retrospective Studies ; von Willebrand Diseases

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease characterized by spiking fever, arthralgia, salmon pink rash, neutrophilic leukocytosis, and multi-organ involvement. Although renal involvement may appear in some cases of adult Still's disease, onset over 70 years of age with renal involvement has not been described. We report a 73-years-old woman whose illness manifested with fever of unknown origin, massive proteinuria, and multiple lymph nodes enlargement. With proteinuria of 2,650 mg/day, a renal biopsy was performed, and histopathological evaluation yielded the diagnosis of chronic glomerulonephritis (CGN). After excluding infectious disease, malignancy, and other rheumatic disease, AOSD was diagnosed with symptoms including fever over 39.0degrees C for more than a week, leukocytosis, generalized lymphadenopathy, and negative autoantibodies. Proteinuria and fever were improved markedly by high dose glucocorticoids and methotrexate therapy.
Adult ; Arthralgia ; Autoantibodies ; Biopsy ; Communicable Diseases ; Diagnosis ; Exanthema ; Female ; Fever ; Fever of Unknown Origin ; Glomerulonephritis ; Glucocorticoids ; Humans ; Leukocytosis ; Lymph Nodes ; Lymphatic Diseases ; Methotrexate ; Neutrophils ; Proteinuria ; Rheumatic Diseases ; Salmon ; Still's Disease, Adult-Onset*

PURPOSE: We aimed to determine the prevalence of allergic rhinitis and nonallergic rhinitis, difference in symptoms between allergic rhinitis and nonallergic rhinitis, and the association between lung function and the degree of asthma control in children with asthma. METHODS: One hundred seventy patients who were followed-up for asthma treatment at the department of pediatrics of CHA Bundang Medical Center were enrolled in this study. We conducted the questionnaire regarding coexistence of rhinitis, childhood asthma control test (C-ACT), and the basic lung function test. The patients were classified as allergic rhinitis group and nonallergic rhinitis group according to the response to 11 common inhalation and food allergens, and assessed the degree of asthma control and the severity of rhinitis. RESULTS: One hundred thirty patients (73%) were found to have rhinitis. Of these, 79 patients (53%) had allergic rhinitis and 34 patients (20%) had nonallergic rhinitis. The allergic rhinitis group was older than the nonallergic rhinitis group or the nonrhinitis group (7.73+/-2.85 vs. 5.97+/-2.48 vs. 6.12+/-2.70, P<0.001). Nasal itching sense was more prevalent in the allergic-rhinitis group than in the nonallergic rhinitis group (3.23+/-1.90 vs. 2.44+/-1.56, P=0.036). There was an inverse correlation between the rhinitis and C-ACT (r= -0.329, P<0.05). Of note, nasal obstruction symptom was highly correlated with C-ACT (r=-0.334, P<0.001). CONCLUSION: Allergic rhinitis and nonallergic rhinitis were highly prevalent in the pediatric patients with asthma and both of them had a significantly adverse impact on asthma control by rhinitis-itself. Therefore, regardless of atopic status, clinicians should focus on relieving rhinitis symptoms.
Allergens ; Asthma ; Child ; Humans ; Inhalation ; Lung ; Nasal Obstruction ; Pediatrics ; Prevalence ; Pruritus ; Respiratory Function Tests ; Rhinitis ; Rhinitis, Allergic, Perennial ; Surveys and Questionnaires