PURPOSE: To quantitatively evaluate by MRI brain atrophy and abnormal parenchymal signal intensity onT2-weighted spin echo image in alcoholics. MATERIALS AND METHODS: MRI of 24 alcoholic patients were retrospectively evaluated to measure brain atrophy (cerebral sulcal width, bifrontal horn distance, third ventricular width, fourth ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci) and abnormal high signal lesions of brain parenchyma onT2-weighted spin echo image, and were compared with age matched controls (n=29). The alcoholics and controls were divided into two age groups, younger (30 - 49 years) and older (50 - 72 years), and statistical analysis was then performed. Axial and sagittal T1- and T2-weighted spin echo images were obtained using a 0.5 Tesla superconductive system. RESULTS: Statistical significant parameters in the supratentorial region were cerebral sulcal width, distance between lateral ends of frontal horns of both lateral ventricles, and third ventricular width (p<0.05),and in the infratentorial region were fourth ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci (p<0.05). In the younger age group, statistical significant parameters were cerebral sulcal width, third ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci (p<0.05) and in the older group were cerebral sulcal width, bifrontal horn distance, third ventricular width, fourth ventricular width, number of cerebellar sulci, and number of vermian sulci (p<0.05). Abnormal high signal intensity onT2-weighted spin echo images were seen in 46% of alcoholics (11/24) and in 13% of controls (3/29). High signal lesions in the older group were statistically significant (p<0.05). CONCLUSION: Atrophic brain changes and periventricular high signal foci on T2-weighted spin echo image are significantly higher in chronic alcoholics than in age-matched normal controls.
Alcoholics* ; Alcoholism ; Animals ; Atrophy* ; Brain* ; Cerebellopontine Angle ; Horns ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging* ; Retrospective Studies

No abstract available.
Drug Therapy, Combination* ; Humans ; Leukemia, Myeloid, Acute*

PURPOSE: Without a specific diagnostic method, the clinical diagnostic criteria for atypical Kawasaki disease is known as the presence of coronary artery changes in a patient who did not meet the already estabilished clinical criteria. With this criteria, we are put into dilemma because atypical Kawasaki disease should exhibit coronary artery disease. So, we demonstrated the rate of coronary artery involvement in atypical Kawasaki disease by another diagnostic criteria. METHODS: This diagnostic criteria for atypical Kawasaki disease is "the clinical symptoms which fulfilled four out of six diagnostic criteria below of typical Kawasaki disease with or without the presence of coronary artery changes, and were inconsistent under a through clinical investigation with any other illness similar to Kawasaki disease." RESULTS: The incidence of coronary artery involvement in atypical Kawasaki disease during the acute phase (analysis of 30 cases who were admitted before the 15th day of illness), on the 30th day of illness (26 cases) and on the 60th day of illness(26 cases) were 20.0% (dilatation : 13.3%, aneurysm : 6.7%), 19.2% (dilatation : 19.2%, aneurysm : 0.0%), 7.7%(dilatation : 7.7%, aneurysm : 0.0%), respectively. CONCLUSOIN: Kawasaki disease may occur in atypical type, ranging over many severe involvements of vital organs including the coronary artery. Up to the present, there are no infallible diagnostic tests for Kawasaki disease and it is advisable to deemphasize the rigid adherence to the current already proposed diagnostic criteria for Kawasaki disease.
Aneurysm ; Coronary Artery Disease ; Coronary Vessels* ; Diagnostic Tests, Routine ; Humans ; Incidence ; Mucocutaneous Lymph Node Syndrome*

The bone scanning has been routinely used for initial report in 1970s showed a high incidence of positive-up to 45%-results in preoperative assessment of these patients. But recent reports have questioned the routine use of bone scanning in preoperative basis by the result of much lower positive result as rate less than 1%. On this point, we analyzed 224 cases of breast cancer, which were operatively managed in the period from January 1990 to January 1995 at the department of surgery, Korea university medical center. All the cases were performed bone scanning preoperatively and followed up more than 3 months. The analytic evaluation was done about age, stage of disease, serum alkaline phosphatase level according to menopausal status and its correlation to the result of bone scanning. The result was 14 positive cases(6.3%) from bone scanning in 224 breast cancer cases, but only 8 cases(3.6%) were true positive with bone metastasis. While 35 stage I cases and 69 stage IIa ones had no true positive, 1 among 63 stage IIb cases(1.6%), 5 among 46 stage IIIa cases(10.9%) and 2 among 11 of stage IIIb ones(18.2%) had true positive. There were high bone metastasis rate in premenopausal patients(5/108 cases, 4.6%) than postmenopausal patients(3/116, 2.6%) (p<0.05). The alkaline phosphatase level shows no significant differences between true positive and other groups(p>0.05). All true positive patients' alkaline phosphatase level shows within normal limits. According to this result, we think that preoperative bone scanning is unnecessary as a routine procedure in Stage I and IIa breast cancer patients. Stage IIb needs more and further study for confirming the indication of bone scanning as combinations with other predictive indicator or symptoms. About Stage III disease, we conclude the bone scanning is absolutely helpful.
Academic Medical Centers ; Alkaline Phosphatase ; Breast Neoplasms* ; Breast* ; Humans ; Incidence* ; Korea ; Neoplasm Metastasis*

PURPOSE: Many burn patients have been suffered from sequelae of burn injury (itching, pain, heating sense, etc.). The treatment of those symptoms was not successful even though they are approached multiply. Some patients depend on folk remedies. We try to find the effectiveness of microneedling procedure (dermastamp(R)) which is used for esthetic purpose. METHODS: 25 patients were included who had been treated with the skin massage therapy from September 2008 to March 2009. They received the dermastamp(R) procedure once a week and surveyed from 2 months after procedure. The survey items were itching, pain, tightness, firmness, shape of scar, joint deformities. We divided the severity of symptoms into digit scale form 0 (no symptoms) to 10 (too severe to sleep) and the severity was estimated by patients. Statistical method was Wilcoxon signed rank test. RESULTS: The patient group consisted of 8 males and 17 females. The mean age was 22.2+/-13.8 years old. The average time that felt the effectiveness was 4.4+/-2.3 times. Statistically significant responses showed in itching, firmness (P<0.05), pain and tightness (P<0.01). Improvement of the shape of scar and joint deformities were not statistically significant. CONCLUSION: Even now, no definite treatment against the sequelae of burn injury. Multimodalities of treatment in sequelae of burn injury are using and dermastamp(R) can be an additional method for sequelae of burn injury.
Burns ; Cicatrix ; Congenital Abnormalities ; Female ; Heating ; Hot Temperature ; Humans ; Joints ; Male ; Massage ; Medicine, Traditional ; Pruritus ; Skin

OBJECTIVE: The elderly population is rapidly growing, and the population over age 65 is expected to increase. To evaluate factors that determine recovery in this population, we report a clinical analysis of 77 elder patients of mild head trauma over 65 years of age. METHODS: The medical records were reviewed retrospectively for 77 head-injured patients aged 65 to 85 years who were admitted to our institution between March, 1995 and December, 1999. The outcome was compared with age, sex, Glasgow Coma Scale score, and radiologic characteristics. RESULTS: As in all age groups, males predominated and motor vehicle accidents accounted for a highest proportion(35%). Of the traffic accidents, pedestrian injuries were more common. The single most common lesion was subdural hematoma. The initial radiologic findings were not correlated with outcome. The GCS score was statistically correlated with prognosis. Sixty-one patients(79.2%) had favorable outcome. Ten of seventy-seven patients(13%) died whereas cerebral injury accounted for 5 deaths. Non-cerebral causes of death were composed of pneumonia, multi-organ failure and sepsis. The mean hospitalization was 52.3+/-12.6 days. CONCLUSION: The mortality rate after injury is higher in elderly patients. It is therefore the factors of intracranial and extracranial cause which influence survival and outcome be carefully treated. Neurologic deficits, even though mild, are the risk factor of poor prognosis in the elderly. Earlier identification of risk and aggressive support may be needed for decreasing the morbidity and the mortality in the elderly.
Accidents, Traffic ; Aged ; Cause of Death ; Craniocerebral Trauma* ; Glasgow Coma Scale ; Head* ; Hematoma, Subdural ; Hospitalization ; Humans ; Male ; Medical Records ; Mortality ; Motor Vehicles ; Neurologic Manifestations ; Pneumonia ; Prognosis* ; Retrospective Studies ; Risk Factors ; Sepsis

A 21-year-old woman, who had a one-year history of pancytopenia with histiocytic necrotizing lymphadenitis and hepatosplenomegaly, presented with a 5 day history of tense bullae, which were localized on the face. These clusters of tense bullae occurred on clinically normal skin, she did not have other skin lesions. A diagnosis of bullous systemic lupus erythematosus (BSLE) was established based on clinical, laboratory, histological, and immunological findings. The bullae showed good responses to dapsone (100mg, daily) and resolved within 10 days with-out scaring. Bullous lesions of SLE may be the first cutaneous manifestation in some patients with SLE and should be considered in the differential diagnosis of the other subepidermal bullous disorders.
Blister ; Dapsone ; Diagnosis ; Diagnosis, Differential ; Female ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lupus Erythematosus, Systemic ; Pancytopenia ; Skin ; Transcutaneous Electric Nerve Stimulation* ; Young Adult

Recently, we found and analyzed vitamin B12 in some Korean traditional plant foods which had not reported, yet. This study was to investigate vitamin B12 intake and its dietary sources and the vitamin B12 status in the very old elderly Koreans. We measured serum vitamin B12 level and estimated the amounts of vitamin B12 intake from different dietary sources in female elderly Koreans aged 85 and over who had consumed a relatively low animal traditional diet for the whole life. The average age of the subjects (n = 127) was 98.0 years (85-108 years). The assessment on energy and nutrient intake involved a one-day 24-hour recall, and serum vitamin B12 concentration was measured by radioimmunoassay. Overall diet pattern was not different between the 85-99 yr-old group and centenarians, except centenarians were taking more dairy product. The average ratio of plant food to animal food consumption was 87.5:12.5 in weight. The average vitamin B12 intake of our subjects was 3.2 microg/day, and 52.7% of subjects consumed under estimated average requirement, 2.0 microg/day. On dietary source, 67.3% of dietary vitamin B12 was from meat, eggs and fishes and 30.6% was from plant foods, such as soybean-fermented foods, seaweeds, and kimchi. The average serum vitamin B12 concentration was 450.5 pg/mL, and low serum vitamin B12 (< 200 pg/mL) was found in 9.6% of subjects. Dietary vitamin B12 intake was significantly lower in subjects with low serum vitamin B12 (0.79 microg/day) than those with normal serum vitamin B12 (3.47 microg/day). There were no significant difference in vitamin B12 intake and its dietary sources and serum vitamin B12 level between the 85-99 yr-old group and centenarians. In conclusion, several plant-origin foods including seaweed, soybean-fermented foods, and kimchi, may contribute significantly to good vitamin B12 status in very old elderly Koreans.
Aged ; Aged, 80 and over ; Animals ; Dairy Products ; Diet ; Eggs ; Female ; Fishes ; Humans ; Meat ; Ovum ; Plants ; Radioimmunoassay ; Seaweed ; Vitamin B 12 ; Vitamins

The purpose of this study was to describe the differences in three phenomenological research methods used to understand the experience of families of patients with cancer and so provide as guideline to novices first attempting qualitative research. The subjects were 3 family members - spouse, daughter, daughter-in-law -of cancer patients at S-hospital. Unstructured deep interviews were carried out and taped for further analyzed. Interviews were analyzed using three phenomenological methods ; Giorgi's, Colazzi's, and Van Kaam's. The results are as follows: The experience of family the analyzed using Giorgi's method showed different characteristics according to the family members' role. According to Colaizzi's method, they experienced burden, a willingness to care, role conflict, thanks to family and significant others, and ambivalence about treatment. Using Van Kaam's methodology, two categories were identified ; change of family function and burden. Themes in change of family function were positive attitude(9), role conflict(6), negative attitude(5), active attitude(2), and passive attitude(2) ; Themes in burden were emotional burden, physical burden, and economic burden. The result from using Giorgi's method were centered or individual characteristics and these results constituteds situational structured description and a general structured description. From Colaizzi's method the focus was on the common experience of all fo the subjects. In Van Kaam's method, subthemes (13), themes(8), and categories(2) were identified. So researchers should choose the qualitative method according to their research goals and methodological characteristics.
Humans ; Nuclear Family ; Qualitative Research ; Research Design* ; Spouses

PURPOSE: The purpose of this study is to examine and share experiences of male nurses who have been rejected during their nursing practice by their patients. METHODS: The participants were 12 male nurses who have worked in several hospitals. Data were collected through personalized in-depth interviews. Collected data were analyzed with the content analysis method. RESULTS: The results can be categorized into three main themes. 1. Rejection based on gender stereotypes of nurses' roles. 2. Nurses' reactions when nursing was rejected 3. Reestablishing the role as a nurse. The results of this study showed that male nurses were struggling to maintain their own positions as professional nurses. They were refused by their patients and they experienced a lack of skill and knowledge in nursing practice. They were harmed physically and psychologically from being turned down, and sometimes they had serious conflicts with female nurses. Meanwhile, the male nurses tried to be faithful to their role as professional nurses. CONCLUSION: The results of this study show the following findings. 1. The male nurses' experiences where mostly ones of understanding and cooperation with patients' caregivers. 2. The need for public relations advertising and systematic support from the media. 3. The need for improving gender equality for nurses. 4. Strengthening male nursing students' endeavors for sound nursing professionalism.
Caregivers ; Female ; Humans ; Male ; Methods ; Nurses, Male ; Nursing ; Professionalism ; Public Relations ; Qualitative Research