The authors report a case of monostotic eosinophilic granuloma which occured in the skull. A 37 year-old woman was presented with headache and soft mass in the occipital region. Plain skull X-ray showed a "punched out" osteolytic lesion in the right paramedian posterior parietal bone. Computed tomography shows a soft tissue mass and irregular bone destruction in corresponding region. On magnetic resonance image, the mass was of high signal intensity, with subgaleal extension and looks like a shirt stud or "collar button" on T2-weighted image. Total excision of the tumor and postoperative radiotherapy(1000cGy) were performed. The woman had no headache complains nor showed any focal neurologic deficit during the six months follow-up period. We report a case of monostotic eosinophilic granuloma of the skull with review of the pertinent literatures.
Adult ; Eosinophilic Granuloma* ; Eosinophils* ; Female ; Follow-Up Studies ; Headache ; Humans ; Neurologic Manifestations ; Parietal Bone ; Skull*

The auther studied 54 lumbar spondylolisthesis patients diagnosed and treated with transpedicular screw fixation and bony fusion at our Hosptial between January 1990 and December 1994, and analysed the outcome. The results may be summarized as follows: 1) Of the 54 cases, 17 were degenerative spondylolisthesis and 37 were spondylolytic spondylolisthesis. Occurrence peaked during the fifth and sixth decades. 2) Posterolateral fusion(P.L.F) was performed in 37 cases and posterior lumbar interbody fusion(P.L.I.F) in eight ; P.L.F and P.L.I.F in combination was performed in nine cases. The mean follow-up period was 25 months. 3) In no patients was significant neurologic injury or functional root loss seen. Complications included two instrument failures and one wound infection. 4) Radiologic and clinical outcome was better in degenerative than in spondylolitic spondylolisthesis. 5) The radiologic and clinical outcome of bony fusion types P.L.F and P.L.I.F was the same. 6) The surgical result as evaluated by Mc.Nab's criteria was satisfactory in 81% of patients.
Follow-Up Studies ; Humans ; Spine* ; Spondylolisthesis* ; Wound Infection

PURPOSE: Antithrombotic therapy could be related with nuisance bleeding. This study investigated whether vitreous hemorrhage (VH) is associated with specific types of antithrombotic medication in patients with atrial fibrillation (AF). MATERIALS AND METHODS: In the Korean National Health Insurance Service National Sample Cohort, we identified 9352 antiplatelet/anticoagulant-treated AF patients. The occurrence of VH was compared between warfarin (n=1493) and a propensity score (PS)-matched antiplatelet group (n=1493) and between warfarin (n=1493) and a PS-matched warfarin+antiplatelet group (n=1493). RESULTS: The outcomes of VH were lower in the warfarin than in the matched antiplatelet (1.45 vs. 3.72 events/1000 patient-years) and matched warfarin+antiplatelet groups (1.45 vs. 6.87 events/1000 patient-years). Compared with warfarin, the risk of VH increased with antiplatelet [adjusted hazard ratio (aHR) 3.90; 95% confidence interval (CI) 1.22–12.4, p=0.022] and warfarin+antiplatelet agents (aHR 4.39, 95% CI 1.74–11.2, p=0.002). Compared with warfarin only, warfarin+antiplatelet agents increased the risk of VH in patients ≥65 years, regardless of gender and hypertension. The risk of VH was significantly higher with dual antiplatelet therapy (aHR: 5.02, 95% CI: 1.56–16.2, p=0.007) or in dual (aHR: 5.02, 95% CI: 1.74–14.5, p=0.003) or triple therapy using warfarin and antiplatelet agents than with warfarin monotherapy (aHR: 6.12, 95% CI: 1.76–21.3, p=0.004). CONCLUSION: Dual antiplatelet or triple therapy increased the risk of VH significantly, compared to warfarin monotherapy. Considering the low efficacy of preventing ischemic stroke and high risk of bleeding, dual or triple therapy using warfarin and antiplatelet agents should be avoided to prevent VH in AF patients.
Atrial Fibrillation* ; Cohort Studies* ; Hemorrhage ; Humans ; Hypertension ; National Health Programs* ; Platelet Aggregation Inhibitors ; Propensity Score ; Stroke ; Vitreous Hemorrhage* ; Warfarin

Cephalosporins are commonly used antibiotics in treatment of clinical infection. They frequently cause a positive direct antiglobulin test, but rarely cause hemolysis. The authors report a case of immune hemolytic anemia due to a second-generation cephalosporin, cefuroxime, by the drug adsorption mechanism.
Adsorption ; Anemia, Hemolytic* ; Anti-Bacterial Agents ; Cefuroxime* ; Cephalosporins ; Coombs Test ; Hemolysis

PURPOSE: There have been no studies on the termination of resuscitation (TOR) in Korea. We retrospectively applied TOR rules to OHCA patient data in order to validate the BLS and ALS TOR rules for Korea. METHODS: We collected OHCA (out-of-hospital cardiac arrest) data from 3 hospitals for the period January 1 to December 31, 2009. We then retrospectively applied BLS and ALS TOR rules to this data. We measured both the specificity and positive predictive value for each BLS and ALS TOR rule. RESULTS: The overall rate of survival until hospital discharge was 14.5%. Out of 102 patients who met BLS criteria TOR rules, 8 patients survived until hospital discharge. Out of 52 patients who met ALS criteria TOR rules, 4 patients survived until hospital discharge. The BLS rule had a specificity of 0.57 and a positive predictive value of 0.92. The ALS rule had a specificity of 0.78 and a positive predictive value of 0.92. CONCLUSION: In this study, the BLS and ALS TOR rules had relatively low positive predictive value and were not applicable to patients with low survival probability in Korea.
Cardiopulmonary Resuscitation ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest ; Resuscitation ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND: LOH11A is a region with frequent allele loss (>75%) in lung cancer that is located on the centromeric part of chromosome 11p15.5. Clinical and cell biological studies suggest that this region contains a gene associated with metastatic tumor spread. RRM1 encoding the M1 subunit of ribonucleotide reductase, which is an enzyme that catalyses the rate-limiting step in deoxyribonucleotide synthesis, is located in the LOH11A region. METHODS: Polymorphisms were found at nucleotide position (-)37 (C/A) and (-)524 (C/T) from the beginning of exon 1 of the RRM1 gene that might regulate the expression of RRM1. We studied the polymorphisms in 127 Korean individuals (66 lung cancer and 61 normal controls) and compared with those of 140 American patients with lung cancer. RESULTS: CC, AC and AA were found at the (-)37 position in 64(50.4%), 55(43.3%), and 8(6.3%) out of 127 Korean individuals (66 cancer, 61 non-cancer patients), respectively. There was a similar frequency of allele A at (-)37 in the American(27.9%) and Korean population(28.0%). CC, CT and TT was found at the (-)524 position in 24(18.9%), 44(34.6%), and 59(46.5%) out of the 127 Korean individuals, respectively. There was a similar frequency of allele C at (-)524 in the American(34.6%) and Korean population(36.2%).There was no difference in the frequency of the (-)37 and (-)524 genotypes between the cancer and non-cancer group. However there was a significant correlation of the genotypes between (-)37 and (-)524 (p<0.001), which suggests the possible coordination of these polymorphisms in the regulation of the promoter activity of the RRM1 gene. CONCLUSION: RRM1 promoter polymorphisms were not found to be significant risk factors for lung cancer. However, a further study of the promoter activity and expression of the RRM1 gene according to the pattern of the polymorphism will be needed.
Alleles ; Catalysis ; Exons ; Genes, vif ; Genotype ; Humans ; Lung Neoplasms* ; Lung* ; Ribonucleotide Reductases ; Risk Factors