OBJECTIVES: The authors developed computerized cognitive function test system for Korean adults for the reliable and valid assessment of the cognitive function. This study was conducted to explore the areas of the cognitive functions of the newly developed system and to provide clinical guidelines for the interpretation of the results by the test system. METHODS: The computerized cognitive function test system was developed through several steps of preliminary application and corrections. The reliability and the validity were also tested. Factor analysis was applied to explore the areas of the cognitive functions from the data of 150 Korean adults, age 20 to 50, whose educational levels were higher than high school graduate. RESULTS: The attention tests evaluated auditory and visual sustained attention, attentional control, and information processing speed. The memory tests consisted of immediate memory, working memory, and auditory and visual learning abilities. Higher cortical function tests evaluated different areas by each test. The total system mainly evaluated attention maintenance, information processing speed, working memory, learning abilities, abstract thinking abilities, and mental flexibilities. CONCLUSIONS: Clinically applicable computerized cognitive function test battery with high reliability and validity were developed. The factor analysis showed that it assessed most of the major cognitive areas, except language and sensorimotor coordination. Future effort is requested to develop tests which can evaluate the cognitive areas omitted in the currest system.
Adult* ; Automatic Data Processing ; Cognition ; Factor Analysis, Statistical* ; Humans ; Korea* ; Learning ; Memory ; Memory, Short-Term ; Reproducibility of Results ; Thinking

PURPOSE: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. METHODS: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. RESULTS: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, 6.54+/-1.06 years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was 1.57+/-0.34 and 14.07+/-1.91 minutes, respectively, the mean catheter dwell time was 14.73+/-2.5 days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). CONCLUSION: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.
Catheterization* ; Catheters* ; Central Venous Catheters ; Child ; Critical Illness* ; Emergencies ; Female ; Humans ; Intensive Care Units ; Internship and Residency ; Jugular Veins* ; Male ; Nervous System Diseases ; Outcome Assessment (Health Care) ; Pneumothorax ; Punctures ; Sepsis ; Skin ; Ultrasonography

No abstract available.
Exanthema* ; Humans ; Infant* ; Leukemia* ; Leukemia, Myeloid, Acute

The intestine harbors a large population of microorganisms that interact with epithelial cells to maintain host healthy physiological status. These intestinal microbiota engage in the fermentation of non-digestible nutrients and produce beneficial metabolites to regulate host homeostasis, metabolism, and immune response. The disruption of microbiota, known as dysbiosis, has been implicated in many intestinal diseases, including colorectal cancer (CRC). As the third most common cancer and the second leading cause of cancer-related death worldwide, CRC poses a significant health burden. There is an urgent need for novel interventions to reduce CRC incidence and improve clinical outcomes. Modulating the intestinal microbiota has emerged as a promising approach for CRC prevention and treatment. Current research efforts in CRC probiotics primarily focus on reducing the incidence of CRC, alleviating treatment-related side effects, and potentiating the efficacy of anticancer therapy, which is the key to successful translation to clinical practice. This paper aims to review the traditional probiotics and new interventions, such as next-generation probiotics and postbiotics, in the context of CRC. The underlying mechanisms of probiotic anti-cancer effects are also discussed, including the restoration of microbial composition, reinforcement of gut barrier integrity, induction of cancer cell apoptosis, inactivation of carcinogens, and modulation of host immune response. This paper further evaluates the novel strategy of probiotics as an adjuvant therapy in boosting the efficacy of chemotherapy and immunotherapy. Despite all the promising findings presented in studies, the evaluation of potential risks, optimization of delivery methods, and consideration of intra-patient variability of gut microbial baseline must be thoroughly interpreted before bench-to-bedside translation.

Situs inversus totalis is a rare condition with a genetic predisposition that is autosomal recessive. We report an elderly patient with situs inversus, multiple choledocholithiasis, and he was treated via endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy, and then his multiple CBD stones were removed with basket and balloon. This paper further expands the application of these techniques and shows that they can be safely and effectively applied in the setting of situs inversus, although attention must be paid to the details of left-right reversal.
Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis* ; Genetic Predisposition to Disease ; Humans ; Situs Inversus*

OBJECTIVE: We evaluated the clinical efficacy of a comprehensive psychiatric rebabiliation of schizophrenia, including family psychoeducation,patient education,socail skills tranining,group psychotherapy,art therapy,and ocupational therapy. METHOD: From September 1993 to february 1995,173 chronic schizophrenics who met DSM-lV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group,n=46) or the customary out patient service group(out-patient group,n=127)prospectively,but not randomly. Assignment was based on preferences of patients and their relatives. Each subject included in the psychiatric rehabilitation group received twice weekly patient education,social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study,all subjects were assessed for the number of readmission,days of hospitalization,and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remailder of the two year follow-up period. RESULTS: With regard to the mean number of hospital admissions per vear,the mean days of hospitalization per year, and the direct treatment costs per year, psychiatric rehabilitation broup had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabiliation group. In contrast, 75 patients(59%) during first year and 90 patients(71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse,4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. CONCLUSIONS: These results indicate that the comprehensive psychiatric rehabiliation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.
Aftercare ; Art Therapy ; Compliance ; Drug Therapy ; Follow-Up Studies* ; Health Care Costs* ; Hospitalization* ; Humans ; Maintenance Chemotherapy ; Occupational Therapy ; Outpatients ; Patient Education as Topic ; Psychotherapy ; Psychotherapy, Group ; Recurrence* ; Rehabilitation* ; Schizophrenia

The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.
Abscess ; Airway Obstruction ; Anti-Bacterial Agents ; Bandages ; Early Diagnosis ; Epidural Abscess ; Fasciitis ; Fasciitis, Necrotizing ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Incidence ; Mandible ; Mediastinitis ; Neck ; Osteomyelitis ; Pericarditis ; Porphyrins

OBJECTIVES: The purpose of this study was to compare lymph node (LN) staging using ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) with contrast-enhancement (CE) PET/CT and contrast-enhanced neck CT (neck CT) in patients with thyroid cancer with level-by-level comparison with various factors. METHODS: This was a retrospective multicenter study. A total of 85 patients were enrolled. Patients who underwent a preoperative evaluation by CE PET/CT and neck CT for thyroid cancer were enrolled. The gold standard for LN was the combination of surgical pathology and clinical follow-up. We compared CE PET/CT with neck CT using a level-by-level method. Factors, including age, sex, camera, arm position, tumor size, extra-thyroidal extension, tumor location, number of primary tumors, primary tumor maximum standardized uptake value, and the interval from scan to operation were also analyzed. RESULTS: Overall accuracy was 81.2% for CE PET/CT and 68.2% for neck CT. CE PET/CT was more sensitive than neck CT (65.8% vs. 44.7%). Also, CE PET/CT showed higher negative predictive value (77.2% vs. 66.1%). CE PET/CT showed good agreement with the gold standard (weighted kappa [κ], 0.7) for differentiating N0, N1a, and N1b, whereas neck CT showed moderate agreement (weighted κ, 0.5). CE PET/CT showed better agreement for the number of levels involved with the gold standard (weighted κ, 0.7) than that of neck CT with the gold standard (weighted κ, 0.5). The accuracies for differentiating N0, N1a, and N1b were 81.2% for CE PET/CT and 68.2% for neck CT. Level-by-level analysis showed that CE PET/CT was more sensitive and has higher negative predictive value for detecting ipsilateral level IV and level VI LNs than neck CT. Other analyzed factors were not related to accuracies of both modalities. CONCLUSION: CE PET/CT was more sensitive and reliable than neck CT for preoperative LN staging in patients with thyroid cancer.
Arm ; Electrons ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Methods ; Neck* ; Pathology, Surgical ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: Appendicitis is the most common condition leading to an intra-abdominal operation for a non-obstetric problem in pregnancy. The aim of this study was to examine our experience and to analyze the clinical characteristics and the pregnancy outcomes for appendicitis during pregnancy that was reported in Korea. METHODS: We reported 25 cases of appendicitis during pregnancy that were treated at Good Moonhwa Hospital from January 2004 to March 2010. We also analyzed appendicitis during pregnancy reported in Korea between 1970 and 2008 by a review of journals. RESULTS: The incidence of acute appendicitis during pregnancy was one per 568 deliveries. The mean age was 27.92 years old, the gestational stage at the onset of symptoms was the first trimester in 10 patients (40%), the second trimester in 14 patients (56%), and the third trimester in 1 patient (4%). Among the 25 cases, 21 were treated with an open appendectomy and 4 with laparoscopic appendectomies. The postoperative complications were 2 wound infections and 1 spontaneous abortion. CONCLUSION: Our experience demonstrated that appendectomies on pregnant patients can be successfully performed at secondary hospitals.
Appendectomy ; Appendicitis ; Female ; Humans ; Incidence ; Korea ; Postoperative Complications ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Wound Infection

Lymphangioma is a rare, benign mesenchymal neoplasm, which is characterized by numerous intercommunicating cystic spaces containing lymphatic fluid. It is considered a congenital disease resulting from the obstruction of regional lymph drainage during the developmental period. Lymphangioma may be focal/unilateral or diffuse/bilateral, and in the latter case, it is referred to as lymphangiomatosis. Here, we report a case of a 38-year-old man with perirenal lymphangiomatosis. The patient's chief complaint was left flank pain, and left pleural effusion was found on radiological examination. After radical nephrectomy, the pathological examinations revealed that the kidney was enclosed by a multicystic mass with intrarenal cystic dilatations. We report the case and discuss the management of perirenal lymphangiomatosis with a literature review.
Adult ; Dilatation ; Drainage ; Flank Pain ; Humans ; Kidney ; Lymphangioma ; Lymphatic Diseases ; Nephrectomy ; Pleural Effusion