Obstructive jaundice of the bile duct resulting from tumor-producing copious, thick mucin, causing ductal obstruction and dilatation, has been reported very rarely. Also, the benign bile duct neoplasm is extremely rare. We report a case of a mucin-secreting villous adenoma of common hepatic duct causing obstructive jaundice and cholangitis. The patient was a 72-year-old male and had a 3 yeared history of common hepatic mass unchanged remarkably in size. The abdominal ultrasonogram and computed tomography revealed well circumscribed, more than 2cm sized mass on the CHD and ductal dilatation. We were able to get an interesting cholangioram showing irregular, nodular, ill defined filling defect in the extrahepatic bile duct, different from US and CT findings, And it was just caused by thick, copious mucin from the tumar. This case was confirmed as mucin-secreting villous adenoma after surgery.
Adenoma, Villous* ; Aged ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Cholangitis ; Dilatation ; Hepatic Duct, Common* ; Humans ; Jaundice, Obstructive ; Male ; Mucins* ; Ultrasonography

No abstract available.
Idiopathic Pulmonary Fibrosis*

PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVES: From February 1995 to April 1998, those patients who had visited for evaluation of infertility, shown abnormal endometrial pattern on hysterosalpingography underwent resectoscopic operation. We evaluated about its therapeutic effect, recurrence rate of uterine adhesion and effectiveness of its assisted method. METHOD: We have reviewed 45 cases of intrauterine adhesion, classified as a central type, marginal type and multiple type. We used 26F resectoscope made in Storz for operation and inserted Lippes loop or pediatric foley catheter for prevention of readhesion. For promoting reepithelialization, conjugated estrogens(premarin) 5mg daily for 30 - 50 days were given and then 10mg of medroxyprogesterone acetate(provera) were added daily for the last 10 days. We evaluated the uterine cavity condition preoperatively and postoperatively by using hysterosalpingography. RESULT: In 45 cases, 41 cases were followed up postoperatively. 21 cases were markedly improved, 12 cases were improved and 8 cases were not improved or recurred on hysterosalpingography. In 41 cases, for prevention of readhesion 20 cases were used pediatric foley catheter and 5 cases(25%) were recurred. 21 cases were used Lippes loop and 3 cases(14%) were recurred. Pregnancy outcome was as follows;15 cases were pregnant and 10 cases delivered a viable infant, 3 cases aborted spontaneously, 1 case was ectopic pregnancy and laparoscopic salpingectomy was done, 1 case was ongoing pregnancy. CONCLUSION: This report suggests that resectoscopic operation is very effective in the treatment of intrauterine adhesion(therapeutic rate of 81%) and that the use of Lippes loop seems like to have the less recurrence rate than the use of pediatric foley catheter in prevention of postoperative readhesion, but more experience and further follow-up are necessary to obtain more detailed conclusions.
Catheters ; Female ; Follow-Up Studies ; Humans ; Hysterosalpingography ; Infant ; Infertility ; Medroxyprogesterone ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Ectopic ; Recurrence ; Salpingectomy

No abstract available.
Clomiphene*

PURPOSE: This study examined the characteristics and service utilization of home nursing care beneficiaries under the Korean Long-Term Care Insurance (LTCI). METHODS: We used assessment data and claim data of National Health Insurance Corporation from July to August 2008. Data were composed of subjects who were the beneficiaries of home nursing care. RESULTS: A total of 634 subjects were analyzed. Of the subjects, 57.1% were 75 years and over. The average score of nursing care need was only 0.71 and the percentage of those whose nursing care need score was zero was 58.0%. More than half of the subjects had partially dependent musculoskeletal conditions, and 75.5% had two or more comorbidities. A third of them usedonly home nursing care, and another third used both home nursing care and general home care at the same time. Those who needed sore care used the largest home nursing care benefits. CONCLUSION: Home nursing care of LTCI performs community-based healthcare services under LTCI. Throughout the past two years, however, it has not been active. Understanding the characteristics of its users is important in order to develop effective strategies for activating home nursing care.
Comorbidity ; Delivery of Health Care ; Home Care Services ; Home Nursing* ; Insurance, Long-Term Care* ; Long-Term Care* ; National Health Programs ; Nursing Care

PURPOSE: The purpose of this study was to estimate the effects of lifestyle factors on metabolic syndrome (MS) among Korean adults (age> or =20). METHODS: A total of 7,798 subjects (weighted subjects=37,215,961) were recruited from the 2009 Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-3). Data were analyzed by t-test, chi2-test, and logistic regression in consideration of strata, cluster and weight as national data using the SAS 9.1 program. RESULTS: The prevalence of MS by definition of AHA/NHLBI and waist circumference cutoff points for Koreans was 22.4%. The mean clinical MS score for MS patients was 3.4, but the mean score for the non-MS group was 1.2 out of 5.0. Among the lifestyle factors, smoking (OR=1.024), stress (0.546< or =OR< or =0.587) and drinking (OR=1.005) had significant influence on the MS risk and MS scores, but exercise did not. CONCLUSION: The results of this study indicate that further research is necessary on the effect of lifestyle factors on MS risk and nurses should focus on effective programs about smoking, stress and drinking for the prevention and reduction of MS risk.
Adult ; Alcohol Drinking ; Drinking ; Humans ; Korea ; Life Style ; Logistic Models ; Metabolic Syndrome X ; Nutrition Surveys ; Phenothiazines ; Prevalence ; Smoke ; Smoking ; Waist Circumference

Nutrient supplements are often used by athletes as ergogenic aids. This study was done to investigate the use of nutrient supplements, nutritional knowledge and nutrient intakes of athletes. Subjects of this survey consisted of 195 national team athletes. The prevalence of nutrient supplement use among all subjects was 30.3%, and the frequency of use, by decreasing order, was weight lifting, taekwondo and badminton athletes. Sport drinks were the type of nutrition supplement used most frequently and vitamin C was the second one. Major reasons for nutrient supplement use were to improve training performance and to recover from fatigue, to supplement fluid and to control weight. The average score of nutritional knowledge was 19.9+/-2.5 for nutrient supplement users, and 19.8+/-3.6 for nutrient supplement nonusers. Intakes of protein, calcium and niacin of the user were higher than those of the nonuser. This information provided by this study can help sport nutritionists identify nutrient supplement most often consumed by national elite athletes and can aid counselors as they guide athletes towards more healthful nutrition practices.
Ascorbic Acid ; Athletes* ; Calcium ; Counseling ; Fatigue ; Humans ; Morinda ; Niacin ; Nutritionists ; Prevalence ; Racquet Sports ; Sports ; Weight Lifting

BACKGROUND: Antioxidants vitamin C and vitamin E may protect against the toxic effect of oxygen free radicals that are preferentially produced after exposures to hyperbaric oxygen (HBO). This study investigated the effect of vitamin C and vitamin E on serum nitric oxide (NO) concentration and intercellular adhesion molecule-1 (ICAM-1) expression on lung after HBO exposure. METHODS: Male Sprague-Dawley rats weighing 200 to 250 g were exposed to HBO at 3 ATA of 100% O2 for 3 hours. The experimental groups were given vitamin C (125 mg/day per rat) and/or vitamin E (50 mg/day per rat) orally, from 5 days prior to the HBO exposure to the day of sacrifice. Serum NO concentrations were determined by measuring NO end product nitrite by non-enzymatic Griess assay. Expression of ICAM-1 on lung was observed by immunohistochemical analysis. RESULTS: The serum nitrite levels were significantly increased after HBO exposure and were higher at 24 hours after HBO exposure than at 0 h (P<0.05). The expression of ICAM-1 was weak immediately after HBO exposure and enhanced at 24 hours. There were no pronounced suppressive effects of vitamins on serum NO production and ICAM-1 expression induced by the 3 hours HBO exposure. CONCLUSION: The 3 hours HBO exposure induces the serum NO production and ICAM-1 expression on lung. The short-term supplementation of vitamin C or/and E do not suppress the NO production and ICAM-1 expression on lung.
Animals ; Antioxidants ; Ascorbic Acid ; Free Radicals ; Humans ; Hyperbaric Oxygenation ; Intercellular Adhesion Molecule-1 ; Lung ; Male ; Nitric Oxide ; Oxygen* ; Rats* ; Rats, Sprague-Dawley ; Vitamin E ; Vitamins*