Cerebral aspergillosis is a rare condition that affects primarily the immunocompromised host. Most of cerebral aspergillosis is developed by hematogenous dissemination from extracranial foci, but aspergillosis of sino-nasal origin rarely affects the CNS. In case 1, wel symptom of tumor recurrence was unilateral numbness of the chin. A 65-year-old male was admitted because of paresthesia around the left chin and left lower lip. Neurologic examination revealed hypesthesia on the left side of chin, lower lip and buccal mucous mem-brane. Bone scan (Tc-99m MDP) showed focal hot uptakes on the left mandible and left first rib. Brain CT with bone window setting showed a focal osteolytic lesion in the bone marrow of the left mandibular canal without destruction of bone cortex. Both coronal T1 weighted image and axial T2 weighted image showed focal low signal intensities on the left ramus. The pathophysiologic mechanism could be understood by identification of the pathologic focus.
Aged ; Aspergillosis* ; Bone Marrow ; Brain ; Chin ; Humans ; Hypesthesia ; Immunocompromised Host ; Lip ; Male ; Mandible ; Neurologic Examination ; Paresthesia ; Recurrence ; Ribs

BACKGROUND: Incontinence and muscle loss are important senior health issues. Nevertheless, there are no available domestic or international studies on the association between urinary incontinence and muscle loss. The aim of this study was to investigate the association between muscle loss and urinary incontinence in elderly Korean woman. METHODS: Korean women (1,313) > or =65 years of age whose complete body composition data were collected using dual X-ray absorptiometry were analyzed from the Fourth Korean National Health and Nutritional Examination Surveys. Class I and II losses of the appendicular, truncal, and total muscle mass were defined using adjustments for weight and height. Each participant's incontinence status was collected using constructed questionnaires. Multiple logistic regression was performed to examine the association between muscle loss and incontinence. RESULTS: On the basis of physician-diagnosed incontinence, weight- and height-adjusted muscle loss showed no association with urinary incontinence (weight-adjusted muscle loss: class I adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.34 to 1.73; class II aOR, 1.37; 95% CI, 0.59 to 3.18; height-adjusted muscle loss: class I aOR, 0.51; 95% CI, 0.18 to 1.51; class II aOR, 1.86; 95% CI, 0.22 to 15.79). Similar results were observed for truncal muscle and total muscle mass as well as self-reported urinary incontinence. CONCLUSION: Our study found no association between urinary incontinence and appendicular, truncal, and total muscle loss in elderly Korean women.
Absorptiometry, Photon ; Aged* ; Body Composition ; Female ; Humans ; Logistic Models ; Muscle, Skeletal ; Muscular Atrophy ; Odds Ratio ; Surveys and Questionnaires ; Urinary Incontinence*

Adult respiratory distress syndrome(ARDS) is described under various names in the medical literature: post-traumatic pulmonary insufficiency, wet lung. DaNang lung and shock lung etc., and the syndrome has been used to describe a serious and often fatal conditions which may develop in any patient subjected to severe trauma, major surgery or critical illness. ARDS is characterized by increasing intrapulmonary shunting, increasing work of breathing and decreasing lung compliance. There is still desagreement about exact nature of ARDS as well as its care and revention. In ARDS, the use of positive end-expiratory pressure(PEEP) has been widely debated since its introduction by Ashbaugh and Petty in 1969. Its purpose is to increase the lung volume, especially functional residual capacity at end expiration in order to obtain better alveolar expansion and improved pulmonary gas exchange. This report described two cases of ARDS following trauma, and respiratory care problems were reviewed and discussed.
Adult ; Male ; Female ; Humans

Synchronous primary tumor is uncommon form of gynecologic malignancy. Synchronous tumor is defined as primary tumor diagnosed simultaneously or within 6 months of one another. The prognosis of the patients with synchronous malignancies was reported to be more favorable when compared to the survival of patients harboring the same neoplasms individually. We report a case of multifocal concurrent adenocarcinoma involving salpinx, ovary, uterine cervix, and endometrium as well as omentum with a brief review of literatures.
Adenocarcinoma* ; Cervix Uteri ; Endometrium ; Fallopian Tubes ; Female ; Humans ; Omentum ; Ovary ; Prognosis

To compare geographic differences in anesthesia between Wonju City and another city, Seoul, anesthetic experiences of a total of l6,457 cases performed at the Department of Anesthesiology of Wonju Christian Hospital, Yonsei University Medical College, from Nov. 1957 tO Dec. 1977 were analyzed statistically according to age, sex, physical status, emergency operation, anesthetic agents and methods and complications. The results are as follows: 1) The cases of anesthesia tended to increase year by year and the rate of increasing was remarkable in female patients. 2) Sexual distribution was 8994 cases of males(54.7%) and 7463 cases of females(45.3%). 3) 44. 5% of cases were of patients in the 2nd to 4th decade of age and the patients under 10 years and over 60 years of age tended to increase. 4) The patients in general surgery were more than half of the total cases and the patients in neurosurgery tended to increase. 5) General anesthesia was given to 91. 6% of total cases, and regional anesthesia to 8.4%. 6) Ether anesthesia was used in about 67% of all surgical patients. 7) About 30% of total cases were emergency cases. 8) Of ll cases of cardiac arrest, 7 cases were successfully resuscitated.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesiology ; Anesthetics ; Emergencies ; Ether ; Female ; Gangwon-do ; Heart Arrest ; Humans ; Neurosurgery ; Seoul

BACKGROUND: The purpose of this study was to compare the long term effect of the cholesterol lowering diet education provided by physicians with the education provided by dieticians on serum lipid profiles of hypercholesterolemic patients. METHODS: Among 248 ambulatory patients who had mean baseline serum total cholesterol (TC) level > or = 200mg/dL and received cholesterol lowering diet education from physicians or dieticians, 41 patients who checked serum lipid profiles three times during the mean of 403 days after education were included as subjects. The differences in means of all serum lipid profiles associated with education methods after controlling for follow up duration, differences in means of all serum lipid profiles associated with follow up duration after controlling for education methods, any interaction between education methods and follow up duration on serum lipid profiles were analysed by using repeated measures of analysis of variance. The difference between the baseline lipid levels and the third lipid levels after education were analyzed by using Wilcoxon signed ranks tests in each group. Correlations between baseline serum lipid profiles and the last changes in serum lipid profiles were analyzed. RESULTS: There were no significant differences in means of all serum lipid profiles associated with education methods or follow up duration except LDL cholesterol (LDL C). The first LDL C level after education was significantly lower in the group educated by physicians compared with the baseline LDL C, but there was no such change in the group educated by dieticians. There were no interactions between education methods and follow up duration on all serum lipid profiles. The last change of total cholesterol in both groups and LDL C only in the group educated by dieticians were significant. Correlation coefficients between baseline triglyceride (TG) and change in TG, baseline LDL C and change in LDL C, baseline total cholesterol (TC) and change in TC in patients with TC > or = 240mg/dL were 0.500 (P=0.002), 0.597 (P<0.001), and 0.578 (P=0.001), respectively. CONCLUSION: The changes of serum lipid profile during more than 1 year after education were not significantly different according to diet education methods, but total cholesterol level was significantly decreased in both groups.
Cholesterol ; Cholesterol, LDL ; Diet* ; Education* ; Follow-Up Studies ; Humans ; Hypercholesterolemia ; Nutritionists* ; Triglycerides

OBJECTIVE: The purpose of this study was to examine the long-term effects of Hospital Information System(HIS) on nurses' job pattern and satisfaction, and attitudes toward electronic medical record system. METHODS: Prospective survey using repeated measures design was performed to compare the changes between 2 years and 4 years after introduction of HIS in a tertiary hospital. Participants were 374 nurses working in the target hospital. Questionnaire was developed by researchers based on Walker, Eyman, Krall, Prophet, and Flanagan(1996)'s study and consisted of 21 questions about job pattern, job satisfaction, and attitudes toward computerization and paper record system. RESULTS: Overall time for documentation, shift reporting, communication with other departments were reduced. Otherwise, direct nursing time was not increased after HIS. Nurses showed positive responses on changes of job pattern after HIS while job satisfaction has been decreased. In addition, nurses' attitudes toward hospital information system and paper medical record system showed they were accepting computerized information system. CONCLUSION: This study identified the long-term positive effects of HIS and the need for nursing sensitive hospital information system.
Electronic Health Records ; Hospital Information Systems* ; Information Systems ; Job Satisfaction ; Medical Records ; Nursing ; Prospective Studies ; Surveys and Questionnaires ; Tertiary Care Centers

Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin's lymphoma, and this tumor is predominantly composed of large lymphoid cells that have a strong expression of CD30. Two major groups of ALCL have been described. The first is a spectrum of CD30+ lymphoproliferative disorders, including primary cutaneous ALCL and lymphomatoid papulosis. The second is systemic nodal ALCL, which can be subdivided into two groups: anaplastic lymphoma kinase (ALK)-positive and ALK-negative. The relative frequency of ALCL in Korea is about 19% of all cutaneous lymphomas. Solitary or multiple large nodular tumoral lesions confined to one body compartment are the most common presentation. We report here on a case of CD30 (+)/ALK (-) primary systemic ALCL in a 77 year-old-male, and the skin lesion manifested as multiple papules, plaques and tumors on the trunk, buttocks and upper and lower extremities.
Buttocks ; Korea ; Lower Extremity ; Lymphocytes ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders ; Phosphotransferases ; Receptor Protein-Tyrosine Kinases ; Skin

No abstract available.
Cyclosporine* ; Fluorescence Polarization Immunoassay* ; Fluorescence Polarization* ; Fluorescence*

OBJECTIVES: There have been many studies on the relationship between diabetes mellitus and presbycusis. Microangiopathy and neuropathy that's caused by chronic hyperglycemia may lead to damage to the inner ear. Several clinical studies on humans and animal studies have been performed to investigate the association between diabetes and hearing loss, however, this relationship is still a matter of debate. We investigated the association of diabetes and sensorineural hearing loss in an animal model of type-2 diabetes and obesity (the ob/ob mouse [OM]). METHODS: The auditory brainstem response (ABR) thresholds were obtained in the OM and the wild type mice (C57BL/6J mice) up to 25 weeks after birth. After the animals were sacrificed, their cochleae were retrieved and then subjected to histopathologic observations. RESULTS: The OM exhibited significantly elevated ABR thresholds at 21 weeks of age, yet the C57BL/6J mice exhibited no significant change until 25 weeks of age. On the histological findings, outer hair cell degeneration and loss of spiral ganglion cells were observed in the middle and basal turns of the OM. On the contrary, no degenerative change was observed until 25 weeks of age in the C57BL/6J mice. CONCLUSION: This study suggests that chronic hyperglycemia and obesity may lead to early sensorineural hearing loss.
Animals ; Cochlea ; Diabetes Mellitus ; Ear, Inner ; Evoked Potentials, Auditory, Brain Stem ; Hair ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Hyperglycemia ; Mice ; Mice, Obese ; Models, Animal ; Obesity ; Parturition ; Presbycusis ; Spiral Ganglion