No abstract available.
Evoked Potentials, Auditory, Brain Stem* ; Humans ; Infant*

Although thrombolytic therapy is one of the most effective therapeutic option for acute ischemic stroke, hemorrhagic complication still remains major concern about its application. A patient with hemoperitoneum, who previously underwent thrombolytic therapy(intraarterial urokinase infusion, IAUK) for acute ischemic stroke was treated successfully with emergency transarterial embolization for rupture of hepatocellular carcinoma. We present a rare case of rupture of hepatocellular carcinoma after intraarterial urokinase infusion for acute ischemic stroke with brief review of the literature.
Carcinoma, Hepatocellular ; Emergencies ; Hemoperitoneum* ; Humans ; Rupture ; Stroke* ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator*

PURPOSE: This study analyzed iodine intake by establishing an iodine database of general Korean foods eaten by Korean adults based on the data from the 1998 ~ 2014 KNHANES (Korea National Health and Nutrition Examination Survey). METHODS: Data on 56,818 subjects aged 19 years and older were obtained from health behavior interviews and a 24-hour dietary recall survey. Iodine intake of subjects was analyzed according to general characteristics, dietary lifestyle, food groups, and cooking method. RESULTS: An iodine database was established for 312 food items. The mean iodine intake of Korean adults decreased from 641.6 μg in 1998 to 236.2 μg in 2014 per day. Iodine intake of women was higher than that of men. For age distribution, those aged 30 ~ 49 years constituted more than 39 ~ 46% of subjects by survey year. Regarding iodine intake according to dietary lifestyle, the highest iodine intake was 29.4 ~ 34.4% for lunch while that of breakfast decreased. The highest iodine contribution by food group was seaweed such as kelp, sea mustard, and laver. CONCLUSION: The results of this study indicate that iodine intake of Korean adults has been decreasing, and iodine intake is associated with the prevalence of thyroid disease. This study provides basic data for the estimation of iodine intake in Korean adults.
Adult* ; Age Distribution ; Breakfast ; Cooking ; Female ; Functional Food ; Health Behavior ; Humans ; Iodine* ; Kelp ; Korea* ; Life Style ; Lunch ; Male ; Methods ; Mustard Plant ; Nutrition Surveys* ; Prevalence ; Seaweed ; Thyroid Diseases

BACKGROUND: Team-based learning is known for its effective and satisfying education methods in the study of various medical schools. This study was prepared to confirm the satisfaction of applying this team-based learning to the training course of emergency medical technician.METHODS: A total of 165 new members of the course of second grade National Emergency medical technician at 2019 were finally enrolled in the study. Data were collected with a self-administered questionnaire. The team-based learning method was organized with eight students per group to conduct pre-learning and then proceed to open book to encourage active discussion among individuals. The questionnaire consisted of questions about the satisfaction of the discussion process, such as whether the knowledge gained from the discussion was appropriate, and whether collaboration between colleagues was successful during the discussion, and about the benefits of team-based learning, how well knowledge transfer compared to existing lectures, and the replacement of existing lectures. The questionnaire used a Likert 5 point scale, and the data obtained were analyzed using the SPSS version 22.0.RESULTS: The overall rating of team-based learning was 7.8 ± 1.5 out of 10. Many students answered positively (88.5%) for benefits, while 87.9% responded positively to whether the knowledge transfer effect was better compared to existing lectures. In addition, the satisfaction of team-based learning was generally high, with more than 90 percent of education students giving positive answers to the replacement of other lectures with team-based learning.CONCLUSION: The learners gave positive answers to the satisfaction, usefulness and learning effects of team-based learning. Team-based learning is a discussion-based study, so it is a good way to improve communication skills. Since communication and teamwork are important in first aid activities, the characteristics of team-based learning could lead to improvements in first aid services, leading to high-quality emergency medical services.
Cooperative Behavior ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; First Aid ; Humans ; Learning ; Lectures ; Methods ; Schools, Medical

PURPOSE: Immunosuppression is important for early success of renal transplantation. Mycofenolate mofetil (MMF) has been substituted for Azathioprine (AZA) and has been shown to have greater effect on T cell and also on B cell function than AZA. Although many side effects like infections have been investigated in patients who received AZA based therapy, they have not extensively been studied in MMF based protocol. The aim of this study is to evaluate the differences in incidence and frequency of infections during the first 6 months in the patients who received AZA or MMF based therapy. METHODS: Renal transplant recipients who received either AZA or MMF based therapy were reviewed. From January 1994 to December 2003, 112 patients were enrolled and analyzed the types and frequency of infection. RESULTS: 78 patients received AZA based therapy, and 34 patients received MMF based therapy. Infection developed in 37 (47.4%) and 12 (35.3%) patients respectively. AZA group showed higher incidence of infection than MMF group (P<0.05). In AZA group, UTI developed in 15 patients (19.2%), URI in 7 patients(9%), CMV infection in 7 patients (9%), tuberculosis in 2 patients (2.6%), and wound infection in 6 patients (7.7%). In MMF group, UTI developed in 6 patients (17.6%), URI in 2 patients (5.9%), CMV infection in 2 patients (5.9%), tuberculosis in 1 patient (2.9%), wound infection in 1 patient (2.9%). There were no significant differences in the type of various infectious episodes between two groups. CONCLUSION: AZA group showed higher incidence in total infection, but there were no differences in the type of various infectious episodes between two groups. MMF has more powerful immunosuppressive effect (18) but has similar infectious adverse effects compared with AZA.
Azathioprine ; Humans ; Immunosuppression* ; Incidence ; Kidney Transplantation ; Transplantation* ; Tuberculosis ; Wound Infection

Intracranial calcification is known to be a physiologic phenomenon and is often seen in brain CTs of patients visiting the emergency department. The pattern of a calcified lesion may be related to the pathologic condition, and calcified lesion itself may cause neurologic symptoms. The causes of pathologic intracranial calcification are infection, brain tumor, vascular disorder, endocrinologic disorders, and genetic disorder associated with calcium metabolic defects. The most common sites of intracranial calcification are the basal ganglia, subcortical tissue of the cerebrum, the thalamus, the choroid plexus, and the dentate nucleus of the cerebellum. The diagnosis of pathologic calcification can be done by using brain CT or MRI, and pathologic calcification should be differentiated from other causes of calcification by using laboratory data. We report and discuss a case of extensive intracranial calcification with idiopathic hypoparathyroidism.
Basal Ganglia ; Brain ; Brain Neoplasms ; Calcinosis ; Calcium ; Cerebellar Nuclei ; Cerebellum ; Cerebrum ; Choroid Plexus ; Diagnosis ; Emergency Service, Hospital ; Humans ; Hypoparathyroidism* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Thalamus

BACKGROUND: Hepatolithiasis is rarely associated with a cholangiocarcinoma and the etiologic relationship between them has not been proved. Hepatolithiasis is a risk factor for cholangiocarcinoma. Accurate preoperative diagnosis remains low, and the survival outcome is still dismal, despite improvements in imaging studies. METHODS: Eighteen cases of intrahepatic cholangiocarcinomas among the 522 cases undergoing treatments from Jan. 1984 to May 1998 for hepatolithiasis at the Department of Surgery, Kyung Hee University Hospital were reviewed. RESULTS: The patients had a significantly long duration of symptoms, a high incidence of previous biliary surgery, and a lower rate of preoperative diagnosis. The eighteen cases accounted for 3.4% of the hepatolithiasis cases and 8.5% of the cholangiocarcinomas. There were 17 women and 1 man, and the most prevalent age group was in the 5th and the 6th decades. HBsAg was positive in one case who had chronic hepatitis, 3 patients had clonorchiasis, and 2 patients had liver cirrhosis. CEA and CA19-9 were elevated in 42.9% (3/7) and 27.3% (3/11) of the patients. Various imaging studies, including ultrasonography, CT, choangiography, angiography, and ERCP were performed for diagnosis. The malignant lesions could not be detected preoperatively in 9 patients, and the presence of a coexisting malignant tumor was confirmed by frozen section or by permanent tissue pathology. The operative methods were as follows; a lobectomy in 4 patients, a segmentectomy in 4 patients, and a CBD resection for palliation or explo-laparotomy only in 4 patients because of multiple hepatic metastases. During the operation, the exact location of the stones and the gross pathology of the tumor were recorded in each case. The left side was more prevalent than the right. The mean survival was 15 months for resection group and 9 months for non resection group. CONCLUSIONS: The lower survival rates may be attributed to delayed diagnosis, lower diagnostic accuracy, and relatively fewer curative resections in the patients with stone-containing cholangiocarcinomas. Hepatolithiasis is one of the risk factors of a cholangiocarcinoma. During the diagnostic and operative procedures, we should not overlook a cholangiocarcinoma which can coexist with hepatolithiasis, and we should examine tumor markers, the results of imaging studies and tissue examinations, and the operative findings.
Angiography ; Biomarkers, Tumor ; Cholangiocarcinoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Clonorchiasis ; Delayed Diagnosis ; Diagnosis ; Female ; Frozen Sections ; Hepatitis B Surface Antigens ; Hepatitis, Chronic ; Humans ; Incidence ; Liver Cirrhosis ; Mastectomy, Segmental ; Neoplasm Metastasis ; Pathology ; Risk Factors ; Surgical Procedures, Operative ; Survival Rate ; Ultrasonography

To date, for facial soft tissue augmentation, numerous implant materials have been used, including autogenous, homogenous, and alloplastic grafts. Among these, the porous material, Gore-tex(R) has a pore (0.5-30 microns, average 22 microns) which allows sufficient but limited soft tissue ingrowth to anchor implants, but not so much to make removal difficult or destructive to adjacent structures. In addition, this material has some advantage: non-carcinogenic, non-allergic, less capsule formation and reduced chance of infection due to high vascularity. In the past years Gore-tex(R) has found multiple applications in facial plastic and reconstructive surgery. However this alloplastic material can be associated with potentially severe complications and side effects such as soft tissue reaction, infection, extrusion, exposure, etc. There have been also adverse criticism of Gore-tex(R) : relative difficulties in postoperative removal, in carving implant, higher infection and extrusion rates in scarred tissue and thicker implant as well as postoperative volume reduction. In order to analyze results depending on the implantation site, the presence of scar on recipient site, thickness and type of implant, a retrospective chart review of 56 patients(69 cases) was undertaken of all patients who underwent facial soft tissue augmentation with Gore-tex(R) graft from November 1998 to November 2001 in a wide variety of situations. All cases were categorized as either primary(normal recipient site) or secondary(scarred recipient site) cases and the thickness of each graft used in millimeters was recorded. Postoperative follow up revealed a stable implant material with no major complications relating to the graft material and no differences in developing complications according to the implantation site, the presence of scar, thickness and type of implant. All patients were highly satisfied with their results.
Cicatrix ; Follow-Up Studies ; Humans ; Plastics ; Retrospective Studies ; Transplants

PURPOSE: To evaluate Doppler sonographic findings of acute renal vein thrombosis in rabbit model induced by renal vein ligation, with an emphasis on the changes in resistive index (RI) on serial follow-up. MATERIALS AND METHODS: Conventional and Doppler sonographies were performed immediately after ligation and 24, 48, and 72 hours after ligation in 12 rabbits weighing 4.5-5.0 kg. We focused on changes in kidney size and echogenicity with conventional sonography and resistive index by time interval and Doppler waveforms with Doppler sonography. RESULTS: Kidney size increased markedly immediately after ligation, and increased slowly until 48 hours after ligation with no change observed afterwards. Echogenicity increased both in the renal cortex and the medulla. RI increased remarkably to an average of 1.38 immediately after ligation, and increased to a peak average of 1.64 48 hours after ligation. After 72 hours RI decreased slightly to 1.59. Reverse 'plateau-like' diastolic waveform was seen in 27 trials (56%) on follow up Doppler sonograms. CONCLUSION: The increase in RI was thought to be due to the increase in renal arterial vascular resistance caused by venous outflow obstruction. The decrease in RI with time suggested adaptation of intrarenal circulation to renal vascular change. Also, the reverse 'plateau-like' diastolic waveform was the predominant waveform.
Follow-Up Studies ; Kidney ; Ligation ; Rabbits ; Renal Veins* ; Thrombosis* ; Ultrasonography ; Vascular Resistance

Persistent gestational trophoblastic tumor develops in about 15-25% after evacuation of complete mole, and arises in about 4-5% after removal of partial mole. Especially there is reported that choriocarcinoma after evacuation of partial mole is extremely rare, and it is well responded to systemic chemotherapy. We have experienced that a case of choriocarcinoma which was developed after evacuation of partial mole. So we report this case with a brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Female ; Pregnancy ; Trophoblastic Neoplasms