Animal bones excavated with earthenware from the shell mound at the Jeju Jongdali 1819 archeological site, where three consecutive chronological layers covering the Neolithic (B.C. 15C-B.C. 10C), early Tamra, and late Tamra periods have been identified, were morphologically classified. The majority of the bones from all three periods were broken or split. The major fauna of the mammalian bones in all periods were Cervus spp., Sus scrofa, and Bos taurus. In the early and late Tamra periods, bones of small animals including Mustela sibirica coreana, Meles meles, Rodentia, and Aves were also found in small number. The excavated bones were from all parts of the animal bodies, including head, trunk, forelimb, and hindlimb. Collectively, these findings suggest that the major fauna from the Neolithic to late Tamra periods consisted of Cervus spp., Sus scrofa, and Bos taurus and that the fauna was dissected and carried to the shell mound site after hunting. Information from the bone remains in the shell mound are useful data for study of the wildlife and domestic animals living during the prehistoric period of Jeju Island.
Animals* ; Animals, Domestic ; Birds ; Cattle ; Forelimb ; Head ; Hindlimb ; Rodentia ; Sus scrofa

OBJECTIVE: We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction. METHODS: Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients. RESULTS: The mean age of the patients was 70+/-13.4 years and the mean survival was 41.7+/-2.8 months. The mean survival of the poor functional outcome group (mRS> or =4) was 33.9+/-3.3 months, whereas that of the good functional outcome group (mRS< or =3) was 58.6+/-2.6 months (p value =0.000). The mean survival of the older patients (> or =70 years) was 29.7+/-3.4 months, whereas that of the younger patients (<70 years) was much better as 58.9+/-3.2 months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study. CONCLUSION: Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.
Atrial Fibrillation ; Cerebral Infarction ; Diabetes Mellitus ; Heart Failure ; Humans ; Hypertension ; Infarction ; Infarction, Middle Cerebral Artery ; Life Expectancy ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Smoke ; Smoking ; Stroke ; Survival Rate

BACKGROUND AND PURPOSE: To investigate the number and characteristics of patients eligible for endovascular treatment (EVT) determined using three different selection methods: clinical-core mismatch, target mismatch, and collateral status. METHODS: Using the data of consecutive patients from two prospectively maintained registries of university medical centers, the number and characteristics of patients according to the three selection methods were investigated and their correlation was analyzed. Patients with anterior circulation stroke due to occlusion of the middle cerebral and/or internal carotid artery and a National Institute of Health Stroke Scale (NIHSS) score of ≥6 points, who arrived within 8 hours or between 6 and 12 hours of symptom onset and underwent magnetic resonance imaging prior to EVT, were included. Collateral status was assessed using magnetic resonance perfusion-derived collateral flow maps. RESULTS: Three hundred thirty-five patients were investigated; the proportions of patients who were eligible and ineligible for EVT in all three selection methods were both small (n=85, 25.4%; n=54, 16.1%, respectively). The intercorrelation among the three selection methods was low (κ=0.235). The baseline NIHSS score and onset-to-selection time interval were associated with the presence of clinical-core mismatch, while the penumbra/core volume ratio and onset-to-selection time interval were related to target mismatch; none of these variables were associated with collateral status. The infarct core volume was associated with favorable profiles in all three selection methods. CONCLUSIONS: Although the application of individual selection methods resulted in favorable outcomes after EVT in clinical trials, there is a significant discrepancy in EVT eligibility depending on the selection method used.
Academic Medical Centers ; Carotid Artery, Internal ; Humans ; Magnetic Resonance Imaging ; Methods ; Prospective Studies ; Registries ; Stroke

The hemolytic uremic syndrome (HUS) is clinically characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The unique cause has not been determined but some bacteria such as E. coli was regarded as the causative agent of HUS in infant. A 30-year-old male patient was admitted due to acute abdomen. In operating field, the periappendiceal abscess was found, so the appendectomy with the drainage of abscess was performed. Initial hemoglobin level was 16.2g/dL but abruptly developed anemia (12.6g/dL) and thrombocytopenia (27000/mm3) was detected at hospital day 3. The urinary outflow was totally absent, the serum creatinine was 12.8mg/dL and the LDH was 3,650IU/L. The peripheral blood smear showed strong evidence of microangiopathic hemolysis. We performed total plasma exchange and hemodialysis under the diagnosis of HUS. The patient's renal function was markedly improved and the last creatinine was 1.9mg/dl. To our knowledge, this is the first report of HUS associated with periappendiceal abscess in Korea. We present a case and the review of literature.
Abdomen, Acute ; Abscess* ; Acute Kidney Injury ; Adult ; Anemia ; Anemia, Hemolytic ; Appendectomy ; Bacteria ; Creatinine ; Diagnosis ; Drainage ; Hemolysis ; Hemolytic-Uremic Syndrome* ; Humans ; Infant ; Korea ; Male ; Plasma Exchange ; Renal Dialysis ; Thrombocytopenia

PURPOSE: This study was performed to investigate the indications, yield, and complications of flexible bronchoscopy for respiratory disease in children compared to earlier domestic studies and to examine if any differences existed in comparison to international studies. METHODS: The medical records of 100 cases of flexible bronchoscopy that were performed in 76 patients at the Department of Pediatrics of The Catholic University of Korea, Seoul St. Mary's Hospital from June 16, 2010 to August 6, 2013 were reviewed. RESULTS: A total of 76 patients (50 males and 26 females) were included in the study. The most common indication of flexible bronchoscopy was persistent pneumonia or pneumonia in immunocompromised patients (53 cases). The object of flexible bronchoscopy was accomplished in 65 of 100 cases, and, the treatment was changed in 24 of 65 cases. The most common abnormal finding was tracheomalacia that was found in 18 cases. In 67 cases where bronchoalveolar lavage was performed, bacteria were identified in 47 cases, fungi in 9 cases, and viruses in 22 cases. Complications occurred in 8 cases. CONCLUSION: Compared to earlier domestic studies, there was no significant change in diagnostic approaches and therapeutic improvement. However, this study showed that flexible bronchoscopy appears to be safe in patients with hemato-oncologic disease. Compared to international studies, the occurrence of complications due to flexible bronchoscopy was relatively low.
Bacteria ; Bronchoalveolar Lavage ; Bronchoscopy* ; Child* ; Fungi ; Humans ; Immunocompromised Host ; Korea ; Male ; Medical Records ; Pediatrics ; Pneumonia ; Seoul ; Tracheomalacia

The severe hypernatremia and hyperosmolar dehydration may occur in the patient with partial urinary tract obstruction. The altered tubular function may be the cause of hypernatremia, but it is not generally appreciated. We experienced a case of severe hypernatremia in a 64-year-old male who had suffered from benign prostate hypertrophy with both hydronephrosis. The mental status was lethargic and the serum sodium showed severe hypernatremia(193mEq/L). The urine specific gravity showed hypotonicity. This suggested that the nephrogenic diabetes insipidus was involved in the pathogenesis of hypernatremia. The hypernatremia may be aggravated by the avoidance of water intake, which is due to decreased thirst sensorium in the elderly. The foley catheter was inserted and postobstructive diuresis was occurred. Initially, the patient was managed with isotonic saline and then with half saline. The hypernatremia resolved after 10 days and the patient's status was fully recovered. To our knowledge, this is the first case of obstructive uropathy accompanied with severe hypernatremia in Korea.
Aged ; Catheters ; Dehydration ; Diabetes Insipidus, Nephrogenic ; Diuresis ; Drinking ; Humans ; Hydronephrosis ; Hypernatremia* ; Hypertrophy ; Korea ; Male ; Middle Aged ; Prostate ; Sodium ; Specific Gravity ; Thirst ; Urinary Tract

INTRODUCTION: The prognosis of peri-ampullary cancer is poor because of its low respectability and high recurrence rate. Yet cancer of the Ampulla of Vater(AOV) has a relatively good prognosis. The aim of this study is to investigate the outcomes and to determine the factors that affect the survival rate of patients who underwent curative resection for AOV cancer. METHODS: From August 1988 to January 2008, 54 patients underwent curative resection for AOV cancer. We retrospectively reviewed the clinocopathologic data. The median follow up period was 45 months. RESULTS: Twenty-seven pancreaticoduodenectomies (PD) and 27 pyrolus-preserving pancreaticoduodenectomies (PPPD) were performed. There was no hospital mortality, but 25 out of 54 patients (47.3%) experienced postoperative complications. The 5-year overall survival (OS) rate was 53.97% and the 5-year disease free survival (DFS) rate was 51.75%. On multivariate analysis, the variables that affected the overall survival rate and the disease free survival rate was poor histologic differentiation (p<0.001). CONCLUSIONS: Although the AOV cancer is one of the periampullary cancers that have a very poor outcome, long-term survival and favorable outcomes can be achieved after a curative resection. In this study, poor-histologic differentiation was the only independent factor for a poor prognosis.
Ampulla of Vater ; Disease-Free Survival ; Follow-Up Studies ; Hospital Mortality ; Humans ; Multivariate Analysis ; Pancreaticoduodenectomy ; Postoperative Complications ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate

BACKGROUND: Blood-brain equilibration rate constant (k(e0)) is derived from either pharmacokinetic and pharmacodynamic modeling (k(e0_model)) or a model-independent observed time to peak effect (k(e0_tpeak)). Performance in bispectral index (BIS) prediction was compared between k(e0_model) and k(e0_tpeak) for microemulsion or long chain triglyceride (LCT) propofol. METHODS: Time to peak effect (t(peak), time to a maximally reduced BIS value) of microemulsion propofol after an intravenous bolus (1 mg/kg) was measured in 100 patients (group A(micro)). An observed t(peak) of 1.6 min for LCT propofol was obtained from an earlier study. Another 40 patients received a target controlled infusions of microemulsion propofol (k(e0_model) = 0.187/min, group B(micro) = 20) or LCT propofol (k(e0_model) = 0.26/min, group B(LCT) = 20) and remifentanil. The k(e0_tpeak)'s in group B(micro) and B(LCT) were calculated using the observed t(peak) value obtained from group A(micro) and 1.6 min, respectively. Effect-site concentrations of propofol were recalculated using the amounts of propofol infused over time and k(e0_tpeak)'s. Predicted BIS values calculated by sigmoid Emax equations with k(e0_model) and k(e0_tpeak) were compared with observed BIS values during induction and emergence for both formulations of propofol. RESULTS: Observed t(peak) of microemulsion propofol was 1.68 min. The median performance errors of BIS in group B(micro) were -1.83% (-24.8 to 18.9, k(e0_model)) and -2.42% (-26.1 to 36.2, k(e0_tpeak)), while 8.01% (-20.5 to 30.1, k(e0_model)) and 7.37% (-27.0 to 49.1, k(e0_tpeak)) in group B(LCT). The median absolute performance errors of BIS in group B(micro) were 11.87% (2.2-31.1k(e0_model)) and 14.38% (-0.6 to 44.6, k(e0_tpeak)), while 17.31% (5.54-36.0, k(e0_model)) and 18.28% (-0.1 to 56.0, k(e0_tpeak)) in group B(LCT). CONCLUSIONS: The k(e0_model) showed better performance in BIS prediction than the k(e0_tpeak).
Colon, Sigmoid ; Humans ; Pharmacokinetic* ; Piperidines ; Propofol*

PURPOSE: This study was designed to examine the reliability and easy applicability of new version of UICC-TNM classification (UICC, 1997) compared with old version of UICC-TNM classification (UICC, 1992) and JRSGC (Japanese Research Society for Gastric Cancer) classification of gastric cancer. MATERIALS AND METHODS: For 1043 patients who underwent curative resection from Jan. 1992 to Dec. 1996 in Korea Cancer Center (KCCH), old version of UICC-TMN classification and JRSGC classification were compared with the new version of UICC-TNM classification. RESULTS: Correlation coefficient between topographic classification (old UICC-TNM, JRSGC) of lymph node and numeric classification was 0.9 (p<0.05). 5-year survival rates according to old UICC, TRSGC, new UICC classification were 94.9% at stage Ia; 96.6, 96.5, 97.1% at stage Ib; 73.8, 73.8, 73.0% at stage II; 54.1, 55.8, 58.0% at stage IIIa; 35.5, 42.0, 36.0% at stage IIlb; 25.9, 22.3, 23.9% at stage IV. 5-year survival rates of each classification had significant difference among stages (p<0.0001), but there was no significant difference among each classification. CONCLUSION: The new version of UICC-TNM classification based on the number of involved lymph nodes allows a staging system as reliable as the old version of UICC-TNM and JRSGC classification. In addition, the new version of UICC-TNM classification can be applied without methodologic problems and seems more convenient and reproducible.
Asian Continental Ancestry Group* ; Classification* ; Humans ; Korea ; Lymph Nodes ; Stomach Neoplasms* ; Survival Rate

No abstract available.
Embryonic Structures* ; Fluorescence* ; Humans* ; In Situ Hybridization* ; Preimplantation Diagnosis*