No abstract available.
Laurence-Moon Syndrome*

No abstract available.
Laurence-Moon Syndrome*

The value of ultrasonography and percutaneous transhepatic cholangiography in determining the site and etiology of biliary obstruction with surgical jaundice was studied in 30 patients. All diagnoses were subsequently made by surgery and pathology. The results were as follows; 1. In ultrasonography, the site of obstruction was delineated in 46%, while the etiology of the lesion was established in 40%, In comparison, percutaneous transhepatic cholangiography delineated the site in 100% and the etilogy in 93%. 2. Although the percutaneous transhepatic cholangiography is invasive to the human body, it is considered to be the single procedure of choicein the managment of the patient with biliary obstructive jaundice because of its diagnostic accuracy, technical simplicity and relative safety.
Cholangiography ; Diagnosis ; Human Body ; Humans ; Jaundice ; Jaundice, Obstructive ; Pathology ; Ultrasonography

Takayasu's arteritis is an arteritis of undetermined etiology, which affects the aorta and the proximal portions of its major branches. But aortic regurgitation and coronary artery involvement were unusual manifestations in this disease. We experienced a patient of Takayasu's arteritis who represented these unusual manifestations. Aortogram revealed grade IV aortic regurgitation and proximal segment narrowing of left main coronary artery. A case of Takayasu's arteritis associated with aortic regurgitation and left main coronary artery involvement is reported with a review of literatures.
Aorta ; Aortic Valve Insufficiency* ; Arteritis ; Coronary Vessels* ; Humans ; Takayasu Arteritis*

No abstract available.
Methicillin Resistance* ; Methicillin* ; Staphylococcus*

Parricide, the crime of murdering a parent, accounts for about 5% of all homicides. Filicide is the crime of murdering one's own child. This study aimed to review demographic features and criminal characteristics of individuals who committed parricide and filicide in Republic of Korea (ROK). This study is based on data from the Korea Police Crime Analysis System, from 2006~2013. We assessed the diverse characteristics of both victims and perpetrators. Over the selected period, 381 parents were killed by their children and 230 children were killed by parents in the ROK. Parricides caused by schizophrenic murders accounted for 39.6% of all cases. Moreover, approximately 44.4% of the perpetrators attempted suicide following the maternal filicide. In our findings, psychiatric illness was a very important predictor in parricide, and these further suggest that young mothers with severe mental illness require careful monitoring by mental health support service.
Child ; Crime ; Criminals ; Homicide ; Humans ; Korea ; Mental Health ; Mothers ; Parents ; Police ; Republic of Korea ; Schizophrenia ; Suicide, Attempted

OBJECTIVE: The aim of this study is to compare the surgical outcome of the initial and recent surgical cases, during our 15-years experience, in terms of the surgical strategies and the prognostic factors for surgically remediable epilepsy. METHODS: We retrospectively reviewed and compared the surgical outcomes between the initial 256 (Group I) and recent 139 (Group II) patients according to the time period of operation for a total of 518 consecutive epilepsy surgeries at our institution since 1992. The patients of the middle intermediate period, which were subjected to changed surgical strategies, were excluded. RESULTS: The surgical outcome data from the initial and recent groups showed a much improved outcome for patients who underwent temporal lobe epilepsy (TLE) surgery over time. The number of patients with a good outcome (Engel class I-II) was much increased from 87.7% (178 TLE cases of Group I) to 94.8% (79 TLE cases of Group II) and this was statistically significant (p = 0.0324) on univariate analysis. Other remarkable changes were the decreased performance of intracranial invasive studies from 43.5% in Group I to 30.9% in Group II due to the advanced neuroimaging tools. The strip/grid ratio was reduced from 131/32 in Group I to 17/25 in Group II, because of a markedly reduced mesial TLE surgery and an increased extratemporal epilepsy surgery. CONCLUSION: Our results show that surgical outcome of epilepsy surgery has improved over time and it has shown to be efficient to control medically intractable epilepsy. Appropriate patient selection, comprehensive preoperative assessments and more extensive resection are associated with good postoperative outcomes.
Epilepsy ; Epilepsy, Temporal Lobe ; Humans ; Neuroimaging ; Patient Selection ; Retrospective Studies

No abstract available.
Leukemia*

BACKGROUND: Preemptive analgesia is an antinociceptive treatment that prevents the establishment of central sensitization, which amplifies the postoperative pain. In this study, we investigated the preemptive effect of local infiltration of bupivacaine on postoperative pain after inguinal herniorrhaphy. METHODS: Thirty adult patients scheduled for inguinal herniorrhaphy were randomly assigned to one of two groups. 0.25% bupivacaine 20 ml was infiltrated in the surgical wound site either 15 min before skin incision or immediately after skin closure. Postoperatively, visual analogue scale (VAS) at rest and movement were assessed. Also the time to the first request for postoperative analgesic and the total dose of postoperative analgesics were assessed. In addition, the number of patients who didn't require any analgesics during the postoperative period were assessed. RESULTS: The VAS at rest and movement was not significantly different between the two groups. The time to the first request for postoperative analgesic, the total dose of supplemental analgesics and the number of patients who didn't require any analgesics were not significantly different. CONCLUSIONS: In pain after inguinal herniorrhaphy, we could not demonstrate the pre-emptive analgesic effect of preincisional bupivacaine infiltration. Traction pain after inguinal herniorrhaphy was sustained during the study period and this kind of pain was not inhibited (or prevented) by local infiltration of bupivacaine.
Adult ; Analgesia ; Analgesics ; Bupivacaine* ; Central Nervous System Sensitization ; Herniorrhaphy* ; Humans ; Pain, Postoperative* ; Postoperative Period ; Skin ; Traction ; Wounds and Injuries

OBJECTIVES: Protein-calorie malnutrition has been shown to be prevalent among patients on chronic dialysis, And assessment of nutritional status of continuous ambulatory peritoneal dialysis(CAPD) patients has assumed greater importance because of the association of protein-calorie malnutrition with increasing morbidity and mortality. So we observed the incidence and clinical effect of protein-calorie malnutrition, and we compared the indices of nutrition with dialysis adequacy utilizing urea kinetic modeling and cretinine clearance in CAPD patients. METHODS: We performed a cross-sectional study in which eight parameters, based on anthropometry, blood chemistry and subjective symptoms, were scored according to the degree of abnormalities in 82CAPD patients. A malnutrition index was derived from these scores. We also performed comparative analysis to identify significant correlations of the indices of urea kinetic modeling and creatinine clearance with the other parameters of nutritional status. RESULTS: The malnutrition index classified 47(57%) patients as normal, 30(37%) intermediately malnourished, and 5(6%) as severely malnourished. Malnutrition index showed a significant correlation with the body mass index(BMI), triceps skinfold thickness(TSF), mid-arm circumference(MAC), mid-arm muscle area (MAMA), duration of CAPD, subjective symptoms, serum albumin, transferrin, cholesterol, and triglyceride. The malnutrition index also showed a significant correlation with residual renal function(RRF), and standardized creatinine clearance(SCCr). The TWR-Kt/V(total Kt/Vurea per week with consideration of residual renal urea clearance) was significantly lower in the severely malnourished group than in the normal group. Serum alkaline phosphatase and BUN levels were higher in the severely malnourished group than in the normal and inter-mediate groups. CONCLUSION: In assessing the nutrition status of CAPD patients, body weight, TSF, MAC, MAMA, subjective symptoms, serum albumin, transferrin, cholesterol, triglyceride, urea nitrogen, and alkaline phosphatase were considered useful parameters. There was a trend of increased BUN and decreased TWR-Kt/V in severely malnourished patients, and the value of SCCr was significantly lower in malnourished patients. However, no meaningful relationships between TW-Kt/V and malnutrition index or between NPCR(normalized protein catabolic rate) and malnutrition index were found m this cross-sectional study. As the number of patients with longer duration of CAPD or negligible RRF has increased in the malnourished patients, regular monitoring of these parameters, especially TWR-Kt/V and SCCr, may be helpful to assess dialysis adequacy to keep good nutritional status of each CAPD patient.
Alkaline Phosphatase ; Anthropometry ; Body Weight ; Chemistry ; Cholesterol ; Creatinine* ; Cross-Sectional Studies ; Dialysis ; Humans ; Incidence ; Malnutrition ; Mortality ; Nitrogen ; Nutritional Status ; Peritoneal Dialysis, Continuous Ambulatory* ; Protein-Energy Malnutrition ; Serum Albumin ; Transferrin ; Triglycerides ; Urea*