No abstract available.
Brain* ; Emergencies* ; Emergency Service, Hospital* ; Humans

PURPOSE: To obtain the findings of normal variant types of lower cervical body configuration for the purpose of differention from compression fracture. MATERIALS AND METHODS: We retrospectively analysed simple true lateral radiographs of cervical spine from C3 to C7 in 157 pediatric patients who did not have definitive clinical symptoms of cervical spinal injury. We classified the variations of normal cervical spine into 5 types by their configuration. In case of rounded upper corner or anteriorly wedged type, we measured the height and the width of vertebral body to classify these types, and undertook ANOVA test and multiple range test to determine the correlation between the gross configuration and the measured values. RESULTS: Type 1 was similarly observed at each of C3 to C7 in age of 1-4 group but the frequency was markedly decreased in age of 5-8 group. Type 2a was frequently observed at both age groups, and its incidence increased considerally at C3 and C4 with advancing age. Type 2b was more frequently observed at C3 body and Type 3 was observed only at C3 body in age group 1-4. Type 4 was markedly increased at 5-8 age group. Type 2b and 3 were seen mostly at C3, but sometimes at C4 body. Height of body was statistically more significant than width of body in classification of type 2a, 2b and 3. CONCLUSION: The configuration of lower cervical spine in infants and children changes from immature oval type(type 1) to mature rectagular type(type 4) with increasing age. Among the 4 types, the rounded upper corner type or anterior wedging type of lower cervical spine should be differentiated from compresson fracture. We concluded that the height of cervical body is more significant than the width of body in simple radiographic classification of types 2a, 2b and 3.
Child* ; Classification ; Fractures, Compression ; Humans ; Incidence ; Infant* ; Retrospective Studies ; Spinal Injuries ; Spine

Liposarcoma is the second most common soft tissue sarcoma next to malignant fibrous histiocytoma and occurs almost exclusively in adults. It is thought to originate from primitive mesenchymal cells rather than from mature adipose tissue. Most liposarcomas usually occur in the deep soft tissue of the extremities and the retroperitoneum, and rarely occur in the cutaneous or subcutaneous tissue. We report a case of an atypical lipomatous tumor in a 63-year-old male, who presented with an asymptomatic, subcutaneous mass on his right axilla.
Adipose Tissue ; Adult ; Axilla ; Extremities ; Histiocytoma, Malignant Fibrous ; Humans ; Liposarcoma ; Male ; Middle Aged ; Sarcoma ; Subcutaneous Tissue

BACKGROUND: The study examined the correlations among the results of the European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire, Core 30 (QLQ-C30) completed by elderly cancer patients and their family caregivers and the Eastern Cooperative Oncology Group (ECOG)-performance status (PS) evaluated by medical doctors. METHODS: The study sample included 269 persons with cancer aged 55 years or older and their family caregivers recruited from hospitals located in Seoul and Gyeonggi-do. The results of the ECOG-PS evaluated by medical doctors were obtained from medical records. Intra-class correlation analysis was used to assess rater reliability between the elderly cancer patients and their family caregivers. Correlations among the EORTC QLQ-C30 and the ECOG-PS were tested using the Kruskal-Wallis test and Spearmen's correlation. RESULTS: The results showed that four subscales of quality of life (physical functioning, emotional functioning, social functioning, and global health status) and three items under symptoms (fatigue, pain, and financial difficulties) in the EORTC QLQ-C30 were highly consistent between patients and their family caregivers. From the EORTC QLQ-C30 results, social functioning, role functioning, health status, fatigue, pain, and appetite loss (patients results) and physical functioning (family caregivers results) were highly consistent with the results of the ECOG-PS by the physicians. CONCLUSIONS: The findings suggest that when the older persons with cancer have difficulty expressing their own thoughts or feelings, the EORTC QLQ-C30 completed by their family caregivers and the results of the ECOG-PS completed by the physicians could be used as substitutes.
Aged ; Appetite ; Caregivers* ; Fatigue ; Gyeonggi-do ; Humans ; Medical Records ; Medical Staff* ; Quality of Life* ; Seoul

Urachal anomalies are very rare. The umbilicus and the structures which lead to its formation rarely cause trouble except in patients with an error. Embryologically, the urachus represents the vestigial remnant of the allantois which, in the fetus, communicates with the cloaca. The patent urachus results from failure of luminal closure of the urachus Herein a case of congenital patent urachus reported with a brief review of literatures.
Allantois ; Cloaca ; Fetus ; Humans ; Phenobarbital ; Umbilicus ; Urachus*

BACKGROUND: This study examined moderating effects of optimism and family support on the depression of family caregivers of cancer patients aged 55 and over by adopting stress process model. METHODS: 359 family caregivers who accompanied with cancer patients to out-patient clinics were recruited and completed questionnaire at three university hospitals located in Seoul and Gyeonggi province. Exploratory factor analysis was applied to test validity of the construction of the scale. Hierarchical multiple regression analysis was used to determine moderating effects of optimism and family support on depression after making mean centering of each variable. RESULTS: Results showed that spouse caregivers have more depression than do adult children as the nursing period gets longer. Education and income status were significant variables affecting depression of family caregivers. Optimism and family support for family caregivers have moderating effects on the association between stressors (emotional functioning of cancer patients and role overload of family caregivers) and depression of family caregivers. CONCLUSIONS: The findings suggest that more attentions are needed to the depression of spouse caregivers. Interventions are strongly recommended for health professionals to provide cancer patients and their family caregivers with "holding environments" caring for emotions and facilitating adjustment.
Adult Children ; Attention ; Caregivers* ; Depression* ; Education ; Gyeonggi-do ; Health Occupations ; Hospitals, University ; Humans ; Nursing ; Optimism* ; Outpatients ; Seoul

Arteries ; Behcet Syndrome ; Central Nervous System ; Gastrointestinal Tract ; Glycosaminoglycans ; Humans ; Inflammation ; Joints ; Oral Ulcer ; Skin ; Skin Ulcer ; Superior Vena Cava Syndrome ; Thrombosis ; Veins ; Vena Cava, Superior ; Wound Healing

BACKGROUND AND OBJECTIVES: During the index procedure of catheter ablation (CA) for atrial fibrillation (AF), it is important to assess whether other atrial or ventricular tachyarrhythmia coexist. Their symptoms are often attributed to residual tachycardia after successful elimination of AF by CA. This tachycardia could also be non-pulmonary vein (PV) foci initiated AF. This study examined the coexistence of other sustained tachyarrhythmia of patients who underwent radiofrequency CA (RFCA) for AF. SUBJECTS AND METHODS: Four hundred fifty-nine consecutive patients (375 males, aged 53.4+/-11.4 years) who underwent RFCA for AF were investigated. Atrial and ventricular programmed stimulation (PS) with or without isoproterenol infusion were performed, and spontaneously developed tachycardias were analyzed. RESULTS: Fifteen patients (3.3% of total) were diagnosed to have other sustained arrhythmias that included slow-fast type atrioventricular nodal reentrant tachycardia (AVNRT, n=6), atrioventricular reentrant tachycardia (AVRT, n=5) that utilized left posteroseptal (n=4) and parahisian bypass tract (n=1), atrial tachycardia (AT, n=2) originating from the foramen ovale (n=1) and the ostium of coronary sinus (n=1), sustained ventricular tachycardia (VT, n=2) involving one from the apical posterolateral wall of left ventricule in a normal heart and one from an anterolateral wall in an underlying myocardial infarction (MI). These sustained tachycardias were neither clinically documented nor had structural heart diseases, with the exception of one patient with MI associated VT. Two patients had the triple tachycardia; one involved AVNRT, AVRT, and AF, and the other involved VT, AT, and AF. All associated tachycardias were successfully eliminated by RFCA. CONCLUSION: Fifteen (3.3%) patients with AF had coexisting sustained tachycardia. RFCA was successful in these patients. Identification of tachycardia by PS before RFCA for AF should be done to maximize the efficacy of the first ablation session.
Aged ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Catheter Ablation ; Catheters ; Coronary Sinus ; Foramen Ovale ; Heart ; Heart Diseases ; Humans ; Isoproterenol ; Male ; Myocardial Infarction ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ventricular ; Veins

PURPOSE: Severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) to antiepileptic drug (AED), are rare, but result in significant morbidity and mortality. We investigated the major culprit drugs, clinical characteristics, and clinical course and outcomes of AED-induced SCARs using a nationwide registry in Korea. METHODS: A total of 161 patients with AED-induced SCARs from 28 referral hospitals were analyzed. The causative AEDs, clinical characteristics, organ involvements, details of treatment, and outcomes were evaluated. We compared the clinical and laboratory parameters between SJS/TEN and DRESS according to the leading causative drugs. We further determined risk factors for prolonged hospitalization in AED-induced SCARs. RESULTS: Carbamazepine and lamotrigine were the most common culprit drugs causing SCARs. Valproic acid and levetiracetam also emerged as the major causative agents. The disease duration and hospital stay in carbamazepine-induced SJS/TEN were shorter than those in other AEDs (P< 0.05, respectively). In younger patients, lamotrigine caused higher incidences of DRESS than other drugs (P= 0.045). Carbamazepine, the most common culprit drug for SCARs, was associated with a favorable outcome related with prolonged hospitalization in SJS (odds ratio, 0.12; 95% confidence interval, 0.02-0.63, P= 0.12), and thrombocytopenia was found to be a risk factor for prolonged hospitalization in DRESS. CONCLUSION: This was the first large-scale epidemiological study of AED-induced SCARs in Korea. Valproic acid and levetiracetam were the significant emerging AEDs causing SCARs in addition to the well-known offending AEDs such as carbamazepine and lamotrigine. Carbamazepine was associated with reduced hospitalization, but thrombocytopenia was a risk factor for prolonged hospitalization. Our results suggest that the clinical characteristics and clinical courses of AED-induced SCARs might vary according to the individual AEDs.
Anticonvulsants ; Carbamazepine ; Cicatrix ; Drug Hypersensitivity Syndrome ; Epidemiologic Studies ; Hospitalization ; Humans ; Incidence ; Korea ; Length of Stay ; Mortality ; Referral and Consultation ; Risk Factors ; Stevens-Johnson Syndrome ; Thrombocytopenia ; Valproic Acid