Multiple primary tumors at adjacent site are rare. We report a rare case of coincidentally found nasopharyngeal cancer and ventral foramen magnum meningioma. The 68-year-old male patient presented with a year history of ataxia. Radiological examination revealed lesions in the nasopharyngeal space and ventral foramen magnum. A needle aspiration biopsy for nasopharyngeal space and surgical removal for foramen magnum lesion were performed. The pathological diagnoses were nasopharyngeal cancer and meningioma, respectively. The concomitant occurrence of these two tumors is very rare and there is no known association between these two tumors. We report a case of ventral foramen magnum meningioma simultaneously present with nasopharyngeal carcinoma.

A 16-year-old, 7.4 kg, castrated male Cocker Spaniel presenting anorexia and weight loss was referred due to a splenic mass, and total splenectomy was performed to resolve clinical signs. Following surgery, the dog developed mild hyperkalemia (6.27 mmol/L) without any clinical symptoms. Further investigations were conducted to determine the cause of hyperkalemia. The serum-plasma potassium difference was measured (1.05 mmol/L), and pseudohyperkalemia was diagnosed. The cause of pseudohyperkalemia was considered as thrombocytosis after splenectomy. The dog did not receive any specific treatment to lower blood potassium. To our knowledge, we report the first case of post-splenectomy pseudohyperkalemia in a dog.

Introduction: Half of facial paralysis in children is idiopathic at origin. However, dismissing facialparalysis as being idiopathic without a thorough history and meticulous examination could bedisastrous as illustrated by this case.Case report: We report a case of sphenoid wing meningioma in a 4-year-old girl. She firstpresented with only facial asymmetry that was noticed by her mother. Examination suggested aleft upper motor neuron facial nerve palsy. A sphenoid wing meningioma was found on magneticresonance imaging (MRI) of her brain. She underwent craniotomy and total tumour excision.Histopathological examination of the tumour showed a grade 1 transitional type meningioma.Meningiomas in children are rare compared to the adult population. Presentations in childrenmay be delayed due to their inability to recognise or communicate abnormalities. Distinguishingbetween upper and lower motor neuron facial palsy is crucial in decision making for facial paralysisin children.

PURPOSE: Automated external defibrillators (AEDs) could not recommend shock for ventricular fibrillation in the presence of electromagnetic interference. The purpose of this study was to examine the effect of an induced electromagnetic field on performance of AED. METHODS: The intensity of magnetic waves from commercial electric mats was measured. Three AEDs were attached to the resuscitation manikin and the question of whether shock would be recommended for simulated electrocardiogram of VF or normal sinus rhythm was tested. The simulation was repeated 10 times under the influence of 0, 5, and 18 µT magnetic field or electric mat. Relevant literature studies on electromagnetic interference on AED were reviewed. RESULTS: The magnetic flux density from the electric mat was measured to 5.67-6.1 µT in warming phase, and 2.25-2.84 µT in maintenance phase. There was no false positive or false negative recommendation of shock under the influence of 0, 5, and 18 µT magnetic field or electric mat. However, one AED detected motion even in the stationary state. Among 11 studies from the literature search, five studies reported misinterpretation of AED. Minor errors including delayed analysis, motion artefact, and noise in speakers were reported from 6 studies. CONCLUSION: Although we could not reproduce false negative interpretation, AED made a mistake in confusing electromagnetic interference with motion artefact. Therefore, emergency providers should be cautious not to use AED close to household appliances or medical equipment inducing electromagnetic interference.
Artifacts ; Defibrillators* ; Electrocardiography ; Electromagnetic Fields ; Emergencies ; Family Characteristics ; Magnetic Fields ; Magnets* ; Manikins ; Noise ; Resuscitation ; Shock ; Ventricular Fibrillation

The Korean Society of Cardiac Rehabilitation (KSCR) have recommended standards for establishing cardiac rehabilitation programs in terms of facility, equipment and staff. This is the first time a statement concerning these types of standards has been issued in Korea, and presents the minimal requirements for establishing cardiac rehabilitation programs. Cardiac rehabilitation facilities should contain individual spaces for patient examination, exercise stress testing, monitoring exercise training, patient education, patient preparation, storing medical records, showers and lockers, toilets, and walking tracks. Essential equipment must include at least four sets of aerobic exercise equipment such as treadmills, bicycles, arm ergometers, step machines, and floor mats, and medical equipment such as exercise stress test for ECG with gas analysis, telemetry ECG monitoring systems, sphygmomanometers, stethoscopes, pulse oximeters, glucometers, portable oxygenators, and emergency carts with defibrillators. Hospital staff should include a medical director (a physician with a subspecialty in cardiac rehabilitation), exercise physiologist, nurse specializing in cardiac rehabilitation, exercise specialist, physical therapist, and clinical nutritionist. All should have an expertise in exercise science and be trained in basic life support or advanced cardiac life support. This statement is a recommendation by KSCR and cardiac rehabilitation council of regional cardiocerebrovascular center, and set forth the standards for facilities, equipment, and staff to set up or upgrade cardiac rehabilitation programs in Korea. These recommendations should be developed as a national standard for the establishment of cardiac rehabilitation programs, and adjusted for the current situation of the Korean medical industry through nationwide and long-term research.
Advanced Cardiac Life Support ; Allyl Compounds ; Arm ; Defibrillators ; Electrocardiography ; Emergencies ; Exercise ; Exercise Test ; Floors and Floorcoverings ; Humans ; Korea ; Medical Records ; Oxygen ; Oxygenators ; Patient Education as Topic ; Physical Therapists ; Physician Executives ; Specialization ; Sphygmomanometers ; Stethoscopes ; Sulfides ; Telemetry ; Track and Field ; Walking

BACKGROUND: Throughout the past 20 years in the Korean academy of family medicine seasonal conference, on-going study is done to promote overall development and satisfaction of the conference participants and to overlook the trend of the conference subject, the number of classes, the number of participants, etc. METHODS: About 2,132 topics during the conference from the year 1992 to 2007 collected from the Korean academy of family medicine website were categorized by subject based on the standard of the contents of the latest textbook. There were a total of 7 main classifications including 5 categories like 'principles of family medicine', 'disease prevention and health promotion', 'symptoms', 'clinical procedures', 'diseases' and adding 2 categories such as each committee's classes and other subjects. The scope of the changes of the main and sub-titles were categorized as in the 1990s and 21 century. RESULTS: The number of attendees has increased during the past 20 years, especially the residents were the main portion of the participants. On the proportion of the clinical topics, there was a remarkable increase of geriatric medicine, palliative medicine, obesity, exercise, nutrition, gastroscopy, and colonoscopy procedure in the later half rather than the former half period. In the field of the main category, the core principle subjects of family medicine seemed to be decreased in contrast to disease category. CONCLUSION: During the last 20 years, the titles of family medicine conference are changing with the trend of practice. The core knowledge of family medicine should be maintained and balanced for the future of family medicine conference.
Colonoscopy ; Gastroscopy ; Humans ; Obesity ; Palliative Care ; Seasons

Although most of pseudocysts as one of complications of pancreatitis occur primarily within the pancreas, the extrapancreatic locations of pseudocysts, especially in the liver, are rare events. With advanced technology of imaging studies including abdominal computed tomography, ultrasonography, and magnetic resonance imaging, their frequency seems to be increasing. We report here a case of left intrahepatic pancreatic pseudocyst following acute pancreatitis. Percutaneous puncture revealed a high level of amylase and lipase in the collection, confirming the diagnosis of intrahepatic pseudocyst. Symptomatic intrahepatic pseudocysts can be managed surgically, transcutaneously or endoscopically, and asymptomatic intrahepatic pseudocysts can be treated conservatively. We report this case with a review of literature.
Acute Disease ; Aged ; Humans ; Liver Diseases/*diagnosis/etiology/ultrasonography ; Magnetic Resonance Imaging ; Male ; Pancreatic Pseudocyst/*diagnosis/etiology/ultrasonography ; Pancreatitis, Alcoholic/complications/*diagnosis/ultrasonography ; Tomography, X-Ray Computed

PURPOSE: Deterioration of consciousness is the most critical problem in patients with fulminant hepatic failure (FHF). Electroencephalography (EEG) is a standard procedure to determine the brain activity in unconscious patients. The bispectral (BIS) index derived from EEG was primarily developed to monitor the depth of unconsciousness. METHODS: A prospective study was performed to assess the clinical utility of peritransplant BIS monitoring in 11 fulminant hepatic failure (FHF) patients who were undergoing emergency living donor liver transplantation (LT) with using a right liver graft. All the patients recovered their consciousness after LT. RESULTS: There was a significant correlation between the BIS index values and the derived GCS score (r2=0.634, p <0.001). Timing of eye opening to voice command matched the BIS index value of 64+/-9.5, which was after 14+/-9.4 hours passing BIS index of 50. All the patients with endotracheal intubation during the early posttransplant period showed progressive increase of their BIS index, which appeared slightly earlier and more evident than the rise of derived GCS scores. CONCLUSION: BIS monitoring is a noninvasive, simple and easy-to-interpret method and it also appears to be a useful to assess and predict the recovery of a patient's consciousness level after LT. Therefore, we concluded that BIS monitoring can be an indispensable component of the peritransplant intensive care for patients with FHF and who require emergency LT.
Brain ; Consciousness ; Consciousness Monitors ; Electroencephalography ; Emergencies ; Eye ; Humans ; Critical Care ; Intubation, Intratracheal ; Liver ; Liver Failure, Acute ; Liver Transplantation ; Living Donors ; Organothiophosphorus Compounds ; Prospective Studies ; Transplants ; Unconscious (Psychology) ; Voice

Respiration gating radiotherapy technique developed in consideration of the movement of body surface and internal organs during respiration, is categorized into the method of analyzing the respiratory volume for data processing and that of keeping track of fiducial landmark or dermatologic markers based on radiography. However, since these methods require high-priced equipments for treatment and are used for the specific radiotherapy. Therefore, we should develop new essential method whilst ruling out the possible problems. This study aims to obtain body surface motion by using the couch based computer-controlled motion phantom (CBMP) and US sensor, and to develop respiration gating techniques that can adjust patients' beds by using opposite values of the data obtained. The CBMP made to measure body surface motion is composed of a BS II microprocessor, sensor, host computer and stepping motor etc. And the program to control and operate it was developed. After the CBMP was adjusted by entering random movement data, and the phantom movements were acquired using the sensors, the two data were compared and analyzed. And then, after the movements by respiration were acquired by using a rabbit, the real-time respiration gating techniques were drawn by operating the phantom with the opposite values of the data. The result of analyzing the acquisition-correction delay time for the data value shows that the data value coincided within 1% and that the acquisition-correction delay time was obtained real-time (2.34 x 10(-4) sec). And the movement was the maximum movement was 6 mm in Z direction, in which the respiratory cycle was 2.9 seconds. This study successfully confirms the clinical application possibility of respiration gating techniques by using a CBMP and sensor.
Feasibility Studies* ; Microcomputers ; Radiography ; Radiotherapy ; Respiration ; Ultrasonics*

PURPOSE: This study was conducted to investigate factors related to middle-aged women's health beliefs and their intention to practice health behaviors for preventing and improving hypertension. METHODS: The participants were 319 middle-aged(40-59 years) women who lived G city. Data was collected from January to February, 2005. Personal interviews were performed. The data was analyzed using t-test, ANOVA, Scheffe's multiple comparison test and hierarchial multiple regression analysis. RESULTS: Perceived susceptibility of health belief was high in those who had higher educational level, disease history and health education experience, significantly(p<0.05). Perceived seriousness was high in those who had higher educational level, middle economic status and health education experience, significantly(p<0.05). Perceived benefits was high in those who had higher educational level and perceived barriers was low in those who had disease history and hypertension, significantly(p<0.05). The subject's intention to practice health behaviors was significantly high in those who were younger, who had higher educational level and menopausal status(p<0.05). In hierarchial multiple regression analysis, the subject's intention was related to perceived seriousness, perceived benefit and educational level, significantly(p<0.05). CONCLUSION: It is necessary to develope the education programs which can increase the subject's health belief and intention to practice health behaviors towards hypertension in middle-aged women.
Education ; Female ; Health Behavior* ; Health Education ; Humans ; Hypertension* ; Intention* ; Women's Health*