BACKGROUND: Intracoronary stent implantation is a promising modality for establishing the blood flow of complex coronary arterial stenosis. However, previous studies have demonstrated that the angiographically visible thrombus is a high risk factor for possibility of stent thrombosis. So many investigators avoided stent implantation traditionally for thrombus containing lesion because of the potency of thrombogenecity of stent. But recently, advanced rapidly growing technique for stenting and powerful antithrombotic regimens make stent thrombosis rare. Stent implantantion has already been showed a acceptable method for bailout procedure of thrombotic occlusion in patients with angioplasty for acute myocardial infarction and also effective in intimal dissection, suboptimal results and arterial recoil. Accordingly, we investigated the effectiveness of stent implantation in the presence of intracoronary thrombus. METHODS: Eighteen patients(AMI 14, Unstable angina 4) underwent PTCA & stent implantation on culprit arterial lesion in all successfully. The stent group was comprised of Palmatz-Schatz stent 10, Cordis 2, Cook 5 and Jo-Med stent 1. Stent implanted to the lesion of remained thrombus visualization on coronary angiography after PTCA. RESULTS: No major complications were developed during hospitalization in all 18 patients. In all patients no stent thrombosis have occurred within 2 weeks after stent implantation. But one patients have showed intracoronary stent thrombus persistently, so we used intracoronary urokinase infusion for 36 hours but there was no visible thrombus after modified anticoagulation and antithrombotic regimen CONCLUSIONS: We harvested good preliminary results of intracoronary stent implantation in the setting of thrombus containing lesion.
Angina, Unstable ; Angioplasty ; Constriction, Pathologic ; Coronary Angiography ; Hospitalization ; Humans ; Myocardial Infarction ; Research Personnel ; Risk Factors ; Stents* ; Thrombosis* ; Urokinase-Type Plasminogen Activator

PURPOSE: The purpose of this study was to evaluate the efficacy of the surgical treatment through the comparison of LC-DCP (Limited Contact-Dynamic Compression Plate) versus LCP (Locking Compression Plate) fixation in the plate augmentation for the nonunion of femur shaft fractures after intramedullary nail fixation. MATERIALS AND METHODS: Twenty-four patients with the nonunion of femur shaft fractures after intramedullary nail fixation who underwent plate augmentation were evaluated from Mar. 2001 to Sept. 2005. The group with LC-DCP augmentation was done bicortical screw fixation and the group with LCP was done monocortical fixation. RESULTS: There was one case of nail breakage in LC-DCP group, but sound bony union were achieved uneventfully in all the cases of both group. LCP fixation was slightly superior to LC-DCP fixation in view of the bony union time, operating time, postoperative Hb down, amount of postoperative transfusion, but there was no statistical difference (p>0.05). CONCLUSION: We got the satisfactory results after monocortical LCP augmentation as well as bicortical LC-DCP fixation and have concluded that monocortical LCP fixation was an effective treatment option for nonunion of femur shaft fracture occurred after Intrmedullary nail fixation.
Femur ; Humans ; Nails

A 57-year-old man was diagnosed with lung cancer and underwent pneumonectomy and mediastinal lymph node dissection. He was discharged without acute complications, but on a regular outpatient follow-up, he was readmitted with postpneumonectomy empyema. He was successfully treated with a vacuum-assisted closure device and for 1 year period of outpatient follow-up, there was no recurrence of empyema or lung cancer.
Empyema ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lymph Node Excision ; Negative-Pressure Wound Therapy ; Outpatients ; Pneumonectomy ; Recurrence

BACKGROUND/AIMS: The mortality rate of pyogenic liver abscess (PLA) has decreased dramatically, but it remains a potentially life threatening disease. Most cases are cryptogenic or occur in elderly men with underlying biliary tract disease. Although several studies have addressed the characteristics and etiology of PLA, research on factors affecting PLA-associated mortality is lacking. This study intended to identify the clinical and radiological features, pathogens, complications, and predictors of mortality in Korean PLA patients. METHODS: The medical records of 231 PLA patients diagnosed at Yeungnam University Medical Center between January 2010 and January 2014 were analyzed. A diagnosis of PLA was made based on imaging studies and blood and abscess cultures. The clinical, radiological, and laboratory findings of patients were analyzed. RESULTS: The mean patient age was 64.0±12.9 years and the male to female ratio was 1.5:1. Klebsiella pneumoniae was the predominant organism isolated from hepatic abscesses (69.9%) and blood (74.2%). The most common complication was pleural effusion (35.8%) and most common co-infection was cholangitis (8.2%). The overall mortality rate of PLA was 6.9% (16/231), and was significantly higher in patients with a history of liver abscess (OR 5.970, 95% CI 1.207-29.529; p=0.028), bilirubinemia (>2 mg/dL) (OR 9.541, 95% CI 2.382-38.216; p=0.001), thrombocytopenia (<140×10(3)/µL) (OR 4.396, 95% CI 1.130-17.106; p=0.033), or anemia (<12 g/dL) (OR 13.277, 95% CI 1.476-119.423; p=0.021). CONCLUSIONS: The prognosis of PLA appears to be dependent on underlying pathologies and severity of condition. More aggressive treatment should be considered if a poor prognosis is expected.
Abscess ; Academic Medical Centers ; Aged ; Anemia ; Biliary Tract Diseases ; Cholangitis ; Coinfection ; Diagnosis ; Female ; Humans ; Hyperbilirubinemia ; Klebsiella pneumoniae ; Liver Abscess ; Liver Abscess, Pyogenic* ; Male ; Medical Records ; Mortality* ; Pathology ; Pleural Effusion ; Prognosis ; Retrospective Studies* ; Risk Factors ; Thrombocytopenia

Psychiatry residency training in South Korea currently has many limits in developing proper competencies of residents. To address this problem, the Korean Neuropsychiatric Association has been developing a new competency-based training program since 2015, using the educational systems of advanced countries such as Canada, the United Kingdom, the United States, and Australia as references. It was found that within the referenced countries' residency training systems, objectives based on competencies are stated in detail by psychiatric topics as well as various assessment methods and feedback about the resident's competency level. In addition, we surveyed psychiatric resident training hospitals, and found that more than 80% of the respondents answered positively in reference to the new training program. This paper briefly reviews competency-based residency training systems of advanced countries and compares them to the current training program in South Korea. Many resources are needed to run a new competency-based training program, and governmental supports are essential to improve the quality of the residency training system.
Australia ; Canada ; Competency-Based Education ; Curriculum ; Education ; Great Britain ; Internship and Residency ; Korea ; Surveys and Questionnaires ; United States

This correction is being published to revise the authorship

Type I neurofibromatosis is an autosomal dominant disorder that occurs in 1 of 3, 000 births. It is characterized by multiple cutaneous neurofibromas, cafe-au-lait spots of the skin. Patients with neurofibromatosis are at increased risk of developing malignancies, particularly neural crest and other non-neural crest neoplasms. The term `malignant fibrous histiocytoma' was first introduced in 1963 to refer to a group of soft tissue tumors characterized by a storiform or cartwheel like growth pattern. Malignant fibrous histiocytomas are the most common type of soft tissue sarcoma that occurs in late adult life. Herein, our recent experienced a case of a malignant fibrous histiocytoma in a 28 year-old female with type I neurofibromatosis is reported, with a review of the literature.
Adult ; Cafe-au-Lait Spots ; Female ; Histiocytoma, Malignant Fibrous* ; Humans ; Neural Crest ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Parturition ; Sarcoma ; Skin

Mediastinal tumors are uncommon in the pediatric age group and teratoma comprises 5 percent of mediastinal lesions developing in the anterior mediastinum. It is characterized by staying asymptomatically till adulthood and the most common symptoms of mediastinal teratoma are chest pains, dyspnea, and coughs due to the compression of adjacent airways. Untreated benign teratoma can cause complications such as atelectasis of the lung, adjacent tissue compression, infection and rupture of mass. The diagnosis can be made by chest radiography and chest CT, and the treatment of choice is surgical. We report a 2 year, 10 months male patient who presented with coughs, respiratory difficulty caused by pleural effusion due to rupture, and perforation of the mass. The diagnosis was made by chest radiography and chest CT and he underwent surgical resection successfully.
Chest Pain ; Cough ; Diagnosis ; Dyspnea ; Humans ; Lung ; Male ; Mediastinal Neoplasms ; Mediastinum ; Pleural Effusion* ; Pulmonary Atelectasis ; Radiography ; Rupture ; Teratoma* ; Thorax ; Tomography, X-Ray Computed

Chondroblastoma is a rare benign cartilaginous neoplasm that accounts for approximately 1% of all bone tumors and characteristically arises in the epiphysis of a long bone, particularly the humerus, tibia, and femur. Chondroblastoma can affect people of all ages. It is, however, most common in children and young adults between the ages of 10 and 20 years. Although most chondroblastomas are cured by limited surgical procedures, occasional lesions behave more aggressively and may even metastasis. In this case a young man with pulmonary metastatic chondroblastoma on spine is presented. Unlike previously published examples of metastatic chondroblastoma, these metastasis developed before any operative manipulation of the primary tumor. And primary tumor site was also unusual. The histologic characteristics of the primary, metastatic tumors were those of a conventional chondroblastoma.
Child ; Chondroblastoma ; Epiphyses ; Femur ; Humans ; Humerus ; Lung ; Neoplasm Metastasis ; Spine ; Tibia ; Young Adult

Bronchogenic cysts are rare developmental anomalies of the primitive foregut that occur during embryogenesis. They may arise in the mediastinum or within pulmonary parenchyma and, less frequently, below or within the diaphragm. Presenting signs may vary from multiple symptomatic to asymptomatic. A 9-year-old boy was coincidentally found to have a round-shaped mass in chest X-ray which he did not possess during neonatal period. Computer tomography showed a round, homogeneous mass in posterior mediastinum which was adhered to the esophagus. The mass was surgically excised and pathologically confirmed bronchogenic cyst. We hereby present the case with review of literature.
Bronchogenic Cyst* ; Child* ; Diaphragm ; Embryonic Development ; Esophagus ; Female ; Humans ; Male* ; Mediastinum ; Pregnancy ; Thorax