Clinical studies on thirteen patients with Behcet's syndrome who had visited during the period from Jan. 1970 to Sep. 1973, to the Department of Dermatology & Ophthahnology, Busan National University Hospital, were made and the following results obtained. 1) The ratio of male vs. female was l. 0: l. 6 with no definite sexual differences. The ages ranged from 17 to 56 years with the peak incidence in third decade of life. 2) The "complete" form consisting of oculo- oro-genital and cutaneous lesions appeared in . 4 patients (30. 8%) and the "incomplet" in 9 patients (69. 2%). 3) Aphthous stomatitis was most predominant, being observed in 12 out of all 13 cases (92.3%), the next was cutaneous manifestations such as erythema nodosum, pyodermas, acneiform & pustular lesions and erythema multiforme in 10 cases (76. 1%) and genital ulcers in 9 cascs (69.2%). Ocular lesions and articular involvements came fourth, each being found in 8 cases (61. 5%). 4) The commonest feature of ocular involvement was relapsing iridocyclitis, being observed in 57. 7% and the disease led to a bilateral loss of vision in 38. 4% 5) Single or combined therapy including corticosteroids and antimicrobials gave transient conservative effects and was of no value to prevent recurrent attacks.
Adrenal Cortex Hormones ; Behcet Syndrome* ; Busan ; Dermatology ; Erythema Multiforme ; Erythema Nodosum ; Female ; Humans ; Incidence ; Iridocyclitis ; Male ; Pyoderma ; Stomatitis, Aphthous ; Ulcer

BACKGROUND/AIMS: Planned endoscopic submucosal dissection with snaring (ESD-S) is thought to shorten operating time spent on submucosal dissection, but may lead to uncertainty of en bloc resection or to a possible increase in tumor-positive margins. The purpose of the present study is to investigate the feasibility of ESD-S as a planned procedure for gastric adenoma. MATERIALS AND METHODS: The medical records of 99 patients who underwent ESD-S or ESD for gastric adenoma between May 2011 and May 2012 were retrospectively reviewed. We analyzed the differences between the ESD-S and the ESD groups, focusing on rates of en bloc resection and pathologic complete resection, mean operation time, and complications. RESULTS: The mean operation time was significantly lower in the ESD-S group than in the ESD group (19.9+/-11.2 vs. 33.8+/-19.9, P=0.012). Cases with an operation time under 30 minutes were more frequent in the ESD-S group (88.9% vs. 48.1%, OR=8.615, 95% CI=2.949~25.168). There were no significant differences in en bloc resection, histologic complete resection, or complication rates between the two groups. CONCLUSIONS: ESD-S has a time advantage over ESD with a comparable compete resection rate. ESD-S can be considered a planned method for available early gastric adenoma.
Adenoma* ; Endoscopy ; Focus Groups ; Humans ; Medical Records ; Retrospective Studies ; SNARE Proteins* ; Uncertainty

A case of persistent Cushing's syndrome in a 25 year-old male is presented. Inspite of bilateral total adrenalectomy twice during two years, there was no clinical improvement. Adrenal scanning revealed no adrenal remnants. ACTH secreting pituitary microadenoma is demonstrated by computed tomographic brain scan and hormonal studies. Selective transsphenoidal microadenomectomy results in clinical and endocrinological improvement.
Adrenalectomy ; Adrenocorticotropic Hormone ; Adult ; Brain ; Cushing Syndrome* ; Humans ; Male

A case of persistent Cushing's syndrome in a 25 year-old male is presented. Inspite of bilateral total adrenalectomy twice during two years, there was no clinical improvement. Adrenal scanning revealed no adrenal remnants. ACTH secreting pituitary microadenoma is demonstrated by computed tomographic brain scan and hormonal studies. Selective transsphenoidal microadenomectomy results in clinical and endocrinological improvement.
Adrenalectomy ; Adrenocorticotropic Hormone ; Adult ; Brain ; Cushing Syndrome* ; Humans ; Male

This study aims to investigate the factors related to the adoption of clinical practice guidelines in clinical settings in Korea; it also aims to determine how these factors differ depending on the specific situation of health care system and professional climate. The research sample comprised physicians who are board members of academic societies with experiences in development of clinical practice guidelines using a convenient sampling. We analyzed 324 physicians with pooling two-year sample of 2007 and 2008. From all the respondents, 48.8% stated that they followed Clinical Practice Guidelines, and 93.4% agreed with the content in the Clinical Practice Guidelines. With regard to the item on the self-efficacy of practicing guidelines, 90.3% of the respondents selected 'low level'. In the regression analysis, the factors associated with implementation were level of recognition, agreement and self-efficacy and positive attitude towards practice guidelines. Although the health care system in Korea differs from those in Western countries, our results revealed that the factors related to the adoption of practice guidelines were similar to the research results of Western countries. These results suggest that professionals' attitudes towards clinical practice guidelines are universal, and implementation strategies should be developed globally.
Adult ; Attitude of Health Personnel ; Awareness ; Female ; Guideline Adherence ; Humans ; Male ; Middle Aged ; *Models, Theoretical ; Physicians/psychology ; *Practice Guidelines as Topic ; Questionnaires ; Regression Analysis ; Republic of Korea ; Self Efficacy

The mediastinal parathyroid cyst is a very rare cause of space occupying lesions in the mediastinum.We report a case of a non-functioning mediastinal parathyroid cyst that occurred ina 42 year-old male. He suffered from foreign body sensation of the throat whenever he wasin the supine position. A chest computed tomography showed a round cyst with a narrowbase attached to trachea. It was white and tan, thin-walled semi-transparent cyst containingyellow and tan serous fluid. Microscopically it was characterized by a thin fibrous wall linedwith a single or double layer of uniform cells with clear cytoplasm and small nuclei. The liningcells were immunopositive for chromogranin A.
Adult ; Chromogranin A ; Cytoplasm ; Foreign Bodies ; Humans ; Male ; Mediastinum ; Parathyroid Glands ; Pharynx ; Sensation ; Supine Position ; Thorax ; Trachea ; Triacetoneamine-N-Oxyl

Authors experienced fifteen cases of the pineal tumors during about 5 years from October, 1977 to September, 1982, which were diagnosed with brain C-T scanning. The details of clinical evaluation and follow up of 15 cases of the pineal tumors are presented. The following results were obtained. 1) The age group below age of 20 years in predominant and include 11 cases(73%) of 15 cases, and male is predominantly much than female. 2) On the neurological examination at admission, the RICP signs were showed in 15 cases, Parinaud's syndrome showed in 6 cases, cranial nerve palsy in 8 cases and DI symptom in 5 cases of all 15 cases. 3) In the follow up study, brain CT was more effective than any other conventional neuroradiologic technique. 4) 8 cases of all 15 cases have had normal life in follow up period with minium of 6 months and maximum of 6 months and maximum of 5 years, and one case with mild neurological deficit has been spent life for about 12 months. 5) Of 6 cases died within 2 years, 3 cases had insufficient treatment and 3 cases had sufficient treatment, of whom ond had tumor recurrence at primary site and dissemination to spinal epidural space and other two cases were suspected to have clinical dissemination to spinal cord. 6) On the basis of high survival rate in 9 cases of 12 cases who were treated completely, we thought that good survival rate in the patient with pinealoma will be resulted from a series of planed treatment, including early diagnosis, correction of hydrocepalus, surgical intervention and irradiation.
Brain ; Cranial Nerve Diseases ; Early Diagnosis ; Epidural Space ; Female ; Follow-Up Studies* ; Germinoma ; Humans ; Immunotherapy ; Male ; Neurologic Examination ; Ocular Motility Disorders ; Pinealoma* ; Recurrence ; Spinal Cord ; Survival Rate

Rounded atelectasis is a focal, pleural-based lesion that is the result of pleural and subpleural scarring and atelectasis of the adjacent lung tissue. We experienced a case of asbestosassociated rounded atelectasis that had developed in a 50-year-old male. When examined with routine chest radiography, the patient was shown to have an asymptomatic chest mass.Computed tomography showed a pleural-based mass with a curvilinear shape about 4.2 cmin greatest diameter in the medial basal segment of the right lower lobe. To exclude the possibilityof malignancy the mass was excised by video-assisted thoracotomy. The mass wasround and firm, and was gray and yellow in color. Microscopically, marked pleural fibrosisextended into the underlying lung parenchyme and then resulted in atelectasis. There areferruginous bodies in dense fibrous pleura.
Asbestos ; Cicatrix ; Humans ; Lung ; Lung Diseases ; Male ; Middle Aged ; Pleura ; Pulmonary Atelectasis* ; Radiography ; Thoracotomy ; Thorax

Subdural empyema is a neurosurgical emergency the mortality of which continues to be as high as 40% in modern reported series. It is also a curable lesion, and the outcome of treatment has been demonstrated to be directly related to the promptness of diagnosis and appropriate surgical drainage. Recently, we have operated upon two cases of intracranial subdural empyema secondary to acute facial furuncle and postoperative craniectomy. Reviewing these two cases and other literatures, we are going to describe about cases, symptoms and signs, and methods of diagnosis and treatment of subdural empyema.
Diagnosis ; Drainage ; Emergencies ; Empyema, Subdural* ; Furunculosis ; Mortality

BACKGROUND AND OBJECTIVES: An association between emotional or physical stressful triggers and adverse cardiovascular events, such as death and myocardial infarction, has been recognized for many years. The clinical features of transient left apical ballooning syndrome have been clearly described, but the effect of chronic stress on the myocardium is unknown. Our objective was to assess left ventricular (LV) function in patients with fibromyalgia (FM) with chronic emotional and physical stress. SUBJECTS AND METHODS: We investigated 30 consecutive postmenopausal women (mean age, 48+/-8 years) satisfying the criteria for FM with atypical chest pain and 20 age-matched healthy controls by means of standard and 2-dimensional strain (2DS) echocardiography. Patients with hypertension, coronary heart disease, or diabetes were excluded. Global and segmental longitudinal deformation parameters of LV function from 3 apical views were analyzed, and patients underwent a manual tender point survey for the number of tender points and tender point counts, and completed the Fibromyalgia Impact Questionnaire (FIQ), which was comprised of physical and feel scores, the Brief Fatigue Inventory (BFI), and the Beck Depression Inventory (BDI). RESULTS: Both global and segmental longitudinal LV strains were significantly reduced in FM patients with high FIQ scores (>50) compared to FM patients with low FIQ scores (-18.98% vs. -22.72%). Various emotional and physical stress indexes were significantly correlated with global LV strain. CONCLUSION: Global and segmental LV strains were negatively associated with fatigue, tender point count, and FIQ score. However, there was no significant association between depression and LV strain. This study demonstrated that chronic emotional or physical stress in FM patients might reduce myocardial longitudinal deformation.
Chest Pain ; Coronary Disease ; Depression ; Echocardiography ; Fatigue ; Female ; Fibromyalgia ; Humans ; Hypertension ; Myocardial Infarction ; Myocardium ; Sprains and Strains ; Stress, Psychological ; Takotsubo Cardiomyopathy ; Surveys and Questionnaires