No abstract available.
Abortion, Spontaneous* ; Chorion* ; Chorionic Villi* ; Female ; Humans ; Pregnancy

Organophosphate is known to damage both the peripheral and central nervous system. We report a case of organophosphate-induced peripheral polyneuropathy with myelopathy. A 46 years old woman who had ingested a large amount of insecticide (organophosphate) was transported to our hospital. Following medical treatment, she was transferred to the Department of Rehabilitation Medicine 1 month later. Upon admission to rehabilitation medicine, the patient was quadriplegic with markedly decreased muscle tone and strength. Electrodiagnostic examination revealed low amplitude of sensory nerve action potential (SNAP), unevokable compound muscle action potential in distal muscles and abnormal spontaneous activities with needle electromyography, which were compatible with peripheral polyneuropathy. Three months later, motor and sensory function of upper extremities were normalized. The muscle tone of lower extremity increased to Ashworth grade II. Follow-up electrodiagnostic examination revealed normalization of SNAP and disappearance of spontaneous activities, but somatosensory evoked potential which were initially normal, revealed prolonged P40 latencies in the lower extremities. These electrophysiological findings were thought to result from the spinal cord lesion and correlated with clinical findings. We diagnosed the patient as peripheral polyneuropathy with delayed myelopathy induced by organophosphate.
Action Potentials ; Central Nervous System ; Electromyography ; Evoked Potentials, Somatosensory ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Middle Aged ; Muscle Hypotonia ; Muscles ; Needles ; Polyneuropathies* ; Rehabilitation ; Sensation ; Spinal Cord ; Spinal Cord Diseases* ; Upper Extremity

Imaging studies play an important role in the detection, diagnosis, assessment of resectability, staging, and determination of patient-tailored treatment options for pancreatic adenocarcinoma. Recently, for patients diagnosed with borderline resectable or locally advanced pancreatic cancers, it is recommended to consider curative-intent surgery following neoadjuvant or palliative therapy, if possible. This review covers how to interpret imaging tests and what to consider when assessing resectability, diagnosing distant metastasis, and re-assessing the resectability of pancreatic cancer after neoadjuvant or palliative therapy.

Imaging studies play an important role in the detection, diagnosis, assessment of resectability, staging, and determination of patient-tailored treatment options for pancreatic adenocarcinoma. Recently, for patients diagnosed with borderline resectable or locally advanced pancreatic cancers, it is recommended to consider curative-intent surgery following neoadjuvant or palliative therapy, if possible. This review covers how to interpret imaging tests and what to consider when assessing resectability, diagnosing distant metastasis, and re-assessing the resectability of pancreatic cancer after neoadjuvant or palliative therapy.

The cross-sectional imaging findings play a crucial role in the diagnosis of hepatocellular carcinoma (HCC). Recent studies have shown that imaging findings of HCC are not only relevant for the diagnosis of HCC, but also for identifying genetic and pathologic characteristics and determining prognosis. Imaging findings such as rim arterial phase hyperenhancement, arterial phase peritumoral hyperenhancement, hepatobiliary phase peritumoral hypointensity, non-smooth tumor margin, low apparent diffusion coefficient, and the LR-M category of the Liver Imaging-Reporting and Data System have been reported to be associated with poor prognosis. In contrast, imaging findings such as enhancing capsule appearance, hepatobiliary phase hyperintensity, and fat in mass have been reported to be associated with a favorable prognosis. Most of these imaging findings were examined in retrospective, single-center studies that were not adequately validated. However, the imaging findings can be applied for deciding the treatment strategy for HCC, if their significance can be confirmed by a large multicenter study. In this literature, we would like to review imaging findings related to the prognosis of HCC as well as their associated clinicopathological characteristics.

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.
Abscess ; Bicuspid ; Dental Pulp Calcification ; Dental Pulp Cavity ; Dental Pulp Necrosis ; Female ; Gutta-Percha ; Humans ; Incisor ; Tooth ; Tooth Bleaching ; Ultrasonics ; Young Adult

PURPOSE: Patients with type 1 diabetes have difficulty controlling diabetes during adolescence. Active self-management of diabetes in school during adolescence is essential for type 1 diabetic adolescents to successfully adapt to school and shift toward a healthy adulthood. This research examined insulin self-injection in school by diabetic adolescents and the correlation between the control of blood sugar and school adaptation. METHOD: Forty adolescents (aged 10-18 years) who were receiving care for type 1 diabetes in pediatric divisions of two university hospitals in the Incheon and Bucheon area from July 2011 to May 2012 were surveyed. RESULTS: Of the intense insulin treatment group (33/40), self-administration of insulin took place outside (22/33, 67%) and inside (11/33, 33%) restrooms. There was no significant difference in hemoglobin A1c between the two groups (P=0.7). 60% of those that had self-injected themselves within the restroom had not exposed their diabetes with more than 5 friends, while only 23% of those that had self-injected themselves outside the restroom had not exposed their diabetes with more than 5 friends, showing statistic significance between the two groups (P=0.02). There was also a significant difference in the frequency of experiencing depression: 91% for the group with self-injection in the restroom and 45% for the group with self-injection outside the restroom (P=0.02). CONCLUSION: Thirty-three percent of diabetic adolescents administered insulin in the restroom. These diabetic adolescents were reluctant to discuss the disease with others and had a higher frequency of experiencing depression. Thus, schools need to provide active support and care for students with type 1 diabetes.
Adolescent ; Blood Glucose ; Child ; Depression ; Diabetes Mellitus, Type 1 ; Friends ; Hemoglobins ; Hospitals, University ; Humans ; Hypogonadism ; Insulin ; Mitochondrial Diseases ; Ophthalmoplegia ; Self Care

Background/Aims: Postal distribution of a fecal immunochemical test (FIT) kit has been recommended as an effective method of increasing participation in colorectal cancer (CRC) screening. The present study was performed to assess the impact of the round-mailed FIT kit on screening participation in underserved regions of Korea and to identify factors related to nonparticipation. Methods: Residents were recruited from three rural regions of Korea that lack screening units for the National Cancer Screening Program. A package containing a FIT kit for stool self-sampling and a return envelope addressed to the local health center was postally distributed to each subject. Thirty days after the kits were mailed, nonresponders were reminded via telephone as the second intervention. The participation rates and odds ratios with 95% confidence intervals (CIs) for each intervention response were calculated to evaluate the effect of the interventions and factors related to screening participation in response to the interventions. Results: CRC screening participation rates increased from 24.5% (95% CI, 21.6% to 27.4%) to 42.6% (95% CI, 39.3% to 46.0%) as a result of postal screening and increased further to 51.4% (95% CI, 48.0% to 54.9%) after the telephone reminder. After controlling for the sex, age, and household type of each subject, factors associated with poor response to postal screening were identified as low educational attainment and poor previous participation in the National Cancer Screening Program. Conclusions Round-mailed FIT kits with phone call reminders were an effective intervention, nearly doubling the screening rate in underserved regions of Korea.

OBJECTIVE: To measure anterior displacement of the humeral head and to observe its relationship with clinical findings in the subluxed hemiplegic shoulders. METHOD: Seventeen hemiplegic patients, having the subluxed shoulder over one finger breadth were subjected. We measured shoulder pain, muscle power of the shoulder abductors, Brunnstrom stage and spasticity in the affected upper extremity. To measure the humeral displacement of the shoulder subluxation, the AP and transthoracic lateral views of simple radiologic picture were taken on both affected and unaffected shoulders, and repeated after donning three kinds of arm slings. RESULTS: Its anterior displacement as well as the inferior displacement occured in all subjects, and was significantly related with the value of shoulder pain and spasticity, and the inferior displacement with Brunnstrom stage and muscle power of the shoulder abductors in the subluxed hemiplegic shoulder (p<0.05). Correction of the humeral displacement occured significantly in anterior direction as well as inferior by use of all tested arm slings. CONCLUSION: Clinical implications of the shoulder subluxation were different according to direction of the humeral displacement, and anterior displacement will be considered for its symptom in hemiplegic shoulder.
Arm ; Fingers ; Hemiplegia ; Humans ; Humeral Head* ; Muscle Spasticity ; Shoulder Pain ; Shoulder* ; Upper Extremity

Vulvar melanosis (VM) is clinically characterized by asymmetric macules or patches of varying size with a tan to black color and irregular borders. VM is more commonly found among perimenopausal women with a median age of 42 years. The exact pathogenesis of VM is not well understood. The proposed etiological factors for VM include oral contraceptive use, infection with human papillomavirus, and chronic inflammatory skin diseases such as lichen sclerosus et atrophicus. Histologic examination can easily differentiate mucosal lentiginosis from melanoma, but VM superimposed on a background of anogenital lichen sclerosus, both clinically and histologically, may mimic malignant melanoma. There have been two cases of VM associated with Dowling-Degos disease in the Korean dermatologic literature. To the best of our knowledge, this is the first case of VM associated with lichen sclerosus et atrophicus in the Korean dermatologic literature.