No abstract available.
Granulomatous Disease, Chronic* ; Trimethoprim-Sulfamethoxazole Combination

Meningioma is usually known to occur stuck to the dura mater, but extradural meningioma occurs rarely. Most of the extradural meningiomas are located in the head and neck and we report a case of the primary intraosseous meningioma in the orbit. A 50-year old woman presented with the left eye hyperemia and exophthalmos. Neuroimaging modalities showed hyperostosis at the left sphenoid and orbital wall. On microscopic view, spindle cells and psammoma bodies between the woven bones were observed. The origin of the intraosseous meningioma is explained with various potent possibilities and differential diagnosis thoroughly explored.
Diagnosis, Differential ; Dura Mater ; Exophthalmos ; Female ; Head ; Humans ; Hyperemia ; Hyperostosis ; Meningioma* ; Middle Aged ; Neck ; Neuroimaging ; Orbit

PURPOSE: The purpose of this study was to develop a model of an elderly health promotion center after witnessing the effect of a social support program on dependent variables in older adults at a local community health center. METHOD: The subjects were 60 female adults over 65 years dwelling in a rural area, and they were divided into experimental and control groups each with 30 people. A social support program was implemented 6 hours a day, 3 times a week, for 4 months in the experimental group. Included was health assessment, health education, counseling, consultation, exercise, physical & occupational therapy, primary care, recreation, lunch & transfer service. Data was collected from May 1stto September 14th, 2002 by questionnaires, and analyzed by x2-test, t-test, Pearson's correlation coefficient and stepwise multiple regression using SAS. RESULT: The social support program in the elderly was very effective on all dependent variables of physical health (t= 4.68, p= .001), health knowledge (t= 3.60, p= .001), life satisfaction (t= 8.65, p= .001), and health promoting behaviors (t= 5.23, p= .001). CONCLUSION: The Social Support Program at a Community Health Center was effective on health promoting behaviors in the elderly.
Aged ; Aged, 80 and over ; *Community Health Centers ; Female ; Health Behavior ; Health Education ; *Health Promotion ; *Health Services for the Aged ; Humans ; Korea ; *Rural Health Services ; Social Support

The aim of this study was to analyse clinical feature and outcome of patients following total abdominal colectomy and ileorectal anastomosis. METHODS: All of 8 patients subjected to surgery during 5 year period from May 1995 to December 1999 were reviewed using retrospective method. RESULTS: All patients had slow colonic transit and 7 patients (male to female, 1:1.6) with a mean age of 54 (range, 27~70) years underwent total abdominal colectomy and ileorectal anastomosis and one patient had right hemicolectomy. Major symptoms were abdominal pain and bloating and mean bowel action was 18.5 days, mean suffered time before operation was 26.3 years. Colonic transit study, defecography and rectal manometry were done in all cases. Pelvic floor dysfunction was combined in 5 patients. Median follow up was 2.7 years. There was one mortality case due to postoperative pneumonia and ARDS in a 70 year old patient. Except one mortality case, there was significant success rate, overall 71%. CONCLUSIONS: Colectomy with ileorectal anastomosis produces a satisfactory outcome in the majority of patients undergoing surgery for chronic idiopathic constipation.
Abdominal Pain ; Aged ; Colectomy* ; Colon ; Constipation* ; Defecography ; Female ; Follow-Up Studies ; Humans ; Manometry ; Mortality ; Pelvic Floor ; Pneumonia ; Retrospective Studies

We hypothesized that lower proportion of serum phospholipid docosahexaenoic acid (DHA) is inversely associated with increased cardiovascular risk and vascular function in metabolically healthy men. To elucidate it, we first compared serum phospholipid free fatty acid (FA) compositions and cardiovascular risk parameters between healthy men (n = 499) and male patients with coronary artery disease (CAD, n = 111) (30-69 years) without metabolic syndrome, and then further-analyzed the association of serum phospholipid DHA composition with arterial stiffness expressed by brachial-ankle pulse wave velocity (ba-PWV) in metabolically healthy men. Basic parameters, lipid profiles, fasting glycemic status, adiponectin, high sensitivity C-reactive protein (hs-CRP) and LDL particle size, and serum phospholipid FA compositions were significantly different between the two subject groups. Serum phospholipid DHA was highly correlated with most of long-chain FAs. Metabolically healthy men were subdivided into tertile groups according to serum phospholipid DHA proportion: lower (< 2.061%), middle (2.061%-3.235%) and higher (> 3.235%). Fasting glucose, insulin resistance, hs-CRP and ba-PWVs were significantly higher and adiponectin and LDL particle size were significantly lower in the lower-DHA group than the higher-DHA group after adjusted for confounding factors. In metabolically healthy men, multiple stepwise regression analysis revealed that serum phospholipid DHA mainly contributed to arterial stiffness (β'-coefficients = -0.127, p = 0.006) together with age, systolic blood pressure, triglyceride (r = 0.548, p = 0.023). Lower proportion of serum phospholipid DHA was associated with increased cardiovascular risk and arterial stiffness in metabolically healthy men. It suggests that maintaining higher proportion of serum phospholipid DHA may be beneficial for reducing cardiovascular risk including arterial stiffness in metabolically healthy men.
Adiponectin ; Blood Pressure ; C-Reactive Protein ; Coronary Artery Disease ; Fasting ; Glucose ; Humans ; Insulin Resistance ; Male ; Particle Size ; Pulse Wave Analysis ; Triglycerides ; Vascular Stiffness*

PURPOSE: This study examined the effects of aerobic exercise using a flex band on the improvement of physical functions & body image in breast cancer women undergoing radiation therapy after a mastectomy. METHOD: Women with breast cancer(n = 26) were assigned to an experimental group(EG, n = 15) and control group(CG, n = 11). The E.G. participated in an aerobic exercise program with a 60% to 80% intensity of maximal heart rate for 25 minutes during the main exercise, 3 times per week, for 6 weeks. The EG did not exercise regularly for 3 months before participating in this program. The CG received no exercise treatment during the research period. Data were analyzed using the chi-square-test and Mann-Whitney U test by the SPSS version 11.0 program at a 5% significant level. RESULTS: Group analysis revealed that the EGwomen had significantly more improved cardiopulmonary functions, ROM of the affected shoulder joint, and body image compared to the CG. CONCLUSION: Aerobic exercise using a flex band may be an effective rehabilitative measure for mastectomy women with respect to cardio-pulmonary functions, ROM, & body image. Further studies are recommended to study early rehabilitation programs within 10 days post-operatively.
Adult ; *Body Image ; Breast Neoplasms/radiotherapy/*rehabilitation/surgery ; Combined Modality Therapy ; Female ; Heart Rate ; Humans ; *Mastectomy ; Middle Aged ; *Muscle Stretching Exercises/instrumentation ; Oximetry ; Program Evaluation ; *Range of Motion, Articular

OBJECTIVE: Sonography is a noninvasive and safe bedside imaging modality that provides rapid and repeatable real-time radiological evaluations without a radiation hazard. However, sonography has not gained widespread acceptance as a diagnostic tool in adult brain disease because of limited imaging resolution through the bony window. We investigated the diagnostic potential and clinical usefulness of bedside brain sonography through surgical bone defects in neurosurgical patients. METHODS: We evaluated twelve patients, each of whom had undergone a decompressive craniectomy, via bedside sonography, and performed comparison CT or MRI for all patients. RESULTS: We obtained reliable information regarding anatomical structure displacement, ventricle systems, intracranial fluid collection, presence and distribution of cerebral infarctions, and hemorrhages. We performed several interventional trials under sonography guidance, including aspiration of entrapped fluid collection and insertion of an external ventricular drainage catheter into a collapsed and displaced ventricle cavity. CONCLUSION: Bedside sonography through surgically created bone defects is a non-invasive method that physicians can repeat as required with no radiation hazard, and it is of particular value in emergent and critical situations when conventional neuroimages are unobtainable. Bedside sonography can be a first-line monitoring tool, in lieu of CT, for critically ill patients with surgical cranial defects.
Adult ; Brain ; Brain Diseases ; Catheters ; Cerebral Infarction ; Critical Illness ; Decompressive Craniectomy ; Displacement (Psychology) ; Drainage ; Hemorrhage ; Humans ; Neurosurgery ; Ultrasonography, Doppler

Currently accurate test for identification of HCV infection is not yet developed. We examined 1) the relationship between the result of anti-HCV by 3rd generation ELISA (ELISA/3) and of HCV-RNA by PCR from pre-transplant stored serum in 89 living donor renal transplant recipients and 2) the correlation between the result of each or combined tests and the development of post-transplant liver dysfunction (LDF). LDF was defined as the increment of serum transaminase over 100 I.U./ml in two consecutive tests. Patients with clinically or biopsy proven LDF by cyclosporine were excluded. Pre-transplant HCV infection rate assessed by ELISA/3 and PCR was 20.2 and 29.2% respectively. Patients with PCR (+) developed LDF frequently compared with negative partners (50 vs. 27%, p=0.0367). Significant disparity between ELISA/3 and PCR was present. In 71 ELISA/3 (-) patients, 16(22.5%) were positive for PCR. However 8 (44.4%) were negative for PCR in 18 ELISA/3 (+) patients. ELISA/3 (+) or PCR (+) patients developed LDF frequently rather than ELISA/3(-)/PCR(-) ones(50.0 vs. 23.6%, p=0.0106). We could explain these data with 5 possibilities; 1) end-stage renal failure patients had a blunt antibody production, 2) serum sample may be collected during the window period for antibody formation, 3) even ELISA/3 could not detect fine molecular response during the early HCV infection(false negative), 4) significant false positive or serum contamination in PCR test, and finally 5) self-clearing of HCV antigen may be present in the body. In conclusion, HCV detection by PCR method and antibody test by ELISA/3 must be complementary for the accurate evaluation of HCV infection during the recipient evaluation and posttransplantation follow-up period.
Antibody Formation ; Biopsy ; Cyclosporine ; Enzyme-Linked Immunosorbent Assay* ; Follow-Up Studies ; Hepacivirus ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Liver Diseases* ; Liver* ; Living Donors ; Polymerase Chain Reaction* ; Transplantation

BACKGROUND/AIMS: Rapid urease tests are used commonly for the detection of H. pylori. These tests are inexpensive and can be done easily and rapidly in the endoscopy room. A new rapid urease test, Hp Kit test, was developed for the first time in Korea. The test kit has two wells for two biopsies taken from each gastric antrum and corpus. We performed this study to estimate the diagnostic usefulness of Hp Kit test for the detection of H. pylori. METHODS: In one hundred patients undergoing gastroscopy, biopsy specimens were taken for Hp Kit test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). The 13C-urea breath test was also performed. The results of Hp Kit test were read after 2 hours. RESULTS: The sensitivity, specificity, positive and negative predictive value of Hp Kit test to diagnose H. pylori infection were 90.0%, 97.5%, 98.2%, and 86.7%, respectively. The positive reactions in only one well were observed in 12.9% of true positives with Hp Kit test. The reaction times of the Hp Kit test were 35.2+/-21.4, 26.6+/-15.3, and 17.8+/-15.8 minutes (mean+/-S.D.) at grade 1, 2, and 3, respectively (r=-0.3, p<0.05), therefore the results were usually observed within 1 hour. CONCLUSIONS: Hp Kit test has a high sensitivity and specificity, and may be used as an alternative rapid urease test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Endoscopy ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Polymerase Chain Reaction ; Pyloric Antrum ; Reaction Time ; Sensitivity and Specificity ; Urease

Acute lower gastrointestinal obstruction due to colorectal neoplasm is a common clinical problem, which frequently requires emergency operation. Morbidity and mortality associated with emergency operation is relatively high, and almost all requires a multi-stage operation. Recently flexible rectal stent has been emerged as an alternative for the management of acute lower gastrointestinal obstruction due to colorectal neoplasm. Thus we analyzed the results of flexible rectal stent treatment for acute lower gastrointestinal obstruction due to colorectal neoplasm. METHODS: From June 1996 to May 1999 47 patients with acute malignant lower gastrointestinal obstruction were included in this study, medical records of these patients were reviewed retrospectively. RESULTS: Of 47 patients 19 were male and 28 were women, with a mean age of 57.3 years (33~77 years). Male to female ratio was 1:1.47. Causes of acute intestinal obstruction were as follows: rectal cancer, 17 patients; sigmoid colon cancer, 18 patients; descending colon cancer, 3 patients; ascending colon cancer, 1 patient; stomach cancer, 5 patients; gall bladder cancer, 1 patient; and uterine cervix cancer, 1 patient; and ovarian cancer, 1 patient. Stent insertion was indicated as palliative treatment in 22 patients and preoperative decompression in 25 patients. Successful stent insertions were achieved in 40 patients (85.1%). Stent insertion was successful in 20 patients (91.0%) among the 22 patients treated for palliation. Stent insertion was successfully achieved in 20 patients (80.0%) among the 25 patients. Stent insertion failure was observed in 7 patients (14.9%). Stent failed due to the complete obstruction, 3 patients; long segmental lesion, 1 patient; anatomic abnormality, 1 patient; multiple lesions, 1 patient, and ultra-low rectal lesion, 1 patient. Colonoscopy-assisted stent insertion was performed in 5 patients. Post-stent complications occurred in 12 patients among the 40 patients (30.0%): stent migration, 8 patients; expansion failure, 2 patients; fecal incontinence, 1 patient; and malposition, 1 patient. The interval between stent insertion and operation was from 1 to 30 days with a median of 7 days. Elective operations were performed as follows: anterior resection, 6 patients; low anterior resection, 7 patients; Miles' operation, 3 patients; sigmoid colostomy, 3 patients; and transverse colostomy, 1 patient. Mean distal resection margin of specimen was 2.3 cm. No postoperative complication was seen. CONCLUSIONS: Multi-stage operation can be avoided with flexible rectal stent without increasing postoperative complications. Complication rate was relatively high in patients whom stent were inserted for palliative intent. Combined colonoscopy increased the successful rate in difficult cases. Immediate operation should be considered for the patients with long segmental lesion, multiple lesions, ultra-low rectal lesion, and when perforation is suspected.
Cervix Uteri ; Colon* ; Colon, Ascending ; Colon, Descending ; Colon, Sigmoid ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Colostomy ; Decompression ; Emergencies ; Fecal Incontinence ; Female ; Gallbladder Neoplasms ; Humans ; Intestinal Obstruction ; Male ; Medical Records ; Mortality ; Ovarian Neoplasms ; Palliative Care ; Postoperative Complications ; Rectal Neoplasms ; Retrospective Studies ; Sigmoid Neoplasms ; Stents* ; Stomach Neoplasms