PURPOSE: In patients with small or large aneurysms, the decision for surgical treatment is not so simple. The mortality of ruptured abdominal aortic aneurysm (AAA) is high. This study was designed to retrospectively analyse the clinical characteristics of patients with AAA. METHODS: Ninety-one cases of AAA were surgically treated between January 1991 and January 2003 at the Department of Surgery, Chonnam National University Hospital. Patients were divided into 49 elective cases and 42 emergency cases, and retrospective analysed on the basis of age, sex, chief complaints, physical examination, associated diseases, size of aneurysm, diagnostic modalities, operative mortality and causes of death. RESULTS: The initial presentations were mainly palpable masses in the elective cases. On the other hand, in the emergency cases which were ruptured, many patients complained of abdominal or back pain. There was a positive relationship between the size of AAA and the incidence of the rupture in our study, especially in the case of transverse diameters above 10 cm (P<0.001). There was no death in the elective cases, but there were 22 surgical mortalities in the 42 emergency cases (52.3%, P<0.001). Overall surgical mortality was 24.1%. The causes of death were intraoperative and postoperative bleeding (11), myocardial infarction (5), acute renal failure (4), and sepsis (2). CONCLUSION: Surgical mortality in ruptured AAA was high. Consequently, surgical intervention is recommended and the operation must be performed. In that way we can reduce the operative mortality and improve the treatment outcome.
Acute Kidney Injury ; Aneurysm ; Aortic Aneurysm, Abdominal* ; Back Pain ; Cause of Death ; Emergencies ; Hand ; Hemorrhage ; Humans ; Incidence ; Jeollanam-do ; Mortality ; Myocardial Infarction ; Physical Examination ; Retrospective Studies ; Rupture ; Sepsis ; Treatment Outcome

No abstract available.
Choriocarcinoma* ; Female ; Ovary* ; Pregnancy

A total of 28 patients of confirmed cerebral parenchymal cysticercosis was followed serologically by ELISA(enzyme linked immunosorbent assay) and clinically over 1 year after praziquantel treatment. The subjects were confined to pure cerebral parenchymal form of neurocysticercosis patients in order to evaluate the effect of praziquantel on specific IgG antibody level. The main clinical features were epilepsy and headache and the brain CT showed multiple low densities, cystic rnass, nodule and calcifications. The patients included in this study were categorized into 3 groups according to the follow-up period, namely, group I (1-2 years), group II (2-3 years) and group III(over 3 years). In serum, the post-treatment(last follow-up) anti-body levels were decreased to 71% in group I, 50% in group II and 52% in group III of pre-treatment levels. Also, in CSF, the post-treatment antibody levels were decreased to 81% in group I, 71% in group II and 33% in group III of pre-treatment levels. Eight patients(2 in group I, 3 in group II, 3 in group III) showed negative conversion of IgG antibody in both serum and CSF during follow-up period. All antibody levels in serum and CSF were expected to decline below negative range around 56-57 months after praziquantel treatment by simple linear regression analysis. However, in CSF, it took about 66-67 months for high pre-treatrnent titer patients above 0.8 to convert into negative range and about 34-35 rnonths for low pre-treatrnent titer ones below 0.8. In conclusion. It might be possible to differentiate serologically the early cured from the chronically ill patients uith slowly calcifying lesion by ELISA in neurocysticercosis, :which would be also helpful to determine the next treatment modality.
Brain ; Chronic Disease ; Cysticercosis* ; Enzyme-Linked Immunosorbent Assay* ; Epilepsy ; Follow-Up Studies* ; Headache ; Humans ; Immunoglobulin G ; Linear Models ; Neurocysticercosis ; Praziquantel*

This study was a correlation study to analyze the effects of smartphone usage time on food choice perceptions and behavior in middle school students in Seoul areas. The subjects to be surveyed were middle school students attending junior high schools in Mapo-gu, Seoul. A total of 133, 102, and 102 students were in the first second, and third grades, respectively. The usage time of smartphones was the weekday and weekend usage time except for the call function. Food choice perception and its behavior as dietary habits were constructed referring to previous research and food balance wheels data for the correct dietary habits of the Ministry of Health & Welfare and Korean Nutrition Society. The food choice behavior was categorized into non-recommended food and recommended food. The results are summarized as follows. First, the longer the time spent on smartphones, the less favorable the perception of correct food choices. Second, the higher the dependence on smartphones, the less favorable the perception of correct food choices. Third, the correct perception of food choices has been shown to reduce food choices, known as non-recommended foods. In addition, proper perception of food choices has been shown to increase the choice of recommended foods. In conclusion, the usage time and reliance of smartphones of middle school students was found to affect the food choice behavior by lowering the perception of correct food choices. This research is expected to form the basis for the development of programs and educational materials that can be of assistance to adolescents who are experiencing difficulties.
Adolescent ; Choice Behavior ; Eating ; Food Habits ; Humans ; Seoul ; Smartphone ; Statistics as Topic

BACKGROUND AND OBJECTIVES: Oroantral fistula is an epithelialized communication between the oral cavity and the maxillary sinus. The aim of this study is to investigate the clinical characteristics and treatment of oroantral fistula. SUBJECTS AND METHOD: Patients who have undergone treatment for oroantral fistula between May 1995 and December 2015 were enrolled in this study. The demographic data of these patients and characteristics of oroantral fistula were analyzed. Patients with oroantral fistula were initially administered oral antibiotics for 3 weeks. If fistula persists in spite of the medication, surgery (soft tissue flap with or without bone graft) was performed. The surgical results according to the presence of bone graft were compared. RESULTS: Twenty-two patients were in accordance with the inclusion criteria. The male to female ratio of patients was 12:10, with the mean age of 47.9±13.4 years. The main complaint of patients was pus discharge from the fistula. Two patients were successfully treated with antibiotics whereas 20 patients underwent surgery. Recurrence occurred in 3 patients, who were treated with soft tissue flap, but no recurrence developed in the patients treated with soft tissue flap and bone graft. Although dehiscence of soft tissue flap occurred in one patient treated with bone graft, it was successfully treated by secondary intention without an additional surgery. CONCLUSION: Bone graft bears the negative pressure of the oral cavity and the weight of secretions including the blood. In addition, it induces secondary intention for the dehiscence of the flap. In this regard, bone graft seems to contribute to the surgical success of oroantral fistula.
Anti-Bacterial Agents ; Bone Transplantation ; Female ; Fistula ; Humans ; Intention ; Male ; Maxillary Sinus ; Methods ; Mouth ; Oral Surgical Procedures ; Oroantral Fistula* ; Recurrence ; Suppuration ; Surgical Flaps ; Transplants

PURPOSE: Anastomotic airway complications are a major cause of morbidity and mortality after lung transplantation (LTx). In this study, the authors identified types and clinical outcomes of airway complications after LTx. MATERIALS AND METHODS: All bronchial anastomotic complications were analyzed in a total of 94 LTx cases involving 90 recipients who underwent surgery between July 2006 and May 2014. Fifteen LTx cases (14 recipients) with incomplete medical records for fiberoptic bronchoscopy (FBS) and three cases underwent heart-lung transplantation (HLT) were excluded. Postoperative FBS at 24-48 hours, 1, 3, 6, and 12 months, and then yearly after the transplantation were performed. RESULTS: A total of 76 LTx cases (75 recipients) were analyzed. The mean age of the recipients was 49.55 years (range, 18-71 years), and 38 (49.4%) were male. Twenty-one out of 76 cases (27.6%) experienced early anastomotic complications, and 12 (15.8%) presented late anastomotic complications. The early anastomotic airway complications presented in various forms: stenosis, 1 case; narrowing, 1; necrosis & dehiscence, 3; fistula, 4; granulation, 10; and infection, 2. Late complications almost entirely presented in the form of bronchial stenosis; five recipients showed stenosis at the anastomosis site, and one of them showed improvement after ballooning. Five others were found to have stenosis at the bronchus intermedius, distal to the anastomosis site. Three of these patients showed improvement after ballooning or bronchoplasty. CONCLUSION: By serial surveillance via FBS after LTx, we detected anastomotic airway complications in 42.9% of cases, which were successfully managed with improved clinical outcomes.
Adolescent ; Adult ; Aged ; Analysis of Variance ; Anastomosis, Surgical/*adverse effects/methods ; Bronchi/blood supply/physiopathology/*surgery ; Bronchial Diseases/epidemiology/*etiology/physiopathology ; Bronchoscopy ; Female ; Humans ; Incidence ; *Lung Transplantation ; Male ; Middle Aged ; Postoperative Complications/epidemiology/*etiology/physiopathology ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Treatment Outcome

BACKGROUND: Escherichia coli and Klebsiella pneumoniae resistant to 3rd generation cephalosporin have been reported with increasing frequency in tertiary-care hospital in Korea. MicroScan Neg Combo Panel Type 21 (Type 21) contains a 1 microgram/mL cepfodoxime (POD) in addition to other screen wells containing ceftazidime, cefotaxime, ceftriaxone, and aztreonam, which are designed for detecting extended-spectrum beta-lactamase (ESBL)-producing E. coli and Klebsiella species. We evaluated the Type 21 panel for its ability to detect ESBL. METHODS: From November to December in 1998, 496 E. coli and 326 K. pneumoniae strains isolated from clinical specimens were tested with Type 21 panel The isolates flagged as ESBL producers by the panel were confirmed by the double disk synergy test (DDS). To evaluate the specificity of POD, n-lactamases of 54 E, coli and 20 K. pneumoniae strains that were flagged by, POD only from January to May 1999 were analyzed by isoelectric focusing(IEF). RESULTS: 75/496(15%) E. coli and 68/326(21%) K. pneumoniae were flagged as ESBL producers by Type 21 panel. Of those, 94 isolates including 38/75 (51%) of E. coli and 56/68 (82%) of K. pneumoniae were positive for DDS. Among the 94 ESBL producers, all were detected by POD, 84% by cefotaxime, 85% by ceftazidime, 84% by ceftriaxone, and 86% by aztreonam. The 74 strains that were flagged as ESBL producers by POD screen well only were mostly DDS-negative, cefoxitin- resistant and showed beta-lactamases with pls of 5.4 and 7.6 or no band, which could be interpreted as the presence of TEM-1 or SHV-1 type beta-lactamases and/or basal AmpC beta-lactamases, not ESBL. CONCLUSION: MicroScan Neg Combo Panel Type 21 was able to detect a greater number of ESBL producers by inclusion of POD in its screening well. However, the specificity of POD was compromised by flagging a significant number of DDS negative strains. We conclude that the isolates with reduced susceptibility to 3rd generation cephalosporins as well as POD can be reported as ESBL-producers and those resistant to POD only should be confirmed by DDS.
Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Cephalosporins ; Escherichia coli ; Klebsiella ; Klebsiella pneumoniae ; Korea ; Mass Screening ; Pneumonia ; Sensitivity and Specificity

BACKGROUND: The detection of circulating microemboli by transcranial Doppler ultrasonography (TCD) has the potential to select the patients with high risk for future symptomatic brain embolism. We prospectively evaluated the positive rate and the frequency of microembolic signals (MES) before and after the heart valve surgery (HVS). MATERIAL AND METHOD: Fifty in-patients with heart valve disease were enrolled in this study. Patients with history of previous stroke or heart valve surgery were excluded. Two unilateral TCD monitoring sessions were performed from middle cerebral artery for 1-hour, before and after HVS. RESULT: Mechanical Heart valves were implanted in 28 patients, tissue valves were implanted in 10 patients, and remaining 12 patients received mitral valve repair. Positive rate of MES was significantly increased after HVS (50%), compared to that of before HVS (8%, p=0.00). There was no relation between MES after HVS and intensity of anticoagulation, cardiac rhythm, patients' age, and history of hypertension. The positive rate of MES after implantation of mechanical heart valve (71.4%) was significantly higher than those after implantation of tissue valve or mitral valve plasty (p=0.002). CONCLUSION: Positive rate of MES was increased significantly after the implantation of HVS. The changes of MES in those with mechanical prosthesis may be related to the increased risk of embolism after HVS.
Embolism ; Heart Valve Diseases ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Humans ; Hypertension ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve ; Prospective Studies ; Prostheses and Implants ; Stroke ; Ultrasonography, Doppler, Transcranial

OBJECTIVES: The purpose of this study was to make empirical evidence for a community based case management program for the first episode of psychosis. METHODS: We provided a case management program for first episode psychosis patients and assessed their symptoms, function, insight, and satisfaction using Positive and Negative Syndrome Scale (PANSS), the Health of Nation Outcomes Scales (HoNOS), Scale to assess Unawareness of Mental Disorder (SUMD), Global Assessment of Functioning Scales (GAF), and Quality of Life scales (QOL) at baseline and after the program. We also evaluated the treatment maintenance rate and the changes of their developmental task achievement. RESULTS: Significant improvement was observed in all sub-domains of PANSS and significant changes were also observed in the areas of symptoms and function of HoNOS. Significant improvement was observed in awareness of mental illness itself and its outcomes. The treatment maintenance rate was 87.5%, including three patients who stopped their medication with the doctor's order. The rate of participation in meaningful social activities, such as school or job showed an increase, from 25% at baseline to 81% after the program. CONCLUSION: Results of this study demonstrate the possibility of community programs for prevention of relapse, improvement of symptoms and function, and facilitation of return to meaningful social activities of first episode psychosis patients.
Case Management ; Humans ; Mental Disorders ; Psychotic Disorders ; Quality of Life ; Recurrence ; Weights and Measures

PURPOSE: Rapamycin (RPM) and its analogues are known for their potent immunosuppressant and anti-proliferative properties, which stem from their ability to modulate the signal transduction pathways involved in cell cycle progression from the G1 to S phase. Thus, RPM has been shown to inhibit the proliferation of a number of non-immune cell types, including hepatocytes, vascular smooth cells and fibroblasts. In addition to its effects on proliferation, RPM may also play a role in the regulation of apoptosis under certain circumstances. METHODS: The effects of RPM on the activation, proliferation and expression of cytotoxic effector molecules were examined on Molt-4 human T-lymphocyte by determining its effects on apoptosis, cell viability, reactive oxygen species (ROS) production and mitochondrial dysfunction. Cells were cultured in the presence or absence of RPM, and then analyzed by Flow cytometry after staining with PI (propidium iodide). RESULTS: The viability of Molt-4 T cells dose- and time-dependently decreased on the addition of RPM. CONCLUSION: RPM induced cytotoxicity was characterized by G2/M phase cell cycle arrest. In addition, a pharmacological scavenging study of ROS, including H2O2, revealed the cytotoxicity was mainly induced by the generation of ROS, which might modulate the expression of Bak protein and mitochondrial dysfunction.
Apoptosis ; bcl-2 Homologous Antagonist-Killer Protein ; Cell Cycle Checkpoints* ; Cell Cycle* ; Cell Survival ; Fibroblasts ; Flow Cytometry ; Hepatocytes ; Humans ; Reactive Oxygen Species ; S Phase ; Signal Transduction ; Sirolimus* ; T-Lymphocytes*