BACKGROUND: This study is aimed at the pathoanatomic correlates of depression and anxiety in acute stroke patients including subcortical lesion(periventricular hyperintensity, deep white matter hyperintensity, subcortical gray matter hyperintensity). METHODS: Sixty nine patients with acute stoke were recruited. Their brain lesions were measured using Brain MRI. Depressive or anxiety symptoms were rated by Beck depression inventory(BDI) or Beck anxiety inventory, respectively. RESULTS: There were significant correlation between depression and periventricular hyperintensity and deep white matter hyperintensity in acute stroke patients. There are no significant pathoanatomic correla- tions between anxiety and brain lesions on MRI. CONCLUSION: Our findings suggest that the white matter lesion may increase the risk of depression after stroke. Prevention of asymptomatic cerebrovascular lesion could decrease the risk of depression in acute stroke patients as well as the risk of stroke.
Anxiety* ; Brain ; Depression* ; Humans ; Magnetic Resonance Imaging ; Stroke*

BACKGROUND: This study is aimed at the pathoanatomic correlates of depression and anxiety in acute stroke patients including subcortical lesion(periventricular hyperintensity, deep white matter hyperintensity, subcortical gray matter hyperintensity). METHODS: Sixty nine patients with acute stoke were recruited. Their brain lesions were measured using Brain MRI. Depressive or anxiety symptoms were rated by Beck depression inventory(BDI) or Beck anxiety inventory, respectively. RESULTS: There were significant correlation between depression and periventricular hyperintensity and deep white matter hyperintensity in acute stroke patients. There are no significant pathoanatomic correla- tions between anxiety and brain lesions on MRI. CONCLUSION: Our findings suggest that the white matter lesion may increase the risk of depression after stroke. Prevention of asymptomatic cerebrovascular lesion could decrease the risk of depression in acute stroke patients as well as the risk of stroke.
Anxiety* ; Brain ; Depression* ; Humans ; Magnetic Resonance Imaging ; Stroke*

PURPOSE: Living donor liver transplantation (LDLT) has several difficulties in biliary reconstruction of the small and thin bile duct, the short stump, and multiple openings. METHODS: 76 cases of LDLT performed in Asan Medical Center from Jan. 1999 to Feb. 2000 were reviewed retrospectively. RESULTS: The causative diseases in this group were hepatitis B associated cirrhosis 47, hepatoma 16, fulminent hepatic failure 6, secondary biliary cirrhosis 3, alcoholic cirrhosis 2, hepatitis C associated cirrhosis 1, and Wilson's disease 1cases. Right lobe graft was done in 54 cases, and a left lobe graft was done in 22. All bile duct reconstructions were done as Roux-en-Y hepaticojejunostomy, single anastomosis in 59, a double anastomosis in 15, and a triple anastomosis in 2cases. Biliary leakage occurred in 7 cases (10.4%), and percutaneous drainage subsequently being done. Post leakage bile duct stricture occurred in 2 cases (2.6%). Delayed bile duct stricture occurred in 3 cases. All stricture cases were treated with PTBD and repeated balloon dilatation. There was no difference between the right and left lobe graft in terms of bile leakage. However, stricture, occurred only in the right lobe graft. Bile duct stricture occurred more frequently in the multiple bile ducts (5% in single duct, 13.3% in double ducts, but there's no significance). CONCLUSION: The prevalence of biliary complication of LDLT was about 10%. In addition, there were more complicationsin the right lobe and multiple bile duct openings. Therefore, careful design and delicate hepatic parenchymal dissection is important to obtain a single duct and safe cut surface of the graft. To avoid severe complications such as an intrahepatic abscess or stone, early diagnosis and treatment of biliary complications is essential.
Abscess ; Bile ; Bile Ducts ; Carcinoma, Hepatocellular ; Chungcheongnam-do ; Constriction, Pathologic ; Dilatation ; Drainage ; Early Diagnosis ; Fibrosis ; Hepatitis B ; Hepatitis C ; Hepatolenticular Degeneration ; Humans ; Liver Cirrhosis, Alcoholic ; Liver Cirrhosis, Biliary ; Liver Failure ; Liver Transplantation ; Liver* ; Living Donors* ; Prevalence ; Retrospective Studies ; Transplants

Polyarteritis nodosa is a systemic vasculitis that affects mainly small and medium-sized muscular arteries. About half of the cases, it involves gastrointestinal tract, mainly jejunum and ileum. Major clinical manifestations are bleeding, ulcer, infection, necrosis, atrophy and stricture. Gastrointestinal involvement suggests a poor prognosis. We have experienced one case of polyarteritis nodosa involving entire gastrointestinal tract that showed various endoscopic features and confirmed by renal biopsy.
Arteries ; Atrophy ; Biopsy ; Colon ; Constriction, Pathologic ; Duodenum ; Gastrointestinal Tract* ; Hemorrhage ; Ileum ; Jejunum ; Necrosis ; Polyarteritis Nodosa* ; Prognosis ; Systemic Vasculitis ; Ulcer

PURPOSE: Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies in children on a weaning diet. We investigated weaning practices in infants and children, as well as their mothers' knowledge about weaning. METHODS: We investigated 129 children with IDA and 166 without IDA (aged 6-36 months) who had visited 10 university hospitals between March 2006 and July 2007. We investigated the hematologic values of both groups. A questionnaire on weaning was answered by the mothers of these children. RESULTS: The hematologic values in the IDA group showed a significant difference from those in the comparison group (P<0.05). Children who were solely breastfed until 6 months of age were 85%, 34% (P<0.05), and weaning was started by 6.3, 6.4 months, respectively (P>0.05). Rice gruel, boiled rice, and fruit juice accounted for approximately 8 0% of the starting foods in both groups (P>0.05). Only 40% of the children in the IDA group had a balanced diet within a month, versus 38% in the comparison group. In response to questions about the necessity of iron-fortified foods for breast-fed infants, less than 50% of mothers in both groups answered correctly. In the IDA group, 42% showed serum ferritin less than 10 ng/ mL, while 92% showed serum MCV less than 72 fL. CONCLUSION: In conclusion, collection of information on history should be thorough for feeding and selective examinations for IDA in high-risk groups. Considering the adaptation period, we suggest beginning children on a weaning diet at 45 months. In addition, we need to educate mothers on weaning practice, especially on the necessity of iron-fortified foods for breast-fed infants.
Anemia, Iron-Deficiency ; Child ; Diet ; Ferritins ; Fruit ; Hospitals, University ; Humans ; Infant ; Iron ; Malnutrition ; Mothers ; Surveys and Questionnaires ; Weaning

Dieulafoy's lesion is an exposed submucosal artery associated with a minute mucosal defect in the stomach, and it is a rare cause of profuse, but intermittent gastrointestinal bleeding. Less commonly, similar lesions have been identified in the duodenum, jejunum, colon, and in rare cases, the rectum. Only four cases of rectal Dieulafoy's lesion have been reported in English Medical literature: one case involved a child, two in otherwise healthy young men, and one in on elderly man. In this report, two elderly men are described, who suffered an massive hematochezia from a small rectal mucosal defect with a visible vessel. Control of the bleeding was successfully achieved with on endoscopic sclerotherapy or hemoclipping. The fact that rectal Dieulafoy disease is one of the causes of massive hematochezia should serve as a reminder in future cases, especially involving alcoholics and elderly men.
Aged ; Alcoholics ; Arteries ; Child ; Colon ; Duodenum ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Jejunum ; Male ; Rectum* ; Sclerotherapy ; Stomach

Eosinophilia is defined as the presence of more than 500 eosinophil/mL of blood and is common in the clinical condition such as parasite infestation, drug, allergy, hypereosinophilic syndrome, and malignant diseases. Determining the cause of eosinophilia may be one of the most frustrating endeavors in clinical medicine. Hepatic infiltration of eosinophils and microabscess formation are observed in many disorders. Gastric cancer and intestinal malignancies show frequent liver metastasis and blood eosinophilia. Several cases of an early gastric carcinoma (EGC) with metastasis of the liver have been reported. When multiple intrahepatic lesions of suspicious malignancy appear in radiologic study, clinicians must differentiate malignancy from benign diseases. A case is herein reported of a 56- year-old male patient with synchronously developed, multiple low density hepatic lesions with early gastric carcinoma. He was managed with systemic chemotherapy at another hospital, because he was diagnosed with distant metastasis of early gastric carcinoma. Upon operating these lesions were proved to be EGC combined with hypereosinophilic multiple liver abscesses. This case is herein reported with a review of relevant literatures.
Clinical Medicine ; Drug Therapy ; Eosinophilia ; Eosinophils ; Humans ; Hypereosinophilic Syndrome ; Hypersensitivity ; Liver Abscess* ; Liver* ; Male ; Neoplasm Metastasis ; Parasites ; Stomach Neoplasms

BACKGROUND: Consultation and referral are important characteristics of modern medicine which has become more segmented and more specialized. In particular, they give essential value to family practitioners to coordinate patients accordingly for proper care. This study analyzed the referred patients in family practices under Cheonan practice based-research network (CPBRN). METHODS: The data was collected via questionnaire in ten family clinics under CPBRN system during the four weeks from June 15, 2006 to July 12, 2006. RESULTS: The total number of referred cases was 103 (0.7%) out of a total of 14,466 office visits. Among the total, 68.9% of referred cases was physician-drived and 31.1% was patient-requested. The reason for referral were 'to get a second opinion of specialist' (34), 'high severity' (20), 'lack of examination tool' (18), 'lack of skill' (10) and 'no response to treatment' (2) in physician-drived cases, whereas in patient-requested cases, they were 'request for advanced hospital' (26) and 'want to meet specialist' (2). The patients were referred to tertiary hospital in 66.7%, secondary hospital in 15.9%, and other specialists of primary setting in 10.1%. Overall, 66.7% of the referred hospital was located in the city area. The main health problems of referred patients was divided into 'gastrointestinal' (17.5%), 'musculoskeletal' (13.6%), 'dermatology' (10.7%) and so on. The speciality consulting physicians were 'internal medicine' (34%), 'pediatrics' (13.6%), and 'orthopedic surgery' (10.7%) specialists. CONCLUSION: The referral rate of family practice in Korea was 0.7%. The main reason for referral was 'to get a secondary opinion of a specialist'. The most common referral problem was 'gastrointestinal'. 'Internal medicine' was the most frequently consulted specialty.
Chungcheongnam-do* ; Family Practice ; History, Modern 1601- ; Humans ; Korea ; Office Visits ; Referral and Consultation* ; Specialization ; Tertiary Care Centers ; Surveys and Questionnaires

BACKGROUND: Consultation and referral are important characteristics of modern medicine which has become more segmented and more specialized. In particular, they give essential value to family practitioners to coordinate patients accordingly for proper care. This study analyzed the referred patients in family practices under Cheonan practice based-research network (CPBRN). METHODS: The data was collected via questionnaire in ten family clinics under CPBRN system during the four weeks from June 15, 2006 to July 12, 2006. RESULTS: The total number of referred cases was 103 (0.7%) out of a total of 14,466 office visits. Among the total, 68.9% of referred cases was physician-drived and 31.1% was patient-requested. The reason for referral were 'to get a second opinion of specialist' (34), 'high severity' (20), 'lack of examination tool' (18), 'lack of skill' (10) and 'no response to treatment' (2) in physician-drived cases, whereas in patient-requested cases, they were 'request for advanced hospital' (26) and 'want to meet specialist' (2). The patients were referred to tertiary hospital in 66.7%, secondary hospital in 15.9%, and other specialists of primary setting in 10.1%. Overall, 66.7% of the referred hospital was located in the city area. The main health problems of referred patients was divided into 'gastrointestinal' (17.5%), 'musculoskeletal' (13.6%), 'dermatology' (10.7%) and so on. The speciality consulting physicians were 'internal medicine' (34%), 'pediatrics' (13.6%), and 'orthopedic surgery' (10.7%) specialists. CONCLUSION: The referral rate of family practice in Korea was 0.7%. The main reason for referral was 'to get a secondary opinion of a specialist'. The most common referral problem was 'gastrointestinal'. 'Internal medicine' was the most frequently consulted specialty.
Chungcheongnam-do* ; Family Practice ; History, Modern 1601- ; Humans ; Korea ; Office Visits ; Referral and Consultation* ; Specialization ; Tertiary Care Centers ; Surveys and Questionnaires

Myocardial free wall rupture is the most serious complication of acute myocardial infarction. Although it is not uncommon, it is difficult to treat successfully. We report a case of acute inferior myocardial infarction complicated with left ventricular free wall rupture that occurred 8 hours after onset of chest pain. In this case, progression of mild pericardial effusion to cardiac tamponade was monitored by transhtoracic echocardiography. Pericardiocentesis and draninage failed to treat cardiac tamponade, and surgical repair was performed successfully. The patient discharged uneventfully on 28th day and followed regularly at the outpatient department.
Cardiac Tamponade ; Chest Pain ; Echocardiography ; Heart Rupture* ; Humans ; Inferior Wall Myocardial Infarction* ; Myocardial Infarction ; Outpatients ; Pericardial Effusion ; Pericardiocentesis ; Rupture