No abstract available.
Hemorrhage*

No abstract available.
Drainage* ; Prognosis*

PURPOSE: To investigate the association of carotid intraplaque hemorrhage (IPH) with acute cerebral ischemic events and progression of stenosis using magnetic resonance (MR) imaging. MATERIALS AND METHODS: From April 2014 to December 2016, 53 patients underwent carotid plaque MR imaging, including magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) sequence. A total of 66 carotid arteries in 53 patients had carotid stenosis, and they were included in this study. Carotid arteries were classified according to the presence of IPH, the age of hemorrhage, and degree of stenosis. We assessed ipsilateral cerebrovascular event rates and progression of stenosis between the IPH and no-IPH groups. RESULTS: Of the 61 carotid arteries assessed, 34 (56%) had IPH, and 27 (44%) had no IPH. Acute cerebral ischemic events were more frequent in the IPH group (47% vs. 22%, P = 0.045), especially in the < 30%-stenosis group (100% vs. 0%, P = 0.028). However, there was no significant difference in the incidence of ischemic events according to the age of hemorrhage (50% vs. 44%, P = 0.492). Among the 61 carotid arteries, 20 carotid arteries had previously undergone carotid artery imaging and were evaluated for plaque progression. The trend for progression of stenosis favored the IPH group versus the no-IPH group, with a marginal P-value (20% ± 12.7 vs. 9.6% ± 5.7, P = 0.063). CONCLUSION: IPH was associated with an increased incidence of acute ischemic events, especially in the mild-stenosis group and it was also associated with progression of stenosis. Evaluation of the carotid IPH by carotid plaque MR could improve discrimination of carotid plaques that cause ischemic events and progression of stenosis.
Carotid Arteries ; Carotid Stenosis ; Constriction, Pathologic* ; Discrimination (Psychology) ; Hemorrhage* ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Stroke

Herpes zoster as a result of reactivated varicella-zoster virus is characterized by vesicular eruptions on skin and painful neuralgia in the dermatome distribution. Pain during an acute phase of herpes zoster has been associated with a higher risk of developing postherpetic neuralgia. The current therapies for herpes zoster including analgesics and sympathetic nerve block as well as antiviral agents are important to alleviate pain and prevent postherpetic neuralgia. However, in some cases, the pain does not respond well to these treatments. We had a case in which a patient with herpes zoster did not respond to conventional therapy so we attempted to administer intravenous infusion of vitamin C which resulted in an immediate reduction in the pain.
Analgesics ; Antiviral Agents ; Ascorbic Acid ; Autonomic Nerve Block ; Herpes Zoster ; Herpesvirus 3, Human ; Humans ; Infusions, Intravenous ; Neuralgia ; Neuralgia, Postherpetic ; Skin ; Vitamins

A 41-year-old male patient presented with idiopathic persistent hiccups. The hiccups did not respond to pharmacologic treatments including cisapride, omeprazole, and baclofen. Phrenic nerve block was also ineffective. However, the persistent hiccups were successfully treated with short-term positive pressure ventilation using a short-acting muscle relaxant.
Adult ; Baclofen ; Cisapride ; Hiccup ; Humans ; Male ; Muscles ; Omeprazole ; Phrenic Nerve ; Positive-Pressure Respiration

Angiosarcoma is a very rare malignant tumor of endothelial cell origin. We experienced a case of angiosarcoma presented with massive pleural effusion, which was considered as a metastasis from right kidney. A 44-year-old male patient was admitted due to dyspnea for one month. He had a history of transient hematuria 3 months before admission, which disappeared spontaneously Chest roentgenography showed total haziness in left hemithorax with multiple nodular shadows in right lung. Abdominal ultrasonogram showed a single heterogeneous hyperechoic mass, measuring about 7.3×7.1×6.5cm in size in the upper and mid-pole of the right kidney, involving. renal sinus. Computed tomography of the chest revealed highly enhanced multiple pulmonary and subpleural nodules with loculated pleurisy. In bronchoscopic finding, a fungating, hypervascular tumor mass was noticed at the orifice of anterior basal segment of left lower lung after removal of tenaceous mucus Pleural and bronchoscopic biopsies showed findings of angiosarcoma confirmed by immunochemical stains with factor VIII related antigen(+), laminin(+) and vimentin(+), and by characteristic electronmicroscopic findings. Massive pleural effusion was controlled with several times of pleurodesis in both pleural spaces.
Adult ; Biopsy ; Coloring Agents ; Dyspnea ; Endothelial Cells ; Factor VIII ; Hemangiosarcoma* ; Hematuria ; Humans ; Kidney ; Lung ; Male ; Mucus ; Neoplasm Metastasis ; Pleural Effusion* ; Pleurisy ; Pleurodesis ; Radiography ; Thorax ; Ultrasonography

Purpose: The purpose of this study was to estimate the medical expenditures for poisoning patients in Korea using data from National Health Insurance and the Korea Health Panel Survey. Methods: The operational definition of poisoning was the presence of Korean Standard Classification of Diseases codes from T36 to T65. The number of poisoning patients, the amount of legal copayments, and benefit and non-benefit costs were extracted from both databases. The frequency of emergency, inpatient, and outpatient treatment utilization by poisoning patients was determined, and medical expenses were calculated. Linear regression analyses were performed to investigate factors affecting the medical expenses of poisoning patients. Results: The number of poisoning patients increased from 97,965 in 2011 to 147,984 persons in 2020. Medical expenses also increased by 74% from Korean won (KRW) 30.1 billion to KRW 52.3 billion, and benefit costs also increased by 79%. The average outpatient cost per person was KRW 67,660, and the inpatient cost was KRW 1,485,103. The average non-benefit medical expenses were KRW 80,298, accounting for about 16.2% of the total expenses. Multivariable analysis showed that the total expenditure was associated with economic status and disabilities. Conclusion The average medical expenditure per poisoning patient was KRW 534,302 in 2020, and poisoning-related costs gradually increased during the study period. Further research on the economic burden of poisoning should include indirect costs and reflect disease-adjusted life years.

High levels of cortisol in blood are frequently observed in patients with major depressive disorders and increased cortisol level induces depressivelike symptoms in animal models. However, it is still unclear whether maternal cortisol level during pregnancy is a critical factor resulting in neuropsychiatric disorders in offspring. In this study, we increased cortisol level in rats by repetitively injecting corticosterone subcutaneously (Corti.Mom, 20 mg/kg/day) during pregnancy and evaluated the behavioral patterns of their pups (Corti.Pups) via forced swimming (FS), open field (OF), elevated plus maze (EPM) and Morris water maze (MWM) tests during the immediate post-weaning period (postnatal day 21 to 25). In results, corticosterone significantly increased plasma cortisol levels in both Corti.Moms and Corti.Pups. Unlike depressive animal models, Corti.Pups showed higher hyperactive behaviors in the FS and OF tests than normal pups (Nor.Pups) born from rats (Nor.Moms) treated with saline. Furthermore, Corti.Pups spent more time and traveled longer distance in the open arms of EPM test, exhibiting higher extremity. These patterns were consistent with behavioral symptoms observed in animal models of attention deficit hyperactivity disorder (ADHD), which is characterized by hyperactivity, impulsivity, and inattention. Additionally, Corti.Pups swam longer and farther to escape in MWM test, showing cognitive declines associated with attention deficit. Our findings provide evidence that maternal cortisol level during pregnancy may affect the neuroendocrine regulation and the brain development of offspring, resulting in heterogeneous developmental brain disorders such as ADHD.

OBJECTIVE: To determine the dincal significance of placenta previa totalis. METHODS: Maternal and neonatal medical rerords were reviewed retrospectively. Between March 1990 and June 1997, sixty-nine pregnant women with placenta previa totalis delivered at Asan Medical Center. Diagnosis of placenta previa totalis was confirmed during cesarean section. RESULTS: Mean maternal age at diagnosis was 31.7+ 3.9 years and 3 patients(4.3%) were nullipara. Fifty two patients(75%) had the history of vaginal bleeding during their index pregnancy and seventeen of 52 patients were admitted more than once. Median gestational age at the time of initial bleeding episode was 33.2 weeks(range 23.5-41. 1) and median interval from the first admission to delivery was 11 days(range 1-63), Major placental implantation site was posterior uterine wall(64%, 44/69). Six cases(8%) were complicated with placenta accreta or increta and no case was combined with abruptio placentae. Estimated blood loss at the time of cesarean section was 1,510+/-952ml(mean+/-SD) and 43 patients(62%) were transfused. No case was complicated with disseminated intravascular coagulation. Eight patients(11.6%, 8/69) underwent cesarean hysterectomy because of uncontrollable bleeding. Thirty four patients(49.3%) delivered their babies before 37 weeks of gestation. The mean gestational age at delivery was 36.4+/-3.0 weeks(mean+/-SD). Major neonatal morbidity was respiratory distress syndrome(20.3%, 14/69). Perinatal death rate was 4.3%(3/70). CONCLUSION: Because pregnant women complicated with placenta previa totalis have high probability for transfusion and cesarean hysterectomy, these patients should be managed cautiously and thoroughly. The most frequent neonatal morbidity was respiratory distress syndrome due to preterm delivery.
Abruptio Placentae ; Cesarean Section ; Chungcheongnam-do ; Diagnosis ; Disseminated Intravascular Coagulation ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hysterectomy ; Maternal Age ; Mortality ; Placenta Accreta ; Placenta Previa* ; Placenta* ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; Uterine Hemorrhage

OBJECTIVE: To evaluate the usefulness of serum CA 125, CA 19-9, and eosinophil as biological markers for the diagnosis and recurrence of endometriosis. METHODS: One hundred seventeen patients who underwent operations for endometriosis between January 2000 and December 2006 at our department were included. A total of 50 reproductive aged women who visited our health care center were the control group. Data on serum level of CA 125, CA 19-9, and eosinophil was collected. Patients symptoms, sonographic findings, stage, treatment, recurrence were also collected. Venous blood sampling was performed 1 month before operation and 1 to 6 months after operation. We analyzed the serum level of CA 125, CA 19-9, and eosinophil according to the endometriosis stage and symptoms. We also analyzed the differences between preoperative and postoperative serum marker levels. RESULTS: The serum level of CA 125 and CA 19-9 was available in 88 patients and 45 patients, respectively. The mean eosinophil count was significantly lower in endometriosis group than in control group. In comparison between preoperative values and postoperative values, the CA 125 and CA 19-9 level showed significant reduction (P<0.05), however the eosinophil level showed no difference. The positive rate of serum CA 125 and CA 19-9 were 68.9% and 60.0% as a single test, whereas the combined positive rate of CA 125 and CA 19-9 was 82.2%. CONCLUSION: For the diagnosis and follow-up of endometriosis, serum CA 125 and CA 19-9 combination test will be valuable. Serum eosinophil count seems to be unsuitable for the screening and follow up test of endometriosis.
Aged ; Biomarkers ; Delivery of Health Care ; Endometriosis ; Eosinophils ; Female ; Follow-Up Studies ; Humans ; Mass Screening ; Recurrence