PURPOSE: To evaluate the various phosphorus metabolism' of breast tumors with use of in vivo phosphorus-31 (31P) M R spectroscopy (MRS) MATERIALS AND METHODS: Five patients with breast tumor (benign in two, malignant in three) and three normal healthy volunteers participated in this study. All in vivo31P MRS examinations were performed on 1.5 Twhole-body MRI/MRS system by using a Free Induction Decay (FID) pulse sequence. Tl-weighted MR images were used for localization of tumors. Peak areas for each phosphorus metabolite were measured using a Marquart algorithm. RESULTS: Breast carcinoma had a substantially larger phosphomonoester (PME) and a smaller phosphocreatine (PCr) peak intensity than normal breast tissue. This was reflected in the relatively higher PME/PCr ratio of breast carcinomas as well as phosphodiester (PDE)/PCr, inorganic phosphate (Pi)/PCr, and adenosine triphosphate (ATP)/PCr ratios, compared with normal controls. The mean pH value of breast tumor demonstrating the alkaline nature was higher than that of normal controls. Spectral patterns between benign breast disease and normal breast tissue were quite similar, and differentiation was not established. CONCLUSION: Our preliminary study suggests that in vivo 31P MRS is a noninvasive examination which may be useful in the early differentiation of malignant breast tumors from normal and benign conditions. However, normal control and benign conditions could not be characterized on the basis of the phosphorus metabolite ratios.
Adenosine Triphosphate ; Breast Diseases ; Breast Neoplasms* ; Breast* ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Magnetic Resonance Spectroscopy* ; Phosphocreatine ; Phosphorus ; Spectrum Analysis

Acute-phase rehabilitation hospitals focus on managing disabilities, reducing sequelae and symptoms, and enhancing social reintegration, to provide patients with the highest possible independence and the best quality of life. In order to achieve these goals, it is necessary to ensure the appropriate length of hospital stays based on a consideration of disease severity and patients' potential for rehabilitation, as well as to provide multidisciplinary rehabilitation. Multidisciplinary rehabilitation has been shown to be effective in the management of complex or severe conditions. Hospitals should include rehabilitation centers (specialized rehabilitation units) for patients with complex or severe needs. Starting in acute settings, specialized rehabilitation wards provide intensive, highly specialized interventions to restore function to patients with complex rehabilitation needs. Financial resources should be allocated to rehabilitation services to implement recommendations for the delivery of medical services In Korea, the appropriate allocation of resources for rehabilitation could increase both the availability and the quality of rehabilitation services by facilitating the establishment of specialized rehabilitation units in acute settings.
Delivery of Health Care ; Humans ; Korea ; Length of Stay ; Quality of Life ; Rehabilitation Centers ; Rehabilitation* ; Resource Allocation

OBJECTIVES: The purpose of this study was to evaluate the psychometric properties of the Korean version of the Readiness to Change Questionnaire-Treatment version (RCQTV-K). METHODS: The participants were 92 patients who were seeking treatment of alcoholism in two hospitals for alcoholism. A confirmatory factor analysis was performed to test whether the factor structure of the RCQTV-K was consistent with the English version. Convergent validity was assessed by correlating the scores on the RCQTV-K with those on other scales (Alcohol Abstinence Self-Efficacy Scale, Beck Depression Inventory, Korean Version of Alcohol Use Disorders Identification Test). RESULTS: The factor structure of the RCQTV-K was consistent with the three-factor structure established for the original RCQTV. Cronbach's alpha was high, indicating that the reliability of the items for each subscale was satisfactory. Allocated stage of change showed significant differences among the scores on the other scales. CONCLUSION: The results of the present study indicate that the RCQTV-K is an effective and valid scale for evaluating the stage of readiness to change in patients seeking treatment for alcoholism. The findings suggest that the RCQTV-K is a promising assessment tool for use in the treatment and study of alcoholism.
Alcoholism ; Depression ; Humans ; Psychometrics ; Surveys and Questionnaires ; Reproducibility of Results ; Weights and Measures

BACKGROUND: Propofol can produce a dose-dependent reduction in blood pressure by providing titratable sedation and rapid recovery. It has been reported that a combination of midazolam and propofol resulted in the significant reduction in the total dose of propofol needed. It was hypothesized that the addition of low-dose midazolam to propofol may provide sufficient sedation without compromising the hemodynamic stability. METHODS: A total of 40 consecutive patients were randomly assigned to one of two groups (n = 20 each). Group M-P received a bolus of 0.02 mg/kg of midazolam, followed by a propofol infusion with a fixed target concentration of 1.0microgram/ml. Group P received only a propofol infusion with an initial target plasma concentration of 2.5microgram/ml. Subsequent titration of the infusion rates in Group P or the additional midazolam boluses in Group M-P were made in order to maintain a predetermined sedation level. RESULTS: In Group P, a mean dose of 5.4 +/- 0.7 mg/kg/h propofol was used compared with 2.7 +/- 0.5 mg/kg/h in Group M-P (P<0.0001, plus additional 2.96 +/- 1.8 mg of midazolam). Ephedrine was administered to 15 patients in Group M-P and 17 patients in Group P. Recovery was significantly fast (Group P, 6.8 +/- 2.9 min vs. Group M-P, 9.8 +/- 4.4 min, P<0.05). CONCLUSIONS: Sedation with propofol plus midazolam requires a lower total dose of propofol compared with propofol alone but has no superior hemodynamic stability. A further study using younger patients and combinations of different doses of each drug will be needed.
Anesthesia, Spinal* ; Blood Pressure ; Ephedrine ; Hemodynamics ; Humans ; Hypotension ; Midazolam ; Plasma ; Propofol* ; Prospective Studies*

Brunners gland adenoma is a benign epithelial tumor of the duodenum originating from submucosal Brunners gland. This is an extremely rare entity that account for only 10.6% of benign duodenal tumor, which are themselves relatively rare, representing 0.008% of all surgical and autopsy specimens. The clinical manifestation are nonspecific gastrointestinal complaints, such as bloating or epigastric pain, and the tumor gives rise to melena or anemia, due to the ulceration or erosion of the tumor. The diagnosis is usually made by radiologic studies and gastroduodenal endoscopy which can also provide definitive treatment. The aim of treatment is complete removal of the lesion and exclude malignancy. We report on 4 cases of Brunners gland adenoma which was confirmed by operation or endoscopic polypectomy.
Adenoma* ; Anemia ; Autopsy ; Diagnosis ; Duodenum ; Endoscopy ; Melena ; Ulcer

Background: FSS is a normal variants in Korea, but some of them had defect of noctumal GH pulse i.e. neurosecretory dysfunction. Although Korean children had strikingly got higher final height in the last decade. We are interested in what kinds of differences were existed in FSS group. Previous study showed theres no difference of GH related biochemical markers between normal and FSS group, like IGF-I, IGFBP-3 etc. We analyzed molecular difference in FSS group. Methods: We screened 23 FSS patients and 16 normal controls to IGF-I gene prornoter region with PCR-SSCP (single strand conformation polymorphisrn) method and sequenced 1 FSS patients who had abnormal SSCP band. Results: We found 1 out of 23 patients with abnormal SSCP band (none for 16 controls). Their IGF-I promoter gene were sequenced with modified Maxam-Gilbert method. One subject had 2 point mutations(+8 and +74). Conclusion: We found point mutations of IGF-I promoter in FSS group, This position was regarded as HNF(hepatic nuclear factor)-3 binding sites. We needed more study for the detection of its biological function according io linear growth with in vivo and in vitro study.
Binding Sites ; Biomarkers ; Child ; Humans ; In Vitro Techniques ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Jupiter ; Korea ; Methods ; Point Mutation ; Polymorphism, Single-Stranded Conformational

A functioning paraganglioma is a rare catecholamine-producing tumor that arises from the extra-adrenal chromaffin tissue. Recently we experienced a case in which a 42 year-old male patient with a functioning extra-adrenal paraganglioma mimicked an acute coronary syndrome. A functioning extra-adrenal paraganglioma was diagnosed by means of a biochemical study and a radiological imaging study. After stabilizing his blood pressure, using alpha adrenergic blocker, we successfully removed a 6?cm sized paraganglioma from between the aorta and the IVC in the retroperitoneal space.
Acute Coronary Syndrome* ; Adrenergic Antagonists ; Adult ; Aorta ; Blood Pressure ; Humans ; Male ; Paraganglioma* ; Paraganglioma, Extra-Adrenal ; Retroperitoneal Space

Twenty-six nalidixic acid-resistant Shigella sonnei strains isolated from 1982 to 2001 and 56 nalidixic acid-resistant mutants induced by quinolone drugs from susceptible wild strains were analyzed by sequencing the gyrA gene. All the 22 nalidixic acid-resistant isolates from 1998 to 2001 showed identical amino acid substitution of Ser to Leu (TCG --> TTG) at codon 83 while 7 different mutation types were detected in artificially induced nalidixic acid-resistant mutants. Asp87 (GGC) type was observed most commonly among mutants induced by nalidixic acid while Ser83 (TTG) type was common among mutants induced by ciprofloxacin or norfloxacin. All the isolates collected between 1998 and 2001 showed identical or nearly identical pulsed-field gel electrophoresis pattern. These results suggest that the explosive increase of S. sonnei infection after 1998 was mainly due to the spread of restricted number of clones resistant to nalidixic acid.
Amino Acid Substitution ; Ciprofloxacin ; Clone Cells ; Codon ; Electrophoresis, Gel, Pulsed-Field ; Epidemiology ; Molecular Epidemiology* ; Nalidixic Acid* ; Norfloxacin ; Shigella sonnei* ; Shigella*

Coexistence of moyamoya disease and Graves' disease is rare. A 41-year-old woman presented with symptoms of left-sided hemiparesis and dysarthria. Magnetic resonance imaging and angiography revealed acute infarction of the right thalamus and occipital lobe with complete obstruction of the distal internal carotid arteries and obstruction of the right P2. Free thyroxine, thyroid-stimulating hormone (TSH), and TSH receptor antibody levels were 79.33 pmol/L, 0.007 uIU/mL, and 151.5 u/L, respectively. She received antiplatelet therapy and standard antithyroid drug dose. After admission, seizure and unexplained fever occurred. The thyroid storm score (Burch and Wartofsky scale) was 90 points. After intensive treatment, mental status and thyrotoxicosis-related symptoms ameliorated and vital signs stabilized. We describe a case of thyroid storm following cerebrovascular ischemic events in a Korean woman with moyamoya disease and Graves' disease. Thyroid storm combined with cerebrovascular events can lead to severe morbidity and mortality. Prompt recognition and strict management are crucial.
Adult ; Angiography ; Carotid Artery, Internal ; Cerebral Infarction* ; Dysarthria ; Female ; Fever ; Graves Disease ; Humans ; Infarction ; Magnetic Resonance Imaging ; Mortality ; Moyamoya Disease* ; Occipital Lobe ; Paresis ; Receptors, Thyrotropin ; Seizures ; Thalamus ; Thyroid Crisis* ; Thyroid Gland* ; Thyrotropin ; Thyroxine ; Vital Signs

Ectopic breast tissue may be seen along a diagonal line drawn from axilla to groin and it is rare with only a few reports in the world. There is a relatively frequent occurrence of ectopic breast tissue close to the breast or in the axilla, but the vulvar location is rare. We experienced a case of ectopic breast tissue in the vulva and reported it with brief review of literatures.
Axilla ; Breast* ; Groin ; Vulva*