BACKGROUND: The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center. METHODS: Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status. RESULTS: Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients' B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum. CONCLUSIONS: Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
Basal Ganglia ; Brain* ; Cerebellum ; Cerebral Cortex ; Emergencies ; Hand ; Humans ; Hypoxia-Ischemia, Brain ; Intensive Care Units ; Magnetic Resonance Imaging* ; Neuroimaging ; Out-of-Hospital Cardiac Arrest* ; Putamen ; Retrospective Studies ; Survivors

: In order to know the species and frequency of human parasitic infection diagnosed by biopsy, 149 cases (0.18%) of parasitic infection were reviwed, which were selected from 80,947 biopsied materials submitted for routine histopathological examination during a period of 10 years from 1980 to 1989 at Department of Pathology, Chonnam National University Hospital. They consisted of 112 cases of cysticercosis, 17 paragonimiasis, 7 clonorchiasis, 4 amebiasis, 1 sparganosis, 1 enterbiasis, 1 aniskiasis, and 1 fascioliasis respectively. Based on morphological preservation of cysticercus, they could be divided into mild (20.2%), morderate (40.4%), and severe (39.4%) degeneration. Except 2 cases biopsied at the lungs, 15 cases of ectopic paragonimiasis were located at abdominal cavity (8 cases) and central nervous system (7 cases). One case of intrahepatic fascioliasis was observed. This is the 13th human fascioliasis reported in Korea. From the above results, the frequency of parasitic infections found in biopsied specimens was on the decrease as the cysticercosis and ectopic paragonimiasis.
parasitology-helminth-cestoda-nematoda-trematoda ; biopsy ; histopathology ; tissue parasite ; cysticercose ; ectopic ; Enterobius vermicularis ; Taenia solium ; Paragonimus westermani ; Clonorchis sinensis ; Entamoeba histolytica ; Anisakis ; Fasciola sp. ; paragonimiasis ; fascioliasis

To evaluate the differentiation status of smooth muscle in gastric stromal tumors which were negative for S-100 protein, immunohistochemistry using desmin, actin, myosin and vimentin was performed in 14 cases of gastric smooth muscle tumors. Ultrastructural Examination was also performed. For comparison a case of leiomyoma of the esophagus, a case of the sigmoid colon, 10 cases of the uterus were also examined. The results obtained were as follows. All gastric smooth muscle tumors showed vimentin-positivity. Six of 14 gastric smooth muscle tumors, (5 of 8 leiomyoma and 1 of 4 leiomyosarcoma) showed positivity for desmin, actin, and myosin(42.9%). All esophageal, colonic, and uterine leiomyomas showed diffuse positive reaction for desmin, actin, and myosin. Vimentin positivity was also noted in leiomyoma of the colon and uterus. Ultrastructurally, a few cells in the gastric stromal tumors had scattered microfilaments with dense bodies, subplasmalemmal dense plaques, and micropinocytic vesicles. However, most of the tumor cells did not have any of the ultrastructural features of smooth muscle differentiation. Leiomyomas of the esophagus and uterus showed many cytoplasmic microfilaments with dense bodies. These results suggest that most of the benign and malignant tumor cells of gastric stromal tumors have features of the undifferentiated cells, immunohistochemically as well as ultrastructurally, although a few cells have. It is speculated that most gastric stromal tumors may have lost their smooth muscle differentiation.

BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.
Echocardiography ; Humans ; Intensive Care Units ; Male ; Mortality* ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Stroke Volume*

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PURPOSE: Early diagnosis of neonatal sepsis is very difficult because of no specific clinical and laboratory findings. It also takes at least 48 hours of incubation period to isolate the organism by culture study. So several laboratory tests have been evaluated for their usefulness in rapid detection of the neonatal sepsis. Those are evaluated either singly or in combination with a defined scoring system include leukocyte count with differential count, platelet count, C-reactive protein level, erythrocyte sedimentation rate, haptoglobin level, fibronectin level, leukocyte alkaline phosphatase and so on. But no single test or combination with others has proved superior to the leukocyte count and differential count as a reliable indirect indicator of neonatal bacterial infection. We performed this study to determine the appropriate screening test for early detection of neonatal sepsis. METHODS: During the period of May 1991 through April 1997, we selected 200 neonates who were admitted to the neonatal intensive care unit of Kon-Kuk University Medical Center Seoul Hospital. All of the cases were retrospectively evaluated and divided two groups; sepsis group-88 neonates who were confirmed by blood cultures, and control group-112 neonates who had no evidence of neonatal bacterial infection. RESULTS: The results were as follows; 1) The sex ratio of male to female was 1.5:1 in the sepsis group and showed significant difference between two groups (P<0.05). The incidence of neonatal sepsis in prernature infant was higher in sepsis group than control group (P<0.05), and mean body weight was lower in sepsis group (2351.4148.3g) than control group (Z821.8 142.6g) significantly (P<0.05). 2) Predisposing perinatal factors associated with neonatal sepsis were premature rupture of membrane (> or = 24hrs) (14.5%) meconiurn staining (6.8%), asphyxia (Apgar score < or = 6 at 5mins) (5.7%), eclampsia and preeclampsia (4.5%), maternal infection (3.4%) and bleeding (including placenta previa, abruptio placenta) (1.1%) in order of frequency. Among th, only premature rupture of membrane was significant difference between two groups (P<0.05). Others risk factors including umbilical catheterization, endotracheal intubation, ventilatory care, total parenteral nutrition were also signi- ficant difference between two groups (P<0.05). 3) The common presenting symptoms of neonatal sepsis were jaundice (48.9%), poor feeding (45.5%), ternperature instability (43.2%), lethargy (30.7%), irritability, dyspnea, diarrhea, vomiting, tachypnea, and cyanosis in order of frequency. Among the above symptoms, poor feeding, dyspnea and cyanosis were significant difference between two groups (P<0.05). 4) The peripheral blood findings (leukocyte count, platelet count, ESR) showed no significant differences between two groups (P>0.05). The acute phase reactants (APR) score above two (37/88) and positive C-reactive protein (51/88) in the sepsis group were regarded as significantly high compared to the control group. 5) In the cases with APR score above two including positive C-reactive protein and abnormal total leukocyte count, sensitivity was 17.0%, specificity 97.3% positive predictive predictive value 83.3%, and negative predictive value 60.0%. CONCLUSIONS: The higher frequency of neonatal sepsis was proved in the cases of APR score above two including positive C-reactive protein. In the cases with abnormal total leukocyte count and APR score above two including positive C-resctive protein, the specificity was 97.3% and the positive predictive value was 83.8%. So APR score above two including positive C-reactive protein and abnormal total leukocyte count could be regarded as an useful test method for early detection of neonatal sepsis.
Academic Medical Centers ; Acute-Phase Proteins ; Alkaline Phosphatase ; Asphyxia ; Bacterial Infections ; Blood Sedimentation ; Body Weight ; C-Reactive Protein ; Catheterization ; Catheters ; Cyanosis ; Diarrhea ; Dyspnea ; Early Diagnosis* ; Eclampsia ; Female ; Fibronectins ; Haptoglobins ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Intubation, Intratracheal ; Jaundice ; Lethargy ; Leukocyte Count ; Leukocytes ; Male ; Mass Screening ; Membranes ; Parenteral Nutrition, Total ; Placenta Previa ; Platelet Count ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Risk Factors ; Rupture ; Sensitivity and Specificity ; Seoul ; Sepsis* ; Sex Ratio ; Tachypnea ; Vomiting

PURPOSE: To obtain magnetization transfer ratio(MTR) of the annulus fibrosus and nucleus pulposus and to assess the feasibility of utilizing the changes of these MTRs as an early indicator of disk degeneration. MATERIALS AND METHODS: MR images of lumbar spine with magnetization transfer(MT) technique in 42 patients were obtained. spin echo techniques (600/14) with same TR/TE with 1KHz off-resonance saturation were employed in 1.0T MR system. MTRs were calculated in two regions, anterior annulus fibrosus and nucleus pulposus, and the results were compared between the normal and degenerative disks, from grade I to IV, on T2-weighted images. RESULTS: MTRs of the nucleus pulposus were 17.6% in the normal disks, and 26.7%, 28.4%, 29.1%, 29.7% in degenerative disks, from grade I to IV, respectively, with a significant difference(P<0.05). On the other hand, MTRs in the annulus fibrosus were 30.2% in the normal disks and 31.5%, 33.2%, 32.1% and 35.6% in degenerative disks, from grade I to IV, respectively, without significant difference. CONCLUSION: Since MTRs are significantly higher in degenerative nucleus pulposus than those of the normal disks, increased MTRs in the nucleus pulposus can be used as an early sign of the degeneration of the nucleus pulposus.
Hand ; Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging* ; Spine

No abstract available.
Tuberculosis*

PURPOSE: Magnetization transfer imaging(MTI) is a new imaging contrast technique. Our MT pulse sequence is designed as fixed time interval between echo and MT pulse. This study was peformed to evaluate the influence of variations in TR/TE on MTR in T1 weighted image of normal brain tissue on this kind of MT pulse sequence. MATERIALS AND METHODS: Seven healthy volunteers in twenties of age as the objectives, MRI was taken under various TR/TE(TR/TE ;700/14, 650/14, 750/14, 700/20 and 1500/20 msec). MTR was calculated from signal intensities measured at the same point in both pre and post MT images and statisticslly analyzed. The MR imager used in this study was 1.0T Magnetom 42SP(Siemens, Erlangen, Germany) and the parameters of additional MT pulse sequence were offset 1000Hz and bandwidth 250Hz, and posteriorly located to echo with 7.7 msec fixed interval. Offset of this MT pulse was variable. RESULT: In white matter of brain tissue from a normal person, MTR was 34-39%(average 37%) for TR and TE of 700/14 in T1WI and 33-36%(average 35%) for TR/TE of 650/14, and 34-38%(average 35%) for TR/TE of 750/14 which showed no statistical difference. However, in case of 1500/20 of TR/TE, MTR was 26-28%(average 26%) which is statistically significant. With TR/TE of 700/14 as the standrd value, the MTR of gray and white matter were 37% and 29% respectively, showing a definite difference of statistical means. Signal from CSF in ventricles is rarely influenced by MT pulse. CONCLUSION: Conclusively, a subtle variation in TR/TE in T1WI has little influence on MTR but wide range of variation in TR/TE as in proton density image induces significant difference in MTR on this kind of MT pulse sequence. Therefore, the exchangeable usage of MTR data would be possible in narrow range of TR/TE change but difficult in wide range of variation.
Brain* ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Protons ; Reference Values*

The purpose of this study was to develop the CORE Program for sex offenders and to determine its effectiveness. The CORE Program was designed with an aim to achieve cognitive restructuring, improve the ability to empathize in interpersonal relationships, and enhance self-esteem and intimacy. We conducted this program over 48 sessions for 28 sex offenders. The effectiveness of the program was evaluated using the Interpersonal Responsiveness Index (IRI), Self-esteem Questionnaire (SEQ), UCLA Loneliness Scale (UCLALS), Coping Using Sex Inventory (CUSI), Rape Myth Acceptance Scale (RMAS), and Wilson's Sex Fantasy Questionnaire (WSFQ). The data were analyzed using paired t-tests. Our results showed no significant changes in the SEQ, UCLALS, and IRI scores after the treatment program. However, the scores for the CUSI, RMAS, and WSFQ significantly improved after this program. In this paper, we demonstrate the effectiveness of the CORE Program for sex offenders. We also discuss the limitations of our study and provide suggestions for future research. Our findings indicate that this treatment program should be provided to sex offenders for preventing recidivism.
Criminals ; Fantasy ; Humans ; Loneliness ; Paraphilic Disorders ; Rape ; Surveys and Questionnaires