We report a caae of hepatic and intestinal infestation with paragonimus wewstermani complicating abscess formation. The pathway by which the paragonimus westermani reaehea liver and intestine is not well understood. However, there was possiblity that it may become lodged in other organs that the lung because of polonged larval migrations through the diaphragm or into various sites in the abdomen. The patient, 52-year-old female gave a history of having reyeatedly consumed raw crabs. An x-ray film of the chest showed clear lunga Skin test for paragonimus-westermani was positive. Abdominal ultrasonogram showed enlargement of the liver with multiple hypoechoic lesiona ERCP revealed multiple ie lesions in the right lobe of the liver. Abdaminal CT showed multifocal abscess cavities with slight rim enhancements. Above meetioned diagnostic procedures suggested liver abscess or hepatoma. Then, an exploratory laparotomy was done for a definite diagnosis, Frozen biopsy, from liver and surgically exe mass from ileocecal region revealed extrpulmonary paragnomiasis involving liver and cecum. Thus, the patient was treated with prasiquantel. Three months later, abdominal ultrasonogram demonstrated slight enlargement of the liver but no evidence of abnormal mass like lesions.
Abdomen ; Abscess ; Biopsy ; Carcinoma, Hepatocellular ; Cecum* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diaphragm ; Female ; Humans ; Intestines ; Laparotomy ; Liver Abscess ; Liver* ; Lung ; Middle Aged ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Praziquantel ; Skin Tests ; Thorax ; Ultrasonography ; X-Ray Film

Purpose: Various intervention strategies are needed to reduce the suicide rate among late adolescents. Therefore, we aimed to investigate the factors that can help overcome suicidal tendencies in late adolescents from the perspective of case managers. Methods: This qualitative study explored the reinforcing factors that can help overcome suicidal behaviors in late adolescents, by conducting focus group interviews with case managers from the local community. Interviews with 10 case managers were recorded and transcribed, and the data were analyzed using the content analysis method. Results: The main theme of this study was “a step in a new direction”. Three categories were derived: “inner changes”, “another possibility opened up by the interest of significant others”, and “connecting with community resources to help overcome”. Each category had subcategories that influenced the intention and course of action of behaviors to overcome the suicide crises. Conclusion Our findings, from the exploration of the experiences of case managers, provide an in-depth understanding of the reinforcing factors for overcoming suicide among late adolescents. They provide useful preliminary data for the development of effective suicide prevention programs for the adolescents.

PURPOSE: F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been proven to be useful in the differential diagnosis of breast mass and staging of breast cancer. This study assessed the diagnostic accuracy of F-18-FDG PET in the differentiation of breast mass and staging of breast cancer. MATERIALS AND METHODS: Total 42 patients who had breast mass underwent F-18-FDG PET (all female, 40+/-10 year old). We compared F-18 FDG PET results with pathologic findings in 24 patients RESULTS: In the differentiation of breast mass, sensitivity and specificity were 95% (19/20) and 77% (7/9) respectively. Three false positive cases were due to inflammation and one false negative patient had small tumor less than 1 cm. In the assessment of axillary lymph node status, sensitivity and specificity were 73% (8/11) and 100% (7/7) respectively. We found distant metastasis that were not suspected before F-18-FDG PET in 2 patients. CONCLUSION: F-18-FDG PET shows good diagnostic performance in differentiation of breast mass and staging of breast cancer.
Breast Neoplasms* ; Breast* ; Diagnosis, Differential* ; Female ; Humans ; Inflammation ; Lymph Nodes ; Neoplasm Metastasis ; Positron-Emission Tomography ; Sensitivity and Specificity

Purpose: The aim of this qualitative study is to explore the health problems and coping experiences of middle-aged and elderly women in the community. Methods: A total of five focus group interviews were conducted with three groups of middle-aged and two groups of elderly women. All interviews were recorded and transcribed. Data were analyzed using the content analysis method. Results: Health problems were categorized as confusion caused by problems that are difficult to handle alone in the middle-aged group and suffering originated by confronting changes in roles and environment in the elderly group. The health problems included stress, suffering, anxiety and social withdrawal as subcategories for the middle-aged women, and the stress, sense of loss, fear, and limited social activities caused by their life events for the elderly women. Meanwhile, the contents of categories about coping were revealed as the beginning of care for the body and mind for healthy life in the middle-aged group and active practice with insight into a healthy lifestyle in the elderly group. While the middle-aged women focused on themselves, attempted changes and started to take care of themselves, the elderly women interacted with the outside world, hardened their mind, made efforts for a dignified death, and managed health by their own methods. Conclusion There were differences in the experiences of middle-aged and elderly women in accepting their health problems and coping. Nursing interventions reflecting these findings can help to manage and promote the health of middle-aged and elderly women based on an integrated perspective.

BACKGROUND: Cardiovascular autonomic dysfunction is one of the most frequent non-motor symptoms in idiopathic Parkinson disease (IPD). Several cardiovascular autonomic indexes (CAIs) have been reported to represent the degree of autonomic dysfunction in various neurodegenerative diseases. However, quantitative assessment by autonomic function tests in IPD has not been fully evaluated yet. The aim of this study is to investigate the usefulness of the quantitative autonomic test for detecting subclinical cardiovascular autonomic dysfunction and their correlation to the clinical severity of motor symptoms in IPD. METHODS: Four parasympathetic and sympathetic indexes during cardiovascular autonomic tests were compared between patients with IPD (n=31, age=65.8+/-9.14, Hoen&Yahr (H&Y) stage=2.1+/-0.68) and age matched healthy controls (n=30, age=63.2+/-7.56). Parasympathetic indexes include expiration:inspiration ratio (E:I ratio), valsalva ratio, 30:15 ratio, and vagal barosensitivity. Sympathetic indexes are pressure recovery time, sympathetic index 1, sympathetic index 3 and adrenergic baroseneitivity. To demonstrate the correlation between severity of clinical motor symptoms and the autonomic abnormality, we also compared the H&Y stage and the abnormalities of those CAIs. RESULTS: E:I ratio (p=0.009) and Valsalva ratio (VR) (p<0.001) were significantly different between IPD and control groups. Among the parameters, E:I ratio (r=-0.466, p=0.005) showed significant negative correlation with severity of clinical motor symptoms in IPD (H&Y< or =3). CONCLUSIONS: Among the CAIs, E:I ratio, VR are useful in detecting subclinical autonomic cardiovascular dysfunction in IPD. E:I ratio may be the possible evaluation method revealing the severity of clinical motor symptoms in IPD.
Humans ; Neurodegenerative Diseases ; Parkinson Disease*

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. MATERIALS AND METHODS: The study population was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 p;tients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. RESULTS: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. CONCLUSION: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis.
Biopsy ; Diagnosis ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Osteomyelitis ; Sensitivity and Specificity

No abstract available.
Brain* ; Glucose* ; Metabolism* ; Vomiting*

No abstract available.
Electromyography ; Leg* ; Myelitis* ; Spasm*

No abstract available.
Electromyography ; Leg* ; Myelitis* ; Spasm*

OBJECTIVE: Sensory symptoms are common in patients with Parkinson disease (PD), although its exact prevalence and causes are not well known. We aimed to investigate whether peripheral pathology contribute to chronic sensory symptoms in patients with PD by nerve conduction test. METHODS: We recruited consecutively 34 patients with clinically probable PD (Hoehn-Yahr stage, 1–3) who developed persistent sensory symptoms in their lower extremities during optimal dopamine replacement therapy. Twenty-five patients who are above age of 70 or have other possible causes of neuropathy as determined by laboratory testing or medical record were excluded. Age- and gender-matched PD patients with same disease severity who have never developed sensory symptom during the same period were allocated to paired controls. Total 18 subjects participated in this study. Nerve conduction tests on peroneal motor nerve and sural sensory nerve were performed in all subjects. Amplitude and conduction velocity were compared between the paired subjects using Wilcoxon signed rank test. RESULTS: Subjective sensory symptoms of the 9 patients were variable: pain (4/9), chilling (3/9), burning (1/9), and tingling sense (1/9). There were no significant difference of mean values of compound muscle action potential/sensory nerve action potential amplitude and conduction velocity between patients and their paired controls. CONCLUSION: This study supports the hypothesis that the origin of chronic sensory symptoms in PD patients is more central than peripheral.
Action Potentials ; Burns ; Dopamine ; Humans ; Levodopa* ; Lower Extremity ; Medical Records ; Neural Conduction* ; Parkinson Disease* ; Pathology ; Prevalence