A case of adenocarcinoma of cystic duct associated with GB empyema is presented. A 72 year old male was admitted to Kwangju Christian hospital because of abdominal pain in right upper quadrant for 4 days. He underwent explolaparotomy under the impression of GB empyema or GB cancer. For seeking causative factor of GB empyema, serial sections of cystic duct and mapping were performed. We can find adenocarcinoma of cystic duct in the specimen removed at cholecystectomy. The criteria for disgnosis of cystie duct carcinoma which was outlined by Farrar. These criteria are; 1) The growth must be restricted to the cystic duct, 2) There is no neoplastic process in the gall bladder, hepatic and common bile duct. 3) Histopathological examination must be comfirm carcinoma. Here we report a case of adenocarcinoma of cystic duct associated with GB empyema with brief review of Literature.
Abdominal Pain ; Adenocarcinoma* ; Aged ; Cholecystectomy ; Common Bile Duct ; Cystic Duct* ; Empyema* ; Gwangju ; Humans ; Male ; Urinary Bladder

OBJECTIVES: The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). METHODS: Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. RESULTS: Fifty-eight subjects with ADHD (41 boys, 7.7+/-1.3 years), 21 SIB (8 boys, 8.2+/-1.8 years), and 22 TC (8 boys, 8.5+/-2.1 years) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). CONCLUSION: These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.
Ambulatory Care Facilities ; Child ; Child Psychiatry ; Chungcheongnam-do ; Humans ; Parents ; Pregnancy ; Risk Factors* ; Siblings ; Surveys and Questionnaires

BACKGROUND: Quality control is important for accurate diagnosis of human immunodeficiency virus (HIV) infection, and proficiency testing with external quality controls is an important part of quality control. This study intended to develop and supply customized external quality controls for HIV antigen/antibody testing fitted with currently used reagents for standardization of HIV infection diagnosis and evaluation of HIV testing competency of laboratories in Korea. METHODS: Serological tests and inactivation were performed on the obtained HIV antibody positive plasma. To manufacture quality controls having the required antibody titers, dilution ratio was searched using VIDAS (bioMérieux, France), Architect (Abbott Laboratories, USA), and Cobas 8000 (Roche Diagnostics, Germany) analyzers. Diluted source plasma was divided into aliquots after filtering. Homogeneity and stability of the produced external quality controls were evaluated. RESULTS: The collected HIV antibody positive plasma was confirmed by Western blot. Dilution ratios for source plasma were produced for each analyzer showing signal-to-cut-off 2–3, 5–7, and 15–16 reactivity. Diluted plasma was made to 1 mL aliquots and total set of 1,500 external quality controls for HIV antigen/antibody were manufactured. Produced controls satisfied the required criteria of homogeneity and showed less than 10% coefficient of variation for stability except negative controls. CONCLUSIONS: Customized external quality controls were developed and qualified for HIV testing reagents used in Korea. Continuous external quality control assessment for HIV tests with controls would be required.
Blotting, Western ; Diagnosis ; HIV Infections ; HIV* ; Humans* ; Indicators and Reagents ; Korea* ; Plasma ; Quality Control* ; Serologic Tests

Primary amenorrhea due to intrasella arachnoid cyst is a very rare disease and require careful and frequent evaluation because may produce intracranial hemorrhage, elevated intracranial pressure and rapid expansion. Surgical intervention is needed only when visual disturbance, hypopituitarism or enlarging lesion is shown. Thus, we present a case of primary amenorrhea due to intrasella arachnoid cyst which was resected through the transsphenoidal approach.
Amenorrhea ; Arachnoid* ; Female ; Hypogonadism* ; Hypopituitarism ; Intracranial Hemorrhages ; Intracranial Hypertension ; Rare Diseases

The emergency arteriography have been performed in a total of 13 patiens with extermity trauma, including 9fractures, 3 blunting traumas, and 1 penetrating injury. over 17 months period. The indications were as follows:absent or diminishe pulse, swelling, sensory or motor deficit , and hypotension. Patients with an absent pulse,the most reliable indication of arterial injury, should have immediate arteriography. The superficial femoralartery was commonly injured especially with distal femoral shaft fracture. The most common arteriographic findingswas arterial occlusion.
Angiography ; Emergencies ; Extremities ; Humans ; Hypotension

Purpose: In February 2020, the first outbreak of coronavirus disease 2019 (COVID-19) occurred in Daegu, South Korea, and confirmed cases increased sharply, sparking intense anxiety among residents. This study analyzed the data of a mental health survey on students enrolled at a medical school located in Daegu in 2020. Methods: An online survey was administered to 654 medical school students (pre-medical course: 220 students, medical course: 434 students) from August to October 2020, with 61.16% (n=400) valid responses. The questionnaire included items about COVID-19-related experiences, stress, stress resilience, anxiety, and depression. Results: Of the survey participants, 15.5% had experienced unbearable stress, with the most significant stress factors (in descending order) being limited leisure activities, unusual experiences related to COVID-19, and limited social activities. Approximately 28.8% reported psychological distress, and their most experienced negative emotions were helplessness, depression, and anxiety (in descending order). The mean Beck Anxiety Inventory and Beck Depression Inventory-II scores were 2.44 and 6.08, respectively, both within normal ranges. Approximately 8.3% had mild or greater anxiety, and 15% had mild or greater depression. For students under psychological distress, the experience of unbearable stress before COVID-19 affected anxiety (odds ratio [OR], 0.198; p<0.05), and having an underlying condition affected depression (OR, 0.190; p<0.05). With respect to their psychological distress during August–October 2020 compared with that during February–March 2020 (2 months from the initial outbreak), anxiety stayed the same while depression increased and resilience decreased at a statistically significant level. Conclusion It was found that some medical students were suffering from psychological difficulties related to COVID-19, and there were several risk factors for them. This finding suggests that medical schools need to not only develop academic management systems but also provide programs that can help students manage their mental health and emotions in preparation for an infectious disease pandemic.

BACKGROUND/OBJECTIVES: As the prevalence of chronic diseases has risen, the need for straightforward diagnostic tools for monitoring nutrition status to improve nutrition counseling and disease prevention has likewise increased. This study developed an easily usable dietary behavior pattern diagnosis checklist and investigated its correlation with dietary quality index. SUBJECTS/METHODS: A draft dietary pattern evaluation tool was generated by analyzing previous studies. The draft questionnaire comprised 61 questions for assessing dietary habits. A survey was administered to 320 adults (19 to 64 years old) using the dietary pattern evaluation tool and 24-hour-recall method between March and May of 2014 in Jeonbuk province and the metropolitan area. Principal component analysis with varimax rotation was performed to identify dietary behavior patterns. Nutritional analysis was conducted using CAN-Pro 4.0, and the Diet Quality Index-International (DQI-I) was calculated to assess dietary quality. The correlation between dietary pattern scores and DQI-I scores was also analyzed. RESULTS: The factor analysis resulted in a total of 34 questions mapped to four main dietary behavior patterns: "high fat and calorie" pattern (12 questions), "overeating/binge" pattern (nine questions), "dietary impulse" pattern (eight questions), and "unbalanced food intake" pattern (five questions). The four dietary behavior patterns were negatively correlated with DQI-I adequacy and total scores (P < 0.01). CONCLUSIONS: The dietary pattern evaluation tool developed in this study can be used to diagnose a client's dietary behavior problems and is available as a nutrition counseling tool in the field.
Adult* ; Checklist ; Chronic Disease ; Counseling ; Diagnosis ; Diet ; Food Habits ; Humans ; Jeollabuk-do ; Methods ; Nutrition Assessment ; Nutritional Status ; Nutritive Value ; Prevalence ; Principal Component Analysis

BACKGROUND/OBJECTIVES: As the prevalence of chronic diseases has risen, the need for straightforward diagnostic tools for monitoring nutrition status to improve nutrition counseling and disease prevention has likewise increased. This study developed an easily usable dietary behavior pattern diagnosis checklist and investigated its correlation with dietary quality index. SUBJECTS/METHODS: A draft dietary pattern evaluation tool was generated by analyzing previous studies. The draft questionnaire comprised 61 questions for assessing dietary habits. A survey was administered to 320 adults (19 to 64 years old) using the dietary pattern evaluation tool and 24-hour-recall method between March and May of 2014 in Jeonbuk province and the metropolitan area. Principal component analysis with varimax rotation was performed to identify dietary behavior patterns. Nutritional analysis was conducted using CAN-Pro 4.0, and the Diet Quality Index-International (DQI-I) was calculated to assess dietary quality. The correlation between dietary pattern scores and DQI-I scores was also analyzed. RESULTS: The factor analysis resulted in a total of 34 questions mapped to four main dietary behavior patterns: "high fat and calorie" pattern (12 questions), "overeating/binge" pattern (nine questions), "dietary impulse" pattern (eight questions), and "unbalanced food intake" pattern (five questions). The four dietary behavior patterns were negatively correlated with DQI-I adequacy and total scores (P < 0.01). CONCLUSIONS: The dietary pattern evaluation tool developed in this study can be used to diagnose a client's dietary behavior problems and is available as a nutrition counseling tool in the field.
Adult* ; Checklist ; Chronic Disease ; Counseling ; Diagnosis ; Diet ; Food Habits ; Humans ; Jeollabuk-do ; Methods ; Nutrition Assessment ; Nutritional Status ; Nutritive Value ; Prevalence ; Principal Component Analysis

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

OBJECTIVE: The purpose of this study is to report the technical feasibility and the result of one stage operation for the bursting fracture of the thoracolumbar spine by posterior approach. METHODS: Seven patients underwent corpectomy and replaced the space with titanium mesh cage filled up with autologous bone pieces through unilateral posterior route after removal of the facet joint and the pedicle followed by pedicle screw fixation at the same surgical field. RESULTS: All patients tolerated the procedures well except one patient complicated with air embolism. Postoperative radiographs showed effective decompression and well placed instruments. Preoperative neurological deficits disappeared completely in two patients but some deficits persisted in the remainders. In two patients, epidural venous bleeding was troublesome and he needed transfusion of 5 pints of packed red blood cell. And another patient complicated with air embolism during operation was recovered with impunity after operation. To insert the mesh cage through the narrow corridor posterolaterally, it was unavoidable to sacrifice one spinal root. CONCLUSION: In spite of technical difficulty, one stage spondylodesis for the bursting thoracolumbar spine though unilateral posterior approach seem to be an effective operative procedure.
Decompression ; Embolism, Air ; Erythrocytes ; Hemorrhage ; Humans ; Spinal Fractures ; Spinal Fusion* ; Spinal Nerve Roots ; Spine* ; Surgical Procedures, Operative ; Titanium ; Zygapophyseal Joint