Young adult stroke is not rare disease and have diverse causes. We studied 135 young adults aged 15 - 45 years who had been admitted to Severance Hospital with a diagnosis of cerebral infarction from January 1990 to June 1995. The results are as follows. 1. The diverse causes of earshot infarction in young adults have been found in most patients(88.2%). The major causes of cerebral infarction in young adults were atherosclerosis(32.6%) and cardioembolism(32.6%). The causes were significantly different between younger(15 - 30 years old) and older(31 - 45 years old) patients. 2. The major risk factors of atherosclerotic cerebral infarction were hypertension(29 patients), smoking(14 patients), and hyperlipidemia(11 patients). 3. The major causes of cardioembolism were valvular heart disease(21 patients) and prosthetic valve(I0 patients). The mitral valve prolapse was discovered only in one patient. 4. Fourteen patients had non-atherosclerotic vasculopathies. The moyamoya disease was the most common cause of them. 5. The other causes of cerebral infarction were found in 17 patients and the major causes were alcohol intoxication and postoperative thromboembolism. 6. The cerebral infarction occurred mostly in the carotid artery territory(95 patients) and the distribution of the involved vascular territory was not different between younger and older age groups. 7. The clinical outcomes were good in most patients (86, 7%). From the above results, we demonstrated that young adults with cerebral infarction had various causes and showed favorable clinical outcomes. We also found that the causes of cerebral infarction varied between younger and older groups. Our findings suggest that careful and thorough case-by-ease evaluation may be mandatory to clarify the causes of cerebral infarction in young adults.
Carotid Arteries ; Cerebral Infarction* ; Diagnosis ; Heart ; Humans ; Infarction ; Mitral Valve Prolapse ; Moyamoya Disease ; Rare Diseases ; Risk Factors ; Stroke ; Thromboembolism ; Young Adult*

Purpose: : This study aimed to comprehensively understand the work experience of the person in charge of the adequacy evaluation of small-and medium-sized hospitals and explore its meaning and essence in-depth. Methods: : This was a descriptive qualitative study. The study participants were 10 nurses who understood the purpose of this study and participated voluntarily. Data collection was conducted via in-depth interviews in January 2021. The interviews were conducted 1-2 times per participant and lasted approximately 40-50 minutes per session. Data analysis was performed using a qualitative content analysis. Results: : The work experience of the person in charge of the adequacy evaluation of small-and medium-sized hospitals included four themes: “difficulty in preparing for evaluation,” “negative views on evaluation,” “lack of a support system,” and “positive improvements and changes due to an evaluation.” Conclusion : Based on the above results, an education program and support system should be developed to strengthen the competence of nurses in charge of the adequacy evaluation of small- and medium-sized hospitals.

Purpose: This study aimed to examine the predictive factors of COVID-19 vaccination behavior by evaluating the moderating effect of perceived behavioral control on the theory of planned behavior. Methods: Data were collected from August 6 to August 31, 2022 from 235 college students (aged 20~29 years) across 12 universities using a structured web-based survey. Statistical analyses were conducted using the SPSS and AMOS software. Results: Attitudes toward COVID-19 vaccination, subjective norms, and intention to be vaccinated significantly influenced COVID-19 vaccination behavior. Attitudes and subjective norms indirectly affected COVID-19 vaccination behavior through intention to vaccinate, whereas intention to vaccinate had a direct effect. The moderating effect of perceived behavioral control on the relationship between subjective norms and intention to vaccinate was significant. Conclusion Interventions that foster a positive attitude toward COVID-19 vaccination and bolster subjective norms and perceived behavioral control can boost the intention to be vaccinated and facilitate the uptake of COVID-19 vaccination.

Purpose: To identify the differences in perception of and adherence to the COVID-19 social distancing behavior guidelines among health care workers, patients, and the general public and to use them to prevent the spread of COVID-19. Methods: From October 16 2020 to November 30, 2020, a survey was conducted among 85 health care workers, 85 patients, and 82 general public regarding the perception of and adherence to the COVID-19 social distancing behavior guidelines. Results: Patients scored significantly higher than the general public in the adherence to the COVID-19 social distancing behavior guideline, and there was no difference between health care workers and general public, and patients and health care workers. In the multivariate analysis, the factors that influence the adherence of the COVID-19 social distancing behavior guide were found in women and the perception of the COVID-19 social distancing behavior guideline. Conclusion In order to promote the implementation of the COVID-19 social distancing behavior guideline, it is necessary to increase the perception of the COVID-19 social distancing behavior guideline and provide additional education in men. It is necessary to investigate the reason behind why men have low adherence to the COVID-19 social distancing behavior guideline.

PURPOSE: Split-thickness skin grafts (STSG), as a treatment of full thickness burn have played a significant role in re-surfacing to date. The major disadvantage of traditional STSG is related to donor site morbidity, including scar formation and cosmetic changes. SureDerm(TM) is acellular human dermis, which is intended for the repair or replacement of damaged soft tissue. Then, we present our experience of using SureDerm(TM) as a tool for the skin graft of full thickness burns. METHODS: We reviewed the medical records of 20 patients treated in our burn center who received SureDerm(TM) graft with thin STSG in full thickness burns since November 2006 to October 2008. RESULTS: SureDerm(TM) was used with thin STSG (range 0.006~0.008 inches) concurrently. Thickness of SureDerm(TM) was 0.2~0.4 mm and the type of SureDerm(TM) was meshed. The average size of SureDerm(TM) used in the burn patients was 329.6 cm2 (32~1,384). All burn areas grafted SureDerm(TM) were full thickness burns and the locations were upper and lower extremities including joints (8 and 6 cases), trunk (3 cases), ankle (2 cases), and axilla (1 case). Each SureDerm(TM) grafted area had more than 95% take-rate. No complications were observed except 1 case of partially infected STSG. The mean follow up period was 8.7 months (1~17), and the assessment of scars, which had more than six months follow up periods was performed by Modified Vancouver Scar Scale and the results were good. CONCLUSION: SureDerm(TM) can be used as a dermal substitute for the treatment of full thickness burns and the result seems to be good cosmetically and functionally while it solves donor site morbidity followed by autograft.
Animals ; Ankle ; Axilla ; Burn Units ; Burns ; Cicatrix ; Cosmetics ; Dermis ; Follow-Up Studies ; Humans ; Joints ; Lower Extremity ; Medical Records ; Skin ; Tissue Donors ; Transplants

BACKGROUND: This study investigated the effects of total knee arthroplasty (TKA) on bone mineral density (BMD) of the proximal femur in patients who underwent the procedure. METHODS: Forty-eight patients scheduled to undergo unilateral TKA because of primary knee osteoarthritis were included in this study, which was conducted at a medical center between October 2006 and October 2009. In these 48 patients, 96 hips were evaluated. Measurement of BMD was performed preoperatively and one month, three months, six months, and one year after unilateral TKA. Repeated measured analysis of variance and paired t-tests for comparison of two repeated samples were used to compare differences between time points (preoperation, one, three, six, and 12 months) and between the operative and nonoperative sides. RESULTS: Preoperatively, BMD of the femoral neck, trochanter, and total hip on the operative side were lower than on the nonoperative side; however, there was no statistical difference. BMD of both femoral neck areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both trochanter areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both total hips was significantly lower than preoperative BMD at three months after TKA. However, no statistical differences of changes in BMD were observed between the operative and nonoperative sides at each measurement time. CONCLUSIONS: According to our results, TKA was found to affect both proximal femurs during the acute period. However, TKA did not affect a change in BMD of the proximal femur during one year postoperative.
Aged ; Arthroplasty, Replacement, Knee/*adverse effects ; Bone Density/*physiology ; Female ; Femur Neck/*physiopathology ; Follow-Up Studies ; Humans ; Male ; Middle Aged

BACKGROUND & SIGNIFICANCE: The neurological manifestations associated with Epstein-Barr viral (EBV) infection includes meningoencephalitis, Guillain Barre syndrome (GBS), Bell's palsy, myelopathy, and radiculopathy. To the best of our knowledge, the neurological manifestation associated with EBV infection has never been reported in Korea. Cases & RESULTS: We have found five patients (3 men, 2 women, mean age 28.4 years ; range 23-42) with EBV-associated neurological illness between August 1994 and July 1995. Serum enzyme immunoassay (EIA) tests for anti- early antigen(EA) IgM and anti-Epstein Barr nucleic acid (EBNA) IgG was positive in all patients, suggestive of reactivated EBV reaction. They showed a wide spectrum of neurological manifestations: 2 meningoecnephalomyelitis, 1 meningoencephalitis and cervical radiculopathy, 1 meningoencephalitis, and 1 GBS. T2-weighted brain magnetic resonance imaging studies showed high signal intensity lesions in three of the four patients who had meningoencephalitis. Outcomes were excellent in all but one patient. CONCLUSIONS: We present five patients with a wide spectrum of neurological manifestations associated with EBV infection. We suggest that one should suspect the EBV infection in a variety of neurological diseases of uncertain etiology.
Bell Palsy ; Brain ; Epstein-Barr Virus Infections ; Female ; Guillain-Barre Syndrome ; Herpesvirus 4, Human ; Humans ; Immunoenzyme Techniques ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Magnetic Resonance Imaging ; Male ; Meningoencephalitis ; Neurologic Manifestations* ; Radiculopathy ; Spinal Cord Diseases

Our objective is to describe the characteristic CT findings of gastrointestinal (GI) tract perforations at various levels of the gastrointestinal system. It is beneficial to localize the perforation site as well as to diagnose the presence of bowel perforation for planning the correct surgery. CT has been established as the most valuable imaging technique for identifying the presence, site and cause of the GI tract perforation. The amount and location of extraluminal free air usually differ among various perforation sites. Further, CT findings such as discontinuity of the bowel wall and concentrated free air bubbles in close proximity to the bowel wall can help predict the perforation site. Multidetector CT with the multiplanar reformation images has improved the accuracy of CT for predicting the perforation sites.
Gastrointestinal Tract/*radiography ; Humans ; Intestinal Perforation/etiology/*radiography ; Peptic Ulcer Perforation/*radiography ; Tomography, X-Ray Computed

BACKGROUND: Inspired concentrations of desflurane > or = 1 minimum alveolar anesthetic concentration (MAC) have been related to sympathetic stimulation such as hypertension and tachycardia. The current study examined whether labetalol, an alpha1 and beta-adrenergic antagonist would blunt these hemodynamic responses. METHODS: Fifty-four ASA physical status I patients, aged 20-60 years, were enrolled in this study. The patients were randomly divided into 2 groups. The breathing circuit was primed with an end-tidal desflurane concentration of 1.2 MAC in 6 L/min O2. Normal saline 5 ml or labetalol 0.3 mg/kg was injected into groups S and L respectively. After 5 minutes, anesthesia was induced with intravenous etomidate 0.2 mg/kg and vecuronium 0.1 mg/kg. Each patient inhaled desflurane through a tight fitting facemask. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and end-tidal concentration of desflurane (et-des) were measured at 5 minutes after saline or labetalol injection (baseline) and every 1 minute for 5 minutes after desflurane inhalation and for 2 minutes after intubation. RESULTS: In the saline injection group (group S), desflurane inhalation increased heart rate and blood pressure, while labetalol 0.3 mg/kg attenuated the heart rate and blood pressure increase in group L. After tracheal intubation, heart rate and blood pressure were significantly lower in group L than in group S. CONCLUSIONS: These results demonstrate that administration of intravenous labetalol is effective in attenuating tracheal intubation and desflurane-induced hemodynamic responses.
Aged ; Anesthesia ; Arterial Pressure ; Blood Pressure ; Etomidate ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Inhalation ; Intubation ; Isoflurane ; Labetalol ; Respiration ; Tachycardia ; Vecuronium Bromide

We report an uncommon case of solitary, small hepatic angiosarcoma that was initially considered as a hemangioma. We present the imaging findings, with an emphasis on the initial and follow-up CT and MR findings, as well as report on the more suggestive findings of angiosarcoma than those of a hemangioma.
Contrast Media ; Diagnosis, Differential ; Gadolinium DTPA/diagnostic use ; Hemangioma/diagnosis ; Hemangiosarcoma/*diagnosis/surgery ; Humans ; Liver Neoplasms/*diagnosis/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed