No abstract available.

OBJECTIVES: Clinical Practice Guidelines (CPGs) are an effective tool for minimizing the gap between a physician's clinical decision and medical evidence and for modeling the systematic and standardized pathway used to provide better medical treatment to patients. METHODS: In this study, sentences within the clinical guidelines are categorized according to a classification system. We used three clinical guidelines that incorporated knowledge from medical experts in the field of family medicine. These were the seventh report of the Joint National Committee (JNC7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure from the National Heart, Lung, and Blood Institute; the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults from the same institution; and the Standards of Medical Care in Diabetes 2010 report from the American Diabetes Association. Three annotators each tagged 346 sentences hand-chosen from these three clinical guidelines. The three annotators then carried out cross-validations of the tagged corpus. We also used various machine learning-based classifiers for sentence classification. RESULTS: We conducted experiments using real-valued features and token units, as well as a Boolean feature. The results showed that the combination of maximum entropy-based learning and information gain-based feature extraction gave the best classification performance (over 98% f-measure) in four sentence categories. CONCLUSIONS: This result confirmed the contribution of the feature reduction algorithm and optimal technique for very sparse feature spaces, such as the sentence classification problem in the clinical guideline document.
Adult ; Cholesterol ; Data Mining ; Heart ; Humans ; Hypertension ; Information Storage and Retrieval ; Joints ; Knowledge Bases ; Learning ; Lung ; Machine Learning

Patients who get tooth loss would also lost their esthetic, stability and functional aspect suddenly. They have to get provisional restoration immediately. This case reports a satisfied result that thermoforming technique is good for patients to get injury from unexpected tooth loss.
Dentures* ; Humans ; Tooth Loss

OBJECTIVES: The purpose of this study was to examine the effects of Koryo Hand Therapy(KHT) on menopausal symptoms and lipid levels in middle-aged women. METHODS: The design of this study was a nonequivalent control-group pretest-posttest design. There were 32 subjects, 40-60 years of age, and assigned to two group. There were 16 members in the experimental group and 16 members in the control group. KHT was applied three times a week, for a total of 8weeks to the experimental group. The instruments used in this study to measure the effects of KHT were the menopausal symptoms scale and clinical laboratory testing(Blood Lipid Levels). Data was analyzed by Fisher's Exact Test, Mann-Whitney U-test, and ANCOVA, using SPSS/Win PC 13.0. RESULTS: There was a statistically significant decrease in the menopausal symptoms, and levels of the total cholesterol and LDL cholesterol in the experimental group compared to the control group. CONCLUSIONS: KHT was effective in decreasing menopausal symptoms in middle-aged women. Therefore KHT is recommended as a nursing intervention strategy for middle-aged women.
Cholesterol ; Cholesterol, LDL ; Female ; Hand* ; Humans ; Nursing

Vasculitis may be a manifestation of the paraneoplastic syndrome in association with solid and hematological cancers. There are few reports of paraneoplastic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in patients with solid tumors. Wegener's granulomatosis is a systemic vasculitis characterized by necrotizing granulomatous vasculitis of the upper and lower respiratory tracts together with glomerulonephritis and are ANCA-positive. We experienced a case of Wegener's granulomatosis complicated by non-small cell lung carcinoma (NSCLC) and we report this case with a brief review of the literature.
Antibodies, Antineutrophil Cytoplasmic ; Carcinoma, Non-Small-Cell Lung* ; Glomerulonephritis ; Humans ; Lung ; Paraneoplastic Syndromes ; Respiratory System ; Systemic Vasculitis ; Vasculitis ; Wegener Granulomatosis*

Mold form fungi such as Fusarium, Acremonium, and Sporothrix species are thought to represent contamination or harmless colonization when isolated from immunocompromised patients. More recently, the pathogenic role of these fungi has been clearly established. The role of implantable subcutaneous central catheters as potential portals of entry for mold form fungus has been underestimated. We describe four cases of implantable subcutaneous central catheter- related mold form fungemia in patients with cancer. One patient responded well only after removal of the implantable subcutaneous central catheter, two patients responded after catheter-removal and IV fluconazole but one patient did not in spite of catheter-removal and amphotericin B.
Acremonium ; Amphotericin B ; Catheters ; Central Venous Catheters* ; Colon ; Fluconazole ; Fungemia* ; Fungi ; Fusarium ; Humans ; Immunocompromised Host ; Sporothrix

Since 1982, many countries have reported outbreaks or sporadic cases by enterohemorrhagic Escherichia coli (E. coli) serogroup strains, mainly E. coli O157 : H7. Hemorrhagic E. coli induces hemolytic uremic syndrome (HUS) in 10 to 15% of cases in infants and young chilidren. HUS is a clinical syndrome of hemolytic anemia, acute renal failure, and thrombocytopenia. We experienced a case of E. coli O8 as the causative organism of hemorrhagic colitis and hemolytic uremic syndrome in 16 year-old man. Hemorrhagic colitis was diagnosed by the sigmoidoscopy and E. coli O8 was identified in the stool culture. Hemolytic uremic syndrome was clinically diagnosed. A conservative management including total parenteral nutrition, plasma exchange transfusion, hemodialysis and continuous arteriovenous hemofiltration with dialysis resulted in a complete recovery of the patient. We herein report this manifestations of E. coli O8 and discuss the therapeutic issues related to hemorrhagic colitis and hemolytic uremic syndrome.
Acute Kidney Injury ; Adolescent ; Anemia, Hemolytic ; Colitis ; Dialysis ; Disease Outbreaks ; Enterohemorrhagic Escherichia coli ; Escherichia coli* ; Escherichia* ; Hemofiltration ; Hemolytic-Uremic Syndrome* ; Humans ; Infant ; Parenteral Nutrition, Total ; Plasma Exchange ; Renal Dialysis ; Sigmoidoscopy ; Thrombocytopenia

The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior. Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.
Cell Differentiation ; Desmin ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Intestine, Small ; Leiomyoma ; Leiomyosarcoma ; Muscle, Smooth ; Necrosis ; Neurilemmoma ; Stomach

The relapse of leukemia is usually classified as hematologic relapse and extramedullary relapse. The most common sites of clinical extramedullary relapse are the central nervous systems (CNS) and gonads. However, the relapse in the uterus is very rare. We experienced a very unusual case of uterine relapse of acute lymphoblastic leukemia (ALL) after about a 6-year remission period. This female patient returned to our hospital with a two-month history of amenorrhea. Pelvic radiology confirmed an about 7 cm sized ill-defined ovoid mass in the uterus. There was no evidence of ALL relapse in the peripheral blood or CNS. The uterine biopsy showed diffused homogenous infiltration of numerous small round cells in uterine corpus, suggesting ALL relapse. The bone marrow study revealed 100% cellularity, most of which were lymphoblasts. Our patient received the bone marrow transplantation (BMT) and achieved the second complete remission (CR). Therefore, we here report our case with a brief review of literature.
Amenorrhea ; Biopsy ; Bone Marrow ; Bone Marrow Transplantation ; Central Nervous System ; Female ; Gonads ; Humans ; Leukemia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence* ; Uterus

PURPOSE: To evaluate the HRCT findings and to correlate the findings with the results of a pulmonary function test (PFT) in patients with reactive airway dysfunction syndrome (RADS). MATERIALS AND METHODS: On March 2003, a fire at a boarding house of primary school soccer players caused a multiple casualty disaster. After 8 months, nine boys that presented with chronic cough and dyspnea were treated, and were subjected to follow-up evaluations. Eight patients underwent a chest radiograph, HRCT, and a PFT. Two patients with severe symptoms received extended follow-up after 1 year. Two radiologists retrospectively reviewed the chest radiographs and the follow-up HRCT scans. We correlated the HRCT findings with the results of the PFT. RESULTS: Six patients with an inhalation injury were diagnosed with RADS. On the chest radiographs, eight patients showed no abnormal findings. On an HRCT scan, four patients showed abnormal findings. The abnormal findings were mosaic air trapping (n = 4), bronchial wall thickening (n = 1), and parenchymal consolidation (n = 1). In all four patients that showed abnormal findings in the HRCT scan, abnormal results of the PFT were also seen. The two patients that received extended follow-up showed an improvement of the clinical symptoms, as seen by the PFT, and had a decreased extent and degree of mosaic air trapping, as seen on HRCT. CONCLUSION: An HRCT scan is an essential modality for the diagnosis and follow-up of patients with RADS. Both a full expiratory and inspiratory HRCT scan must be performed for an accurate diagnosis.
Bronchial Hyperreactivity ; Cough ; Diagnosis ; Disasters ; Dyspnea ; Fires ; Follow-Up Studies ; Humans ; Inhalation* ; Lung ; Radiography, Thoracic ; Respiratory Function Tests* ; Retrospective Studies ; Smoke Inhalation Injury ; Soccer ; Thorax*