This article has been retracted by the author. This article involves in conflicts in authorship. We apologize to the readership of Journal of Korean Neurosurgical Society.

Lichen aureus is a variant of pigmented purpuric lichenoid dermatitis. The skin lesions usually appear asymptomatic rusty, copper, or orange colored roundish lichenoid erythematous-purpuric papules and patches on the lower extremities. Histologically, the epidermis shows minimal changes, with a dense lymphohistiocytic infiltrate observed in the superficial derrnis, typically distributed in a band-like fashion. The typical lesion is a single patch localized on the lower extremity. We report a rare case of segmental lichen aureus localized on the right lower extremity.
Citrus sinensis ; Copper ; Dermatitis ; Epidermis ; Lichens* ; Lower Extremity ; Skin

ObjectiveTo investigate the effect of endovascular stent with or without coil graft on intracranial wide-necked aneurysms. Methods12 cases with intracranial wide-necked aneurysms, among whom, 10 cases were treated with stents and coils, 2 C4 aneurysms were treated with graft stent, were analyzed retrospectively. ResultsOf the 10 cases who were treated with stents and coils, 8 patients were completely occluded and other 2 patients were incompletely (>95%) occluded. 2 cases accepted graft stent were obliterated. Follow-up with angiography in 10 patients for 3～12 months revealed that all the aneurysms were completely occluded. 1 patient among them died. ConclusionEndovascular stent with or without coil graft is effective on intracranial wide-necked aneurysms.

This research was conducted to study the effect of milk consumption on blood lipid levels of Korean college women. According to milk intake from food frequency questionnaire (FFQ), top 20% of subjects were classified as high group(HG) and bottom 20% as low group (LG). Body weight, height and blood pressure were measured and BMI was calculated from the anthropometric data, but there was no significant difference between the groups. Blood samples were collected and analyzed for total cholesterol (TC), triglycerides (TG) and lipoprotein fractions. There was no significant difference in the blood level of albumin, total protein and hemoglobin between two groups, and all blood parameters were in the normal range. Blood lipid levels of two groups were not significantly different, but HDLcholesterol level were higher in HG (p < 0.05). Therefore, according to the result of the research, it is considered that drinking a pack of milk (200 ml) everyday, the average intake of dairy products of HG, is advisable to promote good health without increasing of cardiovascular disease (CVD) risk.
Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Dairy Products ; Drinking ; Female ; Humans ; Lipoproteins ; Milk* ; Reference Values ; Surveys and Questionnaires ; Triglycerides

Objective To explore the psychological experience of ICU nurses who had worked follow different work patterns, and find the most appropriate staffing model. Methods A phenomenological approach of qualitative research was conducted in 5 ICU nurses by intensive interview,then the data collected were read, analyzed, reflected,finally the theme was got. Results In the work pattern of shifted every 12 hours, with low work frequency and strong feeling of fatigue. In the work pattern of shifted every 8 hours, with high work frequency and the disadvantage of nurse- patient relationship. In the short-time continuous APN work pattern, with continuous management of patients' condition, promotion of nurse-patient relationship, improvement of doctor-nurse relationship, comparatively stable biological clock. Conclusions The short-time continuous APN work pattern can concentrate nurses' work and rest time, relieve the press that caused by the shifted work, at the same time, promote the patients',patients' family and doctors' satisfaction degree with nursing work, increase nurses' effect in the ICU team, guarantee the quality of care, eventually ensure the patients' safety.

PURPOSE: Cefepime is a new broad-spectrum antibiotics and is available as initial monotherapy in the management of pediatric cancer patients with febrile neutropenia. The aim of this study is to evaluate the efficacy of Cefepime monotherapy and piperacillin-tazobactam plus gentamicin combination therapy as an initial empirical antibiotics treatment in pediatric cancer patients with febrile neutropenia. METHODS: From January 2003 to July 2004, a total of 55 episodes of febrile neutropenia were analyzed retrospectively for this study. They were treated intravenous Cefepime (50 mg/kg every 8 hour) or piperacillin-tazobactam (90 mg/kg every 8hour) plus gentamicin (2.5 mg/kg every 8hour). Modification of antibiotics was done at 72~96 hour if fever persisted. Clinical responses were evaluated at the completion of therapy. RESULTS: Twenty-eight patients in the cefepime monotherapy and twenty-seven patients in the piperacillin-tazobactam plus gentamicin combination therapy were evaluable for efficacy. Modification of the empirical initial antibiotics therapy was done for 53% in the cefepime monotherapy group compared with 33.3% in the piperacillin-tazobactam plus gentamicin combination therapy group. The modification rate was not statistically significance between the treatment groups (P=0.130). And the overall success rate was 92.9% in cefepime monotherapy and 96.3% in piperacillin-tazobactam plus gentamicin combination therapy. So, there was no significant difference in success rate between two groups (P=0.514). A drug-related adverse event was reported in 1 case of piperacillin-tazobactam plus gentamicin combination therapy. There was no major adverse event. CONCLUSION: The empirical regimen of cefepime monotherapy is at least as effective as the regimen of piperacillin-tazobactam plus gentamicin combination therapy in pediatric malignancy patient with febrile neutropenia.
Anti-Bacterial Agents ; Febrile Neutropenia* ; Fever ; Gentamicins* ; Humans ; Retrospective Studies

Background: Although an ambulatory surgical practice continues to increase, there is a few data exist about patient discharge criteria. This study was undertaken to evaluate the usefulness and safety of Aldrete PAR (postanesthetic recovery) score and modified PADSS (modified postaneathesia discharge scoring system) on ambulatory surgery patients for recovery in Korea. Methods: Demographic, anesthetic data, Aldrete PAR score and modified PADSS on 279 patients were recorded. The time to dicharge, from recovery room and postoperative complications were evaluated, also. Results: PAR score and modified PADSS are correlated to length of stay in ambulatory surgery center. 24hr after discharge, 16% patients complained postoperative complications. Pain was most frequent postoperative complication. The PAR score was correlated with the occurrence of the complication. Conclusion: PAR score and modified PADSS are useful scoring systems to evaluate patients and make a decision to discharge the patients from ambulatory surgery center in safe.
Ambulatory Surgical Procedures* ; Humans ; Korea ; Length of Stay ; Patient Discharge* ; Postoperative Complications ; Recovery Room

BACKGROUND: Doxylamine, an antihistamine with sleep inducing property, is the most commonly intoxicated drug in the urban ED. This drug is relatively safe but is known to induce rhabdomyolysis in rare occasion. The purpose of this study is to determine the incidence of rhabdomyolysis after doxylamine overdose and prognostic factors that contributes to this complication. METHOD: This study was conducted from 26 patients admitted to our hospital after doxylamine intoxication during the period from April 1999 to June 1999. Using the protocol made beforehand, the amount ingested, past history, laboratory results were recorded. Rhabdomyolysis was defined as serum myoglobin over 300 ng/mL or serum creatine phosphokinase(CK) over 1,000 IU/L. Data were analyzed using SPSS program with t-test, Fisher's exact test and discriminant analysis. RESULTS: The rhabdomyolysis was diagnosed in 57.7% of patients. The amount ingested per body weight, prehospital vomiting and low arterial pCO2 predicted occurrence of rhabdomyolysis. The sensitivity of serum CK and myoglobin were 67% and 80% respectively and specificity was 100% for both. The diagnosis was possible for CK after an average of 14hr 20min time after ingestion and 8hr 12min for myoglobin. CONCLUSION: Rhabdomyolysis is a common complication of doxylamine intoxication and if the amount ingested was more than 1 tablet(25mg) per body weight, the incidence of rhabdomyolysis was higher. So, CK measurement after 14 hour postingestion and myoglobin after 8 hour is recommended to decide whether rhabdomyolysis occur.
Body Weight ; Creatine ; Diagnosis ; Doxylamine* ; Eating ; Humans ; Incidence* ; Myoglobin ; Rhabdomyolysis* ; Sensitivity and Specificity ; Vomiting

OBJECTIVE: Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. METHODS: Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6–7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9–10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. RESULTS: We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. CONCLUSION: This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.
Decompression* ; Female ; Gait ; Humans ; Hypesthesia ; Intraoperative Complications ; Leg ; Longitudinal Ligaments* ; Lower Extremity ; Magnetic Resonance Imaging ; Methods ; Middle Aged ; Orthotic Devices ; Paresis ; Postoperative Complications ; Spinal Cord ; Spine* ; Thoracic Vertebrae

Transforming growth factor (TGF)-beta1 is a key cytokine producing extracellular matrix. We evaluated the effect of TGF-beta1 gene polymorphism at codon 10 on the development of cirrhosis in patients with chronic hepatitis B. One hundred seventy eight patients with chronic hepatitis (CH, n=57) or liver cirrhosis (LC, n=121), who had HBsAg and were over 50 yr old, were enrolled. The genotypes were determined by single strand conformation polymorphism. There were no significant differences in age and sex ratio between CH and LC groups. HBeAg positivity and detection rate of HBV DNA were higher in LC than in CH groups (P=0.055 and P=0.003, respectively). There were three types of TGF-beta1 gene polymorphism at codon 10: proline homozygous (P/P), proline/leucine heterozygous (P/L), and leucine homozygous (L/L) genotype. In CH group, the proportions of P/P, P/L, and L/L genotype were 32%, 51%, and 17%, respectively. In LC group, the proportions of those genotypes were 20%, 47%, and 33%, respectively. The L/L genotype was presented more frequently in LC than in CH groups (P=0.017). Multivariate logistic regression analysis confirms that detectable HBV DNA (odds ratio [OR]: 3.037, 95% confidence interval [CI]: 1.504-6.133, P=0.002) and L/L genotype (OR: 3.408, 95% CI: 1.279-9.085, P=0.014) are risk factors for cirrhosis.
Aged ; Asian Continental Ancestry Group/genetics ; *Carrier State ; *Codon ; Female ; Genetic Predisposition to Disease ; Genotype ; Hepatitis B virus/genetics ; *Hepatitis B, Chronic/genetics/virology ; Humans ; *Liver Cirrhosis/genetics/virology ; Male ; Middle Aged ; Odds Ratio ; *Polymorphism, Genetic ; Risk Factors ; Transforming Growth Factor beta1/*genetics