PURPOSE: To evaluate the value and the radiologic findings of CT discography in the diagnosis of the far lateral disk herniation. MATERIALS AND METHODS: We retrospectively reviewed 7 cases of surgically proven far lateral lumbar disc herniation. CT discography was performed for all cases. Four cases underwent conventional CT and three cases MRI as a primary diagnostic imaging method. Far lateral diac herniation was divided into 3 groups by location;Intraforaminal herniation, extraforaminal herniation, and mixed type. We analyzed the findings of CT discography including location and extent of far lateral disc herniation. RESULTS: In all 7 cases, CT discography clearly demonstrated the filling of contrast media in laterally-protruded disc material. Intraforaminal and extraforminal types were seen in 2 cases each, and mixed type in 3 cases. Subligamentous herniated nucleus pulposus was present in 6 cases and extruded disc in 1 case. Far lateral disc herniation was located at L4-5 in 5 cases and L5-S1 in 2 cases. CONCLUSION: CT discography can help establishing accurate preoperative diagnosis for far lateral disc herniation.
Contrast Media ; Diagnosis ; Diagnostic Imaging ; Magnetic Resonance Imaging ; Retrospective Studies

No abstract available.
Brain Diseases* ; Brain Stem* ; Humans ; Hypertensive Encephalopathy ; Stroke, Lacunar*

PURPOSE: To investigate the relationship between the smart devices usage-related factors and self-regulation ability development in early childhood. METHODS: Parental questionnaires of 187 children aged 3–6 years were analyzed. The metrics included smart device usage frequency (times/week, scored as uFreq), smart device usage time (hours/day, scored as uTime), parental scale for appropriate smart device usage level (scored as uLevel), the Korean-developmental screening test (K-DST), and the scale for self-regulation ability in young children (scored as SRS, and including four sub-categories: self-appraisal, self-determination, behavior inhibition, and emotionality). The correlations were analyzed by total age group and by each age. RESULTS: In the total age group analysis, uFreq and uTime were negatively correlated with mean SRS (rs =−0.366, −0.330; P < 0.001) and sub-category SRS (rs =−0.186 to −0.370; P < 0.05). Mean uLevel score was positively correlated with mean SRS (rs =0.406; P < 0.001) and most of the mean sub-category SRS (rs =0.174 to 0.362; P < 0.05). In 3-year-old children, the mean SRS was strongly negatively correlated with uFreq (rs =−0.751; P < 0.001), negatively correlated with uTime (rs =−0.518; P < 0.001), and positively correlated with mean uLevel score (rs =0.533; P=0.013). Such correlations seemed to decrease at the age of 4–6 years. CONCLUSION: Self-regulation ability was significantly correlated with smart device-related factors and was the highest in the 3-year-old children. Encouraging appropriate smart device usage will be helpful for self-regulation development of young children.
Child ; Child, Preschool ; Diagnostic Self Evaluation ; Humans ; Mass Screening ; Parents ; Self-Control* ; Smartphone

OBJECTIVE: School bullying, the most prevalent type of school violence, is known to be related to various behavioral, emotional and social problems both in victims and perpetrators. The purpose of the present study is to investigate the prevalence of school bullying and related psychopathology in a community sample of elementary school students. METHOD: Fourth to 6 th graders of two randomly selected classes in two elementary schools in Anyang City participated in a cross-sectional study. Study subjects completed Korean-Peer Nominating Inventory(K-PNI). Parents completed Korean-Child Behavior Checklist(K-CBCL), ADHD Rating Scale(ARS) and Conners Scales for parents, and teachers completed ARS and Conners Scales for teachers. Descriptive statistics, multiple linear and logistic regression were performed. RESULTS: A Total of 532 students participated in this study. Prevalence of victims, perpetrators, and victim-perpetrators were 48%, 45%, and 30% respectively. Extreme victims and perpetrators of school bullying ranged from 2.1-4.1%. Inattention-passivity in teachers' Conners Scale, social immaturity or aggression in K-CBCL were positively associated with victims and victim-perpetrators, and grade was negatively related to school bullying. Conduct problem in Conners Scale for teachers and emotional instability in K-CBCL, and male gender were positively associated with perpetrators. CONCLUSION: School bullying is very common in Korean children of elementary schools. Those who had experienced school bullying, either as victims or as perpetrators, had signifi-cantly more psychopathology than their counterparts. To clarify a causal relationship between psychopathology and school bullying, a longitudinal follow-up study is suggested.
Aggression ; Bullying* ; Child ; Cross-Sectional Studies ; Gyeonggi-do ; Humans ; Logistic Models ; Male ; Parents ; Prevalence ; Psychopathology* ; Social Problems ; Violence ; Weights and Measures

Lung adenocarcinoma is the cancer originated in terminal bronchiole or alveolar epithelium and its incidence is on the increase. The most common radiologic pattern of lung adenocarcinoma is peripheral nodule or mass, but it can be showed various findings such as hilar mass, consolidation, atelectasis or multicentric lesions. Sometimes it is difficult to differentiate lung adenocarcinoma from other diseases, especially pneumonia. We experienced three patients with lung adenocarcinoma, just only presented as pneumonic consolidation on chest X-ray and CT scan. The clinician should consider seriously lung adenocarcinoma including bronchioloalveolar carcinoma in patients who did not respond to antibiotics. And in such cases, pathologic diagnosis must be perfomed at proper time to confirm disease.
Adenocarcinoma* ; Adenocarcinoma, Bronchiolo-Alveolar ; Anti-Bacterial Agents ; Bronchioles ; Diagnosis ; Epithelium ; Humans ; Incidence ; Lung* ; Pneumonia ; Pulmonary Atelectasis ; Thorax ; Tomography, X-Ray Computed

Fasiglifam (TAK-875) a G-protein coupled receptor 40 (GPR40) agonist, significantly improves hyperglycemia without hypoglycemia and weight gain, the major side effects of conventional anti-diabetics. Unfortunately, during multi-center Phase 3 clinical trials, unexpected liver toxicity resulted in premature termination of its development. Here, we investigated whether TAK-875 directly inflicts toxicity on hepatocytes and explored its underlying mechanism of toxicity. TAK-875 decreased viability of 2D and 3D cultures of HepG2, a human hepatocarcinoma cell line, in concentration- (>50 μM) and time-dependent manners, both of which corresponded with ROS generation. An antioxidant, N-acetylcysteine, attenuated TAK-875-mediated hepatotoxicity, which confirmed the role of ROS generation. Of note, knockdown of GPR40 using siRNA abolished the hepatotoxicity of TAK-875 and attenuated ROS generation. In contrast, TAK-875 induced no cytotoxicity in fibroblasts up to 500 μM. Supporting the hepatotoxic potential of TAK-875, exposure to TAK-875 resulted in increased mortality of zebrafish larvae at 25 μM. Histopathological examination of zebrafish exposed to TAK-875 revealed severe hepatotoxicity as manifested by degenerated hypertrophic hepatocytes with cytoplasmic vacuolation and acentric nuclei, confirming that TAK-875 may induce direct hepatotoxicity and that ROS generation may be involved in a GPR40-dependent manner.
Acetylcysteine ; Cell Line ; Cytoplasm ; Fibroblasts ; GTP-Binding Proteins ; Hepatocytes ; Humans ; Hyperglycemia ; Hypoglycemia ; Larva ; Liver ; Mortality ; Reactive Oxygen Species* ; RNA, Small Interfering ; Weight Gain ; Zebrafish

BACKGROUND: Density patterns on mammography have been related to the risk factors for breast cancer in the western countries. High mammographic density appears to confer a 4-fold risk of breast cancer. While the proportion of high-density mammography is higher in Korean women than in Caucasian women, the incidence of breast cancer in Korean women is considerably lower. Therefore, we examined if the mammographic breast density pattern correlates with the risk factors for breast cancer in Korean women. METHODS: In a cross-sectional design, we recruited 1,758 pre- and post-menopause women without prior history of breast cancer and breast surgery who underwent screening mammogram and completed a self-administered questionnaire in 6 general hospitals. On the basis of ACR BI RADS breast composition, four density patterns were classified in caudocranial and mediolateral mammography by a designated radiologist in each hospital. Multiple linear logistic regression was used for statistical analyses. RESULTS: Inter-rater reliability between the initial report and the report made by another blinded radiologist was high (Pearson's co-efficient=0.81). Overall, the age, body mass index, family history of breast cancer, and duration of hormone replacement therapy correlated with the mammographic density patterns. In pre-menopausal women, the high body mass index and parity (=2) were associated with low mammographic density. In post- menopausal women, older age, high body mass index, negative family history of breast cancer, and duration of hormone replacement therapy were associated with low mammographic density. CONCLUSION: Our data showed that the mammographic breast density patterns correlated with risk factors for breast cancer in Korean women. While the proportion of high-density mammography is higher in Korean women, the incidence of breast cancer is lower than in the western population. This maybe dependent on other unknown factors. (J Korean Acad Fam Med 2006;27: 33-41)
Body Mass Index ; Breast Neoplasms* ; Breast* ; Female ; Hormone Replacement Therapy ; Hospitals, General ; Humans ; Incidence ; Logistic Models ; Mammography ; Mass Screening ; Parity ; Postmenopause ; Risk Factors* ; Surveys and Questionnaires

BACKGROUND: Until the early 1990's in Korea, treatment outcomes of patients with pulmonary tuberculosis in the private sector were reported to be inferior to those of the public health center under the National Tuberculosis Programme. The purpose of this study was to analyze the clinical characteristics and the treatment efficacy of the patients with pulmonary tuberculosis recently diagnosed at a private general hospital. MATERIALS and METHODS: The study included all pulmonary tuberculosis patients diagnosed at Samsung Medical Center and notified to the public health center from August 2000 to January 2001. RESULTS: Of the 232 patients included in the study during a 6-month period, 188 were (81.0%) initial treatment cases and 44 (19.0%) were re-treatment cases. Eighty-three (35.8%) patients had smear-positive sputa, and 27 (11.6%) had smear-negative, culture-positive sputa. Initial sputum examinations were not performed in 47 (20.3%) patients. A six-month, short-course treatment using isoniazid, rifampin, ethambutol and pyrazinamide was prescribed for 31.4% of the patients under the initial treatment. The success rate (cured plus treatment completed) of the initial treatment for the smear-positive patients was 69.1%. Eleven (13.3%) of the 83 patients with smear-positive pulmonary tuberculosis discontinued their treatment without notice. CONCLUSIONS: To improve the treatment efficacy and decrease the default rates of the patients with pulmonary tuberculosis in the private sector, further efforts are required in line with the Korean Academy of Tuberculosis and Respiratory Disease Treatment Guidelines and in the implementation of an appropriate model of public-private mix for tuberculosis control in Korea.
Diagnosis ; Ethambutol ; Hospitals, General* ; Humans ; Isoniazid ; Korea ; Private Practice ; Private Sector ; Public Health ; Pyrazinamide ; Rifampin ; Sputum ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Pulmonary*

Knowledge of clinical demographics and outcomes of mechanically ventilated patients is important but there are few prospectively collected data in Korea. The objective of the present study was to describe the current status of mechanically ventilated patients in Korea as of 2010. We analyzed the data of Korean patients (275 patients in 12 Korean intensive care units [ICU]) participating in a multinational prospective cohort study on mechanical ventilation. The most common indication for mechanical ventilation was pneumonia (23%). Pressure-limited ventilation modes were preferred over volume-cycled ventilation modes. Non-invasive positive pressure ventilation was used in only seven (2%) patients as the initial ventilatory support. Median duration of mechanical ventilation was 7 days and ICU mortality was 36%. The multiple logistic regression model revealed that the Simplified Acute Physiology Score II (SAPS II) score at ICU admission (odds ratio [OR], 1.034; 95% confidence interval [CI], 1.001-1.036; P=0.033), peak pressure (OR, 1.054; 95% CI, 1.016-1.095; P=0.006), and the number of failed organs (OR, 2.132; 95% CI, 1.634-2.781; P<0.001) were independently associated with ICU mortality. This study provides a snapshot of current practice of mechanical ventilation in Korea.
Acute Disease ; Aged ; Cohort Studies ; Demography ; Female ; Hospital Mortality ; Humans ; Intensive Care Units/*statistics & numerical data ; Length of Stay ; Male ; Middle Aged ; Odds Ratio ; Prognosis ; Prospective Studies ; Republic of Korea ; *Respiration, Artificial ; Respiratory Insufficiency/*diagnosis/epidemiology/mortality ; Sepsis/etiology ; Severity of Illness Index

BACKGROUND: The pathophysiologic mechanisms of radiation-induced lung injury should be elucidated to enhance the therapeutic efficacy of radiotherapy and to manage patients exposed to serious radiation by accident. It has been suggested that pro-inflammatory cytokines play an important role in radiation-induced effect on the lung. This study was aimed to investigate changes in pro-inflammatory cytokines such as TNF-alpha, MIP-2, IL-1beta and HMGB1, a newly recognized inflammatory mediator. METHODS: The chests of BALB/c mice were selectively irradiated with single fraction of 20 Gy and then sacrificed at indicated times. Pathologic changes in the lung were examined after H&E staining. The expression level of pro-inflammatory cytokines was evaluated by ELISA kits in lung homogenate and in serum. RESULTS: Radiation induced inflammatory changes and mild fibrosis in lung. Biphasic increase of TNF-alpha and IL-1beta was found in lung homogenate at 4 hours and at 3 weeks after radiation. The elevation in the second phase tended to be more intense. However, there was no similar change in serum. MIP-2 level was slightly increased in lung homogenate at 4 hours, but not at 3 weeks. HMGB1 was increased at 3 weeks in serum while there was no significant change in lung homogenate. CONCLUSION: Radiation induced a biphasic increase in TNF-alpha and IL-1beta. The effective control of second phase cytokine elevation should contribute to preventing severe lung fibrosis caused by radiation.
Animals ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; HMGB1 Protein ; Humans ; Lung ; Lung Injury ; Mice ; Thorax ; Tumor Necrosis Factor-alpha