Background and Objectives: Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. Methods: Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. Results: mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). Conclusions Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.

Background and Objectives: Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. Methods: Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. Results: mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). Conclusions Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.

OBJECTIVES: The purpose of this preliminary study was to investigate job stress and stress coping strategy among workers in a regional statistics office. METHODS: A total of 133 workers in regional statistics office participated in this study and they were divided into two groups, survey group(n=109) and support group(n=24) depending on relation to statistical survey task. They were asked to respond to Short Form of Korean Occupational Stress Scale(KOSS-SF) and Stress Coping Strategy(SCS) to investigate sociodemographic characteristics, job stress, and stress coping strategy. RESULTS: The proportion of the 133 participants in the sample was 59(44.4%) of men, 74(55.6%) of women. There were no significant differences in KOSS-SF scores in relation to age, sex, education, and marital status, while the KOSS-SF scores were significantly different between the two groups. In regard to the subscales of KOSS-SF, the two groups had significant differences in insufficient job control, interpersonal conflict, job insecurity, and organization system. In addition, the total score of KOSS-SF had a negative correlation with problem-focused coping strategy and social support coping strategy of SCS. CONCLUSIONS: Our results suggest that workers of survey group had more job stress compared to those who works in support group in regional statistical office. In addition, in comparison with workers of support group, both men and women of survey group get stressed when they were confronted with interpersonal conflicts. Our results suggest that using problem-focused coping and social support coping strategy lowers job stress.
Education ; Female ; Humans ; Male ; Marital Status ; Self-Help Groups

Emphysematous gastritis is a subtype of phlegmonous gastritis characterized by emphysematous change of the gastric wall. It is associated with infection of gas forming organism and is often fatal because of suppurative bacterial infection. Streptococci is the most commonly involved microorganism of emphysematous gastritis. Aspergillus is a very rare pathogen of this disease, because invasive aspergillosis often presents as pulmonary infections and rarely involves the gastro-intestinal tract. Treatment should be aimed to cover various organism using broad spectrum antibiotics, and sometimes aggressive surgical management may be needed to enhance survival. We report a case of severe emphysematous gastritis caused by invasive aspergillosis with a review of the literature.
Anti-Bacterial Agents ; Aspergillosis ; Aspergillus ; Bacterial Infections ; Cellulitis ; Gastritis

Emphysematous gastritis is a subtype of phlegmonous gastritis characterized by emphysematous change of the gastric wall. It is associated with infection of gas forming organism and is often fatal because of suppurative bacterial infection. Streptococci is the most commonly involved microorganism of emphysematous gastritis. Aspergillus is a very rare pathogen of this disease, because invasive aspergillosis often presents as pulmonary infections and rarely involves the gastro-intestinal tract. Treatment should be aimed to cover various organism using broad spectrum antibiotics, and sometimes aggressive surgical management may be needed to enhance survival. We report a case of severe emphysematous gastritis caused by invasive aspergillosis with a review of the literature.
Anti-Bacterial Agents ; Aspergillosis ; Aspergillus ; Bacterial Infections ; Cellulitis ; Gastritis

Hemobilia is a rare upper gastrointestinal (GI) bleeding phenomenon usually caused by trauma but may occur due to various liver and pancreatobiliary diseases. Causes related to gallbladder disease include vascular disorders, malignancy, polyps, heterotopic GI mucosa, acalculous inflammation, and most commonly gallstones. Most cases are treated with a cholecystectomy. If hemobilia is detected, efforts must be made to exclude malignancy because hemobilia develops from both benign and malignant disease. Particularly in gallbladder disease with hemobilia, the possibility of gallbladder carcinoma should be considered. We report two cases of hemoblia by endoscopic retrograde cholangiopancreatography and duodenoscopy, with a review of the literature. The first case was xanthoglanulomatous cholesystitis and the second case was gallbladder cancer disclosed by cholecystectomy.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis ; Duodenoscopy ; Gallbladder ; Gallbladder Diseases ; Gallbladder Neoplasms ; Gallstones ; Granuloma ; Hemobilia ; Hemorrhage ; Inflammation ; Liver ; Mucous Membrane ; Polyps ; Xanthomatosis

OBJECTIVES: The aim of this study was to investigate brain activation during a Korean language-based 'theory of mind (TOM)' task and fMRI in Korean schizophrenic patients. METHODS: Fourteen Korean schizophrenic patients and 15 normal controls participated in this study. For all participants, several clinical states and psychosocial functions were evaluated. The subjects were then scanned while performing Korean language-based fMRI tasks. The tasks were comprised of conditions-first order false belief (TOM task), physical causality, and unrelated situations. Imaging data were analyzed using SPM2 software (uncorrected p<0.005, extent threshold kappa=10). RESULTS: 1) Compared with the control group, the patient group showed significantly poorer performance on the TOM task, and no significant correlation between TOM and empathic abilitiesy. 2) In the patient group, there were no significantly activated brain regions associated with the TOM task as compared to the physical causality task. With respect to between-group differences, the patient group showed significantly less activation of the left medial frontal region (primarily BA 8) and signifcantly different activation of the left precuneus (BA 7) associated with the TOM task. CONCLUSION: These results suggest that Korean schizophreniac patients show different brain activity associated with TOM functions, especially with respect to the Korean language-based first order false belief tasks.
Brain ; Humans ; Magnetic Resonance Imaging ; Schizophrenia ; Theory of Mind

OBJECTIVES: This study was performed to evaluate the relationships between psychosocial characteristics and changes in the stage of breast cancer screening behavior. METHODS: The 474 study subjects were randomly sampled from 21,459 women (age range, 40-70 years) who were eligible for the Korean National Cancer Screening Program in 2006 in Jinju, Gyeongsangnam-do. The information, including behaviors and sociodemographic characteristics, attitudes, subjective norms and self-efficacy, was collected by trained interviewers via home visits. The breast cancer screening stages were grouped as precontemplation, contemplation, action, maintenance and relapse, according to Rakowski. RESULTS: Of the 474 women, 18.8% were in the precontemplation stage, 23.3% were in the contemplation stage, 13.1% were in the action stage, 36.6% were in the maintenance stage, and 8.2% were in the relapse stage. The distribution of stages was associated with attitude, subjective norms and self-efficacy (p for trend<0.01). To investigate the overall relationship between the variables, we conducted a linear structural equation model analysis based on the theory of planned behavior. The subjective norms and self-efficacy influenced the stage of the women's screening behavior. CONCLUSIONS: We should target on self-efficacy about the screening behavior of women by performing timely, thoughtful interventions. The support from family members, friends and other people is crucial for women to undergo breast cancer screening and to improve the breast cancer screening rate.
Adult ; Aged ; Asian Continental Ancestry Group ; Breast Neoplasms/prevention & control/*psychology ; Data Interpretation, Statistical ; *Early Detection of Cancer ; Female ; *Health Behavior ; Humans ; Interviews as Topic ; Korea ; Mass Screening/*psychology ; Middle Aged ; Models, Theoretical ; Questionnaires ; Self Efficacy ; Socioeconomic Factors ; Women's Health

Aggressive angiomyxoma is a rare, locally infiltrative soft tissue tumor that usually arises in the vulvoperitoneal region of young female. Frequent relapses are common. Clinicians should consider the diagnosis of aggressive angiomyxoma when a patient presents with an atypical vulvoperineal mass, because an incorrect diagnosis may lead to repeated surgical procedures. Treatment is wide surgical excision. Medical management with a GnRH agonist and radiation therapy with total dose of 60 Gy may be helpful adjuvant treatment in recurrent aggressive angiomyxoma. We experienced a case of recurrent aggressive angiomyxoma and report it with a brief review of literatures.
Adolescent* ; Diagnosis ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Myxoma* ; Recurrence ; Vulva*

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin, and a major risk for persistent trophoblastic tumor. Partial hydatidiform moles appear to be a milder version of complete moles with both normal and cystic villi, focal trophoblastic hyperplsia, a fetus or indication of previous fetal existence, 69 chromosomes with a maternal contribution, and a malignant potential less than described for complete moles. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies. Due to advances in cytogenetics and ultrasonography, now permit the diagnosis of this pregnancy antenatally. However this unusual pregnancy has the risks of malignant change and severe medical complications, so it is a dilemma to decide continuation or termination of pregnancy. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 12 gestational weeks, and confirmed normal karyotype (diploid) of the coexistent fetus. A brief reviews of related literature was done.
Classification ; Cytogenetics ; Diagnosis ; Diploidy ; Female ; Fetus* ; Hydatidiform Mole* ; Hyperplasia ; Incidence ; Karyotype ; Pregnancy ; Trophoblastic Neoplasms ; Trophoblasts ; Ultrasonography