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991.
Young Seok Kwak Sung Kyoo Hwang Seong Hyun Park Ji Young Park 《Child's nervous system》2013,29(1):77-82
Background
The pathogenesis of chronic subdural hematoma (CSDH) associated with an arachnoid cyst (AC) is still not clear. We propose an origin of initial bleeding of CSDH in patients with AC based on our experience and discuss the management of this disease.Materials and methods
The total number of operations included in this study was 23. Eleven cases were indicated because of associated CSDH (group 1), and the other cases were due to different reasons (group 2). The relationship of the AC and dura was evaluated in patients who did not have CSDH (group 2) because patients with CSDH would have had structural changes of AC due to hematoma.Results
In group 1, the age distribution was from 8 to 61 years (mean 23.0). The development of CSDH was not related with Galassi types. The hematomas were located outside of the outer cyst membrane in six patients and both inside and outside in three patients. In two patients, the location could not be reviewed. After suspicion of the outer cyst membrane as the origin of the bleeding site, we found small bridging vessels between the dura and outer cyst membrane in three of five consecutive patients in group 2.Conclusions
Based on our surgical experience of AC cyst, we found small bridging vessels between the dura and outer membrane of the AC. We suggested that these small vessels are the source of initial bleeding leading to CSDH in AC. 相似文献992.
Cindy W. Yoon Sang Won Seo Jun-Sung Park Ki-Chang Kwak Uicheul Yoon Mee Kyung Suh Geon Ha Kim Ji Soo Shin Chi Hun Kim Young Noh Hanna Cho Min-Jeong Kim Jong Hun Kim Jee Hoon Roh Jong-Min Lee Duk L. Na 《Cerebellum (London, England)》2013,12(1):35-42
Recent studies suggest that the role of the cerebellum extends into cognitive regulation and that subcortical vascular dementia (SVaD) can result in cerebellar atrophy. However, there has been no evaluation of the cerebellar volume in the preclinical stage of SVaD. We aimed to compare cerebellar volume among patients with amnestic mild cognitive impairment (aMCI) and subcortical vascular mild cognitive impairment (svMCI) and evaluate which factors could have contributed to the cerebellar volume. Participants were composed of 355 patients with aMCI, svMCI, Alzheimer's disease (AD), and SVaD. Cerebellar volumes were measured using automated methods. A direct comparison of the cerebellar volume in SVaD and AD groups showed that the SVaD group had a statistically smaller cerebellar volume than the AD group. Additionally, the svMCI group had a smaller cerebellar volume than the aMCI group, with the number of lacunes (especially in the supratentorial regions) being associated with cerebellar volume. Cerebellar volumes were associated with some neuropsychological tests, digit span backward and ideomotor apraxia. These findings suggest that cerebellar atrophy may be useful in differentiating subtypes of dementia and the cerebellum plays a potential role in cognition. 相似文献
993.
Soo-Jeong Kim June-Won Cheong Yoo Hong Min Young Jin Choi Dong-Gun Lee Je-Hwan Lee Deok-Hwan Yang Sang Min Lee Sung-Hyun Kim Yang Soo Kim Jae-Yong Kwak Jinny Park Jin Young Kim Hoon-Gu Kim Byung Soo Kim Hun-Mo Ryoo Jun Ho Jang Min Kyoung Kim Hye Jin Kang In Sung Cho Yeung Chul Mun Deog-Yeon Jo Ho Young Kim Byeong-Bae Park Jin Seok Kim 《Journal of Korean medical science》2014,29(1):61-68
We assessed the success rate of empirical antifungal therapy with itraconazole and evaluated risk factors for predicting the failure of empirical antifungal therapy. A multicenter, prospective, observational study was performed in patients with hematological malignancies who had neutropenic fever and received empirical antifungal therapy with itraconazole at 22 centers. A total of 391 patients who had abnormal findings on chest imaging tests (31.0%) or a positive result of enzyme immunoassay for serum galactomannan (17.6%) showed a 56.5% overall success rate. Positive galactomannan tests before the initiation of the empirical antifungal therapy (P=0.026, hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.10-4.69) and abnormal findings on the chest imaging tests before initiation of the empirical antifungal therapy (P=0.022, HR, 2.03; 95% CI, 1.11-3.71) were significantly associated with poor outcomes for the empirical antifungal therapy. Eight patients (2.0%) had premature discontinuation of itraconazole therapy due to toxicity. It is suggested that positive galactomannan tests and abnormal findings on the chest imaging tests at the time of initiation of the empirical antifungal therapy are risk factors for predicting the failure of the empirical antifungal therapy with itraconazole. (Clinical Trial Registration on National Cancer Institute website, NCT01060462) 相似文献
994.
Pil Whan Yoon Young-Kyun Lee Jeonghoon Ahn Eun Jin Jang Yunjung Kim Hong Suk Kwak Kang Sup Yoon Hee Joong Kim Jeong Joon Yoo 《Journal of Korean medical science》2014,29(6):852-858
We analyzed national data collected by the Health Insurance Review and Assessment Service in Korea from 2007 to 2011; 1) to document procedural numbers and procedural rate of bipolar hemiarthroplasty (BH), primary and revision total hip arthroplasties (THAs), 2) to stratify the prevalence of each procedure by age, gender, and hospital type, and quantified, 3) to estimate the revision burden and evaluate whether the burden is changed over time. Our final study population included 60,230 BHs, 40,760 primary THAs, and 10,341 revision THAs. From 2007 to 2011, both the number and the rate of BHs, primary THAs increased steadily, whereas there was no significant change in revision THAs. Over the 5 yr, the rate of BHs and primary THAs per 100,000 persons significantly increased by 33.2% and 21.4%, respectively. The number of revision THAs was consistent over time. The overall annual revision burden for THA decreased from 22.1% in 2007 to 18.9% in 2011. In contrast to western data, there were no changes in the number and rate of revision THAs, and the rates of primary and revision THAs were higher for men than those for women. Although 5 yr is a short time to determine a change in the revision burden, there have been significant decreases in some age groups.
Graphical Abstract
相似文献995.
Joanne Kwak‐Kim Shihua Bao Sung Ki Lee Joon Woo Kim Alice Gilman‐Sachs 《American journal of reproductive immunology (New York, N.Y. : 1989)》2014,72(2):129-140
Inflammatory immune response plays a key role in reproductive failures such as multiple implantation failures (MIF), early pregnancy loss, and recurrent pregnancy losses (RPL). Cellular immune responses particularly mediated by natural killer (NK), and T cells are often dysregulated in these conditions. Excessive or inappropriate recruitment of peripheral blood NK cells to the uterus may lead to cytotoxic environment in utero, in which proliferation and differentiation of trophoblast is hampered. In addition, inadequate angiogenesis by uterine NK cells often leads to abnormal vascular development and blood flow patterns, which, in turn, leads to increased oxidative stress or ischemic changes in the invading trophoblast. T‐cell abnormalities with increased Th1 and Th17 immunity, and decreased Th2 and T regulatory immune responses may play important roles in RPL and MIF. A possible role of stress in inflammatory immune response is also reviewed. 相似文献
996.
997.
Injoong Kim Eun-Kyung Kim Jung Hyun Yoon Kyung Hwa Han Eun Ju Son Hee Jung Moon Jin Young Kwak 《Yonsei medical journal》2014,55(1):247-253
Purpose
Thyroid ultrasonography (US) is a useful diagnostic tool in the evaluation of diffuse thyroid disease (DTD), whereas shearwave elastography is a dynamic technique that can provide information about tissue hardness by using acoustic shearwaves remotely induced by a focused ultrasonic beam. This study aims at investigating the role of conventional US and shearwave elastography in the diagnosis of asymptomatic patients with DTD.Materials and Methods
Fifty-seven patients who underwent both conventional US and shearwave elastography were included in this study. Interobserver variability of the three radiologists in assessment of underlying thyroid echogenicity on conventional US was analyzed. Diagnostic performances for diagnosing DTD on conventional US and shearwave elastography were calculated and compared.Results
Fair agreement was observed in the identification of DTD with conventional US (kappa value=0.27). The area under the receiver operating characteristic curve (Az) were 0.52-0.585 on conventional US by three radiologists. The Az values when using the mean and maximum elasticity values as a diagnostic criteria for DTD were 0.619 and 0.59 on shearwave elastography. Patients with DTD showed higher mean [24.1±10 kilo-Pascals (kPa)] and maximum (36.4±13.3 kPa) elasticity values on shearwave elastography when compared to the normal group (23.4±10.8 kPa and 33.7±12.4 kPa, respectively), although without statistical significance (p=0.802 and p=0.452, respectively).Conclusion
Conventional US did not show reliable interobserver agreement in the diagnosis of DTD. Although not statistically significant, shearwave elastography may provide additional information in the diagnosis of DTD. Therefore, larger prospective studies are needed to define the values of shearwave elastography for diagnosing DTD. 相似文献998.
Bo Ra Lee Jong Wook Song Young Lan Kwak Kyoung Jong Yoo Jae Kwang Shim 《Yonsei medical journal》2014,55(1):224-231
Purpose
Hypothermia adversely affects the coagulation that could be of clinical significance in patients receiving clopidogrel. We evaluated the influence of hypothermia on transfusion requirements in patients undergoing isolated off-pump coronary artery bypass surgery (OPCAB) who continued clopidogrel use within 5 days of surgery.Materials and Methods
Protocol-based, prospectively entered data of 369 patients were retrospectively reviewed. The time-weighted average of intraoperative temperatures and the temperature upon ICU admission (TWA-temp) was assessed. Patients were divided into normothermia (≥36℃, n=224) and hypothermia (<36℃, n=145) group. The transfusion requirement for perioperative blood loss was assessed and compared.Results
Patients with hypothermia were older and had lower body surface area (BSA) than patients with normothermia. Age and BSA adjusted transfusion requirement was significantly larger in the hypothermia group [patients requiring transfusion: 64% versus 48%, p=0.003; number of units: 0 (0-2) units versus 2 (0-3) units, p=0.002]. In multivariate analysis of predictors of perioperative multiple transfusion requirements, hypothermia was identified as an independent risk factor along with age, female gender, BSA, chronic kidney disease, and congestive heart failure.Conclusion
Hypothermia was associated with increased transfusion requirement in patients undergoing OPCAB who received clopidogrel in proximity to surgery. Considering the high prevalence and the possibility of hypothermia being a modifiable risk factor, aggressive measures should be undertaken to maintain normothermia in those patients. 相似文献999.
Yun Joo Park Jeong-Ah Kim Eun Ju Son Ji Hyun Youk Eun-Kyung Kim Jin Young Kwak Cheong Soo Park 《Yonsei medical journal》2014,55(2):339-344
Purpose
To analyze which sonographic features of thyroid nodules with macrocalcifications were predictable of thyroid malignancy.Materials and Methods
We reviewed sonographic findings of 854 macrocalcified thyroid nodules in patients who underwent fine needle aspiration biopsy between December 2009 and January 2011. There were 171 non-diagnostic aspirations, 34 nodules with category 3, 4, 5 based on Bethesda system, which were not confirmed by surgery, and these nodules were excluded from the analysis. Sonographic characteristics of the macrocalcifications including its thickness, interruption, and existence of soft tissue rim outside the macrocalcification were analyzed. Other sonographic characteristics of nodules such as shape, margin, composition, echo pattern, vascularity, and underlying parenchymal echogenicity were also evaluated. The correlation of sonographic features with cytopathologic results and the diagnostic performance of sonographic features for the prediction of malignancy were analyzed.Results
Among 649 nodules, 179 (27.6%) nodules were malignant and 470 (72.4%) nodules were benign. Among the features of the macrocalcification, interruption, irregular thickness, or the presence of soft tissue outside calcification rim were associated with malignancy (p<0.001). A high sensitivity and negative predictive values for the prediction of malignancy was found in sonographic characteristics of irregular thickness (92.2% and 91.0%, respectively) and the presence of soft tissue (88.5% and 88.8%, respectively).Conclusion
Sonographic characteristics of macrocalcification such as interruption, irregular thickness and the presence of soft tissue rim were associated with malignancy in thyroid nodules with macrocalcifications. 相似文献1000.
Jae Young Seo Eun-Kyung Kim Jung Hwan Baek Jung Hee Shin Kyung Hwa Han Jin Young Kwak 《Yonsei medical journal》2014,55(4):871-878