• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.397-407
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• 2022

Abusive head trauma (AHT) is the most common and serious form of child abuse and a leading cause of traumatic death in infants and young children. The biomechanics of head injuries include violent shaking, blunt impact, or a combination of both. Neuroimaging plays an important role in recognizing and distinguishing abusive injuries from lesions from accidental trauma or other causes, because clinical presentation and medical history are often nonspecific and ambiguous in this age group. Understanding common imaging features of AHT can increase recognition with high specificity for AHT. In this review, we discuss the biomechanics of AHT, imaging features of AHT, and other conditions that mimic AHT.

• Journal of Information Science Theory and Practice
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• 제12권2호
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• pp.36-48
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• 2024

For consumers making health decisions, Wikipedia is a popular source for health information. This study investigated major factors influencing consumer satisfaction with Wikipedia medical/health articles. Using a crowdsourcing method, data were collected from 322 adults who read/edit English Wikipedia medical/health articles and reside in the US. The results showed that the presentation of information was the most influential factor. Trustworthiness was the second most important factor for consumer satisfaction with the quality of information, followed by reliability, and topic coverage. Study participants did not consider other factors such as accuracy and currency to be crucial factors. Moderating effects of the control variables such as editing experience with Wikipedia articles, gender, and age were also examined to enhance the internal validity of the study. Implications for the Wikipedia editor community and researchers, and directions of future research are presented.

• 대한영상의학회지
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• 제81권6호
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• pp.1453-1458
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• 2020

후복막강 출혈은 항응고 치료의 치명적 합병증일 수 있으며, 나이 및 산과력과 상관없이 난소동맥이 출혈 병소일 수 있다. 저자들은 폐경기 여성에서 항응고 치료 중에 발생한 난소동맥 출혈을 경도관 혈관조영술 및 색전술을 통해 정확한 진단 및 효과적인 지혈이 가능했던 증례를 소개하고자 한다.

• Clinical Endoscopy
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• 제56권2호
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• pp.155-163
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• 2023

Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, the majority of patients with MHO cannot undergo surgery on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and the quality of life. Among the drainage methods, endoscopic biliary drainage is the current standard for palliation of unresectable advanced MHO. In addition, combined with endoscopic drainage, additional local ablation therapies, such as photodynamic therapy or radiofrequency ablation (RFA), have been introduced to prolong stent patency and survival. Currently, RFA is commonly used as palliative therapy, even for advanced MHO. This literature review summarizes recent studies on RFA for advanced MHO.

• 대한간호학회지
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• 제1권1호
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• pp.103-110
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• 1970

It is important to point out that the percental mortality rate of the multiple pregnancy is almost twice of the single pregnancy due mainly to their prematurity and the mothers of twins will also be suffered from the plural births to nurse and take care of them. We therefore studied the incidence, the sex ratio, the types of deliveries, the complications and the percental mortality rate of the twin deliveries in order to promote the development of our field of maternal and child nursing. We selected our materials from the 112 patients who had been admitted and delivered twins in the department of OB. & Gyn. of the S.N.U. Hospital from Jan. 1962 to Dec. 1969. The abstructed results of this study were as follows. 1. The incidence of twins among 7, 731 births was 1:69 2. The occurrence of twins from elder multigravida was 4 to 6 times higher than younger primigravida mothers under 35 years of age. 3. The generational length of 45.5% of all twins was under 38 weeks and the mean birth weight of 1st and 2nd twins were 2, 354.7gm and 2, 215.8gm respectively. 4. The sex ratio of twins was 99 males and 124 females. 5. Presentation of twins: 59 cases (52.69%) were in both vertex. 37 cases (33.03%) in vertex plus breech. 15 cases (13.39%) in both breech and one case (0.89%) in transverse presentation. 6. For the types of deliveries Spontaneous deliveries were in 90 babies (40.6%) Breech extraction in 60 babies (26.3%) Vacuum used in 33 babies (15.0%) Cesarean section in 33 babies (9.8%) Forceps in 9 babies (4.2%) and others such as version and destructive measures in 9 babies (4.1%) 7. Intervals between the 1st and 2nd delivery were analyzed and 93% of 2nd twins were delivered within minutes after 1st delivery. 8. The main complications of twin deliveries were totemic (45.5%), second was postmarital hemorrhage (19.6%) and third was hydrations (7.1%) 9. The mean percental mortality of 1st and 2nd twins was 12.52% and 16.96% respectively of which main cause of death were their prematurity.

• Radiation Oncology Journal
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• 제37권4호
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• pp.293-301
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• 2019

Purpose: External beam radiotherapy (EBRT) is a useful option to treat head and neck skin cancer patients who are not indicated for surgery. In this study, we evaluated the treatment outcomes of EBRT in an Asian population. Materials and Methods: The records from 19 head and neck skin cancer patients (10 with squamous cell carcinoma and 9 with basal cell carcinoma) who were treated with definitive or adjuvant EBRT from 2009 to 2017 were retrospectively reviewed. The radiotherapy doses administered ranged from 50 to 66 Gy (median, 55 Gy) with 2.0-2.75 Gy per daily fraction (median, 2.5 Gy). The T stage at presentation was as follows: Tis (1 patient), T1 (11 patients), T2 (6 patients), and T3 (1 patient). None had regional lymph node disease or distant metastasis at presentation. The local failure-free survival (LFFS) rates, toxicity, and cosmetic results were analyzed. Results: The median age was 75.5 years (range, 52.6 to 92.5 years). The median follow-up duration from the completion of radiotherapy was 44.9 months (range, 5.8 to 82.6 months). One local failure occurred in a patient with a 2.1-cm posterior neck squamous cell carcinoma at 32.5 months after radiotherapy (1/19, 5.3%). The 3-year LFFS rate was 91.7%. No patients died from skin cancer during follow-up, and no grade 3 complications occurred. The cosmetic outcomes were excellent for 16 (84.2%) and good for 3 (15.8%) of the 19 patients. Conclusion: EBRT offers good local control and cosmetic outcomes in patients with head and neck skin cancer, with no grade 3 complications.

• Clinical and Experimental Pediatrics
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• 제58권10호
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• pp.392-397
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• 2015

Purpose: Alagille syndrome is a complex hereditary disorder that is associated with cardiac, hepatic, skeletal, ocular, and facial abnormalities. Mutations in the Notch signaling pathway, such as in JAG1 and NOTCH2, play a key role in embryonic development. A cardiac or hepatic presentation is a critical factor for determining the prognosis. Methods: We conducted a retrospective study of 41 patients with Alagille syndrome or a JAG1 mutation between 1983 and 2013. Results: The first presentations were jaundice, murmur, cyanosis, and small bowel obstruction at a median age of 1.0 months (range, 0-24 months). The JAG1 mutation was found in 27 of the 28 genetically-tested patients. Cardiovascular anomalies were identified in 36 patients, chronic cholestasis was identified in 34, and liver transplantation was performed in 9. There was no significant correlation between the severity of the liver and cardiac diseases. The most common cardiovascular anomaly was peripheral pulmonary stenosis (83.3%), with 13 patients having significant hemodynamic derangement and 12 undergoing surgical repair. A total bilirubin level of >15 mg/dL with a complex surgical procedure increased the surgical mortality (P=0.022). Eight patients died after a median period of 2.67 years (range, 0.33-15 years). The groups with fetal presentation and with combined severe liver and heart disease had the poorest survival (P<0.001). Conclusion: The group with combined severe liver and heart disease had the poorest survival, and a multidisciplinary approach is necessary to improve the outcome.

• Journal of Oral Medicine and Pain
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• 제32권1호
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• pp.81-90
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• 2007

2005년 9월부터 2006년 8월까지 부산대학교병원 구강내과 구강안면통증 클리닉에 측두하악장애를 주소로 내원한 재발환자 33명과 초진환자 32명(대조군)을 대상으로 사회적 재적응 평정척도 설문지를 이용하여 생활변화를 조사 분석한 결과 다음과 같은 결론을 얻었다. 1. TMD 재발환자와 대조군의 생활변화량, 즉 LCU 총점은 $7{\sim}12$개월 이내에는 각각 평균 51.61점과 20.38점으로 재발군이 대조군에 비해 유의한 차이를 나타냈다(P<0.05). 2. TMD 재발환자군은 최근 1년간 생활상의 변화를 대조군에 비해 좀 더 많이 경험하는 경향을 보였다. 3. 연령 및 학령에 따른 TMD 재발군과 대조군의 차이와 고령층과 저령층간 생활변화의 차이는 인정할 수 없었다. 4. 미혼자군과 기혼자군간 생활상의 변화에 유의한 차이는 인정할 수 없었다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1105-1109
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• 2012

Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6501-6504
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• 2012

Background: Multiple myeloma is the most common malignant plasma cell dyscrasia and ranks second among primary haematological malignancies. This study describes the epidemiologic, clinical and pathologic profile of monoclonal gammopathies seen in the University Hospital of the West Indies (UHWI), a tertiary care referral centre. Materials and Method: A retrospective analysis of 85 cases diagnosed at UHWI over the 5-year period 2003-2007 was conducted. The cases were identified from the bone marrow records as well as the computerized database of the Medical Records Department. Clinical presentation, family and personal history and demographic data were retrieved. Haematological and biochemical results were also analyzed. Results: There were 85 patients diagnosed with monoclonal gammopathies. The M:F ratio was 1.2:1 and the mean age was $65.7{\pm}1.3$ years. Eighty percent of the patients had skeletal pain and 40% experienced weight loss. Of the patients experiencing bone pain 56.7% had multiple lytic lesions, 26.7% had pathological fractures and 26.7% had compression fractures. Seventy-four patients (87.1%) had a haemoglobin level <12.0 g/dL with 52.9% having values <8.0 g/dL. Renal impairment was evident at diagnosis in 36.5%. Hypercalcemia was seen in 26.5% and hyperuricemia in 45.9%. Of the 79 patients who had serum protein electrophoresis performed, 77.2% had at least one monoclonal band and of these 24.6% had a monoclonal protein also present on urine protein electrophoresis. Conclusions: The demographic profile in this group of patients is largely similar to other studies in predominantly Caucasian populations; however there was a notable increase in prevalence of severe disease at presentation, with the majority of patients presenting at the most advanced stage. It is probable that these differences reflect socioeconomic factors and not merely inherent ethnic variation in disease biology.