Objective : We analysed diverse clinical features of the cavernous angioma. Also, we report the experience in differ-ent methods of the management and their results. Method : Data from 80 patients who were confirmed pathologically or diagnosed radiologically between Jan. 1990 and Sept. 1998 at our hospital were analysed. Variable factors that were examined were : clinical features, effects of treatment, and complications. Results : There were 47 male and 33 female patients. The age at the first presentation was from 3 to 57(mean 34.1) years old. Clinical features were seizure in 28 cases(38%), bleeding in 24 cases(32%), neurologic deficits in 12 cases(16%), headache in 10 cases(14%), and six incidental cases. The locations of lesion were cerebral and cerebellar hemisphere in 45 cases(56.2%), brainstem, basal ganglia, and thalamus in 32 cases(40%), multiple in 3 cases (3.8%). Seizure was common at the third decade and occurred frequently with the cavernous angioma in temporal (43%) or frontal lobe(39%). Bleeding was frequent after the third decade with peak at the fourth decade and had high incidence in brainstem or thalamus. The gamma-knife radiosurgery was done in 47 cases. Rebleeding occurred in 3 cases, but it was within postradiosurgery 1 year. Symptomatic radiation change occurred in 2 cases of 8 radiation change on MRI. On follow-up MRI, no evidence of rebleeding was found in 30 cases. Also, The lesion size was decreased in 3 cases. Resection was performed in 23 cases ; total 20, subtotal 2, partial 1. Postoperative complication occurred in 6 cases(26.1%). After surgery, 7(63.6%) of 11 seizure patients had outcome of seizure-free. Subclinical rebleeding occurred in one of two subtotal resected cases. In 11 patients, conservative management was done. There was neither rebleeding nor symptom aggravation during follow-up period of mean 17.2 months. Conclusion : The solution for prevention of rebleeding is complete removal of the lesion located at noneloquent area or accessible region, especially for the patients who presented symptoms or intractable seizure. However, the Gamma knife radiosurgery is considered when the lesions are located at eloquent area or when severe postoperative morbidity is expected.
Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).
It is a generalized way for the chartering business to fix the laytime bars except rarely adapting the customary despatch of the cargo work in port. The way of customary despatch is usually accepted by the owners in case the port facilities and other relevant infrastructures are in the satisfactory level for the cargo work whereas the laytime bars to be widely incorporated in the chaterparty for almost all occasions for owners and charterers to bind each other in loading and discharging cargo in port. The main purpose of establishing laytime bars on the charterparty is to secure the right and duty for both parties of the owners and the charterers, and furthermore to make the vessel despatched quickly from the port, whereby the costs incidental to the loading and discharging in port to be saved as much as possible. and the minimized costs in port will contribute to the profits in all parties involved in loading and discharging cargo. The conditions and terms on the laytime bars are expressed variously in their kinds according to the types of the charterparty to be used. The owners and charterers or the ship operators, however, seems not to be so accustomed in lawful understanding on these terms and conditions, and therefrom lots of disputes are noticed practically in the business field. As a result, this study is focused to render the owners and charterers rather clear understanding on their meanings and effects in legal aspects, and the various English Law Cases are referred in order to achieve the purpose of this study.
A 4-year-old girl with Panayiotopoulos syndrome presented with a history of 4 prolonged autonomic seizures. The clinical features of her seizures included, in order of occurrence, blank staring, pallor, vomiting, hemi-clonic movement on the right side, and unresponsiveness. A brain magnetic resonance imaging (MRI) showed a slightly high $T_2$ signal in the left hippocampus. Interictal electoencephalogram revealed spikes in the occipital area of the left hemisphere. We analyzed the current-source distribution of the spikes to examine the relationship between the current source and the high $T_2$ signal. The current source of the occipital spikes was not only distributed in the occipital area of both cerebral hemispheres, but also extended to the posterior temporal area of the left hemisphere. These findings suggest that the left temporal lobe may be one of the hyperexcitable areas and form part of the epileptogenic area in this patient. We hypothesized that the high $T_2$ signal in the left hippocampus of our patient may not have been an incidental lesion, but instead may be related to the underlying electroclinical diagnosis of Panayiotopoulos syndrome, and particularly seizure. This notion is important because an abnormal $T_2$ signal in the hippocampus may represent an acute stage of hippocampal injury, although there is no previous report of hippocampal pathology in Panayiotopoulos syndrome. Therefore, long-term observation and serial follow-up MRIs may be needed to confirm the clinical significance of the $T_2$ signal change in the hippocampus of this patient.
This Comment explores the ICSID case of CMS Gas Transmission Company v. Argentine Republic, awarded on May 12, 2005. The Part II of this Comment first describes the relevant facts of the case including the some background for readers' understanding and the Part III summaries the claimant's requests and the decisions rendered by the Arbitral Tribunal in the Award. At Part IV, the Comment addresses the issue of determinating laws applicable to the merits of dispute in case that the parties of the case have not chosen a governing law, and at Part V, takes a close look into three main issues of (i) the indirect expropriation of the investment, (ii) the breach of fair and equitable treatment and (iii) the protections under umbrella clauses. In this CMS case, we see first that while the Tribunal affirmed that any indirect expropriation can occur from incidental interference depriving the foreign investor of the use or reasonable-to-be-expected economic benefit even if not necessarily to the obvious benefit of the host State, the Tribunal denied the occurrence of indirect expropriation in this case by holding that the Government of Argentina has not breached the standard of protection laid down in the Treaty. Secondly, however, regarding the issue of fair and equitable treatment, we see that the Tribunal, finding Argentina's breach of obligations, affirmed that the foreign investor can expect the host State to act in a consistent manner, free from ambiguity and totally transparently in its relations with the foreign investor, which can give the foreign investor certain degree of foreseeability. Thirdly and finally, we see that, on base of the effect of the umbrella clause, the Tribunal recognized the obligation of the host State undertaken not to freeze the tariff regime or subject it to price controls and not to alter the basic rules governing contracts between the foreign investor and the host State without the first's written consent. However, the protection under the umbrella clause is available only when there is a specific breach of rights and obligations under BIT or a violation of contract rights protected under BIT.
Amongst varieties of clinical nursing role, the administration of medication is often highlighted as of prime importance. In order to attain data for the improvement of teaching strategies of medication, diagnostic evaluation of the knowledge level is a necessity. This study was performed from August through December 1975. 449 registered nurses, randomly sampled from general hospitals:16 of Seoul and 7 of Taegu and Pusan, were tested through 54 test questionaries based on 4 practical dimensions of administration of medication. Results are as follows ; 1. Status of respondents: Length of clinical experiences; the average length revealed to be 2 years and 7 months, 72% revealed to have had less than 3 years of experience; 38.6%-less than 1 year, 19 .2%-over 1 year and less than 2 years, and 14, 2%-over 2 years and less than 3 years. Type of Nursing education received ; 9.4% revealed to have graduated technical high school of nursing, 67.5o/o the 3 year diploma school and 21, 7% the baccalaureate degree program. The knowledge Level; Degree of self-satisfaction on knowledge level revealed that;27, 4% responded to "more or less satisfied", 48.8% "more or less un-satisfied" and 19.8% to "not satisfied". The average level of basic knowledge revealed to be moderate by 66.95 points. The level of knowledge of 4 questionnaire categories revealed that; drug action category by average of 66.5 points, methodology category by 65.4 Points, safety measure category by 71.4 points and terminology and concepts category by 64.6 points, Questionnaire items which revealed high points are of;6 of drug action category, 4 of methodology, 4 of safety measure, and 3 of terminology. The items of low points are: 8 of drug action, 3 of methodology, 3 of safety measure and 5 of terminolology categories. 3. The type of nursing education revealed to have no significant influence on the level of knowledge on the administration of medication. 4. The length of clinical experience revealed to have no significant influence on the level of knowledge. 5. 75. l% responded that the actual practice of medication modes are "similar" to that included in the fundamentals of nursing course. 6. In-service education on medication; 54.0% revealed to have some incidental in-service education on medication while 34.0% receive programmed in- service education. 61.8% revealed to have expressed the need of systemic In-service education as one of the means for improvement of medication. 32.7% revealed to obtain information concerning medicine by reading commercial publications on drug package, while only 20.9% by reading specific information channel.
Joo, Yong Won;Son, Chang Nam;Jung, Kyong Hee;Park, Hae Jeong;Kim, Sang-Heon;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Choi, Yo Won;Chung, Won Sang;Shin, Dong Ho;Park, Sung Soo
Tuberculosis and Respiratory Diseases
/
v.65
no.3
/
pp.216-221
/
2008
A chronic expanding hematoma (CEH) in the thorax is a rare and specific condition of chronic empyema. CEHs in the thorax are often associated with tuberculosis and/or previous surgical procedures. While the incidental detection of a pleural mass and dyspnea are common clinical manifestations, a few cases present with hemoptysis. We encountered a case of CEH in the thorax. This case is unique in that it developed without a prior history of tuberculosis or surgery and presented with massive hemoptysis accompanied by bronchopleural fistula. We report the third case of CEH in the thorax in Korea with a summary of the clinical characteristics of previous cases.
Objectives: Thrombotic risk is increased in patients with cancer and there are important implications for those who suffer a venous thromboembolism (VTE). We undertook this study to determine the frequency, clinical patterns, and outcome of VTE in Saudi patients with cancer. Methods: Cancer (solid tumors and lymphoma) patients who developed VTE from January 2004 to January 2009 were studied retrospectively. Demographics and clinical characteristics related to thrombosis and cancer were evaluated. Results: A total of 701 patients with cancer were seen during the study period. VTE was diagnosed in 47 (6.7%) patients (median age 52, range 18-80 years). Lower limb DVT was the most common type, seen in 47% patients, followed by PE in 19%, and 19% patients had both DVT & PE. Thrombosis was symptomatic in 72% patients while it was an incidental finding on routine workup in 28%. Cancer and VTE were diagnosed at the same time in 38% of patients, and 47% patients developed VTE during the course of disease after the cancer diagnosis. The majority of VTE post cancer diagnoses occurred during the first year (median 4 months, range 1-14). Additional risk factors for VTE were present in 22 (47%) patients and 14 (30%) of these patients were receiving chemotherapy at the time of thrombosis. Only 5 (10.6%) patients were receiving thrombo-prophylaxis at the time of VTE diagnosis. Most common types of tumors associated with thrombosis were breast cancer, non-Hodgkin's lymphoma and lung cancer. The majority of the affected patients (79%) had advanced stage of cancer. After a median follow-up of 13 (range 0.5-60) months, 38 (81%) patients had died. There was no difference in the mortality of patients with symptomatic or asymptomatic thrombosis (82% vs 78.6%). Conclusions: Thrombotic complications can develop in a significant number of patients with cancer, and almost half of the patients have additional risk factors for VTE. Thrombosis is usually associated with advanced disease and can be asymptomatic in more than a quarter of cases. Thromboprophylaxis in cancer patients is under-utilized. Community based studies are needed to accurately define the extent of this problem and to develop effective prophylactic strategies.
The Journal of the Convergence on Culture Technology
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v.6
no.3
/
pp.33-43
/
2020
The purpose of this study is to investigate the level of payment of accommodation charge to hotel customers and to analyze the differences in hotel choice factors according to the level of payment(low, medium and high prices) to present marketing measures for attracting customers by hotel price range. To achieve the purpose of research, a survey was conducted on hotel customers from February 1, 2020 to April 30, 2020. A total of 350 questionnaires were distributed, eliminating 45 inappropriate copies for analysis, and finally utilizing 305 questionnaires for analysis. According to the analysis, among the basic factors, the biggest difference between groups was hotel size, breakfast menu, restaurants, and auxiliary facilities. It was analyzed that there are differences between groups in the amenity section in the room factor and outside tourism programs in the incidental factor. The main factors were analyzed as the most important factor, although there were no differences between groups. Based on this, the marketing plan is proposed as follows. Low-cost hotels are targeted at women in their 20s with high school diplomas, and it is recommended to have low-cost price policies and promotions. Mid-priced hotels are targeted at men in their 40s with college degrees, and they should strive to operate shuttle buses, promote room prices, and educate employees. In the case of high-priced hotels, it was analyzed that overall service reinforcement, employee education, and viral marketing are important, targeting high school graduates in their 20s.
Journal of the Society of Cosmetic Scientists of Korea
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v.37
no.1
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pp.83-90
/
2011
Priming refers to the incidental activation of knowledge structures, such as trait concepts and stereotypes, by the current situational context. Many studies have shown that the recent use of a trait construct or stereotype, even in an earlier or unrelated situation, carries over for a time to exert an unintended, passive influence on the interpretation of behavior. Recent researches have shown that attitudes and other affective reaction can be triggered automatically by the mere presence of relevant objects and events. So assuming that behavioral responses to fragrance are also represented mentally, they should also be capable of becoming automatically activated, by the same principles that govern the development of automaticity of other representations. On the basis of this theory, this study examined the effect of fragrance on the quality of cosmetic products.
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