Impact of previous invasive pulmonary aspergillosis on the outcome of allogeneic hematopoietic stem cell transplantation / 대한혈액학회지

BACKGROUND: Invasive pulmonary aspergillosis (IPA) is one of the major complications encountered by patients receiving chemotherapy for hematologic malignancies. The prolonged period of intense immunosuppression following allogeneic hematopoietic stem cell transplantation (HSCT) may increase the risk of IPA recurrence in patients with a history of IPA. We evaluated the impact of a history of IPA on allogeneic HSCT outcome, and examined the incidence of IPA after HSCT. METHODS: This retrospective study included 22 patients with a history of IPA prior to receiving allogeneic HSCT at the Samsung Medical Center from 1995 to 2007. Diagnosis of IPA was defined as proven (N=5), probable (N=0), or possible (N=17). RESULTS: All 22 patients received amphotericin-based regimens to treat pre-transplant IPA. Secondary antifungal prophylaxis was administered to 10 patients during HSCT. The development of post-transplant IPA was observed in 2 patients. One of the patients died from septic shock within 2 days of the diagnosis of possible IPA. The other patient recovered from IPA, but eventually had a relapse of the primary disease. Of the 22 patients, the overall 2-year survival rate was 63% (95% confidence interval [CI]: 41-85), and the transplant-related mortality rate was 19% (95% CI: 0-38). CONCLUSION: Our results suggest that a history of IPA prior to HSCT does not have an adverse impact on transplant outcomes, although the small number of cases was a limitation in this study. Future studies involving a larger number of cases are needed to further examine this issue.

Validation of a Path Model on Elderly Women's Yangsaeng (Yangsaeng; traditional oriental health promotion)

PURPOSE: This study examined the fitness of a path model on the relationship among perceived health status, self-esteem, self-efficacy, and Yangsaeng for elderly women. METHODS: The subjects consisted of 633 aged women. Data were collected through self-report questionnaires. The data were analyzed with the SPSS and AMOS programs. RESULTS: Perceived health status, self-esteem, and self-efficacy showed a direct effect on elderly women's Yangsaeng while perceived health status and self-esteem showed an indirect effect on their Yangsaeng. Perceived health status and self-esteem showed a direct effect on elderly women's self-efficacy. The hypothetical path model of elderly women's Yangsaeng was proven correct. CONCLUSION: These results suggest that elderly women's Yangsaeng can be enhanced by increasing their perceived health status, self-esteem and self-efficacy. Based on the outcomes of this study, it is necessary to design an intervention program that emphasizes the enhancement of perceived health status, self-esteem and self-efficacy in order to improve elderly women's Yangsaeng.

A Case of Penetration of Mesh after Rectopexy and This Was Found by Colonoscopy / 대한소화기내시경학회지

Rectal prolapse is a protrusion of the rectum beyond the anal canal. Since rectal prolapse is a surgical disease, it is mostly diagnosed and treated at the surgical department. However, when surgical complications occur or they are suspected after an operation for colorectal disease, colonoscopy may now have a role in diagnosing the actual status of the problem. We present here the case of penetration of mesh at the distal rectum that was incidentally diagnosed by colonoscopy and the patient had previously undergone presacral rectopexy for rectal prolapse. Only one such case has been reported abroad and there has been no such case report in Korea. We report here on a case for which colonoscopy had a crucial role in diagnosing an occult complication after a colorectal operation that used a prosthesis.

MR Arthrography of the Labral-Capsular-Ligamentous Complex: Normal Anatomy, Anatomic Variations, and Pitfalls - Preliminary Study

PURPOSE: To evaluate anatomic variations and pitfalls of the labral-capsular-ligamentous complex in the shoulder joint for the proper interpretation of magnetic reasonance arthrographic images. MATERIALS AND METHODS:To determine the presence of sublabral sulci, undercutting of the base of the glenoid labrum by the articular cartilage, and the proximity of the middle glenohumeral ligament to the anterior glenoid labrum, 56 MR arthrograms of 41 asymptomatic volunteers were prospectively evalvated for labral shape and capsular insertion. We also evaluated the axillary fold, which was often confused with a loose body. RESULTS: The anterior and posterior parts of the labra, varied but their shape showed several dominant features; triangular(72%, 36%, respectively), rounded(13%, 35%), cleaved(8%, 1%), notched(2%, 0%), flat(5%, 24%), and absent(0%, 4%). Anterior capsular insertion was type 1 in 82% of cases, type 2 in 13% and type 3 in 5%, whereas posterior insertion was type 1 in 62%, type 2 in 36% and type 3 in 2%. We could also detect many pitfalls, such as undercutting of the base of theglenoid labrum by the articular cartilage(29%), sublabral sulci(25%), a prominent axillary fold(38%), and the middle glenohumeral ligament in proximity to the anterior labrum(5%). CONCLUSION: Our study revealed wide variability in the MR arthrographic appearance of the labral-capsular-ligamentous complex in asymptomatic shoulders. A good understanding of normal variation and pitfalls of the normal shoulder may be helpful pathologic condition in case of glenouhumeral instability.

MR Imaging of Posterior Cruciate Ligament Injury

PURPOSE: There is increasing awareness of the clinical importance of early detection and treatment of posterior cruciate ligament(PCL) injury. We evaluate the usefulness of Magnetic resonance(MR) imaging in the diagnosis of PCL injury. MATERIALS AND METHODS: We retrospectively analysed the MR images of 140 cases with clinically suspected knee injury. Arthroscopic or surgical correlation was available in 63 cases. We observed the finding and extent of PCL injury and other associated abnormalities. The frequency of anterior and posterior meniscofemoral ligament was evaluated. RESULTS: Eleven PCL injuries were observed, six midsubstance tears, two tibial attachment tears, two fernoral attachment tear, one laxity. The sensitivity, specificity and accuracy of MR imaging diagnosis are 100%, 98.1%, 98.4%. MR findings of PCL injury are discontinuity and focal mass formation, irregular increased signal intensity, detachment or redundancy of the ligament with avulsed bony fragment. In all cases of injured PCL, other associated abnormalities of adjacent structures were observed. Accessory anterior and posterior meniscofemoral ligaments were observed in 67.4%(87/129). CONCLUSION: MR imaging is useful in evaluation of presence or absence of PCL injury, accurate extent of PCL injury and other important associated abnormalities of adjacent structures.

MRI Findings of Cervical Lymphadenopathy: Preliminary Study

PURPOSE: The purpose of this study is to evaluate findings in MRI which maybe useful in differential diagnosis of cervical lymph node enlargement. MATERIALS AND METHODS: We retrospectively analyzed the MRI findings of cervical lymph node enlargement in surgically proven 13 patients. We analyzed the location, size and shape, signal intensity, margin between node and surrounding structures degree and patterns of contrast enhancement RESULTS: No disease specificity in location and size of lymphadenopathy. was demonstrated in MRI. Most lymph nodes shows isointensity or slightly increased signal intensity to adjacent muscle on T1WI and high signal intensity on T2WI. Most of the cases showed contrast enhancement with metastatic lymph nodes showing ring-like and/or patchy enhancement. Tuberculous lymphadenopathy showed homogeneous or rather thick walled ring-like enhancement and one or multiple central nonenhancing portions of eccentrical location in the node. Relatively homogeneous enhancements were noted on reactive lymphold hyperplasia, Lymphoma and Castleman's disease. CONCLUSION: MR imaging was helpful in differentiation of cervical lymph node enlargements. Tuberculous lymphadenopathy showed characteristic findings of rather spherical shaped, thick walled ring enhancement and multiple eccentrically located central nonenhancing portions.

Influences of Suture Materials on Corneal Astigmatism After Cataract Surgery

While advancements in microsurgical technique and suture material have led to meticulous wound closure in cataract surgery, excessive postoperative corneal astigmatism may delay visual recovery and compromise the ultimate optical outcome. Greater efforts to prevent and control surgically induced astigmatism have been made recently since the introduction and popularized use of intraocular lenses. Control of astigmatism has been attempted with intraoperative variations in the size, location, and type of incision, the selection of suture material, attention to suture depth and technique, the use of preplaced sutures to facilitate wound closure, and most recently, the application of surgical keratometers. We reviewed follow up records to evaluate and compare the influences on corneal astigmatism after extracapsular cataract extraction(ECCE) with intraocular lens implant in 100 cases of polyglactin 9l0(vicryl) group and 50 cases of polydioxanone (PDS) group, and results were as follows; 1. In planned ECCE group, mean corneal refractive power changes was -0.14D +/- 0.47 in vicryI group and -0.17D +/- 0.78 in PDS group, there was no significant correlation between two. In phacoemulsification(KPE) group, mean corneal refractive power changes was 0.05D +/- 0.49 in vicryl group and 0.27D +/- 0.82 in PDS group. There was no significant correlation between two. 2. In total group, mean corneal refractive power changes was 0.02D +/- 0.48 in vicryl group and 0.08D +/- 0.74 in PDS group. There was no significant correlation between two groups. 3. Mean power of cylindrical lens for correction of astigmatism was -0.76D +/- 0.98 in vicry I group and -0.67D +/- 0.71 in PDS group, there was no significant correlation between two.

Clinical Analysis of Glaucoma Triple Procedure of Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation Combined with Trabeculectomy

Glaucoma triple procedure of extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy which was undergone in 21 eyes(20 cases) since May 1984, were reviewed. The results as follows. 1. In the distribution of sex and age of 20 patients, 16 patients(75%) were male, and seventies, which were most common, were 9 patients(45.0%); fifties, 5; forties, 1; thirties, 1. The average age was 63.9 years old. 2. In type of glaucoma, chronic open angle glaucoma which was most common, were 14 eyes(66.7%); chronic angle closure glaucoma, 5 eyes(23.8%); aphakic glaucoma, 1 eye(4.8%); secondary glaucoma, 1 eye(4.8%). 3. Visual acuity improved in 20 eyes but unchanged in 1 eye, and 14 eyes(66.7%) achieved visual acuity 0.5 or better. 4. Preoperative mean intraocular pressure(IOP)was 20.9mmHg and postoperative mean IOP was 6.1, 4.5mmHg lower than preoperative level at 2 and 6 months res pectively. 5. 2.1 glaucoma medications was needed preoperatively and 0.7, 0.8 was needed at postoperative 2 and 6 months respectively. 6. There were no serious complications that affected the visual acuity. However minor complications were as follows. Hyphema were 4 eyes(19.0%); mydriasis, 3 eyes(14.3%); flat chamber, 1 eye(14.3%); flat chamber, 1 eye(4.8%); cystoid macular edema, 1 eye(4.8%).

Noninvasive Estimation of Pulmonary Artery Pressure with Doppler Echocardiogrphy

No abstract available.

Blood Level of Phenobarbital in Treatment of Seizure After Neonatal Asphyxia

No abstract available.