PURPOSE: To obtain the normal standard of the electrocardiogram(ECG) in newborn infants, METHODS: Standard 12-lead ECG recordings of 146 healthy neonates of gestational age above 30 weeks recorded in 24 hours after birth were analyzed for the following parameters: heart rate, QRS axis, PR interval, QTc interval, R and S wave amplitude. RESULTS: The mean gestational age of preterm(between 30 and 37 weeks) and term infants was 33.2 +/-2.4 and 38.4+/-3.2 weeks, and the mean birth weight was 2,168+/-371 g and 3,254+/-436 g, respectively. There was no meaningful difference between two groups in heart rate, PR interval, QTc interval, and QRS axis. Amplitudes of R waves in V1>-V6 leads and S waves in V2, V3 and V5 leads in term baby group were significantly larger than those in preterm baby group. The sum of amplitudes of R and S waves was largest in V2. The amplitude of combined R+S waves in V2 and V3 leads was significantly larger than that in V5 and V6 leads in both groups. This difference was more prominent in tbaby group. CONCLUSION: The results suggest that the increase in cardiac muscular mass and progressive right ventricular predominance are in accordance with the increase in gestational age.
Axis, Cervical Vertebra ; Birth Weight ; Electrocardiography* ; Gestational Age ; Heart Rate ; Humans ; Infant ; Infant, Newborn* ; Parturition

BACKGROUND: A hand hygiene policy has been introduced by the Joint Commission International Accreditation Standards for Hospitals (JCI); the purpose of this policy is to ensure that systematic standards are continuously practiced at hospitals in order to improve the quality of medical care and the safety of patients and health care workers. This policy requires that phlebotomists wear new gloves and disinfect their hands before attending a patient to prevent nosocomial infections and to protect the phlebotomists. This study aimed to assess the responses of patients and guardians regarding the hand hygiene procedures. METHODS: Between January and February 2010, a questionnaire survey was performed at our hospital for 310 outpatients, 93 inpatients, and 189 guardians. RESULTS: In all, 70.8% of respondents answered that phlebotomists did not require considerable time to remove and wear gloves, and 69.9% responded that phlebotomists could readily detect veins even with their gloves on. Besides, 81.9% respondents thought that it was sanitarily important for phlebotomists to remove their gloves and disinfect their hands after a venipuncture, whereas only 2.8% thought that this practice caused discomfort. CONCLUSION: The patients and guardians recognized that the hand hygiene procedures were important for their own safety and encouraged their application rather than considering them uncomfortable or inappropriate. Introduction and maintenance of the hand hygiene policy of JCI would not be difficult because patients or guardians recognized its importance.
Accreditation ; Cross Infection ; Surveys and Questionnaires ; Delivery of Health Care ; Dietary Sucrose ; Gloves, Protective ; Hand ; Hand Disinfection ; Hand Hygiene ; Humans ; Inpatients ; Joints ; Outpatients ; Phlebotomy ; Veins

A umbilical omphalomesenteric duct polyp is the result of incomplete closure of the omphalomesenteric duct, which connects the midgut with the yolk sac of the embryo. It may be associated with underlying embryologic anomalies such as Meckels diverticulum and umbilical enteric fistula, the complications of which may at times be fatal. This rare malformation should be clinically discerned from persistent granulation tissue or pyogenic granuloma. Histologically, it shows a polypoid lesion consisting of ectopic gastrointestinal epithelium with the appearance of gastric, intestinal, or colonic mucosa. We report a case of an umbilical omphalomesenteric duct polyp in an 8-year-old male patient, who had had a bright-red polyp on the umbilicus from the age of 1 month and had not had any other types of underlying abnormalities.
Child ; Colon ; Diverticulum ; Embryonic Structures ; Epithelium ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Umbilicus ; Vitelline Duct* ; Yolk Sac

Leiomyomas of vagina and vulva are rare solid tumors, but most common mesenchymal tumors in adult woman. Most of the reported cases have been benign. The tumors were firm, well-defined submucosal masses in a majority of patients. We experienced two cases of vulvar and vaginal leiomyoma, thus it is presented with a brief review of the cases and its literatures.
Adult ; Female ; Humans ; Leiomyoma* ; Vagina* ; Vulva*

No abstract available.
Graves Disease* ; Hypothyroidism*

PURPOSE: To determine the detection rate of MRI in the diagnosis of adenomyosis and ascertain the accuracy of MRI in assessing the extent and depth of the myometrial invasion. MATERIALS AND METHODS: By retrospective analysis of MR images of the pelvis in 65 pathologically proven cases of uterine adenomyosis, we investigated the detection rate and differences of in the detection rate when this was based on (a) the extent, and (b) the depth of myometrial invasion. The condition was classified as diffuse or focal according to the extent of invasion, and mild, moderate, or severe according to its depth. RESULTS: Pathologically, there were 35 cases of focal adenomyosis (53.8%), and 30 of diffuse adenomyosis (46.2%). Among patients with the focal variety of this condition, 12 cases were mild, 14 were mild, 14 were moderate, and nine were severe, while among those with the diffuse variety, two were mild, ten were moderate and 18 were severe. A total of 48 cases (73.8%) were detected on MR images; the detection rate of focal adenomyosis was 60.0% (21/35) and that of diffuse adenomyosis was 90.0% (27/30). The detection rates of mild, moderate, and severe adenomyosis were 42.9%(6/14), 79.2%(19/24), and 85.2% (23/27), respectively. Among the 48 cases detected on MR images, the pathologic and MR findings were consistent with regard to both the extent and depth of myometrial invasion in 26(54.2%). For diffuse adenomyosis, the consistency rate was higher than for the focal variety (81.5%, 22/27; compared with 19%, 4/21). The extent of myometrial invasion was correctly evaluated in 32 cases (66.7%); the consistency rate for the diffuse form was higher than for the focal form [96.3% (26/27), compared with 28.6% (6/21)]. In 42 cases (87.5%), the depth of invasion was correctly evaluated, though differences in this depth were not significant. CONCLUSION: MR imaging was a useful imaging modality in the diagnosis of uterine adenomyosis. With regard to the extant of mymetrial invasion, the detection rate was higher among cases of the diffuse form than of the focal form, and with regard to depth, the rate was higher among moderate and severe cases than among mild ones. These findings may be useful for preoperative diagnosis based on clinical symptoms, and provide important yardstick for decisions as to whether hysterectony should be replaced by an alternative therapy.
Adenomyosis* ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Pelvis ; Retrospective Studies ; Uterus

A 51-year-old Korean woman presented with a non-tender, well-demarcated, reddish, edematous patch on the right anterior chest where a previous mastectomy and radiation therapy had been performed. She had been diagnosed as having infiltrating ductal carcinoma of the right breast about 1 year ago. Histopathological findings of the skin lesions were consistent with inflammatory metastatic carcinoma of the breast. Inflammatory carcinoma or carcinoma erysipeloides is a well-established entity most frequently associated with carcinoma of the breast. It is characterized by dermal lymphatic invasion by malignancy and clinically should be distinguished from erysipelas or cellulitis. We describe a case of inflammatory metastatic carcinoma derived from an infiltrating ductal carcinoma of the breast which can be clinically confused with radiation dermatitis.
Breast* ; Carcinoma, Ductal ; Cellulitis ; Dermatitis ; Erysipelas ; Erysipeloid ; Female ; Humans ; Mastectomy ; Middle Aged ; Skin ; Thorax

STATEMENT OF PROBLEM: Resonance frequency analysis (RFA) has been increasingly served as a non-invasive and objective method for clinical monitoring of implant stability. Many clinical studies must be required for standardized baseline data using RFA. PURPOSE: This study was performed to evaluate RFA value changes in two stage surgery group and one stage surgery group in patients. MATERIAL AND METHOD: Forty-seven mandibles in consecutively implant installed patients were selected for this study and 141 fixtures were installed. Ninety-three fixtures were double threaded, machined surface design (Bra.nemark. MK III, Nobel Biocare AB, Go teborg, Sweden) and 48 fixtures were root form, threaded, HA-coated surface one (Replace(TM), Steri-Oss/Nobel Biocare AB, USA). Among those, each 10 fixture was installed in one stage group patients. ISQ values were measured using Osstell(TM) (Integration Diagnostics Ltd. Sweden) during fixture installation, at healing abutment connection and in the loading period for two stage surgery group patients and during at each 4, 6, 8, 10, 12 week and in the loading phase for one stage surgery group patients and evaluated the changes according to the time and fixture type. RESULTS: In two stage surgery group, mean and SD of ISQ values of machined surface implants were 76.85 +/- 3.74, 75.76 +/- 5.04, 75.73 +/- 4.41 and those of HA-coated surface implant were 75.05 +/- 6.23, 77.58 +/- 5.23, 78.32 +/- 4.29 during fixtures installation, at healing abutment connection and in the loading period, respectively. In one-stage surgery group, the ISQ values of machined surface and HA-coated surface implants decreased until 4 or 6 week and maintained at plateau for 1-3 week and increased to the loading period. CONCLUSIONS: Machined and HA-coated surface implants showed minimal ISQ changes with time if they were installed at the sites showing at least intact cortical plate and good bone qualities. And HA-coated implants had a tendency to show somewhat increased ISQ values with time.
Humans ; Mandible

PURPOSE: The Roux en Y method has rarely been performed due to longer operation time and high risk of complication, despite several merits including prevention of bile reflux. We conducted a retrospective review of the result of Roux en Y reconstruction using two circular staplers after subtotal gastrectomy. MATERIALS AND METHODS: From December 2008 to May 2009, a total of 26 patients underwent Roux en Y reconstruction using two circular staplers after subtotal gastrectomy, and seventy-two patients underwent Billroth-I reconstruction. Roux en Y anastomosis was performed using two circular staplers without hand sewing anastomosis. We compared clinicopathologic features and surgical outcomes between the two groups. All patients underwent gastrofiberscopy between six and twelve months after surgery to compare the bile reflux. RESULTS: No significant differences in clinicopathologic findings were observed between the two groups, except for the rate of minimal invasive surgery (P=0.004) and cancer stage (P=0.002). No differences in the rate of morbidity (P=0.353) and admission duration (P=0.391) were observed between the two groups. Gastrofiberscopic findings showed a significant reduction of bile reflux in the remnant stomach in the Roux en Y group (P=0.019). CONCLUSIONS: When compared with Billroth-I reconstruction, Roux en Y reconstruction using the double stapler technique was found to reduce bile reflux in the remnant stomach without increasing postoperative morbidity. Based on these results, we planned to begin a randomized controlled clinical trial for comparison of Roux en Y reconstruction using this method with Billroth-I anastomosis.
Anastomosis, Roux-en-Y ; Bile ; Bile Reflux ; Gastrectomy ; Gastric Stump ; Hand ; Humans ; Pilot Projects ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stomach Neoplasms

OBJECTIVE: To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. MATERIALS AND METHODS: A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. RESULTS: Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. CONCLUSION: Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM.
Adult ; Aged ; Biopsy ; Breast/*pathology ; Breast Neoplasms/*diagnosis/radiography/ultrasonography ; Female ; Humans ; Mammography/*methods ; Middle Aged ; ROC Curve ; Radiographic Image Enhancement/*methods ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography, Mammary/*methods