No abstract available.
Diabetic Foot*

BACKGROUND/AIMS: The Gastroesophageal Reflux Disease Questionnaire (GerdQ) has been developed and validated as a tool for the diagnosis of gastroesophageal reflux disease (GERD) in patients with gastrointestinal symptoms. However, the GerdQ and the cutoff value for determining GERD has not been validated in Korea. METHODS: Patients with symptoms suggestive of GERD were consecutively recruited. The Korean version of GerdQ was developed through a forward-backward translation process according to the cross-cultural adaptation method. Endoscopically documented esophagitis, abnormal results on 24-hour ambulatory pH recording with symptom association monitoring, or response to proton pump inhibitor treatment were used as diagnostic references for GERD. The reproducibility and test characteristics of the Korean version of GerdQ were assessed. RESULTS: A total of 149 patients with a median age of 55 years were analyzed. The intra-class correlation coefficient of 2 subsequently measured GerdQ scores was 0.651 (95% CI, 0.518–0.748). The cutoff value of 8 was found to have the highest sensitivity (64.9%; 95% CI, 56.2–73.7) and specificity (71.4%; 95% CI, 56.5–86.4) for the diagnosis of GERD. The questionnaire had a high positive predictive value (88.1%; 95% CI, 81.2–95.0), but a low negative predictive value (38.5%; 95% CI, 26.2–50.3) for GERD. Any symptom improvement on proton pump inhibitor treatment showed a sensitivity of 93.0% (95% CI, 88.3–97.7) and a specificity of 48.6% (95% CI, 32.0–65.1) for GERD. CONCLUSION: The Korean version of GerdQ is a useful complementary tool in the diagnosis of GERD.
Diagnosis ; Esophagitis ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Korea ; Methods ; Proton Pumps ; Sensitivity and Specificity ; Surveys and Questionnaires ; Symptom Assessment

To know the prevalence of Enterobius vermicularis infection and what are the most important risk factors, we evaluated the incidence and risk factors of enterobiasis among children attended in kindergartens in Busan metropolitan city, Republic of Korea. A total of 1,674 children from 21 kindergartens in 11 of 16 autonomous districts of Busan were evaluated for E. vermicularis infection by the cellotape anal swab technique. The overall egg-positive rate for E. vermicularis was 10.7% (179/1,674), and the prevalence of enterobiasis in each kindergarten ranged between 0% and 32.4%. There was an increasing tendency of the egg positive rate according to the population density; the higher the population density communities had, the higher egg-positive rate for E. vermicularis was detected (P = 0.001). Among personal hygiene factors involving children, thumb-sucking (P = 0.036) and fingernail-trimming (P = 0.024) were highly associated with enterobiasis. In addition, taking anthelmintic medications against E. vermicularis infection was strongly associated with enterobiasis (P = 0.014). Moreover, parents' knowledge of enterobiasis was correlated significantly with the incidence of enterobiasis of their children (P = 0.006). In conclusion, we need to consider not only personal hygiene but also parents' knowledge about enterobiasis as a factor in order to develop new strategies for elimination or to complete reduction of enterobiasis in Korea.

PURPOSE: In pediatric acute respiratory failure patients requiring mechanical ventilator support, mortality is seldom related to respiratory disease alone, but more generally to multiple organ dysfunction syndrome. The purpose of this study is to evaluate whether early changes in the SOFA score (Delta-SOFA) are more effective for predicting the outcome than a single assessment upon admission for pediatric acute respiratory failure patients requiring mechanical ventilator support. METHODS: The medical records of pediatric patients with acute respiratory failure requiring mechanical ventilator support for more than 72 hours in the PICU of the Asan Medical Center Children's Hospital, Seoul, Korea, between January 2008 and May 2009 were retrospectively reviewed. RESULTS: Early Delta-SOFA showed a significantly stronger correlation with patient mortality compared with the initial SOFA score, PRISM III score and PELOD score (P<0.05). When analyzing the trends in the SOFA score during the first 72 hours, the mortality rate was significantly higher in children with increased and unchanged SOFA scores 72 hours after admission than in children with a decreased SOFA score. (14.5% vs. 42.9%, P<0.05) CONCLUSION: Regardless of the initial SOFA score, early serial evaluation of the SOFA scores during the first 3 days of PICU admission is a better indicator of the prognosis than a single assessment obtained at admission in acute respiratory failure patients mechanically ventilated for more than 3 days.
Child ; Humans ; Korea ; Medical Records ; Multiple Organ Failure ; Prognosis ; Respiratory Insufficiency ; Retrospective Studies ; Ventilators, Mechanical

Invasive lobular carcinoma is the second most common breast malignancy. Mammographic finding of invasive lobular carcinoma is often subtle or negative due to its histological feature showing infiltration of tumor cells into surrounding tissue with scanty fibrotic reaction. Thus, ultrasound plays an important role in detection of invasive lobular carcinoma. We report here on our experience with a 70-year-old female who had invasive lobular carcinoma of the breast with unique ultrasound findings; a mixed hyper- and hypoechoic mass at the fatty layer mimicking fat necrosis.
Aged ; Breast* ; Carcinoma, Lobular* ; Fat Necrosis* ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Ultrasonography ; Ultrasonography, Mammary

Basophils ; Carcinoma ; Eosinophils ; Hair Follicle ; Head ; Neck ; Pilomatrixoma ; Upper Extremity

Dental Occlusion ; Humans ; Incisor ; Malocclusion ; Orthognathic Surgery ; Skull ; Skull Base

PURPOSE: Here, our results from a prospective treatment protocol of concurrent radiochemotherapy (CRCT), which was conducted for locally advanced nasopharynx cancers, between April 1994 and May 2001, are reported. MATERIALS AND METHODS: A total of 52 consecutive eligible patients were accumulated for this protocol. The median radiation doses to the primary site, involved nodes and uninvolved neck were 72, 61.2 and 45 Gy, using a serial shrinking field technique. The boost techniques were 3-dimensional conformal radiation therapy in 45, intracavitary brachytherapy in 3 and 2-dimensional radiation therapy, with multiple small fields, in 2 patients. Two chemotherapy regimens were used: the first regimen, used in 8 patients during the earlier part of the study duration, consisted of 2 cycles of cisplatin plus 5- fluorouracil every 4 weeks, with concurrent radiation therapy, and 4 cycles with the same agents every 4 weeks, adjuvantly; the second regimen, used in 44 patients during the later part, consisted of 3 cycles of cisplatin every 3 weeks, with concurrent radiation therapy and 3 cycles of adjuvant cisplatin plus 5-fluorouracil every 3 weeks. RESULTS: The median follow-up period of the survivors was 32 months. The male to female ratio was 36/16, with a median age of 48 years. The stages, according to the new AJCC staging system (1997), were IIb in 6, III in 23, IVa in 14 and IVb in 9 patients. Fifty and 32 patients completed the planned radiation therapy and concurrent chemotherapy, respectively. Two patients died, 1 of septic shock during the CRCT and the other of malnutrition during the adjuvant chemotherapy. There were 12 failures in 11 patients: 7 locoregional recurrences, 1 within and 6 outside the radiation target volume, and 5 distant metastases. The locoregional control, disease-free survival and overall survival rates were 84.3, 78.8 and 92.8% at 3 years, respectively. CONCLUSION: High dose radiation therapy, coupled with concurrent chemotherapy, was judged a highly effective treatment for locally advanced nasopharynx cancers.
Brachytherapy ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Cisplatin ; Clinical Protocols ; Disease-Free Survival ; Drug Therapy* ; Female ; Fluorouracil ; Follow-Up Studies ; Humans ; Male ; Malnutrition ; Nasopharyngeal Neoplasms* ; Nasopharynx* ; Neck ; Neoplasm Metastasis ; Prospective Studies ; Recurrence ; Shock, Septic ; Survival Rate ; Survivors

PURPOSE: To report the results of curative treatment for patients with tonsil cancer by retrospective analysis. MATERIALS AND METHODS: From Jan. 1995 till Dec. 2000, 27 patients with squamous cell carcinoma of the tonsil received curative treatment at Samsung Medical Center. Therapeutic decision was made through multidisciplinary conference, and curative radiation therapy was favored when, (1) the patient's condition was not fit for general anesthesia and surgery, (2) the patient refused surgery, (3) complete resection was presumed impossible, or (4) too severe disability was expected after surgery. Surgery was the main local modality in 17 patients (S+/-RT group), and radiation therapy in 10 (RT+/-CT group). The median follow-up period was 41 months. RESULTS: AJCC stages were I/II in four, III in two, and Iv in 21 patients. The 5-year disease-free survival rate was 73.3% in all patients, 70.6% in the S+/-RT group, and 77.8% in the RT+/-CT group. Treatment failure occurred in seven patients, all with stage III/IV, and all the failures occurred within 24 months of the start of treatment. Five patients among the S CT group developed treatment failures; 2 local, 2 regional, and 1 distant (crude rate=29.4%). Two patients among the RT+/-CT group developed failures; 1 synchronous local and regional, and 1 distant (crude rate=20.0%). The 5-year overall survival rate was 77.0% in all patients, 80.9% in the S+/-RT group, and 70.0% in the RT+/-CT group. CONCLUSION: We could achieve favorable results that were comparable to previously reported data with respect to both the rates of local control and of survival by applying S+/-RT and RT+/-CT. RT+/-CT is judged to be an alternative option that can avoid the functional disability after surgical resection.
Anesthesia, General ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Palatine Tonsil ; Retrospective Studies ; Survival Rate ; Tonsillar Neoplasms* ; Treatment Failure

Controlled-release carbamazepine (CBZ) could be more harmful than the regular form in special situations due to their respective biochemical characteristics. When primary treatment is not effective in acute intoxication, extracorporeal treatment (ECTR) could be an option. We recently applied ECTR to a patient with combined intoxication of topiramate and controlled-release CBZ who deteriorated despite receiving primary treatment. The patient improved after administering ECTR. Early ECTR intervention may be beneficial for the treatment of CBZ intoxication, especially of the controlled-release form.
Carbamazepine* ; Extracorporeal Circulation ; Humans