Diverticular disease of the colon is frequently involved in Western countries, which in korea, it is regarding as rare disease. In Western the diverticulosis is mainly affected on left side and increasing in according to age and false type is more frequent than ture type. While in oriental countries, the diverticulosis of the colon is mainly affected on right side and it is more frequent in younger patients. Cecal diverticulitis is known to a very rare disease and very difficult to be differenciated from acute scopy has purnished another useful tool in the differential diagnosis of diverticular disease. We experienced a case of cecal diverticultitis which had been diagnosed by colonofiberscopy and reviewed literatures briefly.
Colon ; Diagnosis, Differential ; Diverticulitis* ; Diverticulum ; Humans ; Korea ; Rare Diseases

Acidosis ; Airway Obstruction ; Blood Volume ; Emergencies ; Emergency Medical Services ; Hemorrhage ; Humans ; Intubation ; Perfusion ; Respiration ; Shock ; Shock, Hemorrhagic ; Tracheostomy ; Vital Signs ; Wounds and Injuries

PURPOSE: The objective of this work to construct eigenvalue maps that have information of magnitude of three primary diffusion directions using diffusion tensor images. MATERIALS AND METHODS: To construct eigenvalue maps, we used a 3.0T MRI scanner. We also compared the Moore-Penrose pseudo-inverse matrix method and the SVD (single value decomposition) method to calculate magnitude of three primary diffusion directions. Eigenvalue maps were constructed by calculating of magnitude of three primary diffusion directions. We did investigate the relationship between eigenvalue maps and fractional anisotropy map. RESULTS: Using Diffusion Tensor Images by diffusion tensor imaging sequence, we did construct eigenvalue maps of three primary diffusion directions. Comparison between eigenvalue maps and Fractional Anisotropy map shows what is difference of Fractional Anisotropy value in brain anatomy. Furthermore, through the simulation of variable eigenvalues, we confirmed changes of Fractional Anisotropy values by variable eigenvalues. And Fractional anisotropy was not determined by magnitude of each primary diffusion direction, but it was determined by combination of each primary diffusion direction. CONCLUSION: By construction of eigenvalue maps, we can confirm what is the reason of fractional anisotropy variation by measurement the magnitude of three primary diffusion directions on lesion of brain white matter, using eigenvalue maps and fractional anisotropy map.
Anisotropy ; Axis, Cervical Vertebra* ; Brain ; Diffusion Tensor Imaging* ; Diffusion* ; Image Processing, Computer-Assisted* ; Magnetic Resonance Imaging

BACKGROUND: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. METHODS: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. RESULTS: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. CONCLUSIONS: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Prognosis ; Retrospective Studies* ; Risk Factors ; Rotator Cuff* ; Tears*

It is necessary to have accurate statistical data of disease for planning and evaluating public health policy as well as assessing population health index. The national health insurance data is the only data to assess incidence of diseases nation-wide. However, inaccuracy of the data pose serious limitations of use of the data. The Medical Record Departments of individual health facilities have used discharge summary information for hospital management and clinical research, but a nation-wide integrated database of diseases has not been setup and utilized. We applied previously developed Korean Uniform Hospital Discharge Data Sets to collect discha rge summary data from health care facilities and establish integrated database. We also made the question and answer column about disease of the database in the internet. We collected patient discharge data from a tertiary-care hospital for one year using the electronic discharge summary data collection system, except for health care costs. The internet querying system provided optional selection of columns or rows, individual and/or disease groups and surgical procedures. To make query easy, the system provided various functions like querying codes of diseases and/or surgical operations, reviewing questions, downloading results via excel files, help functions of query. The establishment of disease database and the interactive system through internet is in its inception, further studies may be necessary to make it a user friendly and accurate system. There is a need of an accurate assessment of current population-based health status and future trends in Korea. It is hoped that this study may trigger to establish national accurate database for enhancing studies of health policy making, clinical research and vital health statistics by expanding data collections to the se condary- care and primary- care institutions.
Incidence

OBJECTIVE: We report here on analyzing 3,128 subjects with stroke and who were discharged from the Departments of Rehabilitation Medicine of secondary or tertiary hospitals, and all the hospitals subscribed to the Online Database System developed by the Korean Society of Neurorehabilitation. METHOD: This is a retrospective analysis of the brain rehabilitation registry database for outcome of stroke outcome in the year 2006 to 2008. RESULTS: The male stroke subjects and cerebral infarction were 58.4% and 66.3%, respectively. Cerebral infarction in the middle cerebral artery territory was the most common, and the basal ganglia and cerebral cortex were the common areas for the cases of intracranial hemorrhage. The mean age of the patients was 61.7 years, and the most common ages were 45~64 years for all the stroke subjects. The subjects with cerebral hemorrhage (56.1 years) were younger than those with cerebral infarction (63.9 years). Seasonal variation was observed in the occurrence of stroke; spring (34.1%), winter (27.4%), summer (21.6%) and autumn (16.8%) in this order. There was no significant difference of the changes on the Korean version of the modified Barthel index between the patients with cerebral infarction and cerebral hemorrhage after rehabilitation. On analyzing the two groups of stroke subjects admitted before and after 100 days from stroke onset, the changes on the Korean version of the modified Barthel index and the Brunnstrom stage scores of the early admission group were higher that those of the late rehabilitation group. CONCLUSION: The above findings suggest that 1) the incidence, lesion sites and seasonality of stroke in this database system are similar to those of the worldwide data, 2) the length of hospital stay for the subjects with stroke is about 46 days and 3) early rehabilitation is more effective in improving the outcome of stroke subjects.

BACKGROUND: TMP/SMX has been shown to cause hyperkalemia in a few outpatients on standard-dose. This prospective study was aimed at investigating other associated factors inducing clinically important hyperkalemia in outpatients on standard-dose of TMP/SMX. METHODS: Age-matched diabetic(n=22) and non-diabetic (n=20) patients with UTI on standard dose of TMP/SMX for 5 days were given acute oral intake of 40 mEq of potassium chloride(KCl). RESULTS: Before the intake of TMP/SMX, basal levels of serum potassium(K), serum BUN and creatinine, plasma renin activity(PRA), aldosterone(PA), and transtubular potassium gradient(TTKG) were comparable between diabetic and non-diabetic subjects. Also after TMP/SMX was taken, all parameters didnt reveal any overt changes except a slightly increased serum K but not significantly (from 4.20+/-0.15 to 4.14+/-0.21mEq/L in non-diabetics; from 4.13+/-0.18 to 4.25+/-0.13mEq/L in diabetics). Following acute oral KCl load, however, the peak increases of serum K changes were significantly higher in diabetics compared to non-diabetics(0.34 0.06 vs 0.62 0.09mEq/L, p<0.01). Furthermore, 8 out of 22 diabetics but none of non-diabetics after acute KCl load developed hyperkalemia(> 5.0 mEq/L). After KCl load, PRA did not show any significant changes, whereas PA was increased simultaneously with the increments of serum K in both diabetic subgroups hyperkalemic(n=8) and normokalemic (n=14) diabetics. But increment was blunted in hyperkalemic diabetic subgroup. TTKG was increased prominently in normokalemic diabetic subgroup(9.20 from 4.50), while it was slightly increased in hyperkalemic diabetic subgroup(4.63 from 3.79mEq/L). There was statistical difference between two subgroups(p < 0.05). In conclusion, Besides the known effect of blocking sodium channels in distal K secreting cells by TMP/SMX, insulinopenia(DM). Hypoaldosteronism with its decreased tubular bioactivity, and increased exogenous K intake in concert could cause clinically overt hyperkalemia on standard-dose of TMP/SMX. When standard- dose of TMP/SMX is administered to patients with deranged K homeostasis, especially to diabetics with hypoaldosteronism, blood K level should be monitored meticulously to avoid hyperkalemia.
Creatinine ; Diabetes Mellitus ; Homeostasis ; Humans ; Hyperkalemia ; Hypoaldosteronism ; Outpatients* ; Plasma ; Potassium* ; Prospective Studies ; Renin ; Sodium Channels

BACKGROUND/AIMS: Cholecystectomy is necessary for the treatment of symptomatic or complicated gallbladder (GB) stones, but oral litholysis with bile acids is an attractive alternative therapeutic option for asymptomatic or mildly symptomatic patients. This study was conducted to evaluate the efficacy of magnesium trihydrate of ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) on gallstone dissolution and to investigate improvements in gallstone-related symptoms. METHODS: A prospective, multicenter, phase 4 clinical study to determine the efficacy of orally administered magnesium trihydrate of UDCA and CDCA was performed from January 2011 to June 2013. The inclusion criteria were GB stone diameter < or =15 mm, GB ejection fraction > or =50%, radiolucency on plain X-ray, and asymptomatic/mildly symptomatic patients. The patients were prescribed one capsule of magnesium trihydrate of UDCA and CDCA at breakfast and two capsules at bedtime for 6 months. The dissolution rate, response rate, and change in symptom score were evaluated. RESULTS: A total of 237 subjects were enrolled, and 195 subjects completed the treatment. The dissolution rate was 45.1% and the response rate was 47.2% (92/195) after 6 months of administration of magnesium trihydrate of UDCA and CDCA. Only the stone diameter was significantly associated with the response rate. Both the symptom score and the number of patients with symptoms significantly decreased regardless of stone dissolution. Adverse events necessitating discontinuation of the drug, surgery, or endoscopic management occurred in 2.5% (6/237) of patients. CONCLUSIONS: Magnesium trihydrate of UDCA and CDCA is a well-tolerated bile acid that showed similar efficacy for gallstone dissolution and improvement of gallstone-related symptoms as that shown in previous studies.
Adult ; Aged ; Antacids/*administration & dosage ; Chenodeoxycholic Acid/*administration & dosage ; Cholagogues and Choleretics/*administration & dosage ; Drug Administration Schedule ; Drug Combinations ; Female ; Gallstones/*drug therapy ; Humans ; Magnesium Hydroxide/*administration & dosage ; Male ; Middle Aged ; Prospective Studies ; Severity of Illness Index ; Solubility/drug effects ; Ursodeoxycholic Acid/*administration & dosage

BACKGROUND: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. METHODS: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. RESULTS: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. CONCLUSIONS: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Retrospective Studies ; Risk Factors ; Rotator Cuff ; Tears

OBJECTIVES: The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. METHODS: Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. RESULTS: Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. CONCLUSION: The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.
Anxiety ; Attention Deficit and Disruptive Behavior Disorders ; Checklist ; Child Behavior ; Child* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Nocturnal Enuresis* ; Parents ; Psychopathology ; Social Problems