In 25 aortic regurgitation patients relationship between degree of aortic regurgitation graded by 2-D color Doppler echocardiography and diastolic fluttering of anterior mitral leaflet on M-mode echocardiography was evaluated. The results were that all 13 aortic regurgitation patients, not associated with mitral stenosis, showed diastolic fluttering of anterior mitral leaflet; but only 3 patients among 12 patients (25%), associated with mitral stenosis, had characteristic mitral fluttering. On the whole, regardless of associated mitral stenosis, the sensitivity was 64%. In severe aortic regurgitation (Grade 3, 4 group) 12/13 patients revealed diastolic fluttering of anterior mitral leaflet (sensitivity of 92%); in mild to moderate aortic regurgitation (Grade 1, 2 group), only 4/12 patients (sensitivity of 33%). In conclusion, 2-D color Doppler echocardiography is a very useful method for detection of aortic regurgitation without difficulty. And in aortic regurgitation, not associated with mitral stenosis, fine fluttering of anterior mitral leaflet is a very sensitive sign of existence of aortic regurgitation, though there may be some false positive findings in normal individuals.
Aortic Valve Insufficiency* ; Echocardiography ; Echocardiography, Doppler, Color* ; Humans ; Mitral Valve Stenosis

In this research, we examined the frequency of exposure to violence in the home, school and neighborhood among middle school students as well as its related psychiatric symptoms. A total of 1,345 students from 5 middle schools in Seoul participated in this study: 670 were male, 675 were female. We administered self-reported questionaires including discriptions of exposure to violence and a trauma symptom checklist(TSC)(Singer 1995). 1) The total frequency of exposure to any type of violence was 45% in our sample. The frequency of girls' being hit in home was 22.8%, which was significantly higher than it was for boys(p<0.001). The frequency of boys' exposure to violence in school and in the neighborhood was 22.1% and 10.1% respectively, which was higher than it was for girls(p<0.005). 2) In factor analysis of TSC, 4 factors were identified. TSC including depression-anxity, PTSD, dissociation and anger was correlated with violence exposure variables. Multiple regression analysis revealed that TSC is related with violence victimization in life(R2=0.18), sexual assault(R2=0.12), recent victimization in the home(R2=0.08), recent witness to violencein the home(R2=0.07), recent victimization in school(R2=0.08) and all violence exposures(R2=0.29). 3) Among the demographic variables, sex, parental alcohol problem and student alcohol-smoking-drug problems influenced the TSC(p<0.005). TSC could be result of witness to violence as well violence victimization. And the risk factors for violence-related psychiatric symptoms were mainly seen in females, who have parents with alcohol problems or who themselves have alcohol-substance problems. So intervention programs for violence victims should be focused on the these high risk group.
Adolescent ; Anger ; Crime Victims ; Female ; Humans ; Male ; Parents ; Residence Characteristics ; Risk Factors ; Seoul ; Stress Disorders, Post-Traumatic ; Violence*

Neurologic manifestations rarely occur as presenting feature of systemic lupus erythematosus (SLE). We describe two women who presented with several episodes of neurologic symptoms mimicking multiple sclerosis. Several years after disease onset, clinical and laboratory finding were compatible with SLE. These cases show that demyelinating syndrome resembling multiple sclerosis may present as a first manifestation of SLE.
Female ; Humans ; Lupus Erythematosus, Systemic* ; Multiple Sclerosis* ; Neurologic Manifestations

Urticarial vasculitis is characterized clinically by urticarial skin lesions and histologically by leukocytoclastic vasculitis. Hypocomplementemic urticarial vasculitis is associated with connective tissue diseases such as systemic lupus erythematosus (SLE). We report a case of urticarial vasculitis that preceded manifestations of SLE.
Anti-Infective Agents/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Lupus Erythematosus, Systemic/*diagnosis/etiology/pathology ; Middle Aged ; Recurrence ; Skin/pathology ; Urticaria/complications/*diagnosis ; Vasculitis, Hypersensitivity/complications/*diagnosis/pathology

BACKGROUND: Bus drivers are known to be highly at risk of cardiovascular diseases. In this study, we assessed the cardiovascular disease prevalence of bus company employees in Seoul, South Korea, and compared the results to those of general workers. METHODS: We analyzed the 2014 Korean National Health Insurance (NHI) data and defined hypertension, diabetes, dyslipidemia, ischemic heart disease, and cerebrovascular disease based on the KCD-6 medical diagnoses. We used bus company employees as surrogate participants of bus drivers due to the characteristics of Korean NHI data. We identified bus company employees in Seoul based on one’s workplace which the insurance is registered. The prevalence of five diseases was compared between the bus company employees and general workers. We also calculated the odds ratios (OR) of five diseases between the bus company employees and general workers. To compensate the vast demographical differences between the two groups, we performed propensity score matching. RESULTS: Bus company employees have higher OR for having hypertension (OR 1.33, 95% CI: 1.28–1.39), diabetes mellitus (1.14, 95% CI: 1.08–1.22), and dyslipidemia (1.23, 95% CI: 1.17–1.29) than the general workers or propensity score matched controls. However, the OR of having ischemic heart disease were not significant. The OR of cerebrovascular disease were lower in bus company employees than in the general workers after adjusting the covariates, but similar in the propensity score matched model. CONCLUSION: This study showed that the ORs of cardiovascular disease risk factors are high in bus company employees when compared to the general working population. Further studies with the longitudinal design should be conducted to confirm the causal association.
Cardiovascular Diseases ; Cerebrovascular Disorders ; Diabetes Mellitus ; Diagnosis ; Dyslipidemias ; Hypertension ; Insurance ; Korea ; Myocardial Ischemia ; National Health Programs ; Odds Ratio ; Prevalence ; Propensity Score ; Risk Factors ; Seoul

OBJECTS: This open study was designed to investigate the efficacy and safety of risperidone in the treatment-resistant patients with chronic schizophrenia. 24 patients were entered on the 8-week open trial. A total of 3 patients discontinued risperidone treatment before the end of the study. METHODS: We investigated risperidone's efficacy and its side effects in 21 patients with treatment-resistant chronic schizophrenia, who had previously been treated with different kinds of classical antipsychotic drugs but with insufficient clinical effect or distressing extrapyramidal side effects, over a 8-week period. After 3- 7 days of placebo wash-out period, patients were assigned to receive risperidone. The overall clinical efficacy was assessed at the 1st, 2nd, 4th, and 8th week of the treatment using the PANSS and the CGI. Safety and tolerability were assessed by the ESRS, the UKU side effect rating scale, the vital signs, and the laboratory tests including CBC, urinalysis, liver function test, and ECG. RESULTS: Clinically PANSS total score and CGI severity score on the end study point showed a significant improvement compared with baseline state. Significant improvements in both PANSS positive and negative subscale scores was as early as week 1 through week 8. Nine(43%) among of the 21 patients showed at least a 20% decrease in total PANSS scores. The tolerability of risperidone was geneally found to be good. Insomnia(52%), fatigue(52%), and sedation(52%) were the most common side effects. CONCLUSION: These results suggest that risperidone may be a effective antipsychotic agent in the treatment of refractory schizophrenia. However, double-blind comparative trial between risperidone and clozapine should be performed to further clarify the efficacy of risperidone in treatment-resistant patients with chronic schizophrenia.
Antipsychotic Agents ; Clozapine ; Electrocardiography ; Humans ; Liver Function Tests ; Risperidone* ; Schizophrenia* ; Urinalysis ; Vital Signs

Neuroenteric cyst derives from endodermal tissue displaced dorsally into the spinal canal ventral to the neural plaque through the interposed mesodermal layer that forms the vertebral bodies, embryologically. It is located along the alimentary canal, or ventral to the spinal cord in the cervical, thoracic area, or at the cervicothoracic junction within the boundaries of C3 above and T7 below and lies in an intramedullary or intradural extramedullary location in most patients. To date, retroperitoneal neuroenteric cyst has been described in only few cases. We report a case of asymptomatic retroperitoneal neuroenteric cyst in a 28-year-old man with a brief review of literatures, which found incidentally on health care center.
Adult ; Delivery of Health Care ; Endoderm ; Humans ; Mesoderm ; Neural Tube Defects* ; Spinal Canal ; Spinal Cord

Peripheral T-cell lymphomas (PTCLs) are aggressive neoplasms which may involve the liver. The imaging manifestations of hepatic lymphoma are highly variable and show overlapping appearances of numerous other hepatic diseases. As the management and prognosis of lymphoma differ markedly from those of other malignant diseases, prompt diagnosis and early effective treatment are very important. Here, we report an atypical case of primary PTCL not otherwise specified involving the liver that exhibited a solitary hepatic mass mimicking hepatocellular carcinoma (HCC) on CT. Liver biopsy is not commonly recommended in highly suspicious cases of HCC. However, in a patient without risk factors for HCC, consideration of other diagnostic possibilities is required and needle biopsy may be a more rational choice. An imaging approach, based on a careful review of clinical and laboratory findings is essential to prevent false-positive diagnosis of HCC and subsequent invasive treatment.
Biopsy ; Biopsy, Needle ; Carcinoma, Hepatocellular* ; Diagnosis ; Hepatectomy ; Humans ; Liver ; Lymphoma ; Lymphoma, T-Cell, Peripheral* ; Prognosis ; Risk Factors

Gastric carcinoid tumor is a rare neoplasm and it accounts for only 0.3% of all the gastric neoplasms. Gastric carcinoid tumor has high incidence in patients who are aged between 50 and 70 years, and it usually develops over a long period of time. Type I gastric carcinoid tumors are associated with autoimmune atrophic gastritis and pernicious anemia, and there are a few cases of gastric carcinoids in patients with other autoimmune diseases like Sjogren's syndrome and autoimmune thyroiditis. Here, we report on a case of recurrent type I gastric carcinoid tumors in a 42-years old woman who suffered with systemic lupus erythematosus.
Aged ; Anemia, Pernicious ; Autoimmune Diseases ; Carcinoid Tumor ; Female ; Gastritis, Atrophic ; Humans ; Incidence ; Lupus Erythematosus, Systemic ; Sjogren's Syndrome ; Stomach Neoplasms ; Thyroiditis, Autoimmune

OBJECTIVES: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. METHODS: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. RESULTS: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092–1.183) for diagnosis of diabetes, 1.278 (1.278–1.386) for diagnosis of dyslipidemia, 0.940 (0.904–0.977) for diagnosis of arthritis, 0.785(0.736–0.837) for treatment of arthritis, 1.159 (1.116–1.203) for diagnosis of cataracts, and 1.285(1.200–1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p<0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p<0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. CONCLUSION Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.