To evaluate the usefulness of continuous wave Doppler echocardiography in the quantitative assessment of aortic regurgitation, the aortic regurgitant flow velocity curves taken by continuous wave Doppler echocardiography were analyzed to develop indexes such as the peak velocity(PV), the deceleration slope(SLOPE) and the pressure half time(PHT) in 66 patients with aortic regurgitation. The Doppler indexes were compared with the aortic regurgitation fraction(RF) obtained from gated radionuclide ventriculography in 33 patients without other valvular regurgitation, and were also compared with angiographic grading of aortic regurgitation in 47 patients who under went aortic angiography. The results were as follows : 1) The deceleration slope and the pressure half time were correlated well with the regurgitation fraction measured by gated radionuclide ventriculography (r=0.68, -0.78). 2) The deceleration slope increased significantly with increasing angiographic grading (rade 1+vs.2+ ; 1.89+/-0.61m/sec vs.2.64+/-0.39, P<0.05, Grade 2+ vs.3+ ;2.64+/-0.39 vs. 4.37+/-1.35, P<0.01, but statistical singnificance was not found between Grade 3+ and 4+(4.73+/-1.35vs. 5.00+/-0.39, P<0.05). 3) The pressure half time decreased significantly with increasing angiographic grading (Grade 1+vs.2+ ; 0.61+/-0.16 sec vs. 0.49+/-0.08, p<0.05, Grade 2+ vs.3+ ; 0.49+/-0.08vs. 0.29+/-0.07, p<0.01), but statistical significance was not found between Grade 3+ and 4+ (0.29+/-0.07vs. 0.26+/-0.08, p>0.05), either. 4) The pressure half time was independent of aortic or mitral stenosis associated with aortic regurgitation. 5) The peak velocity had no significant relationshop with the regurgitation fraction by gated radionuclide ventriculography or angiographic grading by aortic angiography. 6) A PHT threshold of 400 msec separated mild (Grade 1+ and 2+)and severe (grade 3+ and 4+) aortic regurgitation with sensitivity of 88%, specificity of 96% and predictive value of 95%. Therefore continuous wave Doppler echocardiographic method of anlyzing aoritc regurgitant flow velocity curve seemed to be useful for the noninvasive assessment of the severity of aortic regurgitation.
Angiography ; Aortic Valve Insufficiency* ; Deceleration ; Echocardiography ; Echocardiography, Doppler* ; Gated Blood-Pool Imaging ; Humans ; Mitral Valve Stenosis ; Sensitivity and Specificity

BACKGROUND: The purpose of this study was to identify health practices that would be helpful in order to reduce the prevalence of correctable cardiovascular risk factors (CVR), i.e. hypertension, hypercholesterolemia, and hyperglycemia in male workers by examining the association between health practices and the prevalence of the three risk factors. METHODS: For 1,815 male workers at a car manufacturer who participated in the basic health examination, survey on socioeconomic status and seven healthy practices suchas not currenly smoking, moderate alcohol drinking, proper weight control, regular exercise, 7-8 hour sleep, eating breakfast regularly, and not eating between meals was done and the prevalence of hypertension, hypercholesterolemia, and hyperglycemia as obtained. x2 test, Fisher's exact test, and multiple logistic regression analyses were done for workers under 40 years old and workers 40 and over in two, separate groups by adjusting socioeconomic variables. RESULTS: The prevalence of hypertension and hypercholesterolemia was 1.84 times and 5.22 times, respectively, showing, higher in overweight younger workers than in those of normal weight. The prevalence of hypercholesterolemia was 2.02 times higher in younger smokers than in younger non-smokers. In contrast, the prevalence of hyperglycemia was 4.99 times higher in older smokers than in older non-smokers. The prevalence of hyperglycemia was 16.5 times higher in older workers with regular snacking habit than in those without such a habit. The prevalence of hypercholesterolemia was 7.47 times higher only in younger workers practicing healthy behaviors below 3 than in those practicing at least 6 healthy behaviors. CONCLUSION: Our study suggests that overweight and smoking habit among younger workers, and smoking habit among older workers sould be controlled in order to decrease the prevalence of hypertension, hypercholesterolemia, and hyperglycemia.
Adult ; Alcohol Drinking ; Breakfast ; Eating ; Humans ; Hypercholesterolemia* ; Hyperglycemia* ; Hypertension* ; Logistic Models ; Male* ; Meals ; Overweight ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Snacks ; Social Class

OBJECTIVE: To investigate prevalence of ossification of posterior longitudinal ligament (OPLL) in Korean patients with Spondyloarthropathies (SpA), and the associations between OPLL and clinical, radiologic findings of SpA. METHOD: A cross-sectional radiological review was performed in patients diagnosed with SpA from 2000 to 2007. Each of two physiatrists and musculoskeletal radiologists screened the cervical (lateral) and pelvis (anterior-posterior) radiographs of these patients separately, then confirmed presence of OPLL. Bath ankylosing spondylitis radiology index (BASRI) of the cervical spine and grade of sacroiliitis were also measured. A review of the medical records and laboratory findings was conducted to investigate the association between the clinical, laboratory findings and the OPLL. RESULTS: Among 172 patients with SpA, OPLL was found in 16 patients (9.3%; 95% CI 5.0, 13.6). There were significant associations between OPLL and old age (p=0.043), symptoms and signs of myeloradiculopathy (p=0.030), and diabetes mellitus (DM) (p=0.022). CONCLUSION: The prevalence of OPLL in Korean patients with SpA is 9.3%. OPLL in patients with SpA is associated with old age, symptoms and signs of myeloradiculopathy, and diabetes. However, no factors specific characteristics of SpA were associated with OPLL.
Baths ; Diabetes Mellitus ; Humans ; Longitudinal Ligaments ; Medical Records ; Ossification of Posterior Longitudinal Ligament ; Pelvis ; Prevalence ; Sacroiliitis ; Spine ; Spondylarthropathies ; Spondylitis, Ankylosing

Clear cell carcinoma of the uterine cervix is rare malignancy that accounts for 4% to 9% of the adenocarcinoma of the cervix. It is thought to originate from Mullerian duct, not from mesonephric duct. The etiology and pathogenesis are yet unclear. But among the suspected etiologies, the prenatal diethyl stilbestrol (DES) exposure is well known to be linked to clear cell carcinoma of the vagina and cervix. This cancer occurs primarily during young age (17 to 23 years) in DES-exposure women, but occurs mainly after menopause in non DES exposure women. The biological behavior and prognosis of the cancer are poorer than those of squamous cell carcinomas and non-clear cell adenocarcinomas. Also DES associated clear cell carcinomas behave less aggressively than those that develop in the absence of a history of DES exposure. We experienced a case of clear cell carcinoma in the uterine cervix of 22 years-old virgin who was not related to DES. So, we presented the case with a brief review of related literature.
Adenocarcinoma ; Adenocarcinoma, Clear Cell* ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Diethylstilbestrol ; Female ; Humans ; Menopause ; Prognosis ; Vagina ; Wolffian Ducts ; Young Adult*

PURPOSE: The aim of this study was to compare the difference in acute stroke management between urban and rural areas, to investigate the factors affecting these differences, and to acquire basic information for establishing an efficient regional hub and spoke system for stroke patients. METHODS: This retrospective study was based on adult patients diagnosed with acute ischemic stroke from January 2012 to December 2012 at a regional cerebrovascular center. The term "acute" was defined as 24 hours from symptom recognized. The term "urban" was defined as the region within the boundary of a metropolitan area. The distance from the symptom onset location to the stroke center was calculated using a global positioning system. RESULTS: The rate of arriving at a stroke center within 3 hours after stroke recognition for acute ischemic stroke patients was much higher in urban areas compared to rural areas (27.5 vs. 19.2%, respectively; p-value=0.011). In stroke cases in rural areas, the distance from symptom onset location to a stroke center was determined as statistically significant through multivariate logistic regression analysis (Odds ratio (OR), 0.982; 95% Confidence interval (CI) 0.969-0.995). In contrast, the use of a public ambulance (OR, 4.258; 95% CI 2.233-8.118) and inter-hospital transfer (OR, 0.416; 95% CI 0.216-0.800) were the main prehospital delay factors in urban areas. CONCLUSION: For stroke cases in urban areas, it was important to directly visit a stroke center without transfer using a public ambulance. For rural areas, a new hub hospital and policies are necessary for reducing prehospital delay.
Adult ; Ambulances ; Emergency Medical Services ; Geographic Information Systems ; Humans ; Logistic Models ; Retrospective Studies ; Stroke*

The primary leiomyosarcoma of the vagina is very rare tumor in the female lower genital tract. A case of primary leiomyosarcoma of the vagina in the 44 years old woman was presented with lower abdominal pain and cystic and solid mass in the vagina. The mass was mainly comprised with spindle shaped cells showing moderate degree of cellular atypia and mitosis up to 8/10HPF. The mainstay of treatment is surgical excision of the primary mass. Treatment with chemotherapy or radiation therapy usually reserved for inoperable or recurrent cases. We present this case with a review of literature.
Abdominal Pain ; Adult ; Drug Therapy ; Female ; Humans ; Leiomyosarcoma* ; Mitosis ; Sarcoma ; Vagina*

PURPOSE: To evaluate the clinical utility of the teleradiology system using the information super highway communication network. MATERIALS AND METHODS: Two radiologists selected 101 cases of pneumothorax and 20 cases ofmiliary tuberculosis. There were scanned and transmitted to our hospital at a speed of 640 Kbps and displayed on avideo monitor with a resolution of 1280 pixels/line x 1024 lines. Four radiologists divided into three groups :read the images group A read the images without image processing ; group B read the images with image processing, group C read the radiographic films on the view box. The authors compared sensitivity and specificity between thegroups and checked their statistical significance using the Chi-square test. According to the location of thepleural line, we divided the pneumothorax into four types : continve on this live type 1, pleural line confined tothe apex ; type 2, to the upper half ; type 3, to the lower half ; type 4, to the upper through lower half. We then compared sensitivity between the Three groups. RESULTS: In the pneumothorax group, the average sensitivity of group A, B and C was 79%, 90% and 96%, and average specificity was 99%, 99% and 94%, respectively. There were statistically significant differences in seasitivity between group A and B and between group B and C (p<0.017). There were no statistically significant difference in specificity between group A and B or between group B and C.In the miliary tuberculosis group, the average sensitivity of group A, B and C was 73%, 78% and 90%, and average specificity was 95%, 95% and 100%, respectively. With regard to sensitivity and specificity, there was no statistically significant difference between group A and B or between group B and C but there was a statistically significant difference between group A and C (p<0.017). According to the location of the pneumothorax, for alltypes, the sensitivity of group A was less than that of group B and group B was less than that of group C. CONCLUSION: All groups showed reduced observer performance in the detection of pneumothorax and miliary tuberculosis when reading a transmitted image on the monitor-workstation compared with reading conventional radiographs on the view box. To improve the clinical utility of the teleradiology system, a higher resolution workstation and adequate image processing are required.
Pneumothorax* ; Sensitivity and Specificity ; Teleradiology* ; Tuberculosis ; Tuberculosis, Miliary* ; X-Ray Film

PURPOSE: To estimate the current cancer burden in Korea, newly diagnosed cancer cases and cancer incidence rates were calculated for the years 2003~2005. MATERIALS AND METHODS: The cancer incidence cases and rates were calculated from the Korea National Cancer Incidence Database. Crude and age-standardized incidence rates were calculated by gender for specified cancer sites in 5-year age groups. RESULTS: From 2003 to 2005, 398,824 cases of cancer were newly diagnosed in Korea (218,856 in men and 179,968 in women). For all sites combined, the crude incidence rate (CR) was 300.0 and 248.2 for men and women and the age-standardized incidence rate (ASR) was 297.0 and 191.2 per 100,000, respectively. Among men, five leading cancers were stomach (CR 66.0, ASR 64.2), lung (CR 48.5, ASR 50.3), liver (CR 44.9, ASR 42.1), colon and rectum (CR 37.9, ASR 37.2), and prostate cancer (CR 12.7, ASR 13.8). Among women, five leading cancers were breast (CR 37.3, ASR 29.0), thyroid (CR 36.2, ASR 28.8), stomach (CR 34.1, ASR 25.4), colon and rectum (CR 28.0, ASR 21.1), and lung cancer (CR 17.9, ASR 12.8). In the 0~14-year-old group, leukemia was the most common in both sexes; in the 15~34 group, the most common cancer was stomach cancer for men and thyroid cancer for women; in the 35~64 group, stomach cancer for men and breast cancer for women; among those 65 and over, lung cancer for men and stomach cancer, for women, respectively. CONCLUSION: The cancer incidence rates have increased in recent years, and more cancers are expected to develop as Korea is quickly becoming an aged society. The cancer incidence statistics in this report can be used as an important source to effectively plan and evaluate the cancer control program in Korea.
Aged ; Breast ; Breast Neoplasms ; Colon ; Female ; Humans ; Incidence ; Korea ; Leukemia ; Liver ; Lung ; Lung Neoplasms ; Male ; Prostatic Neoplasms ; Rectum ; Stomach ; Stomach Neoplasms ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: Tension-free vaginal tape(TVT) procedure is an effective surgical procedure for the treatment of female urinary stress incontinence. The purpose of this study was to evaluate the changes of pelvic floor MR imaging findings after tension-free vaginal tape procedure on stress urinary incontinent women. MATERIALS AND METHODS: Thirty two women with complaint of stress urinary incontinence(mean age, 56 years; age range 32~73 years) were included in this study. Pelvic floor MR imaging were performed preoperatively and one month after surgery. The position of the bladder neck in relation to the pubococcygeal line, the position of the bladder neck in relation to a perpendicular line through the posterior edge of symphysis pubis, the angle of urethral inclination were measured. We also measured the position of anterior wall of the urethra in relation to posterior edge of the symphysis pubis and cystocele during resting and pelvic straining and thickness of the anterior wall. We compared all parameters between resting and stress. RESULTS: Twenty nine patients(91%) had normal voiding pattern after TVT procedure. three patients(9%) had voiding difficulty. The position and mobility of the bladder neck during straining showed significant improvement after surgery(p<0.01). During straining, the length between the urethra and the inferior edge of the pubic symphysis with mid-urethra angulation was shorten in twenty eight patients(88%). There is no significant difference among three groups in all parameters. However, 3 patients with voiding difficulty had the significant high bladder neck and moderate cystocele. CONCLUSION: The TVT procedure provides decrease of urethral hypermobility and increase of mid-urethral angulation. MR imaging demonstrate well that urinary continence after surgery is most probably achieved by creating a dynamic mid-urethral knee angulation by which the urethra is closed at stress. Postoperative voiding difficulty may be related to remaining cystocele and high bladder neck.
Cystocele ; Female* ; Humans ; Knee ; Magnetic Resonance Imaging* ; Neck ; Pelvic Floor* ; Pubic Symphysis ; Suburethral Slings* ; Urethra ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress

Patients with Marfan syndrome (MFS) presents with primary skeletal manifestations such as tall stature, chest wall abnormality, and scoliosis. These primary skeletal manifestations affect the growth pattern in MFS. Therefore, it is not appropriate to use normal growth charts to evaluate the growth status of MFS. We aimed to develop disease-specific growth charts for Korean MFS patients and to use these growth charts for understanding the growth patterns in MFS and managing of patients with MFS. Anthropometric data were available from 187 males and 152 females with MFS through a retrospective review of medical records. Disease-specific growth charts were generated and 3, 25, 50, 75, and 97 percentiles were calculated using the LMS (refers to lambda, mu, and sigma, respectively) smoothing procedure for height and weight. Comparisons between MFS patients and the general population were performed using a one-sample t-test. With regard to the height, the 50th percentile of MFS is above the normative 97th percentile in both genders. With regard to the weight, the 50 percentile of MFS is above the normative 75th percentile in male and between the normative 50th percentile and the 75th percentile in female. The disease-specific growth charts for Korean patients with MFS can be useful for monitoring growth patterns, planning the timing of growth-reductive therapy, predicting adult height and recording responses to growth-reductive therapy.
Adolescent ; Adult ; Asian Continental Ancestry Group ; *Body Height ; Body Mass Index ; *Body Weight ; Child ; Child, Preschool ; Female ; *Growth Charts ; Growth Disorders/*physiopathology ; Humans ; Male ; Marfan Syndrome/genetics/*physiopathology ; Microfilament Proteins/genetics ; Reference Values ; Republic of Korea ; Retrospective Studies ; Young Adult