PURPOSE: Our study aimed to determine whether obstructive sleep apnea (OSA) is common among branch retinal vein occlusion (BRVO) patients without systemic risk factors using a Watch PAT-100 portable monitoring device. METHODS: The study participants included consecutive patients with BRVO of less than 3 months duration without any risk factors known to be associated with OSA (diabetes, coronary artery disease, stroke, hematologic diseases, autoimmune disease, etc.) except for hypertension. All patients underwent full-night unattended polysomnography by means of a portable monitor Watch PAT-100 device. The apnea-hypopnea index (AHI) was calculated as the average number of apnea and hypopnea events per hour of sleep, and an AHI score of five or more events was diagnosed as OSA. RESULTS: Among 19 patients (6 males and 13 females), 42.1% (8 of 19) had an AHI reflective of OSA. In the 13 patients who had no concurrent illness, including hypertension, 30.8% (4 of 13) had positive test results for OSA; three of these patients were ranked as mild OSA, while one had moderate OSA. The OSA group had an average AHI of 12.3 ± 7.8, and the average AHI was 2.0 ± 0.9 in the non-OSA group. Although it was not statistically proven, we found that OSA patients experienced a more severe form of BRVO. CONCLUSIONS: We found a higher than expected rate of OSA in BRVO patients lacking concomitant diseases typically associated with OSA. Our findings suggest that OSA could be an additional risk factor in the pathogenesis of BRVO or at least a frequently associated condition that could function as a triggering factor.
Apnea ; Autoimmune Diseases ; Coronary Artery Disease ; Hematologic Diseases ; Humans ; Hypertension ; Male ; Polysomnography ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Risk Factors ; Sleep Apnea, Obstructive* ; Stroke

OBJECTIVE: The purpose of this study was to analyze the stress distribution and the displacement pattern of mandibular anterior teeth under various intrusive force vectors according to the position of orthodontic miniscrews and hooks, using three-dimensional finite element analysis. METHODS: A three-dimensional finite element model was constructed to simulate mandibular teeth, periodontal ligament, and alveolar bone. The displacement of individual tooth on three-dimensional planes and the von Mises stress distribution were compared when various intrusion force vectors were applied. RESULTS: Intrusive forces applied to 4 mandibular anterior teeth largely resulted in remarkable labial tipping of the segment according to the miniscrew position. All 6 mandibular anterior teeth were labially tipped and the stress concentrated on the labiogingival area by intrusive force from miniscrews placed mesial to the canine. The distointrusive force vector led to pure intrusion and the stress was evenly distributed in the whole periodontal ligament when the hook was placed between the central and lateral incisors and the miniscrew was placed distal to the canine. CONCLUSIONS: Within the limits of this study, it can be concluded that predictable pure intrusion of the 6 anterior teeth segment may be accomplished using miniscrews placed distal to the canine and hooks located between the central and lateral incisors.
Displacement (Psychology) ; Incisor ; Periodontal Ligament ; Tooth

BACKGROUND: The aim of this study was to evaluate antibiotic consumption by adult patients at a single university hospital in Korea between 2001 and 2012. METHODS: We used the 2004 World Health Organization Anatomical Therapeutic Chemical Classification System definition of defined daily doses (DDD) per 1,000 patient-days to calculate the annual antibiotic consumption for 18 antibiotic groups. Chi-square linear-by-linear analysis was performed to evaluate antibiotic consumption trends for each group. RESULTS: Average annual antibiotic consumption during 2001-2012 was 644.6 DDD/1,000 patient-days (standard deviation, 33.3 DDD/1,000 patient-days). Although no statistically significant change was observed during the study period, consumption of first- and second-generation cephalosporins, and aminoglycosides was significantly decreased, while that of beta-lactam/beta-lactamase inhibitors, fourth-generation cephalosporins, carbapenem, glycopeptide, linezolid, colistin, and quinolone increased significantly. CONCLUSION: The total amount of prescribed antibiotics did not change, but the use of broad-spectrum antibiotics increased during the study period.
Adult ; Aminoglycosides ; Anti-Bacterial Agents ; Cephalosporins ; Classification ; Colistin ; Hospitals, University ; Humans ; Korea ; World Health Organization ; Linezolid

Malignant Sertoli cell tumor was diagnosed in a 5-year-old male Shih Tzu dog. Clinical features of the dog were anorexia, urinary incontinence, constipation, anemia, alopecia, and epistaxis. The dog also had unilateral cryptorchid testis in the abdomen. Several abdominal and thoracic masses were identified on radiography. Grossly, the cryptorchid testicular mass was markedly enlarged to 8 cm in diameter. On cut surface, firm and well demarcated milk-white neoplastic areas were irregularly separated by white fibrous bands. Histologically, the testicular mass was diagnosed as tubular pattern Sertoli cell tumor. In addition, abdominal and mediastinal lymph nodes metastasis were found. Immunohistochemically, the tumor cells were strongly positive for vimentin and neuron specific enolase, but negative for S-100 and cytokeratin.
Abdomen ; Alopecia ; Anemia ; Animals ; Anorexia ; Constipation ; Dogs ; Epistaxis ; European Continental Ancestry Group ; Humans ; Immunohistochemistry ; Keratins ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Phosphopyruvate Hydratase ; Preschool Child ; Sertoli Cell Tumor ; Testis ; Urinary Incontinence ; Vimentin

BACKGROUND: Psoriasis is belived to be a disorder of keratinocyte hyperproliferation mediated by T helper cells. Cyclosproine is one of the immunosuppressants and there have been several studies showing the benefcial effects of cyclosporine on psoriasis. OBJECTIVE: To evaluate the clinical efficacy, tolerability, and adverse effects of cyclosporine, a randomized open uncontrolled multicenter study was conducted in 15 university hospitals in Korea. METHOD: There were 68 total trial cases and among them 16 patients dropped out from the study. The reported reasons for stopping the use of the medication under study prematurely were lack of cooperation(seven cases), adverse effects(six cases), the ineffectiveness of the medication(two cases), and another(one case). The drug was administered for 18 weeks to 52 patients. The initial dosage of the drug was 2.5mg/kg/day which was maintained or increased to 4mg/kg/day or 5mg/kg/day according to the PASI score reduction rate at the 6th and 12th week. The PASI score was measured and Iaboratory tests and observation of adverse events were done. RESULTS: At the end of therapy PASI score reduction rate of more than 66% occured in 40 patients (76.9%). The PASI score was significantly reduced from 20.0 to 5.4 after treatment for 18 weeks. The social disability score was significantly decreased. Pruritus and nail involvement were also significantly decreased. The change of systolic and diastolic blood pressure were statistically not significant. The 30% increase of serum creatinine level compared to the baseline was observed in six patients(11.5%) at the 6th week, three patients(5.8%) at the 12th week, five patients(9.6%) at the 18th week, but no patients showed an increase above the normal range.The increase of serum total bilirubin and SGOT was observed in six patients(11.5%) and one patient(1.9%0, respectively. The clinical adverse events reported during the study were gastrointestinal trouble(seven cases, 13.5%), hypertrichosis(two cases, 3.8%), generalized weakness(two cases, 3.8%0, paresthesia(one case, 1.9%), hypertension(one case, 1.9%), disturbance of erection(one case, 1.9%). The overall assessment of efficacy and tolerability by investigator and patients were mostly good or very good. CONCLUSION: Generally cyclosporine was well accepted and tolerated and low dose cyclosporine therapy-2.5mg/kg/day to 5mg/kg/day-is an effective therapeutic modality for the treatment of psoriasis.
Aspartate Aminotransferases ; Bilirubin ; Blood Pressure ; Creatinine ; Cyclosporine* ; Hospitals, University ; Humans ; Immunosuppressive Agents ; Keratinocytes ; Korea ; Pruritus ; Psoriasis* ; Research Personnel ; T-Lymphocytes, Helper-Inducer

In this study, to understand the pathogenesis of new rabbit hemorrhagic disease virus (RHDVa) serotype, we carried out to administrate RHDVa to rabbits, and to examine sequential electron microscopic changes and relationship between pathogenesis and apoptosis. TUNEL-positive cells began to be observed from 24 hours after inoculation (HAI) and the number of positive cells was slightly increased with the course of time. Whereas marked increase of positive cells was seen in the liver from the rabbits died acutely. Typical viral particles with cup-like projections and a diameter of 30~40 nm were detected in homogenized liver samples and tissues at 36 and 48, and 48 HAI, respectively. Ultrastructurally, glycogen deposition was observed from the first stage of hepatocellular degeneration by RHDVa infection and then, swelling and disruption of cristae of mitochondria by viral particles, swelling of smooth endoplasmic reticulum, vacuoles and vesicles were detected. Condensation, margination and fragmentation of chromatin were observed in degenerative hepatocytes at 36 and 48 HAI, indicating apoptotic bodies. These data offer that hepatocytic apoptosis by RHDV infection could be closely related with mitochondrial impairment in the hepatocytes.
Apoptosis ; Chromatin ; Electrons ; Endoplasmic Reticulum, Smooth ; Glycogen ; Hemorrhagic Disease Virus, Rabbit ; Hepatocytes ; Liver ; Mitochondria ; Rabbits ; Sprains and Strains ; Vacuoles ; Virion

PURPOSE: This study was conducted to evaluate the short term effect of hospital-based clinical training for emergency medical technicians (EMTs) on improving the quality of prehospital assessment and intervention. METHODS: Three EMTs-level 1 were assigned to a regional emergency medical center and trained as to a designed program with three months. Three EMTs alternatively ran to the scene during later two months. In order to compare the completeness and the appropriateness of prehospital assessment and intervention between trained and nontrained EMTs, we collected pre-hospital records and divided the subjects into a study group who were managed by trained EMTs and a control group who were managed by non-trained EMTs-level 1 (level-1 control) or EMT-level 2 (level-2 control). The completeness and the appropriateness were evaluated by three expert panel groups, each consisting of three emergency physicians, on the basis of the guidelines and professional opinion. In assessing intergroup agreement, weighted kappa values for inter-panel agreement were all above 0.4 except on one factor (k=0.28). RESULTS: No significant difference existed in demographic findings between the study group (N=129) and the control (N=469). The study group showed significantly higher completeness (78.9%) than the level-1 (14.9%, p<0.001) or level-2 control group (9.8%, p<0.001) in their assessment of vital signs. The study group also scored significantly better for appropriateness than did the two control groups, both in evaluation of chief complaints and in prehospital management (p<0.001). CONCLUSION: The quality of pre-hospital assessment and intervention could be significantly improved through hospital-based EMT training, especially in the assessment of vital signs, appropriate evaluation of chief complaints, and prehospital intervention.
Emergencies* ; Emergency Medical Services ; Emergency Medical Technicians* ; Humans ; Pilot Projects* ; Vital Signs

Rabbit hemorrhagic disease is a highly acute and fatal viral disease caused by rabbit hemorrhagic disease virus (RHDV). Since first outbreak in Korea 1987, RHDV has been continually affected in the country, but the pattern of outbreak seem to be changed. In this study, to understand the pathogenesis of the new RHDVa serotype, we therefore carried out to inoculate RHDVa to rabbits, and to examine the sequential histopathologic changes and viral distribution. Macroscopically, various sized dark red or white spots or appearance were observed in the liver, lung, kidney uterus and ureter. In euhanized rabbits, significant pathologic findings such as infiltration of heterophils and mononuclear cells were observed at 24 hours after inoculation (HAI), and these were sequentially extended periportal to centrilobular area. However, in dead rabbits, severe hepatic degeneration and/or necrosis with relatively weak inflammatory responses were observed. RHDV antigens began to detect in liver, spleen, and lung from 12 HAI by PCR. Immunohistochemically, RHDV positive cells were seen in only liver from 24 HAI, and the degree of immunogen reactivity was stronger in dead rabbits than in euthanized ones. In conclusion, RHDVa caused the subacute or chronic infection accompanying low mortality and moderate to severe inflammatory reaction in rabbits, suggesting the possibility that RHD could become endemic.
Dental Caries ; Hemorrhagic Disease Virus, Rabbit ; Kidney ; Korea ; Liver ; Lung ; Necrosis ; Polymerase Chain Reaction ; Rabbits ; Spleen ; Sprains and Strains ; Ureter ; Uterus ; Virus Diseases

BACKGROUND AND OBJECTIVES: Helicobacter pylori infection is strongly associated with chronic gastritis and ulcer disease and is a risk factor for gastric carcinoma and primary gastric B-cell lymphoma. Palatine tonsils and adenoids are a component of mucosa-associated lymphoid tissue (MALT) and represent an extragastric reservoir for H. pylori infection. This study was designed to find out the settling frequency of H. pylori in tonsil and adenoid tissues by Compylobacter like organism (CLO) test on tonsillectomy and adenoidectomy specimens in Koreans. MATERIALS AND METHOD: We reviewed the records of 52 patients aged 3 to 51 who had undergone an adenoidectomy, tonsillectomy, or adenotonsillectomy procedure under local or general anesthesia. Two millimeter diameter tissue pieces had been obtained from each adenoid and tonsil specimens were placed in CLO test kit. Color changes were noted after 20 minutes and after periods of 1, 3, and 24 hours. RESULTS: Thirty three (63.5%) of the 52 patients were shown to be H. pylori positive. H. pylori positive rate was not significantly different according to operation methods, age and sex. H. pylori positive rate in tonsil specimens (62.7%) was significantly higher than that in adenoid specimens (17.6%)(p<0.05). CONCLUSION: This results suggest that palatine tonsils represent an extragastric reservoir for H. pylori infection. Tonsillectomy may be associated with decreased prevalence of H. pylori colonization. Further study is needed about correlation between H. pylori colonization in tonsil and H. pylori associated gastric disease.
Adenoidectomy* ; Adenoids ; Anesthesia, General ; Campylobacter* ; Colon* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Lymphoid Tissue ; Lymphoma, B-Cell ; Palatine Tonsil ; Prevalence ; Risk Factors ; Stomach Diseases ; Tonsillectomy* ; Ulcer

OBJECTIVE: This study was aimed to investigate the disease free interval and feasibility of FDG-PET for following up the patients with no evidence of cervical cancer after primary treatment. METHODS: From May, 1998 to February, 2003, 406 patients with no evidence of cervical cancer by FDG-PET were investigated retrospectively. They underwent primary treatment and FDG-PET between 3 to 16 months after treatment. All of them were monitored closely after FDG-PET scanning. RESULTS: Of the 406 patients with no evidence of cervical cancer by FDG-PET after treatment, recurrence was detected in 17 patients. The recurrence sites were lymph nodes (7), lung (6), liver (1), central lesion (1) and others (2). The Mean disease free interval (DFI) in patients with No evidence of disease (NED) was 27 months, DFI with recurrence was 35 months, and the mean DFI in all patients were 28 months (p=0.051). FIGO stage, initial tumor size, status of lymph node metastasis and cell type had no effect on the recurrence rate of NED patients by FDG-PET. Our study also shows high false positive rate and low sensitivity in the conventional imaging and tumor marker. CONCLUSION: The FDG-PET is proved to be a useful imaging study for following up cervical cancer patients after primary treatment. If there is no evidence of disease by the first FDG-PET after primary treatment, we can expect the average disease free interval to be about 28 months. And it is suggested that the patients should undergo the FDG-PET every one or two years to detect possible early recurrence.
Follow-Up Studies* ; Humans ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Uterine Cervical Neoplasms