PURPOSE: To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. MATERIALS AND METHODS: We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. RESULTS: Total patients were 257 with 186(72.4%) paraplegia and 71(27.6%)quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ ;5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows;15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. CONCLUSION: Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4years, and another peak was in 12-16years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation.
Cervix Uteri ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Kidney ; Korea ; Paraplegia ; Quadriplegia ; Rehabilitation ; Retrospective Studies* ; Spinal Cord Injuries* ; Spinal Cord* ; Thorax ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract* ; Urography

PURPOSE: To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. MATERIALS AND METHODS: We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. RESULTS: Total patients were 257 with 186(72.4%) paraplegia and 71(27.6%)quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ ;5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows;15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. CONCLUSION: Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4years, and another peak was in 12-16years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation.
Cervix Uteri ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Kidney ; Korea ; Paraplegia ; Quadriplegia ; Rehabilitation ; Retrospective Studies* ; Spinal Cord Injuries* ; Spinal Cord* ; Thorax ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract* ; Urography

No abstract available.
Fertilization in Vitro* ; Humans ; Twins* ; Umbilical Cord*

Duodenal diaphragm is a rare congenital anomaly among the congenital duodenal obstructions. Its symptom and sign usually appear since birth if obstruction is complete. The clinical manifestations of incompletely obstructive duodenal diaphragm are intermittent vomiting, abdominal pain and poor weight gain. Diagnosis may be delayed in this case. Authors experienced a case of incomplete duodenal diaphragm with a central hole. A 29 months old girl presented failure to thrive, intermittent episodes of bloating, abdominal discomfort and occasional vomiting. The patient vomited every 10-14 days, then the abdominal pain and distention were relieved. She overate for about 10 days until the next projectile vomiting. The vomitus frequently contained food ingested several days previously. Plain x-ray films of abdomen showed marked gastric distention. Upper gastrointestinal series revealed marked distention of the duodenum with windsock configuration and radiolucent line at the third portion of the duodenum. On gastroscopic examination, gastric bezoar impacting the pyloric canal and antrum was noted. At operation, we found mucosal membrane in the third portion of the duodenum and bezoar(Chinese cabbage) above the membrane. Side-to-side duodeno-jejunostomy was performed and bezoar was removed. She was discharged on the 13th postoperative day without any complication.
Abdomen ; Abdominal Pain ; Bezoars ; Bulimia* ; Child, Preschool ; Diagnosis ; Diaphragm* ; Duodenal Obstruction ; Duodenum ; Failure to Thrive ; Female ; Humans ; Membranes ; Parturition ; Vomiting ; Weight Gain ; X-Ray Film

PURPOSE: To evaluate the feasibility of in-vivo 1H magnetic resonance spectroscopy (1H-MRS) for differentiation between hepatic and renal cysts, with emphasis on the analysis of cystic content. MATERIALS AND METHODS: The 1H-MR spectra of 43 cystic lesions (15 hepatic and 28 renal) obtained using in -vivo 1H-MRS at 1.5 T and with a localized proton STEAM sequence were evaluated. We calculated the ratio of the peak area of lipid/water (Rlipid/water), protein/water (Rprotein/water) and lipid/protein (Rlipid/protein), paying particular attention to identifying differences in peak area ratios between the two types of cyst. RESULTS: The 1H-MR spectra from 26.7% (4/15) of hepatic and 67.9% (19/28) of renal cysts showed the lipid peak as most prominent. Mean+/-standard deviations of the Rlipid/water of hepatic and renal cysts were 0.38+/-0.30x10-6 and 8.42+/-23.24x10-6, respectively; for Rprotein/water the corresponding figures were 0.83+/-0.74x10-6 and 1.50+/-2.94x10-6, and for Rlipid/protein, 0.57+/-0.64 and 2.44+/-3.26. All differences were statistically significant (p<0.05), and positive correlation between lipid and protein in hepatic and renal cysts was demonstrated. CONCLUSION: The different in-vivo 1H-MRS findings, for hepatic and renal cysts can be used in comparative study of cystic tumors of the liver and kidney.
Kidney ; Liver ; Magnetic Resonance Spectroscopy ; Protons ; Steam

BACKGROUND: Both atrophic gastritis and intestinal metaplasia may progress to gastric dysplasia. This study aimed to analyze the factors influencing progression of atrophic gastritis and intestinal metaplasia to dysplasia. METHODS: People diagnosed with atrophic gastritis and intestinal metaplasia for the first time received a follow-up endoscopy and were investigated for the cumulative incidence rate of gastric dysplasia by age, gender, smoking habit, alcohol intake, rice consumption and family history of stomach cancer. RESULTS: The cumulative incidence rate increased with age, consuming > or =3 bowls of rice per day and family history of stomach cancer. Multivariate analysis showed that the cumulative incidence rate of gastric dysplasia increased in subjects >61 years (RR=2.54, P=0.014), in those consuming > or =3 bowls of rice per day (RR=1.46, P=0.021) and in those with a family history of stomach cancer (RR=1.31, P=0.037). CONCLUSIONS: More active management, such as intensive endoscopic follow-up examinations, lifestyle change and education regarding gastric dysplasia, are required in those older than 61 years, having a higher intake of grain or with a family history of stomach cancer.
Edible Grain ; Endoscopy ; Follow-Up Studies ; Gastritis, Atrophic ; Humans ; Incidence ; Life Style ; Metaplasia ; Multivariate Analysis ; Risk Factors ; Smoke ; Smoking ; Stomach ; Stomach Neoplasms

PURPOSE: This study was to identify health needs of the elderly at nursing homes by long-term care grade. METHODS: The health needs of 116 elders at two nursing homes in Seoul were measured with resident assessment protocols (RAPs), activities of daily living (ADL), and cognitive performance scale (CPS), and pain and depression were measured by resident assessment instrument (RAI). RESULTS: With regard to RAPs, 11 out of 18 items had different distribution in the 3 groups significantly. The 1st-grade elders had a higher percentage of 9 items than the 2nd- and 3rd-grade ones but the 3rd-grade ones had the highest health needs related with activity. The 2nd-grade elders had similar health needs to the 1st-grade ones. In terms of functional level, the 1st-grade elders had the highest percentage of CPS and ADL but the 3rd-grade ones had the highest score of pain and depression out of the 3 groups. The standardized assessment instrument to identify specific health needs by the 3 groups should be developed. Therefore, care plans to meet health needs of the 3 groups will be made. CONCLUSION: It is suggested that nursing care is required to the elderly of the 1st- and 2nd-grade and safe activity and environment to the 3rd-graded ones.
Activities of Daily Living ; Aged* ; Depression ; Health Services Needs and Demand ; Humans ; Long-Term Care* ; Nursing Care ; Nursing Homes ; Seoul

Cystic lymphangioma are rare benign tumors that originate as a congenital anomaly of the lymphatic system. Their common presentation is in neck and axillary area at the birth, during infancy or early pediatric age group. Author reports an unusual case of cystic lymphangioma of breast which was diagnosed in a 32-year-old woman. The findings were very dense, sharply defined, and multilobulated masses on mammography, and mu-Itiloculated echo free lesions on ultrasonogram.
Adult ; Breast* ; Female ; Humans ; Lymphangioma, Cystic* ; Lymphatic System ; Mammography ; Neck ; Parturition ; Ultrasonography

PURPOSE: To evaluate the upgrade rate of ultrasonography (US)-guided core-needle biopsy (CNB) of the breast for a pure mucocele-like lesion (MLL), to evaluate the clinical and radiologic features, and to correlate the image-pathologic features further on to guide the management of MLL. METHODS: Between January 2003 and February 2013, 14-gauge US-guided CNB was performed in 18,111 cases. Thirty-two cases associated with MLL were identified, and five cases of MLLs associated with breast carcinoma or with other high-risk breast lesions (i.e., atypical ductal hyperplasia [ADH], papillary lesions, lobular carcinoma in situ, and radial scar complex) were excluded. Among these 27 pure MLLs, 21 cases with surgical or vacuum-assisted excision (VAE) pathology were included in our study. Medical records, mammograms, and ultrasonograms were reviewed for the clinical and radiologic features of the cases. RESULTS: Among the 21 cases with pure MLLs at CNB, the final pathology showed a 0% proportion of cases upgraded to malignancy. All the 21 cases with either surgical or VAE pathology were benign MLLs including three cases of focal involvement of ADH (14.3%). The common features were mammographic features of microcalcifications that were round in shape and had a grouped distribution. The US features included oval shape, circumscribed margin, parallel orientation, complex solid and cystic echo pattern, no posterior feature, and complex solid and cystic echoic masses. The predominant Breast Imaging Reporting and Data System (BIRADS) category was 4A. All the lesions showed image-pathologic concordance. CONCLUSION: For pure MLL on US-guided CNB with image-pathologic concordance, close imaging follow-up might be considered instead of surgical excision.
Biopsy* ; Biopsy, Large-Core Needle ; Breast Neoplasms ; Breast* ; Carcinoma, Lobular ; Cicatrix ; Hyperplasia ; Information Systems ; Medical Records ; Pathology ; Ultrasonography

OBJECTIVES: Despite the accumulating evidence of the effectiveness of positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) syndrome, adherence to PAP therapy is not high. Several factors reportedly affect PAP adherence; however, it remains unclear whether patients' symptoms were detrimental to adherence rate. This study is aimed at investigating the relationship between insomnia symptoms and adherence. METHODS: Retrospective analyses were performed in 359 patients with OSA (mean age 58.4±13.2 years; females, n=80). Logistic regression analyses were performed between PAP adherence with clinical factors and questionnaires, such as Epworth Sleepiness Scale, Insomnia Severity Index, and Beck Depression Inventory (BDI). RESULTS: PAP adherence was defined as the use of PAP for ≥4 h per night on 70% of nights during 30 consecutive days. The median follow-up time was 55 days (interquartile range, 30–119 days), and 54.3% showed poor adherence. Non-adherent patients showed more severe sleep onset insomnia, higher BDI, and higher nadir oxygen saturation (SaO₂). Patients with good adherence had higher apnea–hypopnea index, oxygen desaturation index, and respiratory arousal to total arousal ratio. Sleep onset insomnia [odds ratio (OR)=1.792, p=0.012], BDI (OR = 1.055, p=0.026), and nadir SaO₂ (OR=1.043, p=0.040) were independently associated with PAP non-adherence. CONCLUSIONS: Not the severity of insomnia but sleep onset insomnia was associated with PAP adherence, as well as depressive mood. It suggests that different interventions for reducing insomnia and depressive mood are needed to increase PAP adherence in patients with OSA.
Arousal ; Continuous Positive Airway Pressure ; Depression ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Oxygen ; Retrospective Studies ; Sleep Apnea, Obstructive ; Sleep Initiation and Maintenance Disorders