No abstract available.

OBJECTIVES: A healthcare decision-making support model and rule management system is proposed based on a personalized rule-based intelligent concept, to effectively manage chronic diseases. METHODS: A Web service was built using a standard message transfer protocol for interoperability of personal health records among healthcare institutions. An intelligent decision service is provided that analyzes data using a service-oriented healthcare rule inference function and machine-learning platform; the rules are extensively compiled by physicians through a developmental user interface that enables knowledge base construction, modification, and integration. Further, screening results are visualized for the self-intuitive understanding of personal health status by patients. RESULTS: A recommendation message is output through the Web service by receiving patient information from the hospital information recording system and object attribute values as input factors. The proposed system can verify patient behavior by acting as an intellectualized backbone of chronic diseases management; further, it supports self-management and scheduling of screening. CONCLUSIONS: Chronic patients can continuously receive active recommendations related to their healthcare through the rule management system, and they can model the system by acting as decision makers in diseases management; secondary diseases can be prevented and health management can be performed by reference to patient-specific lifestyle guidelines.
Chronic Disease* ; Decision Support Systems, Clinical ; Delivery of Health Care* ; Expert Systems ; Health Records, Personal ; Humans ; Knowledge Bases ; Life Style ; Mass Screening ; Self Care

A new antireflux surgical technique was introduced by Gil Vernet in 1984, which is simple and rapidly accomplished without mobilization of the distal ureter. The technique involves a single stitch that implicates the trigone, effectively lengthening the intramural segment of terminal ureter, which is particularly effective in patients with megatrigone. We applied this new technique in 2 children with vesicoureteral reflux, of whom one had unilateral grade III reflux and the other bilateral grade II and grade IV reflux. Vesicoureteral reflux and urinary tract infection were lost at follow up voiding cystourethrogram and urinalysis 4 months after operation. We think that this new technique is excellent method in surgical treatment of vesicoureteral reflux.
Child ; Follow-Up Studies ; Humans ; Ureter ; Urinalysis ; Urinary Tract Infections ; Vesico-Ureteral Reflux

No abstract available.
Plasma ; Protein C Deficiency* ; Protein C* ; Purpura Fulminans* ; Purpura* ; Warfarin

Eosinophilic pustular folliculitis (EPF) is a rare dermatosis of unknown cause. It is characterized by recurrent crops of sterile, pruritic, follicular papulopustules on the face, trunk, and extremities. Although various treatments have been attempted for EPF, including systemic corticosteroid dapsone, cetrizine, UVB phototherapy, as well as cyclosporin, no uniformly effective treatment has been found. We describe a 20-year-old man with long standing EPF which was resistant to various treatments, but who responded dramatically to indomethacin.
Cyclosporine ; Dapsone ; Eosinophils* ; Extremities ; Folliculitis* ; Humans ; Indomethacin* ; Phototherapy ; Skin Diseases ; Young Adult

Nevus sebaceus is a hamartoma of both epithelial and non-epithelial components, which that undergoes age-related change. It commonly affects the head and neck, particularly the scalp. In 10-20% of nevus sebaceus cases, secondary benign or malignant neoplasms such as syringocystadenoma papilliferum, trichoblastoma or basal cell carcinoma occur between 40-80 years of age. In only rare instances does a sebaceous carcinoma develop within a nevus sebaceus. To our knowledge, only 3 cases of sebaceous carcinoma in nevus sebaceus have been reported in the Korean dermatologic literature. We present a case of a sebaceous carcinoma arising from nevus sebaceus in a 46-year-old Korean man.
Carcinoma, Basal Cell ; Hamartoma ; Head ; Humans ; Middle Aged ; Neck ; Nevus* ; Scalp

OBJECTIVE: To assess the clinical usefulness of ultrasonography for the diagnosis of mild and very mild carpal tunnel syndrome. METHOD: Ultrasonographic evaluation was performed in 39 hands of 29 patients with mild and very mild carpal tunnel syndrome according to Bland's neurophysiologic grading scale. Controls included 41 hands of 34 subjects without electrophysiologic evidence of carpal tunnel syndrome. Ultrasonographic findings were evaluated quantitatively with regard to the cross-sectional area, the flattening ratio, the swelling ratio of the median nerve, and palmar displacement of the flexor retinaculum. The analysis of differences between controls and patients group were done by independent t-test. Cut-off values using receiver operation characteristic, were calculated. RESULTS: Patients had significantly increased cross sectional area and flattening ratio of the median nerve at proximal carpal area, palmar displacement of the flexor retinaculum at proximal carpal area. A critical value of equal or higher to 8.5 mm(2) for cross-sectional area at the pisiform level showed a sensitivity 79.5%, a specificity of 95.1%, which had most diagnostic value compared with the value of cross-sectional area at the distal radius level, flattening ratio at the pisiform level and palmar displacement. CONCLUSION: Ultrasonography was useful in the diagnosis of mild and very mild carpal tunnel syndrome.
Carpal Tunnel Syndrome ; Displacement (Psychology) ; Hand ; Humans ; Median Nerve ; Radius ; Sensitivity and Specificity

Objective: : Deep learning is a machine learning approach based on artificial neural network training, and object detection algorithm using deep learning is used as the most powerful tool in image analysis. We analyzed and evaluated the diagnostic performance of a deep learning algorithm to identify skull fractures in plain radiographic images and investigated its clinical applicability. Methods: : A total of 2026 plain radiographic images of the skull (fracture, 991; normal, 1035) were obtained from 741 patients. The RetinaNet architecture was used as a deep learning model. Precision, recall, and average precision were measured to evaluate the deep learning algorithm’s diagnostic performance. Results: : In ResNet-152, the average precision for intersection over union (IOU) 0.1, 0.3, and 0.5, were 0.7240, 0.6698, and 0.3687, respectively. When the intersection over union (IOU) and confidence threshold were 0.1, the precision was 0.7292, and the recall was 0.7650. When the IOU threshold was 0.1, and the confidence threshold was 0.6, the true and false rates were 82.9% and 17.1%, respectively. There were significant differences in the true/false and false-positive/false-negative ratios between the anteriorposterior, towne, and both lateral views (p=0.032 and p=0.003). Objects detected in false positives had vascular grooves and suture lines. In false negatives, the detection performance of the diastatic fractures, fractures crossing the suture line, and fractures around the vascular grooves and orbit was poor. Conclusion : The object detection algorithm applied with deep learning is expected to be a valuable tool in diagnosing skull fractures.

We report a case of irreducible atlantaxial dislocation with spinal cord injury. The patient was a 36-year-old man who suffered from the sudden onset of shallow respiration and severe motor weakness after slip down. We have performed the one-stage operation, the transoral decompression, reduction and posterior interspinous wiring with bone fusion. Three weeks after surgery, the reduction state and posterior wiring procedure were failed, due to severe osteoporotic change. So, we have performed second operation, the transarticular facet screw fixation and occipito-cervical fixation with Steinmann pin, from which good postoperative stability and neurological improvements, were obtained.
Adult ; Decompression* ; Dislocations* ; Humans ; Osteoporosis ; Respiration ; Spinal Cord Injuries* ; Spinal Cord*

BACKGROUND: Hyperlipidemia is the one of the major risk factors causing the atherosclerosis of coronary arteries. Treatment of hyperlipidemia with drugs has been confirmed the effects of therapy showing a decreased incidence of coronary artery disease. Simvastatin is a new drug of HMG-CoA reductase inhibitors and the short-term hypolipidemic effects and safety of simvastatin is evaluated in patients with hyperlipidemia. METHODS: We studied 63 patients (39 males and 24 females, mean age 58) for 12 weeks whose plasma levels of total cholesterol were higher than 240 mg/dL or higher than 220 mg/dL with ischemic heart disease. Simvastatin was administered 20 mg/day and measured lipid profile at 12 week interval. RESULT: 1)Simvastatin significantly reduced the level of the plasma total cholesterol(-29.3%), LDL- cholesterol(-36.9%) and triglyceride(-13%)(p<0.05) but the level of HDL-cholesterol was not changed after 12 weeks simvastatin therapy. 2)the clinical symptoms and laboratory examination before and after simvastatin treatment showed no particular abnormal findings in short term follow up. CONCLUSION: These results suggested that short-term simvastatin therapy in patients with hyperlipidemia seeems to be very effective and safe.
Atherosclerosis ; Cholesterol ; Coronary Artery Disease ; Coronary Vessels ; Female ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias* ; Incidence ; Male ; Myocardial Ischemia ; Plasma ; Risk Factors ; Simvastatin