Situs inversus is an extremely rare autosomal recessive disease with left-right inversion of internal organs. It carries technical difficulties in diagnostic or therapeutic procedures. There have been a few case reports on stone extraction by ERCP in situs inversus patients. ERCP techniques in situs inversus can be classified into conventional method and mirror image method. In mirror image method, the procedure is performed with the patient in the right lateral decubitus position and the endoscopist on the patient's left side. Until now, there is no consensus about which method is better. Herein, we report an unusual case of choledocholithiasis in a patient with situs inversus who underwent ERCP for stone extraction by both conventional method and mirror image method.
Aged ; Balloon Occlusion ; Cholangiopancreatography, Endoscopic Retrograde ; Gallstones/complications/*diagnosis/therapy ; Humans ; Male ; Situs Inversus/complications/*diagnosis ; Stents ; Tomography, X-Ray Computed

Hyperinsulinemia may increase the risk of colorectal neoplasia because of its mitogenic and antiapoptotic properties, which have a growth-promoting effect. We examined the association between circulating concentrations of C-peptide, a biomarker of insulin secretion, and colorectal adenoma prevalence in a case-control study of Korean adults. A total of 364 participants (112 cases and 252 controls) were included. Participants who underwent a colonoscopy completed questionnaires and provided blood samples. We used multivariate logistic regression models to obtain odds ratios (ORs) and 95% confidence intervals (CIs) for colorectal adenoma. Circulating concentrations of C-peptide were not associated with colorectal adenoma; the multivariate OR (95% CI) was 0.95 (0.51-1.75) comparing the highest tertile with the lowest tertile (p for trend = 0.91). When we used a conditional logistic regression model by fasting status and sex matching, there was still no association (OR = 0.92; 95% CI = 0.43-1.99) when comparing the highest tertile with the lowest tertile. We observed no association between circulating concentrations of C-peptide and colorectal adenoma prevalence in Korean adults.
Adenoma* ; Adult ; C-Peptide* ; Case-Control Studies ; Colonoscopy ; Fasting ; Humans ; Hyperinsulinism ; Insulin ; Logistic Models ; Odds Ratio ; Prevalence ; Surveys and Questionnaires

PURPOSE: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. METHODS: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. RESULTS: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. CONCLUSION: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.
Clinical Trials as Topic ; Databases, Factual ; *Exercise Therapy ; Fecal Incontinence/*prevention & control ; Female ; Humans ; Muscle Contraction/physiology ; Postpartum Period ; Pregnancy ; Urinary Incontinence/*prevention & control

PURPOSE: Infrared thermometers are increasingly used as a convenient, non-invasive assessment method for febrile children. However, the diagnostic accuracy of the infrared thermometer for children has been questioned, particularly in relation to sensitivity and specificity. The aim of this study was to evaluate diagnostic accuracy of infrared thermometers in febrile children. METHODS: Articles published between 1966 and 2012 from periodicals indexed in the Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected, using the following keywords: 'infrared thermometer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. RESULTS: Nineteen diagnostic studies with high methodological quality, involving 4,304 children, were included. The results of meta-analysis showed that the pooled sensitivity, specificity and AUC (Area Under the Curve) of infrared tympanic thermometers in children over 1 year were 0.80 (95% CI 0.78, 0.81), 0.94 (95% CI 0.93, 0.95) and 0.95 respectively. However the diagnostic accuracy of infrared tympanic thermometers in children with hyperthermia was low. CONCLUSION: The diagnostic accuracy of infrared tympanic thermometer was similar to axillary and rectal thermometers indicating a need for further research to substantiate these findings in children with hyperthermia.
Adolescent ; Area Under Curve ; Body Temperature ; Child ; Child, Preschool ; Databases, Factual ; Fever/*diagnosis ; Humans ; Infant ; Infant, Newborn ; Infrared Rays ; Odds Ratio ; ROC Curve ; Sensitivity and Specificity ; Thermometers/*standards

BACKGROUND AND OBJECTIVES: Arterial stiffness is a precursor to premature cardiovascular disease. The augmentation index (AI) and pulse pressure (PP) are cardiovascular risk factors. The aim of this study was to define the diagnostic values of the AI and PP from the peripheral arterial and central aortic waveforms in healthy subjects. SUBJECTS AND METHODS: We recruited 522 consecutive subjects (mean age 46.3+/-9.6 years, 290 males) who came to our facility for a comprehensive medical testing. We measured the body mass index (BMI), blood pressure, peripheral and central PP, and a pulse wave analysis that included the central and peripheral AI. RESULTS: The peripheral and central AIs in the female subjects were significantly higher than that in the male subjects (p<0.001). The peripheral and central PPs in the subjects with hyperlipidemia were significantly higher than subjects with normal lipid profiles (p<0.001). The peripheral and central PPs and peripheral and central AIs significantly increased with age. CONCLUSION: Pending validation in prospective outcome-based studies, a peripheral PP of 70 mmHg, central PP of 50 mmHg, peripheral AI of 100%, and central AI of 40% may be preliminary values in adult subjects.
Adult ; Arteries ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Female ; Humans ; Hyperlipidemias ; Male ; Porphyrins ; Prospective Studies ; Pulse Wave Analysis ; Reference Values ; Risk Factors ; Vascular Stiffness

BACKGROUND: Due to the irreversible nature of chronic obstructive pulmonary disease (COPD), the treatment aim in patients with COPD is not to cure but to reduce the symptoms, increase lung function, and improve the quality of life. It has been suggested that depression is a common emotional disturbance in patients with COPD who are faced with a major physical impairment and embarrassing symptoms. This study evaluated the prevalence and risk factors of depression in patients with chronic obstructive pulmonary disease. METHODS: A total of 59 patients with a registered diagnosis of chronic obstructive pulmonary disease were selected. Depression was assessed using the Centers for Epidemiologic Studies Depression (CES-D) scale. The quality of life was assessed using the Korean version of the St. George's Respiratory Questionnaire. RESULTS: The prevalence of depression was 17.0%. In the correlation model, the interaction of the FEV1% over predicted value and SGRQ score(symptom, activity, impact, overall score) was statistically significant. The interaction of the FEV1% over predicted value and depression scale(CES-D) was also statistically significant. There was a positive correlation between the SGRQ scores(symptom, activity, impact, overall score) and the depression scale. CONCLUSION: The prevalence of depression in patients with chronic obstructive pulmonary disease is relatively high. The pulmonary function and the living standards were found to be significant risk factors for depression.
Affective Symptoms ; Depression ; Epidemiologic Studies ; Humans ; Lung ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Quality of Life ; Surveys and Questionnaires ; Risk Factors ; Socioeconomic Factors

Mediastinal hemangiomas are extremely rare tumors that originate from vascular endothelial cells. It is well known that mediastinal hemangiomas appear on CT as solid masses with heterogeneous enhancement. We describe here a case of venous hemangioma, and the tumor was seen of the CT scan as a well-marginated cystic mass with a fluid-fluid level in the middle mediastinum; this mass mimicked a foregut cyst or cystic lymphangioma.
Endothelial Cells ; Hemangioma* ; Lymphangioma, Cystic ; Mediastinal Cyst* ; Mediastinum ; Tomography, X-Ray Computed

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. METHODS: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male: female 20: 7; age 47.6+/-12.9 years old; age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. RESULTS: Mean total sleep time on polysomnography was 401.4+/-57.8 min (range of 274.0 to 514.1 min). Mean RDI was 21.7+/-20.4 /hour. Mean FI was 21.9+/-13.0 / hour. RDI and FI showed significant correlation (r=0.55, p< 0.01). CONCLUSIONS: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.
Accident Proneness ; Actigraphy* ; Female ; Follow-Up Studies ; Humans ; Inpatients ; Outpatients ; Polysomnography ; Prevalence ; Seoul ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Deprivation ; Sleep Wake Disorders ; Wrist

No abstract available.
Breast Neoplasms* ; Breast* ; Ion Transport* ; Sodium Iodide* ; Sodium*

No abstract available.
Breast Neoplasms* ; Breast* ; Ion Transport* ; Sodium Iodide* ; Sodium*