To assess the value of routine chest roentgenographic examinations at the time of admission, we analysed chest roentgenogram of 1,283 patients under the age of 15 who were admitted to St. Paul's Hospital from 1975 to 1977. A bonormal radiographic findings were detected in 111out of 1,283 Patients(8.7%). In 108 patients with abnormal findings, no medical or surgical therapy was required except three nowborn infants who had medical therapy as a result of pneumonic infiltration. In view of clinical analysis of 1,283 patients, it is considered that routine chest roentgenographic examinations were not warranted in patients under the age of 15 but justifiable in newborn infants.
Child* ; Humans ; Infant ; Infant, Newborn ; Radiography* ; Thorax*

OBJECTIVE: To investigate whether the findings of wrist magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) is representative of their disease activity. METHODS: MRI and plain radiographs were performed on the wrists of 15 patients with RA. Four MRI techniques were used; T1 weighted spin echo image (T2WI), chemical fat suppression T2 weighted image (FS-T2WI) and Gadolinium-DTPA contrast enhanced T1 weighted image (CE-TIWI). Erosion scores used as radiologic index were calculated from total counts of bone erosion in all coronal planes of wrist MRI and .plain radiographs. This erosion score was compared with the clinical indices (Ritchie index, grip strength, visual analogue pain scale) and laboratory indices (ESR, CRP, hemoglobin, immunoglobulins). RESULTS: MRI erosion score of the wrist in patients with RA significantly correlated with ESR and serum IgG level, but did not correlate with global clinical indices such as grip strength and Ritchie index. MRI was especially useful in early detection of erosive bone change. Special MR images such as fat suppres-sion and Gd-DTPA enhanced images were superior to plain radiographs and conventional MR images in detecting the erosive lesion of carpal bones. CONCLUSIONS: Wrist MRI is useful in early detection of erosive bone change and may be an important tool for the measurement of disease activity in RA. We prospect that it could be used to assess the progression of the disease and the response of drug therapy.
Arthritis, Rheumatoid ; Carpal Bones ; Drug Therapy ; Gadolinium DTPA ; Hand Strength ; Humans ; Immunoglobulin G ; Magnetic Resonance Imaging* ; Wrist*

OBJECTIVES: The aim of this study was to evaluate the effect of red vinegar drink on sound enamel surface. METHODS: Commercially available red vinegar drink was used for the study. Firstly, pH values were measured in commercially available red vinegar drinks. Secondly, four groups; mineral water as the control group and red vinegar drink, red vinegar drink + mineral water (mixing ratio, 1:3), red vinegar drink + milk (mixing ratio,1:4) as the experimental group were selected. Forty specimens of bovine teeth were made and then divided into the four groups and treated with the test drinks for 1, 15, 30 and 60 minutes. The surface microhardness (vickers hardness number, VHN) was measured using the microhardness tester before and after the treatments. The surface of specimens was observed with Scanning Electron Microscopy (SEM). RESULTS: The average pH of red vinegar drinks was 2.91+/-0.02. The change values (before treatment - after treatment of surface microhardness of enamel surface) were significantly difference among groups (P<0.05). There was no significant difference between control and red vinegar drink + milk (1:4) and there was the significant difference between control group and red vinegar drink groups, and control and red vinegar drink + mineral water (1:3) groups. In SEM, damage of enamel surface was observed in Red vinegar and Red vinegar+Mineral water group. CONCLUSIONS: The results showed that the all experimental red vinegar drinks, except red vinegar drink + milk (1:4) can reduce the surface microhardness of sound enamel. Thus, it is suggested that the red vinegar drink with milk could be recommended the preventive eating method for reducing the risk of dental erosion on the red vinegar drink diet.
Acetic Acid* ; Dental Enamel* ; Diet ; Eating ; Hardness ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning ; Milk ; Mineral Waters ; Tooth ; Water

BACKGROUND/AIMS: There is a paucity of national guideline for colorectal cancer screening and polyp diagnosis in Korea. Thus, we investigated the present state of colorectal cancer screening and polyp diagnosis methods using web-based survey to use as reference data for developing a guideline. METHODS: A multiple choice questionnaires of screening recommendations was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians who participated in the national colonoscopy surveillance program. Among 425 colonoscopists, a total 263 colonoscopists replied (response rate, 61.9%). RESULTS: The most commonly recommended starting age for colorectal cancer screening and polyp diagnosis was 50 years old in the average risk group, and 40 years old in groups who had a family history of colon cancer (64.3% and 65.0% respectively). Surgeons had a tendency to recommend screening in younger people than internist do. Ninety-eight percent of physicians recommended screening colonoscopy to asymptomatic, average-risk patients as a first choice. Only 2% of physicians chose sigmoidoscopy as a screening tool. When the initial colonoscopy showed a negative finding, over 60% of internists repeated the exam 5 years later, whereas 62% of surgeons did so within 3 years. CONCLUSIONS: The starting age of colorectal cancer screening and the interval of the colorectal polyp examination are not uniform in various medical environments, and there is a discrepancy between the practical recommendations and western guidelines. Thus, a new evidence-based national practice guideline for colorectal cancer screening and polyp diagnosis should be developed.
Adult ; Age Factors ; Asian Continental Ancestry Group ; Colonic Polyps/*diagnosis/surgery ; Colonoscopy ; Colorectal Neoplasms/*diagnosis ; Data Collection ; Early Detection of Cancer ; Female ; Health Care Surveys ; Humans ; *Internet ; Male ; Middle Aged ; Physician's Practice Patterns ; Questionnaires ; Republic of Korea

BACKGROUND/AIMS: There is a paucity of information on postpolypectomy surveillance currently practiced in Korea. Thus, we investigated the present state of postpolypectomy surveillance in Korea using a web-based survey. METHODS: A multiple choice questionnaire was used to determine the preferred surveillance modality, the colonoscopic surveillance interval used in 11 case scenarios, and clinical factors influencing surveillance intervals. The form was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians involved in a colonoscopy surveillance program. Of 425 colonoscopists contacted, 263 replied (response rate, 62%). Of the respondents, 94% were internists and 54% practiced in tertiary referral hospitals. RESULTS: All respondents chose colonoscopy as a preferred surveillance modality following polyp removal. Colonoscopy at 3 years was the most frequent answer after removal of 1 or 2 tubular adenoma(s) <1 cm in size, while 1 year was the most frequent answer after removal of an advanced adenoma or > or =3 adenomas, and 6 months was the most frequent choice after removal of adenoma with high-grade dysplasia or a sessile polyp > or =2 cm. The agreement rate for the time of first surveillance between preferred guideline recommendations and respondent answers was in the low range at 14-43%. CONCLUSIONS: A significant disagreement exists between current postpolypectomy surveillance practices of Korean colonoscopists and preferred guideline recommendations. This discrepancy may be due to the fact that the guidelines do not reflect recent studies and the specific medical environment in Korea. Thus, there is a need to develop new evidence-based Korean guidelines for postpolypectomy surveillance.
Adenoma ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Electronic Mail ; Humans ; Intestinal Diseases ; Korea ; Physicians, Primary Care ; Polyps ; Referral and Consultation ; Surveys and Questionnaires

There are indirect evidences to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary outpatient clinics and secondary and tertiary medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, PubMed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action.
Adenomatous Polyps ; Ambulatory Care Facilities ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms ; Consensus ; Humans ; Incidence ; Korea ; Polyps ; Prospective Studies ; Standard of Care

There are indirect evidences to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary outpatient clinics and secondary and tertiary medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, PubMed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action.
Adenomatous Polyps ; Ambulatory Care Facilities ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms ; Consensus ; Humans ; Incidence ; Korea ; Polyps ; Prospective Studies ; Standard of Care

Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient's general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available.
Adenoma ; Adenoma, Villous ; Colonoscopy ; Colorectal Neoplasms ; Humans ; Hypogonadism ; Incidence ; Judgment ; Korea ; Mass Screening ; Mitochondrial Diseases ; Ophthalmoplegia ; Polyps

Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient's general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available.
Adenoma ; Adenoma, Villous ; Colonoscopy ; Colorectal Neoplasms ; Humans ; Hypogonadism ; Incidence ; Judgment ; Korea ; Mass Screening ; Mitochondrial Diseases ; Ophthalmoplegia ; Polyps

Colorectal cancer is the second most common cancer in males and the fourth most common in females in Korea. Since the most of colorectal cancer occur through the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. Korean Multi-Society Take Force developed the guidelines with evidence-based methods. Parts of the statements drawn by systematic reviews and meta-analyses. Herein we discussed the epidemiology of colorectal cancers and adenomas in Korea, optimal screening methods for colorectal cancer, and detection for adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.
Adenoma ; Colonography, Computed Tomographic ; Colonoscopy ; Colorectal Neoplasms ; Early Detection of Cancer ; Female ; Humans ; Incidence ; Korea ; Male ; Mass Screening ; Occult Blood ; Polyps