BACKGROUND: Metabolic syndrome (MetS) is constellation of cardiovascular risk factors. There are three typically used definitions of MetS proposed by WHO, IDF and NCEP-ATP III. We conducted this study to compare the associations of MetS by WHO, IDF and NCEP-ATP III definition to various metabolic markers of coronary heart diseases in Korean type 2 diabetes patients. METHODS: We enrolled 151 Korean type 2 diabetes patients in one hospital. Anthropometric and biochemical parameters, including high-sensitivity C-reactive protein (hsCRP), homocysteine, uric acid were measured. And then, we divided MetS group from non-MetS group according to three other definitions. RESULTS: Serum hsCRP level was higher in those with MetS group than non-MetS group by WHO definition (0.33 +/- 0.36 mg/dL vs 0.18 +/- 0.26 mg/dL, P < 0.001). But, there are no difference in MetS group and non-MetS group by IDF and NCEP-ATPIII definition. (By IDF, 0.28 +/- 0.31 mg/dL vs 0.25 +/- 0.34 mg/dL, P = 0.64; By NCEP-ATP III, 0.28 +/- 0.33 mg/dL vs 0.22 +/- 0.32 mg/dL, P = 0.41). Uric acid and homocysteine levels were higher in those with MetS by WHO definition (P < 0.05). Similarly, analyses according to IDF and NCEP ATP III definition showed no significant difference. CONCLUSION: In conclusion, WHO definition of MetS has a stronger relationship with the biochemical markers of coronary heart disease in Korean type 2 diabetes patients.
Adenosine Triphosphate ; Biomarkers ; C-Reactive Protein ; Cardiovascular Diseases ; Coronary Disease ; Diabetes Mellitus ; Homocysteine ; Humans ; Risk Factors ; Uric Acid

No abstract available.
Proliferating Cell Nuclear Antigen* ; Stomach Neoplasms*

Fibrous dysplasia is a benign disorder of bone primarily affecting young people from childhood through the third decade. It usually manifests as an enlargement of bones in and about the orbits or the the cranial vault. Whether localized or diffuse, it rarely involves the cervical spine. We report a case of fibrous dysplasia involving axis combined with atlantoaxial instability which was caused by odontoid process fracture. Transfacetal screw fixation augmented with Halifax interlaminar clamp technique was applied to obtain atlantoaxial stability. Postoperative course was unevenful and postoperative radiologic findings revealed favorable fixation of atlantoaxial joint. The pertinent literature on fibrous dysplasia and atlantoaxial instability is reviewed and discussed.
Atlanto-Axial Joint ; Axis, Cervical Vertebra ; Odontoid Process ; Orbit ; Spine*

BACKGROUND AND OBJECTIVES: Off-thyroxine serum thyroglobulin (Tg) level is important to predict metastatic disease (MD) in papillary thyroid cancer (PTC); however, it is unclear whether a single off-thyroxine Tg level is sufficient for predicting MD. In this study, we determined whether serial measurement of off-thyroxine serum Tg level can predict metastasis in PTC patients after total thyroidectomy. MATERIALS AND METHODS: We enrolled 140 PTC patients in whom serum thyroid-stimulating hormone (TSH) and Tg levels were measured 7 days before radio-iodine (RAI) treatment (TSHA and TgA) and on the day of RAI treatment (TSHB and TgB) with withholding L-thyroxine for 4 weeks before RAI treatment. The values of TSHinc (TSHB-TSHA) and Tginc (TgB-TgA), Tgratio (TgB/TgA), Tginc/TSHinc and Tgratio/TSHinc were calculated. Tginc/TSHinc and Tgratio/TSHinc were tested if those parameters can predict MD in patients with TSHA>30 microIU/mL and TgA<10 ng/mL. RESULTS: Forty-four patients had MD and 96 had no evidence of MD (non-MD). MD group showed higher levels of TgA, TgB, Tginc, Tginc/TSHinc and Tgratio/TSHinc compared with non-MD group. A significant correlation was found between TSHinc and Tgratio (r=0.669) in MD group. In 43 patients with TSHA>30 microIU/mL and TgA<10 ng/mL (MD, 9; non-MD, 34), both Tginc/TSHinc (100%) and Tgratio/TSHinc (89%) had higher sensitivities for predicting MD than TgB (78%). CONCLUSION: With the increment in serum Tg corrected for the increment in serum TSH, serial measurements of off-thyroxine serum TSH and Tg levels can help predict PTC metastasis.
Factor IX ; Humans ; Neoplasm Metastasis ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin ; Thyroxine

BACKGROUND: Arterial emboli remain an important cause of acute arterial ischemia. Despite simplification of operative techniques, the substantial morbidity and mortality still associated with an acute embolus remain a challenge to the vascular surgeon. We wanted to know the adequate evaluation and treatment modality for this limb threatened condition, and to evaluate the results according to etiology, location, time interval before starting treatment, clinical conditions, and limb survival rate. MATERIAL AND METHODS: A retrospective review was conducted on 91 patients who treated for acute lower leg thromboembolism between Jan. 1992 and Dec. 1997. RESULTS: There were 73 men and 18 women and most prevalent age group was in the 5th and 6th decades (53.8%). Over all amputation rate was 25.3% and mortality rate was 5.5%. Cardiac problem was the most common etiologic factor. Associated diseases were cardiac problem (37.4%), hypertension (35.2%), cerebrovascular accident (17.6%), and diabetes (15.4%). Interval from attack to definite therapy, within 24 hours in 14 cases (15.4%), 1~3 days in 23 (25.3%), after 4 days in 54 (59.3%) were noted. The locations were aorta and iliac in 25.3%, femoral in 38.5%, popliteal in 19.8%, tibial in 4.4%, and 15.4% in graft site in other of frequency. Clinical categories were grade I in 9.9%, IIa in 40.7%, IIb in 30.8%, and III in 18.7%. According to Eagle's criteria, low risk group were 34 cases (37.4%), moderate risk group were 39 cases (42.9%), and high risk group were 18 cases (19.8%). Of the 91 patients, conservative treatment in 2 (2.2%), thrombolytic therapy in 33 (36.3%), thromboembolectomy in 56 (61.5%), bypass in 16 (17.6%), endarterectomy and vessel ligation were performed. The 1-month and 1-year limb salvage rates were 73.4% and 71.1%, respectively. Especially, salvage rates in the Department of Vascular Surgery were 84.9% and 83.7%, whereas that of Thoracic and Orthopedic Surgery were 44.4% and 33.0% (p=0.0001). CONCLUSIONS: Cardiac problem especially atrial fibrillation was the most common etiologic factor. Prompt balloon catheter embolectomy performed under local anesthesia is a safe, simple, and effective method of treatment and the preferred mode of management in the great majority of patients. Nonoperative management with thrombolytic agents or high-dose heparin therapy alone is occasionally indicated in highly selected patients. The prognosis of acute arterial thromboembolism of lower extremity can be improved by early detection, early adequate treatment, and the involvement of a qualified vascular surgeon.
Amputation ; Anesthesia, Local ; Aorta ; Atrial Fibrillation ; Catheters ; Embolectomy ; Embolism ; Endarterectomy ; Extremities ; Female ; Fibrinolytic Agents ; Heparin ; Humans ; Hypertension ; Ischemia ; Leg ; Ligation ; Limb Salvage ; Lower Extremity ; Male ; Mortality ; Orthopedics ; Prognosis ; Retrospective Studies ; Stroke ; Survival Rate ; Thromboembolism* ; Thrombolytic Therapy ; Transplants

PURPOSE: The laparoscopic cholecystectomy has increasingly been accepted as the procedure of choice for treatment of symptomatic gall stones and chronic cholecystitis. However, its role and its timing in the management of patients with acute cholecystitis remain controversial. This retrospective study was undertaken to compare on early laparoscopic cholecystectomy with a delay one for patients with acute cholecystitis. METHODS: Between January 1995 and June 1999, 15 patients were operated on within 72 hours of symptom onset. Those patients were classified as the early laparoscopic cholecystectomy group. The 18 patients who underwent a delayed laparoscopic cholecystectomy after a percutaneous transhepatic cholecystostomy (PTCS) and conservative management were classified as the delayed laparoscopic cholecystectomy group. RESULTS: No significant differences were seen in the conversion rate (1 case in the delayed group), the operation time (early group 107.3 min., delayed group 118.6 min.), postoperative complications (early group 20.0%, delayed group 16.7%), and the postoperative hospital stay (early group 4.7 days, delayed group 7.1 days). The early group had significantly more frequent operation modifications and decreased total hospital stays than the delayed group: 86.7% and 7.0 days, for the early group and 44.4% and 22.8 days for the delayed group. CONCLUSION: Early laparoscopic cholecystectomy for acute cholecystitis did not increase the operation time, the morbidity, or the conversion rate. Although this study was not a randomized study and the sample size was small, an early laparoscopic cholecystectomy seems to be safe and feasible for patients with acute cholecystitis, having the benefit of a decreased total hospital stay.
Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute* ; Cholecystostomy ; Gallstones ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Sample Size

The colostomy may cause considerable discomfort as well as surgical, psychological and esthetic problems. The ostomates probably suffer most from fecal incontinence, even though many attempts have been made to eliminate the problems related to the spontaneous colonic emission. Hence the aims of this study are to survey ostomates' satisfaction with colostomy irrigation. METHODS: This medical survey attempts to assess the degree of satisfaction that ostomates are satisfied with the quality of their lives and the extent to which they are affected in doing their jobs and sexuality. The survey was conducted for 146 ostomates, who responded to the questionnaire at the 3rd & 4th Workshop for Stoma Rehabilitation for Ostomates in 1998 and 1999 developed by the Department of Surgery, Kyung Hee University Hospital. The irrigation group was formed with 66 cases (45.2%) and the non-irrigation group 80 cases (54.8%). In assessment of the satisfaction of sexuality, the irrigation group was composed of 37 cases (male: 22 cases, female: 15 cases) and the non-irrigation group 48 cases (male: 30 cases, female: 18 cases). RESULTS: It is found out that the ratio of male to female is 1.5:1 (97:59) and by the age distribution, the ostomates in their 50's and 60's constitute 67.1%: by the cause of stoma operation, malignancy consists of 133 cases (91.1%), Inflammatory Bowel Disease (IBD) 6 cases, the others 7 cases. As for the degree of the satisfaction of ostomates for their life quality, it is found that 52 cases (78.9%) of the irrigation group and 71 cases (88.8%) of the non-irrigation group (p<0.05) reveal dissatisfaction. As for the degree of the satisfaction of the ostomates for the extent to which they are affected in doing their social activities, dissatisfaction is revealed in 52 cases (78.9%) in the irrigation group and in 64 cases (80.0%) in the non-irrigation group (p>0.05). As for the degree of the satisfaction of the ostomates for the sexuality in male, dissatisfaction is revealed in 13 cases (59.1%) of the irrigation group and in 23 cases (76.7%) of the non-irrigation group (p<0.05). In the case of female, the dissatisfaction is observed in 8 cases (53.3%) of the irrigation group and in 13 cases (72.2%) of the non-irrigation group (p<0.05). CONCLUSIONS: This medical survey clearly shows high dissatisfaction rates especially in the non-irrigation group, and the better significant satisfaction was shown in the quality of life and sexuality between the male and the female in the irrigation group. Therefore, colostomy irrigation may be an effective method for the management of colostomy.
Age Distribution ; Colon ; Colostomy* ; Education ; Fecal Incontinence ; Female ; Humans ; Inflammatory Bowel Diseases ; Male ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation ; Sexuality

Peripheral nervous system involvement is common in systemic vasculitis, occurring most frequently in the polyarteritis nodosa (PAN) group of disorders and in rheumatoid vasculitis. Within the polyarteritis nodosa group of systemic necrotizing vasculitides, three subgroups have been described: classic polyarteritis nodosa, Churg-Strauss syndrome, and an overlap syndrome. Three patients with evidence of systemic vasculitis and peripheral neuropathy were clinically and electrophysiologically investigated. All cases presented clinically with mononeuropathy multiples considered typical pattern of ischemic involvement of the peripheral nerve. The causes included polyarteritis nodosa, its Churg-strauss variant, and the overlap syndrome. Pain and weakness were frequent symptoms. Nerve conduction studies were abnormal In all cases. Necrotizing vasculitis was present as pathologic findings in two cases. All patients were treated with prednisolone alone or in combination with other immunosuppressive agents or with plasmapheresis.
Churg-Strauss Syndrome ; Humans ; Immunosuppressive Agents ; Mononeuropathies* ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Plasmapheresis ; Polyarteritis Nodosa ; Prednisolone ; Rheumatoid Vasculitis ; Systemic Vasculitis ; Vasculitis*

The purpose of this studs is to evaluate the Scientific soundness. reliability and harmfulness of medical information on world wide web in Korea. We focused this study just in "hepatitis" information, considering the high incidence of this disease in Korea. 689 web pages relating to hepatitis were collected by means of Lycos Korea search engine. and finally 182 web pages were selected. These 182 web paces were analyzed as category (western/oriental/folk medicine and as subject (prevention/diagnosis/treatment/others). Alter this analysis, these web paces were evaluated by investigators composed of two family physicians and one gastroenterologist. They analyzed the information on the criteria of "scientific soundness" "omission/ . exaggeration" and "harmfulness". The major results were as follows: 1. 133 web pages (73.3%) were scientifically sound. But the web pages relating to oriental and folk medicine revealed relatively low scientific soundness. compared with western medicine wet) pages. Also, the scientific soundness revealed low especially in the web pages that mainly described the treatment of hepatitis. 2. The web pages that had the omission of essential information was 9,3% . and those of the exaggeration" was 26% These results were related to the scientific soundness. The rate of the omission was relating high in the web pages related to the folk medicine (34.6% ), and the rate of exaggeration was remarkably high in die web pages related to the oriental medicine (89.5%), Both rates of the omission (20.9%) and exaggeration (67.2%) revealed especially high in the web pages that mainly described treatment of hepatitis. 3. The web pages that had the harmful information was also had the scientific unsoundness. The rate was high in the web pages related to the folk medicine, and the rate of web pages that had direct persuasion of harmful acting was as remarkably high in the oriental medicine. Also these rates were high in the web pages that mainly describe the treatment of hepatitis. This investigation showed that the large part of internet health information about `hepatitis in korea had the scientific soundness, but also revealed there were mails information that could give unhealthy influence to internet navigators it Korea. The most powerful element that could give unhealthy influence to internet navigators was lack of the scientific soundness, and this unhealthy information mainly revealed in the oriental or folk medicine web pages. especially in the treatment information.
Hepatitis* ; Humans ; Incidence ; Internet ; Korea* ; Medicine, East Asian Traditional ; Medicine, Traditional ; Persuasive Communication ; Physicians, Family ; Postal Service ; Research Personnel ; Search Engine

Background: Recent studies about completely displaced midshaft clavicle fractures have reported that their nonunion/malunion rates were significantly higher in conservatively treated patients compared to surgically treated patients. The purpose of this study was to evaluate the factors associated with treatment decisions for midshaft clavicle fractures and also the factors that affect patient satisfaction with their treatment choice. Methods: We retrospectively reviewed the records of 75 patients who had been diagnosed with a midshaft clavicle fracture and were treated conservatively at a single institution between March 1, 2013, and December 31, 2014. Their medical records were reviewed to investigate the severity of the initial vertical displacement. A telephone survey was carried out to identify the presence of any patient-perceived deformity and determine if the patient eventually underwent surgery and whether the patient would prefer surgery if the injury recurred. Results: Significantly more patients with vertical displacement ≥100% (9/28) eventually underwent surgery compared to patients with vertical displacement <100% (3/32; p=0.028). Patients with vertical displacement ≥100% (13/28) were significantly more likely to prefer surgery compared to patients with vertical displacement <100% (7/32, p=0.044). Among the conservatively treated patients, nine of 32 participants with a patient-perceived deformity and one of 16 without a patient-perceived deformity responded that they would prefer to receive surgery in same situation in the future (p=0.079). Conclusions Patients with a midshaft clavicle fracture with vertical displacement of ≥100% may eventually require surgical treatment. When conservative treatment is carried out, the long-term patient results may be unsatisfactory due to perceived residual deformities.