No abstract available.
Korea* ; Otolaryngology*

BACKGROUND: Bilirubin has been suggested as a antioxidant which protect oxidation of lipids and lipoproteins. Given that oxidized lipids and lipoproteins are known to be atherogenic, low serum concentrations of bilirubin could be associated with the high risk of coronary artery disease (CAD). But few studies have been performed for confirmation of this hypothesis. In this study, we evaluated the relationship between serum concentrations of billrubln and the angiographically documented CAD. METHODS: Eighty five CAD patients and 56 non-CAD patients, classified according to the maximum stenosis of coronary artery at angiography, were enrolled in this study. The degree of the coronary arterial stenosis were subclassified into <10% (non-CAD), 10-49% (mildly stenotic CAD) and > or =50% (severely stenotic CAD). We retro-spectively reviewed serum concentrations of total and direct bilrubin at the time of angiography, compared tine mean concentrations of bilirubin between two groups and evaluated it in relation to the severity of CAD by statistical analysis. RESULTS: The mean concentration of total bilrubin was significant1y lower in CAD group 4han non-CAD group (12.8 micromol/L vs. 15.2 micromol/L, p value=0.04) The mean concentration of direct bilirubin was lower in CAD group than non-CAD group but not statistically significant (3.3 micromol/L vs. 4.2 micromol/L, p value=0.07). Although not significant, the concentration of total bilirubin in severely stenotic group (12.8 CAD group 12.8+/-4.3 micromol/L) was lower than mildly stenotic group (13.5+/-3.8 micromol/L) and non CAD group (15.2+/-7.4 micromol/L ) (p=0.07). CONCLUSIONS: This study showed that low serum concentrations of total bilirubin were associated with the high risk of CAD and supports the hypothesis that serum bilirubin could act as an antiatherosclerotic factor. Further prospective studies are required to confirm the relationship between bilirubin and CAD and to elucidate the most associated fraction of bilirubin and pathogenic mechanism.
Angiography ; Bilirubin* ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Lipoproteins

No abstract available.
Korea

Aplasia cutis congenita represents a congenital absence of all skin layers, and it may occasionally extend through the bone and dura of the skull. Since the first report was described in the extremity by Cordon 1767, and Campbell 1826, approximately over 500 cases have been reported. About eighty five percents of all cases are found in the scalp, with 15 to 30 percents involving the skull as well. Fifteen percents of all cases involve nonscalp locations and are often bilateral symmetrical. It has been relatively rarely reported disorder abroad as well as domestically. It has several clinical subtypes classified by the location and pattern of skin absence, the presence of associated malformation and the mode of inheritance with unknown cause. We had a new born female infant with this disorder, who presented with a full thickness skin defect on scalp and skull defect. No skin defect were reported in other family members, including a first child born several years previously. Chromosomal analysis revealed as normal female karyotype, but she had double pelvis and double ureter of both kidney The legions healed for five weeks by conservative treatment as moist wound dressing and systemic antibiotic administrations. As a relatively uncommon skin anomaly with congenital anomaly, one case of aplasia cutis congenita involving scalp and skull is reported with the review of reference.
Bandages ; Child ; Ectodermal Dysplasia* ; Extremities ; Female ; Humans ; Infant ; Karyotype ; Kidney ; Kidney Pelvis* ; Pelvis ; Scalp* ; Skin ; Skull ; Ureter* ; Wills ; Wounds and Injuries

PURPOSE: This study examined the health status among elderly in community. METHOD: This is a survey using cross-sectional design. The subjects were 531 elders who were 65 and over in Pusan, Korea. Data were collected by 17 trained interviewers from April 10 to August 26, 2000. Functional status for physical health status, depression, loneliness, self-esteem for psychological health status, and social support for social health status were measured. RESULT: About forty three percent of the subjects were found as the elderly who need support in physical status. About fifty six percent of the subjects were depressed. The mean score on the Loneliness scale was 40.4, which means relatively higher. For self-esteem, its score was lower than that of elderly who were examined in other studies. The subjects were living in the state of lower social support. The risk factors for vulnerable health status were being female, becoming older, lower income and education, and living alone. CONCLUSION: This finding indicates that the elderly subjects in Korean community were in poor health status in physical, psychological and social aspects.

BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate

Purpose: This study examined the definitions, diagnostic criteria, and measurements of sarcopenic obesity and identified effective exercise interventions that improve cardiometabolic outcomes in middle-aged and older adults, in whom the prevalence of sarcopenic obesity is increasing. Methods: This comprehensive review followed the principles of literature search, data extraction, and review, as described in the PRISMA 2009 guidelines. Results: The 11 articles included in this study presented different concepts of sarcopenic obesity. Exercise interventions for sarcopenic obesity varied in their effects. Resistance exercise improved muscle mass and physical function, while aerobic exercise primarily impacted obesity and cardiometabolic indicators. Combined exercise had mixed results across indicators. Conclusion This study addressed a pressing public health concern in the context of an aging population, acknowledged the unique challenges of sarcopenic obesity, and attempted to clarify definitions and assessment methods, while identifying effective exercise interventions to reduce cardiometabolic risk. Sarcopenic obesity is a multifaceted condition with varying definitions and diagnostic criteria. Its association with cardiometabolic risk underscores the need for comprehensive assessments considering both muscle and obesity indicators. While exercise interventions hold promise for managing sarcopenic obesity, further research is required to establish effective strategies.

Purpose: The purpose of this study was to identify the relationship between intrinsic motivation and learning outcomes of nursing college students who took the Fundamentals of nursing as a problem-based learning method. Methods: In this cross-sectional study, we identified the intrinsic motivations of 114 nursing students who completed problem-based learning using the Intrinsic Motivation Inventory. The t-test was conducted to identify differences according to intrinsic motivation, and correlation analysis was performed to confirm the relationship between intrinsic motivation and learning outcomes. Results: The group with higher intrinsic motivation showed higher scores in all domains of self-assessed learning outcomes than the lower group. It was the ‘Relatedness with an instructor’ that showed the highest correlation with the learning outcomes in the domains of intrinsic motivation. Conclusion Problem-based learning is an effective learning method for cultivating the competencies needed for nurses. The intrinsic motivation of students is an important factor in the performance of problem-based learning. For the efficiency of problem-based learning, efforts should be made to develop and apply autonomy-supportive interventions that can enhance intrinsic motivation.

OBJECTIVE: To evaluate the association between neuralgic pain distribution and the severity of carpal tunnel syndrome (CTS). METHOD: Pain drawings using computerized pain chart system were collected from 131 patients (213 hands) with CTS. The presence and severity of CTS were determined by means of median motor and sensory nerve conduction studies. The severity was divided into 3 classes on the basis of electrophysiological findings: mild (93 hands), moderate (70 hands) and severe (50 hands). The similarities between pain drawing patterns and median nerve dermatome in the hands were evaluated. The pain distributions of the palmar and dorsal sides of each five fingers, palm and dorsum of hand were also evaluated. RESULTS: There were no significant differences in similarity values of pain distribution among the groups of CTS hands divided by severity: similarity values were 0.22+/-0.14 in mild CTS patients, 0.24+/-0.16 in moderate CTS patients and 0.27+/-0.14 in severe CTS patients. In the CTS patients, the pain drawings showed relatively frequent distributions in the palmar side of 2nd to 4th fingers. CONCLUSION: There was no significant correlation between pain drawing patterns and severity of CTS. The pain drawings of patients with CTS indicate distribution to be most frequent in the palmar side of 2nd to 4th fingers.
Carpal Tunnel Syndrome* ; Fingers ; Hand ; Humans ; Median Nerve ; Neural Conduction

The diagnosis of thoracic outlet syndrome (TOS) is sometimes confused by its nonspecific symptoms and various etiologies. Moreover, the paths of involving nerves and arteries are highly diverse. We report a 35 year-old man who had numbness and coldness in his left upper extremity with no improvement to medical therapy. The electrophysiologic studies were normal. Radial artery pulse was absent and the thermography revealed markedly reduced temperature below the left mid-forearm. The arteriography showed compression of the left subclavian artery between the clavicle and the 1st rib with aneurysmal change proximal to the compression. Occlusion of the left brachial artery and collateral arteries were also observed. Under the diagnosis of vascular TOS, 1st rib resection was performed and his symptoms were relieved. Vascular TOS may be considered in cases of upper limb paresthesia.
Adult ; Aneurysm ; Angiography ; Arteries ; Brachial Artery ; Clavicle ; Diagnosis ; Embolism ; Humans ; Hypesthesia ; Paresthesia ; Radial Artery ; Ribs ; Subclavian Artery ; Thermography ; Thoracic Outlet Syndrome* ; Upper Extremity