BACKGROUND: Several practice guidelines for management of dyslipidemia including the National Cholesterol Education Program recommend regular physician follow-up and lipid testing to promote adherence with lipid-modifying drugs. The objective of this study was to analyze the pattern of medical care use among lipid-modifying drug users. METHODS: A retrospective cohort study was conducted with 57,801 new users of lipid-modifying drugs who initiated treatment in 2005. The Korean National Health Insurance Claims Data was used to examine the pattern of medical care use and related factors after treatment initiation for up to two years. Getting the prescription and follow-up lipid testing were considered use of medical care. RESULTS: More than 95% of the patients visited physicians for prescriptions or lipid testings in the first year after initiating drug therapy. In the first two months, 77% had both prescription and follow-up lipid testing, while in the second year, approximately 57% had. Rate for follow-up lipid testing in the first two months was about 78%, but 55% in the second year. Approximately 74% of the patients continued using ambulatory medical care in the second year. In multiple logistic regression analysis, the probability of continual visits in the second year increased in patients who visited one medical institution for prescription and lipid testing within six months. CONCLUSIONS: Early and frequent visits, especially for lipid testings, were associated with continuous medical care use. Patients should be educated regarding the importance of dyslipidemia management in the early stage after treatment initiation.
Cholesterol ; Cohort Studies ; Drug Users ; Dyslipidemias ; Follow-Up Studies ; Humans ; Logistic Models ; National Health Programs ; Prescriptions ; Retrospective Studies

Peterson's hernia is an internal hernia that can occur after Roux-en-Y anastomosis. It often accompanies small bowel volvulus and is prone to strangulation. Reconstruction of intestinal continuity after massive small bowel resection in a patient who undergoes near total gastrectomy and Roux-en-Y anastomosis can be difficult. A 74-year-old man who had undergone a near total gastrectomy and Roux-en-Y gastrojejunostomy for stomach cancer presented with abdominal pain. The preoperative computed tomography showed strangulated small bowel volvulus. During the emergent laparotomy, we found a strangulated Peterson's hernia with small bowel volvulus. After resection of the necrotized intestine, we made a new Roux-en-Y anastomosis connecting the remnant stomach and the jejunum with a transverse colon segment. We were safely able to connect the remnant stomach and the jejunum by making a new Roux-en-Y anastomosis utilizing a transverse colon segment as a new Roux-limb by two stage operation.
Abdominal Pain ; Aged ; Anastomosis, Roux-en-Y ; Colon, Transverse* ; Extremities* ; Gastrectomy ; Gastric Bypass ; Gastric Stump ; Hernia* ; Humans ; Intestinal Volvulus* ; Intestines ; Jejunum ; Laparotomy ; Stomach Neoplasms

Erythema nodosum is clinical entity defined easily, but because of the variable histopathologic findings showing involvement of the vessels, septa, and fat lobules, the histopathologic features often are not compatible with the clinical diagnosis, We present the results of clinical and histopathologic findings in 26 patients with erythema nodosum observed at the Department of Dermatology, Seoul National University Hospital, fram January 1973 to August 1976. 1. Clinical Findings Erythema nodosum is characterized by painful erythematous nodose lesion occurring symmetrically(92%) on shins(50%) or shins and calves(50%) of women(M: F==4: 22) between sixteen to twenty five years old of age(58%) chiefly. In laboratory study, leukocytosis(1/17) was rare but increased titers of antistreptolysin(64%) and elevation of E.S.R.(88%) were found frequently. 2. Histopathologic Findings Even though hemorrhage(73%), perivascular(100%) and periadnexal(85%) inflammatory cell infiltration were frequently seen in histopathologic changes of erythema nodosum, these changes were nonspecific. Moreover, granulomatous change (38%), thrombophlehitis(35%) and necrosis of fatty tiasue(38%) were observed not infrequently in erythema nodosum. So we concluded that there were no specific histopathologic findings in erythema nodosum which differentiated from the other erythematous nodose diseases on the legs consisted of panniculitis, thrombophlebitis or granulomatous changes.
Dermatology ; Diagnosis ; Erythema Nodosum* ; Erythema* ; Humans ; Leg ; Necrosis ; Panniculitis ; Seoul ; Thrombophlebitis

No abstract available.
Atherosclerosis* ; Diabetic Foot*

No abstract available.

Although this vascular anomaly, angiomatosis retinae, was initially observed over 85 years ago, and although excellent clinical description of the lesion exist in the literature, treatments for the angiomatosis retinae is difficult and unless the condition is in its early stages, impossible but available symptomatic therapy. Two cases of the angiomatosis retinae, the first, 11 year old girl, von Hippel disease, early stage of vascular dilatation and angiomatous formation, and the second, 15 year old boy, von Hippel-Lindau disease, the final stage of glaucoma and destruction of the eye, are reported. Intravenous fluorescein angiography has been demonstrated, the retinal vascular malformations in von Hippel-Lindau disease are distributed focally and not diffusely, The retinal veins showing greater changes than the arteries are disclosed. This paper presents the fluorscein angiographic findings of von Hippel-Lindau disease and discusses the treatments and the pathologic findings of angiomatosis retinae with literatures related to von Hippel-Lindau disease.
Adolescent ; Arteries ; Child ; Dilatation ; Female ; Fluorescein Angiography ; Glaucoma ; Humans ; Male ; Retinal Vein ; Retinaldehyde ; Vascular Malformations ; von Hippel-Lindau Disease*

No abstract available.
Humans ; Infant, Newborn*

OBJECTIVE: This study was aimed to obtain information on normal MIS serum levels according to menstrual cycles of adult normal cycling women . It was also designed to obtain information on the ontogeny of the production profile of MIS and the pattern of its localization in ovary from adult normal cycling women. METHODS: Between January 1998 and January 1999, normal MIS serum levels were measured according to menstrual cycles using 160 serum samples from adult normal cycling women by ELISA. The ontogeny of the production profile of MIS and the pattern of its localization were also studied by immunohistochemical staining using the rabbit polyclonal antibody against human recombinant MIS in 35 ovarian specimens from adult normal cycling women. RESULT: The MIS levels were gradually increased through the follicular phase, reaching at its maximum at the ovulatory phase(4.2+/-2.6 ng/ml), and sharply decreased at the beginning of the luteal phase being minimized at the premenstrual phase(0.5+/-0.2 ng/ml). In average, the MIS levels of the follicular phase(3.7+/-1.9 ng/ml) were significantly higher than those of the luteal phase(1.8+/-2.4 ng/ml)(P<0.05). The MIS levels of the preovulatory and ovulatory phase were significantly higher than those of the other cycle days(P<0.05). Even the early follicular phase(2.9+/-1.6 ng/ml) showed higher MIS levels than the advanced luteal phase(0.9+/-0.7 ng/ml) and the premenstrual phase(0.5+/-0.2 ng/ml)(P<0.05 and P<0.05, respectively). The first staining for MIS was detected in the cytoplasm of granulosa cells when the flattened granulosa cells changed to the cuboidal cells in primordial follicles. The granulosa cells of both single and multiple layered growing follicles showed strong specific staining for MIS. but the MIS staining was not found not in the mature follicle just before ovulation, atretic follicles, corpus luteum, and corpus albicans. MIS staining waned in the mature follicles just before ovulation. CONCLUSION: These experiments demonstrate that the MIS is produced by ovarian granulosa cells in normal reproductive females. The MIS may play an important role as a hormone of follicular development and oocyte maturation through interactions with female steroid hormones, gonadotropins, and growth factors during the adult reproductive cycle.
Adult ; Anti-Mullerian Hormone* ; Corpus Luteum ; Cytoplasm ; Enzyme-Linked Immunosorbent Assay ; Female ; Follicular Phase ; Gonadotropins ; Granulosa Cells ; Humans* ; Intercellular Signaling Peptides and Proteins ; Luteal Phase ; Menstrual Cycle* ; Oocytes ; Ovarian Follicle ; Ovary* ; Ovulation

Since the classical description of pyoderma gangrenosum by O'Leary, Brunsting and Goecgerman in 1930, a considerable nurnber of reports of this clinical entity has appeared. Pyoderma gangrenosum is a painful, ulcerative disease of the skin. The ulcers are highly characteristic in clinical feature as necrotic pus covered lesions having purple colored and elevated border with red halo. Frequently, the ulcers heal with a cribriform type of scar. Its pathogenesis is not understood clearly. We present a case of pyoderma gangrenosum deveIoped on the leg in a 11-year old boy occurring with rectal poIyp, the association of whicb is very rare in world wide. And this case has the evidence of cell mediated immunity impairment characterized by no response to mumps antigen and purified protein derivatives, and not to be activively sensitized by DNCB.
Child ; Cicatrix ; Dinitrochlorobenzene ; Humans ; Immunity, Cellular ; Leg ; Male ; Mumps ; Polyps* ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Suppuration ; Ulcer

PURPOSE: The reported clinical manifestations in Turner syndrome were different by karyotypes, countries and races. So, We evaluated the physical findings & medical problems in patient with Turner syndrome according to karyotype. METHODS: We examined prospectively 53 cases that diagnosed as Turner syndrome by chromosome study at the Pediatric Endocrine Clinic, YUMC from May 1999 to Aug 1999. According to the karyotype, they were divided into 3 groups:45, X(22 cases, 41.5%), mosaicism(18 cases, 34%) and structural aberration group(13 cases, 24.5%), and 53 cases were reevaluated by prepared protocol of 22 abnormal physical findings and 4 medical problems. Chi-square test was used for statistic analysis. RESULTS: 1)In case of 45, X group, they had short stature(100%), cubitus valgus(95.5%), widely spaced nipples(86.4%), shield chest(72.7%), low posterior hair line(68.2%), in case of mosaicism group, they had short stature(100%), cubitus valgus(72.2%), high arched palate(66.7%), widely spaced nipples(61.1%), short neck(61.1%) and in case of structural aberration group, they had short stature(100%), high arched palate (92.3%), widely spaced nipples(92.3%), low posterior hair line(76.9%), shield chest (76.9%), in frequency order. Short stature was the most common finding in Turner syndrome. The incidence of high arched palate was significantly higher in structural aberration group(P<0.05). 2)In case of 45, X group, they had otitis media(63.6%), thyroid problem(4.5%) and no renal problem and cardiac problem, in case of mosaicism group, they had otitis media(38.9%), thyroid problem(5.6%) and no renal problem and cardiac porblem and in case of structural aberration group, they had otitis media(61.5%), thyroid problem(15.4%), renal problem(7.7%) and cardiac problem(7.7%) in frequency order, they had no statistical difference in among three groups. CONCLUSION: In case of 45, X group, the incidence of cubitus valgus, webbed neck were more common findings and of high arched palate, micrognathia were less common findings compared to other group. In case of mosaicism group, the incidence of micrognathia, epicanthal fold were more common findings and wide spaced nipples, antimongoloid fissure were less common findings compared to other group. In case of structural aberration group, the incidence of high arched palate is most common finding among 3 group(P<0.05) and pigmented nevi and epicanthal fold were less common findings compared to other group. The incidence of medical problems such as otitis media and thyroid problem were than other foreign country reports.
Continental Population Groups ; Hair ; Humans ; Incidence ; Karyotype* ; Mosaicism ; Neck ; Nevus, Pigmented ; Nipples ; Otitis ; Otitis Media ; Palate ; Prospective Studies ; Thorax ; Thyroid Gland ; Turner Syndrome*