With the change of medical mode and deepening of the medical education reforms,such educational idea as giving prominence to practice is widely used to improve students' comprehensive quality and innovative ability and practice ability. The medical shool of Tibet university has established long-term apprentice mechanism during the before class and playtimes and found four county hospitals, five health clinics in towns and townships and gradually improved the construction of mutual win-win 9clinical teaching bases. In this way it has been cultivating many advanced medical personnels, who are reliable, available, able to stay, and highly praised by the employers.

OBJECTIVES: The Berlin Questionnaire (BQ) has been used to help identify patients at high risk of having sleep apnea in primary care. But it has not been validated in a sleep clinic for Korean patients. The aim of this study is to evaluate the usefulness of the BQ as a screening tool for obstructive sleep apnea (OSA) for Korean patients in a sleep clinic. METHODS: The BQ was prospectively applied to 121 subjects with OSA suspicion who visited to our sleep clinic. All subjects performed overnight polysomnography. OSA was defined as an apnea-hypopnea index (AHI) > or =5. We investigated the sensitivity, specificity, positive and negative predictive values of the BQ according to severity by AHI. RESULTS: In 121 subjects, 73.6% were males, with a mean age of 48.8+/-13.0 years. Twenty-five (20.6%) patients did not have OSA (AHI<5), 30 (25%) patients had mild OSA (AHI> or =5 and <15), 26 (21.4%) had moderate (AHI> or =15 and <30), and 40 (33%) had severe OSA (AHI> or =30). The BQ identified 69.4% of the patients as being at high risk for having OSA. The sensitivity and specificity of the BQ were 71.9% and 40%, for AHI> or =5, 75.8% and 38.2% for AHI> or =15, 77.5% and 34.6% for AHI> or =30, respectively. The positive and negative predictive values of the BQ were 82.1% and 27.0% for AHI> or =5, respectively. Positive and negative likelihood ratios were 1.2 and 0.7, and the overall diagnostic accuracy of the BQ was 65.3%, using an AHI cut-off of 5. CONCLUSION: Due to modest sensitivity and low specificity, the BQ does not seem to be an appropriate tool for identifying patients with obstructive sleep apnea in a sleep clinic population.
Berlin ; Humans ; Male ; Mass Screening ; Polysomnography ; Primary Health Care ; Prospective Studies ; Surveys and Questionnaires ; Sensitivity and Specificity ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

OBJECTIVES: The percentage of positional sleep apnea in obstructive sleep apnea (OSA) varies in different reports from 9% to 60%. If there is a positional dependency in patients with OSA, positional therapy alone could be successful in treating about 50% of all OSA cases. The aim of this report is to compare anthropomorphic and polysomnographic data between the positional sleep apnea group and non-positional sleep apnea group with OSA whose conditions were diagnosed in our sleep clinic. METHODS: This is a retrospective study of anthropomorphic and polysomnographic data of patients with OSA who was performed a nocturnal polysomnography. Positional sleep apnea was defined as having a supine apnea-hypopnea index (AHI) of twice or more compared to the AHI in the non-supine position. The patients were divided in the positional sleep apnea group and the non-positional sleep apnea group. RESULTS: In 101 patients with OSA, 81 were male, and the mean age was 49.2+/-11.9 years. Seventy-six (75.2%) were diagnosed as the positional sleep apnea. Waist to hip ratio and body mass index (BMI) were significantly higher in non-positional sleep apnea group. The frequency of severe OSA was significantly higher in this group. In the positional sleep apnea group, nocturnal sleep quality was better preserved, and consequently these patients were less sleepy during daytime. AHI was significantly lower and minimal arterial oxygen saturation during sleep was significantly higher in this group. CONCLUSION: The percentage of positional sleep apnea in OSA was 75.2%. AHI, BMI, and waist to hip ratio were lower in the positional sleep apnea group. These patients have less severe breathing abnormalities than the non-positional sleep apnea group in polysomnography.
Body Mass Index ; Dependency (Psychology) ; Humans ; Male ; Oxygen ; Polysomnography ; Respiration ; Retrospective Studies ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Waist-Hip Ratio

Fixation failure is a major complication of intertrochanteric fracture. The causes of fixation failure were assessed in a series of 80 patients with intertrochanteric fractures, which had been internally fixed with either a sliding hip screw or a Gamma interlocking nail. The overall rate of fixation failure was 16.3%, in which the cutting-out of the implant from the femoral head was the only cause of the instance. The cutting-out rate was influenced by the accuracy of fracture reduction, the position of implant placement within the femoral head, and the bone mineral density. Anatomical reduction and the central placement of implant within the femoral head showed the most excellent results compared to other treatment modalities. Age, gender, fracture type and a kind of fixation implant had no significant effect. Our results showed that the intertrochanteric fractures should be reduced as anatomically as possible and it is essential that the central placement of the implant within the femoral head be obtained.
Bone Density ; Head ; Hip ; Hip Fractures* ; Humans

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

BACKGROUND: The purpose of this study is to obtain the accurate information on the obesity indices, such as body mass index(BMI), relative weight and waist-hip ratio(WHR) and to investigate their relationship in order to assess the childhood and adolescent obesity more appropriately. METHODS: In May, 1995, a total of 6943(male; 3469, female; 3474) students from primary, middle and high schools in Seoul were selected and each students height, weight, waist and hip circumference data were collected. RESULTS: The BMI increased with age in both sexes. From age 12 to 16, values of BMI 50th percentiles for females exceeded those for males. And the BMI 95th percentiles at the age of 13 to 14 years were higher for females than for males. The prevalence of obesity by relative weight was higher in males than in females(male ; 17.9%, female ; 13.1%). The WHR was higher in males than females in all age group and decreased with age in both sexes, showing more sharp reduction in females. Strong correlations were observed between the BMI and the relative weight, and the BMI and the relative weight correlated closely with WHR. The WHR was significanly higher in obese group' than in non-obese group. In the female obese group aged 6 to 11 years, no significant correlation was found between the relative weight and the WHR. CONCLUSIONS: There were significant relationships between the indices of obesity and body fat distribution. This study suggests that WHR as well as BMI and relative weight might be useful in assessing the childhood and adolescent obesity.
Adolescent* ; Body Fat Distribution ; Body Mass Index* ; Child* ; Female ; Hip ; Humans ; Male ; Obesity ; Pediatric Obesity ; Prevalence ; Seoul* ; Waist-Hip Ratio*

Phenolate type siderophore was produced in Pseudomonas sp. PY002 (P. sp. PY002) which cultured in M9 minimal medium supplemented with 0 to 500 uM of dipyridyl. Pyochelin, a kind of siderophore, was detected as a single broad absorption band (280 nm) at pH 12.0, which is a characteristic of phenolate type siderophore. The 280 nm absorption spectrum of pyochelin was changed to 310 nm at pH 1.5. The pyochelin produced was a structurally unique phenolate siderophore, designated 2-[2-(o-hydroxyphenyl)-2-thiazolin-4-yl]-3-methyl-4-thiazolidine car- boxylic acid on the analysis of infrared radiation and 'H and ""C nuclear magnetic resonance spectroscopy. Additionally, purified pyochelin increased the cell growth rate, like as growth fac- tor. All these results suggest that phenolate type siderophore play an important role in cell growth of P. sp. PY002.
Absorption ; Hydrogen-Ion Concentration ; Magnetic Resonance Spectroscopy ; Phenol* ; Pseudomonas* ; Spectrum Analysis

Systemic lupus erythematous (SLE) is an autoimmune inflammatory disease of unknown etiology which affects various parts of body. SLE can involve all parts of the heart including the pericardium, myocardium, endocardium, heart valves and coronary arteries. Cardiopathy of SLE is the third common cause of death in all patients with SLE. Although cardiopulmonary symptoms are common in SLE, symptomatic acute lupus myocarditis is a very rare and fatal complication of SLE. We report here on a 20-year-old female patient with acute myocarditis as a initial manifestation of SLE and rapidly diagnosed using echocardiogram.
Cause of Death ; Coronary Vessels ; Endocardium ; Female ; Heart ; Heart Valves ; Humans ; Lupus Erythematosus, Systemic* ; Myocarditis* ; Myocardium ; Pericardium ; Young Adult

BACKGROUND: The purpose of this study was to compare the clinical outcome in patients aged less than 55 years who underwent arthroscopic tenodesis and arthroscopic repair for type 2 superior labrum anterior and posterior (SLAP) lesions. METHODS: Between April 2008 and December 2014, surgery was performed on a total of 45 patients with isolated type 2 SLAP lesions. Arthroscopic repair was performed in 22 patients and arthroscopic tenodesis was performed in 23 patients. In both groups, the clinical outcomes at follow-ups were evaluated using the University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and visual analogue scale (VAS) score. RESULTS: In both groups, the VAS scores for pain had improved significantly throughout the postoperative follow-up period. The VAS score showed a statistically significant difference at postoperative 3 and 6 months (p<0.05); however, there was no statistically significant difference between preoperative and postoperative results at 12 months (p>0.05). In both groups, the functional outcome was statistically improved postoperatively. In a comparison of the UCLA and ASES scores between the two groups, there was a statistically significant difference at postoperative 3 and 6 months (p<0.05), but there was no statistically significant difference between preoperative and postoperative results at 12 months (p>0.05). CONCLUSIONS: Based on the results of this and other studies, patients with isolated type 2 SLAP lesions showed better short-term clinical outcome with tenodesis than with repair. However, there was no difference between the two groups at the final follow-up.
California ; Elbow ; Follow-Up Studies ; Humans ; Shoulder ; Surgeons ; Tenodesis*

No abstract available.