BACKGROUND: The patients visiting the primary care complain of the various symptoms. This symptoms may induce the stress or the reverse. In fact the stress can influence the symptoms and signs. So this study was done for the correlation of the symptoms and signs with stress. METHODS: This study was done about the patients visiting the family medicine department of the one university hospital. We collected the all items that can find in the charts for examining the symptoms and signs, and did the requests pater the patients wrote by themselves. The stress test was Psychosocial well being index to be constructed from the General Health Questionnaire. We tested the study by t-test, anova, chi-square, linear logistic regression. RESULTS: The total study numbers were 351. The stress cut-off point was 63 score. The stress group was consisted of 15 males and 43 females. The meaningful symptoms were headache, dizziness, fatigue, weakness, insomnia, anxiety or depression. The meaningful diagnoses were anxiety or depression, tension headache(p<0.05). The meaningful sociodemographic factors were female, housewife or unemployed, menopause, monthly income below 200 ten thousands won. CONCLUSIONS: It was found that the some symptoms and signs were statistically correlated with stress.
Anxiety ; Depression ; Diagnosis ; Dizziness ; Exercise Test ; Fatigue ; Female ; Headache ; Humans ; Logistic Models ; Male ; Menopause ; Primary Health Care ; Sleep Initiation and Maintenance Disorders ; Surveys and Questionnaires

BACKGROUND: Recently, according to many studies, variable factors have been known to be associated with physical fitness. The factors such as obesity and inactivity are associated with poor physical fitness, but regular exercise is associated with good physical fitness. In our country, these studies are not yet reported. And so, this study was designed to investigate the factors associat,ed with physical fitness. METHODS: From May 1st, until July 30th 1996, we recruited the 411 subjects who visited the Health Promotion Center at Seoul National University Hospital. Data related to sex, age, exercise, job, cigarette smoking, alcohol consumption were obtained by self-administered Questionnaire. Obesity index was calculated by the percentage of standard body weight. And VO2max were obtained by submaximal bicycle ergometer test. High level exercise group was defined as the persons who had taken exercise more than 3 times a week and 20 minutes per session, and moderate exercise group was defined as the persons who had taken exercise one or two times a week and 20 minutes per session, and sedentary group was defined as the persons who had taken exercise more than 20 minutes less than one time per week. RESULTS: The subjects were 230 males(56%), total numbers were 411. The results were as follows. Compaired to women and nonexercise group, men and exercise group had high VO2max(p<0.005). The relationship between VO2max and age showed negative, and the VO2max of obese group(obesity index>_120) was greater than that of nonobese group. Any significant relationships between VO2max and job, disease were not found. In multiple regression analysis, significant relationships between VO2max and age, sex, exercise type, and obesity index were observed(p<0.01). CONCLUSIONS: We concluded that there were significant relationships between VO2max and obesity index, exercise group.
Alcohol Drinking ; Body Weight ; Female ; Health Promotion ; Humans ; Male ; Obesity ; Physical Fitness* ; Seoul ; Smoking ; Surveys and Questionnaires

Panner's disease, osteonecrosis of the capitellum of the elbow, was first reported by Panner in 1927. The disease occurs mainly in boys between 6 and 15 years old and shows unilateral distribution. Pain, stiffness, localized tenderness over the lateral condyle of the elbow, and decreased range of motion are the typical clinical symptoms. Conservative treatment is generally recommended for patients in the early stage of this disease. A few cases of Panner's disease have been reported and few are related to long-term follow-up results. To the best of our knowledge, all reported cases were over six years. Therefore, we report on a five-year-old boy diagnosed as Panner's disease that showed resorption and regeneration of the humeral capitellum with no limitation of motion over three years. The current study was exempted from review by the institutional review board because it was a single retrospective case report. Informed consent was obtained from the patient's guardian.
Child* ; Elbow ; Ethics Committees, Research ; Follow-Up Studies ; Humans ; Informed Consent ; Male ; Osteochondrosis ; Osteonecrosis ; Range of Motion, Articular ; Regeneration ; Retrospective Studies

X-linked recessive chondrodysplasia punctata (CDPX1) is caused by a hemizygous mutation in the arylsulfatase E (ARSE) gene located on chromosome Xp22.3. It is a rare congenital disorder of punctate calcifications in cartilages, leading to short stature and facial and limb anomalies. These clinical features are frequently observed in all types of chondrodysplasia punctata and have also been seen in other cartilage developmental disorders. Because of the phenotypical similarities, specific testing for only one gene is inefficient and time consuming. The advent of next-generation sequencing has provided an opportunity to improve diagnostic accuracy as well as save on time and cost. Here, we report on a patient diagnosed with CDPX1, who was identified via diagnostic exome sequencing to have a novel nonsense mutation in the ARSE gene, that was inherited from the mother.
Cartilage ; Chondrodysplasia Punctata* ; Codon, Nonsense* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Exome ; Extremities ; Humans ; Mothers

PURPOSE: To identify the anatomy of the levator aponeurosis (LA) and Whitnall's ligament (WL) in Korean subjects using cadavers. METHODS: Orbital exenteration was performed in ten cadavers (20 eyeballs) that had no history of trauma near the eyeball. We observed characteristics of WL (tension, density, and shape) and the relationship between the superior rectus muscle (SR) and the levator palpebrae superioris. We measured the distance from both the eyelid margin and the upper border of the tarsal plate to the insertion of the LA medially, centrally, and laterally. RESULTS: The WLs we observed showed several shapes. In 12 eyes, we saw clear, white fibrotic bands, while in four others, we found thin, less taut bands. In four eyes, we were unable to identify the precise shape of the band. The insertions of the LA showed nasal dehiscence in 13 eyes and parallel attachment in seven eyes. The distances from the eyelid margin to the insertion of the LA medially, centrally, and laterally were 8.31 mm, 5.57 mm, and 5.15 mm, respectively. The distances from the upper border of the tarsal plate to the insertion of the LA medially, centrally, and laterally were 2.75 mm, 4.82 mm, and 4.29 mm, respectively. CONCLUSIONS: This study examined the anatomy of WL and the LA in Korean subjects and may be helpful as a reference in levator muscle surgery.
Adult ; Aged ; Aged, 80 and over ; Cadaver ; Eyelids/*anatomy & histology ; Female ; Humans ; Ligaments/*anatomy & histology ; Male ; Middle Aged ; Muscle, Skeletal/anatomy & histology ; Oculomotor Muscles/anatomy & histology ; Tendons/*anatomy & histology

Methods: Thirty-six patients with calcific tendinitis of the shoulder treated by US-guided barbotage with a spinal needle and subacromial steroid injection were included in the study. We evaluated clinical outcomes based on American Shoulder and Elbow Surgeons (ASES) score, Constant score, and visual analog scale (VAS) for pain score. Radiological outcomes were assessed by X-ray imaging at each visit. Results: Our results showed that US-guided barbotage and subacromial steroid injection produced good clinical and radiological outcomes in patients with calcific tendinitis of the shoulder. Of the 36 patients, only one required surgical treatment, while the others showed improvement without any complications. Compared to values before the procedure, calcific deposit size and VAS, ASES, and Constant scores showed significant improvement 6 weeks after the procedure. No significant correlation was found between the initial calcific deposit size and clinical outcomes at each time point. Conclusions In patients with calcific tendinitis of the shoulder, US-guided barbotage using a spinal needle and subacromial steroid injection can yield satisfactory clinical and radiological results.

PURPOSE: The purpose of this study was to determine the underestimation rate of ductal carcinoma in situ (DCIS) on sonographically guided 14-gauge core needle biopsy of the breast and to investigate the factors associated with this underestimation. MATERIALS AND METHODS: We retrospectively reviewed 2990 consecutive lesions that underwent sonographically guided 14-gauge core needle biopsy between January 2005 and December 2008. Among them, 61 lesions were pathologically proven to be DCIS (2.04%). A total of 50 DCIS lesions (mean patient age: 50.7 years old, age range: 36-79 years old) that underwent surgical resection were included in this study. After surgery, the lesion proven to be invasive was defined as being in the underestimated group and the lesion proven to DCIS was defined as being in the correctly diagnosed group. We determined the underestimation rate of DCIS and we retrospectively reviewed and compared the clinical, pathologic and radiologic features of the two groups. RESULTS: The underestimation rate of DCIS was found to be 28% (14 of 50 lesions). The underestimation of DCIS was significantly frequent for a clinically palpable lesion (78.6% (11/14) vs. 30.5% (11/36), respectively, p = 0.002). The sonographically maximal diameter of a lesion was significantly larger in the underestimated group than that in the accurately diagnosed group (28.4 +/- 14.0 mm vs. 17.6 +/- 10.3 mm, respectively, p = 0.017) and underestimation was significantly frequent when the sonographic lesion size was > 20 mm (p = 0.012). There was no significant difference in terms of age, the lesion type, the Breast Imaging-Reporting and Data System (BI-RADS) category or the pathologic features between the two groups. CONCLUSION: The underestimation rate of DCIS was 28% for sonographically guided 14-gauge core needle biopsy of the breast. Clinical symptoms such as a palpable lesion and a sonographic lesion size > 20 mm were the factors related with the underestimation of DCIS.
Biopsy, Large-Core Needle ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Information Systems ; Retrospective Studies

The Bosniak renal cyst classification has been accepted by urologists and radiologists as a way of diagnosing cystic renal masses and determining the management approach. We report two cases of a renal cystic mass that showed a category change from category II on the basis of enhanced computed tomography to category IV after further gadolinium-enhanced magnetic resonance imaging. In both cases, the cysts were later confirmed as kidney cancer by pathology.
Kidney ; Kidney Neoplasms ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets

Anatomical variations of the extensor tendon of the hand are common. However, the majority of anomalous variations are asymptomatic throughout a lifetime and are found incidentally during surgery or after trauma of the hand. The index finger has two independent extensor tendons and lower incidence of anomalous variations than other extensor tendons. We experienced a rare muscular variant of extensor indicis proprius (EIP) during a tendon reconstruction for spontaneous rupture of the 3rd and 4th extensor digitorum communis. Tendon reconstruction using EIP was planned preoperatively. However, EIP was absent and anomalous muscle known as extensor indicis brevis, which originated from the capsular ligament of the wrist and inserted into the ulnar side on the 2nd extensor digitorum communis of the extensor hood, was found. We performed tendon reconstruction using an alternative surgical procedure because extensor indicis brevis was not useful. Attention is required during tendon reconstruction because anatomical variation of EIP may affect a surgical procedure.
Fingers ; Hand ; Incidence ; Ligaments ; Rupture, Spontaneous ; Tendons ; Wrist

BACKGROUND: The purpose of this study was to examine the sensitivity and specificity of ECG as a tool for detecting echocardiographically defined LVH in a population-based sample and to examine the impact of a variety of factors that affect the sensitivity and specificity of ECG for detection of LVH. METHODS: A total of 1,130 subjects who received a thorough medical checkup for cardiologic department voluntarily were selected. The subjects were examined using M-mode echocardiography and standard 12-lead ECG. The chi-square test was used to test for differences in sensitivity and specificity of ECG for echocardiographically defined LVH. Cochran-Mantel-Haenszel statistic was used to adjust for sex, age, and obesity and to test the association between cigarette smoking, amount of alcohol, exercise, hypertension, diabetes mellitus (DM) and sensitivity and specificity of ECG. RESULTS: Echocardiographic LVH was detected in 434 (38.4%) and electrocardiographic features of LVH were present in 146 (12.9%). ECG for diagnosis of LVH showed sensitivity of 20.0%, specificity of 91.5%, and diagnostic accuracy of 64.1%. Sensitivity of ECG for LVH was higher in persons with obesity (P=.04) or hypertension (P=.04). Specificity of ECG for LVH was lower in persons with hypertension (P=.003) CONCLUSION: ECG has a low sensitivity and a high specificity for echocardiographically defined LVH. Attention must be paid to carefully interpret ECG for diagnosis of LVH in persons with obesity or hypertension, because the rate of false positives and negatives can be increased.
Diabetes Mellitus ; Diagnosis ; Echocardiography ; Electrocardiography* ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Obesity ; Sensitivity and Specificity ; Smoking