PURPOSE: Obesity is a risk factor for cardiovascular morbidity and is frequently associated with coronary artery disease, hypertension, and diabetes mellitus. Conventional Doppler technique is limited by the absence of an adequate apical window to assess the transmitral flow in obese patients. Tissue Doppler imaging(TDI) and strain rate imaging(SRI) were performed to assess the influence of obesity on left ventricular systolic function. METHODS: In 13 obese and 15 normal adolescents aged 16 to 17 years, height, weight, body mass index(BMI), and obesity index(OI) were measured. Fat mass, body fat percent, and abdominal fat percent were estimated by bioelectrical impedance. Ejection fraction(EF) and myocardial performance index(MPI) were estimated by conventional echocardiography to evaluate left ventricular systolic function. Systolic myocardial velocity and strain rate were estimated by TDI and SRI. RESULTS: EF(63.8+/-6.4% vs 55.7+/-3.4%) was significantly lower in obese adolescents than normal controls. MPI(0.34+/-0.03 vs 0.48+/-0.06) was significantly higher in obese adolescents than normal controls. Systolic myocardial velocity and strain rate were significantly lower in obese adolescents than normal controls. Strain rate showed a negative correlation with arm circumference(r=-0.558, P<0.05) and BMI(r=-0.332, P<0.05). Strain rate was positively correlated with EF(r=0.557, P<0.05) at the base of left ventricle by SRI CONCLUSION: Significant decrease in left ventricular systolic function was noted in the moderate degree of obesity. SRI may be a more useful diagnostic tool in evaluating systolic dysfunction in patients with moderate degree of obesity.
Abdominal Fat ; Adipose Tissue ; Adolescent* ; Arm ; Body Weight ; Coronary Artery Disease ; Diabetes Mellitus ; Echocardiography ; Electric Impedance ; Heart Ventricles ; Humans ; Hypertension ; Obesity ; Risk Factors

BACKGROUND: Infectious complications frequently occur after cardiac arrest and may be even more frequent after therapeutic hypothermia. Pneumonia is the most common infectious complication associated with therapeutic hypothermia, and it is unclear whether prophylactic antibiotics administered during this intervention can decrease the development of early-onset pneumonia. We investigated the effect of antibiotic prophylaxis on the development of pneumonia in cardiac arrest patients treated with therapeutic hypothermia. METHODS: We retrospectively reviewed the medical records of patients who were admitted for therapeutic hypothermia after resuscitation for out-of-hospital cardiac arrest between January 2010 and July 2015. Patients who died within the first 72 hours or presented with pneumonia at the time of admission were excluded. Early-onset pneumonia was defined as pneumonia that developed within 5 days of admission. Prophylactic antibiotic therapy was defined as the administration of any parenteral antibiotics within the first 24 hours without any evidence of infection. RESULTS: Of the 128 patients admitted after cardiac arrest, 68 were analyzed and 48 (70.6%) were treated with prophylactic antibiotics within 24 hours. The frequency of early-onset pneumonia was not significantly different between the prophylactic antibiotic group and the control group (29.2% vs 30.0%, respectively, p = 0.945). The most commonly used antibiotic was third-generation cephalosporin, and the class of prophylactic antibiotics did not influence early-onset pneumonia. CONCLUSION: Antibiotic prophylaxis in cardiac arrest patients treated with therapeutic hypothermia did not reduce the frequency of pneumonia.
Anti-Bacterial Agents ; Antibiotic Prophylaxis* ; Heart Arrest* ; Humans ; Hypothermia* ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Pneumonia* ; Resuscitation ; Retrospective Studies

Purpose: There are various neurogenic bladder patterns that occur in patients during stroke. Among these patterns, the focus was mainly on the patient’s facial parsy diagnosis. Stroke requires early response, and it is most important to identify initial symptoms such as facial parsy. There is an urgent need for a diagnostic technology that notifies patients and caregivers of the onset of disease in the early stages of stroke. We developed an artificial intelligence (AI) stroke early-stage analysis software that can alert the early stage of stroke through analysis of facial muscle abnormalities for the elderly neurogenic bladder prevention. Methods: The method proposed in this paper developed a learning-based deep learning analysis technology that outputs the initial stage of stroke after acquiring a high-definition digital image and then deep learning face analysis. The applied AI model was applied as a multimodal deep learning concept. The system is linked and integrated with the existing urine management integrated system to support patient management with a total-care concept. Results: We developed an AI stroke early-stage analysis software that can alert the early stage of stroke with 86% hit performance through analysis of facial muscle abnormalities in the elderly. This result shows the validation result of the landmark image learning model based on the distance learning model. Conclusions We developed an AI stroke early-stage diagnostic system as a wellness personal medical service plan and prevent cases of missing golden time when existing stroke occurs. In order to secure and facilitate distribution of this, it was developed in the form of AI analysis software so that it can be mounted on various hardware products. In the end, it was found that using AI for these stroke diagnoses and making them quickly and accurately had a positive effect indirectly, if not directly, on the neurogenic bladder.

PURPOSE: To characterize autonomic dysfunction in patients with benign prostatic hyperplasia(BPH), we measured heart rate variability(HRV) and analyzed them compared with those of normal population. MATERIALS AND METHODS: ECG signals were obtained from 11 male patients(mean age, 63.1 years) and 23 healthy male controls(mean age, 57.0 years) in resting state. We analyzed their parameters of HRV and compared them between groups. RESULTS: Time domain analysis including standard deviation of NN interval(SDNN), square root of mean of sum of squares of differences between adjacent NN intervals(RMSSD) in patients with BPH were not significantly different with those of controls. There were suggested evidence of decreased total power(TP), high frequency (HF) in patients with BPH(p<0.05) while no significant difference in other frequency domain such as very low frequency(VLF), low frequency(LF) and LF/HF ratio. CONCLUSION: This preliminary study shows that patients with BPH have different results on HRV study comparing to controls. With the exception of LF and LF/HF ratio, all parameters of HRV in patients with BPH lower than normal controls. TP, HF in patients with BPH significantly lower than that of normal controls. The decreased values of HRV study means that they may have some kinds of disease or imbalance in autonomic nervous system(ANS). So we suggest that HRV study may be a tool to describe the possibility of altered ANS activity in patients with BPH.
Autonomic Nervous System ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Male

Cancer is the most frequent cause of death in both developing and developed countries, including Korea. The aim of this study was to present survival rates of Korean cancer patients. Survival analysis was carried out with data collected under the Korea Central Cancer Registry Program, which included all cancer patients diagnosed from January 1, 1997 to December 31, 1997. We have analyzed the effects of age at diagnosis and sex on cancer survival from the cancer registry data of 64,240 Korean patients diagnosed of cancer in 1997. The overall survival rate of all Korean cancer patients (both men and women) was 67% at 1 yr and 57% at 2 yr. The 1- and 2-yr survival rates for all cancers in men were 58% and 47%, respectively, while those in women were 77% and 69%, respectively. Men had a lower survival rate than women in most malignancies. The pancreatic cancer was shown the lowest 1-yr survival rate.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Korea ; Male ; Middle Aged ; Neoplasms/*mortality ; Survival Analysis ; Survival Rate

Three fungi newly intercepted from importing plants were identified in 2004. They were Ascochyta chrysanthemi on Lactuca sativa from China, A. spinaciicola on Spinacia oleracea from Denmark, and Leptosphaerulina australis on Brassica oleracea var. capitata from China. The characters of these fungi were described and illustrated.
Brassica ; China ; Denmark ; Fungi* ; Korea* ; Lettuce ; Spinacia oleracea

BACKGROUNDS/AIMS: Early colorectal cancer is defined as carcinoma with invasion to mucosa or submucosa irrespective of involvement of lymph node. Gross morphology is divided into elevated and depressed type according to growth pattern. Until now, carcinomas with elevated type have been found more frequently than depressed type in Korea. It is necessary to classify the macroscopy of morphology and evaluate histo-pathologic findings of early colorectal cancers. METHODS: 33 patients (35 foci) with early colorectal cancers were analyzed, macroscopically and pathologically. Early colorectal carcinoma with mucosal invasion is 25 cases, and with submucosal invasion, 10. RESULTS: Macroscopic classification: Ip 12, Isp 6, Is 9, IIa 1, IIa IIc 4, Isp IIc 1, LST 2. Among them, Ip (34%) is most. Among cancers with mucosal invasion, Ip (36%) is common, and with submucosal invasion, Is (40%) is common. Most of early colorectal cancers with elevated type were accompanied with surrounding adenoma. It's ratio is 100% in early colorectal cancer with mucosal invasion, and 50% with submucosal invasion. CONCLUSIONS: Pedunculated type (Ip) is common in early colorectal cancer with elevated type. Surrounding adenoma was usually (85%) accompanied with those. It is suggested that early colorectal cancer with elevated type would be originated from adenoma.
Adenoma ; Classification* ; Colorectal Neoplasms* ; Humans ; Korea ; Lymph Nodes ; Mucous Membrane

Obstruction of the common bile duct (CBD) by direct extension of a tumor is occasionally found in patients with a hepatic neoplasm, but a bile duct tumor embolus caused by intrabiliary transplantation of a free floating tumor is a rare complication of a hepatocellular carcinoma. A patient of ours was recently observed with a fragment of tumor from a primary hepatocellular carcinoma (HCC) that obstructed the distal CBD. A-46-year-old man was admitted to our hospital with a distal CBD mass, measuring 1.2x1.5 cm, found by a biliary computed tomography (CT) scan. Four month prior to his admission, he had undergone a right hemihepatectomy for a HCC accompanied by direct intrahepatic bile duct invasion, without obstructive jaundice. On admission, there were no abnormal findings in the physical and laboratory examinations. An Endoscopic retrograde cholangiopancreatography and papillotomy had been performed, which showed an irregular shaped filling defect in the distal CBD. Endoscopic nasobiliary drainage (ENBD) was carried out for biliary decompression. Partially extracted soft tissue from the CBD by ERCP revealed a HCC. On performed a pylorus- preserving pancreaticoduodenectomy, a 1cm sized tumor remnant was found attached to the mucosa of the intrapancreatic portion of the bile duct, but without any invasive growth into the submucosa. The tumor may have been an intrabiliary transplantation from the HCC in the right lobe through the bile duct. When an obstructive mass is found in the distal CBD, tumor embolus should be considered, and a radical pancreaticoduodenectomy can be adopted as a safe and effective treatment modality.
Bile Ducts ; Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Decompression ; Drainage ; Embolism* ; Humans ; Jaundice, Obstructive ; Liver Neoplasms ; Mucous Membrane ; Neoplastic Cells, Circulating ; Pancreaticoduodenectomy

OBJECTIVE: We studied the effects of the age factor in pregnant women who are over the age of 35 on pregnancy, parturition and verified its usefulness in the future managements of the old aged pregnancy. METHODS: Out of 2,526 mothers who delivered in Dongguk university hospital from April 2000 to June 2003, we selected 183 mothers who aged more than 35 years as a study group, and 150 mothers aged between 25 and 29 years as a control group. We then statistically evaluated and analyzed the two groups. RESULTS: Study group consumed up to 7.24%. Placenta previa, male birth delivery, abnormal presentation, low birth weight, iron deficiency anemia and preterm labor was noted more in the study group. Likewise, preterm delivery, pregnancy induced hypertension and cesarean section rates were significantly high in the study group. CONCLUSION: Pregnancy in old age is currently a rising trend. Whlie they might have the tendency to show prenatal complications, neonatal complication and difficult decision making in delivery method, early detection and treatment of presumable complications by adequate antenatal care and appropriate selection of delivery method can reduce the section rates and obtain relatively successful pregnancy outcome.
Age Factors ; Anemia, Iron-Deficiency ; Cesarean Section ; Decision Making ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Mothers ; Obstetric Labor, Premature ; Parturition ; Placenta Previa ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women*

PURPOSE: The purpose of this study is to compare the rehabilitation effects between aquatic physiotherapy and land-based physiotherapy after total knee arthroplasty. PARTICIPANTS AND METHODS: The study was performed by patients with TKA caused by knee OA. The participants were divided into two groups based on random sampling method. One group received aquatic physiotherapy while the other received land-base physiotherapy. Each physiotherapy program lasted 40 minutes a day, 5 days a week, for 1 week starting a week after the operation. Pertinent indicators, knee extensor strength, knee flexor strength, walking speed, knee circumference, WOMAC index and Visual analogue scale were recorded before and after the physiotherapy programs, 1 week, 2weeks and 6 weeks after the operation. RESULTS: The aquatic physiotherapy group showed statistically significant improvements in knees circumference and VAS scores, compared to the land-based physiotherapy group between 1week and 2 weeks after the operation, whereas no statistical differences were found in Knee extensor strength, knee flexor strength, walking speed and WOMAC index. CONCLUSION: The aquatic physiotherapy group showed statistically significant improvements in knee circumference and VAS scores compared to the land-based physiotherapy group between 1 and 2 weeks after the operation. Further studies are required to confirm these findings. We were able to conclude that aquatic physiotherapy is an alternative rehabilitation program for patients with TKA.
Arthroplasty, Replacement, Knee ; Humans ; Knee ; Walking