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

BACKGROUND: The purpose of this study was to determine cut-off point of appendicular skeletal muscle mass (ASM) adjusted body mass index (BMI) for sarcopenia in the Korean women and evaluate the prevalence of sarcopenia in postmenopausal women. METHODS: This study was based on the data obtained from 2008 to 2011 Korean National Health and Nutrition Examination Survey (KNHANES) IV and V. A whole body dual energy X-ray absorptiometry (DXA) scan and measurement of BMI were performed on individuals of ≥10 years old. Five thousand, two hundred and fifteen women older than 50 years were included in the study. ASM was obtained by adding the muscle masses of the four limbs. To determine the young reference group, mean and standard deviation of ASM and ASM/BMI by ages was measured. We calculated the prevalence rate of sarcopenia by each age group according to the cut-off point based on ASM and ASM/BMI. RESULTS: In determining the cut-off values related ASM/BMI, using the value that is two standard deviations below mean values for young reference group (20's and 30's) thus recommends 0.50 m² in women. The overall prevalence among women older than 50 years was 15.6%. Among women older than 65 years prevalence of sarcopenia was 22.9%. CONCLUSIONS: The prevalence of sarcopenia among Korean women obtained in this study is within the proper range of value to research about sarcopenia. Furthermore, using 0.50 m² as the cut-off value can help compare various studies about sarcopenia in Korea.
Absorptiometry, Photon ; Body Mass Index* ; Extremities ; Female ; Humans ; Korea ; Muscle, Skeletal ; Nutrition Surveys ; Postmenopause ; Prevalence* ; Republic of Korea ; Sarcopenia*

PURPOSE: To study the development of inferior shoulder subluxation after surgery for proximal humerus fractures. To analyze the mechanism development of such subluxation and the association between different types of proximal humerus fractures, quality of reduction achieved the method of operation performed. MATERIALS AND METHODS: A retrospective analysis of 45 proximal humerus fractures that were treated by surgery between March 1997 and July 2002 was done. All patients had a minimum of 12 months of postoperative follow up. Preoperative radiographs were classified by the Neer's classification. Different operative treatment methods, post reduction alignment and the degree of postoperative subluxation if present, were analysed. In order to evaluate effect of loss of negative intraarticular pressure, we compared this series with 15 cases of recurrent shoulder dislocation treated by open Bankart operation. RESULTS: 13 patients out of 45 (29%) developed immediate postoperative inferior shoulder subluxation. 3-part fractures of the proximal humerus showed a higher incidence of the same than the 2-part types. The better reduced fractures had lesser rates of subluxation. Open reduction (39%, 11 patients) results in an increased incidence of inferior subluxation than closed methods of reduction (13%, 2 patients). CONCLUSION: Inferior subluxation of the humeral head after surgery for the proximal humerus fracture can occur and persist till postoperative period of 2 months. Deltoid muscle tone affected by shortening of humeral neck plays an important role. Early active exercise for restoration deltoid tone may be effective in prevention of inferior subluxation.
Classification ; Deltoid Muscle ; Follow-Up Studies ; Head* ; Humans ; Humeral Head ; Humerus* ; Incidence ; Neck ; Postoperative Period ; Retrospective Studies ; Shoulder ; Shoulder Dislocation

PURPOSE: Blowout fracture can lead to functional impairments and esthetic deformities such as impairment of ocular movement, diplopia, visual loss and enophthalmos. The object of this study is to present a classification and its analysis according to the computed tomographic scan in blowout fractures. We classified blow out fractures into three types according to the anatomical location of fracture, the size of the bone defect and the degree of periosteal injury by using the computed tomography scan. Each progress and complications were analyzed more than mean 1 year. METHODS: Among the 155 cases during 4 years, there were 11 cases of medial orbital wall fracture, 97 cases of inferior orbital wall fracture, 47 cases of combined type. The mean age of patients was 31.2 years, ranged from 8 to 84 years. RESULTS: According to our classification, surgical treatments through the nasoendoscopic approach, the subciliary approach, the transconjunctival approach or their combinations were performed in 116 patients, and conservative treatments were done in 46 patients. Presurgical clinical findings of diplopia, impairment of ocular movement, enophthalmos of more than 2 mm were present in 62 patients. After surgical treatment, clinical findings were remained in 7 patients. CONCLUSION: We think that our classification according to computed tomographic scan is helpful for the indication and it may decrease the complications such as impairment of ocular movement, diplopia, visual loss and enophthalmos.
Classification* ; Congenital Abnormalities ; Diplopia ; Enophthalmos ; Humans ; Orbit ; Orbital Fractures

Dermal melanocytosis is characterized by the presence of ectopic melanocytes in the dermis. Dermal melanocytosis assumes several morphologic forms, including the Mongolian spot, the blue nevus, the nevus of Ota, the nevus of Ito and dermal melanocytic hamartoma. Differential diagnostic features of these dermal melanocytic lesions depend on onset, course, distribution, histologic features, uniformity of pigmentation, etc. In our case, an 18-year-old girl had asymptomatic 5x3cm sized ill-defined bluish patch on left forearm since birth. Histologic examinations revealed marked increased infiltrate of pigment cells mainly in the upper dermis in Hematoxylin & eosin stain . Fontana-Masson stain and Gp 100 stain revealed marked infiltrate of melanin-containing cells in upper dermis. We report a rare case of dermal melanocyte hamartoma.
Adolescent ; Dermis ; Eosine Yellowish-(YS) ; Female ; Forearm ; Hamartoma* ; Hematoxylin ; Humans ; Melanocytes* ; Mongolian Spot ; Nevus ; Nevus of Ota ; Nevus, Blue ; Parturition ; Pigmentation

A 22 year old male with hemophilia B was scheduled for the correction of a right subtrochanteric femur fracture. Plasma concentration of coagulation factor IX in this patient was 50% of the normal level and the partial thromboplastin time was 57 seconds on the first day of hospital administration. We started the intravenous administration of facnyne injection (factor IX) 11 days before the operation when his plasma concentration was 20%. His plasma concentration was 40% on the operation day. The operation and general anesthesia were accomplished safely without severe hemorrhage or major complication. He received facnyne injection continuously until the 5th postoperative day: 25-43% of his plasma concentrations of factor IX was maintained. He had no problem with postoperative care.
Administration, Intravenous ; Anesthesia, General ; Factor IX ; Femur ; Hemophilia A* ; Hemophilia B* ; Hemorrhage ; Hospital Administration ; Humans ; Male ; Partial Thromboplastin Time ; Plasma ; Postoperative Care ; Young Adult

The isotopic response defined by Wolf et al. describes the occurrence of a new skin disorder at the site of another, unrelated and already healed skin disease. In most of the reported cases, the first diseases were herpes zoster. We report a case of leukemia cutis developed on the exact same site of previous invasive cutaneous candidiasis, regarded as Wolfs isotopic response.
Candidiasis, Cutaneous* ; Herpes Zoster ; Leukemia* ; Skin ; Skin Diseases ; Wolves*

BACKGROUND: Although the incidence of chronic urticaria in children is increasing, research on the disease is limited. OBJECTIVE: We aimed to study the clinical and etiological characteristics of chronic urticaria in pediatric patients. METHODS: From July 2013 to December 2016, patients with chronic urticaria aged less than 18 years answered questionnaires regarding their symptoms and provoking factors or specific exposures related to the disease. Some patients were also investigated with physical provocation and/or laboratory tests. RESULTS: A total of 74 patients (male to female ratio, 1.0) with a mean age of 11.1 years (range, 1.1~18.7 years) were evaluated. The severity of urticaria was classified into mild (23.0%), moderate (43.2%), and severe (33.8%) according to the patient rating scale. Twenty-one patients (28.4%) had a previous history of atopic disease. Some patients reported accompanying angioedema (18.9%) and general symptoms, such as fatigue (14.9%) and nausea or vomiting (8.1%). The etiology was identified in 14 patients (18.9%): 9 patients had dermographic urticaria, 3 patients had cholinergic urticaria, 1 patient had cold urticaria, and 1 patient had dermographic combined with cholinergic urticaria. Results of thyroid autoantibody and antinuclear antibody tests were positive in 4 patients (30.8%) and 13 patients (27.7%), respectively. Remission rates at 1, 2, and 3 years after the onset of chronic urticaria symptoms were 40.6%, 50.7%, and 52.2%, respectively. A mild urticaria severity score and the presence of angioedema seemed to be good prognostic factors for the remission of chronic urticaria. CONCLUSION: Based on the results of this single-center study, further investigation is warranted to determine the incidence, etiology, and distinct features of chronic urticaria in children compared to those in adults.
Adult ; Angioedema ; Antibodies, Antinuclear ; Child* ; Fatigue ; Female ; Humans ; Incidence ; Nausea ; Prognosis ; Thyroid Gland ; Urticaria* ; Vomiting

Objectives: ：The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing ‘with re-consultation’ and ‘without re-consultation’ groups. Methods: ：We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results: ：For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in ‘with re-consultation’ group and there was no statistically significant difference when comparing ‘with re-consultation’ group and ‘without re-consultation’ group. How-ever, there was a difference in the tendency of the two groups in the type of consultation request. ‘With re-consultation’ group was in the order of frequency of consultation type 3-2-1, whereas the ‘without re-consultation’ group was in the order of frequency of consultation type 2-3-1. Conclusions ：The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. ‘With re-consultation’ group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to ‘without re-consultation’ group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.

OBJECTIVES: Insomnia patients who visited the psychiatric outpatient of a university department, were divided into those patients with insomnia alone and those with depression or anxiety disorder, along with insomnia. The study analyzed their demographic characteristics and the differences in State-Trait Anxiety Inventory (STAI) results among the patient groups. METHODS: Patients who visited the psychiatric department in Konkuk University hospital from 1 January 2006 to 31 December 2018. If they were diagnosed with insomnia disorder based on DSM IV-TR and had undergone STAI, their electronic records were retrospectively analyzed. Based on the records, the patients were classified into those with insomnia disorder only, those with insomnia and anxiety disorder, and those with insomnia and depressive disorder. This study analyzed the demographic characteristics and STAI results of each group, and compared the differences among those groups. RESULTS: During the period, 99 of 329 insomnia disorder patients who had performed STAI were diagnosed with depressive concurrent disorder and 61 with concurrent anxiety disorder. There was no difference in demographic characteristics of age and sex ratio among the three patient groups, and all had greater than 70% proportions of patients aged from 50s to 70s (71.8%, 77.1%, and 73.8% respectively). The average scores of STAI-I were 51.85 ± 10.15 for the patients with anxiety disorders and 54.18 ± 10.32 for those with depressive disorders, both of which were higher than the score of the patients with insomnia alone (44.55 ± 8.89). However, the score difference was not statically significant between the anxiety and depression groups. Similarly, in the STAI-II comparison, the averages of patients with anxiety or depressive disorders along with insomnia were 49.98 ± 8.31 and 53.19 ± 10.13 respectively, which were higher than that of the insomnia only group (42.71 ± 8.84), but there was no significant difference between the anxiety and depressive disorder groups. CONCLUSION Although there were no differences in demographic data between the patients with insomnia only and those with accompanying depressive or anxiety disorder, the STAI-I and II scores were lower in the insomnia only group. In the future, it is necessary to consider other demographic characteristics including comorbidities and to conduct similar analyses with a larger sample.