Effects of thoracentesis on thoracic impedance and cardiac performance were studied in patients with uncomplicated unilateral tuberculous pleural effusion. The speed of the removal of the pleural effusion in thoracentesis was essentially similar to that of a generally used for therapeutic purpose in daily practice. Thoracic impedance was measured in 23 cases before, 4 and 10 minutes after thoracentesis to the amount of pleural effusion aspirated was observed. In 11 cases out of 23, the changes in cardiac performance as assessed by stroke volume, cardiac output, heart rate, heather index and ratio of pre-ejection period to left ventricular ejection time(PEP/LVET) were observed 4 minutes after 150 ml to 1,000 ml of thoracentesis. In these cases, stroke volume, cardiac output, and Heather index were determined from impedance cardiograms, and PEP/LVET from mechanocardiograms recorded simultaneously with the former. A significant increase in thoracic impedance was observed both 4 and 10 minutes after thoracentesis. There was a slight but a significant correlation between the changes in thoracic impedance and the amount of pleural fluid aspirated only 4 minutes after thoracentesis. Thoracentesis showed no consistent influence on cardiac performance as reflected to stroke volume, cardiac output, heart rate, heart index and PEP/LVET. These facts suggest that measurement of thoracic impedance may be a useful method reflecting alterations in pleural fluid volumes, particularly when it occurs in a relatively short period of time, and the effects of thoracentesis of less than one liter on the cardiac functions as determined by the above-mentioned parameters were variable.
Cardiac Output ; Electric Impedance* ; Heart ; Heart Rate ; Humans ; Pleural Effusion ; Stroke Volume

Twenty-one cases of mitral valve prolapse (MVP) diagnosed by M-mode echocardiograms were studied in regard to the underlying or associated conditions, types of MVP, and dimensions of the cardiac structures and parameters reflecting cardiac performance determined by echocardiograms. In 9 cases, MVP was thought to be idiopathic origin. Associated conditions in the remainder were 5 cases of congenital heart disease, 2 cases of rheumatic myocarditis, 1 case each of aortic valve disease, ischemic heart disease and hyperthyroidism, and 2 cases of undiagnosed cardiac conditions. There were 2 cases of buckling type of MVP and in the remainder hammock type. In these 2 patients with hammock type of MVP, mitral valve echoes were seen in the left atrium during systole in 1 case, and diastolic anterior displacement of posterior mitral leaflet in the other. In 9 cases of idiopathic MVP, cardiac dimensions and parameters reflecting cardiac performance as determined from echocardiograms showed no significant differences from those of 27 normal controls.
Aortic Valve ; Echocardiography* ; Heart Atria ; Heart Defects, Congenital ; Humans ; Hyperthyroidism ; Mitral Valve Prolapse* ; Mitral Valve* ; Myocardial Ischemia ; Myocarditis ; Systole

STUDY DESIGN: A retrospective study. OBJECTIVE: To analyze the clinical significance of the radiolucent zones surrounding pedicle screws. SUMMARY OF LITERATURE REVIEW: Clear zones have been suggested in pseudoarthrosis and a loss of fixation. However, few reports have clearly described the long-term course and clinical significance of clear zones. MATERIALS AND METHODS: The clear zones were evaluated in 399 patients with pedicle screw fixation after 6 months, 1 year, 2 years and 3 years. The patient was considered to be clear zone positive when 1 mm or greater circumferential lucency was confirmed around a screw on film from 2 or more directions. The time-course of the clear zones was examined with regard to age, number of levels fused, bone union, fusion method and reoperation. RESULTS: After 6 months, clear zones were observed in 124 patients (31.1%) but the clear zone-positive rate decreased with time. Clear zones were observed in 89 patients(22.3%), 44 patients(11.0%) and 41 patients(10.3%) after 1 year, 2 years and 3 years, respectively. No new clear zones had developed after 6 months. At the final follow-up, pseudoarthrosis was observed in 12 patients(3.0%). Among them, 11 were clear zone-positive and 1 was clear zone-negative. There was a statistically significant relationship between the clear zone-positive rate and multi-levels, older age and nonunion during following up. In addition, there was a relatively lower clear zone-positive rate in posterolateral fusion combined with posterior lumbar interbody fusion than only posterolateral fusion. However, the difference between them was not statistically significant. CONCLUSION: The presence of clear zones does not always mean pseudoarthrosis but clear zones persisting for more than 2 years after surgery have a higher rate of pseudoarthrosis.
Follow-Up Studies ; Humans ; Pseudarthrosis ; Reoperation ; Retrospective Studies

BACKGROUND: Shift work is associated with a higher risk of cardiovascular diseases. Here, we sought to assess the relationship between shift work and plasma homocysteine levels. Determining the correlations between shift work and homocysteine levels may provide a better understanding of the mechanisms underlying cardiovascular diseases. METHODS: This study was performed using data from routine health examinations of steel workers in 2017. In total, 431 male workers (70 daytime workers and 361 shift workers) employed on a rolling departure schedule were recruited. Plasma homocysteine levels > 15 μmol/L were considered elevated. The χ2, analysis of variance, and multiple logistic regression analyses were used to examine the association between shift work and plasma homocysteine levels. RESULTS: In comparison to daytime workers, the odds ratio (OR) of hyperhomocysteinemia in individuals with < 10 years of shift work was 1.14 (95% confidence interval [CI]: 0.64–2.03), compared to 2.01 (95% CI: 1.14–3.54) for workers with ≥ 10 years of experience. After adjusting for confounding variables, the adjusted OR for shift workers with < 10 years of experience was 0.95 (95% CI: 0.50–1.80), compared to 2.00 (95% CI: 1.07–3.74) for workers with ≥ 10 years of experience. CONCLUSIONS: The risk of hyperhomocysteinemia was significantly higher in shift workers compared to those working normal daytime hours, particularly among long-term shift workers.
Appointments and Schedules ; Cardiovascular Diseases ; Confounding Factors (Epidemiology) ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Logistic Models ; Male ; Odds Ratio ; Plasma ; Steel

The purpose of this study is to observe and compare the remineralization tendencies of artificially demineralized enamel by remineralization solutions of different degree of saturations at pH 5.5, using a polarizing microscope and computer programs (Photoshop, Image pro plus, Scion Image, Excel). For this study, 36 sound permanent teeth with no signs of demineralization, cracks, or dental restorations were used. The specimens were immersed in lactic acid demineralization solution for 3 days in order to produce dental caries artificially that consist of surface and subsurface lesions. Each of 9 or 10 specimens was immersed in pH 5.5 lactic acid buffered remineralization solution of three different degrees of saturation (0.25, 0.30, 0.35) for 12 days. After the demineralization and remineralization, images were taken by a polarizing microscope (x 100). The results were obtained by observing images of the specimens, and using computer programs, the density of caries lesions were determined. In conclusion, in the group with the lowest degree of saturation, remineralization occurred thoroughly from the surface to the subsurface lesion, whereas in the groups with greater degree of saturation showed no significant change in the subsurface lesion, although there was corresponding increase in the remineralization width on the surface zones.
Dental Caries ; Dental Enamel ; Hydrogen-Ion Concentration ; Lactic Acid ; Software ; Tooth

PURPOSE: To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. METHODS: We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. RESULTS: Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was 54.3+/-49.2 months, and the current mean age of the children was 8.3+/-6.4 years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. CONCLUSION: A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.
Child ; Child Abuse ; Child Advocacy ; Fathers ; Follow-Up Studies ; Humans ; Infant ; Korea ; Medical Records ; Mothers ; Surveys and Questionnaires ; Retrospective Studies ; Social Workers ; Wit and Humor as Topic

PURPOSE: To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. METHODS: We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. RESULTS: Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was 54.3+/-49.2 months, and the current mean age of the children was 8.3+/-6.4 years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. CONCLUSION: A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.
Child ; Child Abuse ; Child Advocacy ; Fathers ; Follow-Up Studies ; Humans ; Infant ; Korea ; Medical Records ; Mothers ; Surveys and Questionnaires ; Retrospective Studies ; Social Workers ; Wit and Humor as Topic

It has been known that the size of arterial diameter during growth in primates is closely dependent on blood flow. Flow induced arterial size can be influenced by contractile or structual characters of vascular smooth muscle cells. Furthermore it had been confirmed through experimental study that vascular endothelium releases vasoactive substances which adjust smooth muscle tone, and could detect shear stress on the vascular wall by its direct contact with luminal flow. The authors tried to prove it through the angiographic measurement of the major vessel sizes in cerebrovascular diseases with changed blood flow. We measured the major vessel sizes of 36 cases of cerebrovascular diseases:arteriovenous malformation in 14 cases, cerebral infarction in 8, cerebral hemiatrophy in 6 moyamoya disease 5, occlusion of the internal carotid artery in 2, and carotid-cavernous fistula in 1, which may influence cerebral blood flow, on angiography under the same circumstances. Results are as the followings: 1) In the cases of arteriovenous malformation and carotid-cavernous fistula, all of the major vessel sizes of the lesion wite were increased and all became decreased postoperatively. 2) In the cases of major vessel occlusion and cerebral hemiatrophy, the major vessel size of the lesion site was smaller than that of the normal site. 3) In the cases of moyamoya disease, there was no definite size different between both ICA sizes. In conclusion, the change in cerebral blood flow is a determinant factor of the major vessel sizes in the cases of cerebrovascular disorders which an influence cerebral blood flow.
Angiography ; Arteriovenous Malformations ; Carotid Artery, Internal ; Cerebral Infarction ; Cerebrovascular Disorders ; Endothelium, Vascular ; Fistula ; Moyamoya Disease ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Phenobarbital ; Primates

BACKGROUND: Stigma may affect the interpersonal relationship and coping ability of epilepsy patients. This study was aimed to evaluate the degree of stigma and the relationship between the clinical factors, quality of life (QOL) and the stigma in epilepsy patients. METHODS: One hundred and sixty-three patients with epilepsy were included. The research instruments were questionnaires for collecting demographic and disease-specific data, the stigma and quality of life. The modified Kim Eun Ja's stigma scale (1997) was used. It consists of two domains (enacted stigma, felt stigma) and has 10 items. The quality of life was evaluated by QOLIE-31. To test the correlation between the clinical factors, QOL and the stigma, Pearson correlation coefficient and ANCOVA were used. RESULTS: 51.5% of all patients had stigma. There was a significant negative correlation (r=-0.585, p<0.01) between the total score of stigma and the QOL. Two domains of stigma were also negatively correlated with QOL as follows : felt stigma vs. QOL (r=-0.429, p<0.01) and enacted stigma vs. QOL (r=-0.542, p<0.01). The patients with higher seizure frequency had lower QOL (F=4.834, p=0.03). The clinical factors that could predict the degree of stigma were the seizure frequency (F=7.86, p=0.006), duration of seizure disorder (F=7.34, p=0.008), seizure pattern (F=4.48, p=0.036) and the number of AED (F=2.51, p=0.045). CONCLUSIONS: The felt stigma and the enacted stigma affected the QOL of epilepsy patients. These results suggest that psychosocial interventions are necessary to treat the negative reaction and depressed self-esteems of epilepsy patients in order to improve their QOL.
Epilepsy* ; Humans ; Quality of Life* ; Surveys and Questionnaires ; Seizures

BACKGROUND: Electronic bulletin board systems have been used for education, information exchange, and medical consultation for a number of years. However, most of these systems have been text-based. The field of dermatology has never had a system that allowed a quick exchange of visual information. OBJECTIVE: Dermatology is a field of medicine which especially requires a visual image for an accurate diagnosis, and subsequent effective treatment. We have developed a web-based bulletin board system which can be used by any clinician with access to the internet to view clinical images of skin diseases with accompanying clinical findings. METHODS: A web-based bulletin board system was developed for the internet. The system is designed to operate independently of client hardware and software using hyper text markup language so participants using different platforms can access and use the site effectively. RESULTS: Any participant can easily upload a diagnostic image to the board along with relevant clinical information. Other participants can make comments regarding the presented case which may prove useful to the presenter in diagnosis and development of an effective treatment modality. CONCLUSION: Our web-based bulletin board system for discussion of skin diseases has the potential to help in the diagnosis and treatment of various skin diseases. Dissemination of information relating to clinical cases and participation of a widespread audience of experienced clinicians will allow better practice of dermatology and aid in further training of inexperienced clinicians.
Dermatology ; Diagnosis ; Education ; Internet ; Skin Diseases* ; Skin*