PURPOSE: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. MATERIALS AND METHODS: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of 99mTc-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. RESULTS: GBEF was significantly reduced in diabetes with autonomic neuropathy (43+/-12.3%) and without autonomic neuropathy (57.5+/-13.2%) compared with normal controls (68+/-11.6%, p <0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p <0.05). Fasting blood glucose level, age, sex, hemoglobin A1c, body mass index, serum lipid level were not different in these two diabetic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. CONCLUSION: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy.
Blood Glucose ; Body Mass Index ; Diabetic Neuropathies* ; Fasting ; Female ; Gallbladder* ; Humans ; Injections, Intravenous ; Male ; Meals ; ROC Curve ; Sensitivity and Specificity ; Technetium Tc 99m Disofenin*

No abstract available.
Sturge-Weber Syndrome*

No abstract available.
Aneurysm* ; Aorta*

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

OBJECTIVE: To evaluate the technical feasibility and the clinical effectiveness of sclerotherapy for the treatment of peritoneal inclusion cysts (PICs). MATERIALS AND METHODS: Between June 1996 and February 2001, eight PICs in seven female patients aged 28-43 (mean, 36) years were instilled with sclerosant (povidone-iodine in three, ethanol in three, both povidone-iodine and ethanol in one). All seven patients subsequently experienced less abdominal pain. After drainage via an 8.5-Fr pigtail catheter inserted in the PICs (transabdominally in six cases, transvaginally in one), sclerosant equivalent in volume to about one-third that of drained fluid was introduced daily until the drained volume was less than 5ml. Follow-up by means of clinical procedures and ultrasound was performed every three months, at which time the success rate, possible complications and recurrence were determined. RESULTS: Sclerotherapy was technically successful in all seven patients, though immediately after the procedure, minor complications were noted in three patients (mild pain in two, mild fever in one). During the follow-up of 4-60 (mean, 24.7) months, sclerotherapy proved successful and without long-term complications in all seven patients: lower abdominal pain disappeared and the diameter of the cysts decreased more than 50%, with complete regression in four cases. During the follow-up period there was no recurrence. CONCLUSION: Sclerotherapy following catheter insertion is technically feasible and effective for the treatment of PICs.
Adult ; Cysts/diagnosis/*therapy ; Female ; Follow-Up Studies ; Human ; Magnetic Resonance Imaging ; Peritoneal Diseases/diagnosis/*therapy ; Sclerosing Solutions ; *Sclerotherapy ; Support, Non-U.S. Gov't ; Time Factors ; Tomography, X-Ray Computed

PURPOSE & METHOD: To evaluate clinical pattern and operative outcome of the ischemic lower extremity, 142 patients who were admitted to Yeungnam University Hospital between January 1996 to December 1998 were analyzed. RESULTS: The patients were 125 males and 17 females ranging from 21 to 88 years of age. The mean age was 59, with the highest incidence among people in their 60s, followed by those in their 70s and then in their 50s. The causes of arterial occlusive disease were artherosclerotic obliterans (ASO) in 87 cases (61.2%), thromboangitis obliterans (TAO) in 44 cases (30.9%), thromboembolism in 10 cases and superficial femoral aneurysm in 1 case. Associated diseases in ASO were hypertension in 37 cases (42.5%), diabetes mellitus in 17 cases (30.9%), cardiac disease in 24 cases (27.5%) and cerebrovascular disease in 7 cases (8.0%). History of smoking was noted in 77.4% of the cases. The major arterial occlusive site of ASO were femoral artery in 36 cases (41.3%), aortoiliac artery in 26 cases (29.8%), iliofemoral artery in 9 cases (10.3%), popliteal artery in 5 cases (5.7%), tibial artery in 6 cases (6.8%) and multi-level occlusion in 5 cases (5.7%). The major arterial occlusive site of TAO were tibial artery in 35 cases (79.5%), pedal artery in 8 cases (18.1%) and popliteal artery in 1 case. According to the Fontaine classification of clinical symptoms, the distribution was as follows: Grade 0 0 case, Grade I 48 cases (33.8%), Grade II 46 cases (32.3%) and Grade III 48 cases (33.8%). The operative procedures of arterial occlusive disease were bypass graft operation in 72 cases, thromboembolectomy in 12 cases, endarterectomy in 2 cases and percutaneous transluminal angioplasty (PTA) was performed in 9 cases. Arterial bypass operation with autogenous or artificial prosthesis were done in 72 cases, which included aortobifemoral or aortobipopliteal bypass in 12 cases, iliofemoral bypass in 5 cases, femoropopliteal bypass in 26 cases, femorotibial bypass in 5 cases, popliteotibial bypass in 8 cases. axillobifemoral bypass in 4 cases and femorofemoral bypass in 12 cases. In over 90% of the operative cases, the early outcome was good with 3+ to 2+ rating according to Rutherford criteria. Mortality for 114 cases was 2.6% (3 cases), including 2 resulting from associated cardiac condition and 1 resulting from ARDS. CONCLUSION: Strategies for successful revascularization and long term patency may be made by consideration of the extent of diseases, associated diseases, clinical symptoms and status of distal perfusion.
Aneurysm ; Angioplasty ; Arterial Occlusive Diseases ; Arteries ; Classification ; Diabetes Mellitus ; Endarterectomy ; Female ; Femoral Artery ; Heart Diseases ; Humans ; Hypertension ; Incidence ; Ischemia* ; Lower Extremity* ; Male ; Mortality ; Perfusion ; Popliteal Artery ; Prostheses and Implants ; Smoke ; Smoking ; Surgical Procedures, Operative ; Thromboangiitis Obliterans ; Thromboembolism ; Tibial Arteries ; Transplants ; Troleandomycin

The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Therefore, proper treatment method should be applied in order to achive aesthetic and funtioning hand. To reconstruction of soft tissue defect in hand, a variety of treatment have been, but most are associated with drawbacks, such as limited range, limited application, long time surgery, 2nd stage surgery, large donor defect. The reverse dorsal digital and metacarpal island flaps use the dorsal skin of the digital or metacarpal areas, and they are based on the arterial branches anastomosing the volar and dorsal arterial networks. The series of 15 cases of reconstruction for soft tissue defect due to electrical burn in hand were reviewed. Most cases survived completely and we could gain satisfactory results. Advantages of these flaps are minimal defect in donor site, good reliability, short time and easy technique, versatile variation, usefulness in secondary reconstruction. In conclusion, our result suggested that the reverse dorsal digital and metacarpal artery island flap are very useful methods for reconstruction of soft tissue defect due to electrical burn in hand, functionally and aetheticallly.
Arteries* ; Burns* ; Hand* ; Humans ; Skin ; Surgical Flaps ; Tissue Donors

Split-thickness skin graft is a frequent, necessary method of treatment in burn patients. After harvesting a split thickness skin graft, there is a variety of options in the post-operative management of the donor site created. Dressing materials provide an occlusive and wet environment and aids in superior wound healing. Of the commercially available dressing materials, Medifoam(R), Allevin(R) and Polymem(R) are the most commonly used materials during the early phases of epithelization. Medifoam-B(R) is a more absorbant dressing material compared to other dressing materials. Its swelling ratio is 1200% and it contains a layer of wound promoters and antibiotics. The purpose of this study is to compare medifoam-B(R), Allevyn(R) and Polymem(R) in the healing time, infection rate, absorption ratio and pain degree. This study is based on 30 patient who underwent split-thickness skin graft in Hanil General Hospital from March 2002 to July 2002. All skin grafts were harvested with an electric dermatome, with a thickness depth of 0.012 to 0.016 inches. Three divisions of each donor site was managed separately with each different materials through postoperative days 0 to 1. Absorption property, infection rate, pain degree, time to complete epithelization were assessed. Medifoam-B(R) performed superior to Allevyn(R), Polymem(R). In conclusion, We suggest Medifoam-B(R) as a useful alternative in the management of the split-thickness donor site wound in the early phases.
Absorption ; Anti-Bacterial Agents ; Bandages* ; Burns ; Hospitals, General ; Humans ; Skin ; Tissue Donors* ; Transplants ; Wound Healing ; Wounds and Injuries

Objectives: This study aims to identify the factors affecting unmet dental care needs in pregnant women in Korea, and analyze the results. Methods: The study used original data from the 2019 Community Health Survey. A total of 1,146 women who were pregnant at the time were selected as the final subjects for analysis. Complex sample logistic regression analysis was conducted to understand the factors contributing to unmet dental care needs. Results: Among the subjects, 16.3% reported experiencing unmet dental care needs. The main reasons were a lack of time, other reason (pregnancy, bother to go) and minor symptoms. This study found that age and marital status as predisposing factors, number of household members as enabling factors, and subjective oral health status, chewing difficulties, tooth brushing frequency, and subjective stress levels as need factors significantly impacted the experience of unmet dental care needs. Conclusions Customized oral health education for pregnant women is crucial to raise awareness about its significance. Considering that pregnant women may be single-person households or face challenges in visiting the dentist alone, it is necessary to establish a medical delivery system that facilitates access to medical treatment. Furthermore, policy efforts should be directed toward reducing unmet dental care needs among pregnant women.