No abstract available.
Curriculum* ; Emergencies* ; Emergency Medical Technicians* ; Humans

No abstract available.
Diffusion* ; Teicoplanin*

PURPOSE: To determine referring physicians 'general attitudes, preferred reporting types, and opinions on radiologic reports. MATERIALS AND METHODS: A survey questionnaire was distributed to the 315 staff and residents of four university hospitals with 400 to 800 beds, and a total of 228 physicians responded. The questionnaire aimed to determine of the general attitude of referring physicians to radiologic reports, the type of report they preferred, and other opinions and suggestions. The responses elicited, as well as discrepancies among residents, staff, internist, and surgeons, were analyzed. RESULTS: Most referring physicians replied that they read an entire report regardless of its length, and the second majority read the conclusion first and then the remainder of the report only if clarification was required. With regard to report length, physicians answered that reports describing the findings of conventional radiography were often too short, while those dealing with MRI were verbose. The majority experienced occasional confusion when reading a report, the major cause being grammatical errors and incomprehensible sentence structure. When confused, most physicians consulted the radiologist; staff showed a greater inclination than residents to pursue this option. Most physicians preferred brief phrases or telegraphic-style sentences to a style which stressed completeness and detail, a preference which was statistically higher among residents than staff. Whereas physicians favored a brief radiologic report in cases of normal radiologic findings, conventional radiologic studies or no clinical findings, they wished to see a more detailed report in cases of abnormal radiologic findings, specific radiologic studies (special radiographs, US, CT, or MRI), or positive clinical findings. This need for more detail was expressed more frequently by internists than by surgeons. CONCLUSION: If implemented, the results of this study can be expected to enhance the quality and comprehensibility of radiologic reports, and may also lead to more efficient communication between radiologists and physicians.
Hospitals, University ; Magnetic Resonance Imaging ; Surveys and Questionnaires ; Radiography

We analysed the 49 probands of autosomal dominant polycystic kidney disease (ADPKD) in Korea to elucidate clinical and genetic characteristics. 1) Family history of renal disease or ADPKD was taken from 44% of probands; hypertension 88%, cerebrovascular attack 64%, end stage renal disease 16%. 2) From the family screening with renal ultrasonography, we have confirmed dominant trait in 24 families. We found 2 families which have suspicious new mutations. 3) We performed linkage analysis of 15 families. The PKD-1 to non PKD-1 ratio was 13 : 2. 4) The male to femal ratio was 17 : 32 and age at diagnosis was 41 (24-65)years (mean (range)) in male, 45 (26-68) years in female. 5) The factors leading to the diagnosis of ADPKD were flank pain (23%), incidental finding (17%), palpable abdominal mass (11%), headache (9%) and gross hematuria (9%) 3) Hypertension (80%), azotemia (43%), flank pain (42%), renal calcification (42%), gross hematuria (33%) and cyst hemorrhage (25%) were renal complications. There were 2 renal cell carcinoma cases. 4)Liver cyst (82%) was the most common extrarenal manifestations. There were colonic diverticulosis (13%), cerebral artery aneurysm (7%), adrenal cyst (4%) and pancreatic cyst (2%). Results of our study revealed the clinical and genetic characteristics of ADPKD in Korea. We found only 44% of family history of renal disease, variable initial manifestations, variable renal and extrarenal complications. And we also found the similar percentage of PKD-2 (13%) to that (5-15%) of western countries, but it is necessary to study with more patients and families.
Aneurysm ; Azotemia ; Carcinoma, Renal Cell ; Cerebral Arteries ; Diagnosis ; Diverticulosis, Colonic ; Female ; Flank Pain ; Headache ; Hematuria ; Hemorrhage ; Humans ; Hypertension ; Incidental Findings ; Kidney Failure, Chronic ; Korea* ; Male ; Mass Screening ; Pancreatic Cyst ; Polycystic Kidney, Autosomal Dominant* ; Ultrasonography

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.
Adult ; Drainage ; Dyspnea ; Hemoptysis ; Humans ; Korea ; Lung ; Mycobacterium tuberculosis ; Oxygen ; Posture ; Prevalence ; Quadriplegia ; Spine ; Thoracic Wall ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.
Adult ; Drainage ; Dyspnea ; Hemoptysis ; Humans ; Korea ; Lung ; Mycobacterium tuberculosis ; Oxygen ; Posture ; Prevalence ; Quadriplegia ; Spine ; Thoracic Wall ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

Background: Recently, a piezoelectric ultrasonic scaler based on a feedback control mechanism was introduced for pain relief. This study aimed to investigate the effects of a new ultrasonic scaler in reducing pain and discomfort in adults. Methods: A newly introduced ultrasonic scaler (Master 700Ⓡ ) was used as the test device and a conventional ultrasonic scaler device (PIEZONⓇ ) was used as the control device. Forty-one healthy adults visited the dental clinic for dental scaling but did not undergo scaling or periodontal treatment within 6 months. Intraoral examinations were performed before scaling and 3 months later; before scaling, both devices were randomly assigned on the left or right side of each dentition (split-mouth model) and scaling was performed by a registered dental hygienist. The levels of pain and discomfort during scaling were evaluated subjectively and objectively using the visual analog scale (VAS) and physiological monitoring of the heart rate (HR), respectively.Time was measured for each device. Results: All clinical indicators, except bleeding on probing, significantly improved with both devices. The treatment times were 7 minutes, 13 minutes (control) and 6 minutes, 59 minutes (test). VAS scores for pain were 4.89±2.12 (control) and 4.58±2.77 (test) points out of 10; for noise, these were 4.68±2.33 (control) and 4.55±2.55 (test), and for vibration, the values were 4.26±2.0 (control) and 4.18±2.48 (test). HR averages were 72.34±3.39 (control) and 75.97±9.78 (test) beats/min. No statistically significant differences were observed between the devices. Conclusion The pain, discomfort levels, and scaling time of the new piezoelectric ultrasonic scaler did not differ from those of the conventional device. Further research and development are necessary for more prominent pain-relief effects of scaling devices.

BACKGROUND/AIMS: Patients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC. METHODS: We retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as > or =1 pp65-positive cell per 2x10(5) polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration. RESULTS: A total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025). CONCLUSIONS: The CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia.
Colitis ; Colitis, Ulcerative* ; Colon ; Cytomegalovirus* ; Diagnosis ; Humans ; Immunohistochemistry ; Inclusion Bodies ; Medical Records ; Mucous Membrane ; Neutrophils ; Odds Ratio ; Retrospective Studies ; Sensitivity and Specificity ; Steroids ; Treatment Failure

Insulin therapy is indicated in the treatment of gestational diabetic women and overt diabetic pregnant women for hyperglycemia after failure to respond to the diets and exercise regimens. The insulin is administered to mimic normal pancreatic function. The normal pancreas secretes 50% of the total daily insulin as mealtime boluses. This delivery may be mimicked by four-injection-per-day of combination of NPH and regular insulin (RI). Hypoglycemia is a well-recognized complication of intensive insulin therapy in patients with Type II diabetes. Recently, it has been reported that insulin-lispro, an analogue of regular human insulin with a peak insulin action achieved with a 1 hour after injection improves postprandial glucose concentration in non-pregnant diabetic patients. Treatment of gestational or diabetic pregnant women with NPH and insulin-lispro has significantly lower postprandial glucose levels without an increase in hypoglycemic events. Here, we report 2 cases of hyperglycemic control with four times daily administration of NPH & insulin-lispro on diabetes in pregnancy, with brief reviews.
Diabetes Mellitus ; Diet ; Female ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia* ; Insulin Lispro* ; Insulin* ; Meals ; Pancreas ; Pregnancy* ; Pregnant Women

OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.
Adenomyosis ; Endometrium ; Female ; Humans ; Hysterectomy* ; Leiomyoma ; Uterus