BACKGROUND/AIMS: A self-report questionnaire is frequently used to measure symptoms reliably and to distinguish patients with functional gastrointestinal disorders (FGIDs) from those with other conditions. We produced and validated a cross-cultural adaptation of the Rome III questionnaire for diagnosis of FGIDs in Korea. METHODS: The Korean version of the Rome III (Rome III-K) questionnaire was developed through structural translational processes. Subsequently, reliability was measured by a test-retest procedure. Convergent validity was evaluated by comparing self-reported questionnaire data with the subsequent completion of the questionnaire by the physician based on an interview and with the clinical diagnosis. Concurrent validation using the validated Korean version of the Short Form-36 Health Survey (SF-36) was adopted to demonstrate discriminant validity. RESULTS: A total of 306 subjects were studied. Test-retest reliability was good, with a median Cronbach's alpha value of 0.83 (range, 0.71-0.97). The degree of agreement between patient-administered and physician-administered questionnaires to diagnose FGIDs was excellent; the kappa index was 0.949 for irritable bowel syndrome, 0.883 for functional dyspepsia and 0.927 for functional heartburn. The physician's clinical diagnosis of functional dyspepsia showed the most marked discrepancy with that based on the self-administered questionnaire. Almost all SF-36 domains were impaired in participants diagnosed with one of these FGIDs according to the Rome III-K. CONCLUSIONS: We developed the Rome III-K questionnaire though structural translational processes, and it revealed good test-retest reliability and satisfactory construct validity. These results suggest that this instrument will be useful for clinical and research assessments in the Korean population.
Dyspepsia ; Gastrointestinal Diseases* ; Health Surveys ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Surveys and Questionnaires*

Uterine torsion is defined as the mtation of more than 45 degrees around the long axis of the uterus or a rotation which is severe enough to produce symptoms. Torsion of the human pregnant uterus is a very rare complication. The diagnosis is problematic and is often made during a cesrean section due to inhibited labor. Torsion of the human pregnant uterus can be caused by myoma or other uterine abnormalities, ovarian cysts, adhesions, abnormal fetal presentations, or fetal abnormalities ( though no cause can be found in about 20% of cases ). Uterine torsion produces symptoms of varying severity depending on the degree of rotation, and duration of the pregnancy. High mortality rates for both mother and infant have been reported. We experienced one case of the torsion of term pregnant uterus and report this case with a brief review of the concerned literature.
Axis, Cervical Vertebra ; Diagnosis ; Female ; Fetus* ; Humans ; Infant ; Mortality ; Mothers ; Myoma ; Ovarian Cysts ; Pregnancy ; Uterus*

PURPOSE: Reactive oxygen species (ROS) are known as a potential mediators that sustain chronic inflammation in atopic dermatitis (AD). To determine the role of peripheral blood mononuclear leukocytes (MO) and polymorphonuclear leukocytes (PMN) in prolonged inflammation, ROS generation of those cells in AD was examined. METHODS: Seventeen AD patients and 10 healthy controls were enrolled. MO and PMN were stimulated with the reagents: phobol ester (PMA), adenosine triphosphate (ATP), and chemotactic peptide (f-MLP). ROS levels were measured using chemiluminescence assay. RESULTS: In AD, chemiluminescence response of unstimulated MO was higher than that of normal controls. MO from AD patients produced 1.58-1.80 higher ROS for up to 30 minutes than the controls. When the cells were treated with the reagents (PMA, ATP, f-MLP), all the stimuli enhanced chemiluminescence activity of MO. When MO were treated with PMA, the ratio of ROS produced by MO of patients to that of the controls decreased. When the cells were treated with either ATP or f-MLP, the quantity of ROS generated by MO from the controls was greater than the controls. PMN from both AD patients and the controls generated ROS for 30 min similarly. As treated with the reagents, PMN from AD patients produced a smaller ROS than the controls. CONCLUSION: These results indicate MO but not PMN from AD patients were primed and ready for activation in vivo, and a reduced function of PMN from AD patients was observed. In conclusion, enhanced respiratory burst activity of MO is implicated in the prolonged inflammation of AD.
Adenosine Triphosphate ; Dermatitis, Atopic* ; Humans ; Indicators and Reagents ; Inflammation ; Leukocytes, Mononuclear* ; Luminescence ; Neutrophils* ; Reactive Oxygen Species* ; Respiratory Burst

We treated 8 patients with large pituitary adenomas(4 females, 4 males) with bromocriptine. In all patients the level of prolactin was decreased to within the normal range and in most patients the size of tumor was decreased remarkably, high cure rate of large pituitary tumor fallowing operation after pretreated bromocriptine was obtained.
Bromocriptine* ; Female ; Humans ; Pituitary Neoplasms* ; Prolactin ; Reference Values

No abstract available.
Humans*

Diffuse myalgia is common in transient systemic viral infections but overt myositis, with weakness and signs of muscle inflammation, rarely accompanies viral infection in chidren. We describe a 8-year-old boy with severe myalgia and tenderness in both lower extremities, whose unusual skeletal muscle uptake on Technetium-methylene diphosphate bone scan helped to diagnosis of myositis. Clinical course, muscle-derived enzyme studies(AST, ALT, LD, CK), electromyogram findings, histopathologic findings obtained from left gastrocnemius muscle biopsy and serologic studies for enteroviral antibodies (enterovirus type 71 and Coxsackie B4 neutralization antibody titer 1:128 respectively) were all compatible with acute viral myositis.
Antibodies ; Biopsy ; Child ; Diagnosis ; Humans ; Inflammation ; Lower Extremity ; Male ; Muscle, Skeletal ; Myalgia ; Myositis*

BACKGROUND: The authors have developed a Digital image chart(DIC) and digital Radiotherapy Record System (DRRS). We have evaluated the DIC and DRRS for reliability, usefulness, ease of use, and efficiency. METHOD AND MATERIALS: The basic design o f the DIC and DRRS was to build an digital image database of radiation therapy patient records for a more efficient and timely flow of critical image in formation throughout the department. This system is a subunit of comprehensive radiation oncology managemert system (C-ROMS) and composed of a picture archiving and communication system (PACS), radiotherapy information database, and a radiotherapy imaging database. The DIC and DRRS were programmed using Delphi under a Windows 95 environment and is capable of displaying the digital images of patients identification photos, simulation films, radiotherapy setup, diagnostic radiology image... Gross lesion photos, and radiotherapy planning isodose charts with beam arrangements. Twenty-three clients in the department are connected by Ethernet (10 Mbps) to the central image server (Sun Ultra-sparc 1 workstation). RESULTS: From the introduction of this system in February 1998 through December 1999, we have accumulated a total of 15,732 individual images for 2,556 patients. We can organize radiation therapy in; paperless environment in 120 patients with breast cancer. Using this system, we have succeeded in the prompt, accurate, and simultaneous access to patient care information from multiple locations throughout the department. This coordination has resulted in improved operational efficiency within the department. CONCLUSION: The authors believe that the DIC and DRRS has contributed to the improvement of radiation oncology department efficacy as well as to time and resource savings by providing necessary visual information throughout the department conveniently and simultaneously. As a result, we can also achieve the paperless and filmless practice of radiation oncology with this system.
Breast Neoplasms ; Dacarbazine ; Hospital Information Systems ; Humans ; Income ; Patient Care ; Radiation Oncology* ; Radiotherapy*

PURPOSE: In order to avoid functional disability that may be caused by radical excision or amputation in extremity soft tissue sarcomas, authors employed limb-conserving surgery together with extemal radiation therapy plus interstitial brachytherapy. MATERIALS AND METHODS: From June 1995 to Febrary 1997, 10 extremity soft tissue sarcoma patients were treated with limb-conserving surgery and external radiation therapy plus interstitial brachytherapy. In six patients, whose histologic diagnoses were made at the time of surgery, wide or marginal excision and interstitial brachytherapy was done 4 weeks before postoperative external radiation therapy. In four patients whose histologic confinnations were done before definitive treatment, preoperative external radiation therapy was given 4 weeks before surgery and interstitial brachytherapy. The types of surgery were wide excision in five patients, and marginal excision in five patients. Gross or microscopic residual was left at the surgical resection margins in four patients. The brachytherapy dose ranged from 17.5 Gy to 24 Gy and external beam radiation did from 40 Gy to 45 Gy. RESULTS: With the median follow-up duration of 21.5 months(range: 13 to 29 months); one local recurrence, and three new distant metastases were observed. There were three patients with wound complications attributable to the current treatment regimen. CONCLUSION: Satisfactory local tumor control may be achievable with limb-conserving surgery and external radiation therapy plus brachytherapy in patients with extremity soft tissue sarcomas, while more caution should be used to avoid wound problems.
Amputation ; Brachytherapy* ; Diagnosis ; Extremities* ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Sarcoma* ; Wounds and Injuries

The thymoma with extrathoracic metastasis is an exceedingly rare malady. We report here on the surgical resection and the pathologic findings of liver metastasis from an invasive thymoma in a 57-year-old female. In 1998, a benign thymoma in the anterosuperior mediastinum was removed from the patient and then postoperative radiation therapy was given. After 6 years, the patient complained of dyspnea, dry cough and abdominal pain. Abdominal CT and MRI showed an encapsulated and septated 19 x 14 cm sized cystic mass in the right liver. Right hepatectomy was done and it was shown to be a metastatic thymoma. An extensive literature review has revealed only a few cases of surgical resection of liver metastasis in a patient with invasive thymoma.
Abdominal Pain ; Cough ; Dyspnea ; Female ; Hepatectomy ; Humans ; Liver ; Magnetic Resonance Imaging ; Mediastinum ; Middle Aged ; Neoplasm Metastasis* ; Thymoma* ; Tomography, X-Ray Computed

One hundred patients who underwent bilateral subtotal thyroidectomy for Graves' disease between January 1980 and September 1984 have been evaluated. The observation period ranged from 5 to 9 years, the average being 6.2 years. Postoperative thyroid function was evaluated with T3, T4 and TSH and compared with their clinical manifestations. Eighty-two patients became euthyroid, 14 patients had recurrence and 4 patients developed hypothyroidism. The thyroid hormone level of euthyroid patients were in an unstable state up to 5 years after the operation. Sixteen variables which might influence the postoperative recurrence and hypothyroidism were analyzed but no statistically significant factors were determined, although recurrences were found frequently in patients over 30 years, the patients with lower infiltration of lymphocytes and absent of fibrosis of thyroid tissue. The results obtained in the present study suggest that mean 6.0 gm of remnant thyroid is suitable for maintaining euthyroidism postoperatively in a majority of patients. In addition, patients should be followed closely for many years and should undergo hormonal determination periodically because recurrence and hypothyroidism can occur at 5 years or more after the operation.
Adolescent ; Adult ; Chi-Square Distribution ; Female ; Follow-Up Studies ; Graves' Disease/physiopathology/*surgery ; Human ; Logistic Models ; Male ; Middle Age ; Prognosis ; Support, Non-U.S. Gov't ; Thyroid Gland/*physiopathology ; *Thyroidectomy/methods