No abstract available.
Hepatitis* ; Immunoglobulins* ; Plasmapheresis*

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.
Basal Ganglia* ; Brain ; Brain Edema ; Brain Ischemia* ; Cerebral Infarction ; Cerebrum ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Prognosis* ; Stroke, Lacunar ; Thalamus* ; Thromboembolism ; Tomography, X-Ray Computed

The double eyelid operation is one of the most common cosmetic surgery performed in orientals, and there are numerous studies about surgical procedures of that. In the case of appropriate candidates, the non-incision technique makes excellent cosmetic results, with the advantages of shorter operating time, less morbidity, less pain, no scarring and easy revision of shape. But, usually the non-incision technique is recommended in the cases with thin upper eyelid, small amount of orbital fat, less redundant skin of upper eyelid and in whom a wide fold is not desired so on. Therefore, the disadvantages of this method are that it cannot be applied to all patients. The postoperative complications are disappearance or faded fold, formation of cyst or lumps, asymmetry etc. and the incidence of these complications is slightly higher than those of the incisional method. In this study, the double eyelid operation using the continuous buried suture method was performed in 210 patients for formation of double eyelid from Jan. 1993 to Dec. 1995. In conclusion very good results can be obtained by the continuous buried suture method even in the cases of puffy upper eyelid. This method can make a double eyelid shape in the fashion the patient wants and can be a new indication for correction of unilateral double eyelid. This method is safe, satisfactory and take shorter postoperative recovery time and it can reduce the incidence of postoperative complications.
Cicatrix ; Eyelids* ; Humans ; Incidence ; Orbit ; Postoperative Complications ; Skin ; Surgery, Plastic ; Sutures*

No abstract available.
Carotid Artery, Common* ; Rupture*

The use of a tissue expander and implant is the simplest option for breast reconstruction after mastectomy. Use of a round dome-shaped prosthesis and the commonly used one-stage technique with a Becker type prosthesis, however, often produces an undesirable upper pole fullness. To overcome this and to achieve improved aesthetic results, we started using an anatomically-shaped expander and implant, as described by Maxwell, as a two-stage breast reconstruction. We reviewed the results of our 21 reconstructed breasts in 22 patients who were deemed suitable for reconstruction using this technique since January 1995. The most commonly used expander was 350cc (range 350-550cc) and an average of 4.2 inflations were required before replacing the expander with a permanent implant. All the expanders were placed in submuscular pockets and implant volume. The longest follow-up was 36 months. Few complications developed and most patients were satisfied with the results. We found that the anatomically-shaped expander and implant produced better aesthetic results compared to a done-shaped prosthesis.
Breast* ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy ; Prostheses and Implants ; Tissue Expansion Devices

PURPOSE: The main issue with the current ultrasonography (US) guidelines is the overestimation of malignant and indeterminate nodules as they do not aid in making decisions to treat patients. To overcome this, new US guidelines for thyroid nodules that have been shown to be better correlated with cytologic results have been proposed. We also suggested specific indications for US-guided fine needle aspiration (FNA) using the new US guidelines. METHODS: Clinical and pathologic data from 925 patients and 1,419 thyroid nodules were retrospectively collected. All subjects underwent US- and US-guided FNA at Department of Surgery, Wonju Christian Hospital, between March 2010 and July 2011. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both the current guidelines and the new guidelines. RESULTS: The accuracy, sensitivity, specificity, PPV, and NPV for the current guidelines in predicting malignancy were 24.1%, 99.3%, 62.2%, 25.0%, and 99.8%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV for the new guidelines in predicting malignancy were 66.0%, 96.0%, 86.7%, 47.7%, and 99.4%, respectively. CONCLUSION: The use of the new US guidelines allow for a more accurate and specific diagnosis and a better treatment plan than the current guidelines. Additionally, the use of the new FNA guidelines may help prevent unnecessary FNAs and promote cost-effective follow-up for patients.
Biopsy, Fine-Needle ; Follow-Up Studies ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

The ulcerative colitis is a relatively common disease in the European and North American countries aince Dr. Wilks has first reported the cases in 1895, But in Korea, this disease is a rare entity and only a few case have been reported. However, rescently the diagnoetic methods for ulcerative colitis are much developed we have experienced 28 cases of ulcerative colitis which were diagnosed by endoscopy, barium enema exam and biopsy. Therefore a total of 28 patient with ulcerative colitis diagnosed and treated at the department of internal medicine of HYUH from June 1979 to June 1986 was reviewed. We obtained the results as follows; 1) The sex distribution assumed a ratio of 1 to 1.33 with 12 males and 16 females. 2) The age dietribution was relatively even but the majority of cases were between 5th and 6th decade (32.1%), 3) The most prominent clinical symptoms were rectal bleeding, abdominal pain, diarrhea, fever, wight loss and vomiting. 4) Significant laboratory findins were anemia, eleveited ESR, leukocytosis, positive stool OB, electrolyte imbalance and decreased serum albumin level. 5) As to the extent of disease determined by the barium enema examination and endoscopic exam., rectum or rectosigmoid colon is involved in majority of the cases (92.8%). 6) The endoscopic examination was performed in all 28 cases and showed significant findings such as ulceration, hyperemia, mucosal friability, bleeding etcs. 7) The barium enema examination was performed in 19 cases and showed positive findings such as ulceration, luminal narrowing, bowel shortening and rigidity in 17 cases. 8) 21 of 28 patients treated by medical therapy showed relatively improved but 4 of 28 patients was exacerbated or relapsed and one has expired.
Abdominal Pain ; Anemia ; Barium ; Biopsy ; Colitis, Ulcerative* ; Colon ; Diarrhea ; Endoscopy ; Enema ; Female ; Fever ; Hemorrhage ; Humans ; Hyperemia ; Internal Medicine ; Korea ; Leukocytosis ; Male ; Phenobarbital ; Rectum ; Serum Albumin ; Sex Distribution ; Ulcer* ; Vomiting

Acute pulmonary edema during anesthesia and operation is not common. We have recently experienced a case of acute pulmonary edema in a 13 year old girl which developed during anesthesia and operation for her fractured radial head. No specific cause could be found. She didn't have any known cardiopulmonary disease, and responded well to vigorous therapy, but hypoxic brain damage resulted. Her semicomatose state lasted about 40days, and she then recovered slowly and completely in several months.
Adolescent ; Anesthesia* ; Female ; Head ; Humans ; Hypoxia, Brain ; Pulmonary Edema*

OBJECTIVES: REM sleep behavior disorder (RBD) has received little attention in epidemiologic studies. This study aimed to determine the prevalence of probable REM sleep behavior disorder (pRBD) in the elderly population and its clinical features. METHODS: A random sample of 1,588 was selected from a roster of 14,050 elderly population living in Osan city. The subjects were asked to fill out the REM sleep behavior disorder screening questionnaire (RBDSQ). Subjects whose score were 5 or higher on RBDSQ underwent a diagnostic phase of person-to-person assessment by experts in RBD. RESULTS: Among 1,588 subjects, 886 elderly subjects participated in the screening phase and 123 subjects were assessed in the diagnostic phase. Eleven subjects were diagnosed as having pRBD, so prevalence was 1.5% (95% CI=0.70-2.30%). The frequency of depression and cognitive decline was significantly increased in patients with pRBD compared to subjects without pRBD, and there was no difference in sleep disturbances between two groups. CONCLUSIONS: Probable REM sleep behavior disorder is not rare in the elderly but frequently under-recognized. More attention should be paid to evaluation and treatment of RBD.
Aged ; Depression ; Epidemiologic Studies ; Humans ; Mass Screening ; Prevalence ; Surveys and Questionnaires ; REM Sleep Behavior Disorder ; Sleep, REM