No abstract available in English.
Tibia

BACKGROUND: Osteoporosis is developed by progressive decrease of bone rnass from decreased collagen content of bone. Accurate measurement of bone collagen is necessary for the diagnosis of osteoporosis and it is possible by bone biopsy, however bone biopsy is not easy in clinical practice. Skin collagen is consist with type I collagen which is same type of bone collagen and progressive decrease of bone collagen is reflected by decrease of skin collagen. Since skin thickness reflect skin collagen amount, skin thickness measurement may be a useful method for the evaluation of osteoporosis. So ultrasonic skin thickness measurement was developed for the evaluation of osteoporosis. METHODS: A randomly selected 200 women aged fram 30 to 71 years old were asked to have their skin thickness measured as well as lumbar vertebral DXA(Norland, USA) bone densitometry. Except for the two women who failed to complete the study, 45(22.7%) of these women were diagnosed as normal, 74(37.4%) were osteopenic and 79(39.9%) were diagnosed as osteoporosis patients using the WHO criteria. Skin thickness was measured using 20MHz Osteoson DCIII (Minhorst, Germany) at the medial side of the upper arm. A minimal of Two scans were measured and the mean value was cakulated automatically. RESULTS: The correlation coefficient of skin thickness and age was -0.121(ns), DXA BMD(bone mineral density) and age was -0.420(P<0.01), skin thickness and DXA BMD L2-L4 was 0.181(P<0.05). Skin thickness was significantly correlated with body weight(correlation coefficient 0.254, P<0.01) and BMI(correlation coefficient 0.195, P<0.01). Furthermore, the mean and standard deviation of skin thickness in normal BMD group was 0.94+-0.021mm, osteopenic group was 0.92+-0.006mm, and osteoporotic group was 0.89+-0.018mm. There was statistically significant difference in the mean values of skin thickness between the three groups even adjusted with age and BMI(P<0.05). The mean and standard deviation of skin tbickness of healthy 20-40 year old women was 1.11+-0,023mm and their mean and standard deviation of L2-L4 mean BMD was 1.17+-0.145mg/cm2. The diagnostic predictability of skin thickness less than 1mm as the risk of osteoporosis(BMD T score less than -1.0) was evaluated. The sensitivity and the specificity of skin thickness less than 1mm being osteoporotic were 78,2% and 57.8% respectively. The positive and negative predictive value of the skin thickness less than 1mm being osteoporotic were 82.2% and 36.5% respectively. CONCLUSION: This study indicate that the skin thickaess measured with the ultrasound method show good correlatian with the bone density measured with conventional DXA at the lumbar vertebra and the skin thickness less than 1mm on the medial side of the opper arm is relatively sensitive in diagnosing osteoporosis risk in Korean women. The authors suggested that a large randomized control study to define the relationship between the skin thickness and the other determinants of bone turnover in the near future.
Aged ; Arm ; Biopsy ; Bone Density ; Collagen ; Collagen Type I ; Densitometry ; Diagnosis* ; Female ; Humans ; Osteoporosis ; Osteoporosis, Postmenopausal* ; Sensitivity and Specificity ; Skin* ; Spine ; Ultrasonics ; Ultrasonography

BACKGROUND: Nutrition label reading is helpful in attaining a healthy diet. Nutrition label use and its related factors have been studied in many Korean articles, but their research samples were the general population and not chronic disease patients. This study aimed to explore the use of nutrition labels and its relation to dietary intake among chronic disease patients in Korea. METHODS: A total of 3160 respondents aged> or =20 years from the 2008-2009 Fourth Korean National Health and Nutrition Examination Survey (KNHANES-IV) participated in the study. Their chronic medical conditions included hypertension, hyperlipidemia, coronary artery disease, diabetes and/or stroke and they were interviewed regarding their use of nutrition labels. Nutrition intake was also estimated by 24-hour dietary recalls. RESULTS: Overall, 10.4% of the chronic disease patients reported to using nutrition labels. The nutrients they looked at first were total calories, fat and cholesterol. Factors related to reading nutrition labels were relatively higher education, high body mass index and lower frequency of alcohol intake in males and relatively younger age and higher education in females. Nutrition label users consumed lower total calories, protein and fat in the male CAD group, lower total calories and carbohydrate in both diabetes and total groups and lower total calories and fiber in the female stroke group. CONCLUSIONS: Our study found that, in Korea, a significantly lower rate of patients with chronic disease read nutrition labels. Strategies need to be developed to improve clinical application of nutrition labels in this population.
Body Mass Index ; Cholesterol ; Chronic Disease* ; Coronary Artery Disease ; Surveys and Questionnaires ; Diet ; Education ; Female ; Food Labeling ; Humans ; Hyperlipidemias ; Hypertension ; Korea ; Male ; Nutrition Surveys* ; Stroke

PURPOSE: To analyze the characteristics of defendants, court rulings and the compensation received in medical disputes relating to ophthalmology. METHODS: Retrospective analyses of ophthalmic claims obtained from websites between 1989 and 2014 were performed. RESULTS: Among 42 cases, 26 cases were ruled partially in favor of plaintiffs and 16 cases, ruled in favor of the defendant. Regarding the type of hospital, private clinics accounted for 22 claims, tertiary referral hospitals took 16 claims, and the secondary hospitals took 6 claims. The judgment amount of all of the lawsuits was Won1,770,466,250 and average amount was Won66,743,168 (Won5,000,000-Won455,869,936). The condition with the highest mean payment per claim was glaucoma (Won223,788,608). The consolation money for emotional distress due to violation of liability for explanation comprised a large proportion of the compensation, accounting for 62% of total payment. The conditions most likely to result in payment were those related to the retina, which occurred in 7 cases (70%). The conditions most likely to be appealed to a higher court were those involving oculoplasty (100%). Mismanagement of tests and misdiagnosis occurred in 8 cases (62%), mismanagement of treatment occurred in 3 cases (23%), and mismanagement of anesthesia and recovery occurred in 1 case (9%). CONCLUSIONS: Among all claims, those involving private clinics were most commonly involved (52%) and 62% of all claims were decided partially in favor of plaintiffs. Violation of liability during the explanation of the condition and negligence during the act of diagnosis and treatment were significant reasons for payment. Examination of these cases will help to promote patient safety and reduce repeated medical disputes.
Anesthesia ; Compensation and Redress ; Diagnosis ; Diagnostic Errors ; Dissent and Disputes ; Glaucoma ; Hospitals, Private ; Judgment ; Jurisprudence* ; Korea ; Malpractice ; Ophthalmology* ; Patient Safety ; Retina ; Retrospective Studies ; Tertiary Care Centers

PURPOSE: To analyze the characteristics of defendants, court rulings and the compensation received in medical disputes relating to ophthalmology. METHODS: Retrospective analyses of ophthalmic claims obtained from websites between 1989 and 2014 were performed. RESULTS: Among 42 cases, 26 cases were ruled partially in favor of plaintiffs and 16 cases, ruled in favor of the defendant. Regarding the type of hospital, private clinics accounted for 22 claims, tertiary referral hospitals took 16 claims, and the secondary hospitals took 6 claims. The judgment amount of all of the lawsuits was Won1,770,466,250 and average amount was Won66,743,168 (Won5,000,000-Won455,869,936). The condition with the highest mean payment per claim was glaucoma (Won223,788,608). The consolation money for emotional distress due to violation of liability for explanation comprised a large proportion of the compensation, accounting for 62% of total payment. The conditions most likely to result in payment were those related to the retina, which occurred in 7 cases (70%). The conditions most likely to be appealed to a higher court were those involving oculoplasty (100%). Mismanagement of tests and misdiagnosis occurred in 8 cases (62%), mismanagement of treatment occurred in 3 cases (23%), and mismanagement of anesthesia and recovery occurred in 1 case (9%). CONCLUSIONS: Among all claims, those involving private clinics were most commonly involved (52%) and 62% of all claims were decided partially in favor of plaintiffs. Violation of liability during the explanation of the condition and negligence during the act of diagnosis and treatment were significant reasons for payment. Examination of these cases will help to promote patient safety and reduce repeated medical disputes.
Anesthesia ; Compensation and Redress ; Diagnosis ; Diagnostic Errors ; Dissent and Disputes ; Glaucoma ; Hospitals, Private ; Judgment ; Jurisprudence* ; Korea ; Malpractice ; Ophthalmology* ; Patient Safety ; Retina ; Retrospective Studies ; Tertiary Care Centers

BACKGROUND: Rapid sequence induction (RSI) is indicated in various situations. Succinylcholine has been the muscle relaxant of choice for RSI, and rocuronium has become an alternative medicine for patients who cannot be administered succinylcholine for various reasons. Although rocuronium has the most rapid onset time among non-depolarizing muscle relaxants, the standard dose of rocuronium (0.6 mg/kg) takes 60 seconds to achieve appropriate muscle relaxation. We evaluated intubating conditions using the "modified timing principle" with rocuronium and succinylcholine. METHODS: In this prospective controlled blinded study, all patients received 1.5 microg/kg fentanyl intravenously with preoxygenation for 2 minutes and were randomized to receive 0.6 mg/kg rocuronium followed by 1.5 mg/kg propofol or 1.5 mg/kg propofol and 1.5 mg/kg succinylcholine. The rocuronium group was intubated just after confirming loss of consciousness, and the succinylcholine group was intubated 1 minute after injecting succinylcholine. Intubation condition, timing of events, and complications were recorded. RESULTS: All patients were successfully intubated in both groups. Apnea time of the rocuronium group (38.5 seconds) was significantly shorter than that in the succinylcholine group (100.7 seconds). No significant differences were observed in loss of consciousness time or intubation time. The succinylcholine group tended to show better intubation conditions, but no significant difference was observed. None of the patients complained awareness of the intubation procedure or had respiratory difficulty during a postoperative interview. CONCLUSIONS: The modified RSI with rocuronium showed shorter intubation sequence, acceptable intubation conditions, and a similar level of complications compared to those of conventional RSI with succinylcholine.
Androstanols ; Apnea ; Complementary Therapies ; Fentanyl ; Humans ; Intubation ; Muscle Relaxation ; Muscles ; Neuromuscular Nondepolarizing Agents ; Propofol ; Prospective Studies ; Succinylcholine ; Unconsciousness

Purpose: The characteristics of pediatric dermoid cyst patients. Methods: This was a retrospective chart review of 64 dermoid cyst patients (65 eyes) aged < 18 years. Results: Limbal dermoids and conjunctival dermolipomas were observed in 49 and 16 eyes (48 and 16 patients), respectively. Limbal dermoids were more common in the left eye (61%), particularly on the inferotemporal side (80%). Three (6%) of the patients were diagnosed with Goldenhar syndrome. The horizontal diameter (3.76 ± 1.30 mm) was greater than the vertical diameter (3.74 ± 1.30 mm). Most of the lesions were yellow (35.2%) in color, mildly elevated (n = 19, 55.9%), and not visible when the eyes were closed. The mean best corrected visual acuity was 0.8 ± 0.2 in 23 patients, with mean astigmatism and mean corneal astigmatism values of -2.1 ± 2.2 diopters (D) and -2.0 ± 1.1 D, respectively. None of the conjunctival dermolipoma patients had any ocular history. The left eye (75%), particularly the temporal and superiotemporal conjunctival fornix, was the most commonly affected site. The mean best corrected visual acuity was 0.9 ± 0.0 in seven patients, with an average astigmatism of -0.3 ± 0.2 D. Conclusions Dermoid cysts are congenital benign tumors that may be associated with congenital diseases. They vary in size, location, color, and extent of invasion, and may cause functional problems, such as astigmatism and amblyopia. Therefore, timely surgical treatment is desirable.

By doing MRI of spinal cord and elctrophysiological studies we were going to correlate MRI and electrophysiologi-cal findings with the known pathology of tabes dorsalis. A 45 year old male patient developed gait ataxia with a tin-gling sense in hands and feet in september of 1996. Neurological examination revealed impaired position sense in his great toes and thumbs with profound instability in the Romberg test, and areflexias in his knee and ankle jerks. Serum VDRL and TPHA test results were positive. CSF revealed pleocytosis(WBC : 16/cubic mm), elevated protein level, and reactive VDRL and FTA-ABS tests. Spinal MRI showed high signal intensity in the posterior part of the entire length of the cervical cord without enhancement with Gadolinium. Follow-up spinal MRI of the cervical area, which was taken two years after penicillin treatment did not show any interval change and spinal MRI of thoracolumbar area also showed similar finding to that of the cervical cord. Nerve conduction studies before and after the penicillin trea-ment showed normal findings except absent H-reflexes. However, the somatosensory evoked potentials with posterior tibial nerve stimulation did not show any abnormalities, which were incompatible with previous report and the known pathologic abnormality. Normal somatosensory evoked potentials suggests using any other pathways than the posterior column in conducting somatosensory evoked potentials.
Ankle ; Evoked Potentials, Somatosensory ; Fluorescent Treponemal Antibody-Absorption Test ; Follow-Up Studies ; Foot ; Gadolinium ; Gait Ataxia ; H-Reflex ; Hand ; Humans ; Knee ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Neural Conduction ; Neurologic Examination ; Pathology ; Penicillins ; Proprioception ; Spinal Cord ; Tabes Dorsalis* ; Thumb ; Tibial Nerve ; Toes

Background: and Purpose Fatigue is common in demyelinating disorders of the central nervous system (CNS), including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).We aimed to validate the usefulness of the Functional Assessment of Chronic Illness Therapy– Fatigue (FACIT-F) and the Fatigue Severity Scale (FSS) relative to the Korean version of the Modified Fatigue Impact Scale (MFIS-K) in Korean patients with MS, NMOSD, and MOGAD. Methods: There were 294 patients with MS (n=120), NMOSD (n=103), or MOGAD (n=71) enrolled in a prospective demyelinating CNS registry. Fatigue was measured using the FACIT-F, MFIS-K, and FSS. Sleep quality, quality of life, depression, and pain were evaluated using the Pittsburgh Sleep Quality Index (PSQI), 36-item Short-Form Survey (SF-36), and Beck Depression Inventory-II (BDI-II). Results: The MFIS-K, FACIT-F, and FSS scores showed high internal consistencies and strong correlations with each other in the MS, NMOSD, and MOGAD groups. The scores on all three fatigue scales were correlated with PSQI, SF-36, and BDI-II results in the three groups. The areas under the receiver operating characteristic curves for the FSS and FACIT-F were 0.834 and 0.835, respectively, for MS, 0.877 and 0.833 for NMOSD, and 0.925 and 0.883 for MOGAD. Conclusions These results suggest that the MFIS-K, FSS, and FACIT-F are useful and valuable assessment instruments for evaluating fatigue in Korean patients with MS, NMOSD, and MOGAD.

PURPOSE: Epilepsy, a typical chronic disease, may cause severe of psychosocial difficulties for all family members, including stigmatization. The present study focused on how children with epilepsy affect their parents' perceived stigma. METHODS: Participants were 87 parents(21 fathers and 66 mothers) whose children were diagnosed as and treated for epilepsy at the pediatric epilepsy clinic in Dongguk University Hospital. To obtain data, the parental perceived stigma scales with 3 questionnaires were developed by modifying Jacoby's stigma scales. Data were analyzed with the SPSS 10.0 program using oneway ANOVA and multiple regression. RESULTS: The results of the analysis showed that 22 parents(25.3%) have perceived stigma. Oneway ANOVA showed significant differences of the parental perceived stigma level according to the parental academic background, the number of antiepileptic drugs, the combined disabilities, the educational institution of epileptic children, and the desire for support. Multiple regression showed that the parental academic background and the existence of combined disabilities are the factors which influence significantly on the parental perceived stigma level. CONCLUSION: These results suggest that the parents of epileptic children who have low academic background and who care for the epilepsy-plus children may have more perceived stigma. These findings may help healthcare providers prepare for the epilepsy family programs in terms of relieving their social stigma.
Anticonvulsants ; Child* ; Chronic Disease ; Epilepsy ; Fathers ; Health Personnel ; Humans ; Parents* ; Surveys and Questionnaires ; Social Stigma ; Stereotyping ; Weights and Measures