BACKGROUND: A predominant accumulation of adipose tissue in abdominal region confers increased risk of cardiovascular disease. The best technology available for measurement of regional fat distribution is computed tomography. However, computed tomography is limited its use for clinical purposes by cost. The aim of this study is to identify the best simple anthropometric index of abdominal visceral fat accumulation. METHODS: To quantify the relationship between anthropometric indices of abdominal obesity(waist circumference, waist to hip ratio, waist to height ratio, body mass index, abdominal sagittal diameter) and abdominal(total, visceral, subcutaneous) fat areas measured by computed tomography, correlation and multiple regression analyses have been conducted. RESULTS: No significant difference for waist circumference, body mass index and sagittal diameter between men and women have been found. Mean value of waist to hip ratio is larger in women, but waist to height ratio is larger in men. The mean abdominal total fat area and mean subcutaneous fat area are higher in women. Interestingly, men, despite lower total fat area, have higher mean abdominal visceral area. Thus, the mean visceral fat to subcutaneous fat ratio is much higher in men. Abdominal sagittal diameter shows the highest correlation(men: 0.69, women: 0.76) with abdominal visceral fat area in both genders. Stepwise regression analyses have been performed to determine the best simple anthropometric index of abdominal visceral fat accumulation. In men, the significant indices are abdominal sagittal diameter, body mass index, and waist to height ratio. In women, abdominal sagittal diameter is the only significant index. CONCLUSION: Abdominal sagittal diameter, in comparison with the waist circumference, waist to hip ratio, waist to height ratio and body mass index, is the best predictor of the amount of abdominal visceral fat.
Adipose Tissue ; Body Mass Index ; Cardiovascular Diseases ; Female ; Hip ; Humans ; Intra-Abdominal Fat* ; Male ; Obesity ; Subcutaneous Fat ; Waist Circumference ; Waist-Hip Ratio

OBJECTIVES: The protective effects of estrogen against the development of schizophrenia have been investigated in various perspectives. Previous studies showed patients with earlier age of menarche had later onset of schizophrenia and less frequent admissions. This study was performed to evaluate the effect of the age of menarche on subsequent courses including hospitalizations, suicidal attempts, physical harm to others, and psychotic symptoms in women with schizophrenia. METHODS: Self-report menarche age, onset of psychotic symptoms, and clinical status were collected in a sample of 108 premenopausal women with the diagnosis of schizophrenia. RESULTS: There was significant correlation between the age of menarche and the frequency of admissions (r=.321, p=.006). Also, patients with history of physical harms to others showed later age of menarche than those without (t=2.025, df= 106, p=.045). CONCLUSION: In women with schizophrenia, the age of onset of menarche affects subsequent courses indicated by frequency of admissions and violent behaviors. It is suggested that identifying the age of menarche might be helpful to predict the courses in women with schizophrenia. Further investigations regarding the relationship between estrogen and the courses of schizophrenia in women are needed.
Age of Onset ; Diagnosis ; Estrogens ; Female ; Hospitalization ; Humans ; Menarche* ; Schizophrenia*

OBJECTIVES: The protective effects of estrogen against the development of schizophrenia have been investigated in various perspectives. Previous studies showed patients with earlier age of menarche had later onset of schizophrenia and less frequent admissions. This study was performed to evaluate the effect of the age of menarche on subsequent courses including hospitalizations, suicidal attempts, physical harm to others, and psychotic symptoms in women with schizophrenia. METHODS: Self-report menarche age, onset of psychotic symptoms, and clinical status were collected in a sample of 108 premenopausal women with the diagnosis of schizophrenia. RESULTS: There was significant correlation between the age of menarche and the frequency of admissions (r=.321, p=.006). Also, patients with history of physical harms to others showed later age of menarche than those without (t=2.025, df= 106, p=.045). CONCLUSION: In women with schizophrenia, the age of onset of menarche affects subsequent courses indicated by frequency of admissions and violent behaviors. It is suggested that identifying the age of menarche might be helpful to predict the courses in women with schizophrenia. Further investigations regarding the relationship between estrogen and the courses of schizophrenia in women are needed.
Age of Onset ; Diagnosis ; Estrogens ; Female ; Hospitalization ; Humans ; Menarche* ; Schizophrenia*

BACKGROUND/AIMS: Although colonoscopy is not indicated in patients with hematochezia, many surgeons, internists, and physicians are recommending colonoscopy for these patients in Korea. The aim of this study is to evaluate the diagnostic value of colonoscopy for patients with hematochezia. METHODS: We retrospectively reviewed the data of colonoscopy between January 2010 and December 2010. A total of 321 patients among 3,038 colonoscopies (10.6%) underwent colonoscopy to evaluate the cause of hematochezia. The patients with previous colorectal surgery (2) or polypectomy (5) were excluded. We analyzed endoscopic diagnoses. Advanced neoplastic polyps were defined as adenomas with villous histology or high grade dysplasia, or adenomas more than 10 mm in diameter. RESULTS: Hemorrhoid was the most common diagnosis (217 cases, 67.6%). Polyps were detected in 93 patients (29.0%), but advanced neoplastic polyps were found in only 14 cases (4.4%). Colorectal cancers were diagnosed in 18 patients (5.6%) including 14 rectal cancers. There was no cancer located above sigmoid-descending junction. Diverticuli were detected in 41 patients (12.8%) but there was only one case of suspected diverticular bleeding. Colitis was diagnosed in 24 patients (7.5%). Other lesions included acute anal fissure, rectal tumor, stercoral ulcer, and radiation proctitis. CONCLUSIONS: The colonoscopy had little value in patients with hematochezia because the most pathologic lesions were located below sigmoid colon. The first choice of diagnosis in patients with hematochezia is sigmoidoscopy.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Colitis/complications/diagnosis ; Colonic Neoplasms/complications/diagnosis ; Colonic Polyps ; *Colonoscopy ; Colorectal Neoplasms/complications/diagnosis ; Female ; Gastrointestinal Hemorrhage/diagnosis/*etiology ; Hemorrhoids/complications/diagnosis ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Porcelain gallbladder is characterized by extensive deposition of calcium in the wall of the gallbladder. It is commonly associated with gallbladder cancer, but it has been rarely reported in Korea. Porcelain gallbladder is regarded as a precancerous lesion and prophylactic cholecystectomy is the treatment of choice. We report here a case of a patient with porcelain gallbladder. This case showed the typical radiologic and pathologic findings of this disease. The patient was treated by laparoscopic cholecystectomy.
Calcium ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Dental Porcelain* ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Korea

PURPOSE: Early detection and treatment of cancer is a primary focus of health care. Many serum markers are available for breast cancer, but are not good enough for screening. Cancer antigen CA 15-3 is the most widely used biomarker for breast cancer. However, CA 15-3 has low sensitivity and specificity. This study was performed to analyze the serum proteomic pattern in breast cancer patients by surface-enhanced laser desoption/ionization time- of-flight (SELDI-TOF). METHODS: We screened for potential tumor biomarkers in 42 serum samples, including samples from a group of 23 breast cancer patients at different clinical stages [stage I (n=3), stage II (n=11), stage III (n=6), and stage IV (n=1)], and a control group of 19 healthy women. Diluted serum samples were applied to a C16 hydrophobic interaction chip (H4). Complex protein profiles of different groups were compared and analyzed using the Protein Chip software 2.1 (Ciphergen Biosystems). RESULTS: There were 7 significant protein peaks in the breast cancer group and 5 in the control group. Scoring the expression of each peak, the mean score was 8.5 in the cancer group and 3.5 in the control. The results of the combination of each peak were highly sensitive (91.2%) and specific (94.7%). These proteomic patterns did not correlate with tumor stage and hormonal receptor, c-erb B2. CONCLUSION: In this preliminary report, we identified protein profiles that were differentiated in breast cancer patients. After proper validation, serum proteomic pattern analysis may ultimately be applied in screening breast cancer as a stand-alone or combined with current options.
Biomarkers ; Breast Neoplasms* ; Breast* ; Delivery of Health Care ; Female ; Humans ; Hydrophobic and Hydrophilic Interactions ; Mass Screening ; Protein Array Analysis ; Proteomics ; Sensitivity and Specificity

PURPOSE: To evaluate the changes of anterior chamber parameters and intraocular pressure (IOP) with Pentacam(R) after intravitreal injection. METHODS: A total of 76 eyes of 76 patients received an intravitreal injection of either triamcinolone acetonide (TA) or bevacizumab. Twelve patients were treated with an intravitreal injection of TA 0.1 ml, 16 patients were treated with an intravitreal injection of TA 0.05 ml, while the remaining 48 patients received a bevacizumab 0.05 ml injection. All patients underwent anterior chamber depth, anterior chamber angle, and anterior chamber volume evaluation with Pentacam(R) before and 5 minutes after injection. Additionally, IOP measurements were taken 5 minutes before and 5 minutes, 30 minutes, 1 hour and 1 day after injection. RESULTS: Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving TA 0.1 ml were 0.4 +/- 0.11 mm, 10.2 +/- 4.1degrees, 33.7 +/- 5.9 mm3 and 18.8 +/- 12.1 mm Hg, respectively. Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving TA 0.05 ml were -0.01 +/- 0.05 mm, 2.4 +/- 3.2degrees, 5.8 +/- 9.5 mm3 and 4.8 +/- 7.4 mm Hg, respectively. Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving bevacizumab were 0.28 +/- 0.99 mm, 0.8 +/- 4.0degrees, 7.1 +/- 9.6 mm3 and 5.4 +/- 6.3 mm Hg, respectively. There was a significant difference between TA 0.1 ml and 0.05 ml. However, there was no significant difference between TA 0.05 ml and bevacizumab 0.05 ml. CONCLUSIONS: Because of similar anterior chamber parameters changes after 0.05 ml intravitreal injection with TA or bevacizumab, early period IOP increases due to intravitreal volume expansion. Intravitreal 0.05 ml injections do not require any other procedures for controlling IOP 30 minutes after injection.
Anterior Chamber* ; Humans ; Intraocular Pressure ; Intravitreal Injections* ; Triamcinolone Acetonide ; Bevacizumab

BACKGROUND: Symptoms of musculoskeletal system is a common problem, followed by those of respiratory system. Most patients with problems of musculoskeletal system are examined and treated by a primary doctor. This research was performed to inquire into a method which can increase the effectiveness and the precision of history taking in patients with problems of musculoskeletal system in primary care and also to assess a self-marking method where patients can mark their pain site on a normalized picture. METHODS: In the department of family medicine and rehabilitation of an university hospital in Seoul, 44 patients with musculoskeletal pain on their first visit in an outpatient clinic were asked to put marks on a normalized picture and also mark the degree of pain with a visual analog scale from 0 to 10, before history taking. After history taking, the doctor also marked the spot of the patient's pain on the normalized picture and then compared the spots together. After comparing the two pictures of the doctor's and the patients', they then drew another picture with only one spot to avoid overlapping spots. We compared the differences among the patients in every decade from ages 20 to 60 and divided the value of visual analog scale into 3 groups concerning the spots drawn by patients, and compared the relations between them. RESULTS: The pain spots drawn by doctor only were on the lumbar spine and the shoulder whereas most of pain spots drawn by patients only were on the upper back, the cervical spine, and the lumbar spine. The older the patient and the lower the degree of pain was, the more humerous it had spots. CONCLUSIONS: It is considered that with a general history taking method and a self-marking method, clinical effectiveness will be great to the patients having pain on the abdomen, the cervical spine, and the lumbar spine and to those who are elderly and with lower pain spots.
Abdomen ; Aged ; Ambulatory Care Facilities* ; Humans ; Musculoskeletal Pain* ; Musculoskeletal System ; Outpatients* ; Primary Health Care ; Rehabilitation ; Respiratory System ; Seoul ; Shoulder ; Spine ; Visual Analog Scale

OBJECTIVE: To evaluate the clinical significance of fetal choroid plexus cysts (CPCs) in the second trimester, especially an association with trisomy 18. METHODS: From March 1998 through June 1999, second trimester screening ultrasonography was performed on 4,948 unselected single-ton pregnancies. CPCs were noted in 132 fetuses. Among them, detailed ultrasonography and follow-up was possible in 119 cases and they were recruited into the study. There were 91 cases of isolated CPCs and 28 cases of CPCs in high-risk population. "Isolated CPCs" were defined as: mother did not have any risk factors requiring amniocentesis and there were no other sonographic abnormalities on detailed ultrasound. "CPCs in high-risk population" were defined as: mother had any risk factor requiring karyotyping or there were any other sonographic abnormalities although she was general population. Amniocentesis was performed in 39 cases. We compared gestational age at time of detection, size, bilaterally, multiplicity, and complexity of CPCs in the group of isolated CPCs and CPCs in high-risk population (t-test, chi-square test; P<0.05). We evaluated the findings of detailed and follow-up ultrasonography, karyotypes, and final outcomes of pregnancy. RESULTS: Gestational age at time of detection was not different in both groups of isolated CPCs and CPCs in high-risk population (19+/-2 vs 18+/-1 wk, p>0.05). Mean size (6.4 vs 6.2 mm), bilaterality (60% vs 57%), multiplicity (66% vs 57%), and complexity (8% vs 14%) of CPCs were also similar. All CPCs were disappeared irrespective of size and mean time of disappearance was 25+/-3 and 26+/-3 week, respectively (p>0.05). All cases of isolated CPCs resulted in phenotypically-normal neonates. It was confirmed by either amniocentesis or postnatal examination by the pediatrician. Among fetuses having CPCs in high-risk population, two trisomy 18 and one trisomy 21 were detected. All of them had positive result of maternal serum marker test and/or sonographic abnormalities. Remaining cases were proved normal. CONCLUSION: The risk of chromosome abnormalities is very high when CPCs are associated with other abnormalities on detailed ultrasound, indicating a clear need to offering genetic amniocentesis. As contrast, the risk of chromosome abnormalities for a case of isolated CPCs is very low, and in this series there was no trisomy 18. Therefore isolated CPCs should be considered as the indication of detailed ultrasound examination, but not routine karyotyping.
Amniocentesis ; Biomarkers ; Choroid Plexus* ; Choroid* ; Chromosome Aberrations ; Down Syndrome ; Female ; Fetus ; Follow-Up Studies* ; Gestational Age ; Humans ; Infant, Newborn ; Karyotype ; Karyotyping ; Mass Screening ; Mothers ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Risk Factors ; Trisomy* ; Ultrasonography

PURPOSE: To investigate the causes and to determine the most useful test for the early diagnosis of infected TKRA, and to present the treatment modality and its possible complications. MATERIALS AND METHODS: We reviewed 17 cases, with follow up, among the 18 infected TKRA cases registered from March 1992 to June 2000. Diagnosis of deep infection after TKRA was made by assessing clinical symptoms, laboratory and radiological findings, nuclear scan studies and aspirate culture results. Data were analyzed clinically by HSS score, recurrence of infection and postoperative complications. RESULTS: The overall incidence of deep infection after TKRA was 1.4%. In fourteen of the 17 cases TKRA was revised. In 13 cases, excluding 1 case of infection recurrence after 2-stage TKRA revision, the mean ROM increased from 55o to 86o and the mean HSS score increased from 53 points to 84. Knee fusion was performed in 4 cases, including one case of infection recurrence after 2-stage TKRA revision. CONCLUSION: The most reliable clinical results were achieved after a 2-stage TKRA revision. Knee joint fusion should be considered when the general condition is poor, with an initial diagnosis of infection, and in the presence of skin problems.
Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Incidence ; Knee ; Knee Joint ; Postoperative Complications ; Recurrence ; Skin