Adult ; Follow-Up Studies ; Humans ; Malocclusion ; Molar ; Orthopedics ; Osteotomy ; Palatal Expansion Technique ; Recurrence

A 25-year-old woman complaining of dyspnea on exertion, coughing, fever and chills was admitted in January, 1998. Her clinical, radiological, and pathological findings were compatible with hypersensitivity pneumonitis and precipitin antibody to Trichosporon cutaneum was detected in her serum. Although some cases of T. cutaneum-induced hypersensitivity pneumonitis developed during the winter season were reported in Japan, there had been no report of such a case in Korea. This case suggests that T. cutaneum-induced hypersensitivity pneumonitis can develop beyond the summer season in certain environments.
Adult ; Alveolitis, Extrinsic Allergic* ; Chills ; Cough ; Dyspnea ; Female ; Fever ; Humans ; Hypersensitivity* ; Japan ; Korea ; Seasons ; Trichosporon*

BACKGROUNDS: The Third Report of the Adult Treatment Panel (NCEP-ATP III) has newly introduced the clinical diagnosis guideline of the metabolic syndrome which is characterized by clustering of the CHD risk factors. The purpose of this study was to estimate the prevalence of the metabolic syndrome in Korean adults by the newly introduced guideline and to evaluate possible risk factors with the syndrome. METHODS: The subject of this study included 3,873 adults (males 2,144, females 1,729) aged 20 years or older who visited the Health Promotion Center of SNUH. Among the subjects, we excluded those who did not have records of physical parameters, blood test results and who were on current medications except antihypertensives and oral hypoglycemic agents. We estimated the prevalence of the metabolic syndrome in Korean adults according to the ATP III waist-circumference guideline, Asia-Pacific waist- circumference, and Body Mass Index (BMI), respectively, and calculated the age-adjusted prevalence of the metabolic syndrome using the direct standardized method. While applying the Asia-Pacific waist circumference, we estimated the prevalence of the metabolic syndrome by age group and the prevalence of the individual abnormalities of the metabolic syndrome. To identify variables associated with the metabolic syndrome, we used the multiple logistic regression method to estimate the prevalence odds ratios for the metabolic syndrome vs. the non-metabolic syndrome. RESULTS: The age-adjusted prevalence of the metabolic syndrome in Korean adults was 9.3% when ATP III waist-circumference was applied, 15.4% for Asia-Pacific waist-circumference, and 18.6% for body mass index (BMI). The highest prevalence of the individual criteria among the metabolic syndrome diagnostic criteria in men was hypertension, followed by hypertriglyceridemia, abdominal obesity, high fasting blood glucose, and low HDL-cholesterolemia. And in women, it was also hypertension, followed by abdominal obesity, low HDL- cholesterolemia, hypertriglyceridemia, and high fasting blood glucose. The prevalence increased from 3.8% among participants aged 20 through 29 years to 27.1% for ages 60 through 69 years and 31.6% for ages above 70 years. Females, increasing age, increased BMI, current smoking, physical inactivity were higher risk factors for the metabolic syndrome, but mild drinking was a lower risk factor for the metabolic syndrome. CONCLUSION: These results show that the metabolic syndrome is highly prevalent although less prevalent than in American adults. The family physician should focus on the screening and comprehensive management of the metabolic syndrome.
Adenosine Triphosphate ; Adult ; Antihypertensive Agents ; Blood Glucose ; Body Mass Index ; Diagnosis ; Drinking ; Fasting ; Female ; Health Promotion ; Hematologic Tests ; Humans ; Hypertension ; Hypertriglyceridemia ; Hypoglycemic Agents ; Logistic Models ; Male ; Mass Screening ; Obesity, Abdominal ; Odds Ratio ; Physicians, Family ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Waist Circumference

No abstract available.
Classification* ; Wounds and Injuries* ; Wounds, Gunshot*

BACKGROUND: The aim of this study was to analyze the gender factors associated with good or bad prognosis after return of spontaneous circulation after out-of hospital cardiac arrest. METHODS: The patients admitted to the intensive care unit after successful resuscitation after out-of hospital cardiac arrest were retrospectively identified and evaluated. Thirty days mortality after admission, and neurologic outcome at 6 months after hospital discharge (cerebral performance category [CPC]) were evaluated. RESULTS: One hundred forty-two patients were evaluated in this study; there were 101 males (71.1%). The median age was 52 years old (43-63). Thirty days after admission, 85 patients (59.9%) survived, 40 patients had a good neurologic outcome (CPC 1-2). The factors associated 30 days mortality were cause of arrest (non-cardiac, p = 0.03), lactate in emergency department (p = 0.05) and the factors associated with good neurologic outcome were males (p = 0.007), young age (p = 0.01), body weight and height (p = 0.001), cause of death (cardiac, p = 0.000). Alcohols and smoking were not associated with mortality and neurologic outcome. In multiple logistic regression analysis, men had a 8-fold increased good neurologic outcome (CPC 1-2) (odds ratio [OR] 8.038, 95% Confidence Interval [CI] 1.079-59.903). Other factors associated with good neurologic outcome were cardiac cause of death (OR 5.523, 95% CI 1.562-19.533) and young age (OR 1.055, 95% CI 1.009-1.103). CONCLUSIONS: Men had a good neurologic outcome after return of spontaneous circulation after out-of hospital cardiac arrest in one emergency center. Other additional factors including gonadal hormones should be evaluated.
Alcohols ; Body Weight ; Cause of Death ; Emergencies ; Gonadal Hormones ; Heart Arrest ; Humans ; Intensive Care Units ; Lactic Acid ; Logistic Models ; Male ; Out-of-Hospital Cardiac Arrest ; Prognosis ; Resuscitation ; Retrospective Studies ; Smoke ; Smoking

PURPOSE: We aimed to assess whether nerve-sparing radical prostatectomy (nsRP) is associated with improved recovery of urinary continence compared to non-nerve-sparing radical prostatectomy (nnsRP) in patients with localized prostate cancer and preoperative erectile dysfunction. METHODS: A total of 360 patients with organ-confined prostate cancer and an International Index of Erectile Function score of less than 17 were treated with nsRP or nnsRP in Seoul St. Mary's Hospital. Patients who received neoadjuvant or adjuvant androgen deprivation therapy or had a history of prostate-related surgery were excluded. Recovery of urinary continence was assessed at 0, 1, 3, 6, and 12 months. Postoperative recovery of continence was defined as zero pad usage. The association between nerve-sparing status and urinary continence was assessed by using univariate and multivariate Cox regression analyses after controlling for known predictive factors. RESULTS: Urinary continence recovered in 279 patients (77.5%) within the mean follow-up period of 22.5 months (range, 6-123 months). Recovery of urinary continence was reported in 74.6% and 86.4% of patients after nnsRP and nsRP, respectively, at 12 months (P=0.022). All groups had comparable perioperative criteria and had no significant preoperative morbidities. Age, American Society of Anesthesiologists score, and nerve-sparing status were significantly associated with recovery of urinary continence on univariate analysis. On multivariate analysis, age (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.002-1.478; P=0.026) and nerve-sparing status (HR, 0.713; 95% CI, 0.548-0.929; P=0.012) were independently associated with recovery of urinary continence. CONCLUSIONS: nsRP, as compared to nnsRP, improves recovery rates of urinary incontinence and decreases surgical morbidity without compromising pathologic outcomes.
Erectile Dysfunction* ; Follow-Up Studies ; Humans ; Male ; Multivariate Analysis ; Prostatectomy* ; Prostatic Neoplasms ; Seoul ; Urinary Incontinence

BACKGROUND: Recently, a hemoglobin A1c (HbA1c) level of 6.5% has been determined to be a criterion for diabetes mellitus (DM), and it is a widely used marker for the diagnosis of DM. However, HbA1c may be influenced by a number of factors. Anemia is one of the most prevalent diseases with an influence on HbA1c; however, its effect on HbA1c varies based on the variable pathophysiology of anemia. The aim of this study was to determine the effect of anemia on HbA1c levels. METHODS: Anemic subjects (n=112) and age- and sex-matched controls (n=217) who were drug naive and suspected of having DM were enrolled. The subjects underwent an oral glucose tolerance test and HbA1c simultaneously. We compared mean HbA1c and its sensitivity and specificity for diagnosing DM between each subgroup. RESULTS: Clinical characteristics were found to be similar between each subgroup. Also, when glucose levels were within the normal range, the difference in mean HbA1c was not significant (P=0.580). However, when plasma glucose levels were above the diagnostic cutoff for prediabetes and DM, the mean HbA1c of the anemic subgroup was modestly higher than in the nonanemic group. The specificity of HbA1c for diagnosis of DM was significantly lower in the anemic subgroup (P<0.05). CONCLUSION: These results suggest that the diagnostic significance of HbA1c might be limited in anemic patients.
Anemia ; Blood Glucose ; Diabetes Mellitus* ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Humans ; Prediabetic State ; Reference Values ; Sensitivity and Specificity

BACKGROUND: Recently, a hemoglobin A1c (HbA1c) level of 6.5% has been determined to be a criterion for diabetes mellitus (DM), and it is a widely used marker for the diagnosis of DM. However, HbA1c may be influenced by a number of factors. Anemia is one of the most prevalent diseases with an influence on HbA1c; however, its effect on HbA1c varies based on the variable pathophysiology of anemia. The aim of this study was to determine the effect of anemia on HbA1c levels. METHODS: Anemic subjects (n=112) and age- and sex-matched controls (n=217) who were drug naive and suspected of having DM were enrolled. The subjects underwent an oral glucose tolerance test and HbA1c simultaneously. We compared mean HbA1c and its sensitivity and specificity for diagnosing DM between each subgroup. RESULTS: Clinical characteristics were found to be similar between each subgroup. Also, when glucose levels were within the normal range, the difference in mean HbA1c was not significant (P=0.580). However, when plasma glucose levels were above the diagnostic cutoff for prediabetes and DM, the mean HbA1c of the anemic subgroup was modestly higher than in the nonanemic group. The specificity of HbA1c for diagnosis of DM was significantly lower in the anemic subgroup (P<0.05). CONCLUSION: These results suggest that the diagnostic significance of HbA1c might be limited in anemic patients.
Anemia ; Blood Glucose ; Diabetes Mellitus* ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Humans ; Prediabetic State ; Reference Values ; Sensitivity and Specificity

BACKGROUND: The AdvanSure TB/NTM real-time PCR kit (AdvanSure) was newly developed in Korea to detect Mycobacterium tuberculosis and nontuberculous mycobacteria (NTM) utilizing a specific primer and TaqMan probe targeting the IS6110 and rpoB genes which are unique to these species. The purpose of the present study was to evaluate the clinical utility of AdvanSure by comparing the results of acid-fast staining, mycobacteria culture, COBAS Amplicor MTB PCR (Amplicor), and AdvanSure. METHODS: A total of 182 specimens (105 respiratory and 77 nonrespiratory specimens) were obtained from 165 patients, and acid fast bacilli (AFB) staining, mycobacteria culture, and Amplicor were performed on all specimens. AdvanSure was also performed on the above specimens using the SLAN real-time PCR detection system. The sensitivity and specificity of AdvanSure were analyzed using AFB staining and culture. RESULTS: Of the 182 specimens, M. tuberculosis was detected in 43 specimens and NTM was detected in 12 specimens according to PCR and/or culture. The sensitivity and specificity of the AdvanSure based on AFB culture were 97.3% (36/37) and 95.5% (127/133) in M. tuberculosis and 75.0% (9/12) and 100% (0/133) in NTM, respectively. CONCLUSION: AdvanSure could be useful for detecting M. tuberculosis and NTM in the clinical laboratory with high sensitivity and specificity.
Humans ; Korea ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Tuberculosis

Celiac disease is an intestinal autoimmune disorder, triggered by ingestion of a gluten-containing diet in genetically susceptible individuals. The genetic predisposition is related to human leukocyte antigen (HLA) class II genes, especially HLA-DQ2-positive patients. The prevalence of celiac disease has been estimated to be ~1% in Europe and the USA, but it is rarer and/or underdiagnosed in Asia. We report a case of celiac disease in a predisposed patient, with a HLA-DQ2 heterodimer, and Graves' disease that was treated successfully with a gluten-free diet. A 47-year-old woman complained of persistent chronic diarrhea and weight loss over a 9 month period. Results of all serological tests and stool exams were negative. However, the patient was found to carry the HLA DQ2 heterodimer. Symptoms improved after a gluten-free diet was initiated. The patient has been followed and has suffered no recurrence of symptoms while on the gluten-free diet. An overall diagnosis of celiac disease was made in a genetically predisposed patient (HLA-DQ2 heterodimer) with Graves' disease.
Asia ; Celiac Disease* ; Diagnosis ; Diarrhea ; Diet ; Diet, Gluten-Free ; Eating ; Europe ; Female ; Genes, MHC Class II ; Genetic Predisposition to Disease ; Graves Disease* ; Humans ; Leukocytes ; Middle Aged ; Prevalence ; Recurrence ; Serologic Tests ; Weight Loss