Coarctation and occlusion of the aorta is a rare condition that typically presents with hypertension or cardiac failure. However, neuropathy or myelopathy may be the presenting features of the condition when an intraspinal subarachnoid hemorrhage has compressed the spinal cord causing ischemia. We report two cases of middle-aged males who developed acute non-traumatic paraplegia. Undiagnosed congenital abnormalities, such as aortic coarctation and occlusion, should be considered for patients presenting with nontraumatic paraplegia in the absence of other identifiable causes. Our cases suggest that spinal cord ischemia resulting from acute spinal subarachnoid hemorrhage and can cause paraplegia, and that clinicians must carefully examine patients presenting with nontraumatic paraplegia because misdiagnosis can delay initiation of the appropriate treatment.
Aorta ; Aortic Coarctation* ; Congenital Abnormalities ; Diagnostic Errors ; Heart Failure ; Humans ; Hypertension ; Ischemia ; Male ; Paraplegia* ; Spinal Cord ; Spinal Cord Diseases ; Spinal Cord Ischemia ; Subarachnoid Hemorrhage

BACKGROUND: It has been found that parental role is essential for obesity management in childhood. However, there are few studies concerning parental perception on childhood obesity in Korea. Parental perception on childhood obesity according to weight status in elementary school children was examined. METHODS: The subjects were 3,996 elementary school children and their parents in Busan. The surveys which included socioeconomic characteristics, children's eating habits and activities, parental weight and height, parental perception on childhood obesity, were filled out by parents. Children's body mass index (BMI) were calculated using the height and weight measured in school children were classified into the obese group (BMI 95 Percentile) , the high risk group (85 percentile BMI <95 percentile) and the normal weight group (85 percentile) according to BMI gender and age. The analyses were done using x2_ test and ANOVA. RESULTS: Parental BMI in the obese group was higher than the normal weight group in boys a girls (P<0.001) . Participation in regular exercise was higher among the obese group compared to the normal weight group regardless of sex, but daily exercise time was lesser among the obese group only in boys (P <0.001) . Daily TV watching time was not different according to weight status in both sex. The parents with obese children perceived their children's weight as an appearance problem or a health problem about 7-18 times more likely than the parents of children with normal weight. 70% of obese children have tried weight control. The proportion of parental understanding on childhood obesity as a disease was not different among boys, but different among girls (P<0.001) . Eighty five percents of the parents perceived childhood obesity as a disease or a risk factor. But, their perception for the association of hypertension, fatty liver, sleep apnea syndrome with obesity was relative low. CONCLUSION: Most parents with obese children perceived childhood obesity as an appearance problem, a health problem and as a disease or a risk factor.
Body Mass Index ; Busan* ; Child* ; Eating ; Fatty Liver ; Female ; Humans ; Hypertension ; Korea ; Obesity ; Parents* ; Pediatric Obesity* ; Risk Factors ; Sleep Apnea Syndromes

PURPOSE: Low-birth-weight(LBW) neonates often need multiple transfusions during their neonatal period. The routine use of the 500ml mono-bag system in Korea, even in neonatal transfusions, results in a great waste of blood and exposes the neonate to multiple blood donors. To reduce the waste of blood and the number of exposures, we used quadruple blood bags in the transfusion of LBW neonates. METHODS: From November 1995 to April 1997, 86 neonates weighing less than 2,000gm were enrolled in this study. Forty-four of those neonates needed blood transfusions. Using quadruple blood bags, we were able to safely make 3 units of packed red blood cell(RBC) from each directed donors. RESULTS: Seventy-seven units of packed RBC could be made from 29 directed donors and 58 of those units were actually transfused to the 25 neonates. Blood age of the directed donor blood prepared in the quadruple blood bags were relatively older than those of bank bloods at the time of transfusion, thus, K+ concentration was higher but the total K+ amounts infused through transfusions were within tolerable ranges in both groups. CONCLUSION: Using quadruple blood bag in the transfusion of LBW neonates, we could reduce the number of donor exposures and also the waste of blood. K+ loads to the neonates through the transfusion of directed donor blood were within tolerable range in the neonatal physiology.
Blood Donors ; Blood Transfusion ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Newborn* ; Korea ; Physiology ; Tissue Donors

To more fully define the nature of the antibody response to melanocytes which is associated with vitiligo, a Western immunoblot assay was used to test the sera of 28 patients with vitiligo (21 with active non-segmental, and 7 with stable segmental diseases) and 26 normal individuals for antibodies to antigens in detergent extracts of melanocyte membrane fractions. Antibodies to melanocytes were found in 26 (93%) of the patients with vitiligo, and in 16 (62%) of the control individuals. Patients with vitiligo and control individuals both had antibodies to an 80 approximately 83 kD antigen. The patient with vitiligo, in addition, had antibody responses to antigens with MWs of 45, 65, and 110 kD. Antibodies to these antigens were present in 46, 25, and 31% of vitiligo patients, but in only 19%. 0%, amd 0%, respectively, of the normal individuals. The heterogeneity of the antibody responses to melanocytes in vitiligo was further confirmed by the presence of antibodies to at least 3 distinct antigens in one-third of vitiligo patients but in none of the normal individuals. There was no difference in antibody response between patients with generalized and segmental vitiligo, suggesting that the pathogenesis of diseases was similar in both cases.
Antibodies/*analysis ; Antigens/immunology ; Blotting, Western ; Human ; Melanocytes/*immunology ; Reference Values ; Support, Non-U.S. Gov't ; Vitiligo/*immunology/*pathology

OBJECTIVE: This study was designed to evaluate the effect of the introduction of picture archiving and communication system(PACS) by identifying the change of the interpretation rates of radiologic examinations. METHODS: The data about total of 297,314 radiologic examinations done from June, 2001 to June 2002 was collected through medical record. December, 2001 which was the month of PACS introduction was excluded from the analysis for controlling the bias. Data concerning the time spent on interpretation, types of patients, clinical departments and types of radiologic examinations were collected. Chi-square test was performed to evaluate differences before and after introduction of PACS. RESULTS: 1. The interpretation rates of total radiologic examinations significantly increased after the introduction of PACS. The interpretation rate within 1 day increased 2.3 times higher after the introduction of PACS. 2. Both of the interpretation rates of radiologic examinations for outpatients and inpatients were significantly increased after the introduction of PACS. The interpretation rate within 1 day of radiologic examinations among outpatients increased 2.1 times higher and that among inpatients increased 3 times higher after the introducton of PACS. CONCLUSION: There was overall increase of interpretation rate suggesting the improvement of performance in department of radiology. This indicated that introduction of PACS brought about a positive impact on medical service quality through improving operational efficiency.
Bias (Epidemiology) ; Humans ; Inpatients ; Medical Records ; Outpatients

BACKGROUND: The purpose of this study was to assess the lifestyle associated with weight gain and persistent overweight for 2 years. METHODS: The subjects were 580 workers (109 men, 471 women) at one university affiliated hospital. Their height and weight were measured twice in 2000 and 2002. A questionnaire, about lifestyle was filled out in 2000. The questionnaire included the average amount of alcohol intake and the number of days per week in which alcohol was consumed, smoking status, and the number of days per week in which exercise was done. Their weight change in 2 years was calculated and their weight status was classified into two groups: persistent normal weight (BMI <23 kg/m2) and persistent overweight (BMI> or =23 kg/m2). RESULTS: Among the total, 54.3% of men and 10.0% of women had persistent overweight over 2 years. Overall 93.4% of overweight men and 68.7% of overweight women remained overweight after 2 years. Compared with male non-smokers and male ex- smokers, current male smokers gained weight as much as 1.17 kg over 2 years after adjusting for age and initial BMI (P=0.033). Compared with females who exercised less than 3 per week, those who exercised 3 or more per week lost weight as much as 1.21 kg over 2 years after adjusting for age and initial BMI (P=0.005). Compared with males who consumed alcohol an average of< or =30 g per consumption, those who consumed an average of > 30 g were 4.1 times (95% C.I. 1.04~16.21) more likely to maintain persistent overweight over 2 years after adjustment for age and frequency of alcohol use. However no particular lifestyle was shown to predict the risk of persistent overweight for women. CONCLUSION: Regular exercise of moderate intensity and modest alcohol consumption seemed to prevent weight gain and persistent overweight. Such lifestyle may be encouraged to maintain healthy weight.
Alcohol Drinking ; Female ; Follow-Up Studies ; Humans ; Life Style* ; Male ; Overweight* ; Smoke ; Smoking ; Weight Gain*

BACKGROUND: There has been no general agreement on classifying basal cell carcinoma (BCC), and little is known about the squamous cell differentiations of each subtype of BCC. BCC is a locally-invasive tumor, but its aggressive forms tend to recur and metastasize. OBJECTIVE: We have compared the histolopathological subtypes of BCC by squamous differentiation, with special emphasis on basosquamous carcinoma and the difference between the non- aggressive and aggressive forms of BCC. MATERIALS AND METHOD: A total of 87 BCC specimens were collected from the 7 branch hospitals of The Catholic University of Korea from July 1997 to June 2003. RESULTS: 1. The 87 samples were divided into 6 subtypes: 18 nodular, 19 nodular infiltrative, 12 micronodular, 14 infiltrative, 11 morpheaform, 13 basosquamous. Overall, 18 samples were classified as non- aggressive and the remaining 69 as aggressive. 2.In nodular-infiltrative BCC and basosquamous carcinoma, squamous cell differentiation was significantly more prominent than in the nodular BCC. CONCLUSION: Squamous cell differentiation should be considered as one of the aggressive markers, especially in nodule-forming BCC.
Carcinoma, Basal Cell* ; Carcinoma, Basosquamous ; Cell Differentiation* ; Hospitals, Satellite ; Korea

OBJECTIVE: Human leukocyte antigen-G (HLA-G) is a nonclassical major histocompatibility complex (MHC) molecule with highly limited tissue distribution that has been proposed to protect tumor cells from natural killer cell lysis. To delineate the potential role of HLA-G in ovarian cancer, we investigated expression patterns of this molecule in human ovarian cancer cell lines and tissues. METHODS: HLA-G expression was determined both at RNA level by reverse transcriptase-polymerase chain reaction (RT-PCR) and protein level by Western blotting and immunohistochemistry using monoclonal antibody against denatured heavy chain of HLA-G, MEM-G1, in 13 ovarian cancer patient tissues and 6 ovarian cancer cell lines (OVCAR-3, SKOV-3, ES-2, PA-1, TOV-112D, TOV-21G). RESULTS: We found mRNA transcripts of different HLA-G isoforms in five of 6 ovarian cancer cell lines (OVCAR-3, SKOV-3, ES-2, TOV-112D, TOV-21G). HLA-G protein was also detected in 5 cell lines that exhibited expression of HLA-G mRNA transcripts. Immunohistochemical analysis of human ovarian cancers revealed expression of HLA-G in eight of 13 tissue samples. CONCLUSION: Our results provide additional clues as to how a tumor can be selected in vitro and in vivo to escape from cytotoxic anti-tumor responses. We suggest that the aberrant expression of HLA-G may contribute to immune escape in human ovarian cancer.
Blotting, Western ; Cell Line ; HLA-G Antigens ; Humans* ; Immunohistochemistry ; Killer Cells, Natural ; Leukocytes* ; Major Histocompatibility Complex ; Ovarian Neoplasms* ; Protein Isoforms ; RNA ; RNA, Messenger ; Tissue Distribution ; United Nations

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare neoplasm known by a variety of names including melanotic progonoma and retinal anlage tumor, and currently thought to be neural crest derivation. The vast majority develop within the first year of life. The behavior is generally benign, but recurrent and metastatic cases have been documented. It arises in the head and neck in over 90%, mainly in the maxilla, but is extremely rare in the epididymis. We report a case of MNTI together with a review of literature, which occurred in the right epididymis of a 6-month-old boy who presented with a painless, slowly growing, scrotal mass and was treated with radical orchiectomy.
Epididymis* ; Head ; Humans ; Infant ; Male ; Maxilla ; Neck ; Neural Crest ; Neuroectodermal Tumor, Melanotic* ; Orchiectomy

BACKGROUND: Brief intervention with problem drinkers have been shown to be effective, but physicians often do not ask about alcohol use because of time constraints and lack of knowledge. If a sin gle question can be used to screening for problem drinker effectively, primary care physicians could detect problem drinker earlier and reduce future complication and morbidity. The purpose of this study was to evaluate the usefulness of single question. METHODS: One family medicine's resident interviewed 163 patients who visited Dongdaemun Hospital's Health care management center of Ewha Woman's university from January 27th 1999 to February 26th 1999, and the patients answered the written forms of questionnares. This written forms contained the followings: (1) age, sex, education, income level, occupation, smoking, drunken driving, (2) "On any single occasion during the past 3 months have you had more than a bottle of Soju or three bottles of beer or five glasses of whisky?" (3) CAGE, NAST test. Quantity of alcohol was determined by the calendar based review in the past 4 weeks. At risk drinker defined as drinking more than 56 g on one occasion, or more than 196 g of pure alcohol during a week for men ; more than 42 g on one occasion, or more than 98 g of pure alcohol during a week for women. Also alcohol use disorder was defined by the DSM IV criteria and problem drinker was defined as either at risk drinker or a alcohol use disorder. RESULTS: The single question had a positive predictive value of 82.2%, and negative predictive value of 95.5% with a sensitivity of 93.8% and a specificity of 86.9% for problem drinkers. CONCLUSION: A single question about alcohol use would be a effective tool for detecting problem drinker.
Beer ; Delivery of Health Care ; Drinking ; Education ; Eyeglasses ; Female ; Glass ; Humans ; Male ; Mass Screening ; Occupations ; Physicians, Primary Care ; Sensitivity and Specificity ; Smoke ; Smoking