No abstract available.
Bronchopulmonary Sequestration*

The present survey was undertaken to observe the geographical distribution of metacercaria among the sweetfish, Plecoglossus altivelis, the most important second intermediate host of Metagonimus yokogawai, which were collected during the period from 1983 to 1984 in south-eastern coastal areas of Korea. The results obtained were summarized as follows: A total of 668 sweetfish collected from 70 chons (=streams) in the above coasta1 areas was examined for the metacercariae, and 432(64.7 percent) among them were infected with metacercariae of M. yokogawai. The mean number of metacercariae in a fish was in the range from 0 to 29,604 and the mean number of the metacercariae in a fish was 640.3. It was observed that the mean infection rate showed 46.4 percent in Gangweon-Do (=province). The infection rates varied from stream to stream showing 100 percent in Namdae stream(Gangnun-city), Obsib-stream(Samchok-gun) and Dongmak, 95.0 percent in Hosan stream, 90.0 percent in Gungchon stream, and Namdae stream (Yangyang-up), 80.0 percent in Hwasang stream, 50.0 percent in Daebong stream, 45.0 percent in Yonghwa stream, 30.0 percent in Sangchon stream and Sachon stream, 20.0 percent in Munam stream and Okgyoe stream, 15.0 percent in Imweon stream, 10.0 percent in Namchon stream. And no metacercarial infections in their fish host were found in the areas of Mulchi stream, Sangun stream, Gosamun stream, Jonchon stream snd Gagok stream. It was observed that the mean infection rate showed 50.9 percent in Kyongsangbuk-Do(=province). The infection rates also varied from stream to stream showing 100 percent in Songchon stream, Osib stream (Yongdok-gun) and Daejong stream, 60.0 percent in Pyonghae stream snd Gunmu stream, 50.0 percent in Buhwung stream, 25.0 percent in Nagok stream, 20.0 percent in Oangbi stream, 10.0 percent in Namhodong stream. And no metacercarial infections in their fish host were found in the areas of Namdae stream (Uljinup) and Choksan stream. It was observed that the mean infection rate showed 67.6 percent in Kyongsangnam-Do(=province). The infection rates varied from stream to stream showing 100 percent in Taehwa river, Hwiya river, Inchon stream, Miryang river, Nam river, Hwagae stream, Koha stream, Sosang stream, and Tongchon stream, 90.9 percent in Yoncho stream, 90.0 percent in Hoihwa stream, 80.0 percent in Chindong stream, 66.7 percent in Chingyo stream, 40.0 percent in Hoyam river. And no metacercarial infections in their fish host were found in the areas of Chinjon stream, Sanchon stream and Jukchon stream. It was observed that the mean infection rate showed 94.6 percent in Chollanam-Do(=province). The infection rates varied from stream to stream showing 100 percent in Dongchon stream, Isachon stream, Somjin river (Goksong-gun), Somjin river (Kurye-gun), Sosi stream, Gokchon stream, Kohung stream, Kwansan stream, Youi stream, Unjon stream and Apnae stream, 92.3 percent in Tamjin river, 90.9 percent in Okkok stream, 84.6 percent in Songgun stream. And no metacercarial infections in their fish host were found in the area of Yongok stream. On the other hand, the infection rate showed 100 percent in Inchon river of Chollabuk-Do (=province) and Kangon stream of Cheju-Do (=province).
parasitology-helminth-trematoda ; Metagonimus yokogawai ; epidemiology ; Plecoglossus altivelis

Background: Little is known regarding the effects of continuous positive airway pressure (CPAP) on sleep misperception in obstructive sleep apnea (OSA). Methods: Sleep state perception was measured by subtracting the objective total sleep time from the subjective sleep duration. Sleep underestimation and overestimation were defined as ± 60 minutes sleep perception. Insomnia and depressive symptoms were assessed using questionnaires. Finally, nonparametric statistical analyses were performed. Results: Of the 339 patients with OSA included in the study, 90 (26.5%) and 45 (13.3%) showed sleep underestimation and overestimation, respectively. Overall, a significant underestimation of sleep was noted during CPAP titration comparing to a diagnostic PSG (P < 0.001). OSA patients with insomnia or depressive symptoms did not show any changes in sleep perception between diagnostic and CPAP titration studies, whereas those without insomnia or depressed mood showed significantly underestimated sleep duration during CPAP titration. Patients with OSA and either underestimated or overestimated misperception showed perceptual improvements during CPAP titration regardless of the presence of insomnia or depressive symptoms. However, of 204 patients with normal sleep perception, 138 (67.6%) and 10 (4.9%) had underestimation and overestimation of sleep during CPAP titration. Conclusion CPAP titration may improve sleep perception with moderate to severe OSA who have sleep misperception. However, CPAP titration may result in sleep misperception especially underestimation of sleep in those who have normal sleep perception.

BACKGROUND/AIMS: The c-met proto-oncogene encodes the tyrosine kinase receptor for hepatocyte growth factor (HGF), a potent mitogen and motogen for epithelial cells. Because of its profound effects on cell growth and motility, HGF may be important in the development of cancer metastases in hepatocellular carcinoma (HCC). We examined the expression of the c-met proto-oncogene product (c-Met) in the patients with HCCs to determine the relationship between the level of expression of c-Met and clinicopathological features, and patient outcome following hepatectomy. METHODS: Fifty patients with surgically resected hepatocellular carcinoma at Seoul National University Hospital from January 1997 to December 1998 were included in this study. Western blotting was used to examine the c-Met expression of tumor and surrounding tissues. The clinicopathologic features and treatment results of the patients were analyzed by medical records. Patients were divided into two groups, low c-met HCC and high c-met HCC. RESULTS: c-Met was not overexpressed in HCC compared to surrounding tissue. The expression of c- Met in tumor tissue was correlated with well-differentiated HCCs, and adversely correlated with tumor necrosis by transcatheter arterial chemoembolization (TACE). There was no correlation between c-Met expression and intrahepatic recurrence. CONCLUSION: In conclusion, these results indicate that c-Met expression in HCC is not correlated with intrahepatic recurrence, and tumor necrosis by TACE reduces c-Met expression in tumor tissue. More large-scaled study is needed for exact relation between c-Met expression and clinicopathologic features of HCCs.
Blotting, Western ; Carcinoma, Hepatocellular* ; Epithelial Cells ; Hepatectomy ; Hepatocyte Growth Factor ; Humans ; Medical Records ; Necrosis ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Recurrence ; Seoul

OBJECTIVES: This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. METHODS: The Health Insurance Review and Assessment Service data in 2014–2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. RESULTS: It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. CONCLUSIONS: It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.
Comorbidity ; Data Accuracy ; Delivery of Health Care ; Humans ; Insurance, Health ; Prevalence ; Schizophrenia

PURPOSE: We developed an objective structured oral examination (OSOE) case to assess the medical ethics of students. The aim of this study was to assess the reliability of OSOE with generalizability theory. METHODS: One 10-minute OSOE that contained key questions was developed. The evaluation sheet consisted of 4 domains: moral sensitivity, moral reasoning, decision making, and attitude. The total number of items was 13. The numbers of checklist items and global rating items were 11 and 2, respectively. Items and key questions were validated by 6 professionals. Standardization of the raters and the pilot study was performed before the OSOE. Fifty-four third-year medical students participated in the OSOE. The OSOE was duplicated, and 2 professors assessed 1 student independently. Each station lasted 8 minutes and was followed by a 2-minute interval,during which raters completed the checklist forms. We analyzed the reliability of the OSOE with the GENOVA program. RESULTS: The reliability (generalizability coefficient) was 0.945, and the interrater agreement was 0.867. The type of item, checklist or global rating, was the largest variance component. The reliability of the checklist alone was 0.668 and that of the global rating alone was 0.363. CONCLUSION: The OSOE is reliable and can be used to assess ethics. More research should focus on achieving validity.
Checklist ; Clinical Competence ; Decision Making ; Diagnosis, Oral ; Educational Measurement ; Ethics, Medical ; Humans ; Mental Competency ; Pilot Projects ; Statistics as Topic ; Students, Medical

Background: and Purpose To identify sex differences in daytime sleepiness associated with apnea severity and periodic limb movements during sleep (PLMS) in subjects with obstructive sleep apnea (OSA). Methods: This study used the Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Sleep Hygiene Index (SHI) in logistic regression analyses with interaction terms. Severe OSA, excessive daytime sleepiness (EDS), and PLMS were defined as an apnea-hypopnea index of ≥30, an ESS score of ≥11, and a periodic limb movements index of >15, respectively. Results: The 1,624 subjects with OSA (males, 79.1%) comprised 45.3%, 38.2%, and 16.4% with severe OSA, EDS, and PLMS, respectively. Multiple logistic regression without interaction terms showed that sex, severe OSA, and PLMS were not significantly associated with EDS. However, significant interactions were noted between sex and severe OSA and PLMS in EDS in both crude and adjusted models (all p values<0.05). In the adjusted model, severe OSA was associated with EDS in males (p=0.009) but not in females. PLMS were more likely to be associated with EDS in females (p=0.013), whereas PLMS were less likely to be associated with EDS in males (p=0.041). The models were adjusted by the BDI score, SHI, and presence of medical comorbidities. Conclusions There are significant sex differences in subjective daytime sleepiness in subjects with severe OSA and PLMS. Severe OSA and PLMS may influence daytime sleepiness more in males and females, respectively.

Biloma is defined as an extraductular collection of bile within a defined capsular space. Biloma usually occurs secondary to traumatic or iatrogenic injury including abdominal surgery, percutaneous catheter drainage, and transhepatic cholangiography. The diagnostic methods include clinical history and physical examination, abdominal ultrasound, abdominal CT scan, hepatobiliary scintigraphy, endoscopic cholangiography and percutaneous aspiration, Though definite treatment by percutaneous radiographic catheter drainage and endoscopic drainage with sphincterotomy are now feasible in many instances, surgical drainage is often needed. We report a case of posttraurnatic biloma which was developed after car accident. Liver scan and endoscopic cholangiography showed typical features of biloma in this patient.
Bile ; Catheters ; Cholangiography ; Drainage ; Humans ; Liver ; Physical Examination ; Radionuclide Imaging ; Tomography, X-Ray Computed ; Ultrasonography

Hemobilia is a hemorrhage into the biliary tract that may follow trauma (including surgical and percutaneous techniques in hepatobiliary system), aneurysms of the hepatic artery (and its branch), tumors of the biliary tract, hepatoma, inflammation, liver abscess, and gallstone disease. But, a case has not been reported involving of hemobilia associated with gallbladder hemorrhage without obvious predisposing factors or causes. A 62-year-old woman was admitted to Kyunghee Medical Center due to intermittent nausea, and right upper quadrant pain for 2 days before admission. She had no history of abdominal trauma. On the second and third day of her stay, she experienced melena of which the amount was about 300 ml. Abdominal ultrasonography revealed a gallbladder with a 8 mm sized cystic lesion attached to the fundus. Computed tomographic (CT) evaluation of the abdomen demonstrated a highly enhanced 7~8 mm sized nodular mass in the lumen of the gallbladder. The gallbladder, cystic duct, and CBD were dilated due to the filling of blood clots or sludge material. An ERCP was performed and bleeding from the papilla of Vater was confirmed. Subsequently, emergent laparoscopic cholecystectomy was conducted. Pathologic evaluation revealed a grayish-red gallbladder that had a ruptured vessel. The ruptured vessel showed a severe hypertrophic state but there was no evidence of vasculitis, aneurysm, arterio-venous malformation, or malignancy. The case is here in reported of hemobilia associated with spontaneous gallbladder hemorrhage.
Abdomen ; Aneurysm ; Biliary Tract ; Carcinoma, Hepatocellular ; Causality ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Cystic Duct ; Female ; Gallbladder* ; Gallstones ; Hemobilia* ; Hemorrhage* ; Hepatic Artery ; Humans ; Inflammation ; Liver Abscess ; Melena ; Middle Aged ; Nausea ; Sewage ; Ultrasonography ; Vasculitis

BACKGROUND: Low body weight was one of the risk factors of osteoporosis. Little is known about the correlation between body weight change and bone mineral density (BMD) in Korean women. Therefore, this study was designed to reveal the impact of body weight change on BMD of the lumbar spine in perimenopausal women. METHODS: 105 healthy perimenopausal women aged between 44 and 50 years old were enrolled from August 2002 to March 2009. BMD was measured by dual energy X-ray absorptiometry. Partial correlation coefficients between body weight change and BMD change were calculated after the adjustments for several variables. BMD changes among groups based on BMI and the percentage change in body weight during 1-year follow-up period were compared. RESULTS: At both baseline and year 1, BMD of lumbar spine tended to be associated more with body weight. There was a significant association between body weight change and BMD change in lumbar spine during 1-year follow-up period. The weight gain group relatively showed an increase in BMD of lumbar spines than weight loss group. There was no BMD change in BMI less than 23 kg/m2 group, but in case of BMI more than 23 kg/m2 group, BMD in weight gain group increased more than the weight maintaining group. CONCLUSION: This study demonstrated that body weight change is associated with change in BMD of lumbar spine in perimenopausal women especially if they are overweight.
Absorptiometry, Photon ; Aged ; Body Weight ; Body Weight Changes ; Bone Density ; Female ; Follow-Up Studies ; Humans ; Osteoporosis ; Overweight ; Perimenopause ; Retrospective Studies ; Risk Factors ; Spine ; Weight Gain ; Weight Loss