Objective: Previous studies have provided inconclusive results on the association between depression and stroke risk, and the potential modifying effect of comorbid insomnia on this association remains unclear. Our study aimed to clarify the independent roles of depression and insomnia as risk factors for stroke and to investigate the possibility of an interaction effect between these two conditions on stroke incidence. Methods: We used data from the Korean Genome and Epidemiology Study. The primary exposure was depression, measured by the Beck Depression Inventory. The secondary exposure was insomnia. The main outcome was the occurrence of stroke observed in biennial follow-up surveys. Cox proportional regression analysis was performed to estimate the effects of depression and insomnia on stroke incidence. We also conducted interaction analysis to investigate the interaction between depression and insomnia on stroke incidence. Results: During 16 years of follow-up involving 3,301 individuals, we documented 172 cases of new-onset stroke (4.3 cases per 1,000 person-years). Cox proportional logistic regression analysis showed that severe depression significantly increased the risk of stroke (hazard ratio [HR]: 2.06, 95% confidence interval [CI]: 1.13–3.75), whereas mild and moderate depression did not increase this risk. Interaction analysis demonstrated that stroke risk was increased with only moderate (HR: 2.04, 95% CI: 1.04–4.00) and severe (HR: 3.01, 95% CI: 1.43–6.31) depression among individuals without insomnia. Conclusion Although general depression does not significantly increase stroke risk, moderate-to-severe depression may increase this risk, particularly in individuals without insomnia.

Objective: Previous studies have provided inconclusive results on the association between depression and stroke risk, and the potential modifying effect of comorbid insomnia on this association remains unclear. Our study aimed to clarify the independent roles of depression and insomnia as risk factors for stroke and to investigate the possibility of an interaction effect between these two conditions on stroke incidence. Methods: We used data from the Korean Genome and Epidemiology Study. The primary exposure was depression, measured by the Beck Depression Inventory. The secondary exposure was insomnia. The main outcome was the occurrence of stroke observed in biennial follow-up surveys. Cox proportional regression analysis was performed to estimate the effects of depression and insomnia on stroke incidence. We also conducted interaction analysis to investigate the interaction between depression and insomnia on stroke incidence. Results: During 16 years of follow-up involving 3,301 individuals, we documented 172 cases of new-onset stroke (4.3 cases per 1,000 person-years). Cox proportional logistic regression analysis showed that severe depression significantly increased the risk of stroke (hazard ratio [HR]: 2.06, 95% confidence interval [CI]: 1.13–3.75), whereas mild and moderate depression did not increase this risk. Interaction analysis demonstrated that stroke risk was increased with only moderate (HR: 2.04, 95% CI: 1.04–4.00) and severe (HR: 3.01, 95% CI: 1.43–6.31) depression among individuals without insomnia. Conclusion Although general depression does not significantly increase stroke risk, moderate-to-severe depression may increase this risk, particularly in individuals without insomnia.

Objective: Previous studies have provided inconclusive results on the association between depression and stroke risk, and the potential modifying effect of comorbid insomnia on this association remains unclear. Our study aimed to clarify the independent roles of depression and insomnia as risk factors for stroke and to investigate the possibility of an interaction effect between these two conditions on stroke incidence. Methods: We used data from the Korean Genome and Epidemiology Study. The primary exposure was depression, measured by the Beck Depression Inventory. The secondary exposure was insomnia. The main outcome was the occurrence of stroke observed in biennial follow-up surveys. Cox proportional regression analysis was performed to estimate the effects of depression and insomnia on stroke incidence. We also conducted interaction analysis to investigate the interaction between depression and insomnia on stroke incidence. Results: During 16 years of follow-up involving 3,301 individuals, we documented 172 cases of new-onset stroke (4.3 cases per 1,000 person-years). Cox proportional logistic regression analysis showed that severe depression significantly increased the risk of stroke (hazard ratio [HR]: 2.06, 95% confidence interval [CI]: 1.13–3.75), whereas mild and moderate depression did not increase this risk. Interaction analysis demonstrated that stroke risk was increased with only moderate (HR: 2.04, 95% CI: 1.04–4.00) and severe (HR: 3.01, 95% CI: 1.43–6.31) depression among individuals without insomnia. Conclusion Although general depression does not significantly increase stroke risk, moderate-to-severe depression may increase this risk, particularly in individuals without insomnia.

Objective: Previous studies have provided inconclusive results on the association between depression and stroke risk, and the potential modifying effect of comorbid insomnia on this association remains unclear. Our study aimed to clarify the independent roles of depression and insomnia as risk factors for stroke and to investigate the possibility of an interaction effect between these two conditions on stroke incidence. Methods: We used data from the Korean Genome and Epidemiology Study. The primary exposure was depression, measured by the Beck Depression Inventory. The secondary exposure was insomnia. The main outcome was the occurrence of stroke observed in biennial follow-up surveys. Cox proportional regression analysis was performed to estimate the effects of depression and insomnia on stroke incidence. We also conducted interaction analysis to investigate the interaction between depression and insomnia on stroke incidence. Results: During 16 years of follow-up involving 3,301 individuals, we documented 172 cases of new-onset stroke (4.3 cases per 1,000 person-years). Cox proportional logistic regression analysis showed that severe depression significantly increased the risk of stroke (hazard ratio [HR]: 2.06, 95% confidence interval [CI]: 1.13–3.75), whereas mild and moderate depression did not increase this risk. Interaction analysis demonstrated that stroke risk was increased with only moderate (HR: 2.04, 95% CI: 1.04–4.00) and severe (HR: 3.01, 95% CI: 1.43–6.31) depression among individuals without insomnia. Conclusion Although general depression does not significantly increase stroke risk, moderate-to-severe depression may increase this risk, particularly in individuals without insomnia.

Objective: Previous studies have provided inconclusive results on the association between depression and stroke risk, and the potential modifying effect of comorbid insomnia on this association remains unclear. Our study aimed to clarify the independent roles of depression and insomnia as risk factors for stroke and to investigate the possibility of an interaction effect between these two conditions on stroke incidence. Methods: We used data from the Korean Genome and Epidemiology Study. The primary exposure was depression, measured by the Beck Depression Inventory. The secondary exposure was insomnia. The main outcome was the occurrence of stroke observed in biennial follow-up surveys. Cox proportional regression analysis was performed to estimate the effects of depression and insomnia on stroke incidence. We also conducted interaction analysis to investigate the interaction between depression and insomnia on stroke incidence. Results: During 16 years of follow-up involving 3,301 individuals, we documented 172 cases of new-onset stroke (4.3 cases per 1,000 person-years). Cox proportional logistic regression analysis showed that severe depression significantly increased the risk of stroke (hazard ratio [HR]: 2.06, 95% confidence interval [CI]: 1.13–3.75), whereas mild and moderate depression did not increase this risk. Interaction analysis demonstrated that stroke risk was increased with only moderate (HR: 2.04, 95% CI: 1.04–4.00) and severe (HR: 3.01, 95% CI: 1.43–6.31) depression among individuals without insomnia. Conclusion Although general depression does not significantly increase stroke risk, moderate-to-severe depression may increase this risk, particularly in individuals without insomnia.

Periventricular-intraventricular hemorrhage (PV-IVH)is one of the most important neurologic lesion of the low birth weight infants. Serial neurosonographic exeaminations were performed in 113 low birth weight infants who were admitted to the neonatal intensive care unit of Presbyterian Medical Center from November 1, 1990to July 31, 1991. The results were summarized as follows: 1) The incidence of PV-IVH in the study was 54% 2) According to Papile's grading system of PV-IVH, grade I was 32.8%, grade II was 45.9%, grade IIIwas 11.5% and grade IV was 9.8%. 3) The onset of PV-IVH was within the first 7 days of life in 82%. 4) Poor activity, apnea, bradycardia and hypotension were statistically significant clinical findings associated with PV-IVH(P<0.05). 5) The risk factors associated with PV-IVH were gestational age, birth weight, hyaling membrane disease, patent ductus arteriosus and artifical ventilation. 6) The mortality of PV-IVH was 0% for grade I, 10.7% for grade II,42.9% for grade III and 83.3% for gradeIV.
Apnea ; Birth Weight ; Bradycardia ; Diagnosis* ; Ductus Arteriosus, Patent ; Gestational Age ; Hemorrhage* ; Humans ; Hypotension ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Membranes ; Mortality ; Protestantism ; Risk Factors ; Ventilation

Thyroid hemiagenesis is a development failure of one of the thyroid lobes, predominantly in females with a left lobe. The associated disease in the remaining thyroid lobe include benign adenoma, multinodular goiter, hyperthyroidism, chronic thyroiditis, and carcinoma etc. We report a very rare case of thyroid hemiagesesis with hyperthyroidism, thyroid cancer, and ectopic thymus. A 43-year-old female presented with hyperthyoidism and thyroid nodule. Thyroid scan with 99mTcO4 revealed cold nodule in left lobe with absent right lobe. The patient underwent thyroid exploration. Because nodule in the remaining thyroid lobe proved to be a thyroid cancer on frozen biopsy, total thyroidectomy was performed. There was a thyroid-like tissue at the right side (scan 'absent' side) and removed. Pathology confirmed that the removed tissue from right side was thymus. There has been no report in world literatures of such case; in one patient, thyroid hemiagenesis, hyperthyroidism, thyroid carcinoma, and ectopic thymus coexists. We report the case and review the literature on thyroid hemiagenesis and ectopic thymus.
Adenoma ; Adult ; Biopsy ; Female ; Goiter ; Humans ; Hyperthyroidism* ; Pathology ; Sodium Pertechnetate Tc 99m ; Thymus Gland* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Thyroiditis

Bart's syndrome was initially described as a genodermatosis characterized by congenital localized absence of the skin with blistering and nail deformities 1-3. However, it is considered as any type of epidermolysis bullosa(EB) with localized congenital absence of the skin on the extremities. A 33-day-old fbmale baby was presented with congenital absence of the skin over the left shin and dorsa of both feet which were covered with the thin, translucent, and brown-red glistening membranes. Blistering of the right calf and left great toe nail deformity were also noted. She was diagnosed as a recessive dystrophic EB by the histopathological, ultra- structural and immunomapping studies.
Blister ; Congenital Abnormalities ; Extremities ; Foot ; Membranes ; Skin ; Toes

Most proximal humeral fractures respond satisfactorily to simple conservative treatment, but operative treatment is recommended in cases where poor results are anticipated by prolonged immobilization, or because of severe displacement and comminution. We used a minimal internal fixation and tension band technique in severely displaced and comminuted cases to achieve firm fixation and avoid subacromial impingement. Passive range of motion of the involved shoulder began within the first postoperative day and active range of motion exercise was encouraged as soon as possible within the first postoperative week. Between February 1996 and November 1997, we operated using this technique on 15 patients ranging in age from 16 to 71 years (average 52). Follow-up averaged 13 months. During the follow-up period, all patients except one patient, had a active full range of motion on the affected limb. According to the evaluation on the 10 patients who had follow- up periods over 12 months by Hawkins rating scale of shoulder function, 6 patients had achieved a good result and 4 patients had achieved a fair result at the last follow up. In conclusion, tension band technique with minimal internal fixation could afford sufficient fracture stability to allow early, aggressive rehabilitation. As a method of internal fixation on a proximal humerus fracture, this technique may have particular advantages in elderly osteoporotic patients.
Aged ; Extremities ; Follow-Up Studies ; Humans ; Humerus ; Immobilization ; Range of Motion, Articular ; Rehabilitation ; Shoulder ; Shoulder Fractures*

The origins of medullary carcinoma and papillary carcinoma of thyroid are embryologically different. We report a case of simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in the same thyroid gland. In this case, the occurrence of the two tumors may be a coincidence, does not have embryological or genetical significance.
Carcinoma, Medullary ; Carcinoma, Papillary* ; Thyroid Gland*