No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

No abstract available.
Hyperostosis, Cortical, Congenital*

A series of 1909 computed tomography(CT) scan performed for head injury mostly after traffic accident was retrospectively reviewed. 17 patients were found to have clearly definable traumatic intraventricular hemorrhage(TIVH). TIVH was associated with various brain lesions in most cases; Intracerebral lesions with contusional hemorrhage and subdural hematoma(Glasgow Coma Scale Score) coexisted in 6 and 5 instances. The outcome(Glasgow Outcome Scale) of this series was related with initial clinical findings, and 11 patiens survived. We have designed this study to assess the occurrence of TIVH in our series of head-injured patients in Korea, and to correlate these findngs with the clinical status, the presence of associated lesions, and their relation to final outcome of these patients, and conculsions are as follows: 1) The incidence of TIVH and its associated mortality is 0.9% and 35.3%, respectively, Most of them occurs below 5 th decade(70.6%) with male predominace(88.2%). 2) Mode of injury is mainly from traffic accident(94.1%), followed by fall down(5.9%). 3) The presence of concomitant lesions has a definite influence on poor outcome(P<0.02), whereas skull fracture or multiplicity of TIVH deos not. 4) Primary impact site to induce TIVH is primarily on frontal portion(58.9%). 5) With regard to brain stem injury in TIVH, the final outcome clearly depends on pathological demonstration on CT(P<0.005%), but not on location of hemorrhage(P<0.5%).
Accidents, Traffic ; Brain ; Brain Stem ; Coma ; Contusions ; Craniocerebral Trauma ; Hemorrhage ; Humans ; Incidence ; Korea ; Male ; Mortality ; Retrospective Studies ; Skull Fractures

PURPOSE: Deep vein thrombosis (DVT) is a serious disease which causes life-threatening pulmonary embolism and chronic venous insufficiency. In order to prevent pulmonary embolism, inferior vena cava (IVC) filter placement is commonly performed nowadays. We carried out this study to analyze the patterns of the indications for IVC filter placement, the complications associated with procedure, and the follow-up results. METHOD: We treated 42 patients with acute DVT between September 2001 and November 2002 at Gil Medical Center. Our subjects included 10 patients who underwent IVC filter placement during the same period. Duplex sonography and CT venography were performed in all cases. The filter was placed by one interventional radiologist just after checking the nonselective venography. The patients were followed monthly with a physical examination. Plain abdominal film was checked every 3 months, and CT venography every 6 months. RESULT: The mean age was 55.6 years (range 35~72) and the male-to-female ratio was 1:4. The associated diseases were advanced cancer in 3 cases, intracranial hemorrhage in 2 and spinal cord injury and ankylosis of the hip joint in 1. There were 8 cases of hypercoagulable states; 7 of protein S deficiency, 3 of protein C deficiency and 1 of antithrombin III deficiency. Indications for filter insertion were a contraindication to anticoagulation in 5 cases, recurrent pulmonary embolism in 2, floating IVC thrombosis in 2, complication of anticoagulation in 1, prophylactic use before catheter-directed thrombolysis in 1, and quadriplegia in 1. Four Greenfield filters and six TrapEase filters were used. Filters were deployed at infrarenal IVC in 8 cases and suprarenal IVC in 2 cases. There were no major complications related to the procedure. Late complications were not detected during the 7-month follow-up (range 2~16 months). CONCLUSION: We performed 10 IVC filter placements for therapeutic purpose without any serious complications. A wider range of indications, including prophylactic use, might be considered in the future practice for DVT.
Ankylosis ; Antithrombin III Deficiency ; Follow-Up Studies ; Hip Joint ; Humans ; Intracranial Hemorrhages ; Phlebography ; Physical Examination ; Protein C Deficiency ; Protein S Deficiency ; Pulmonary Embolism ; Quadriplegia ; Spinal Cord Injuries ; Thrombosis ; Vena Cava Filters* ; Vena Cava, Inferior* ; Venous Insufficiency ; Venous Thrombosis*

No abstract available.
Aldosterone* ; Humans* ; Prolactin*

BACKGROUND: The current various case-finding instruments for detecting depression in Korea are too cucumbersome and time-consuming for routine use in primary care or student and soldier groups because of too many questions. We carried out this study in order to investigate the validity of the two-question case-finding instrument for detecting depression easily in the primary care or the mentioned groups. METHODS: We selected one boy high school in Seoul and 155 sophomer students answered the questionnaire by self-report. The questionnaire included two questions about depressed mood and anhedonia: (1) "During the past month, have you often been bothered by feeling down, depressed or hopeless?" (2) "During the past month, have you often been bothered by little interest or pleasure in doing things(e.g., studying, playing or talking with friends) ?". And then a resident of family medicine interviewed them and made a diagnosis for depression using the diagnostic criteria of DSM-IV. Simultaneously we compared the test characteristics of a two-question case-finding instrument with those of a previously validated Beck Depression Inventory as a currently world-wide used screening instrument for depression. RESULTS: The prevalence of major depression as determined by the interview was 6.6%(10 of 151). The two-question case finding instrument had a Cronbach's alpha of 0.663-internal consistency, a sensitivity of 100%, a specificity of 54.6%, a positive likelihood ratio of 2.20 and a negative predictive value of 1.00.(A "yes" answer to either of the two questions was considered a positive test.) And the BDI had a sensitivity of 90%, a specificity of 68.1%, a positive likelihood ratio of 3.63 and a negative predictive value of 0.99(cut-off point=15). Area under the ROC curves of the two-question case-finding instrument was 0.882, greater than that of the BDI, 0.834. CONCLUSIONS: The test characteristics of a two-question case-finding instrument were higher compared to those of BDI for major depression. Therefore, the two-question case-finding instrument is a useful measure for detecting depression and less time-consuming in primary care and certain groups.
Adolescent ; Anhedonia ; Depression* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Male ; Mass Screening* ; Military Personnel ; Pleasure ; Prevalence ; Primary Health Care ; ROC Curve ; Sensitivity and Specificity ; Seoul ; Surveys and Questionnaires

PURPOSE: Thyroid nodules are a common disease in clinical practice. The prevalence of thyroid nodules has recently increased according to the development of thyroid ultrasonography. Thyroid nodules are more commonly found in women, but the potential for malignant nodules is much higher in men. The purpose of this study was to assess clinical characteristics and the incidence of thyroid nodules and malignancy in the adult male population. METHODS: Clinical characteristics and incidence of thyroid nodules was examined by screening ultrasonography targeting 6,968 male patients over the age of 40 who visited the National Police Hospital from January 2012 and April 2015. RESULTS: Among 6,968 male patients, 2,481 (35.6%) showed abnormal findings on ultrasonography. Of the 2,481 patients, 2,370 patients (34.01%) had a thyroid nodule and 111 patients (4.47%) had thyroiditis without a thyroid nodule, previous thyroidectomy, lymphadenopathy, esophageal diverticulum, parathyroid cyst, and benign calcification. Of the 2,481 patients, 958 patients (38.6%) had abnormal TFT and 204 patients (8.22%) had thyroiditis with or without a thyroid nodule. Thyroid nodules were benign in 1993 (80.33%) cases, indeterminate in 313 (12.61%) cases, and suspicious in 64 (2.56%) cases. Among the 2,481 subjects, thyroid cancer was detected in 37 subjects (1.49%). CONCLUSION: The incidence of thyroid nodules has recently increased according to the development of thyroid ultrasonography.
Adult ; Diverticulum, Esophageal ; Female ; Humans ; Incidence* ; Lymphatic Diseases ; Male* ; Mass Screening ; Police ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Thyroidectomy ; Thyroiditis ; Ultrasonography

BACKGROUND: The intimal thickening of coronary artery was understood as an early process in the beginning of atherosclerosis. However, the implication of intimal thickening as a morphologic change of coronary artery disease, on the coronary vascular hemodynamics has not been explored. METHODS: To evaluate the effect of intimal thickening on the coronary vascular hemodynamics, we studied the extent of intimal thickening on intravascular ultrasound(IVUS) and the coronary vascular flow and resistance by using Doppler wire in left anterior descending coronary arteries after successful intervention in 40 patients(29 males, mean age 55+/-9 years) with coronary artery disease. Mean intimal index and mean lumen cross sectional area were determined by IVUS and coronary flow average peak velocity was obtained by using Doppler wire before and after intracoronary adenosine in distal artery to the stenosis. Coronary flow velocity reserve(CFR), volumetric coronary blood flow(CBF) and coronary vascular resistance index(CVRI) were calculated. Hyperemic pressure-to-flow ratio(hyperemic mean aortic pressure/hyperemic volumetric coronary blood flow), ie, an index of minimal coronary vascular resistance(mCVR), was further derived. RESULTS: Intimal index(mean 20.0+/-8.3%) was significantly correlated with CVRI(mean 0.33+/-0.14, r=.37, p=.02) and mCVR(mean 0.81+/-0.40mmHg/ml/min, r=.36, p=.02). However, there was no correlation with CBF and CFR. CONCLUSION: The CVRI and mCVR(hyperemic pressure to flow ratio), the indices coronary microvascular resistance, were significantly related to the degree of intimal thickness of coronary artery. The extent of intimal thickness of coronary artery on IVUS study may be related to microvascular integrity.
Adenosine ; Arteries ; Atherosclerosis ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Hemodynamics ; Humans ; Male ; Vascular Resistance*

Malakoplakia is an uncommon granulomatous disease most frequently found in the bladder or ureter. Howevcr, it has been reyorted in almost every ather organ and structure, the colon is the most common site of malakoplakia outside the urogenital tract and colonic carcinoma is the most commonly associated disease. A case of malakoplakia of the colon in a 54-year-old female is reported. Sigmoidoscopy revealed multiple whiteyellowish nodules simulating polypoid lesion at 10cm from the anal verge. The biopsy showed characteristically comprised submucosal proliferations of histiocyte and chronic inflammatory cells with typical cytoplasmic inclusions known as Michaelis-Gutmann bodies. Intravenous pyelogram showed no evidence of involvement of the urinary system. These nodules were removed by endoscopic polypectomy, So far, this is the first case of isolated colonic malakoplakia in Korea.
Biopsy ; Colon ; Female ; Histiocytes ; Humans ; Inclusion Bodies ; Korea ; Malacoplakia* ; Middle Aged ; Rectum ; Sigmoidoscopy ; Ureter ; Urinary Bladder

BACKGROUND AND OBJECTIVES: It is well known that anti-platlet agents decrease the rate of subacute thrombosis after intracoronary stenting significantly. The aim of this study is to assess the antithrombotic effect and safety of 2-month combined regimen of cilostazol and aspirin on intracoronary stenting. METHODS: The study population consisted of 78 lesions of 57 patients (age: 58.1+/-10.3, male 47, female 10) with ischemic heart disease who were underwent successful intracoronary stenting. They were received cilostazol(200mg/day) and aspirin(100mg/day) two days before intracoronary stenting and continued for 8 weeks, and then aspirin was medicated continuously during the study. The laboratory and clinical findings were evaluated before cilostazol administration, 4 weeks, 8 weeks and 6 months after intervention. The excercise treadmill test was done at 6 months after intervention. RESULTS: Subacute thrombosis occurred in 2 patients(3.5%). Target lesion revascularization(TLR) was done in 4 patients(7.3%). Clinical restenosis (symptomatic or positive stress test, subacute thrombosis and TLR) occurred in 15 patients(26.3%). There was no granulocytopenia, or severe liver dysfunction. HDL-cholesterol was increased significantly at 2 months(36.6+/-7.4 mg/dl versus 41.6+/-9.3 mg/dl. p<0.01) and 6 months(36.6+/-7.4 mg/dl versus 42.4+/-10.6 mg/dl. p<0.01) follow up. CONCLUSION: Two-month combined regimen of cilostazol and aspirin was effective and safe after intracoronary stenting. Subacute thrombosis and clinical restenosis rate were comparable with pervious reports. Further large randomized trials are needed for the evaluation of favorable effect of cilostazol on lipid metabolism.
Agranulocytosis ; Aspirin* ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Lipid Metabolism ; Liver Diseases ; Male ; Myocardial Ischemia ; Stents* ; Thrombosis