In the condition of diabetic retinopathy, the vascular changes are localized primarily in the retinal capillaries and are presumed to promote angiogenesis. To investigate the change of retinal blood flow velocities and morphological parameters in diabetic retinopathy, we measured perifoveal capillary blood velocities(v) and the size of foveal avascular zones(FAZ). Thirteen patients with diabetic maculopathy and nine healthy volunteers were included in this study. The scanning laser technique in conjunction with an image analysing system were used to assess the morphological and hemodynamic changes in diabetic retinopathy. Diabetic maculopathy group showed a slower capillary blood velocity than normal group(2.44+/-0.39mm/sec vs2.75+/-0.61 mm/sec, p>0.18). The foveal avascular zone was significantly larger in diabetic maculopathy group than in normal group(313.5+/-64.6micrometervs. 238.9+/-93.8micrometer, p<0.05). This results indicate that the retinal microcirculation is altered in diabetic patients compared with healthy subjects. These alterations may be due to the change of the capillary wall and blood viscosity in diabetic patients. The determination of these parameters can be utilized in monitoring the progress of diabetic maculopathy.
Blood Flow Velocity ; Blood Viscosity ; Capillaries ; Diabetic Retinopathy ; Healthy Volunteers ; Hemodynamics ; Humans ; Microcirculation ; Retinaldehyde

BACKGROUND: Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection. METHODS: Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed. RESULTS: E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3-9] vs. 4 [range, 0-9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics. CONCLUSIONS: E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.
Adult* ; Anti-Bacterial Agents ; Cause of Death ; Chryseobacterium ; Ciprofloxacin ; Colon ; Comorbidity ; Cross Infection ; Fluoroquinolones ; Humans ; Levofloxacin ; Male ; Medical Records ; Minocycline ; Mortality ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Sputum ; Survivors ; Tertiary Care Centers* ; Tracheostomy

The Ewing's sarcoma comprises approximately less than 10 percent of malignant bone tumors and 5 percent of allbone tumors, occures in almost all bones of the body, and presents a widely divergent roentgenographicmanifestations. The tarsal bones are involved only 2 percent in the Ewing's sarcoma. Two cases experienced byauthors and ten cases published in literatures of Ewing's sarcoma of the tarsal bone were analizedretrospectively. The result were as follows; 1. Of tarsal bones, the calcaneus was 7 cases, the talus 4 cases,cuneiform 1 case. 2. Female was affected more commonly than male, the ratio being 4 to 1 in the tarsal bones. 3.About sixty percent of total case in the tarsal bones had evidence of diffuse sclerotic pattern. All the cases ofthe talus had evidence of diffuse sclerotic pattern. 4. The diseases to be considered in differential diagnosisare as follows: avascular necrosis, tuberculous osteomyelitis, osteosarcoma, and pyogenic osteomyelitis. 5. Thediffuse sclerosis radiographically showed a close relation with dead bone resulting from avascular necrosis due totumor infiltration histologically. Periosteal reactive new bone and osteoid deposition on the dead bone were alsocorrelated with diffuse sclerosis. 6. Because it is difficult to differentiate sclerotic lesions in the tarsalbones by radiographic methods alone, all such lesions should be subject to biopsy as early as possible.
Biopsy ; Calcaneus ; Female ; Humans ; Male ; Necrosis ; Osteomyelitis ; Osteosarcoma ; Sarcoma, Ewing ; Sclerosis ; Talus ; Tarsal Bones

Biliary endoprosthesis could provide permanent internal biliary drainage inpatient with obstructive jaundicewith advantages of absence of troublesome external catheter and no loss of fluid, bile and electrolytes overexternal drainage. Incidence of sepsis and cholangitis may be lowered. Endoprosthesis was performed in 18 patientsof obstructive jaundice from January, 1985 to december, 1985 at Department of Radilogy, Kyungpook NationalUniversity Hospital. The results are as follows: 1. The cases of obstructive jaundice included bile duct cancer in11, stomach ca. metastasis in 3, ca. of ampulla of Vater in 1, ca. of head of pancresas in 1, CBD cancer withpostop. recurrenced in 1, and impacted CBD stone in 1 case. 2. The levels of obstruction were at the trifurcationin 8, CHD in 5, proximal CBD in 3, and distal CBD in 2 cases. 3. Decline of serum bilirubin level was noted in 15cases with the most rapid decline wihtin 1 week after the procedure. 4. The complication occurred in 5 cases. Thethree cases were recovered spontaneously, but one died of bile peritonitis, another experienced obstrution ofendoprosthesis. 5. The endoprosthesis is benificial intreatment of obstructive jaundice for which surgery is notindicated, and saving expensive abdominal surgery and less advantageous percutaneous external drainage, henceenhancing life quality.
Ampulla of Vater ; Bile ; Bile Duct Neoplasms ; Bilirubin ; Catheters ; Cholangitis ; Drainage ; Electrolytes ; Gyeongsangbuk-do ; Head ; Humans ; Incidence ; Inpatients ; Jaundice, Obstructive ; Neoplasm Metastasis ; Peritonitis ; Quality of Life ; Sepsis ; Stomach

Purpose: To determine the clinical manifestations and maternal and perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19). Methods: We conducted a retrospective observational study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to National Health Insurance Service (NHIS) Ilsan Hospital between August 2020 and October 2021. The maternal and perinatal outcomes were investigated. Results: Among 184 pregnant women infected with SARS-CoV-2, 79 women delivered. Of the women who delivered, with 36 women giving birth during the quarantine period. At delivery, 45 women were positive for SARS-CoV-2 by polymerase chain reaction (PCR), whereas 34 women were negative. The most common clinical manifestations were cough (65.2%), fever (38.0%), and myalgia (33.2%). Regarding perinatal outcomes, none of the babies had an Apgar score <7 at 5 minutes, and none were intubated following the delivery. The preterm birth rate and small-for-gestational-age (SGA) rate were 15.2% and 16.5%, respectively. All babies who was delivered at NHIS Ilsan Hospital were negative for SARS-CoV-2 infection by PCR, which was evaluated using amniotic fluid, cord blood, neonatal nasopharyngeal and oropharyngeal swabs in the 1st and 2nd days following delivery, although 45 women were positive for SARS-CoV-2 infection by PCR at the time of delivery. Conclusion Most pregnant women with COVID-19 in South Korea were unlikely to manifest symptoms or present with a severe disease progression. The observed preterm birth rate and SGA rate were higher in women with COVID-19 than in those without COVID-19. However, there was no evidence of vertical transmission, and all babies were negative for SARS-CoV-2 infection during pregnancy.

Fractures, Comminuted ; Humans ; Immobilization ; Incidence ; Mandibular Fractures ; Wounds and Injuries

BACKGROUND/AIMS: There are increasing numbers of North Korean defectors, and their health status differs from that of the South Korean population. This study was performed to investigate the clinical characteristics of North Korean defectors visiting a single tertiary hospital in South Korea. METHODS: The medical records of North Korean defectors who visited Dankook University Hospital, Cheonan, South Korea from 1 February 2006 to 30 April 2014 were retrospectively reviewed. Their comorbidities, main reasons for the visit, and most common diseases were investigated. RESULTS: A total of 169 North Korean defectors (163 females, 6 males) visited our hospital. Sixty-eight patients (40.24%) had comorbidities, the most common of which was tuberculosis (13.60%), followed by chronic hepatitis B (10.06%) and chronic hepatitis C (9.47%). North Korean refugees visited the department of ophthalmology (15.71%) most frequently, followed by gastroenterology (15.18%). Cataracts, chronic hepatitis C, chronic hepatitis B, and pulmonary tuberculosis were the most common reasons for the hospital visit. Chronic hepatitis B and chronic hepatitis C were diagnosed in 19.32% and 17.58% of the patients, respectively. Sixteen patients (9.47%) were diagnosed with tuberculosis, and eight of these patients showed multidrug resistance. Of all 169 patients, 17 underwent colonofibroscopy or stool examination, and parasites (Trichuris trichiura, n = 6; Clonorchis sinensis, n = 1) were found in 7 patients (41.18%). CONCLUSIONS: Most North Korean defectors who visited this tertiary hospital in South Korea were female, and they mainly visited the departments of ophthalmology, gastroenterology, and pulmonology. Compared with South Koreans, they showed high rates of chronic hepatitis B, chronic hepatitis C, pulmonary tuberculosis with multidrug resistance, and parasite infection.
Cataract ; Chungcheongnam-do ; Clonorchis sinensis ; Comorbidity ; Democratic People's Republic of Korea* ; Drug Resistance, Multiple ; Female ; Gastroenterology ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Humans ; Korea ; Medical Records ; Ophthalmology ; Parasites ; Pulmonary Medicine ; Refugees ; Retrospective Studies ; Tertiary Care Centers* ; Tuberculosis ; Tuberculosis, Pulmonary

Purpose: This study examines errors in death certificates (DCs) issued to cases of poisoning. Methods: DCs issued in poisoning cases were retrospectively reviewed. Errors in the DC were classified as major and minor errors, and were evaluated in accordance with their impact on the process of selecting the cause of death (COD). Results: A total of 79 DCs were evaluated; 43 (54.4%) DCs were issued in the emergency department (ED), and 36 (45.6%) DCs were issued outside the ED. The average major and minor errors per DC were determined to be 0.4 and 3.3, respectively. Moreover, an average of 3.0 errors were discovered in DCs issued at the ED, and 4.4 errors in DCs issued outside the ED. The most common major errors were incorrect manner of death (11.4%, 9/79), followed by unacceptable COD (7.6%, 6/79), and the mode of dying as an underlying COD (5.1%, 4/79). The common minor errors most frequently encountered were incorrect time interval (86.1%, 68/79), followed by incorrect other significant conditions (73.4%, 58/79), and no record for date of onset (62.0%, 49/79). Conclusion Our results indicate that the total numbers of major errors, minor errors and cases of misjudged cause of death were greater in DCs issued outside the ED than in DCs issued at the ED. The most frequently quoted major error of DCs related to poisoning was determined to be the incorrect manner of death.

OBJECTIVE: Carpal tunnel syndrome(CTS) is one of the compression neuropathy in long-term hemodialysis patients, that considerably caused by venous stasis or edema in the site of the vascular access, arterial steal syndrome and currently reported, amyloid deposit. CTS shows pain, paresthesia and weakness in the area that median nerve is distributed. We analysed the incidence and characteristics of nerve conduction test of CTS in the patients of hemodialyzed chronic renal failure. METHODS: Thirty hemodialyzed patients were enrolled and divided three groups in peripheral polyneuropathy(PNP) only, CTS only, and both by clinical manifestations and results of nerve conduction test. RESULTS: 1) In all thirty patients, two(7%) had a CTS only, seven(23%) had a PNP only and sixteen(54%) had combined PNP with CTS. 2) In al thirty patients(60 hands), 2 cases(two-3%) had a CTS with clinical manifestations, 25 cases (siteen-42%) had a CTS without clinical manifestation and 1 case(one-1.7%) showed clinical manifestations of CTS but was not diagnosed CTS by nerve conduction test. There was no significant correlation between clinical manifestations and development of CTS(p>0.05). 3) In all thirty patients(60 hands), 6 cases(four-10 %) had a CTS with edema, 21 cases(fourteen-35%) had a CTS without edema and 2 cases(two-1.7%) showed edema of hands but was not diagnosed CTS by nerve conduction test. There was no significant correlation between edema and development of CTS (p>0.05). 4) Among the eighteen patients with CTS, nine (50%) patients were involved in one hand, nine(50%) patients in both. 5) In the sixty hands, 33 hands had vascular access, in which 13 cases(39.4%) had CTS and 20 cases(60.6%) had not. In the 27 hands which had not vascular access, 14 cases(51.6%) had CTS and 13 cases(48.1%) had not. There was no significant correlation between vascular access and development of CTS(p>0.05). CONCLUSION: The incidence of CTS in the patients of hemodialyzed chronic renal failure was 60%. There was no significant correlation between CTS and vascular access, edema, duration of hemodialysis. Subclinical CTS was more frequent compared to the overt CTS.
Carpal Tunnel Syndrome* ; Edema ; Hand ; Humans ; Incidence ; Kidney Failure, Chronic* ; Median Nerve ; Neural Conduction ; Paresthesia ; Plaque, Amyloid ; Polyneuropathies ; Renal Dialysis*

BACKGROUND AND OBJECTIVES: Dobutamine stress echocardiography (DSE) with 2D echocardiography (2DE) is one of the time-consuming procedures in the diagnosis of coronary artery disease (CAD). Moreover, the accuracy of DSE with 2DE depends on the operator's skill or bias during the image acquisition. This study was conducted to determine the feasibility and accuracy of DSE with real-time 3D echocardiography (RT3DE) for the diagnosis of CAD. SUBJECT AND METHODS: 62 patients (RT3DE: 36, 2DE: 26), suspected of angina pectoris and post-revascularization ischemia, underwent DSE and coronary angiography (CAG). Image acquisition was performed at the baseline, and at 4 times during the dobutamine infusion and recovery stages. The procedure time (from the baseline to the end of the peak dose stage) was recorded. Off-line analyses of the volumetric images acquired with RT3DE were performed using 3D computer software (TomTec, Co.). Digitized quad-screen images acquired with 2DE were analyzed using the 2DE review system (ProSolv 4.0). >50% luminal diameter stenosis of any coronary artery on CAG was defined as significant coronary artery stenosis. RESULTS: The procedure time of DSE with RT3DE was significantly shorter than that of DSE with 2DE (25+/-4 vs. 37+/-4 mins, p<0.001). There was no significant difference in the sensitivity (p>0.05) or specificity (p>0.05) between the two procedures. CONCLUSION: DSE with RT3DE seems to be a feasible and less time consuming diagnostic procedure, probably providing comparable sensitivity and specificity for the detection of coronary artery stenosis, than DSE with 2DE.
Angina Pectoris ; Bias (Epidemiology) ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Dobutamine* ; Echocardiography* ; Echocardiography, Stress* ; Echocardiography, Three-Dimensional* ; Humans ; Ischemia ; Phenobarbital ; Sensitivity and Specificity