No abstract available.
Aspergillosis*

BACKGROUND: Although there are several methods for evaluating bone quality, Hounsfield units (HU), a standardized computed tomography (CT) attenuation coefficient, provide a useful tool for estimating focal bone mineral density (BMD). The aim of this study is to investigate the HU for evaluating the degree of osteoporosis in greater tuberosity with regard to anchor positioning. METHODS: Forty patients diagnosed as normal on shoulder CT were included and categorized according to age and gender. Axially sectioned CT images were processed to 3-dimensional models containing information about bone quality using Mimics (14.11 platform v14.1.1.1 Materialise). Three-dimensional anchors were simulated and positioned according to 6 regions of interest (ROI) in the greater tuberosity classified using Tingart's system. Mean HU of intra-anchor volumes in the 6 regions was measured. RESULTS: A significant decrease in HU was observed with increasing age (p=0.0001) and menopause (p<0.001). A significant difference in HU was found between male and female groups with males showing the higher values (p=0.0001). HU of proximal areas of ROI was higher than those of distal areas (p<0.005). However, although mean HU of distal posterior ROI showed the lowest values, no statistically significant difference was found between anterior, middle, and posterior regions (p=0.087). CONCLUSION: Mean HU of ROIs provides a tool for preoperative assessment of focal BMD, which is a factor of suture anchor stability and can be used to aid decision-making regarding secure anchor positioning for rotator cuff repair. Our data support that the most secure point is the proximal regions of ROI.
Bone Density* ; Female ; Humans ; Humerus* ; Male ; Menopause ; Osteoporosis ; Rotator Cuff ; Shoulder ; Suture Anchors

Actinic reticuloid as a manifestation of chronic actinic dermatitis (CAD) is a rare dermatosis whose clinical and histologic features resemble other types of pseudolymphomas including mycosis fungoides and Jessner's lymphocytic infiltration, and it is regarded as an eventual stage of various photodermatoses like photosensitive eczema or persistent light reaction or chronic photoallergic contact dermatitis and so on. Phototests in the patients with actinic reticuloid usually reveal hypersensitivity to UVB, UVA, and sometimes to visible light. We present a case of actinic reticuloid in a 65-year-old male, whose skin lesions developed as erythematous lichenified infiltrating plaques on the face at first, and then spread themselves onto the upper trunk later. Histologically those skin lesions showed the aggregation of atypical lymphocytes and photobiologically the results of phototests revealed photosensitivity to UVB and UVA.
Actins* ; Aged ; Dermatitis, Photoallergic ; Eczema ; Humans ; Hypersensitivity ; Light ; Lymphocytes ; Male ; Mycosis Fungoides ; Photosensitivity Disorders ; Pseudolymphoma ; Skin ; Skin Diseases

Torsades de pointes, a polymorphic ventricular tachycardia associated with prolonged QT interval, is a well-known life-threatening arrhythmia, which has been found to be induced by various causes such as drugs, electrolyte imbalances, and severe bradycardia. Cisapride is a gastrointestinal prokinetic drug, which is widely used to treat gastroesophageal reflux disease or other functional gastrointestinal disorders. Cisapride can cause torsades de pointes and cases of torsedes de pointes induced by cisapride have been reported in other countries. Cases of torsades de pointes associated with antihistamine drugs have been reported in Korea, however, cisapride-induced torsades de pointes case has not been reported. We report a case of 31 year-old female patient who experienced repeated loss of consciousness due to cisapride-induced torsades de pointes.
Adult ; Arrhythmias, Cardiac ; Bradycardia ; Cisapride* ; Female ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Humans ; Korea ; Tachycardia, Ventricular ; Torsades de Pointes* ; Unconsciousness

Background: Fluvastatin is the first entirely synthetic 3-hydroxy-3-methylglutaryl-coenzyme A(HMG-CoA) reductase inhibitor. Clinical data indicate that this agent exhibits the proven efficacy of its class and also has some theoretical advantages in safety for long-term use because of its unique pharmacololgic property consistent with hepatoselectivity(i.e., low systemic exposure). This study is to evaluate efficacy and safety of fluvastatin in hypercholesterolemic patients in Korea. Methods: An open clinical trial with fluvastatin was conducted in 31 subjects who continued to have high blood cholesterol levels of 6.21 mmol/L(240 mg/dl) or greater after 1 month of lipid-lowering diet plus single blind placebo period. Fluvastatin was administered for 8 weeks with the initial dose of 20 mg per day and if serum cholesterol levels did not fall below 5.20 mmol/L(200 mg/dl) after 4 weeks the dose was increased to 40 mg per day for the second 4 weeks. On each visit every 4 weeks they underwent interview and laboratory tests about side effects and tolerability. Results: The mean % changes in plasma total cholesterol and LDL-cholesterol from baseline were
Cholesterol ; Creatine Kinase ; Diet ; Humans ; Hypercholesterolemia ; Korea ; Oxidoreductases ; Plasma ; Sleep Stages ; Triglycerides

OBJECTIVES: The early detection of ectopic tubal pregnancy in unruptured state is increased as the transvaginal sonography and sensitive serum hCG test are available. For this unruptured tubal pregnancy, the medical treatment using methotrexate via various routes and dosage is being tried. Our study was to evaluate the efficacy of single systemic injection of methotrexate in the treatment of unruptured tubal pregnancies. Material and METHODS: From the January 1997 to July 1999, of 152 ectopic pregnancy patients, 22 patients who were diagnosed as unruptured tubal pregnancies were treated with single-dose systemic methotrexate injection (50 mg/m2/IM). Exclusion criteria were unstable vital signs with hemoperitoneum, adnexal mass > 5-6 cm. Serum hCG titers were checked before injection and 4, 7 day after injection. If serum hCG titer declined more than 15% on 7 day after injection compared with titer on 4 day, the weekly hCG titer was followed until it was <10 mIU/ml .If the hCG titer did not decline more than 15 %, a second dose was given. If hCG titer was not decreased or vital signs became unstable after 1-2 injections, the treatment was considered failure and surgery was done. RESULTS: 18 cases (82%) of 22 were successfully treated with single-dose methotrexate. The mean size of ectopic mass and initial serum hCG titers were 2.7+/-1.3 cm (range, 1.5-5.4 cm) and 3,298+/-1,007 mIU/ml (range, 132-12,239), respectively. Of 22, 6 cases (28%) needed second dose of methotrexate. The mean time to resolution of serum beta-hCG titer was 27.5+/-13.6 days (range, 8-53 days). Elevation of liver enzyme did not occurred in all cases during treatment. Initial hCG titer was more important prognostic factor than ectopic mass size for successful medical treatment. CONCLUSION: Single-dose methotrexate appears to be an effective medical treatment for the unruptured tubal pregnancy. However, patients selection using strict criteria is needed to increase its success rate.
Female ; Hemoperitoneum ; Humans ; Liver ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Vital Signs

BACKGROUND AND OBJECTIVES: It is estimated that more than 2 in every 1,000 neonates suffers from hearing loss. Early detection with appropriate rehabilitation of congenital hearing loss can reduce the adverse developmental consequences such as language delays, and behavior and attention deficits. The purpose of this study is to evaluate our newborn hearing screening program using the combined transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR), and to estimate the cost-effectiveness of our program. MATERIALS AND METHOD: 6,634 infants (5,918 well babies and 716 NICU babies) underwent the newborn hearing screening program at Ajou University Hospital for 4 years. Initially well babies were screened with TEOAEs, and those failing the TEOAEs were tested with the rescreening program. Neonates failing the TEOAE rescreening and the NICU babies were examined with ABR. The cost included personnel, fringe benefits, supplies, equipment and overhead. RESULTS: 660 (11%) out of 5,918 well babies failed the initial TEOAE screening and 27 (0.46%) babies failed the TEOAE rescreening. Eleven babies (0.16%), 3 of the well babies and 8 of the NICU babies, were confirmed to have hearing loss of more than 60 dB. We detected four deaf babies out of these eleven. From the four deaf babies, we confirmed a connexin 26-related deafness and an enlarged vestibular aqueduct syndrome. It cost $6 to screen one infant and $3,700 to detect one infant with hearing loss. CONCLUSION: We could detect 11 babies (0.16%) with hearing loss out of 6,634 neonates during the 4 years. Considering the benefits of early identification and rehabilitation of congenital hearing loss, the cost for the newborn hearing screen program is affordable. The newborn hearing screen should be extended as a national health program.
Deafness ; Equipment and Supplies ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Hearing* ; Humans ; Infant ; Infant, Newborn* ; Language Development Disorders ; Mass Screening* ; National Health Programs ; Rehabilitation ; Salaries and Fringe Benefits ; Vestibular Aqueduct

PURPOSE: This aim of this study is to analyze the dosimetric difference between intensity-modulated radiation therapy (IMRT) using 3 or 5 beams and MSF in the radiotherapy of the left breast. MATERIALS AND METHODS: We performed a comparative analysis of two radiotherapy modalities that can achieve improved dose homogeneity. First is the multistatic fields technique that simultaneously uses both major and minor irradiation fields. The other is IMRT, which employs 3 or 5 beams using a fixed multileaf collimator. We designed treatment plans for 16 early left breast cancer patients who had taken breast conservation surgery and radiotherapy, and analyzed them from a dosimetric standpoint. RESULTS: For the mean values of V95 and dose homogeneity index, no statistically significant difference was observed among the three therapies. Extreme hot spots receiving over 110% of the prescribed dose were not found in any of the three methods. A Tukey test performed on IMRT showed a significantly larger increase in exposure dose to the ipsilateral lung and heart than multistatic fields technique (MSF) in the low-dose area, but in the high-dose area, MSF showed a slight increase. CONCLUSION: In order to improve dose homogeneity, the application of MSF, which can be easily planned and applied more widely, is considered an optimal alternative to IMRT for radiotherapy of early left breast cancer.
Breast ; Breast Neoplasms ; Heart ; Humans ; Lung

Congenital diverticulum of the left ventricle is a very rare disease. Ventricular diverticulum is usually associated with other anomalies including intracardiac and midline thoracoabdominal defect. We describe a case with congenital left ventricular diverticulum presenting as an isolated lesion. A 37-year-old man presented with 4-year history of chest pain. Diverticulum was diagnosed by echocardiography and left ventriculogram.
Adult* ; Chest Pain ; Diverticulum* ; Echocardiography ; Heart Ventricles ; Humans ; Rare Diseases

Sudden cardiac death accounts for approximately half of all cardiovascular mortality in the industrialized countries and ventricular tachyarrhythmia is the most common mechanism for this event. Implantable cardioverter-defibrillator (ICD) has been effectively used for prevention of sudden cardiac death in patients with life-threatening ventricular tachyarrhythmias since 1980. Clinical experience with ICD device now exceeds 100,000 implants worldwide and the number of implantation is increasing. In Korea, there is also increasing trend of ICD implantation. The authors report the initial experience of of ICD implantation in 6 patients who had high risk of sudden cardiac death.
Death, Sudden, Cardiac ; Defibrillators, Implantable* ; Developed Countries ; Humans ; Korea ; Mortality ; Tachycardia