No abstract available.
Emphysema* ; Heart Septal Defects, Ventricular*

No abstract available.
Posterior Cruciate Ligament*

The Korean Diabetes Association (KDA) published the 3rd edition of the diabetic neuropathy management guidebook in 2010. This publication has been recognized as the definitive guide for the clinical management of diabetic neuropathy in the Korean medical system. In this report, we provide a modified summary of the 3rd edition of the diabetic neuropathy management guidebook. We hope this summary will serve as a helpful reference in the daily clinical practice of diabetes care.
Diabetic Neuropathies ; Peripheral Nervous System Diseases ; Publications

No abstract available.
Iron* ; Mesangial Cells* ; Perfusion*

For many years, NO2 has been regarded as one of the elements among indoor air pollutants of urban homes, leading to increased public concerns on this gas. For the purpose of preparing the fundamental data for the evaluation and control of health effect relevant to NO2 levels, authors measured the indoor (kitchen, living room, bedroom) and outdoor NO2 levels categorized by the type of house(apartment, detached dwelling) and cooking fuel(L.P.G., briquette) in the winter and summer, and surveyed the variables(kitchen ventilation, family size, parental smoking) may effect the indoor NO2 levels. The level of NO2 was measured by Palmes tube, and this survey was carried out at 110 homes in the Pusan area from October 1984 to September 1985. The obtained results were as follows: 1) The mean indoor and outdoor NO2 level in winter and summer, respectively, was 0.029+/-0.012 ppm and 0.022+/-0.012 ppm in the kitchen, 0.022+/-0.009 ppm and 0.018+/-0.010 ppm in the living room, 0.017+/-0.008 ppm and 0.016+/-0.010 ppm in the bed room, and 0.021+/-0.007 ppm and 0.016+/-0.007 ppm outdoors. 2) In the category of the type of house and cooking fuel, the highest mean indoor and outdoor NO2 level in the winter was in apartments using briquettes, and in the summer, the highest level was in apartments using L.P.G. 3) In the category of the type of house, the mean indoor and outdoor NO2 level in the winter and summer was higher in the apartment group compared to detached dwelling. 4) In the category of the type of cooking fuel, the mean indoor and outdoor NO2 level in the winter was higher in the briquette group, and in the summer, the L.P.G. group was higher. 5) In the category of the kitchen ventilation, family size, parental smoking and asthma attack history of children, there was an insignificant difference in the indoor NO2 levels.
Air Pollutants ; Asthma ; Busan ; Child ; Cooking ; Family Characteristics ; Humans ; Parents ; Smoke ; Smoking ; Ventilation

BACKGROUND: Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes. METHODS: We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients' characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications. RESULTS: Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment. CONCLUSION: Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.
Bone Plates ; Consensus ; Flail Chest ; Fracture Fixation ; Humans ; Male ; Medical Records ; Methods ; Postoperative Complications ; Retrospective Studies ; Sensitivity Training Groups ; Sternum ; Thoracic Injuries ; Thoracic Wall ; Thorax

PURPOSE: This study was designed to investigate the significance of preoperative serum CA 19-9 level as a prognostic factor and postoperative serum CA 19-9 level as an indicator for recurrence in gastric adenocarcinoma patients. MATERIALS AND METHODS: 328 patients, who received curative resection of stomach for gastric cancer from 1989 to 1996 and followed up successfully, were analyzed retrospec- tively. Median follow-up period was 24 months (range: 11-38 months). The cut off level of serum CA 19-9 was 37 U/ml. The relationships between preoperative serum CA 19-9 status and prognostic parameters, recurrence and survival rate were analyzed. Multivariate analysis using Cox proportional hazards regression analysis was performed to evaluate as an independent prognostic factor. The relationship between postoperative serum CA 19-9 level and recurrence was investigated. RESULTS: Out of 328 cases, 29 cases (8.8%) showed elevated preoperative serum CA 19-9 level. The preoperative serum CA 19-9 level was correlated with the degree of depth of invasion and the status of lymph node metastasis (p<0.05). Patients with positive pre- operative serum CA 19-9 status showed higher incidence of recurrence (p<0.05) and poorer survival rate (p=0.00003) than patients with negative status. Preoperative serum CA 19-9 status (risk ratio: 3.4464, p=0.0039) revealed as an independent prognostic factor in multivariate analysis. Postoperative serum CA 19-9 status revealed as a useful predictor for recurrence in patients with positive preoperative serum CA 19-9 status. CONCLUSION: Preoperative serum CA 19-9 determination in patients with gastric cancer was valuable for predicting tumor progression and prognosis. Preoperative serum CA 19-9 status may be helpful to predict recurrence earlier than other diagnostic tools, especially in the patients with positive preoperative serum CA 19-9 status.
Adenocarcinoma* ; Follow-Up Studies ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Stomach ; Stomach Neoplasms ; Survival Rate

PURPOSE: CEA, CA19-9, and CA72-4 are the most commonly used tumor markers in stomach cancer. This clinical study was performed to evaluate the diagnostic value of these tumor markers in stomach cancer patients. MATERIALS AND METHODS: A retrospective analysis of 170 stomach cancer patients who had undergone curative gastrectomy between January 1991 and December 1996 at the Department of Surgery was performed. The preoperative and postoperative serum levels of these tumor markers were measured in 170 patients. RESULTS: The preoperative positive cases were 28 cases (16%) in CEA, 15 (9%) in CA19-9, and 24 (14%) in CA72-4. The postoperative positive cases among 48 recurrences were 21 cases (44%) in CEA, 10 (21%) in CA19-9, and 10 (21%) in CA72-4. The combination of CEA with CA19-9 or CA72-4 had higher positivity rate (58%) than single tumor marker. The highest positivity rate was found in CEA at recurrences of anastomotic site, in CA19-9 at recurrences of lymph node, in CA72-4 at peritoneal seeding and distant metastasis. In multivariate analysis, these tumor markers were not independent prognostic factors. CONCLUSION: CEA, CA19-9, and CA72-4 have proved unhelpful in initial diagnosis of stomach cancer because of their low positivity rate. And the combination of 3 tumor markers was the useful method for raising positivity rate in diagnosis of recurrences.
Diagnosis ; Gastrectomy ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Stomach* ; Biomarkers, Tumor*

Antithyroid drugs (ATD) has been widely used to treat Graves' disease. However agranulocytosis, a serious fatal complication of ATD treatment, occurs in about 0.5 percent. The symptoms may mimic viral infections (fever, sore throat), and the potentially life-threatening pyogenic infections can go unrecognized initially. The median duration of drug exposure before the onset of acute agranulocytosis is within 30 days in most cases. We report a case of agranulocytosis with secondary soft tissue infection and abscess occuring after increasing the dose of methimazole in a woman who had taken methimazole for more than 10 years. We administered broad-spectrum antibiotics and aspirated the soft tissue abscess. A review of the medical literature regarding agranulocytosis in the setting of ATDs is presented.
Abscess ; Agranulocytosis ; Anti-Bacterial Agents ; Antithyroid Agents ; Female ; Graves Disease ; Humans ; Hydrazines ; Methimazole ; Soft Tissue Infections

BACKGROUND: Monitoring the "depth of anesthesia" is an ongoing problem. To identify a useful parameter for determining the depth of anesthesia with enflurane, EEG data was obtained using a Physiolab 800. METHODS: Variations in EEG signals were measured and analyzed by the stage of anesthesia. EEG data was obtained from 15 patients during general anesthesia with enflurane. The EEG signal was acquired and analyzed in 5 steps (one day before anesthesia, during induction, during skin incision, at end of anesthesia, and one day after anesthesia). Fp1 electrode and the EEG data mainly from the forehead were used to determine the depth of anesthesia using EEG characteristics during enflurane anesthesia. All data were preprocessed by filtering, baseline correction and using the linear detrend method to reliable analyze of sample data in the surgical environment. Data obtained were transformed to frequency and power spectrum analysis was performed. RESULTS: alpha, beta, delta and theta waves were detected by frequency area separation and the trend of each wave was observed during each anesthesia stage. EEG data was slowed down and the theta wave ratio increased as the depth of anesthesia increased. Accordingly, spectral edge frequency (SEF) and median frequency (MF) were used as parameters to determine the depth of anesthesia. The frequencies of SEF and MF decreased during anesthesia and returned to the preanesthetic level after the cessation of anesthesia. CONCLUSIONS: Our results suggest that SEF and MF can contribute as useful parameters to determine the depth of anesthesia. Anesthetics not only affect the central nervous system, but also affect the autonomic nervous system. If the autonomic nervous system signals such as heart rate variability are taken into account, more reliable evaluations would be possible.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Autonomic Nervous System ; Central Nervous System ; Electrodes ; Electroencephalography* ; Enflurane ; Forehead ; Heart Rate ; Humans ; Skin ; Spectrum Analysis*