No abstract available.
Panniculitis, Peritoneal*

No abstract available.
Alleles* ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; HLA-DRB1 Chains*

BACKGROUND: This study was performed to compare the effectiveness of cholesterol-lowering diet therapy instructed by physicians with that instructed by dieticians using techniques that remove regression to the mean. METHODS: 118 patients who visited the office of Family Medicine department in Pusan Paik Hospital from February to November, 1996 and had serum total cholesterol(TC) concentrations greater or equal to 200mg/dL from two measurements were enrolled. The patients were divided into two groups randomly according to the cholesterol-lowering dietary education methods : the one was educated by physicians(Group I), and the other by dieticians(Group II). We evaluated the differences of lipid levels after education in consideration of regression to the mean. RESULTS: The mean reduction in TC concentrations achieved by dietary therapy was 10.7 % and 7.3%(without and with adjustment for regression to the mean) in Group I, and 9.8 and 6.5%(without and with adjustment, for regression to the mean) in Group II. The baseline TC concentrations and TC concentrations after dietary therapy were significantly different in individual group regardless of adjustment for regression to the mean. However, the reduction degrees of TC concentrations were not significantly different between two groups. CONCLUSIONS: The results indicate that even after adjustment for regression to the mean, dietary therapy will achieve the expected reduction. And it seems that the diet education by physicians will be effective as much as that by dieticians.
Busan ; Diet Therapy ; Diet* ; Education ; Humans ; Nutritionists*

Sepsis refers to the systemic response to serious infection. Patients with sepsis usually manifest fever, tachycardia, tachypnea, leukocytosis, and a localized site of infection. Methicillin-resistant Staphylococcus aureus(MRSA) is a gram-positive, nonmotile, aerobic, catalase- positive coccus, which is resistant to all the B -lactam antibiotics. Cutaneous manifestations in sepsis are maculopapules, nodules, petechiae, ecchymoses, purpurae, pustules, vesiculobullae, hemorrhagic bullae and ulcers. When MRSA is identified in blood cultures and skin tissue cultures, the skin lesions can be considered as cutaneous manifestations in sepsis caused by MRSA. We report two cases with erythematous pustules, petechiae, hemorrhagic bullae and maculopapules caused by MRSA sepsis. MRSA grew in blood cultures and skin tissue cultures.
Anti-Bacterial Agents ; Ecchymosis ; Fever ; Humans ; Leukocytosis ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Purpura ; Sepsis* ; Skin ; Staphylococcus ; Tachycardia ; Tachypnea ; Ulcer

Foreign bodies in genitourinary tract are not rare and most of them are present in the bladder. Various kinds of object are introduced into bladder through urethra by both male and female patients. Traditionally, they were introduced mainly for the purpose of sexual behavior. But recently like in our cases, many of them are inserted iatrogenically with development of endourologic procedure. We report 14 cases of bladder foreign bodies. Some of them are surprising and beyond common sense in kind of object and aim of insertion. Six cases were inserted by iatrogenic, 5 cases for masturbation, 2 cases by independently of patient`s intention by other person(s). One patient who had history of mental retardation did not remember when, how, why and by whom the foreign body had been introduced. All the foreign bodies could be diagnosed by history, symptom, X-ray and cystoscopy and removed by cystoscopic manipulation or cystostomy with ease and without complication.
Cystoscopy ; Cystostomy ; Female ; Foreign Bodies* ; Humans ; Intellectual Disability ; Intention ; Male ; Masturbation ; Sexual Behavior ; Urethra ; Urinary Bladder*

Foreign bodies in genitourinary tract are not rare and most of them are present in the bladder. Various kinds of object are introduced into bladder through urethra by both male and female patients. Traditionally, they were introduced mainly for the purpose of sexual behavior. But recently like in our cases, many of them are inserted iatrogenically with development of endourologic procedure. We report 14 cases of bladder foreign bodies. Some of them are surprising and beyond common sense in kind of object and aim of insertion. Six cases were inserted by iatrogenic, 5 cases for masturbation, 2 cases by independently of patient`s intention by other person(s). One patient who had history of mental retardation did not remember when, how, why and by whom the foreign body had been introduced. All the foreign bodies could be diagnosed by history, symptom, X-ray and cystoscopy and removed by cystoscopic manipulation or cystostomy with ease and without complication.
Cystoscopy ; Cystostomy ; Female ; Foreign Bodies* ; Humans ; Intellectual Disability ; Intention ; Male ; Masturbation ; Sexual Behavior ; Urethra ; Urinary Bladder*

OBJECTIVES: The diagnosis of ASCUS(atypical squamous cells of undetermined significance) and LSIL(low-grade squamous intraepithelial lesion) was introduced in 1988 by the Bethesda system for reporting cervical/vaginal cytologies. A significant proportion of women referred for colposcopy with low grade cervical cytologic abnormalities(ASCUS and LSIL) will have high grade cervical intraepithelial neoplasia(CIN II or CIN III) and therefore require adequate management. The purposes of this study were to evaluate the usefulness of high risk type HPV(human papillomavirus) DNA detection using PCR(polyerase chain reaction) in patients with low grade cervical cytologic abnormalities in the prediction of high grade CIN and invasive cancer and to determine the clinical triage in the management of low grade cervical cytologic abnormalities. METHODS: We reviewed 18,942 cases of Papanicolau smears that were performed at our hospital from Jan. 1995 to Mar. 1999. Colposcopically directed biopsy or LLETZ(large loop excision of transformation zone) or hysterectomy were performed on 318 patients with abnormal PAP smears of low degree. HPV PCR testing of high risk types(16 and 18) was also performed on 115 patients. RESULTS: Histologic outcome of ASCUS included 43 cases(38.4%) of high grade CIN and invasive cancer, and that of LSIL included 65 cases(47.5%) of high grade CIN and invasive cancer. In cases of high risk HPV type, 19 patients(73.1%) were at age over 30 years. A highly significant correlation was found between a positive test for high risk types of HPV and finding of high grade CIN and invasive cancer. Among 51 women with ASCUS, a positive test for high risk type had a sensitivity and specificity of 40.0% and 86.1%, and positive predictive value(PPV) and negative predictive value(NPV) of 54.5% and 77.5%, respectively. In 64 women with LSIL, a positive high risk type test was associated with sensitivity and specificity of 30.0% and 94.1%, and PPV and NPV of 81.8% and 60.4%, respectively. CONCLUSION: Our results suggest that high risk type HPV may be positively predictive of and may act as a surrogate marker for high grade CIN and invasive cancer in women with low grade cervical cytologic abnormalities. The management of women with a low grade cervical cytologic abnormalities should be active such as colposcopically directed biopsies.
Biomarkers ; Biopsy ; Colposcopy ; Diagnosis ; DNA* ; Female ; Humans* ; Hysterectomy ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Triage

OBJECTIVES: Depression, sleep complaints and cognitive impairments are commonly observed in the elderly. Elderly subjects with depressive symptoms have been found to show both poor cognitive performances and sleep disturbances. However, the relationship between sleep complaints and cognitive dysfunction in elderly depression is not clear. The aim of this study is to identify the association between sleep disturbances and cognitive decline in late-life depression. METHODS: A total of 282 elderly people who underwent nocturnal polysomnography in a sleep laboratory were enrolled in the study. The Korean version of the Neuropsychological Assessment Battery developed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was applied to evaluate cognitive function. Depressive symptoms were assessed with the geriatric depression scale (GDS) and subjective sleep quality was measured using the Pittsburg sleep quality index (PSQI). RESULTS: The control group (GDS< or =9) when compared with mild (10< or =GDS< or =16) and severe (17< or =GDS) depression groups, had significantly different scores in the Trail making test part B (TMT-B), Benton visual retention test part A (BVRT-A), and Stroop color and word test (SCWT)(all tests p<0.05). The PSQI score, REM sleep duration, apnea-hypopnea index and oxygen desaturation index were significantly different across the three groups (all indices, p<0.05). A stepwise multiple regression model showed that educational level, age and GDS score were predictive for both TMT-B time (adjusted R2=35.6%, p<0.001) and BVRT-A score (adjusted R2=28.3%, p<0.001). SCWT score was predicted by educational level, age, apnea-hypopnea index (AHI) and GDS score (adjusted R2=20.6%, p<0.001). Poor sleep quality and sleep structure alterations observed in depression did not have any significant effects on cognitive deterioration. CONCLUSION: Older adults with depressive symptoms showed mild sleep alterations and poor cognitive performances. However, we found no association between sleep disturbances (except sleep apnea) and cognitive difficulties in elderly subjects with depressive symptoms. It is possible that the impact of sleep disruptions on cognitive abilities was hindered by the confounding effect of age, education and depressive symptoms.
Adult* ; Aged ; Alzheimer Disease ; Depression* ; Education ; Humans ; Oxygen ; Polysomnography ; Sleep, REM ; Trail Making Test

No abstract available.
Appendicitis* ; Child* ; Humans

A 38-year-old male patient visited our clinic complaining of three skin lesions on the scalp. There were yellowish to brownish, waxy, non-tender, walnut-sized nodules. Hematoxylin and eosin staining revealed amorphous pinkish material deposits in the dermis. The Congo red stain and Dylon stain under polarizing microscopy showed yellow-green birefringence and the immunoglobulin-lambda light chain stain showed a positive reaction. An electron microscopic examination revealed filaments with uniform diameter(6 to 10nm) that were straight and neither branched nor anastomosed. Based on the clinical, histopathological, immunohistochemical and electron microscopical findings, the skin lesions were diagnosed as nodular amyloidosis.
Adult ; Amyloidosis* ; Birefringence ; Congo Red ; Dermis ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Male ; Microscopy ; Scalp ; Skin