Electrocardiograms were observed in 168 patients with typhoid fever and were analyzed according to the duration of illness and hemoglobin level. The following results were obtained. 1) 124 patients out of 168 patients showed abnormal electrocardiographic findings. 2) The most prevalent abnormal findings were observed during third to fourth week of illness. 3) The lower the hemoglobin level, the higher frequency of electrocardiographic abnormalities were found. 4) Among the electrocardiographic disorders, sinus tachycardia was the most common finding and it was found in 60 cases(35.7%). The major abnormalities were ST-T change, low QRS voltage, prolongation of Q-T interval and prolongation of P-R interval: the over all incidence of these were 26.8%, 15.5%, 13.7% and 9.55 respectively. In addition to the major abnormalities, incomplete right bundle branch block (5.4%), premature ventricular contractions(3.0%) and abnormal Q wave(1.2%) were observed.
Bundle-Branch Block ; Electrocardiography* ; Humans ; Incidence ; Tachycardia, Sinus ; Typhoid Fever*

We analyzed the surgical result of pars plana vitrectomy using silicone oil tamponade and evaluated the effect of different silicone oil viscosity on the result. Of all 66 patients, 48 were male and their mean age was 45.9 years. The most common underlying disease was proliferative vitreoretinopathy (29 patients) and 54 patients (81.9%) had visual acuity of 5/200 or less. Mean follow-up period was 8.94 months. Twenty eight patients had undertaken two or more vitreoretianl surgeries. Anatomical and functional success was achieved in 57 (86.4%) and 31 patients (47.0%), respectively. Complications included hypotony (7 patients), increased intraocular pressure (6 patients), keratopathy (4 patients) and closure of inferior iridectomy (3 patients) on the last follow-up. There was statistically significant correlation between preoperative and final visual acuity (p=0.0001), anatomical success and improvement of visual acuity (p=0.0057), and frequency of vitreoretinal surgery and final visual acuity (p=0.0143). There was no statistically significant difference in the surgical result between eyes using 1,000 cSt and 5,000 cSt silicone oil. This result suggests silicone oil injection may effectively support the surgical treatment of intractible retinal detachment. However, difference of its viscosity seems to make little effect on the surgical result.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Iridectomy ; Male ; Retinal Detachment ; Silicone Oils* ; Viscosity* ; Visual Acuity ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

No abstract available.
Lymphoma, Non-Hodgkin*

BACKGROUND: Recent studies have documented increased release of endothelin(ET) during acute attack of asthma. The purpose of this study is to observe the link between plasma level and urinary excretion of each and changes during acute exacerbation. METHOD: Plasma and 24 hour urine were collected from sixteen asthmatics during acute exacerbation, twice ; first day of symptomatic exacerbation and two weeks after treatment. Controls were ten healthy normal subjects. All patients were treated with corticosteroid and beta-2 adrenergic agonist on admission. ET was determined by radioimmmunoassay and had 100% cross reactivity with ET-1, 67% with ET-2, 84% with ET-3, and 8% with Big-ET. RESULTS: Plasma ETs were significantly elevated during acute attack of asthma compared with those in remission and controls. However, there was no significant changes in urine ET concentrations or total ET amounts in 24 hour urine during exacerbation upto two weeks. Those levels of urine ET in asthmatics were still higher than controls. ET concentrations in plasma or urine were not correlated with pulmonary functional parameters and hypoxemia. CONCLUSION: The findings suggests that increased plasma ETs are related with exaggerated release during acute asthma. Urinary ET excretion is increased in asthma. However, urine ET changes during exacerbation should be observed in a larger and longer scale.
Adrenergic Agonists ; Anoxia ; Asthma* ; Endothelin-2 ; Endothelins* ; Humans ; Plasma*

PURPOSE: The purpose of this study was to identify the correlation between communication skills for emotional empathy and academic achievement on the Clinical Performance Examination (CPX). METHODS: One hundred twelve medical school students were observed to determine the extent to which they applied communication skills for emotional empathy (preparation stage: interview attitude, respect; rapport stage: encouragement, active listening, will for support; empathy stage: verbal expression empathy, nonverbal expression empathy, acceptance) to the CPX, as well as their level of understanding of these skills to calculate the Pearson r, which can be used to determine the correlation between communication skills and academic achievement (hematochezia, fatigue, abnormal menstruation, chest pain, alcohol problems). RESULTS: Male students had higher scores than females for all communicational skills except verbal expression empathy. Fourth-year students had statistically more significant correlations than third-year students with regard to the rapport stage 'active listening' and empathy stage 'nonverbal expression' and abnormal menstruation and chest pain. Correlations were also more significant for hematochezia in the preparation stage 'interview attitude,' rapport stage 'encouragement,' and empathy stages 'verbal and nonverbal expression' and 'acceptance.' The empathy stage 'nonverbal expressions' was more significant for fourth-year students with alcohol problems. Third-year students largely had negative correlations between emotional empathy communication skills and CPX academic achievement, especially between the preparation stage 'respect' and abnormal menstruation, and between the rapport stage 'encouragement' and hematochezia. CONCLUSION: There was a significant correlation between hematochezia, wherein MS students deliver bad news to patients, and communication skills for emotional empathy.
Achievement ; Chest Pain ; Clinical Competence ; Empathy ; Fatigue ; Female ; Gastrointestinal Hemorrhage ; Humans ; Male ; Menstruation ; Schools, Medical

The purpose of this study is to assess the usefulness of digital infrared thermographic image(DITI) in patients with surgically treated lumbar disc disease. A series of 480 patients with lumbar herniated disc was studied. The mean age of the patients was 37 years, with a range of 18 to 64 years. Of which 126 cases of chemonucleolysis. 18 cases of percutaneous endoscopic laser discectomy, and 336 cases of laminectomy with discectomy were performed. Among these patients, 336 cases of laminectomy were assessed by DITI preoperatively. The thermal differences(delta T) between the symptomatic and asymptomatic limbs were evaluated. We have categorized the types of herniations into 3 classes: 200 protruded, 99 extruded, and 37 sequestered. The thermal differences were classified into 3 groups: 177 patients had delta T < 0.5 degrees C, 74 patients had 0.5 degrees C < or = delta T < 0.8 degrees C and 85 patients had delta T > or = 0.8 degrees C. Among the group of patients with the sequestered disc, 30(i.e. 80%) had delta T > or = 0.8 degrees C. Among the surgically treated 336 patients, non-visualization of a part of the sciatic limb on preoperative DITI was the condition used to coin the term amputation sign by the authors. In the sequestered group, the "amputation sign" was observed in 28 cases(75%). We conclude that DITI can predict a sequestered disc disease, and it allows more precise indication regarding open surgery.
Amputation ; Diskectomy ; Extremities ; Humans ; Intervertebral Disc Chemolysis ; Intervertebral Disc Displacement ; Laminectomy ; Numismatics

Background: When a sudden outbreak of an infectious disease occurs, emergency medical services (EMS) response could be negatively affected. The poor prognosis of acute stroke may be largely attributed to delays in treatment. This study aimed to identify the impact of the sudden outbreak of coronavirus disease 2019 (COVID-19) on EMS response for patients with acute stroke. Methods: This comparative cross-sectional study was conducted in 25 safety centers in Seoul, Korea. We enrolled patients with acute stroke who were transferred to the emergency department by EMS. The study period was from February–April 2020 and the same period in 2019. Patients were divided into two groups, pre-COVID-19 period and early-COVID-19 period, and previously collected patient data were analyzed. We performed comparative analyses of EMS response and clinical outcomes between the groups. Results: Of 465 patients, 231 (49.7%) had an acute stroke during the study period. There was no significant difference between clinical characteristics of patients with acute stroke before and after the COVID-19 outbreak. EMS response times increased significantly during the early COVID-19 outbreak. The intensive care unit admission rate and mortality rate increased during the early COVID-19 outbreak. Conclusion In the initial phase after the sudden COVID-19 outbreak, EMS response times for acute stroke were delayed and the clinical outcomes of patients with acute stroke deteriorated.

Background: This study aims to investigate the relationship between metabolic syndrome and depression in Korean adults using data from the 2016 and 2018 Korean National Health and Nutrition Examination Surveys (KNHANES). Methods: The total number of participants in the 7th period 1st year (2016) and 3rd year (2018) surveys of KNHANES was 16142. This study was conducted with 10,722 subjects who met the diagnostic criteria for metabolic syndrome and responded to the Patient Health Questionnaire-9 (PHQ-9). Analysis of covariance was used to adjust the differences due to demographic factors, laboratory findings, and underlying diseases to understand the relationship between metabolic syndrome and PHQ-9 scores, if any. Results: The prevalence of metabolic syndrome was determined to be 25.6% in this study. The PHQ-9 scores with and without metabolic syndrome were 2.56 and 2.48, respectively, and there was no significant difference when the confounding variable was corrected (p=0.406). According to the analysis of each PHQ-9 item and metabolic syndrome, the results were not significant. Conclusion In this cross-sectional study conducted in Korean adults, no significant correlation was found between metabolic syndrome and depression.

Objectives: We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women. Methods: The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes—visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)—were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC. Results: VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women. Conclusions Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.

PURPOSE: The purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs. MATERIALS AND METHODS: Location-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation. RESULTS: The smallest difference between the calculated and the actual distance was 0.1+/-0.7 mm in Group 1/Method 3. The largest difference was -4.2+/-1.6 mm in Group 3/Method 2. In all groups, method 3 was the most accurate. CONCLUSION: Quantitative localization of impacted mesiodens is possible by using panoramic radiograph.
Incisor ; Radiography, Dental ; Radiography, Panoramic ; Skull ; Tooth, Supernumerary