BACKGROUND: Fine needle aspiration cytology is an effective and important diagnostic procedure to distinguish benign from malignant thyroid nodule. The purpose of this study is to compare the results of thyroid fine needle aspiration cytology performed by the residents of family medicine and internal medicine. METHODS: Among patients who underwent fine needle aspiration cytology for differential diagnosis of thyroid nodule at the department of family medicine, Pusan National University Hospital from July 1996 to June 1998, we randomly selected 96 patients. We also selected 96 control patients at the department of internal medicine. We assessed the patients age, sex, accompanying symptoms, diagnostic procedures, pathologic results of fine needle aspiration cytology from the medical records and biopsy records. For statistical analysis, we used t-test and Chi-square test. RESULTS: Mean age of 96 patients of family medicine was 44.4 years. Females were 89(92.7%) and males 7(7.3%). Age and sex distributions were not significantly different from that of internal medicine patients(p>0.05). Patients with thyroid nodule had underwent fine needle aspiration cytology(100.0%), thyroid function test(76.0%), thyroid scan(49.0%), and thyroid ultrasond(35.4%). There were more thyroid scans performed in the intemal medicine department, as there were more ultrasonograms done in the family medicine department(p<0.05). Pathology results of 96 cases showed benign in 51 cases(53.1%), malignant in 8(8.3%), indeterminate in 16(16.7%), and insufficient in 21(21.9%). Among the 51 benign cases, there were cystic nodule(27.1%), adenomatous hyperplasia(22.9%), and thyroiditis(3.1%). All 8 malignant cases were papillary carcinoma. The frequency of malignancy thyroid nodules and insufficient specimens were not significantly different between the two departments(p>0.05). Complications of aspiration were rare and not significantly different between the two departments(p>0.05). CONCLUSIONS: Pathology results and complications of fine needle aspiration cytology performed by residents of family medicine and internal medicine were not significantly different.
Biopsy ; Biopsy, Fine-Needle* ; Busan ; Carcinoma, Papillary ; Diagnosis, Differential ; Female ; Humans ; Internal Medicine* ; Male ; Medical Records ; Pathology ; Sex Distribution ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

PURPOSE: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. MATERIALS AND METHODS: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. RESULTS: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. CONCLUSION: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.
Arthralgia ; Displacement (Psychology) ; Hallux ; Hallux Valgus ; Humans ; Inflammation ; Metatarsal Bones ; Osteotomy ; Skin ; Sutures

Chronic constrictive pericarditis is an uncommon disease, but an importanat one because of its potential curability. It usually begins with an initial episode of acute pericarditis often with a pericardial effusion which may not be detected clinically. This then progresses to resorption of the effusion followed by obliteration of pericardial abity with formation of fibrotic tissue, which results in symmetrical scarring that produce uniform restriction. In general, there are no specific problems due to remained pericardial effusion in the clinically manifestated case of constrictive pericarditis. We report a case of chronic constrictive pericarditis with localized pericardial effusion, which caused to hemodynamic compromise due to local compression of the right ventricle.
Cicatrix ; Heart Ventricles ; Hemodynamics ; Pericardial Effusion* ; Pericarditis ; Pericarditis, Constrictive*

Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and nonepithelial components, that is, carcinoma and sarcoma in the same tumor. Since Queckenstedt reported the case of carcinosarcoma of the stomach in 1904, only 30 cases have been reported. We present a case of carcinosarcoma and adenocarcinoma of the stomach in 63-year-old man with the review of the literature.
Adenocarcinoma* ; Carcinosarcoma* ; Humans ; Middle Aged ; Sarcoma ; Stomach*

PURPOSE: To evaluate the efficacy of surgical treatment through retrospective comparison of minimally invasive percutaneous plate osteosynthesis (MIPPO) vs open plate fixation in the treatment of the distal femur fractures. MATERIALS AND METHODS: Thirty-one patients with distal femur fractures from January 2002 to December 2010 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 17 patients treated with MIPPO, and group B was comprised of 14 patients treated with open plate fixation. Clinical outcomes including operation time, transfusion rate, rehabilitation, range of motion, and interval change of postoperative C-reactive protein (CRP) were evaluated to assess postoperative inflammatory reaction, postoperative complications and clinical results with the use of Sanders criteria. RESULTS: The operative time was 86/135 min and transfusion volume was 0.8/1.9 unit respectively. The postoperative 3-day and 7-day CRP were 7.4/1.5 mg% in group A and 10.3/2.4 mg% in group B, showing more minimal tissue injury and early recovery in group A. There were no significant differences in clinical results by Sanders criteria in both groups. CONCLUSION: Both MIPPO and open plate fixation for the treatment of distal femur fractures showed comparably good results. However, the MIPPO technique is superior to group B in view of minimal tissue injury and operation time and was proven to lessen the transfusion rate.
C-Reactive Protein ; Femur* ; Follow-Up Studies ; Humans ; Operative Time ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: To evaluate the efficacy and safety of silodosin 8 mg once daily in a 12-week treatment of subjects with severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 100 subjects from 10 urology centers in Korea were included in this study. The inclusion criteria were as follows: age > or =50 years, International Prostate Symptom Score (IPSS) > or =20, quality of life (QoL) score > or =3, urine volume > or =120 mL and maximal urinary flow rate (Qmax) <15 mL/s, and postvoid residual volume (PVR) <100 mL. We assessed the improvement of LUTS with change in IPSS, QoL score, Qmax, PVR, and adverse events at baseline and 4 and 12 weeks after treatment with silodosin 8 mg once daily. RESULTS: The IPSS values were 23.27+/-3.34, 15.89+/-6.26, and 13.80+/-6.31 at baseline, 4, and 12 weeks, respectively, with significant improvements (p<0.0001, p=0.0214, respectively). QoL scores were 4.44+/-0.85, 3.38+/-1.20, and 3.04+/-1.20 at baseline, 4, and 12 weeks, respectively, and the differences were statistically significant (p<0.0001). There was a significant difference in Qmax between baseline and 12 weeks (p<0.0001) but not in PVR (p=0.9404) during the clinical trial. The most frequent adverse event in this study was ejaculation failure with 13 cases. However, no subject dropped out because of ejaculation failure, and in 12 of the 13 cases it was fully resolved without further treatment. CONCLUSIONS: Silodosin 8 mg once daily may be effective and safe in Korean patients with severe LUTS associated with BPH.
Ejaculation ; Humans ; Korea ; Lower Urinary Tract Symptoms* ; Male ; Prospective Studies* ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Residual Volume ; Urology

Hemophagocytic lymphohistiocytosis (HLH) can develop following strong activation of the immune system and the cardinal symptoms are a prolonged fever, hematological abnormalities, hepatosplenomegaly, and hemophagocytosis. HLH can be classified as primary or secondary HLH, associated with infections, malignancy and autoimmune disease. There is no consensus on the primary treatment regimen in systemic lupus erythematosus (SLE)-associated HLH. We experienced a case of SLE-associated HLH in a previously healthy adult. She was initially treated with intravenous immunoglobulin, cyclosporine, and high-dose steroid, but had a poor clinical response. After intravenous etoposide, the patient stabilized and has been followed for 1 year without reactivation of the HLH or SLE.
Adult ; Autoimmune Diseases ; Consensus ; Cyclosporine ; Etoposide ; Fever ; Humans ; Immune System ; Immunoglobulins ; Lupus Erythematosus, Systemic ; Lymphohistiocytosis, Hemophagocytic

BACKGROUND: Although intraoperative opioids provide more comfortable anesthesia and reduce the use of postoperative analgesics, it may cause opioid induced hyperalgesia (OIH). OIH is an increased pain response to opioids and it may be associated with N-methyl-D-aspartate (NMDA) receptor. This study aimed to determine whether intraoperative nefopam or ketamine, known being related on NMDA receptor, affects postoperative pain and OIH after continuous infusion of intraoperative remifentanil. METHODS: Fifty-four patients undergoing laparoscopic cholecystectomy were randomized into three groups. In the nefopam group (N group), patients received nefopam 0.3 mg/kg at the induction of anesthesia followed by a continuous infusion of 0.065 mg/kg/h. In the ketamine group (K group), patients received ketamine 0.3 mg/kg at the induction of anesthesia followed by a continuous infusion of 3 µg/kg/min. The control group did not received any other agents except for the standard anesthetic regimen. Postoperative pain score, first time and number of demanding rescue analgesia, OIH and degrees of drowsiness/sedation scale were examined. RESULTS: Co-administrated nefopam or ketamine significantly reduced the total amount of intraoperative remifentanil and postoperative supplemental morphine. Nefopam group showed superior property over control and ketamine group in the postoperative VAS score and recovery index (alertness and respiratory drive), respectively. Nefopam group showed lower morphine consumption than ketamine group, but not significant. CONCLUSIONS: Both nefopam and ketamine infusion may be useful in managing in postoperative pain control under concomitant infusion of remifentanil. However, nefopam may be preferred to ketamine in terms of sedation.
Analgesia ; Analgesics ; Analgesics, Opioid ; Anesthesia ; Cholecystectomy, Laparoscopic* ; Humans ; Hyperalgesia ; Ketamine* ; Morphine ; N-Methylaspartate ; Nefopam* ; Pain, Postoperative*

BACKGROUND: The objectives of this study are to determine the positive rate of HBV serologic markers and infection rate, and to evaluate the efficiency of hepatitis B vaccination. METHODS: Study subjects included 905 persons in 1988-1989 and 744 persons in 1993-1994 living in typical rural communities in Korea. Three serologic markers(HBsAg, anti-HBs, anti-HBc) were tested by radio-immunoassay(RIA). Supplemental informations were collected by self-administered questionnaire and interview on age, sex, history and frequency of vaccination. RESULTS: 1) Among non-vaccinees, HBsAg, anti-HBs, anti-HBc positive rates and infection rate in 1993-1994/1988-1989 were 5.4%/6.5%, 49.1%/45.9%, 48.3%/44.1% and 60.6%/54.5% respectively. The infection rate showed a trend of continuous increase as the age increased, while statistically significant increase was seen over age 20. 2) Overall vaccination rate was 18.1% in 1988-1989 and 37.9% in 1993-1994, showing statistically significant increase in vaccination rate. The rate in younger age groups were higher than in older groups in 1988-1989, but there was no difference by age groups in 1993-1994. Among vaccinees, anti-HBs only positive group occupied 42.7% in 1988-1989 and 41.3% in 1993-1994. HBs Ag negative and anti-HBc positive group occupied 26.2% in 1988-1989 and 36.73% in 1993-1994. CONCLUSION: 1) Among non-vaccinees, HBsAg positive rate was decreased, but the hepatitis B infection rate was not decreased. 2) The test for selection of eligible person of vaccination and education program for completion of vaccination schedule must be reevaluated to improve the efficiency of hepatitis B vaccination.
Appointments and Schedules ; Education ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea* ; Rural Population ; Seroepidemiologic Studies* ; Vaccination* ; Surveys and Questionnaires

A neurofibroma is a benign tumor of the peripheral nerve sheath characterized by proliferation of Schwann cells, perineural cells, and endoneurial fibroblasts. Different types of neurofibromas can be identified, including localized, plexiform, and diffuse types. Neurofibromas can involve any site on the body skin. The diffuse variant is rare and occurs primarily in children and young adults. It involves the skin and subcutaneous tissue in a plaque-like fashion on the head and neck regions. We present a case of a 10-year-old boy who had a diffuse neurofibroma on the scalp.
Child ; Fibroblasts ; Head ; Humans ; Neck ; Neurofibroma ; Peripheral Nerves ; Scalp ; Schwann Cells ; Skin ; Subcutaneous Tissue ; Young Adult