BACKGROUND: Nocturia is a common event among the elderly that is often understood to be a potential cause of sleep disorder. However, only a few such studies have been reported in Korea. The purpose of this study was to investigate physical diseases including nocturia as a risk factor for sleep disturbance in the Korean elderly. METHODS: Subjects included 433 patients older than 60 years (average age, 69.7 years) who had completed a structured questionnaire from June to August 2009. The questionnaire asked about the quality of their sleep, nocturia and physical diseases such as hypertension, diabetes mellitus, gastrointestinal problems, arthralgia and chronic obstructive pulmonary disease. Logistic regression analysis was used to evaluate the nocturia and the physical diseases associated with sleep. RESULTS: Incidence of nocturia increased with age and showed a significant variation among the different age groups (p<0.05): 35.7% in their 60s, 41.5% in their 70s and 60.4% in their 80s and older. Nocturia (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.10 to 2.58) and arthralgia (OR, 1.69; 95% CI, 1.10 to 2.60) were two important factors causing sleep disorder. CONCLUSION: In conclusion, nocturia and arthralgia were the main causes of sleep disorder. As the elderly population is continually increasing, further studies are needed to improve our understanding of this subject and to find a potential cure.
Aged ; Arthralgia ; Diabetes Mellitus ; Humans ; Hypertension ; Incidence ; Korea ; Logistic Models ; Nocturia ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Risk Factors

BACKGROUND: Nocturia is a common event among the elderly that is often understood to be a potential cause of sleep disorder. However, only a few such studies have been reported in Korea. The purpose of this study was to investigate physical diseases including nocturia as a risk factor for sleep disturbance in the Korean elderly. METHODS: Subjects included 433 patients older than 60 years (average age, 69.7 years) who had completed a structured questionnaire from June to August 2009. The questionnaire asked about the quality of their sleep, nocturia and physical diseases such as hypertension, diabetes mellitus, gastrointestinal problems, arthralgia and chronic obstructive pulmonary disease. Logistic regression analysis was used to evaluate the nocturia and the physical diseases associated with sleep. RESULTS: Incidence of nocturia increased with age and showed a significant variation among the different age groups (p<0.05): 35.7% in their 60s, 41.5% in their 70s and 60.4% in their 80s and older. Nocturia (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.10 to 2.58) and arthralgia (OR, 1.69; 95% CI, 1.10 to 2.60) were two important factors causing sleep disorder. CONCLUSION: In conclusion, nocturia and arthralgia were the main causes of sleep disorder. As the elderly population is continually increasing, further studies are needed to improve our understanding of this subject and to find a potential cure.
Aged ; Arthralgia ; Diabetes Mellitus ; Humans ; Hypertension ; Incidence ; Korea ; Logistic Models ; Nocturia ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Risk Factors

Fine needle aspiration cytology is gold standard for diagnosis of thyroid nodule. However, it is not perfect and its results are cytologically indeterminate nodules (Bethesda classification III-V) in 15-30%, which remains diagnostic challenges. So, the method that provide information about cancer risk is necessary to establish management strategy. As results of studies about genetic changes in thyroid cancer, remarkable advances have been achieved in understanding thyroid carcinogenesis, which produced applications of molecular biomarkers and profiling panels for diagnosis of thyroid nodule. These tests help clinicians make decision regarding the need for surgery and the surgical extent. In this review, published researches related to molecular diagnosis of thyroid cancer are reviewed and performance of the diagnostic tests and its interpretation were discussed.
Biomarkers ; Biopsy, Fine-Needle ; Carcinogenesis ; Classification ; Diagnosis* ; Diagnostic Tests, Routine ; Genetic Testing ; Methods ; Molecular Diagnostic Techniques ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule*

OBJECTIVE: To investigate the correlation of multifidus muscle atrophy on MRI findings with clinical findings in low back pain patients. METHOD: Medical records of 80 patients presenting with low back pain were retrospectively reviewed. Their MR images were visually analysed to know lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compression. RESULTS: Multifidus muscle atrophy increased from the upper lumbar level to the most caudal intervertebral level. It was bilateral in the majority of the cases. Multifidus muscle atrophy was well correlated with patient's age, referred leg pain, and disc degeneration. However, duration of low back pain, disc herniation, spinal stenosis, nerve root compression, sex, weight, height and BMI had no correlation with multifidus muscle atrophy. CONCLUSION: Examination of multifidus muscle atrophy should be considered when assessing MR images of lumbar spine. It may help for further evaluation and planning the treatment modalities of low back pain.
Atrophy* ; Humans ; Intervertebral Disc Degeneration ; Leg ; Low Back Pain* ; Magnetic Resonance Imaging ; Medical Records ; Muscular Atrophy ; Paraspinal Muscles* ; Radiculopathy ; Retrospective Studies ; Spinal Stenosis ; Spine

With the aim of gaining more insight into the catecholaminergic system in the nervous system of the rat, we have studied the precise distribution pattern of the tyrosine hydroxylase immunoreactive[TH-IR] fibers and soma in the spinal cord and dorsal root ganglion. In the dorsal root ganglion[DRG], TH-IR fibers were observed to run along the vessel wall, spirally and not found in the neural tissue itself. A few TH-IR fibers were found in the spinal nerve, not in the ventral root. Many TH-IR neurons were distributed in the L3, 4, 5, and 6 DRG but none of them were found in the other DRG segments. In the spinal cord, TH-IR fibers have shown sparse distribution all over spinal cord but relatively dense distribution in the ventral horn, intermediolateral column, lamina I of the dorsal horn of the cervical, lumbar, sacral, and coccygeal segment. TH-IR neurons were found in the intermediolateral column, dorsal gray commissure, dorsal horn of the C1 and C2 segments and S1-4 segments. TH-IR neurons in the cervical segments were polygonal and spindle shaped with well developed processes. In contrast to this, TH-IR neurons in the sacral segments were oval or spindle shaped with no processes. In conclusion, neurons in the DRG were not influenced by catecholaminergic nervous input. Intrinsic catecholaminergic nervous systems were found in both of spinal cord and DRG.
Animals ; Carisoprodol ; Diagnosis-Related Groups ; Ganglia, Spinal* ; Horns ; Immunohistochemistry ; Nervous System ; Neurons ; Rats* ; Spinal Cord* ; Spinal Nerve Roots* ; Spinal Nerves ; Tyrosine 3-Monooxygenase ; Tyrosine*

We report on a 28 years old female with recurred cardiac myxomas who presented with dizziness, headache, and blurred vision. She had an excision of biatrial atrial myxomas 10 years age. Varying sized multiple cerebral aneuysms and myxomas in left atrium and left ventricle were found on a cerebral angiogram and echocardiogram, respectively. After wide excision including interatrial septum and part of left ventricular septum, her symptoms were much improved.
Adult ; Dizziness ; Female ; Headache ; Heart Atria ; Heart Ventricles ; Humans ; Intracranial Aneurysm ; Myxoma* ; Ventricular Septum

BACKGROUND: Many difficulties exist in establishing a treatment plan for slow-flow vascular malformation (SFVM). In particular, little research has been conducted on the surgical treatment of SFVMs. Thus, we investigated what proportion of SFVM patients were candidates for surgical treatment in clinical practice and how useful surgical treatment was in those patients. METHODS: This study included 109 SFVM patients who received care at the authors' clinic from 2007 to 2015. We classified the patients as operable or non-operable, and analyzed whether the operability and the extent of the excision varied according to the subtype and location of the SFVM. Additionally, we investigated complications and self-assessed satisfaction scores. RESULTS: Of the 109 SFVM patients, 59 (54%) were operable, while 50 (46%) were non-operable. Total excision could be performed in 44% of the operable SFVM patients. Lymphatic malformations were frequently non-operable, while capillary malformations were relatively operable (P=0.042). Total excision of venous malformations could generally be performed, while lymphatic malformations and combined vascular malformations generally could only undergo partial excision (P=0.048). Complications occurred in 11% of the SFVM patients who underwent surgery; these were minor complications, except for 1 case. The average overall satisfaction score was 4.19 out of 5. CONCLUSIONS: Based on many years of experience, we found that approximately half (54%) of SFVM patients were able to undergo surgery, and around half (44%) of those patients were able to fully recover after a total excision. Among the patients who underwent surgical treatment, high satisfaction was found overall and relatively few complications were reported.
Capillaries ; Follow-Up Studies ; Humans ; Treatment Outcome ; Vascular Malformations*

The coexistence of craniofacial cleft and bilateral choanal atresia has only been reported in three cases in the literature, and only one of those cases involved a Tessier number 3 facial cleft. It is also rare for bilateral choanal atresia to be found in adulthood, with 10 previous cases reported in the literature. This report presents the case of a 19-year-old woman with a Tessier number 3 facial cleft who was diagnosed with bilateral choanal atresia in adulthood. At first, the diagnosis of bilateral choanal atresia was missed and septoplasty was performed. After septoplasty, the patient’s symptoms did not improve, and an endoscopic examination revealed previously unnoticed bilateral choanal atresia. Computed tomography showed left membranous atresia and right bony atresia. The patient underwent an operation for opening and widening of the left choana with an image-guided navigation system (IGNS), which enabled accurate localization of the lesion while ensuring patient safety. Postoperatively, the patient became able to engage in nasal breathing and reported that it was easier for her to breathe, and there were no signs of restenosis at a 26-month follow-up. The patient was successfully treated with an IGNS.

BACKGROUND: Differentiated thyroid carcinoma (DTC) shows a very good prognosis, but older patients have a higher recurrence rate and those show poor prognosis than younger patients. The aim of this study was to determine the clinical outcomes of thyroid cancer patients who experienced recurrence in old age according to the treatment strategy used. METHODS: This retrospective observational cohort study was conducted at Asan Medical Center, Seoul, Korea. Among DTC patients with no evidence of disease after initial treatment, we enrolled 86 patients who experienced recurrence at an age >65 years from 1994 to 2012. Sixty-nine patients had local recurrence and 17 patients showed distant metastasis. RESULTS: The mean age of patients at recurrence was 72 years. Patients were followed up for a median of 4.1 years after recurrence. Sixty-three of the 69 patients with local recurrence received additional treatment, while the other six received conservative care. The cancer-specific mortality rate was 15.5% in the local recurrence group. Airway problems were the main cause of death in patients who did not receive further treatment for local recurrence. Among the 17 patients with distant metastasis, 10 underwent specific treatment for metastasis and seven received only supportive management. Seven of those 17 patients died, and the cancer-specific mortality rate was 35% in the distant metastasis group. CONCLUSION: The overall cancer-specific mortality rate was 20% in DTC patients in whom recurrence was first detected at an age >65 years. Mortality due to uncontrolled local disease occurred frequently in patients who did not receive definitive management for recurrence.
Cause of Death ; Chungcheongnam-do ; Cohort Studies ; Humans ; Korea ; Mortality ; Neoplasm Metastasis* ; Neoplasm Recurrence, Local ; Prognosis ; Recurrence* ; Retrospective Studies ; Seoul ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: Intentional replantation (IR) is a suitable treatment option when nonsurgical retreatment and periradicular surgery are unfeasible. For successful IR, fracture-free safe extraction is crucial step. Recently, a new extraction method of atraumatic safe extraction (ASE) for IR has been introduced. PATIENTS AND METHODS: Ninety-six patients with the following conditions who underwent IR at the Department of Conservative Dentistry, Seoul National University Bundang Hospital, in 2010 were enrolled in this study: failed nonsurgical retreatment and periradicular surgery not recommended because of anatomical limitations or when rejected by the patient. Preoperative orthodontic extrusive force was applied for 2-3 weeks to increase mobility and periodontal ligament volume. A Physics Forceps was used for extraction and the success rate of ASE was assessed. RESULTS: Ninety-six premolars and molars were treated by IR. The complete success rate (no crown and root fracture) was 93% (n = 89); the limited success rates because of partial root tip fracture and partial osteotomy were 2% (n = 2) and 5% (n = 5), respectively. The clinical and overall success rates of ASE were 95% and 100%, respectively; no failure was observed. CONCLUSIONS: ASE can be regarded as a reproducible, predictable method of extraction for IR.
Bicuspid ; Crowns ; Dentistry ; Humans ; Meristem ; Molar ; Orthodontic Extrusion ; Osteotomy ; Periodontal Ligament ; Replantation ; Retreatment ; Surgical Instruments