BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

No abstract available.
Humans ; Sinusitis*

No abstract available.
Cervix Uteri* ; Female ; Health Expenditures*

No abstract available.

PURPOSE: This study attempted to investigate the frequency, duration, and risk factors of antibiotic-associated diarrhea (AAD) in infants hospitalized due to febrile urinary tract infection (UTI). This is a basic research on the probiotics used in the prevention and treatment of AAD in infants. METHODS: Medical records of the infants aged 3-6 months hospitalized in Gachon University Gil Hospital from January 2008 to September 2010 due to the febrile UTI were retrospectively reviewed. The episodes of loose or watery stool were investigated for frequency, onset, and duration. Those who had AAD and those who did not (non-AAD) were compared. The antibiotic regimens and the episodes of diarrhea were investigated in AAD group. RESULTS: Total 147 infants were included. Fifty-four (36.7%) showed AAD. Intravenous third-generation cephalosporin (3rd CS) single therapy was used for 102 patients (69.4%), the 3rd CS and non-3rd CS combination therapy for 24 (16.3%), and non-3rd CS combination therapy for 21 (14.3%). There was no significant difference in the dose of cefotaxime between AAD and non-AAD group (P=0.601). According to the antibiotic therapies above, in AAD group, there was no significant difference in the onset and duration of diarrhea respectively (P=0.717, P=0.830). Although the frequency of diarrhea was higher for the 3rd CS and non-3rd CS combination therapy subgroup with 9.25+/-5.30 times/day than the other two subgroups (7.58+/-2.97 times/day in 3rd CS single therapy subgroup, 6.75+/-4.40 times/day in non-3rd CS combination therapy subgroup), there was no statistical significance (P=0.078). CONCLUSION: AAD seems common to the infants aged 3-6 months with febrile UTI, regardless of regimen and amount of antibiotics in usual dosage. Further research on the effects of probiotics used in the prevention and treatment of AAD in infants is warranted.
Aged ; Anti-Bacterial Agents ; Cefotaxime ; Child ; Diarrhea ; Humans ; Infant ; Medical Records ; Probiotics ; Retrospective Studies ; Risk Factors ; Urinary Tract ; Urinary Tract Infections

A central question to the pathogenesis of leprosy is how Mycobacterium leprae, the causative agent of leprosy, survives and replicates within macrophages. 18-kDa protein of M. leprae, a major antigen, is found in solely M.leprae and contains T-cell antigenic epitopes and has been implicated in survival of M. leprae within macrophages and ultimately in pathogenesis. The latter is supported further by a recent finding that 18-kDa gene is activated during intracellular growth. To further understand M. leprae-specific 18-kDa gene expression regulation mechanism during intracellular growth, the present studies have been undertaken. To examine the presence of a regulatory sequence(s) in the promoter of 18-kDa gene and its binding factor(s) in M. leprae cell lysate, a gel mobility shift assay was performed. A 350-bp sequence containing the promoter of 18-kDa gene resulted in a protein-DNA complex formation with increasing amounts of M. leprae crude lysate. However, the protein-DNA complex formation was not detected in the presence of a nonspecific carrier, salmon sperm DNA.
DNA ; Electrophoretic Mobility Shift Assay ; Epitopes ; Gene Expression Regulation ; Leprosy ; Macrophages ; Mycobacterium leprae ; Salmon ; Spermatozoa ; T-Lymphocytes

A central question to the pathogenesis of leprosy is how Mycobacterium leprae, the causative agent of leprosy, survives and replicates within macrophages. 18-kDa protein of M. leprae, a major antigen, is found in solely M.leprae and contains T-cell antigenic epitopes and has been implicated in survival of M. leprae within macrophages and ultimately in pathogenesis. The latter is supported further by a recent finding that 18-kDa gene is activated during intracellular growth. To further understand M. leprae-specific 18-kDa gene expression regulation mechanism during intracellular growth, the present studies have been undertaken. To examine the presence of a regulatory sequence(s) in the promoter of 18-kDa gene and its binding factor(s) in M. leprae cell lysate, a gel mobility shift assay was performed. A 350-bp sequence containing the promoter of 18-kDa gene resulted in a protein-DNA complex formation with increasing amounts of M. leprae crude lysate. However, the protein-DNA complex formation was not detected in the presence of a nonspecific carrier, salmon sperm DNA.
DNA ; Electrophoretic Mobility Shift Assay ; Epitopes ; Gene Expression Regulation ; Leprosy ; Macrophages ; Mycobacterium leprae ; Salmon ; Spermatozoa ; T-Lymphocytes

OBJECTIVES: This research used queueing theory to analyze changes in outpatients' waiting times before and after the introduction of Electronic Medical Record (EMR) systems. METHODS: We focused on the exact drawing of two fundamental parameters for queueing analysis, arrival rate (λ) and service rate (µ), from digital data to apply queueing theory to the analysis of outpatients' waiting times. We used outpatients' reception times and consultation finish times to calculate the arrival and service rates, respectively. RESULTS: Using queueing theory, we could calculate waiting time excluding distorted values from the digital data and distortion factors, such as arrival before the hospital open time, which occurs frequently in the initial stage of a queueing system. We analyzed changes in outpatients' waiting times before and after the introduction of EMR using the methodology proposed in this paper, and found that the outpatients' waiting time decreases after the introduction of EMR. More specifically, the outpatients' waiting times in the target public hospitals have decreased by rates in the range between 44% and 78%. CONCLUSIONS: It is possible to analyze waiting times while minimizing input errors and limitations influencing consultation procedures if we use digital data and apply the queueing theory. Our results verify that the introduction of EMR contributes to the improvement of patient services by decreasing outpatients' waiting time, or by increasing efficiency. It is also expected that our methodology or its expansion could contribute to the improvement of hospital service by assisting the identification and resolution of bottlenecks in the outpatient consultation process.
Delivery of Health Care ; Electronic Health Records ; Hospitals, Public ; Humans ; Outpatients

Complement 1 (C1) inhibitor is an acute phase protein with anti-inflammatory properties. The aim of the present study was to elucidate the relationship between brachial ankle pulse wave velocity (baPWV), the parameter of arterial stiffness, and C1 inhibitor. One hundred subjects were randomly enrolled in this study. Data about baPWV, age, gender, hypertension, smoking, and body mass index (BMI) were measured. Blood tests for total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, hemoglobin A1c, erythrocyte sedimentation rate, C-reactive protein, complement 3, and C1 inhibitor were performed. Based on the Pearson correlation, the C1 inhibitor showed a positive relation to the baPWV (P<0.001). Multiple regression analysis revealed the significant predictors of baPWV were not only the conventional risk factors of arteriosclerosis and/or atherosclerosis, such as age (P<0.001), gender (P<0.001), hypertension (P<0.001), and BMI (P=0.006), but also the acute phase protein, C1 inhibitor (P=0.025). In conclusion, C1 inhibitor is associated with arterial stiffness through its association with increased inflammation.
Adolescent ; Adult ; Age Factors ; Aged ; Ankle/blood supply ; Ankle Brachial Index ; Blood Flow Velocity/physiology ; Blood Pressure/physiology ; Body Mass Index ; Brachial Artery/*physiology ; Complement C1 Inhibitor Protein/*metabolism ; Elasticity ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Regression Analysis ; Risk Factors ; Sex Factors

The objective was to identify the correlation between the sign of lower limb swelling and unilateral deep vein thrombosis (DVT) in patients with brain lesions. A total of 194 patients, between May 12th, 2011 and December 30th, 2015, who had initially elevated plasma D-dimer level (> 0.55 mg/L) and underwent enhanced DVT computed tomography (CT) were recruited in this study. The circumference of bilateral lower limbs in CT image, below 10 cm and above 15 cm from the prominence of tibial tuberosity, were measured by a single intra-observer using NIH ImageJ software. The difference of 2 cm or more between both sides was considered as significant swelling. We also evaluated patients' range of mobility and cognitive function and its relation to lower limb swelling in DVT in patients with brain lesions. Thirty-five patients were diagnosed with DVT. The presence of lower limb swelling was not statistically significant between patients with DVT and those without DVT in the proximal limb (p = 0.330) and distal limb (p = 0.405). In DVT patients (n = 35), there was no statistically significant correlation between lower limb swelling and other covariates of the patient group. There was no statistically significant correlation between lower limb circumference and DVT.
Brain* ; Cognition ; Extremities ; Humans ; Lower Extremity* ; Plasma ; Pulmonary Embolism ; Venous Thrombosis*