No abstract available.
Ankle Fractures* ; Ankle*

PURPOSE: Cough is a frequent symptom in bronchial asthma. Acoustic digital analysis of cough has been reported using digital signal processing techniques. Differences between asthmatic and control cough sounds are presented. The main purpose of this study was to examine whether overall spectral energy and the visual observation of the fine details of the cough spectrographs, explain the differences in cough between normal subjects and asthmatic patients. METHODS: We presented data from 7 asthmatic patients and 8 non-asthmatic subjects using a new method of acoustic analysis. Cough sound was digitalized at a sampling rate of 5 kHz. Individual coughs were divided into two or three phases, presents the data of RMS (Root Mean Square), duration, RMS in the frequency band. Factor analysis and iogistic regression analysis were performed to identify groups of variables. RESULTS: Duration of cough was longer in asthmatics cough. The number of additional cough sounds showed no difference. RMS of cough in total cough and 2nd phase cough was stronger for asthmatics cough. Energy of frequency band is significantly different in 1,000-1,500 Hz, 1,500-2,000 Hz, 5,000-5,500 Hz, 5,500-6,000 Hz, 6,000-6,500 Hz, 9,000-9,500 Hz at total phase, 0-500 Hz, 1,000-1,500 Hz, 2,000-2,500 Hz, 5,000-5,500 Hz, 6,000-6,500 Hz, 9,000-9,500 Hz at 1st phase. Factor analysis and logistic regression analysis for the two groups provoded a classification table of 96.3% of sensitivity and 86.0% of specificity. CONCLUSION: We provided a new approach to the analysis of cough sounds. Significant differences were found between asthmatic and non-asthmatic cough sounds. It has potential as a tool with which to study the pathophysiology of cough and diagnosis the respiratory disease.
Acoustics ; Asthma ; Classification ; Cough* ; Diagnosis ; Humans ; Logistic Models ; Sensitivity and Specificity ; Signal Processing, Computer-Assisted

A study was performed to investigate a relationship between the status of T lymphocyte subsets in the peripheral blood and the pathogenesis of erythema nodosum leprosum (ENL) reactions. T lymphocyte subsets, B lymphocytes and serum immnnoglobulin levels were explored in 40 leprosy patients (10 tuberculoid (TT), 17 lepromatous (LL), and 13 lepromatous with ENL). In patients with LL, suppressor cells increased and helper cell diminished, resulting in a decrease in the helper/suppressor (Th/Ts) ratio to 0.86 + 0.20, as compared with controls (1. 77 + 0.41). But in ENL patients, there was a significant diminution of suppressor cells and an increase of helper cells, resulting in an increase in Th/Ts ratio to 2.08 + 0.30. Four weeks after treatment of ENL, Th/Ts ratio decreased to l.18+ 0.31 again. The mean percentages of B cells and serum immunoglobulin levels in with LL. and ENL increased significantly compared with controls. Only IgG increased in patients with ENL compared with patients with LL. The results in patiients with TT did not differ significantly from those of controls. The findings suggest that cell-mediated immune responses, imbalance in T lymphocyte subsets, may play a role in the pathogenesis of ENL, either directly or by inducing an antibody critical to the formation of the immune complex
Antigen-Antibody Complex ; B-Lymphocytes ; Erythema Nodosum* ; Erythema* ; Humans ; Immunoglobulin G ; Immunoglobulins ; Leprosy ; T-Lymphocyte Subsets* ; T-Lymphocytes, Helper-Inducer

A 25 year old patient who had low back pain and sciatica was diagnosed as having a lumbar intraspinal extradural synovial cyst adjacent to a facet joint between the third and fourth lumbar vertebrae. The extradural defects defined with positive contrast myelography and postmyelographic computed tomographic scanning were posterolateral to the dural sac. Biopsy revealed the findings compatible with synovial cyst. Treatment consisted of laminectomy and surgical excision of the cyst.
Biopsy ; Humans ; Laminectomy ; Low Back Pain ; Lumbar Vertebrae ; Myelography ; Sciatica ; Synovial Cyst ; Zygapophyseal Joint

Between August 1994 and June 1995, seventeen patients diagnosed as having partial or complete ruptures of the anterior cruciate ligament on MRI were managed by non-operative methods. Among them four patients were excluded due to operation during follow-up and the results were evaluated at a one year follow-up. We selected the patients prospectively for non-operative care using the selection criteria of age, degree of instability, activity level and patient compliance. The average age of them was 37.7 years. Initially knee stress test and MRI were checked, and Cybex study and Lysholm knee scoring were done at post-trauma one year follow-up. They were managed conservatively by ROM and muscle strengthening exercises and a brace fitting schedule for three months. Among them, six cases had partial tears and seven had a complete tear initially. At the one year follow-up, five of six cases who had shown partial ruptures, and two of seven cases with complete tears, recovered continuity of the ruptured ACL on MRI. Their Lysholm knee score was 84.4, and the Cybex test showed no difference in muscle power between the injured and uninjuried side. Those patients who had loss of continuity on follow-up MRI showed Lysholm score of 57.4 and decreased muscle power on Cybex study. Although there are still controversies about the adequate management of ACL injuries, our study suggests that conservative management is a viable alternative to surgery as long as the patients are selected prudently. For more concrete results, however, careful analysis based on a longer follow up period is necessary.
Anterior Cruciate Ligament* ; Appointments and Schedules ; Braces ; Exercise ; Exercise Test ; Follow-Up Studies ; Humans ; Knee ; Magnetic Resonance Imaging ; Patient Compliance ; Patient Selection ; Prospective Studies ; Rupture*

The formation of cysts in the parameatal area has been reported as rare. A parameatal urethral cyst is a congenital anomaly and has been reported even more rarely in adults. In this study, we present two cases of parameatal urethral cyst and aim to investigate their causes and treatment methods. The extent of cyst spread was assessed using a urethroscope prior to cyst excision, and the excision range was determined accordingly. Complete excision of the cyst was performed as the treatment for parameatal urethral cyst. Both patients were adults who presented with urinary symptoms related to the cyst, necessitating the excision of the congenital parameatal urethral cyst.

Osteoporosis and osteoporosis related fractures contribute a large part of the medical cost in developed countries. Considering the preventive effect of osteoporotic medications, high rate of mortality and complications, poor quality of life after osteoporosis related fractures, the growing trend of older populations in the future, osteoporosis and osteoporosis related fractures are important targets of preventive treatment and also targets of socioeconomic cost reduction. Treating osteoporosis and preventing osteoporosis related fractures have become an essential element in Korean medical system. Despite the various differences in the health care system, hospitals in many other countries are operating fracture liaison service and they have confirmed its cost-effectiveness. In Korea's health care system, further research on cost-effectiveness as well as its clinical effects is needed.

Hamartomas are the most common benign neoplasms of the lung. However, multiple pulmonary hamar-tomas are veryrare. We describe the radiographic findings of multiple pulmonary hamartomas without Carney's or pulmonaryhamartoma syndrome with review the literature describing to this entity.
Hamartoma* ; Lung

PURPOSE: Ultrasound (US) and US-guided fine needle aspiration biopsies (FNAB) are considered the modalities of choice for assessing lymph nodes suspected of containing metastases, but the sensitivity of FNAB varies and is specific to the operator. We analyzed the risk of FNAB providing false negative results of lateral neck node metastasis, and evaluated diagnostic accuracy of FNAB, in patients with papillary thyroid cancer. MATERIALS AND METHODS: FNAB was performed in 242 patients suspected of having lateral neck node metastasis on preoperative imaging. Thyroglobulin in the fine-needle aspirate washout (FNA wash-out Tg) and computed tomography enhancement (Hounsfield units) were measured. Patients with negative results on FNAB were examined by intraoperative frozen section. The false negative and true negative groups were compared. RESULTS: Of the 242 patients, 130 were confirmed as having lateral neck node metastases. In 74 patients, the metastasis was identified by FNAB. False positive results were observed in 2 patients (0.8%) and false negatives in 58 (44.6%). Risk analysis showed that patient age <45 years (p=0.006), tumor size >1 cm (p=0.008) and elevated FNA wash-out Tg (p=0.004) were significantly associated with false negative results on FNAB. The accuracy of FNAB increased significantly when combined with FNA wash-out Tg (p=0.003). CONCLUSION: To reduce the false negative rate of FNAB, patient age (<45 years), tumor size (>1 cm) and FNA wash-out Tg (>34.8 ng/mL) should be considered in preoperative planning. Accuracy may be improved by combining the results of FNAB and FNA wash-out Tg.
Adolescent ; Adult ; Aged ; Biopsy, Fine-Needle ; Carcinoma/*diagnosis/*pathology/radiography/surgery ; False Negative Reactions ; Female ; Humans ; Lymph Nodes/*pathology/radiography ; Lymphatic Metastasis/*pathology/radiography ; Male ; Middle Aged ; Multivariate Analysis ; Preoperative Care ; Risk Factors ; Sensitivity and Specificity ; Thyroglobulin/metabolism ; Thyroid Gland/*pathology ; Thyroid Neoplasms/*diagnosis/*pathology/radiography/surgery ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: Both carotid intima-media thickness (IMT) and global risk score of cardiovascular disease were independent risk factors of stroke and heart disease. We assessed the correlation between the 10-year risk of Korean Stroke Risk Prediction model (KSRP) and carotid intima-media thickness. Additionally, from a perspective of carotid IMT measurement following KSRP risk stratification, we analyzed the difference of carotid IMT and plaque according to the KSRP risk strata. METHODS: Subjects were 282 persons who visited one hospital for the screening of stroke. The 10-year risk was calculated automatically based on the equation of KSRP model. The maximal carotid IMT and the plaque were adopted as the study variables. The sensitivity and the positive predictive value of the KSRP risk categories were calculated. RESULTS: The correlation coefficient between the KSRP risk and the maximal carotid IMT was 0.29 (p<0.01). The mean (+/-standard deviation) of KSRP risk of the group with carotid plaque was statistically significantly higher, 5.3 (+/-4.1), than that of the group without plaque, 3.3 (+/-3.1) (p< or =0.01). The sensitivity of the risk stratum with more than 6% of KSRP risk for the plaque was 28.2%. The positive predictive value of the above cut-point was 48.8%. CONCLUSIONS: The 6% of KSRP risk may be considered as the beginning point of intermediate risk stratum to recommend the carotid ultrasonography. However, generalization needs further studies for various populations.
Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Generalization (Psychology) ; Heart Diseases ; Humans ; Mass Screening ; Risk Factors ; Stroke