Thermography is a sensitive and reliable method for diagnosis of radiculopathy. Skin temperature alterations of the involved dermatome named thermatone are diagnostic for sensory root involvement in radiculopathy which can be demonstrated by thermography. Digital infrared thermographic imaging system using computer is development and could measure thermal difference more exactly without hazards or discomforts to patient. Authors present 186 cases of thermographic evaluation in herniated lumbar disc disease by digital infrared thermographic imging system and the results are evaluated with literature review.
Diagnosis ; Humans ; Radiculopathy ; Skin Temperature ; Thermography

Essential palmar hyperhidrosis is a disease characterized by excessive perspiration on the palms and hands due to the hyperaction of sympathetic nervous discharge. In severe cases, excessive sweating is seen on the face, axilla, trunk, and soles. Several therapeutic modalities were applied but surgical resection of the sympathetic ganglion is the only curative method. Numerous open surgeries of the thoracic sympathetic ganglia for the treatment of palmar hyperhidrosis have been advocated, but they have also produced several complications. A new therapeutic technique for this disorder has been introduced by combining a thoracoscope and video system. Nowadays, thoracoscopic transthoracic sympathectomy is accepted as the treatment of choice for essential palmar hyperhidrosis. This technique is safe and easy. It also reduces the operating time and admission period. It has also very few complications. Compensatory hyperhidrosis on the trunk, back, and thigh, etc. is commonly an unwanted and unsolved complication after thoracic sympathectomy. Through my experience of thoracic sympathectomy, I thought that the incidence of compensatory hyperhidrosis was closely related to the extent of thoracic sympathectomy. So I restricted the extent of thoracic sympathectomy as a T2 sympathetic ganglion from September 1995. From Mar., 1989 To Aug., 1995, T2, T3 sympathetic ganglionectomies were performed for palmar hyperhidrosis patients and from Sept. 1995 T2 sympathetic ganglionectomies were performed. Using questionnaires, I compared these 2 groups. The results of this study are summarized as follows; 1) Using thoracoscopic transthoracic sympathectomy, operating time, admission period and complications could be reduced. 2) The risk of bleeding during the operation(especially bleeding from the hemiazygous vein) could be reduced in the T2 sympathectomy group. 3) The treatment effect of T2 sympathectomy is no different from T2, T3 sympathectomy for essential palmar hyperhidrosis. 4) The incidence of compensatory hyperhidrosis is less in the T2 sympathectomy group than in the T2, T3 sympathectomy group. From the above results, I concluded thoracoscopic transthoracic sympathectomy is the treatment of choice for essential palmar hyperhidrosis and the adequate extent for sympathectomy is T2 sympathetic ganglion.
Axilla ; Ganglia, Sympathetic ; Ganglionectomy ; Hand ; Hemorrhage ; Humans ; Hyperhidrosis* ; Incidence ; Surveys and Questionnaires ; Sweat ; Sweating ; Sympathectomy* ; Thigh ; Thoracoscopes

We describe a case of cutaneous angiomyolipoma found in the ear lobe, that is not associated with tuberous sclerosis. The lesion developed on the youngest patient yet reported in the literature.
Angiomyolipoma* ; Ear ; Humans ; Tuberous Sclerosis

BACKGROUND AND OBJECTIVE: Whabyung is a Korean cultural disorder characterized by a combination of emotional stress and physical symptoms. Acupuncture, herbal medicines and other complementary medicinal treatments are used to treat the symptoms of whabyung. The purpose of this study is to investigate the effects of acupuncture treatment and herbal medicine treatments on anger, anxiety and depression of whabyung. METHODS: Using PubMed, CENTRAL, AMED, MEDLINE, EMBASE, MEDLINE, CINAHL, Cnii, CNKI, J-SATGE, PsycArticles, KISS, KoreaMed, kmbase, NDSL, RISS, OASIS and Korean Traditional Knowledge Portal, articles published by March 2017 for whabyung or whabyung-related syndrome were searched. The quality of selected articles was evaluated using RoB and RoBANS. The effects of acupuncture and herbal medicines on anger, anxiety, and depression levels of whabyung patients were considered for meta-analyses. RESULTS: Of the total 2408 articles retrieved from the database, 11 were finally selected and 4 articles were used for meta-analyses. Acupuncture reduced whabyung patients' anger and anxiety. Especially, the state anxiety was significantly reduced (effect size= −0.676, p= .026). Herbal medicine had effects on reducing anxiety and state anger while trait anger was increased without statistical significance. CONCLUSION: The present study showed the effectiveness of acupuncture and herbal medicines for whabyung patients in general. However, considering the limited availability of articles and the heterogeneity between them included for the meta-analysis, the results should be generalized with caution. In the future, more studies within the structure of evidence-based medicine need to be conducted to generate objective and valid evidences of korean medicine.

BACKGROUND: To assess the diagnostic value of 13C-UBT using capsulated 38 mg low dose for H. pylori infection, we investigated the sensitivity and specificity of 13C-UBT and to suggest the optimal positive cut-off value of DOB20 in 13C-UBT using ROC analysis. METHODS: The study subjects were 76 healthy individuals (males; 52, females; 24) who visited a health promotion center at a university hospital between July 2005 and June 2007. We tested for H. pylori infection by 38 mg low dose 13C-UBT and histology. We measured the expiratory 13C-urea concentration of basal and 20 minutes value after oral ingestion of 38 mg 13C- labelled urea with capsulated. The breath samples were analysed by gas chromatograph isotope ratio mass spectrometer and expressed as units of delta. RESULTS: Fifty subjects (65.8%) were H. pylori positive as judged from histology. ROC analysis showed an area under the curve (AUC) of 0.943 (95% confidence interval: 0.891~0.995), indicating an excellent classification performance of the model. The sensitivity of 96%, specificity of 85% were achieved at the optimal cut-off value of DOB20 which was 1.39. The 38 mg low dose 13C-UBT was a non-invasive, simple, short-time required and highly accurate method. CONCLUSION: The results suggested that capsulated 38 mg low dose 13C-UBT is considered more in term of accuracy, costeffectiveness and convenient method for the diagnosis of H. pylori infection. Further long-term research and meta analysis based on large-scale investigations is needed to establish a standardized testing method in creating protocol of 13C-UBT.
Breath Tests ; Eating ; Health Promotion ; Helicobacter ; Helicobacter pylori ; ROC Curve ; Sensitivity and Specificity ; Urea

Melkersson-Rosenthal (M-R) syndrome consists of a triad of (1) recurrent peripheral facial nerve paralysis which develops alternatively on both sides of face, (2) non-inflammatory facial edema, and (3) furrowed tongue. Since the cause of M-R syndrome is unknown, various forms of therapy have been tried, but there were no conclusive evidence that they altered the course of the disease. A 27-year-old female and a 44-year-old male patient with recurrent facial nerve paralysis were diagnosed with M-R syndrome. We report the two cases of M-R syndrome with the brief review of literatures.
Adult ; Edema ; Facial Nerve ; Female ; Humans ; Male ; Melkersson-Rosenthal Syndrome* ; Paralysis ; Tongue, Fissured

OBJECTIVE: The main purposes of this study were to understand the correlations among Modified Barthel Index (MBI), Functional Independence Measure (FIM), and ESCROW (Environment, Social support, Cluster of family members, Resources, Outlook, Work or School status) Profile, and to establish the more appropriate assessment standards to check patient's conditions in the hospital and in their homes and society. METHOD: Thirty-four patients, who received the rehabilitation treatment and home visiting at the Presbyterian Medical Center, were evaluated for their functions by MBI, FIM, and ESCROW Profile. RESULTS: The mean scores of assessment measures by home visiting were all higher than in the hospital showing an improvement of the patients' functions after discharge from the hospital. The results of MBI and FIM in the hospital and home visiting showed a significant correlation, while the results of MBI and Cognitive FIM measure indicated a relatively low correlation coefficient. Although each result of MBI, FIM, and ESCROW provided a low correlation when the patients were in the hospital, the result for home visiting revealed very significant correlations. Especially, the items of environment, social support, outlook, and work status of ESCROW showed very significant correlations with MBI and FIM. CONCLUSION: The results showed that MBI and FIM measurements were very useful in observing and following up the functional conditions of the patients, while ESCROW profile was more appropriate to evaluate the familial and social rehabilitation status.
House Calls ; Humans ; Protestantism ; Rehabilitation* ; Social Environment

Primary transitional cell carcinoma of ovary has been recently recognized as a separate subtype of epithelial cancer. It is unusual tumor and in which definite urothelial features are present, but no benign Brenner component is identified. These tumor are more aggressive and tend to present at a higher stage than malignant Brenner tumors, but they appear to respond better to chemotherapy than other type of ovarian epithelial cancer. We have experienced two cases of ptimary transitioaal cell carcinoma of ovary. So we report these cases with a brief review of literature.
Brenner Tumor ; Carcinoma, Transitional Cell* ; Drug Therapy ; Female ; Ovary*

Since developmental lumber atenosis was described by Verbiest in 1954, there have been many reports on lumbar stenosis. But there have been many limitations in diagnosis and treatment of lumbar stenosis. Recently, the development of water-soluble contrast media and high resolution spine CT scan have not only brought about significant progress in diagnosis of the etiology and levels of lumbar stenosis, but also better surgical therapetic results could be expected. The author has reviewed 433 patients with lumber stenosis operated at the department of Neurosurgery YUMC Yongdong Severance hospital from March 1983 to September 1987 and analyzed the measurements of various parts of the spinal canal by high resolution spine CT scan, and evaluated the clinical courses and their surgical outcomes. The results were summarized as following: 1) Male to female ratio was 1:1.3. The peak age incidence were 40's in male and 50's in female. 2) By the causes of lumbar stenosis, degenerative stenosis was most common as 78%, and followed by degenerative spondylolisthesis 7.2%, spondylolytic spondylolisthesis(1.6%), iatrogenic stenosis(1.6%), developmental stenosis(0.7%) and posttraumatic stenosis(0.7%). 3) Single level stenosis was most common(47.1%), two levels 32.8% and three levels or more 20.1%. In the single level stenosis L4/5 was most common as 85.8% and L5/S1 10.3%. In the two levels stenosis, L4/5 and L4/S1 were most common at 72.5% and L3/4 and L4/5 26.1%. 4) The characteristic clinical symptoms were chronic back pain and neurogenic intermittent claudication(65.6%). Few patient showed abnormal neurological findings. Common abnormal sign was loss or decrease of ankle jerk(73%). The straight leg raising test was not significant, and it was positive only in 10.3%. 5) In diagnosis of lumbar stenosis, it was most important to identify the causes of lumbar stenosis and degree of compression on cauda equina, or lateral recess stenosis by the spine CT or spine CT myelograms. 6) On myelogram, the findings of complete or incomplete block were present in 44.1%, and indentations of contrast dye column at the levels of stenosis was noted in 55.9%. 7) The common findings on spine CT scan were hypertrophy of posterior articular facet joints(65.8%), osteophyte formation(37.1%), thicking of yellow ligament(21.7%), ossification of posterior longitudinal ligament(23.8%), ossification of yellow ligament(4.9%). 8) In the diagnosis of degenerative lumbar stenosis with high resolution of spine CT scan, anteroposterior diameter of spinal canal was not so significant, but the cross sectional areas of dural sac and spinal canal were most sensitive indexes. The anteroposterior diameter of dural sac and interfacetal distance provided th e clue of lumbar stenosis. If the anteroposterior diameter of the lateral recess was less than 3mm it could be diagnosed as the lateral recess stenosis. And if the angle between both yellow ligaments(yellow ligament angle, Y-angle) was less than 60( it must be suspected as the central stenosis. 9) In the examination of degenerative spondylolisthesis with spinal CT scan, anterior-posterior diameter and cross sectional area of spinal canal and dural sac at the disc level were smaller than those of upper and lower vertebral levels. The angle of yellow ligament was almost normal. 10) For the definite treatment wide decompressive laminectomy, medial facetectomy and foraminotomy should be carried out. 11) Our results of surgery were good to excellent in 90.3% and fair to poor 9.7%.
Ankle ; Back Pain ; Cauda Equina ; Constriction, Pathologic* ; Contrast Media ; Diagnosis ; Female ; Foraminotomy ; Humans ; Hypertrophy ; Incidence ; Laminectomy ; Leg ; Ligaments ; Male ; Neurosurgery ; Osteophyte ; Spinal Canal ; Spine ; Spondylolisthesis ; Tomography, X-Ray Computed

To investigate the NS4 region of JEV, NS4 cDNA of K94P05 (JEV strain isolated from Korea in 1994) was amplified by RT-PCR and analyzed by sequencing PCR product. Genomic size of NS4 was 1212bp and nucleotide sequence was compared with that of other JEV strains. Nucleotide homology between JaOAr582 and K94P05 was 91.1% and that between Beijing and K94P05 was 89.8%, respectively. But the nucleotide sequence of I region of JaOAr582 and K94P05 showed 97.0% homology and that of Beijing and K94P05 did 95.8% homology. NS4 protein was expressed as a form of fusion protein by a prokaryotic expression system. The induced fusion product showed a lower molecular weight than predicted size and remained insoluble. The NS4 protein might be cleavages by E. coli protease. Concluding above results, high hydrophobicity of the NS4 protein supported the fact that this protein played a role as a membrane component and the poor nucleotide sequence conservativity among JEV strains suggested that this region might be important to adapt each viral growth environment.
Asian Continental Ancestry Group* ; Base Sequence ; DNA, Complementary ; Encephalitis Virus, Japanese* ; Encephalitis, Japanese* ; Humans ; Hydrophobic and Hydrophilic Interactions ; Korea* ; Membranes ; Molecular Weight ; Polymerase Chain Reaction