The cardiovascular manifestations in hyperthyroidism are sinus tachycardia, paroxysmal supraventricular tachycardia, atrial flutter, atrial fibrillation, atrioventricular block, bundle branch block(especially right bundle branch block), angina pectoris, heart failure and cardiomyopathy. Of these, angina pectoris is commonly seen in hyperthyroidism with coronary artery disease and the potential mechanisms have been attributed to the increased metabolic demand and consequently increased cardiac work which result in the more demand of coronary blood flow than that can be delivered via a fixed atherosclerotic coronary artery stenosis. Hyperthyroidism associated anginas without underlying coronary artery stenosis have also been reported where the mechanism of these was suspected to be the coronary vasospasm. Ventricular fibrillation may occur in the thyrotoxic patients due to myocardial ischemia such as variant angina, but it is very rare in the condition without previous heart disease. A 30-year-old male was admitted to the hospital because of palpitation, weight loss and proptosis for the previous 3 months. There was no history of effort related chest pain, syncope, drug abuse or medical illnesses such as diabetes mellitus, hypertension. The laboratory results were, TSH: 0.38uU/mL(0.4~5,0 uU/mL), free T4: 8.9ng/dL(0.8~1.9ng/dL), TSH receptor antibody: 43.6%(-15~15%), antiTPO antibody: 5000 IU/mL(0~100 IU/mL). The initial EKG showed normal sinus rhythm. He was diagnosed as Graves disease with ophthalmopathy, class 3a and was put on propylthiouracil 200 mg po tid, propanolol 40 mg po tid and started solumedrol pulse therapy for the exophthalmos on the first day of admission. He was found to have generalized tonic seizure with apnea attack on second hospital day and twice thereafter. Ventricular fibrillation was documented at that time. DC cardioversion was performed with successful response. After the attack, he was treated as accelerated hyperthyroidism namely with increased dosage of propylthiouracil, dexamethasone and Lugols solution, The echocardiogram, treadmill test, ergonovine echocardiography, coronary angiography and electrophysiologic study disclosed no abnormalities. Further episodes of ventricular fibrillation didnt occur after being euthyroid state. In conclusion, we report a case of ventricular fibrillation associated with hyperthyroidism itself without underlying coronary artery disease with brief review of literatures.
Adult ; Angina Pectoris ; Apnea ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block ; Cardiomyopathies ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vasospasm ; Dexamethasone ; Diabetes Mellitus ; Echocardiography ; Electric Countershock ; Electrocardiography ; Ergonovine ; Exercise Test ; Exophthalmos ; Graves Disease ; Heart Diseases ; Heart Failure ; Humans ; Hypertension ; Hyperthyroidism ; Male ; Methylprednisolone Hemisuccinate ; Myocardial Ischemia ; Propranolol ; Propylthiouracil ; Receptors, Thyrotropin ; Seizures ; Substance-Related Disorders ; Syncope ; Tachycardia, Sinus ; Tachycardia, Supraventricular ; Ventricular Fibrillation* ; Weight Loss

BACKGROUND: Obesity is not anly one of the risk factors that affects the prevalence and aggravation of chronic diseases, but is also the cause of social unfitness because slimness has become a standard of beauty. We surveyed on the satisfaction about self body image, the factors which are related to it and weight control behavior of the adolescents in a local area of Korea. METHODS: The survey was performed in a high school of Pocheon on August, 1996. Five classes out of 14 classes in 1st and 2nd grade were selected. The body mass index(BMI) was calculated from the measured height and weight. The satisfaction about body image which was estimated by the difference between present body image and wanted body image in 9 graded figures of body image was obtained from the questionnaire. The information about sex, religion, history of being teased about body image, body image of their parents, mean duration of watching TV in a day, body esteem, and binge-eating was obtained from the questiannaire and we evaluated the relationship between all of the above with BMI and body image satisfaction. We also investigated on the interest in education about weight control and efforts made by adolescents from the questionnaire on weight control behavior. RESULTS: Total of 224 students participated in this study and only 14.7% of them were satisfied with their body image. 58.9% wanted weight reduction and 26.4% wanted weight gain. They were more dissatisfied with their body image when they were girls(p<0.01), had the experience of being teased about their body image(p<0.01), had low body esteem(p<0.01), and had high BMl(p<0.01). We could not find statistically significant relationship between body image satisfaction and other factors such as religion, the duration of watching TV in a day, the body image of their parents and binge eating. 64.3% of the subjects tried to control their weight and most(87.5%) tried to lose weight. The selected methods were diet control(65.3%) and exercise(52.1%) and the most preferred method of diet control was skipping meah(45.7%). CONCLUSIONS: Most of adolescents were not satisfied with their body image and this dissatisfaction was related to gender, history of being teased about their body image, BMI, and body esteem. Many of them had tried to lose weight and among the methods of weight reduction, there were behaviors that were injurous to their health and growth
Adolescent* ; Beauty ; Body Image* ; Bulimia ; Chronic Disease ; Diet ; Education ; Humans ; Korea ; Obesity ; Parents ; Prevalence ; Risk Factors ; Weight Gain ; Weight Loss ; Surveys and Questionnaires

The clinical trial was carried out with carteolol in 30 patients with essential hypertension. The results were as follows : 1) Before medication and after 2,4,6 and 8 weeks of medications, the overall average systolic and diastolic blood pressure were 175+/-17.7/105+/-9.3, 144+/-8.9/92+/-6.9, 143+/-11.2/90+/-6.6, 141+/-8.4/88+/-6.9, and 142+/-9.0/88+/-7.1 mmHg. As a result, blood pressure significantly fell with carteolol treatment. 2) In 80+/- of all cases, marked or moderate degree of hypotnesive effect was observed within 2 weeks of treatment. 3) Before medication and after 2, 4, 6 and 8 weeks of medication, the overall average heart rates were 75+/-11.8, 73+/-9.0, 71+/-8.7, 71+/-8.2 and 71+/-8.6 beats/minute. There was no significant changes in heart rates before and after treatment. 4) Dizziness or fatigability were complained in 4 patients (13+/-) each while receiving carteolol. These side effects were mild in 3 patients, but one patient discontinued treatment due to dizziness. On the basis of these results, carteolol was evaluated to be promising hypotensive drug.
Blood Pressure ; Carteolol* ; Dizziness ; Heart Rate ; Humans ; Hypertension

BACKGROUND AND OBJECTIVES: Angiogenesis is the process of new blood vessel development from preexisting vessel. In many human solid tumor, the extent of angiogenesis is one of the most significant prognostic factors that can be used to predict the patient survival rate and metastasis. The aim of this study is to investigate the role of new blood vessel formation in the thyroid tumors. SUBJECTS AND METHOD: We analyzed the microvascular density and proliferation index in the 70 cases of thyroid tumors by double immunohistochemistry with anti-CD34 and anti-Ki67 antibody. The microvascular density and Ki67 index were compared with the clinical parameters such as sex, age, stage, tumor extension, cervical lymph node metastasis, and prognostic factors, which were obtained through the retrospective review of the medical records. RESULTS: The microvascular density and Ki67 index were higher in malignant tumors than in benign tumors. Higher microvascular density and Ki67 index were associated with tumor stage and increased risk of AMES, AGES and MACIS scores. CONCLUSION: The microvascular density and Ki67 index may serve as significant prognostic factors in the differentiated thyroid cancer.
Angiogenesis Inducing Agents ; Blood Vessels ; Humans ; Immunohistochemistry ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate ; Thyroid Gland* ; Thyroid Neoplasms

The aim of this paper is to estimate the nationwide incidence rate of lung cancer in Korea. The potential incident cases were identified by hospital visiting and mailing, based on the ICD-9 diagnostic codes on the claims as one of the following: ICD-9 162-165 (malignant neoplasms of the respiratory system), 212 (benign neoplasm), 231 (carcinoma in situ), 511 (pleurisy), or 195-199 (malignant neoplasms with uncoded sites) in beneficiaries data of the Korea Medical Insurance Corporation from January, 1988 to December, 1989. Thereafter, the identified cases were confirmed by an oncologist (Dr. DS Heo). When adjusted with age distribution of the Korean population based on the 1985 Population Census, the incidence rate was 22.3 per 100,000 in males (95% CI: 21.70-23.01) and 8.37 (95% CI: 7.97-8.78) in females in 1989. And the age-adjusted rate for the world population was 39.63 in males and 9.95 in females.
Adult ; Age Factors ; Aged ; Comparative Study ; Female ; Human ; Incidence ; Korea/epidemiology ; Lung Neoplasms/*epidemiology/pathology ; Male ; Middle Age ; Sex Factors

OBJECTIVES: Schizophrenic patients having a disturbance of cognition and emotion are least likely to identify emotional (especially negative) stimuli and cue in tense background stimuli. Also, schizophreinic patients tend to experience relapse if they are exposued to a situation which is emotionally laden. Although emotion itself is important, emotional processing has not been a therapeutic target and skill trainig which improves social competence has provided patients with emotional load. Therefore, we introduced Emotional Management Trainig (EMT) which deal with indirect and direct emotional processing, applied it to schizophrenic patients, and investigated the therapeutic effects. METHODS: We applied the Emotional Management Training (EMT) to 30 schizophrenic patients for 12 weeks, 2 times every week and psychoeducation to 23 schizophrenic patients as control group attention-placebo for 12 weeks, during the same period. Before and after treatment, we used the Trait Meta Mood Scale-short form (TMMS-S) as emotional proper, Social Perception Scale, Verbal Fluency Test, Verbal Paired Associates, and Similarities for cognitive functions. We also used Positive And Negative Syndrome Scale (PANSS) as psychopathology measurement and Social Problem Solving Scale (SPSI) as various kinds of social problem solving function measurement before and after treatment. RESULTS: The results showed that EMT group appeared to be more effective in improving the visual perception of social perception scale, verbal fluencies, positive symptoms, general psychopathology, and total score in PANSS than the control group. Also EMT group seemed to be more effective in total score and Problem Orientation score in SPSI than the control. But there were no differences in abstract function and verbal memory, negative symptoms, and Problem-Solving Skill score between the two groups. CONCLUSION: This study suggests that despite the limitations of the generalizability and the questions for the persistence of effectiveness, EMT might help schizophrenics get the motivational aspects, the familiarity with emotional-loaded situation, and initial processes, for social problem-solving.
Cognition ; Cues ; Humans ; Memory ; Mental Competency ; Psychopathology ; Recognition (Psychology) ; Recurrence ; Schizophrenia ; Social Perception ; Social Problems ; Transcutaneous Electric Nerve Stimulation ; Visual Perception

A stable cohort (n = 369,725) was reconstructed to test the association of hepatitis B virus (HBV) infection with subsequent occurrence of liver cancer in a healthy Korean population. The cohort consisted of male beneficiaries of the Korea Medical Insurance Corporation over 30 years of age, living nationwide. The HBV infection was tested by the reversed passive hemagglutination method for the HBsAg and by the passive hemagglutination method for the anti-HBs at the time of recruitment in 1984. Admissions due to liver diseases were identified through a computerized system for reimbursements on medical insurance claims from January 1, 1985 to December 31, 1987. For a more valid estimate of incidence, a sample survey was carried out, obtaining correction coefficients against misclassification of the diagnosis, as well as those for duplicate claims in a year. The incidence rate of liver cancer steadily increased with age (kappa 2 TREND = 51.1, df = 1, p = 0.00).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult ; Age Factors ; Aged ; Cohort Studies ; Hepatitis B/*complications ; Humans ; Incidence ; Income ; Korea/epidemiology ; Liver Neoplasms/epidemiology/*microbiology ; Male ; Middle Aged ; Risk Factors

The authors conducted a nationwide survey to estimate the incidence rates of female breast cancer among Korean women in 1990-1991. We identified potential breast cancer cases based on the claims sent by medical care institutions throughout Korea to the Korea Medical Insurance Corporation (KMIC) from January 1988 to December 1989, whose diagnoses in the claims included one of the following diagnostic codes; ICD-9 174-175 (malignant neoplasms of the breast), 217 (benign neoplasms of the breast), 610-611 (benign mammary dysplasia and other disorders of the breast), 233 (carcinoma in situ of the breast and genito-urinary system), or 195-199 (malignant neoplasms with uncoded sites). In order to collect the final diagnosis of the potential cases, abstracting medical records was performed through visiting or mailing an abstracting format to the corresponding medical institutions. Thereafter oncologists reviewed the abstracting formats and confirmed the incident cases of female breast cancer among the potential breast cancer cases. Using these data from the KMIC, the incidence patterns of female breast cancer among Korean women were estimated as of July 1, 1988 to June 30, 1989. The incidence rate of female breast cancer adjusted for the Korean population was estimated to be 9.9 (95% confidence interval: 9.5-10.4). The cumulative rates for the ages 0-64 and 0-74 were 0.85% and 1.0%, respectively. The standardized rate for the world population was 10.9, which was lower than those of any other Asian country including China and Japan in 1983-1987.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent ; Adult ; Age Factors ; Aged ; Breast Neoplasms/*epidemiology ; Female ; Human ; Incidence ; Korea/epidemiology ; Middle Age ; Support, Non-U.S. Gov't

BACKGROUND AND OBJECTIVES: Cervical lymph node metastasis develops in approximately 30% to 80% of patients with papillary thyroid carcinoma. In papillary thyroid carcinoma, lymph node metastasis at presentation do not seem to adversely affect survival, but do increase the risk of loco-regional recurrence. The management of cervical metastasis in thyroid papillary carcinoma ranges from selective removal to a formal comprehensive neck dissection. In this study, we analyzed the pattern of cervical lymph node metastasis and the impact of prognostic variables in oder to plan how to manage the cervical lymph node metastasis in patients with papillary thyroid carcinoma. SUBJECTS AND METHOD: The clinical records and pathological reports of 114 patients who underwent surgery for thyroid papillary carcinoma at the Department of Otolaryngology-Head and Neck Surgery, Hanyang university from 1996 to 2002 were analyzed retrospectively. RESULTS: Cervical nodal metastasis was found in 57 (50.0%) patients. Occult metastasis was found in 26 (22.8%) patients. Cervical lymph node metastasis was most frequently noted in the level VI (38.6%). The size of primary tumor and extrathyroidal invasion were associated with cervical metastasis. CONCLUSION: Based on our results, it might be suggested that elective central neck dissection is needed for patients with papillary thyroid carcinoma which is larger than 35mm or has extrathyriodal extension.
Carcinoma, Papillary ; Humans ; Lymph Nodes* ; Lymphatic Metastasis ; Neck ; Neck Dissection ; Neoplasm Metastasis* ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms*

Background: Rituximab (RTX), a monoclonal antibody that selectively binds to CD20+ B cells, showed favorable outcomes in patients with idiopathic inflammatory myopathies (IIM) in small case series, but the evidence is still not enough. Our goal was to determine the efficacy and safety of RTX for Korean patients with refractory IIM. Methods: We retrospectively analyzed the medical records of 16 patients with refractory IIM treated with RTX in seven tertiary rheumatology clinics in the Korea. The efficacy of RTX was evaluated with the improvement of serum creatine phosphokinase (CPK) level and physician's global assessment (PGA), and daily corticosteroid dose reduction. A > 25% decrease in CPK level, corticosteroid dose, or PGA was considered significant. A complete response (CR) was designated by meeting three efficacy criteria and a partial response (PR) by only two criteria. Results: Sixteen patients with IIM were evaluated (13 female; median age, 51.8 years). All patients had received at least one conventional immunosuppressive agent (median, 3.6 [2.0–5.0]) and concomitant corticosteroids. The median CPK level and median dose of prednisolone was 421.0 units/L and 20.0 mg/day respectively. Eleven patients were treated with intravenous immunoglobulin. Seven patients received 2,000 mg of RTX and the others received lower dose. Twenty-four weeks after RTX treatment, 11 patients achieved a > 25% reduction in corticosteroid dose and CPK levels, and nine showed improved PGA. The overall response rate was 68.8% (11 patients). At the end of follow-up (median 24 weeks), 12 (75.0%) patients responded overall: four (25.0%) and eight (50.0%) patients achieved CR and PR, respectively. Baseline muscle enzyme levels were higher in responders than non-responders, but disease duration, RTX dose, ESR and serum CRP were not significantly different between the two groups. The rate of adverse event was 25.4/1,000 person-years. Conclusion RTX could be an effective and relatively safe therapeutic option in patients with refractory IIM.