BACKGROUND: Statistical type II error has seemed to be ignored commonly by medical researchers. To control and present a power value could be helpful to reduce this type of error and to improve a quality of scientific decision making. We performed the post-hoc survey of the power of the negative results in Korean Journal of Anesthesiology (KJA). METHODS: One Hundred nineteen articles with negative results published in KJA during a year of 1997 were selected. We collected the numbers of the sample size and calculated the power of the given negative result only when applicable. And each author's attitude to negative results was taken by arbitrary criteria. RESULTS: Median sample size of these negative results was 16 12 (median interquartile range). We can calculate the power only in 43 articles of 119 negative results. Median power is 18.0% (interquartile range 26.0). In thirty six articles (83.8% of 43) the powers are proved to be under 80.0%. And 22 articles (51.2% of 43) have the powers even under 20.0%. We couldn't find any author who included either power or effect size in the article, and there was only one article in which its authors considered their inadequate number of sample size. CONCLUSIONS: We conclude that authors of KJA tend to ignore statistical type II error. In 119 negative results published in KJA during 1997, the calculated powers were very low and were not reported in the text.
Anesthesiology* ; Decision Making ; Sample Size

We report two human cases of tick bite. A 63-year-old male had a pruritic pea-sized brownish nodule on the left popliteal area. Another 41-year-old male had an asymptomatic bean-sized black nodule in the pubic area. The ticks were identified as Ixodes nipponensis, which are the 18th and the 19th cases in Korea.
Adult ; Animals ; Bites and Stings/*parasitology/pathology ; Human ; *Ixodes/anatomy & histology ; Male ; Middle Aged ; Skin/*parasitology/pathology ; Tick Infestations/*parasitology/pathology

Objectives : Depression is a common psychiatric disorder in cancer patients. The Brief Edinburgh Depression Scale(BEDS), which is an abbreviated version of the Edinburgh Depression Scale, may serve as a useful tool in screening for the depression in patients with the medical illnesses. This report investigated the reliability and validity of the Korean Version of the BEDS(K-BEDS) for the depression in cancer patients. METHODS : One-hundred cancer patients were enrolled in this study. All subjects completed the K-BEDS, the Hospital Anxiety Depression Scale(HADS), and the Karnofsky Performance Status Scale(KPSS). Reliability, validity and Receiver Operating Characteristic(ROC) curve analysis measures were assessed. RESULTS : The K-BEDS showed good internal consistency(Cronbach alpha=0.77) and test-retest reliability(0.94, p<0.001). All item-total correlations were above 0.3. Also, it revealed moderate correlation with the depression subscale of the HADS(r=0.617), but no correlation with the KPSS. Exploratory factor analysis produced only one factor, accounting for 47.1% of the total variance. The most valid cutoff value to screen for depression was a total score of 5 on the K-BEDS, which showed sensitivity of 62.5% and specificity of 86.4% with a positive predictive value of 4.60 and a negative predictive value of 0.43. CONCLUSION : The present findings suggested that the K-BEDS would have good psychometric properties to screen for the depression in cancer patients.
Accounting ; Anxiety ; Depression ; Humans ; Karnofsky Performance Status ; Mass Screening ; Psychometrics ; Reproducibility of Results ; Sensitivity and Specificity

PURPOSE: To introduce a case of bilateral anterior ischemic optic neuropathy (AION) after blood loss due to gastrointestinal bleeding. CASE SUMMARY: A 50-year-old male patient with a history of type 1 diabetes mellitus and alcoholic liver cirrhosis presented with 3 days of melena and 1 day of general weakness and dizziness. Initial hemoglobin level was 4.7 g/dL and blood pressure was 100/55 mm Hg. On esophagogastroduodenoscopy, a peptic ulcer with evident recent bleeding was observed. After transfusion of packed red blood cells and endoscopic hemostasis of bleeding, his general condition improved but he complained of blurred vision in both eyes which developed immediately after the onset of melena. Initial best-corrected visual acuity (BCVA) was 0.5 in his right eye and 0.6 in the left eye. On fundus examination, swollen optic disc with blurred margin was noted and he had constricted visual fields. On follow-up, the patient received posterior subtenon triamcinolone injection in his right eye. After the procedure, the BCVA was improved to 0.8 in both eyes, but he still had bilateral pale optic disc with constricted visual field. CONCLUSIONS: In the case of visual loss after recent blood loss, AION should be considered as a diagnosis, which can present as bilateral involvement.
Blood Pressure ; Diabetes Mellitus, Type 1 ; Diagnosis ; Dizziness ; Endoscopy, Digestive System ; Erythrocytes ; Follow-Up Studies ; Hemorrhage* ; Hemostasis, Endoscopic ; Humans ; Liver Cirrhosis, Alcoholic ; Male ; Melena ; Middle Aged ; Optic Neuropathy, Ischemic* ; Peptic Ulcer ; Triamcinolone ; Visual Acuity ; Visual Fields

PURPOSE: To evaluate the role of bile duct obstuction in the development of atrophy of the liver, using ananimal model. MATERIALS AND METHODS: Seven rabbits were divided into two groups : group 1(n=5), in which therewas selective bile duct ligation, and group 2(n=2), which underwent a sham operation. Each group was evaluated using CT for changes in hepatic volume after selective bile duct ligation or a sham operation. In group I, the diameter of dilated bile duct was measured 2, 4, 8, 12 and 16 weeks after bile duct ligation, while gross andhistologic change were evaluated in all cases. RESULTS: In group 1, bile duct dilatation was seen on CT two weeks after selective bile duct ligation, and did not change significantly during follow-up. In four of five cases, CT revealed no evidence of significant atrophy of the involved segment. Pathologic specimens, however, revealed dilatation of the bile duct, periductal fibrosis, infiltration of chronic inflammatory cells, and periportalfibrosis. One of five cases showed segmental liver atrophy after selective bile duct ligation. In addion to the above pathologic findings, there was obstruction of the portal vein by foreign body reaction. In group 2, no evidence of dilated bile duct or liver atrophy was revealed by CT or pathologic specimen after a sham operation. CONCLUSION: During long-term follow-up of 16 weeks, obstruction of the bile duct did not play a major role in the development of lobar atrophy in the rabbit.
Animals ; Atrophy ; Bile Ducts* ; Bile* ; Dilatation ; Fibrosis ; Follow-Up Studies ; Foreign-Body Reaction ; Ligation* ; Liver ; Portal Vein ; Rabbits

PURPOSE: To introduce a case of intravitreal cysticercosis presenting as neovascular glaucoma. CASE SUMMARY: A 42-year-old female who lives in the Philippines visited our clinic complaining of reduced visual acuity and decreased visual field in her right eye. She was treated at another clinic for neovascular glaucoma and posterior uveitis. Initial best-corrected visual acuity was 0.7 and intraocular pressure was 13 mm Hg with Goldmann applanation tonometry. Slit lamp examination showed inflammatory cells in the anterior chamber and vitreous with florid new vessel on iris. On fundus examination, a cystic lesion without movement was observed in the superonasal vitreous as well as tractional band. As other retinal vascular diseases were not observed on fluorescein angiography, the patient was diagnosed with secondary neovascular glaucoma due to cysticercosis. After a single course of intravitreal bevacizumab injection and cyst removal with pars plana vitrectomy, the best-corrected visual acuity was 0.5 and intraocular pressure was 14 mm Hg without recurrence of iris neovascularization during the 3 months of follow-up.
Adult ; Anterior Chamber ; Antibodies, Monoclonal, Humanized ; Cysticercosis* ; Eye ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Glaucoma, Neovascular* ; Humans ; Intraocular Pressure ; Iris ; Manometry ; Philippines ; Recurrence ; Retinaldehyde ; Traction ; Uveitis, Posterior ; Vascular Diseases ; Visual Acuity ; Visual Fields ; Vitrectomy ; Bevacizumab

PURPOSE: Multidrug resistance in the treatment of cancer mediated by several drug resistant genes impedes the successful management of cancer. The authors investigated the expression of drug resistant genes, including multidrug resistance (mdr1), multidrug resistance-associated protein (mrp), topoisomerase IIalpha (Topo IIalpha), and topoisomerase IIbeta (Topo IIbeta) in patients with childhood acute lymphoblastic leukemia (ALL; n=24) and in normal controls (n=6). METHODS: The levels of their transcripts in the bone marrow mononuclear cells were compared by semiquantitative RT-PCR, comparing the optical density ratio of PCR products of target genes to that of beta2-microglobulin. RESULTS: The expression of all 4 genes were detected in ALL patients as well as in normal controls except for Topo IIalpha, which were not detected in controls. The expression levels of mdr1, mrp and Topo IIbeta in ALL patients were significantly higher than those of normal controls [(2.1+/-2.2 vs 0.9+/-0.3, P> 0.024), (0.5+/-0.2 vs 0.2+/-0.1, P=0.016), and (0.7+/-0.2 vs 0.3+/-0.1, P=0.016)], respectively. The expression level of mdr1 gene transcript was relatively higher than those of mrp and Topo IIbeta. However, there was no correlation between the expression of multidrug resistant genes and survival and/or relapse of ALL. CONCLUSION: Though multidrug resistance genes did not serve as an independent prognostic factor, they might be used for markers for disease progression or relapse in childhood ALL. A longitudinal study of those genes is necessary to elucidate the prognostic significance in childhood ALL.
Bone Marrow ; Disease Progression ; DNA Topoisomerases, Type II ; Drug Resistance, Multiple* ; Genes, MDR* ; Humans ; Multidrug Resistance-Associated Proteins ; Polymerase Chain Reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence

PURPOSE: To investigate the short-term efficacy of topical immunosuppressive agents on the survival of cultivated allo-conjunctival equivalents. METHODS: Twenty-five eyes of New Zealand white rabbits were included. Temporal conjunctivae were trephined to a diameter of 7.5 mm, and then cultured allo-conjunctival epithelial cells on amniotic membrane were transplanted onto them. Various immunosuppressants including steroid, cyclosporine, and rapamycin were applied topically four times a day for a week. Epithelial defects and graft edema were graded daily. Numbers of inflammatory cells were measured in H&E. PKH26 and cytokeratin 4 and 7 were immunostained. RESULTS: Earlier epithelialization was observed in 1% steroid-treated eyes and defects persisted significantly in 0.5% CsA applied eyes. In histology, PKH26 positive cells considered as donor cells were only found in 1% steroid or 0.01% rapamycin applied eyes. 1% steroid- or 0.01% rapamycin-applied eyes both showed positive staining for keratin-4 and -7. Inflammatory cells were less found in 1% steroid or 0.01% rapamycin treated eyes. CONCLUSIONS: Topical steroid or rapamycin can help to suppress acute inflammation and enhance the acute survival of transplanted conjunctival cells.
Administration, Topical ; Animals ; Cell Count ; *Cell Transplantation ; Cells, Cultured ; Conjunctiva/*cytology ; Cyclosporine/pharmacology ; Epithelial Cells/metabolism/*transplantation ; Female ; Fluorescent Antibody Technique, Indirect ; Graft Survival/*drug effects ; Immunosuppressive Agents/*pharmacology ; Keratin-4/metabolism ; Keratin-7/metabolism ; Male ; Organic Chemicals/metabolism ; Prednisone/pharmacology ; Rabbits ; Sirolimus/pharmacology ; Transplantation, Homologous

Mesenteric lymphangioma, which is rare and often diagnosed incidentally, is a benign tumor in infants and children. Most cases of lymphangioma are in the neck and axilla. About 5% of these lesions are in the mediastinum, mesentery or retroperitoneal region. Although most lymphangioma produce no symptoms, it may present an acute surgical condition suggesting acute intestinal obstruction. We report one case of histologically confirmed mesenteric lymphangioma causing billous vomiting and bloody stool in a 3-day-old infant.
Axilla ; Child ; Humans ; Infant* ; Intestinal Obstruction ; Lymphangioma* ; Mediastinum ; Mesentery ; Neck ; Vomiting*

A 72-year-old man who had suffered several episodes of syncope was diagnosed as having hyperinsulinemic hypoglycemia. Although imaging studies and percutaneous transhepatic portal venous sampling did not reveal the existence of any tumors in the pancreas, distal pancreatectomy was performed because the possibility of a small pancreatic endocrine tumor could not be completely rejected. External examination of the surgically removed pancreas did not reveal any tumors. Microscopically, the pancreas exhibited diffuse islet cell hyperplasia without nesidioblastosis. The patient remains euglycemic and has tolerated 24-hour fasting without any medication for a period of 10 months after the operation.
Aged ; Case Report ; Human ; Hyperinsulinemia/etiology* ; Hyperplasia ; Hypoglycemia/etiology* ; Islets of Langerhans/surgery ; Islets of Langerhans/pathology* ; Male ; Pancreatectomy/methods ; Treatment Outcome