We report a case of central venous stenosis due to a structural deformity caused by a tuberculosis-destroyed lung in a 65-year-old woman. The patient presented with left facial edema. She had a history of pulmonary tuberculosis, and the chest X-ray revealed a collapsed left lung. Angiography showed leftward deviation of the innominate vein leading to kinking and stenosis of the internal jugular vein. Stent insertion improved her facial edema.
Aged ; Brachiocephalic Veins/*pathology/radiography ; *Central Venous Pressure ; Constriction, Pathologic/*etiology/pathology/therapy ; Edema/therapy ; Female ; Humans ; Jugular Veins/pathology/radiography ; Stents ; Tuberculosis, Pulmonary/*complications/pathology/radiography ; Vascular Diseases/*etiology/pathology/therapy

No abstract available.
Fistula* ; Stomach* ; Tuberculosis*

PURPOSE: We assessed the usefulness of resistive index(RI) on spectral analysis of Doppler sonography for differential diagnosis of benign and malignant breast lesions. MATERIALS AND METHODS: We retrospectively reviewed 29 benign and 22 malignant lesions of breast, which were examined preoperatively with color and duplex Doppler andwere confirmed by histopathologically after operation. We analyzed the average and distribution of RI in benignand malignant lesions. RESULTS: Although, there was no difference in the average values of RI in benign and malignant breast lesions, the distribution of RI was below 0.7 in eighteen cases (62%) of benign lesions, and above 0.7 in eighteen cases (82%) of malignant lesions. Thus, RI is valuable for differentiation between benignand malignant lesions of breast. CONCLUSIONS: Measurement of RI in breast disease using color and duplex Dopplerstudy is useful modality adjunct to the conventional ultrasonographic differentiation of benign and malignantlesions.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Diagnosis ; Retrospective Studies

The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.
Current Procedural Terminology ; Fees, Medical ; Hospitals, General ; Insurance, Health ; Lymph Node Excision ; Mandibular Fractures ; Mandibular Osteotomy ; Neck ; Surveys and Questionnaires ; Surgery, Oral* ; Tooth, Impacted

The enzyme complex 3beta-hydroxysteroid dehydrogenase (3beta-HSD) is involed in the biosynthesis of all classes of active steroids. It has been known that the enzymatic activity of 3beta-HSD is present not only in the classical steroido-genic tissues, but also in many peripheral tissues. This study was performed to investigated of 3beta-HSD immunore-activity in the rat cardiovascular tissues such as the ventricle, atrium, aortic arch, and abdominal aorta. Immunoblot analyses and immunohistochemical studies were performed using polyclonal antibodies raised against purified human placental 3beta-HSD. We identified 43 and 37KDa bands in the ventricle and atrum, whereas only 37KDa band was observed in the aortic arch and abdominal aorta. Immunostaining for 3beta-HSD was detected in the ventricular and atrial cardiocytes. The intensity of staining was much higher in the atrial cardiocytes than in the ventricular cardiocytes. Immunostaining was also found in the smooth muscles of aortic arch and abdominal aorta.
Animals ; Antibodies ; Aorta, Abdominal ; Aorta, Thoracic ; Cardiovascular System* ; Humans ; Muscle, Smooth ; Oxidoreductases ; Rats* ; Steroids

OBJECTIVE: The purpose of this study is to present the epidemiological data on patients with a stroke admitted to the severance hospital, Yonsei University College of Medicine (YUMC) and to investigate the significant risk factors of stroke. METHODS: We reviewed medical records of 532 patients with a stroke admitted to the hospital of from 1992 to 1996 retrospectively. RESULTS: The incidence was highest in the sixth decade. Ischemic stroke (64.3%) was more common than a hemorrhagic stroke (35.7%) and the thrombotic infarction was the leading type (28.3%) of all kinds of stroke. Middle cerebral arterial territory was the most commonly involved site for the thrombotic and embolic stroke. Of the intracerebral hemorrhages, basal ganglia (48.4%) was the most commonly involved site with was followed by the thalamus (24.2%), lobar (19.3%), and cerebellum (6.5%). In subarachnoid hemorrhages, the aneurysm was most frequently located in the middle cerebral artery (34.4%). The possible contributing factors of stroke were hypertension, hypercholesterolemia, cigarette smoking and diabetes mellitus. The common complications during hospitalization were the frozen shoulders, depression, pneumonia, reflex sympathetic dystrophy (RSD), and hydrocephalus. CONCLUSION: This study showed the changing trends of stroke in its distribution of subtypes. Multicenter prospective study using stroke registry would be required for the determination of national epidemiologic trends.
Aneurysm ; Basal Ganglia ; Cerebellum ; Cerebral Hemorrhage ; Depression ; Diabetes Mellitus ; Epidemiology ; Hospitalization ; Humans ; Hydrocephalus ; Hypercholesterolemia ; Hypertension ; Incidence ; Infarction ; Medical Records ; Middle Cerebral Artery ; Pneumonia ; Reflex Sympathetic Dystrophy ; Retrospective Studies ; Risk Factors ; Shoulder ; Smoking ; Stroke* ; Subarachnoid Hemorrhage ; Thalamus

This study investigated the effects of the nutrition education on body weight, visceral fat and diet quality in the postmenopausal women. The subjects (n = 101) were randomly divided into two groups: Nutrition education + Exercise (NEE) group (n = 51) and Exercise only (EO) group (n = 50). Nutrition education was consisted of counseling in portion control, food selection for low carbohydrate, high fiber food items and for the improvement in micronutrient intakes and diet quality. After 6 months, the reduction in the body weight and visceral fat area was significantly greater in the NEE than in the EO group. The NEE subjects were further divided into two groups according to the amount of visceral fat area reduction; high visceral fat area loss (HVL) group with a visceral fat area reduction 2.35% or greater and low visceral fat area loss (LVL) group with a reduction less than 2.35%. In the HVL group, the reduction in body weight, BMI, percent body fat, waist to hip ratio and visceral fat area was significantly greater than that in the LVL group. We observed a significant increase in the serum HDL-cholesterol level and a decrease in systolic blood pressure, fasting blood sucrose, total and LDL-cholesterol levels in the HVL group compared to the LVL group. The energyadjusted protein, fiber, calcium, vitamin B6, vitamin C, vitamin E intakes were significantly increased in the HVL compared to LVL group. The index of nutritional quality (INQ) and mean adequacy ratio (MAR) were also increased in the HVL group compared to the LVL group. These results show that our nutrition education program was an effective intervention measure for the reduction of body weight and visceral fat, blood pressure, glucose and lipid levels in the blood and also for the improvement of nutrient intake and diet quality in postmenopausal women who are overweight.
Adipose Tissue ; Ascorbic Acid ; Blood Pressure ; Body Weight ; Calcium ; Counseling ; Diet ; Fasting ; Female ; Food Preferences ; Glucose ; Humans ; Intra-Abdominal Fat ; Micronutrients ; Nutritive Value ; Sucrose ; Vitamin B 6 ; Vitamin E ; Vitamins ; Waist-Hip Ratio

A total of 631 species of spiders have been reported in Korea. However, there are no spiders with noxious venom such as Latrodectus sp. Because of this, to date, no serious medical problems due to spider bites have been reported in Korea, and only two cases of spider bite were officially reported. However, as the number of earning spiders from other countries is increased, the number of cases of spider bite has also shown a recent increase. A 17-year-old man presented with numbness of both extremities after being bitten by a spider which he had as a pet. The spider is called an Indian ornamental tree spider (Poecilotheria regalis sp.), one kind of tarantula species. Herein, we report on a case of a spider bite by a tarantula.
Adolescent ; Extremities ; Humans ; Hypesthesia ; Korea ; Spider Bites* ; Spider Venoms ; Spiders ; Venoms

Hypernatremia is a common electrolyte disorder in children and elderly people and has high short-term mortality. However, no high-quality studies have examined the correction rate of hypernatremia and the amount of fluid required for correction. Therefore, in this study, we will compare the efficacy and safety of rapid intermittent bolus (RIB) and slow continuous infusion (SCI) of electrolyte-free solution in hypernatremia treatment. Methods: This is a prospective, investigator-initiated, multicenter, open-label, randomized controlled study with two experimental groups. A total of 166 participants with severe hypernatremia will be enrolled and divided into two randomized groups; both the RIB and SCI groups will be managed with electrolyte-free water. We plan to infuse the same amount of fluid to both groups, for 1 hour in the RIB group and continuously in the SCI group. The primary outcome is a rapid decrease in serum sodium levels within 24 hours. The secondary outcomes will further compare the efficacy and safety of the two treatment protocols. Conclusion: This is the first randomized controlled trial to evaluate the efficacy and safety of RIB correction compared with SCI in adult patients with severe hypernatremia.

INTRODUCTION: This study examined the genetic influence of mandibular prognathism epidemiologically in Korean families. MATERIALS AND METHODS: Over a 5-year period from 2005 to 2009, a questionnaire with a pedigree chart was given to 100 (male 51, female 49) probands with skeletal Class III mandibular prognathism, who had undergone orthognathic surgery in Samsung Medical Center. RESULTS: The average age of the probands was 22.1. The average SNA, SNB and ANB angles of the probands were 81.2degrees, 84.1degreesand -2.9degrees, respectively. A total of 2729 (male 1,354, female 1,375) family members were examined, and the affected ratio of the families was 3.5% with no significant difference between genders. 45% of families had at least one member with a Class III malocclusion other than the proband. The affected ratio of the first-degree relatives (10.9%) was significantly higher than those of the second-degree (3.3%) and third-degree (1.9%) relatives. The affected ratio of the total relatives from the male probands (4.2%) was significantly higher than that of the female probands (2.8%). Heritability (h2, Falconer'method) was estimated to be 29.8% (0.298+/-0.059) in first-degree relatives. CONCLUSION: These results showed the significant influence of mandibular prognathism with relatively low heritability in first-degree relatives in Korean families of probands, who had undergone orthognathic surgery to correct a skeletal Class III malocclusion.
Female ; Humans ; Male ; Malocclusion ; Orthognathic Surgery ; Pedigree ; Prognathism ; Surveys and Questionnaires