No abstract available.
Anterior Cruciate Ligament* ; Rupture*

OBJECTIVES: This study was conducted to review the diffusion process and factors affecting the adoption of the Health Center Information System (HIS). METHODS: Data were collected from POSDATA (private company), MOHW, other Ministries and local governments. To specify the date of adoption, supplementary information was collected from 40 health centers. The following three kinds of factors were analyzed. Internal factors included type, size, and innovativeness of health centers. Community factors were composed of population size, economic status, and level of education. Organizational environmental factors consisted of information score of the municipalities, financial support of the from central government, and the neighborhoodness of innovator health centers. RESULTS: All health centers in the metropolitan cities of Seoul, Gwangju and Jeju adopted the HIS. The laggards were those in the metropolitan cities of Busan (18.8%), Incheon (20.0%) and Daejun (20.0%), and cities with population more than 300, 000 (54.8%) and counties with health center hospitals (47.1%). Financially supported rural health centers adopted the HIS more rapidly than those not supported. The factors identified as being statistically significant (p< 0.05), from a univariate analysis by Kaplan-Meier method, were: (1) internal factors of the type, size and innovativeness of health centers; (2) community factors of population size and economic status; (3) organizational environmental factors of the central government financial support and the neighborhoodness of innovator health centers. A multivariate analysis, using a Cox proportional hazard method, proved the innovativeness of health centers, central government financial support and the neighborhoodness of innovator health centers, were statistically significant (p< 0.05). CONCLUSIONS: The innovativeness of health centers, financial support from central government and the neighborhoodness of innovator health centers, rather than community factors related to regional socioeconomic status, affected the adoption of the HIS in health centers. Further in-depth studies, modifying the MOHW's strategy to propagate the HIS to the laggard health centers, are recommended.
Busan ; Diffusion of Innovation ; Diffusion* ; Education ; Financial Support ; Gwangju ; Incheon ; Information Systems* ; Methods ; Multivariate Analysis ; Population Density ; Residence Characteristics ; Rural Health Services ; Seoul ; Social Class

OBJECTIVE: This study aimed to evaluate the total antioxidant activity (TAA) in patients with major depressive disorder (MDD) and the effect of antidepressants on TAA using a novel potentiometric method. METHODS: Twenty-eight patients with MDD and thirty-one healthy controls were enrolled in this study. The control group comprised 31 healthy individuals matched for gender, drinking and smoking status. We assessed symptoms of depression using the Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI). We measured TAA using potentiometry. All measurements were made at baseline and four and eight weeks later. RESULTS: There was a significant negative correlation between BDI scores and TAA. TAA was significantly lower in the MDD group than in controls. When the MDD group was subdivided into those who showed clinical response to antidepressant therapy (response group) and those who did not (non-response group), only the non-response group showed lower TAA, while the response group showed no significant difference to controls at baseline. After eight weeks of antidepressant treatment, TAA in both the response and non-response groups was similar, and there was no significant difference among the three groups. CONCLUSION: These results suggest that the response to antidepressant treatment in MDD patients might be predicted by measuring TAA.
Antidepressive Agents ; Depression ; Depressive Disorder, Major* ; Drinking ; Humans ; Potentiometry ; Smoke ; Smoking

It is difficult to distinguish nodular fasciitis (NF) from other neoplasm of the parotid gland, especially pleomorphic adenoma (PA) by fine needle aspiration cytology. A 39-year-old female noticed a mass in the parotid region. The aspirate material showed cohesive parts composed of the cells that had oval or spindle-shaped nuclei and relatively abundant cytoplasm and some cells with plasmacytoid features. The background substance was fibromyxoid. PA was diagnosed based on the cytologic findings. Subsequently, parotidectomy was performed and NF was diagnosed based on histologic and immunohistochemical findings. NF in the parotid region is rare and may be misdiagnosed as other benign or malignant tumors of the parotid gland. The clinical history of rapid growth and the presence of mitoses and inflammatory cells help to distinguish NF from PA. In addition, immunohistochemical stains for smooth muscle actin and CD68 are useful to confirm the diagnosis of NF.
Actins ; Adenoma, Pleomorphic* ; Adult ; Biopsy, Fine-Needle ; Coloring Agents ; Cytoplasm ; Diagnosis ; Fasciitis* ; Female ; Humans ; Mitosis ; Muscle, Smooth ; Parotid Gland* ; Parotid Region

Nephrogenic diabetes insipidus (DI) secondary to chronic urinary tract obstruction is a rare disease. The exact cause is unknown but it is likely that increased collecting duct pressures cause damage to the tubular epithelium, resulting in insensitivity to the action of arginine-vasopressin (AVP). A 77-year-old man complaining of polyuria and polydipsia was treated with alpha glucosidase inhibitor under the impression of polyuria due to diabetes mellitus. But his symptoms did not improve. Water deprivation and AVP administration study revealed that the patient had nephrogenic DI. Urinary tract obstruction due to an enlarged prostate was suggested as a principal cause of nephrogenic DI. The patient underwent transurethral resection of the prostate and bilateral subcapsular orchiectomy. After surgery, the urine osmolarity was normalized and the patient became symptom-free. We report a case of nephrogenic DI due to obstructive uropathy which was cured by surgery eliminating obstruction.
Adenocarcinoma/ultrasonography ; Adenocarcinoma/radionuclide imaging ; Adenocarcinoma/pathology ; Adenocarcinoma/complications* ; Aged ; Case Report ; Constriction, Pathologic/etiology ; Diabetes Insipidus, Nephrogenic/etiology* ; Human ; Male ; Prostatic Neoplasms/ultrasonography ; Prostatic Neoplasms/radionuclide imaging ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/complications* ; Urologic Diseases/etiology*

OBJECTIVE: To identify an imaging predictor for the assessment of early treatment response to yttrium-90 transarterial radioembolization (TARE) in patients with hepatocellular carcinoma (HCC), using a quantitative assessment of dynamic computed tomography (CT) images. MATERIALS AND METHODS: Dynamic contrast-enhanced CT was obtained pre- and 4 weeks post-TARE in 44 patients (34 men, 10 women; mean age, 60 years) with HCC. Computer software was developed for measuring the percentage increase in the combined delayed-enhancing area and necrotic area (pD + N) and the percentage increase in the necrotic area (pNI) in the tumor-containing segments pre- and post-TARE. Local progression-free survival (PFS) was compared between patient groups using Cox regression and Kaplan-Meier analyses. RESULTS: Post-TARE HCC with pD + N ≥ 35.5% showed significantly longer PFS than those with pD + N < 35.5% (p = 0.001). The local tumor progression hazard ratio was 17.3 (p = 0.009) for pD + N < 35.5% versus pD + N ≥ 35.5% groups. HCCs with a high pNI tended to have longer PFS, although this difference did not reach statistical significance. CONCLUSION: HCCs with a larger pD + N are less likely to develop local progression after TARE.
Carcinoma, Hepatocellular ; Disease-Free Survival ; Female ; Humans ; Male ; Tomography, X-Ray Computed ; Treatment Outcome ; Yttrium Radioisotopes

OBJECTIVE: To set up the methodology for fluorescent PCR analysis of intron 13 and intron 22 microsatellite polymorphisms of the factor VIII gene, and to identify the usefulness of intron 13 and intron 22 microsatellite polymorphism for the carrier detection and prenatal diagnosis of hemophilia A in the Korean population. METHODS: Intron 13 and intron 22 microsatellite polymorphisms of the factor VIII gene were analyzed in 30 unrelated Korean mothers of patients with severe hemophilia A using fluorescent PCR. RESULTS: Analysis of intron 13 and intron 22 microsatellite polymorphisms of the factor VIII gene was feasible by the fluorescent-PCR method. The expected heterozygosity rates of intron 13 and intron 22 polymorphisms of the factor VIII gene were 67% and 34%, respectively. Combined analysis of intron 13 and intron 22 polymorphisms revealed heterozygous patterns in 16 (53%) of 30 mothers studied. Using linkage analysis with intron 13 and intron 22 polymorphisms, we have attempted three cases of carrier detection and one cases of prenatal diagnosis in two families of patients with severe hemophilia A. CONCLUSION: These results suggest that flourescent-PCR analysis of the intron 13 and intron 22 microsatellite polymorphisms within the factor VIII gene is very useful in the carrier detection and prenatal diagnosis of hemophilia A in the Korean population.
Dinucleotide Repeats ; Factor VIII ; Hemophilia A ; Humans ; Introns ; Microsatellite Repeats ; Mothers ; Polymerase Chain Reaction ; Prenatal Diagnosis

OBJECTIVE: To set up the methodology for fluorescent PCR analysis of intron 13 and intron 22 microsatellite polymorphisms of the factor VIII gene, and to identify the usefulness of intron 13 and intron 22 microsatellite polymorphism for the carrier detection and prenatal diagnosis of hemophilia A in the Korean population. METHODS: Intron 13 and intron 22 microsatellite polymorphisms of the factor VIII gene were analyzed in 30 unrelated Korean mothers of patients with severe hemophilia A using fluorescent PCR. RESULTS: Analysis of intron 13 and intron 22 microsatellite polymorphisms of the factor VIII gene was feasible by the fluorescent-PCR method. The expected heterozygosity rates of intron 13 and intron 22 polymorphisms of the factor VIII gene were 67% and 34%, respectively. Combined analysis of intron 13 and intron 22 polymorphisms revealed heterozygous patterns in 16 (53%) of 30 mothers studied. Using linkage analysis with intron 13 and intron 22 polymorphisms, we have attempted three cases of carrier detection and one cases of prenatal diagnosis in two families of patients with severe hemophilia A. CONCLUSION: These results suggest that flourescent-PCR analysis of the intron 13 and intron 22 microsatellite polymorphisms within the factor VIII gene is very useful in the carrier detection and prenatal diagnosis of hemophilia A in the Korean population.
Dinucleotide Repeats ; Factor VIII ; Hemophilia A ; Humans ; Introns ; Microsatellite Repeats ; Mothers ; Polymerase Chain Reaction ; Prenatal Diagnosis

Background/Aims: Transarterial radioembolization (TARE) has shown promising results in treating advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). However, whether TARE can provide superior or comparable outcomes to tyrosine kinase inhibitor (TKI) in patients with HCC and PVTT remains unclear. We compared the outcomes of TARE and TKI therapy in treatment-naïve patients with locally advanced HCC and segmental or lobar PVTT. Methods: This multicenter study included 216 patients initially treated with TARE (n=124) or TKI (sorafenib or lenvatinib; n=92) between 2011 and 2021. Baseline characteristics were balanced using propensity score matching (PSM) or inverse probability of treatment weighting (IPTW). The primary outcome was overall survival (OS). The secondary outcomes included progression-free survival (PFS) and objective response rate (ORR). Results: In the unmatched cohort, the median OS of the TARE and TKI groups were 28.2 and 7.2 months, respectively (p<0.001), and the TARE group experienced significantly and independently longer OS compared to the TKI group (adjusted hazard ratio=0.41, 95% confidence interval=0.28–0.60, p<0.001). Similar results were observed in the study cohorts balanced with IPTW (p=0.003) or PSM (p=0.004). Although PFS was comparable between the two groups, the TARE group showed a trend of prolonged PFS in a subpopulation of patients with Vp1 or Vp2 PVTT (p=0.052). In the matched cohorts, the ORR of the TARE group was 53.0–56.7%, whereas that of the TKI group was 12.3–15.0%. Conclusions For patients with advanced HCC with segmental or lobar PVTT and well-preserved liver function, TARE may provide superior OS compared to sorafenib or lenvatinib.