A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

BACKGROUND: Effective evaluation of an article's scientific merit requires familiarity with the methodology described, especially when quantitative techniques, such as statistical procedures, are invoked to clarify research findings or to summarize data. OBJECTIVE: The purpose of this study was to describe the frequency with which various statistical concepts were reported in journals important to dermatology. From these results, dermatologists can identify the major statistical skills needed to critically evaluate their literature. METHODS: All 376 original articles of the Korean Journal of Dermatology(KJD) and the Annals of Dermatology(KAD) during 1990-1994 were chosen for review. Each article was re-viewed to determine the statistical content. RESULTS: The two most commonly used statistical techniques in the two journals were mean and standard deviation. The t-test was the next most frequently used statistical technique in the reviewed journals, followed by non-parametric, chi-square test, orphan p, ANOVA, and correlation/regression. CONCLUSION: These results indicate the need for wider education about the use of descriptive and basic comparative statistics. It is impossible to evaluate the dermatological literature critically without these skills.
Child ; Child, Orphaned ; Dermatology* ; Education ; Humans ; Recognition (Psychology)

The common causes of visual loss in branch retinal vein occlusion[BRVO] have been reported as the macular edema, macular non-perfusion and the vitreous hemorrhage due to neovascularization.These factors have close relationship with the status of the posterior vitreous. The purpose of this study was to evaluate the factors of visual prognosis in BRVO and the relationship between visual prognosis and vitreomacular status.Fifty-two patients with branch retinal vein occlusion in the department of ophthalmology, Yeungnam University college of Medicine were included for vitreo macular examination.The eyes were classified as two groups, vitreomacular attachment[Group I]and posterior vitreous detachment[Group II]. The incidence of macular edema was significantly lower in eyes with group I [Fisher's exact Test:p<0.05].Final visual acuity was better than the initial visual acuity, regardless of the presence of posterior vitreous detachment [Paired t-test:p<0.01].Group I developed higher rate of neovascularization and vitreous hemorrhage, but statistical significance was not noted.
Humans ; Incidence ; Macular Edema ; Ophthalmology ; Prognosis* ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Visual Acuity ; Vitreous Detachment* ; Vitreous Hemorrhage

PURPOSE: This study compared the accuracy of an abutment-framework (A-F) taken with open tray impression technique combining cementon crown abutments, a metal framework and resin cement to closed tray and resin-splinted open tray impression techniques for the 3-implant definitive casts. The effect of angulation on the accuracy of these 3 techniques was also evaluated. MATERIAL AND METHODS: Three definitive casts, each with 3 linearly positioned implant analogs at relative angulations 0, 30, and 40 degrees, were fabricated with passively fitted corresponding reference frameworks. Ten impressions were made and poured, using each of the 3 techniques on each of the 3 definitive casts. To record the vertical gap between reference frameworks and analogs in duplicate casts, a light microscope with image processing was used. Data were analyzed by two-way analysis of variance and the Tukey test. RESULTS: The open tray techniques showed significantly smaller vertical gaps compare to closed tray technique (P < .05). The closed tray and the resin-splinted open tray technique showed significantly different vertical gaps according to the angulation of implant (P < .05), but the A-F impression technique did not (P > .05). CONCLUSION: The accuracy of the A-F impression technique was superior to that of conventional techniques, and was not affected by the angulation of the implants.
Crowns ; Light ; Resin Cements

The t(8;21)(q22;q22) is one of the most frequent structural chromosomal anomaly found in AML, occurring in about 5% of all AML and in 10% of AML with maturation (M2). And approximately 3.4% of AML with t(8;21)(q22;q22) occurs as a complex chromosomal abnormality and occasionally shows discrepancy between cytogenetic and molecular genetic analyses. We report a case of 42 yr old male patient that revealed morphological characteristics of AML-M2 and karyotypic abnormality of 45,X,-Y,t(8;17)(q22;p13) without visible involvement of chromosome 21 by conventional cytogenetic study with masked t(8;21) identified by FISH using RUNX1/RUNX1T1 probes. FISH confirmed nuc ish (RUNX1T1x3),(RUNX1x3), (RUNX1T1 con RUNX1x1). According to the results of conventional cytogenetic and FISH analyses, the karyotype was revised to 45,X,-Y,t(8;17;21)(q22;p13;q22).
Chromosome Aberrations ; Chromosomes, Human, Pair 21 ; Cytogenetics ; Humans ; Karyotype ; Leukemia, Myeloid, Acute ; Male ; Masks ; Molecular Biology

BACKGROUND: Systemic lupus erythematosus(SLE) is a clinical syndrome of unknown causes characterized by inflammat.ion and multisystem involvement. Since Hargravas describe the LE cell in 1948, a profound change has occured in the concept of SLE. Many studies of the large series have been reported in the West, but few collective studies have been reported in Korea. OBJECTIVE: The goal of this study was to elucidate the clinical and laboratory characteristics of SLE in Korean people. METHODS: We carried out retrospective study of 64 patients, who were diagnosed as SLE on the base of the 1982 revised bacteria for the SLE by American Collepe of Rheumatology(formerly, American Rheumatism Association), at Korea University Hospital from 1982 to 1991. The results were compared with those of previous studies in Korea and western countries. RESULTS: 1. In 64 patients with SLE, female patients outnumbered male by 6.1 to 1 and the mean age of onset was 28.6 years. 2. The initial manifestations were arthritis or arthralgia, 25%; fatigue, malaise, weight, loss, 21.8%; facial rash or blush, 12.5%, fever, 12.5%. 3. The major clinical manifastations were hematologic(90.6 %), muccutaneous(89%), musculoskeleta (79.7%), and renal(73.4%) involvemant. 4. The ANA test were positive in 83.9% of the patients, and homoenous pattern was most common. There was no significant difference of organ involvement according to the nuclear patterns of ANA, but cardiopulmonary, renal involvement, hypocomplement,emia and positive anti-ds DNA were less frequent in ANA neghative group. 5. In 73.7% of the patients, the titers of anti-ds DNA antibody was elevated. The amount of anti-ds DNA Ab in serum did not always correlate with disease activity. 6. Photosensitivity, arthritis or arthralgia and CNS manifestatioris were less common, but hematologic findings, including anenia and leukopenia were more common in Korean than western reports. CONCLUSION: Patients with SLE are heterogenous in the natural h story of their disease, which is not an uncommon disease in Korea. Continued efforts to clarify the immunopathologic basis for SLE should eventually lead to more effective treatment.
Age of Onset ; Arthralgia ; Arthritis ; Bacteria ; DNA ; Exanthema ; Fatigue ; Female ; Fever ; Humans ; Korea ; Leukopenia ; Lupus Erythematosus, Systemic* ; Male ; Neutrophils ; Retrospective Studies ; Rheumatic Diseases

The short term beneficial effect of arthroscopic excision of synovial tissue in knees with rheumatoid arthritis have been well documented. The purpose of this study to report the results of synovectomy in patients with rheumatoid arthritis who have been observed at least 3 years. We analysed the clinical result with modified Laurin criteria, radiologic change and patients own satisfaction degree with survey. The results were as follows; 1. The preoperative symptoms were pain (100%), swelling (100%), decreased range of motion (83%) and joint tenderness (74%), and those were improved postoperatively to 43%, 60%, 11%, 43% each other. 2. Among the laboratory parameters, C-reactive protein (CRP) was improved most significantly (pvalue =0.026). 3. On simple supine A-P X-rays, the width of medial joint space and lateral joint space were compared to preoperatively and postoperatively. The width of medial joint space was 4.33mm preoperatively, and it was changed to 3.22mm at last follow up (p=0.032). Those of lateral joint space was changed from 4.24mm preoperatively to 3.27mm at last tollow up (p=0.106). 4. The grade of articular cartilage damage was related with severity of preoperative symptoms and the patients with low grade of articular cartilage damage showed more postoperative improvement. The result of operation was related to symptom duration, degree of X-ray change and degree of cartilage damage. 5. 58% ot patients were satisfied to results of synovectomy, 28% were answered neither satisfied nor ansatisfied and 14% were unsatisf'ied to operation. We concluded the arthroscopic synovectomy of the knee joints was effective procedure to improve the clinical symptoms, range of knee motion and to alleviate the inflammatory reaction at mid-term period al'ter the operation. So we consider this procedure is a palliative treatment that modified and alleviate the progression of rheumatoid arthritis of knee joints.
Arthritis, Rheumatoid* ; C-Reactive Protein ; Cartilage ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Joints ; Knee Joint* ; Knee* ; Palliative Care ; Range of Motion, Articular

The total knee arthroplasty (TKA) is now an established treatment of severe arthritis of the knee joint. The results of TKA estimate good result in mid-90% of patient. But most of assessing method was based on the evaluation methods, made by surgeons, so the patients own evaluation of success may different from the assessment of the surgeons. Especially the Korean life style is different from western style because Korean need more flexed knees for sitting position on the floor. But there no paper about patient subjective satisfactory result of Korean in the authors knowledge. So we studied the satisfactory degree about the outcome of TKA in Korean by the survey. A total 90 patients (103 cases), had undergone TKA were asked to complete a questionnaire-the questionnaire composed of question; ""are you satisfactory with operation?""and the answer; ""very satifactory, generally satisfactory, improved, no change or aggravated-about their satisfaction with the outcome of surgery. The results were as follows; 1.Of 90 patients, 90.3% were satisfied with the outcome of TKA. 2. The patints were satisfied 100% in avascular necrosis of femoral condyle, 83.8% in degenerative osteoarthritis, and 93.6% in rheumatoid arthritis. 3. The satisfactory degree had no relations with age, prevalent period, bilaterality and the evaluation period after the TKA (P>0.05). 4. There was a significant difference in knee scores between the patients who satisfied or not (P<0.05) and the satisfactory degree had a correlation with the points of knee score and amelioration rate of knee and function scores.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Humans ; Knee Joint ; Knee* ; Life Style ; Necrosis ; Osteoarthritis ; Surveys and Questionnaires

Behavioral and psychological symptoms of dementia are major components of Alzheimer’s disease. In this study, we aimed at investigating the prevalence and severity of behavioral and psychological symptoms of dementia in very mild to mild Alzheimer’s disease. Forty-four patients with Alzheimer’s disease who visited the neurology outpatient clinic of Seoul Medical Center were included. A trained neurologist or a supervised test technician administered the neuropsychological test, the Seoul Neuropsychological Screening Battery including Mini Mental State Examination and Clinical Dementia Rating. The instrument used for assessing behavioral and psychological symptoms of dementia was Neuropsychiatric Inventory-Questionnaire. In order of prevalence, apathy, depression, irritability, anxiety, and agitation were the most common symptoms occurring in very mild-to-mild Alzheimer’s disease group. The prevalence and severity of behavioral and psychological symptoms of dementia were found to be in positive correlation with the Clinical Dementia Rating scores. Behavioral and psychological symptoms of dementia are found even in the very early stage of Alzheimer’s disease, apathy and depression being the most common symptoms. Physicians should be aware of this when managing dementia patients.

Several attempts have been made to assess the relative importance of the vasa nervorum and the intrinsic longitudinal vascular plexuses of nerve in maintaining the blood supply of a segment of nerve trunk, but the effect of mobilization on the ability of an injuried or repaired nerve to regenerate and regain function has been less certain and is the subject of these investigations. Thirty-two Korean rabbits of both sexes were used for these studies and we concluded that it is increased fibrosis with adhesion to surrounded tissues, loss of glistening and milk-like discoloration of never grossly, and increased degeneration and milk-like discoloration of nerve grossly, and increased degeneration of axons and demyelization progressively and early proliferated Schwann cells with increasing length of neurolysis. And there was no recovery of damage in nerve tissue induced by above 7 cm of neurolysis. (1:35)
Axons ; Fibrosis ; Nerve Tissue ; Rabbits ; Schwann Cells ; Sciatic Nerve ; Vasa Nervorum