STUDY DESIGN: A retrospective study. OBJECTIVES: Using ultrasound to evaluate association of minor cutaneous stigmas with occult spinal dysraphism (OSD) according to the presence of co-morbidities. SUMMARY OF LITERATURE REVIEW: OSD can be associated with various cutaneous markers. Ultrasound of the spine is an effective, non-invasive screening method. MATERIALS AND METHODS: Over a 5-year period (2009-2013), a total of 180 infants with various skin stigmas were evaluated. Ninety-seven patients were normal infants, eighty-three had other co-morbidities. The type of skin stigmata and/or co-morbidities as well as lumbar ultrasound results were reviewed for all patients. RESULTS: Three of the 97 normal infants had abnormalities. One of the three had OSD. Eighteen of the 83 infants with congenital anomalies had abnormalities, and eleven of the 18 had OSD. Infants with congenital anomalies were 6 times more likely to have OSD than normal infants (OR 5.98, 95% CI 1.927 to 18.612, p=0.001) and there was no significant correlation between the presence of minor skin lesions and the presence of dysraphism. CONCLUSIONS: So-called minor skin lesions were not markers of OSD in normal infants. However, because of the feasibility, simplicity, and low cost of spinal ultrasound, the examination is justified by the benefits of early diagnosis.
Christianity* ; Early Diagnosis ; Humans ; Infant* ; Mass Screening ; Neural Tube Defects ; Retrospective Studies ; Skin ; Spinal Dysraphism* ; Spine ; Ultrasonography*

BACKGROUND/AIMS: In 2010, the American Diabetes Association (ADA) adopted glycated hemoglobin (HbA1c) as a new diagnostic criterion for diabetes mellitus. However, HbA1c values may differ among races. We determined whether this criterion could be applied to Korean diabetics. METHODS: Between January 2000 and January 2010, 1,862 patients among Konyang University Hospital visitors in which the 75 g oral glucose tolerance test (OGTT) and HbA1c were checked at the same time were enrolled. We excluded patients with acute disease, an Hb < or = 10 g/dL, a Cr > or = 2 mg/dL, those prescribed oral hypoglycemic agents or insulin, and those who were pregnant. RESULTS: After applying the exclusion criteria, 1,474 Korean patients were enrolled. All had common features of Korean diabetics for body mass index and homeostatic model assessment of insulin resistance values. Using the 0 and 120 minute glucose levels of the OGTT from the receiver operating characteristic curve, the HbA1c cutoff value was 6.25%. The cutoff value to diagnose diabetes with the presence of diabetic retinopathy was 6.75%. CONCLUSIONS: Our study showed a difference between the HbA1c values for diagnosing diabetes and the new diagnostic criterion from the ADA. Considering that the HbA1c characteristics may be influenced by race or culture, larger studies on diabetes complications are needed to identify the appropriate HbA1c value for Korean diabetics.
Acute Disease ; Body Mass Index ; Continental Population Groups ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Retinopathy ; Glucose ; Glucose Tolerance Test ; Hemoglobins ; Humans ; Hypoglycemic Agents ; Insulin ; Insulin Resistance ; Korea ; ROC Curve

PURPOSE: Recently, there have been many attempts to use PET-CT for the diagnosis of metastasis of soft tissue tumors and for differentiating benign tumors from malignant tumors. In this study, we wanted to evaluate the efficacy of 18-FDG PET CT in soft tissue tumors. MATERIALS AND METHODS: Patients (n=64) with suspected malignant soft tissue tumor had 18-FDG PET CT scans. This included 15 cases of benign soft tissue tumor, 34 cases of malignant soft tissue tumor and 15 cases of inflammatory lesions. All patients went through surgical treatment after PET-CT imaging was done, and all dissected tissues were biopsied. For semiquantitive analysis, SUVmax(Maximal standard uptake value) was measured, and SUVmax was determined using ROC analysis, the Kruskal-Wallis test and the Mann-Whitney test. RESULTS: Using 18-FDG PET CT it was possible to differentiate benign from malignant tumor using SUVmax values. But, discrimination between different grades of tumor was not possible. Also discrimination between malignant tumors and inflammatory lesions was not possible. CONCLUSION: PET-CT can be considered as a useful nuclear imaging method that can detect local recurrence and distant metastasis of soft tissue sarcoma and can differentiate benign from malignant tumors. But PET-CT results must be interpreted carefully in diagnoses when there is inflammatory disease or a suspected lesion present.
Discrimination (Psychology) ; Humans ; Neoplasm Metastasis ; Recurrence ; ROC Curve ; Sarcoma

BACKGROUND/AIMS: Endoscopic pancreatic ductal drainage may help alleviate the pain from chronic pancreatitis, but stricture dilatation may be technically difficult. Dilatation of high grade strictures of the pancreatic ducts with using dilating or balloon catheters may result in failure. We evaluated the efficacy of using the Soehendra stent retriever as a dilator. METHODS: Fourteen patients with pancreatic stricture had dilation performed with a Soehendra stent retriever. Each patient had sphincterotomy, guidewire placement and stent retriever dilatation. RESULTS: All procedures were successful and none of the patients had complications. Symptom relief was observed after dilation in all patients. There was no complication associated with the use of the stent retriever. None of the patients have relapsed for 6 months. CONCLUSIONS: The Soehendra stent retriever is safe and effective as a dilating device for the pancreatic strictures that are resistant to conventional dilation.
Catheters ; Constriction, Pathologic ; Dilatation* ; Drainage ; Humans ; Pancreatic Ducts* ; Pancreatitis, Chronic* ; Stents*

BACKGROUND/AIMS: The extraction of large common bile duct (CBD) stones after an endoscopic sphincterotomy (EST) is successful in 80~90% of cases but it often requires a prolonged time and repeated trials. This study investigated the utility of a combined endoscopic papillary large balloon dilatation (EPLBD) and a mid-incision of an EST (m-EST) method for the removal of large CBD stones. METHODS: Thirty patients with large CBD stones were enrolled in this study. EPLBD was carried out using the one-step inflation of a 15~18 mm diameter balloon after m-EST. RESULTS: The maximum stone diameter was 21.62+/-5.38 mm. Twelve patients had more than 4 stones, 7 patients had 2 stones, and the remainder had a single large stone. Complete ductal clearance was achieved in all patients. After the procedure, the serum amylase and/or lipase levels were elevated in 3 patients (13.3%). However, there was no episode of true pancreatitis. Minor bleeding was encountered in only one patient (3.3%), and was easily controlled by an endoscopic epinephrine injection. The procedure was carried out safely in 6 patients with periampullary diverticulum. No perforation or mortality was encountered. CONCLUSIONS: Combined EPLBD and m-EST is a safe and effective method, and may be a good alternative treatment for removing large CBD stones.
Amylases ; Bile Ducts* ; Bile* ; Choledocholithiasis ; Common Bile Duct ; Dilatation* ; Diverticulum ; Epinephrine ; Hemorrhage ; Humans ; Inflation, Economic ; Lipase ; Mortality ; Pancreatitis ; Sphincterotomy, Endoscopic*

Leptospirosis is a zoonotic disease of worldwide distribution that is caused by spirochetes known as Leptospira; more than 20 serogroups and more than 200 serovars are known. The disease has seasonal incidence occurring in the late summer or early fall. The typical severe case of leptospirosis is known as Weil's disease; it is characterized by hepatic and renal involvement and is common in Korea. Elevated amylase can be seen when ARF is associated but true acute pancreatitis is an uncomon complication of leptospirosis and only seven cases of well documented pancreatitis have been described abroad, with there was no case report in Korea yet. We experienced a 55-year old male patient who had Weil's disease associated with acute pancreatitis which was confirmed by elevated amylase and lipase with pancreatic swelling and peripancreatic fat infiltration on abdomen CT.
Abdomen ; Amylases ; Humans ; Incidence ; Korea ; Leptospira ; Leptospirosis ; Lipase ; Male ; Middle Aged ; Pancreatitis* ; Seasons ; Spirochaetales ; Weil Disease* ; Zoonoses

Leptospirosis is a zoonotic disease of worldwide distribution that is caused by spirochetes known as Leptospira; more than 20 serogroups and more than 200 serovars are known. The disease has seasonal incidence occurring in the late summer or early fall. The typical severe case of leptospirosis is known as Weil's disease; it is characterized by hepatic and renal involvement and is common in Korea. Elevated amylase can be seen when ARF is associated but true acute pancreatitis is an uncomon complication of leptospirosis and only seven cases of well documented pancreatitis have been described abroad, with there was no case report in Korea yet. We experienced a 55-year old male patient who had Weil's disease associated with acute pancreatitis which was confirmed by elevated amylase and lipase with pancreatic swelling and peripancreatic fat infiltration on abdomen CT.
Abdomen ; Amylases ; Humans ; Incidence ; Korea ; Leptospira ; Leptospirosis ; Lipase ; Male ; Middle Aged ; Pancreatitis* ; Seasons ; Spirochaetales ; Weil Disease* ; Zoonoses

Recently, Skeletal Anchorage System (SAS) has been focused clinically with the view point that it could provide the absolute intraoral anchorage. First, it began to be used for the patient of orthognathic surgery who had difficulty in taking intermaxillary fixation due to multiple loss of teeth. And then, its uses have been extended to many cases, the control of bone segments after orthognathic surgery, stable anchorage in orthodontic treatment, and anchorage for temporary prosthesis and so on. SAS has been developed as dental implants technique has been developed and also called in several names; mini-screw anchorage, micro-screw anchorage, mini-implant anchorage, micro-implant anchorage (MIA), and orthosystem implant etc. Now many clinicians use SAS, but the anatomical knowledges for the installed depth of intraosseous screws are totally dependent on general experiences. So we try to study for the cortical thickness of maxilla and mandible in Korean adults without any pathologic conditions with the use of Computed Tomography at the representative sites for the screw installation.
Adult ; Dental Implants ; Humans ; Mandible ; Maxilla ; Orthognathic Surgery ; Prostheses and Implants ; Tooth

PURPOSE: Gingko biloba extract (GBE), a natural product extracted from Gingko leaves, is known to increase the radiosensitivity of tumors. This radiosensitization probably arises from the increase in the peripheral blood flow by decreasing the blood viscosity and relaxing the vasospasm. The influence of a GBE on the metabolic status in fibrosarcoma II (FSaII) of a C3H mouse was investigated using 31P magnetic resonance spectroscopy (MRS). MATERIALS AND METHODS: Eighteen C3H mice with fibrosarcoma II (from 100 mm3 to 130 mm3) were prepared for this experiment. The mice were divided into 2 groups; one (9 mice) without a priming dose, and the other (9 mice) with a priming dose of GBE. The GBE priming dose (100 mg/kg) was administered by an intraperitoneal (i.p.) injection 24 hours prior to the measurement. First 31P MRS spectra were measured in the mice from each group as a baseline and test dose of GBE (100 mg/kg) was then administered to each group. One hour later, the 31P MRS spectra were measured again to evaluate the change in the energy metabolic status. RESULTS: In the group without the priming dose, the mean pH, PCr/Pi, PME/ATP, Pi/ATP, PCr/(Pi+ME) values 1 hour after the test dose were not changed significantly compared to the values at the baseline. However, in the group with the priming dose, the mean PCr/Pi, Pi/ATP, PCr/(Pi+PME) values 1 hour after the test dose changed from the baseline values of 0.49, 0.77, 0.17 to 0.74, 0.57, 0.28 respectively. According to the paired t-test, the differences were statistically significant. CONCLUSION: The above findings suggest that the metabolic status is significantly improved after administering GBE if the priming dose is given 24 hours earlier. This shows that the radiosensitizing effect of GBE is based on the increase of tumor blood flow and the improvement in the metabolic status.
Animals ; Blood Viscosity ; Energy Metabolism ; Fibrosarcoma* ; Ginkgo biloba* ; Hydrogen-Ion Concentration ; Magnetic Resonance Spectroscopy* ; Mice ; Mice, Inbred C3H* ; Radiation Tolerance ; Radiation-Sensitizing Agents

BACKGROUND: Coronary artery bypases grafting in the old aged is associated with high mortality and morbidity, and it is difficult to perform if the coronary artery is diffusely disease. Recently it has been known that platelet derived growth factor(PDGF), especially PDGF-BB, stimulates angiogenesis. MATERIAL AND METHOD: New Zealand white rabbit were used. In an attempt to achieve effevtive cardiac revasculatrization without vascular anastmosis, we divided into three groups(group I : Left anterior descending artery(LAD) was occluded by ligature, group II : Bilateral internal mammary vascular pedicles were dissected and implanted into myocardium, group III : The vascular pedicles were implanted into myocardium and PDGF-BB was injected into the myocardial tissue). Two weeks after IMA implantation, the proximal region of implanted LAD was ligated. Four days after LAD ligation angiogram, triphenyl tetrazolium chloride(TTD) staining and hematoxylin eosin staining were performed. RESULT: 1. Survival rate in group II was significantly higher than that in group I (P<0.05), and survival rate in group III was signficantly higher than that in group II(53% vs 93%, P<0.01). 2. There were significant differences in the ratio of area of necrosis to area at risk between group I and group II, and between group II and group III (P<0.01). 3. Microangiogram for angiogenic response revealed wide area of extensive revascularization with patent vessels in group III. 4. Histologic findings of three groups showed that polymorphonuclear leukocyte infiltration was minimal in group II and none in group III. CONCLUSIONS: PDGF-BB can establish functinal cardiac revasculatization through systemic vessels implanted directly into the myocardium.
Blood Platelets* ; Coronary Artery Bypass ; Coronary Vessels ; Eosine Yellowish-(YS) ; Hematoxylin ; Ligation ; Mammary Arteries* ; Mortality ; Myocardial Revascularization* ; Myocardium ; Necrosis ; Neutrophils ; New Zealand ; Platelet-Derived Growth Factor* ; Survival Rate ; Transplants