Magnetic resonance imaging (MRI) is an essential modality for the diagnosis of musculoskeletal system defects because of its higher soft-tissue contrast and spatial resolution. With the recent development of MRI-related technology, faster imaging and various image plane reconstructions are possible, enabling better assessment of three-dimensional musculoskeletal anatomy and lesions. Furthermore, the image quality, diagnostic accuracy, and acquisition time depend on the MRI protocol used. Moreover, the protocol affects the efficiency of the MRI scanner. Therefore, it is important for a radiologist to optimize the MRI protocol. In this review, we will provide guidance on patient positioning; selection of the radiofrequency coil, pulse sequences, and imaging planes; and control of MRI parameters to help optimize the MRI protocol for the six major joints of the musculoskeletal system.

The guidelines for chronic obstructive pulmonary disease (COPD) treatment are important for the management of the disease. However, studies regarding the treatment adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have been scarce in Korea. Therefore, to examine the adherence to the GOLD guidelines, we examined the patterns of prescribed medication in COPD patients from 2011 to 2018. Patients were classified as having been appropriately and inappropriately treated (overtreatment or undertreatment) for the GOLD group. Appropriate medical therapy was defined as using the first choice or alternative choice drug recommended in the GOLD guidelines. Inappropriate therapy was classified as overtreatment or undertreatment in accordance with the categorization in the GOLD guidelines. According to treatment of 2011 GOLD guidelines, there was inappropriate treatment in 52.3% in group A, 47.3% in group B, 56.3% in group C, and 17.8% in group D. According to treatment of 2017 GOLD guidelines, there was inappropriate treatment in 66.7% in group A, 45.3% in group B, 14.3% in group C, and 24.0% in group D. The common type of inappropriate COPD treatment is overtreatment, with inhaled corticosteroid (ICS) containing regimens. In conclusions, adherence to the GOLD guideline by the pulmonologist in clinical practice is still low in Korea. Therefore, we need better strategies to both optimize the use of the guidelines and adhere to the guidelines as well.
Humans ; Korea* ; Lung Diseases ; Medical Overuse ; Pulmonary Disease, Chronic Obstructive*

BACKGROUND/AIMS: In spite of increased concerns about the overlaps among the various functional gastrointestinal disorders (FGIDs), studies for the overlap between constipation and other common FGIDs are rare. Therefore, we investigated the patterns of overlaps between constipation and other common FGIDs. METHODS: This study was designed as a prospective nationwide multi-center questionnaire study using Rome III questionnaires for functional dyspepsia (FD), irritable bowel syndrome (IBS), and functional constipation (FC), as well as various questionnaires about patients’ information, degree of symptoms, and quality of life. For the evaluation of gastroesophageal reflux disease (GERD), GERD-Q was used. RESULTS: From 19 centers, 759 patients with constipation were enrolled. The proportions of FC and IBS subtypes of constipation (IBS-C) were 59.4% and 40.6%, respectively. Among them, 492 (64.8%) showed no overlap. One hundred and thirty-six patients (17.9%) presented overlapping GERD, and 80 patients (10.5%) presented overlapping FD. Fifty one (6.7%) of patients were overlapped by both GERD and FD. Coincidental herniated nucleus pulposus (HNP) (P = 0.026) or pulmonary diseases (P = 0.034), reduced fiber intake (P = 0.013), and laxative use (P < 0.001) independently affected the rate of overlaps. These overlapping conditions negatively affected the constipation-associated quality of life, general quality of life, and degree of constipation. CONCLUSIONS: The overlap of GERD or FD was common in patients with constipation. Coincidental HNP or pulmonary diseases, reduced fiber intake, and laxatives use were found to be independent associated factors for overlapping common FGIDs in Korean patients with constipation.
Constipation* ; Dyspepsia ; Gastroesophageal Reflux ; Gastrointestinal Diseases* ; Humans ; Irritable Bowel Syndrome ; Laxatives ; Lung Diseases ; Prospective Studies ; Quality of Life

BACKGROUND: Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. OBJECTIVE: To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. METHODS: To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. RESULTS: The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. CONCLUSION: Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment.
Activities of Daily Living ; Dermatitis, Contact ; Eczema* ; Female ; Hand* ; Health Personnel ; Humans ; Korea* ; Medical Records ; Occupations ; Prevalence ; Quality of Life ; Seasons ; Skin ; Surveys and Questionnaires

OBJECTIVES: The aim of this study was to evaluate the effect of red vinegar drink on sound enamel surface. METHODS: Commercially available red vinegar drink was used for the study. Firstly, pH values were measured in commercially available red vinegar drinks. Secondly, four groups; mineral water as the control group and red vinegar drink, red vinegar drink + mineral water (mixing ratio, 1:3), red vinegar drink + milk (mixing ratio,1:4) as the experimental group were selected. Forty specimens of bovine teeth were made and then divided into the four groups and treated with the test drinks for 1, 15, 30 and 60 minutes. The surface microhardness (vickers hardness number, VHN) was measured using the microhardness tester before and after the treatments. The surface of specimens was observed with Scanning Electron Microscopy (SEM). RESULTS: The average pH of red vinegar drinks was 2.91+/-0.02. The change values (before treatment - after treatment of surface microhardness of enamel surface) were significantly difference among groups (P<0.05). There was no significant difference between control and red vinegar drink + milk (1:4) and there was the significant difference between control group and red vinegar drink groups, and control and red vinegar drink + mineral water (1:3) groups. In SEM, damage of enamel surface was observed in Red vinegar and Red vinegar+Mineral water group. CONCLUSIONS: The results showed that the all experimental red vinegar drinks, except red vinegar drink + milk (1:4) can reduce the surface microhardness of sound enamel. Thus, it is suggested that the red vinegar drink with milk could be recommended the preventive eating method for reducing the risk of dental erosion on the red vinegar drink diet.
Acetic Acid* ; Dental Enamel* ; Diet ; Eating ; Hardness ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning ; Milk ; Mineral Waters ; Tooth ; Water

This study was conducted to evaluate treatment outcome, mortality, and predictors of both in patients with multidrug-resistant tuberculosis (MDR-TB) at 3 TB referral hospitals in the public sector of Korea. We included MDR-TB patients treated at 3 TB referral hospitals in 2004 and reviewed retrospectively their medical records and mortality data. Of 202 MDR-TB patients, 75 (37.1%) had treatment success and 127 (62.9%) poor outcomes. Default rate was high (37.1%, 75/202), comprising 59.1% of poor outcomes. Male sex (adjusted odds ratio [aOR], 2.91; 95% confidence interval [CI], 1.13-7.49), positive smear at treatment initiation (aOR, 5.50; 95% CI, 1.22-24.90), and extensively drug-resistant TB (aOR, 10.72; 95% CI, 1.23-93.64) were independent predictors of poor outcome. The all-cause mortality rate was 31.2% (63/202) during the 3-4 yr after treatment initiation. In conclusion, the treatment outcomes of patients with MDR-TB at the 3 TB hospitals are poor, which may reflect the current status of MDR-TB in the public sector of Korea. A more comprehensive program against MDR-TB needs to be integrated into the National Tuberculosis Program of Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antitubercular Agents/*therapeutic use ; Demography ; Drug Resistance, Multiple, Bacterial ; Drug Therapy, Combination ; Female ; Hospitals, Chronic Disease ; Humans ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Retrospective Studies ; Sex Factors ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant/drug therapy/*mortality

This study was conducted to evaluate treatment outcome, mortality, and predictors of both in patients with multidrug-resistant tuberculosis (MDR-TB) at 3 TB referral hospitals in the public sector of Korea. We included MDR-TB patients treated at 3 TB referral hospitals in 2004 and reviewed retrospectively their medical records and mortality data. Of 202 MDR-TB patients, 75 (37.1%) had treatment success and 127 (62.9%) poor outcomes. Default rate was high (37.1%, 75/202), comprising 59.1% of poor outcomes. Male sex (adjusted odds ratio [aOR], 2.91; 95% confidence interval [CI], 1.13-7.49), positive smear at treatment initiation (aOR, 5.50; 95% CI, 1.22-24.90), and extensively drug-resistant TB (aOR, 10.72; 95% CI, 1.23-93.64) were independent predictors of poor outcome. The all-cause mortality rate was 31.2% (63/202) during the 3-4 yr after treatment initiation. In conclusion, the treatment outcomes of patients with MDR-TB at the 3 TB hospitals are poor, which may reflect the current status of MDR-TB in the public sector of Korea. A more comprehensive program against MDR-TB needs to be integrated into the National Tuberculosis Program of Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antitubercular Agents/*therapeutic use ; Demography ; Drug Resistance, Multiple, Bacterial ; Drug Therapy, Combination ; Female ; Hospitals, Chronic Disease ; Humans ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Retrospective Studies ; Sex Factors ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant/drug therapy/*mortality

No abstract available.
Echocardiography ; Heart

BACKGROUND/AIMS: We conducted a prospective, randomized, double-blinded, placebo-controlled trial to investigate the effect of hyoscine-N-butyl bromide during colonoscopy. METHODS: A total of 133 patients undergoing colonoscopy were randomized to receive either 20 mg of hyoscine-N-butyl bromide (n=70) or normal saline solution (n=63) via intramuscular injection as premedication. RESULTS: The mean cecal intubation time and withdrawal time in the hyoscine-N-butyl bromide group were significantly shorter than those of the control group (5.26+/-2.78 min vs. 6.74+/-4.89 min; p=0.032, 5.42+/-1.54 min vs. 6.18+/-2.54 min; p=0.038, each). The spasm grade in the hyoscine-N-butyl bromide group was significantly lower than that of the control group (p<0.001). No significant differences were found in the polyp detection rate (15.7% vs. 28.6%; p=0.073) and adenoma detection rate (10.0% vs. 15.9%; p=0.311). Difficulty of colonoscopy for the endoscopists and nurses (p=0.853; p=0.732), the patient's comfort (p=0.891) and the patient's willingness to repeat colonoscopy (85.7% vs. 82.5%; p=0.932) were also similar in both groups. CONCLUSIONS: Premedication with intramuscularly administered hyoscine-N-butyl bromide do not demonstrate any additional benefits except reducing the colonoscopy insertion time.
Adenoma ; Colonoscopy ; Humans ; Injections, Intramuscular ; Intubation ; Parasympatholytics ; Polyps ; Premedication ; Prospective Studies ; Scopolamine Hydrobromide ; Sodium Chloride ; Spasm

BACKGROUND: Tinea pedis is the most common dermatophytosis in Korea. It has been increased gradually with time and the proportion of that in the aged has been significantly increased. OBJECTIVE: The aim of this study is to evaluate the clinical characteristics of tinea pedis according to the clinical types and their mycologic findings. METHODS: A clinical and mycological study was performed with 212 cases of tinea pedis among outpatients examined for 9 months from March 2005 to November 2005 at Department of Dermatology of the 11 University Hospitals in Korea. RESULTS 1. The age distribution showed patients in their 50s and 60s to be the most common. The ratio of male to female was 1.33:1 2. The most frequent clinical type was interdigital only type (55.2%), interdigital hyperkeratotic type (39.8%), vesicular type (2.8%) and interdigital vesicular type (2.2%), in descending order. There are no hyperkeratotic only type and hyperkeratotic vesicular type. 3. The duration of tinea pedis was longer than 5 years in 73.1%. The proportion of interdigital hyperkeratotic type was the highest in longer than 10 years of duration group than in other duration groups. 4. The rate of coexistent dermatophytosis with tinea pedis was 19.3%, and tinea cruris was the most common (10.3%). 5. The positive culture rate was 73.1%, and Trichophyton(T.) rubrum was the most common isolates (93.5%) followed by T. mentagrophytes var. mentagrophytes (3.9%) and T. mentagrophytes var. interdigitale (2.6%). CONCLUSIONS: All these findings suggest that the prevalence of tinea pedis in the aged was high, longer duration of the disease was more common and the rate of coexistent dermatophytosis increased. Further studies about tinea pedis and other dermatophytosis in the aged person will be necessary.
Age Distribution ; Dermatology ; Female ; Hospitals, University ; Humans ; Korea ; Male ; Outpatients ; Prevalence ; Tinea Pedis* ; Tinea*