OBJECTIVES: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. METHODS: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. RESULTS: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. CONCLUSIONS: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cerebral Hemorrhage/physiopathology ; Female ; Humans ; Incidence ; Income/statistics & numerical data ; Male ; Middle Aged ; Republic of Korea ; Sex Factors ; *Social Class ; Stroke/classification/*epidemiology/psychology

Parathyroid cysts are uncommon lesions of the neck and superior mediastinum, rarely large enough to be of clinical significance. They frequently present as a clinical diagnostic problem. They may mimic solitary thyroid nodule. They can be classified as either functioning or non-functioning depending on whether or not they are associated with hypercalcemia. Non-functioning or "true" cysts are those associated with normocalcemia (85%), whereas functioning or "pseudocysts" are those associated with hypercalcemia (15%). The presence of a high content of intact parathyroid hormone (iPTH) in the cystic fluid on fine-needle aspiration (FNA), in conjunction with elevated serum levels of calcium and iPTH is diagnostic of a functional parathyroid cyst, which usually requires surgical removal. We report herein two cases of such a functional parathyroid cyst and present a review of the literature.
Biopsy, Fine-Needle ; Calcium ; Hypercalcemia ; Mediastinum ; Neck ; Parathyroid Hormone ; Thyroid Nodule

PURPOSE: To determine the prevalence of thyroid nodules discovered incidentally at ultrasonography and to reassess their significance. MATERIALS AND METHODS: During a six-month period and using a high-frequency transducer, 1033 subjects with suspected breast disease underwent a prospective study of the thyroid. We determined the prevalence of thyroid nodules according to age, and the malignancy rate. RESULTS: Focal thyroid nodules were detected in 291 women (28.2%), their prevalence increasing with age (p<0.01). The nodules, totalling 337, were single in 260 cases (89.3%) and multiple in 31 (10.7%); 271 were less than 1 cm in diameter, 53 were 1-2 cm, and 13 were more than 2 cm [mean, 7.1(range, 2-34) mm]; 126 (37.4%) were pure cysts, 62 (18.4%) were mixed, and 149 (44.2%) were solid. Of the 149 solid nodules, 139 were hypoechoic. Eighty women (with 106 nodules) underwent fine-needle aspiration bipsy, and 35 (with 45 nodules) underwent surgery. It was discovered, finally, that 29 women (2.8%) had 35 malignancies, of which 33 were papillary carcinomas and two were carcinomas which had metastasized from a breast malignancy. Eleven women (37.9%) had extrathyroidal invasion and 6 (20.7%) had cervical lymph node metastasis despite incidentaloma. CONCLUSION: The prevalence of incidentally found thyroid nodules was 28.2%. Since the malignancy rate of these was relatively high, at 10.4%, the clinical significance of this finding should be reassessed.
Biopsy, Fine-Needle ; Breast ; Breast Diseases ; Carcinoma, Papillary ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prevalence ; Prospective Studies ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Nodule* ; Transducers ; Ultrasonography

Twin gestations complicated by a single anomalus fetus present difficulties in obstetric management. It is unclear how the presence of a congenital anomaly in one twin affects its normal sibling. Parents may elect for obstetric management option such as expectant management or selective termination of the anomalous fetus in the hope maximizing the outcome for the normal co-twin. Thanatophoric dysplasia (TD) is the most common type of lethal skeletal dysplasia. Features of the disease are micromelic shortening of the limbs, relative macrocephaly with frontal bossing, flattened vertebrae, disorganized chondrocytes and trabeculae in the growth plates of the long bones, and shortened ribs resulting in a reduced thorax and a bell-shaped abdomen. We experienced a case of TD type I diagnosed in a dizygotic twins by ultrasound at 23 weeks' gestation and reported with concerned literatures.
Abdomen ; Chondrocytes ; Extremities ; Fetus ; Growth Plate ; Hope ; Humans ; Insemination* ; Macrocephaly ; Parents ; Pregnancy ; Ribs ; Siblings ; Spine ; Thanatophoric Dysplasia* ; Thorax ; Twins, Dizygotic* ; Ultrasonography

There are several difficulties in treating aneurysmal subarachnoid hemorrhage(SAH) with chronic renal failure(CRF). First, fluid therapy is not feasible especially in vasospasm. Second, hypertonic solution therapy used to reduce intracranial pressure(ICP) is restricted. Third, hemorrhage2) and disequilibrium syndrome1)2)9) associated hemodialysis can occur. In this article, the authors experienced two cases of aneurysmal SAH with CRF. The first patient was a 57-year old man who suffered from CRF for 8 years. Magnetic resonance angiography had demonstrated a middle cerebral artery(MCA) bifurcation aneurysm on right side. He was treated with early surgery and recovered without neurological deficits. The second patient was a 43-year old woman who suffered from CRF for 5 years. Posterior communicating artery(P-Com) aneurysm was identified on the left side and delayed surgery was performed. After operation, vasospasm occurred and she died of brain swelling from infraction on the left MCA territory. It is noteworthy that the most important factor in aneurysmal SAH with CRF is the prevention vasospasm, because the use of fluid and hypertonic solution therapy is not feasible. To prevent vasospasm, early operation is warranted for the removal of SAH during operation. Non-anticoagulant agent hemodialysis is used during pre and post operative period.
Adult ; Aneurysm* ; Brain Edema ; Female ; Fluid Therapy ; Humans ; Magnetic Resonance Angiography ; Middle Aged ; Renal Dialysis

Slowly growing intracranial tumors, especially located in the supratentorial compartment, permit major volume-spacial compensation. Patient with large supratentorial tumor may not even present any specific symptoms or signs related to the elevated intracranial pressure. We experienced a patient who showed delayed emergence from general anesthesia for total knee replacement without any pharmacologic or metabolic causes. Computerized tomogram scan and magnetic resonance image revealed an unnoticed large supratentorial tumor considered as a cause of delayed emergence. After removal of intracranial tumor, the patient regained consciousness and discharged from the hospital in a relatively good health.
Anesthesia, General* ; Arthroplasty, Replacement, Knee ; Brain ; Compensation and Redress ; Consciousness ; Humans ; Intracranial Hypertension ; Supratentorial Neoplasms

We evaluated the clinical effects of Nicorandil in 27 patients (17 male and 10 female) with ischemic heart disease (17 patients of stable effort angina, 3 patients of unstable effort angina, 6 patients of spontaneous angina, 1 patient of variant angina) in terms of the effect on the anginal pain, electrocardiographic changes and side effects. The results obtained were as follows; 1. The pulse rate was not changed by the drug administration and blood pressure were decreased slightly by Nicorandil in a daily dose of 15 mg divided into 3 dose, but these decrease were not significant in statistical meaning. 2. Improvement in EKG changes was observed in 9 patients (69%) among the 13 patients who showed abnormal EKG initially. 3. Anti-anginal effect of nicorandil were excellent in 14 patients, good in 8 patients, fair in 3 patients and so the rate of global improvement was 82%. 4. Nicorandil had side effects in 7 patients, headache (4 patients), palpitation, ocular pain, edema, but these were transitory and tolerable except of one case who could not be continued because of severe headache.
Angina Pectoris* ; Blood Pressure ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Nicorandil*