BACKGROUND AND OBJECTIVES: To improve hearing screening, we developed a more effective hearing screening questionnaire for infants and children to be utilized during medical check-ups. SUBJECTS AND METHOD: Through literature review and discussions with an advisory council, we selected 10 questions to ask parents at each of the seven screening periods for their infants and children. In total, 223 parents of infants and children with and without hearing impairment (119 normal hearing, 104 hearing impaired) answered questionnaires at seven university hospitals in Korea. The advisory council modified questions with regard to sensitivity, specificity, positive, and negative prediction rate, preventing duplication among screening periods, and to address other questions related to development. RESULTS: For hearing screens, we asked five questions per screening period. Collectively, these questions had 40-100% sensitivity and 45-90% specificity at each of the seven screening periods. CONCLUSION: Although we do not advise that hearing questionnaires replace hearing tests, we developed in this study a more effective questionnaire that we suggest could be utilized during medical check-ups to enhance the hearing screening process.
Child* ; Hearing Loss ; Hearing Tests ; Hearing* ; Hospitals, University ; Humans ; Infant* ; Korea ; Mass Screening* ; Parents ; Sensitivity and Specificity

We report here the results of surveys on external quality assessment (EQA) of blood bank tests in Korea carried out in 2014. The proficiency testing specimens were prepared at Ajou University Hospital and the response rates for the 1st and 2nd trials were 94.3% (537/549) and 96.0% (545/554), respectively. No answers were considered incorrect, and the average accuracy rates of six different test items on the regular survey were as follows: ABO grouping, 98.5% to 100.0%; RhD typing, 98.1% to 99.4%; crossmatching, 91.2% to 99.6%; direct antiglobulin test (DAT) using a polyspecific reagent, 96.7% to 98.4%; DAT using an immunoglobulin-G monospecific reagent, 93.8% to 98.7%; DAT using a C3d monospecific reagent, 89.5% to 98.7%; unexpected antibody screening test, 96.2% to 100.0%; and antibody identification test, 69.8% to 100.0%. Test items for the pilot survey were reactivities to anti-A1 and anti-H, Rh subgrouping, and ABO antibody titration. Except for the result of the antibody identification test for specimens with multiple antibodies, we obtained excellent survey results for the EQA of blood bank tests carried out in 2014. In addition, the number of participating institutes was higher in 2014 than in 2013. The EQA of blood bank tests in 2014 should be helpful for improving the quality of the participating laboratories.
Academies and Institutes ; Antibodies ; Blood Banks ; Coombs Test ; Korea ; Laboratory Proficiency Testing ; Mass Screening

PURPOSE: This study was conducted to establish the production conditions through optimization of the production process of beverages using Aspergillus oryzae CF1001, and to analyze volatile compounds and antidiabetic activity. METHODS: The optimum condition was selected using the response surface methodology (RSM), through a regression analysis with the following independent variables gelatinization temperature (GT, X1), saccharogenic time (ST, X2), and dependent variable; DeltaE value (y). The condition with the lowest DeltaE value occurred with combined 45 min ST and 50degrees C GT. The volatile compounds were analyzed quantitatively by GC-MS. RESULTS: Assessment of antidiabetic activity of saccharogenic mixed grain beverage (SMGB) was determined by measurement of alpha-glucosidase inhibition activity, and glucose uptake activity and glucose metabolic protein expression by reverse transcriptase polymerase chain reaction (RT-PCR) and western blot analysis. Results of volatile compounds analysis, 62 kinds of volatile compounds were detected in SMGB. Palmitic acid (9.534% ratio), benzaldehyde (8.948% ratio), benzyl ethyl ether (8.792% ratio), ethyl alcohol (8.35% ratio), and 2-amyl furan (4.826% ratio) were abundant in SMGB. We confirmed that alpha-glucosidase inhibition activity, glucose uptake activity, and glucose-metabolic proteins were upregulated by SMGB treatment with concentration dependent manner. CONCLUSION: Saccharogenic mixed grain beverage (SMGB) showed potential antidiabetic activity. Further studies will be needed in order to improve the taste and functionality of SMGB.
alpha-Glucosidases ; Aspergillus oryzae ; Beverages* ; Blotting, Western ; Edible Grain* ; Ethanol ; Ether ; Gelatin ; Glucose ; Palmitic Acid ; Reverse Transcriptase Polymerase Chain Reaction

PURPOSE: Soft-tissue reconstruction in the knee area requires thin, pliable, and tough skin. The range of motion of the knee also acts as a limitation in using only local flaps for coverage. The author has successfully used various perforator flaps for soft tissue reconstruction around the knee while preserving its functional and cosmetic characteristics. MATERIALS AND METHODS: Out of the twenty patients assessed from April 2009 to March 2011, seven received anterolateral thigh perforator flaps, four received medial sural perforator island flaps, four received lateral supragenicular perforaor perforator flaps, and five received medial genicular artery flaps. The age of the patients ranged from 44 to 79 and the size of the defects ranged from 4x5 cm to 17x11 cm. Fifteen of the twenty patients had histories of total knee replacement (TKR) surgery. RESULTS: There were no flap losses in any of the twenty patients assessed. Two patients showed partial losses in the distal area of the flap, but were treated through careful wound care. One patient presented with pedicle adhesion at the drainage site from a past TKR, but it did not hinder the flap survival. Primary closure at the donor site was possible in nine patients, while split skin graft was necessary for the other 13. CONCLUSION: In soft tissue reconstruction of the knee, various perforator flaps can be used depending on the condition of the preoperation scar, wound site, and size. It also proved to provide better functional and cosmetic results than in primary wound closure or skin grafts.
Arteries ; Arthroplasty, Replacement, Knee ; Cicatrix ; Drainage ; Humans ; Knee ; Knee Prosthesis* ; Perforator Flap* ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; Skin ; Surgical Flaps ; Thigh ; Tissue Donors ; Transplants ; Wounds and Injuries

BACKGROUND: The natural course of cytologically benign thyroid nodules remains unclear. The aim of this study was to evaluate whether ultrasonographic (US) changes are associated with changes in nodule volume during follow-up. METHODS: We retrospectively reviewed over 4 years of clinical records of patients with benign thyroid nodules as confirmed by fine needle aspiration (FNA). In total, 186 patients with 202 benign thyroid nodules were included for study. We assessed for changes in nodule volume and examined the cystic portion of the nodule as well as four US features (echogenicity, margin, calcification pattern, and shape). RESULTS: During follow-up (mean, 21.7+/-10.7 months) and using 50% as a cutoff value, nodule volumes increased in 11.8%, exhibited no change in 79.9%, and decreased in 8.3% of patients. Proportion of nodules demonstrating at least one US change was 20.8% (42/202). The most common US changes (in descending order of frequency) were cystic change, margin change, and calcification pattern change. Nodule shape and echogenicity rarely changed. Increased nodule volume was not significantly associated with any US features or with the number of FNAs but was associated with younger age at time of diagnosis. CONCLUSION: Although a portion of thyroid nodules confirmed as benign showed US changes or volume changes during the follow-up period, these findings may only represent the natural course of benign nodules. Frequent follow-up with US might be needed for only a small number of cases with suspicious US findings.
Biopsy, Fine-Needle ; Follow-Up Studies ; Humans ; Retrospective Studies ; Thyroid Gland ; Thyroid Nodule ; Tumor Burden

There is controversy regarding definition of vitamin D inadequacy. We analyzed threshold 25-hydroxyvitamin D (25[OH]D) below which intact parathyroid hormone (iPTH) increases, and examined age- and sex-specific changes of 25(OH)D and iPTH, and association of 25(OH)D and iPTH with bone mineral density (BMD) in elderly Koreans. Anthropometric parameters, serum 25(OH)D and iPTH, lumbar spine and femur BMD by dual-energy radiography absorptiometry (DXA) were measured in 441 men and 598 postmenopausal women. iPTH increased below serum 25(OH) of 36.7 ng/mL in men, but failed to reach plateau in women. Femur neck BMD above and below threshold differed when threshold 25(OH)D concentrations were set at 15-27.5 ng/mL in men, and 12.5-20 ng/mL in postmenopausal women. Vitamin D-inadequate individuals older than 75 yr had higher iPTH than those aged < or = 65 yr. In winter, age-associated iPTH increase in women was steeper than in summer. In conclusion, vitamin D inadequacy threshold cannot be estimated based on iPTH alone, and but other factors concerning bone health should also be considered. Older people seemingly need higher 25(OH)D levels to offset age-associated hyperparathyroidism. Elderly vitamin D-inadequate women in the winter are most vulnerable to age-associated hyperparathyroidism.
Absorptiometry, Photon ; Age Factors ; Aged ; *Bone Density ; Female ; Femur/anatomy & histology ; Humans ; Hyperparathyroidism/diagnosis/etiology ; Lumbosacral Region/anatomy & histology ; Male ; Middle Aged ; Parathyroid Hormone/*blood ; Postmenopause ; Republic of Korea ; Seasons ; Sex Factors ; Vitamin D/*analogs & derivatives/blood

PURPOSE: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. METHODS: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. RESULTS: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. CONCLUSION: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.
Biopsy ; Cheek ; Female ; Follow-Up Studies ; Head ; Humans ; Liposarcoma ; Liposarcoma, Myxoid ; Neck ; Neoplasm Metastasis ; Rare Diseases ; Retroperitoneal Space ; Sarcoma ; Thigh ; Young Adult

We report a case of transfusion-associated hemochromatosis in a 38-year-old female who had severe aplastic anemia. She had undergone conservative treatment consisting of multiple transfusions because she had no suitable HLA-matched bone marrow donor. She had received 400 units of red blood cells (RBCs) over 10 years. The transferrin saturation and serum ferritin were increased to 88.4% and 29,905 ng/mL, respectively. Abdominal computed tomography (CT) showed increased densities in the liver and myocardium, suggesting iron deposits in those organs. In general, transfusional iron overload results in primarily reticuloendothelial iron accumulation, which is considered to be less harmful than parenchymal iron accumulation. Nevertheless, our patient had many striking complications associated with hemochromatosis, such as skin pigmentation, hypogonadotropin hypogonadism, insulin-requiring diabetes mellitus, impaired liver function, and left ventricular dysfunction.
Adult ; Anemia, Aplastic ; Bone Marrow ; Diabetes Mellitus ; Erythrocytes ; Female ; Ferritins ; Hemochromatosis ; Humans ; Hypogonadism ; Iron ; Iron Overload ; Liver ; Myocardium ; Skin Pigmentation ; Strikes, Employee ; Tissue Donors ; Transferrin

BACKGROUND AND OBJECTIVES: In the era of stents, lesion length remains an important predictor of restenosis. Drug-eluting stents (DESs) have significantly reduced in-stent restenosis (ISR), but results in long lesions are still lacking. Therefore, we investigated the impact of DESs on clinical outcomes in patients with diffuse coronary lesions. SUBJECTS AND METHODS: Between January 2004 and January 2005, 80 patients (94 lesions) with lesions >20 mm in length were treated with one or more DESs and underwent follow-up coronary angiography. The patients were divided into three groups: Group 1 was composed of those with lesions 21 to 35 mm in length, Group 2 was composed of those with lesions 36 to 50 mm in length, and Group 3 was composed of those with lesions > or =51 mm in length. RESULTS: The mean clinical follow-up duration was 9 months. On the 6-month follow-up angiogram, 6.4% of the lesions had binary ISR (5.0% in group 1, 8.7% in group 2, and 9.1% in group 3). The percent diameter stenosis was 6.0+/-18.15% in Group 1, 12.61+/-21.99% in Group 2, and 19.81+/-31.26% in Group 3(p< 0.05). Late lumen loss was 0.17+/-0.50 mm in Group 1, 0.39+/-0.66 mm in Group 2, and 0.59+/-0.93 mm in Group 3 (p<0.05). Lesion length was associated with an increase in percent diameter stenosis and late lumen loss (of 6.9% and 0.21 mm per 15 mm). CONCLUSION: DES implantation is considered safe and effective in the treatment of diffuse lesions. However, lesion length may be associated with an increase in percent diameter stenosis and late lumen loss at 6-month follow-up.
Constriction, Pathologic ; Coronary Angiography ; Coronary Restenosis ; Coronary Stenosis ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Stents

During 3 years surveillance (January 2001 through December 2003) for acute gastroenteritis in human in Daejeon region, 432 out of 4,869 stool samples were selected as rotavirus-positive specimens by means of antigen-capture enzyme-linked immunosorbent assay (ELISA). The P (VP4) and G (VP7) genotypes for 432 stool samples were investigated by reverse transcription polymerase chain reaction (RT-PCR) and nested multiplex PCR. The most prevalent P subtype was P[8] (44.9%), followed by P[4] (25.7%) and P[6] (17.1%). No cases for P[10] and P[9] subtypes were found through the study. In G subtyping, G1 (53.2%) was the most frequently found G type, followed by G2 (23.1%), G3 (9.5%), G4 (6.7%), and G9 (0.9%). The order of detection rates for G2, G3 and G4 was variable by years. The most common G- and P- type combination found in this study was G1P[8] (33.1%), followed by G2P[4] (20.4%), G1P[6] (10.0%), G3P[8] (7.2%) and G4P[6] (4.2%). The mixed types of G and P were observed most frequently in P[8] (1.4%) and G1 (3.2%), respectively. This is the first molecular epidemiological study for Group A rotavirus in Daejeon region. The results might be useful data for evaluating the epidemiological status of rotaviral diarrhea in the region.
Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Epidemiologic Studies ; Gastroenteritis ; Genotype* ; Humans ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Reverse Transcription ; Rotavirus*