BACKGROUND AND OBJECTIVES: The transradial approach for coronary intervention has a lower incidence of access site complications and can increase patient comfort after percutaneus tansluminal coronary angioplasty(PTCA). The purpose of this study is to compare procedural success and complication rates of percutaneous transradial coronary stenting which was performed by four operators in two hospitals with those using transfemoral approach. MATERIALS AND METHOD: From September 1998 to July 1999, one hundred seventy five consecutive patients(201 lesions) treated with coronary stent implantation were enrolled for this study : 84 patients underwent transradial coronary stenting(Radial Group), and 91 patients transfemoral coronary stenting(Femoral Group). RESULTS: Seven patients who failed coronary cannulation via radial artery were crossed over to the Femoral Group. The measurements of the radial artery were not done. Patient demographics were similar in both groups. Procedural success was similar in both group(95.2% in Radial Group vs. 97.8% in Femoral Group, p=S). All transradial coronary stenting were possible using conventional guiding catheters which are used in transfemoral intervention. Local vascular complication rates showed a trend toward a reduction in the Radial Group(2.4% vs. 8.8%, p=.06). CONCLUSION: This study showed the similarity in the safety and efficacy of transradial coronary stenting compared to those of transfemoral approach.
Catheterization ; Catheters ; Demography ; Humans ; Incidence ; Radial Artery ; Stents*

No abstract available.
C-Peptide* ; Diabetes Mellitus, Type 1*

No abstract available.
Estrogens, Conjugated (USP)* ; Hypersplenism*

The purpose of this study is to review the validity of quantitative indices on the Evaluation of Korean Medical Schools in 1996. The data required for the indices were obtained from the 1996's edition of the Directory of Korea Medical Education and compared to the results of the evaluation. Among the quantitative indices of the evaluation the number of professors and assistants of basic medical science was the most valuable index to differentiate the better group from lesser groups of medical schools in Korea.
Education, Medical ; Korea ; Schools, Medical*

PURPOSE: Perforated duodenal ulcer can be treated by variable methods ranging from non-operative management to immediate definitive acid-reduction surgery. With the current availability of potent H2 blocker, proton pump inhibitor, and effective Helicobacter pylori (H. pylori) eradication regimens, ulcer recurrence is usually low and the need for definitive surgery has been reduced. Furthermore, the introduction of laparoscopic closure makes the principles of conventional surgical approach weakened at present and surgeons are faced with the choice of definitive surgery or omental patch repair, open or laparoscopic surgery. The aims of this study were to evaluate the feasibility and efficacy of laparoscopic omental patch repair in comparison with conventional surgery and to investigate the status of H. pylori infection and the role of eradication of H. pylori. In addition, we tried to introduce our unique surgical experience using a 3-port technique. METHODS: We treated 31 patients of perforated duodenal ulcer laparoscopically and compared with 30 patients operated by conventional omental patch repair. The patients treated by laparoscopy were evaluated for H. pylori status postoperatively. H. pylori infected patients received 1 or 2 weeks course of Omeprazole plus Amoxicillin and Clarithromycin. RESULTS: Laparoscopic repair was successful in 26 cases and the conversion rate was 16.1%. There was no statistically significant difference in terms of operative time and mortality. Morbidity was comparable between both groups, but the wound infection was more common in the open group. The clinical course and hospital stay were significantly shorter in the laparoscopic group. H. pylori infection rate was 47% and there were 2 cases of ulcer recurrence and 2 cases of reperforation in H. pylori negative patients. CONCLUSIONS: Laparoscopic closure of perforated duodenal ulcer using a 3-port technique is a technically feasible and safe alternative to open repair, with early recovery and low morbidity. H. pylori is positive in about half of perforated duodenal ulcer patients and should be eradicated in positive patients. Other risk factors on ulcer perforation should be identified.
Amoxicillin ; Clarithromycin ; Duodenal Ulcer* ; Helicobacter pylori ; Humans ; Laparoscopy ; Length of Stay ; Mortality ; Omeprazole ; Operative Time ; Proton Pumps ; Recurrence ; Risk Factors ; Sutures* ; Ulcer ; Wound Infection

OBJECTIVES: Because shipyard workers are involved with various manufacturing process, they are exposed to many kinds of hazardous materials. Welders especially, are exposed to bisphenol-A (BPA) during the welding and flame cutting of coated steel. This study was conducted to assess the exposure status of the endocrine disruptor based on the job-exposure matrix. The effects of the genetic polymorphism of xenobiotic enzyme metabolisms involved in the metabolism of BPA on the levels of urinary metabolite were investigated. METHODS: The study population was recruited from a shipyard company in the K province. A total of 84 shipbuilding workers 47 and 37 in the exposed and control groups, respectively, were recruited for this study. The questionnaire variables included, age, sex, use of personal protective equipment, smoking, drinking and work duration. The urinary metabolite was collected in the afternoon and correction made for the urinary creatinine concentration. The of the CYP1A1, CYP2E1 and UGT1A6 genotypes were investigated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods with the DNA extracted from venous blood. RESULTS: The urinary BPA level in the welders group was significantly higher than in the control group (p< 0.05). The urinary BPA concentration with the wild type UGT1A6 was higher than the other UGT1A6 genotypes, but with no statistical significant. From themultiple regression analysis of the urinary BPA, the regression coefficient for job grade was statistically significant (p< 0.05). CONCLUSIONS: The grade of exposure to BPA affected the urinary BPA concentration was statistically significant. However, the genetic polymorphisms of xenobiotics enzyme metabolism were not statistically significant. Further investigation of the genetic polymorphisms with a larger sample size is needed.
Biomarkers* ; Creatinine ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2E1 ; DNA ; Drinking ; Genotype ; Hazardous Substances ; Metabolism ; Personal Protective Equipment ; Polymorphism, Genetic ; Sample Size ; Smoke ; Smoking ; Steel ; Welding ; Xenobiotics

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) symptoms are associated with the deficit in executive functions. Playing Go involves many aspect of cognitive function and we hypothesized that it would be effective for children with ADHD. METHODS: Seventeen drug naive children with ADHD and seventeen age and sex matched comparison subjects were participated. Participants played Go under the instructor's education for 2 hours/day, 5 days/week. Before and at the end of Go period, clinical symptoms, cognitive functions, and brain EEG were assessed with Dupaul's ADHD scale (ARS), Child depression inventory (CDI), digit span, the Children's Color Trails Test (CCTT), and 8-channel QEEG system (LXE3208, Laxtha Inc., Daejeon, Korea). RESULTS: There were significant improvements of ARS total score (z=2.93, p<0.01) and inattentive score (z=2.94, p<0.01) in children with ADHD. However, there was no significant change in hyperactivity score (z=1.33, p=0.18). There were improvement of digit total score (z=2.60, p<0.01; z=2.06, p=0.03), digit forward score (z=2.21, p=0.02; z=2.02, p=0.04) in both ADHD and healthy comparisons. In addition, ADHD children showed decreased time of CCTT-2 (z=2.21, p=0.03). The change of theta/beta right of prefrontal cortex during 16 weeks was greater in children with ADHD than in healthy comparisons (F=4.45, p=0.04). The change of right theta/beta in prefrontal cortex has a positive correlation with ARS-inattention score in children with ADHD (r=0.44, p=0.03). CONCLUSION: We suggest that playing Go would be effective for children with ADHD by activating hypoarousal prefrontal function and enhancing executive function.
Attention Deficit Disorder with Hyperactivity* ; Brain* ; Child* ; Depression ; Education ; Electroencephalography ; Executive Function ; Humans ; Neurobehavioral Manifestations ; Prefrontal Cortex

Multiple system atrophy (MSA) is an idiopathic neurodegenerative disorder involving many neuronal structures. It is a heterogeneous system disorder affecting extrapyramidal, cerebellar and autonomic nervous system. Only a minority of MSA patients are diagnosed before reaching the full blown stage. Its autonomic features like orthostatic hypotension, vocal cord paralysis are directly related to mortality. Up to now, rehabilitation of MSA patients had been rarely reported. Early, proper diagnosis and comprehensive rehabilitation for their heterogeneous clinical features are important. We experienced 54 year old hemiplegic paient who overlaps MSA. He showed some improvement in ADL and cerebellar symptoms after comprehensive rehabilitation programs.
Activities of Daily Living ; Autonomic Nervous System ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Middle Aged ; Mortality ; Multiple System Atrophy* ; Neurodegenerative Diseases ; Neurons ; Rehabilitation ; Stroke* ; Vocal Cord Paralysis

BACKGROUND: Thyroid diseases is common in adult and frequently has significant clinical consequences. But, Prevalence have not been accurately estimated before performance of sensitive TSH and high resolution ultrasound devices on thyroid gland in practice. The objective of the study was to obstain prevalance rate of thyroid dysfunction and structural abnormality by sensitive TSH, Free T4 and high resolution ultrasound. METHODS: The subjects were 10,543(5,638 male and 4,815 female) individuals who visited a health care center of a general hospital in Kangnung city during the period of Jan. 1st, 1997 through May 31st, 2000. For thyroid dysfunction, serum TSH(Thyroid Stimulation Hormone) and Free T4 concentration of those were measured by RIA or IRMA. During the period of Dec. 1st, 1997 through May 25th, 1998, 1,316 individuals were examined by radiology specialists using high resolution ultrasonography with 7.5 MHz linear array. Consequently 21 patients who showed thyroid nodule were performed ultrasound-guided fine needle aspiration. Accordingly medical records containing results of physical examination made by 3 specialists in family medicine before thyroid ultrasonography were investigated in association with other diagnostic modalities. RESULTS: The measurements of thyroid function revealed that 10,090(96.5%) were normal, 240(2.3%) low(below 0.39 mU/L) and 123(1.2%) high(above 5.1 mU/L) in TSH. In terms of prevalence rate per 1,000 population, 15.2 cases were with subclinical hyperthyroidism, and 9.0 cases with subclinical hypothyroidism, 7.7 cases with hyperthyroidism and 3.3 cases with hypothyroidism. Among 94 individuals(7.1%) with structural abnormality on thyroid gland by ultrasonography, 60(4.6%) showed solitary solid nodule, 12(0.9%) multiple solid nodules, 18(1.4%) cystic nodules and 3(0.3%) diffuse parenchymal lesions. Physical examination found only 13.3% of 91 nodules found by high-resolution ultrasonography, and nodules as large as above 1.0 cm in size were palpable only in 22.2%. 21 Of 91 thyroid nodules was received ultrasound-guided FNA and 4(19%) were found to have malignant nodules. CONCLUSION: The study results showed the relatively high rate of thyroid diseases among general population, with the prevalence rate of thyroid dysfunction 3.6%, thyroid nodule 6.9%, malignant incidentaloma among thyroid nodules 4.4%. Physical examination was relative ineffective in detection for thyroid nodules in routine health examinations.
Adult* ; Biopsy, Fine-Needle ; Delivery of Health Care ; Gangwon-do* ; Hospitals, General ; Humans ; Hyperthyroidism ; Hypothyroidism ; Male ; Medical Records ; Physical Examination ; Prevalence* ; Specialization ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

In order that anesthesiologists may reduce the anesthetic and surgical stress on the heart, they frequently use regional anesthesia in patients with coronary artery disease, even though there is no evidence that it reduce the incidence of myocardial ischemia. We report a case of life-threatening cardiovascular collapse that occurred in a 47 years old male patient at the emergence from regional anesthesia. He underwent open reduction and internal fixation for femur fracture under combined spinal epidural anesthesia.The cause of serious hypotension is suspected of myocardial ischemia on the basis of ST segment elevation on EKG. We considered that these cardiovascular events were due to coronary spasm.The possible inducing factors of coronary spasm were altered autonomic balance and arteriosclerotic change related endothelial dysfunction.
Anesthesia, Conduction ; Coronary Artery Disease ; Electrocardiography ; Femur ; Heart ; Humans ; Hypotension ; Incidence ; Male ; Myocardial Ischemia ; Spasm