No abstract available.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating*

BACKGROUND: A postoperative pain management has been considered as an important issue in surgery. However, any systematic information or standard method about it has not been so far provided for clinicians in Korea. This study aims to analyze the current practices of in-hospital postoperative pain controls and suggest clinical implications. METHODS: A descriptive statistical analysis was adopted to review a nationwide distribution of postoperative pain control methods for the types of patients, surgery, hospitals, specialties, and analgesia. The data is based on the medical claims database of Health Insurance Review Agency (HIRA), which covers all reimbursement claims from hospitals in Korea. All inpatient surgery cases implemented during one year were included in the analysis. RESULTS: It was reported that 1,539,662 cases out of total 1,891,596 inpatient surgery cases were associated with one or more types of analgesia in 2005. The most frequent type of inpatient surgery was bone surgery (24.4%). In all cases related with analgesia, bone surgery took the highest percentage of 28.6%. It was also revealed that the most frequently used postoperative pain management was oral or external use of NSAID (non steroidal anti-inflammatory drug), which was 75.0% of all analgesia treatments. An epidural PCA (patient controlled analgesia), IV PCA (intra-venous patient controlled analgesia) and epidural opioid bolus were 0.2%, 0.2% and 0.1%, respectively, of all analgesia treatments. CONCLUSIONS: The results would certainly be useful to develop a clinical practice guideline in postoperative pain management to enhance patient outcomes.
Analgesia ; Analgesia, Patient-Controlled ; Humans ; Inpatients ; Insurance, Health ; Korea ; National Health Programs ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis

The measurement of the intraocular pressure were made with the Mackay-Marg electronic applanation tonometer, as compared with standard Goldmann tonometer and Schiotz tonometer in Korean 114 normal eyes. The results were as follows: 1. The mean intraocular pressure of 114 normal eyes was 16.61 +/- 3. 77 mmHg with a Mackay-Marg tonometer. 2. There was significant differances between the Mackay-Marg tonometer and Goldmann tonometric values(p<0.005). The corelation coefficent(r) was 0.975, the linear regression was Y = 1.37 + 1.06X. 3. The standard deviation for Mackay-Marg tonometer was greater thandoldmann readings, and it was about 1.37 mmHg higher than Goldmann's. 4. There was significant differances between the Mackay-Marg tonometer and Schiotz tonometric values(p<0.005). The corelation coefficent(r) was 0.938, the linear regression was Y = 0.82X - 0.07.
Intraocular Pressure* ; Linear Models ; Reading

Nerve compression syndromes can be caused by compression of the peripheral nerve from interior or exterior of the nerve. In the upper extremities, brachial plexus, ulnar nerve and median nerve can be compressed in thoracic outlet syndrome, cubital tunnel syndrome and carpal tunnel syndrome respectively. Because these syndromes are caused by compression, decompressive management can be expected to be the principle of treatment. From Jan. 1980 to Dec. 1988, 94 patients were admitted and treated for nerve compression syndromes of the upper extremities in Seoul National University Hospital. Among these, 52 patients suffered from carpal tunnel syndrome and operation was performed to 86 hands. Twelve patients suffered from thoracic outlet syndrome and 25 from cubital tunnel syndrome. Ten patients were treated with conservative method and 84 with decompressive surgery. Satisfactory results were obtained in 92.3% of carpal tunnel syndrome and 84% of cubital tunnel syndrome. Of 4 operated cases of thoracic outlet syndrome, 3 cases were satisfactory.
Brachial Plexus ; Carpal Tunnel Syndrome ; Cubital Tunnel Syndrome ; Hand ; Humans ; Median Nerve ; Methods ; Nerve Compression Syndromes ; Peripheral Nerves ; Seoul ; Thoracic Outlet Syndrome ; Ulnar Nerve ; Upper Extremity

Authors have reviewed a series of 41 cases of fibrous dysplasia which were treated surgically at the Department of Orthopedic Surgery, College of Medicine, Seoul National University. After mean follow-up of 25 months, we summarized the results as follows; 1. Among the 41 patients, 20 were male patients(M:F= 1:1.05). The average age was 20.2 years old. It was the most common in the 2nd decade(44%). The most common site was femur (53.6%) followed by tibia (28.6%) in monostotic type. Each polyototic patient had 3.8 locations in average. 2. The results were better in skeletally mature patients (86%) than in immature patients (42%). 3. Satisfactory results seemed to be expected in monostotic type (71%) than polyostotic type(33 %) 4. Satisfactory results seemed to be expected in sclerotic type(78%) than cystic type(50%) or ground glass appearance type (62%). 5. Autograft(71%) was superior to xenograft(40%) in our study. However, xenograft only or xenograft with autograft can be a recommendable method of treatment for a very large lesion or for a patient with insufficient graft donor site.
Autografts ; Femur ; Follow-Up Studies ; Glass ; Heterografts ; Humans ; Male ; Methods ; Orthopedics ; Seoul ; Tibia ; Tissue Donors ; Transplants

The diagnostic accuracy of myelography, electromyography, and clinical-neurological findings in 64 patients on whom the presence of herniated intervertebral disc was proved surgically from March, 1974 to February, 1980 in Severance Hospital was discussed and the results of this study was compared with those in comparable studies in the literature. 1. Of the cases in which operation revealed disc herniation or protrusion, the clinical neurological diagnosis was correct in 71.9%, the myelographic diagnosis was coincided in 79.7%, the electromyographic diagnosis was agreed in 73.4%. 2. In the patients which the patellar tendon reflex was weak or absent, operation revealed a herniation between L3 and L4 in 66.7%. The disc herniation bewteen L4 and L5 was noted in 93.0% of patients with weakness of the extensors of the great toe. Of the patients in whom the Achilles tendon reflex was weak or absent, operation revealed a tumbosacral disc herniation in 87.0%. 3. If the myelogram showed lumbar disc changes, these changes were confirmed at operation in the same level in all patients. 4. A disc herniation between L3 and L4 was demonstrated in aH cases of the patients had L4 denervation of the electromyographic findings. The disc herniation between L4 and L5 was seen in 93.0% of them had L5 denervation. A lumbosacral disc herniation was noted in 83.3% of them had 51 denervation. 5. Polyphasic motor units were significant in the absence of diagnosis of the herniated lumbar disc. 6. Signs of denervation in the spinal muscalature but not in the leg muscles were considered significant in patients with diagnostic problems of the lumbar radiculopathy. In summary, it is suggested that electromyography is not superior to the myeolgraphy or the clinicalneurogical examination. But the electromyography aids the surgeon in the dlagnosis of a compression lesion of a specific nerve root.
Achilles Tendon ; Denervation ; Diagnosis ; Electromyography ; Humans ; Intervertebral Disc ; Leg ; Muscles ; Myelography ; Patellar Ligament ; Radiculopathy ; Reflex ; Toes

The thymus is the central lymphoid organ for development of bone marrow-derived precursor cells into mature T-cells. The thymic stroma provides the specialized microenvironment for the proliferation, differentiation, and maturation of the immature T-cells, thymocytes. The CD27 is a tumor necrosis factor (TNF) receptor family member whose expression is limited to cells of the lymphoid lineage. CD70, the ligand of CD27, is a TNF related trans-membrane protein induced upon activation on T and B cells, dendritic cells and macrophages. CD70/CD27 interaction plays a key role in T dependent B cell responses and is responsible for plasma cell differentiation. This study was performed to investigate the expression of CD70 during regeneration following acute involution induced by cyclophosphamide (CY) in the rat thymus using RT-PCR analysis and single and double immunohistochemistry. The results from RT-PCR analysis showed that CD70 is expressed in mouse thymic medullary interdigitating (IDC)-like cells (MDC), DC2.4 and Raw264.7 but not expressed in the mouse thymic epithelial cells (subcapsular/cortex epithelial cells, cortical epithelial cells and medullary epithelial cells). Interestingly, upregulation of CD70 expression was observed in the thymic stromal cells and thymocytes isolated from rat thymus during thymus regeneration. Furthermore, immunohistochemistry demonstrated that CD70 was mainly expressed in the ED1 positive macrophages predominantly in the thymic cortex both in the normal thymus and during thymus regeneration. In line with the data obtained by biochemical analysis, CD70 immunoreactive macrophages is increased both in number and in size during thymus regeneration. Thus, the results of the present study suggest that CD70 expressed on the thymic macrophages could play a role in the development of new T cells to replace T cells damaged by cyclophosphamide treatment during thymus regeneration.
Animals ; B-Lymphocytes ; Cyclophosphamide ; Dendritic Cells ; Epithelial Cells ; Humans ; Immunohistochemistry ; Macrophages ; Mice ; Plasma Cells ; Rats* ; Regeneration* ; Stromal Cells ; T-Lymphocytes ; Thymocytes ; Thymus Gland* ; Tumor Necrosis Factor-alpha ; Up-Regulation

We describe here a 67-year-old man who was diagnosed with a rare case of intraductal papillary mucinous tumors that occurred simultaneously in the liver and pancreas. Abdominal computed tomography showed a tubular and cystic dilatation of the pancreatic duct in the pancreas tail, which suggested an intraductal papillary mucinous tumor (IPMT), and multiple intrahepatic duct stones. The patient underwent a distal pancreatectomy with splenectomy and a lateral segmentectomy of the liver. Microscopic examination showed an intraductal papillary mucinous neoplasms of borderline malignancy in the pancreas and a non-invasive intraductal papillary mucinous tumor with moderate dysplasia of the bile duct. Although several cases of intraductal papillary mucinous neoplasm of the liver (IPNL) without any pancreatic association have been described, the simultaneous presentation of both IPMT of the pancreas and IPNL is very rare. The patient has been doing well for 10 months postoperatively.
Aged ; Bile Ducts ; Dilatation ; Humans ; Liver ; Mastectomy, Segmental ; Mucins ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Splenectomy

No abstract available.
Cushing Syndrome* ; Hyperplasia*

No abstract available.
Breast Neoplasms* ; Breast* ; Lymph Node Excision* ; Lymph Nodes* ; Mastectomy, Segmental* ; Radiotherapy*