The objective of this study is to identify any differences in disease status between foreign patients staying in Korea and Korean patients. The study results are : First, more foreign stayers than Korean in their 20's and 30's seek medical services but those after age of 60 show the opposite pattern. This difference seems to feflect cultural difference in the concept of medical services and health seeking behavior. Second, foreign pateints were much more frequently(almost threee times) diagnosed as having an acute disease, and the fact that the most common diseases were "diseases of the respiratory system" can suggest the seriousness of air pollution problem in Korea. And, the fact that foreign stayers, especially those from developed countries, tend to take more periodic general physical examina-tion indicated that their health maintenance efforts place emphasis on prevention. Foreign patients seek more medical services during the spring and summer time when compared to Korean patients, and Korean patients visited the clinic more frequently during the autum time. Also, the review of the number of outpatients seeking medical services and the average duration of outpatient follow-up mainten-ance after discharge suggest that foreigners suffer less severe diseases than Koreans do. Finally, in contrast to the usual practice of Koreans of coming to the center without prior calling for reservation, most foreign patients tend to make reservations before coming(usually a day before) in general. This is also reflective of cultural difference related to the way of utilizing medical services.
Acute Disease ; Air Pollution ; Developed Countries ; Emigrants and Immigrants ; Follow-Up Studies ; Humans ; Korea ; Outpatients

Intrathoracic omental herniation through the esophageal hiatus is extremely rare. Here, we report a case of a 57-year-old male with continuous ambulatory peritoneal dialysis (CAPD) who was admitted to our hospital after experiencing nausea and abdominal discomfort for 3 days. Computed tomography (CT) revealed a fatty mass, extended continuously through the esophageal hiatus into the thoracic cavity. Laparoscopic surgery revealed an omental herniation through the esophageal hiatus. There was no herniation of the stomach or intestines. Peritoneal dialysis was resumed six weeks later. This is a report of omental herniation through the esophageal hiatus in a patient with CAPD.
Hernia ; Humans ; Intestines ; Laparoscopy ; Male ; Middle Aged ; Nausea ; Omentum ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Stomach ; Thoracic Cavity

As digital technologies develop further, computer and communication networks combined more and more. In addition,the integrated systems of broadcasting and communication accelerate the disappearance of business borderline between them.Intemet broadcasting technology such as Video on Demand(VOD) system is a good example. There are also digitized, two-way communication systems such as web-casting, satellite and cable communication networks In order to get better information more effectively in the modern society, the authors needed to actively deal with multimedia contents provided by new media system, such as video-conferencing, distance education, Internet broadcasting, and things go on.This was the way to satisfy customers desire for better services in medical area. Consequently, it became possible to practice telemedicine, including distance medical examination and treatment, counseling, and education. The updated networksystems using ISDN, optical lines, microwaves and multi-channel satellite can be utilized for a video-conferencing system to support an effective telemedicine. In order to establish and execute national information policies effectively, it is requiredthat the laws, regulations, and the organizations related to broadcasting and communication matters need to be modified.The purpose of this paper is to suggest a model of a medical web- casting system with high cost-effectiveness. This has been supported by our experience in establishing an internet broadcasting system at a general hospital.
Commerce ; Counseling ; Education ; Education, Distance ; Hospitals, General ; Internet ; Jurisprudence ; Microwaves ; Multimedia ; Social Control, Formal ; Telemedicine

Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures.
Aged ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Colon ; Diagnosis, Differential ; Humans ; Keratins ; Liver ; Male ; Neoplasm Metastasis ; Prognosis ; Rectum* ; Synaptophysin

Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures.
Aged ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Colon ; Diagnosis, Differential ; Humans ; Keratins ; Liver ; Male ; Neoplasm Metastasis ; Prognosis ; Rectum* ; Synaptophysin

Bezoars are the most common foreign bodies in the stomach as seen endoscopically with a frequency of approximately 0.4%. They consist of persistent concretions or hard accumulations of non-digestible vegetable matter, hair or more unusual materials. Gastric bezoars develop in patients with previous gastric surgery, gastric outlet obstruction, or poor gastric emptying such as gastroparesis due to hypothyroidism, diabetes mellitus or mixed connective tissue disease. The clinical presentations of gastric bezoars include epigastric pain, a palpable mass, a gastrointestinal obstruction and peptic ulceration. The treatment options include surgery, enzymatic dissolution or endoscopic mechanical fragmentation and/or removal. Recently, the efficacy of the administration or lavage of 'Coca-Cola' for the effective dissolution of gastric bezoars has been reported. We report a case of a 27-year-old woman with a large gastric bezoar that was successfully removed by the direct endoscopic injection of a carbonated beverage ('Coca-Cola light', a sugar free product; Coca cola Co., Seoul, South Korea) into the bezoar, which led to fragmentatio
Adult ; Bezoars* ; Carbonated Beverages ; Coca ; Cola ; Diabetes Mellitus ; Endoscopy ; Female ; Foreign Bodies ; Gastric Emptying ; Gastric Outlet Obstruction ; Gastroparesis ; Hair ; Humans ; Hypothyroidism ; Mixed Connective Tissue Disease ; Peptic Ulcer ; Seoul ; Stomach ; Therapeutic Irrigation ; Vegetables

BACKGROUND/AIMS: Apolipoprotein E polymorphism plays an important role in the metabolism of cholesterol and bile acids, which may be related to the development of colorectal adenomas. An association between apolipoprotein E genotype and colonic adenomas has been reported in a western country. This study was designed to determine whether the apolipoprotein E was genotype would be associated with proximal or distal colonic adenomas in Koreans. METHODS: On the colonoscopy, colonic adenomas were found in 132 patients. Proximal colonic adenoma was found in 35 patients and distal colonic adenoma was found in 97 patients. Serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride were measured. Apolipoprotein E genotype was determined by PCR and allele specific oligonucleotide hybridization. 279 control subjects without an adenoma on the screening sigmoidoscopy were selected randomly. RESULTS: The serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride did not significantly differ between each adenoma group and control group. The individual frequencies of epsilon2, epsilon3 and epsilon4 alleles in patients with colonic adenomas did not differ from those in control subjects. The frequency of either heterozygote or homozygote for epsilon4 allele in patients with proximal adenoma was lower than that in control subjects (0.029 vs 0.168, p<0.05). CONCLUSIONS: The data suggest that epsilon4 allele may be associated with a lower risk for the development of proximal colonic adenoma in Korean men.
Adenoma* ; Alleles ; Apolipoproteins* ; Bile Acids and Salts ; Cholesterol ; Colon* ; Colonoscopy ; Genotype* ; Heterozygote ; Homozygote ; Humans ; Male ; Mass Screening ; Metabolism ; Polymerase Chain Reaction ; Sigmoidoscopy ; Triglycerides