As the average life expectancy in Korea continues to rise, the number of elderly patients with pancreatobiliary disease is also expected to increase. Thus, it has been important to perform safe and quality-controlled endoscopic retrograde cholangiopancreatography in nowadays. However, there has been no standard educational programs of endoscopic retrograde cholangiopancreatography and quality control system, so Korean Pancreatobiliary Association has a plan to make credentialing organizations especially for pancreatobiliary certification. In this article, we would like to discuss the suitable framework and practical problems about the process and renewal of pancreatobiliary certification system.

No abstract available.
Renal Artery* ; Ureter* ; Veins*

OBJECTIVE: The purpose of this study was to evaluate of course of delivery & perinatal outcomes for postterm pregnancy compared with fullterm pregnancy. METHODS: This study included 360 cases of postterm pregnancy out of 16,992 cases delivered at Department of Obstetrics and Gynecology from January 1, 1993 to December 31, 1997. 16,143 cases of full term deliveries of 38 to 42 gestational weeks conducted in same period were used as the control group. Postterm pregnancy was defined as a pregnancy that it exceeds 295 days calculated from first day of the last menstrual period. RESULTS: The incidence of postterm pregnancy was 2.13% with the highest incidence occurring in the 26 ~30 years age group. This study group was significantly different from the control group in the incidence of fetal distress (10.28% vs. 2.20%), large fetus (10.83% vs. 6.95%), perinatal death (1.67% vs. 0.27%). CONCLUSIONS: Adverse perinatal outcomes were increased markedly as the gestational weeks to be prolonged. Therefore, careful prenatal care, accurate determination of delivery date is very important.
Fetal Distress ; Fetus ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy* ; Prenatal Care

The purpose of present study is comparing the effect of Teflon Membrane and Nylon Membrane on bone regeneration in rabbit tibia. The 6 defects of 8x8x5mm size were drilled with dental handpiece in rabbit tibia, which on left side as an order of Control group(no coverage), Group 1(Nylon 5 micrometer size), Group 3(Nylon 10 micrometer size), and on right side Control group, Group 2(5 micrometer Teflon), Group 4(10 micrometer Teflon). Animals were killed at 7, 10, 14, 42 days to make specimens and observed the difference of healing potentials with light microscopy. The results were as follows ; 1. New bone formation has taken place at 14 days in Guided Bone Regeneration (GBR) group comparing to the Control group of massive inflammatory status. 2. Larger pore membrane allows more favorable healing potentials. Bone formation started earlier in larger membrane pore groups than smaller groups, until 14 days. 3. Bone forming potentials of Teflon membrane group was higher than Nylon membrane groups, Control group has the lowest bone forming potentials. 4. New bone formation was almost ended in 42 days, and there was no difference of bone formation between Nylon and Teflon membrane group of different size. There was no difference of bone formation at final stage(42 days) between Nylon membrane and Teflon membrane of same pore size. So nylon membrane may be clinically usable in guided bone regeneration case with further studies.
Animals ; Bone Regeneration ; Control Groups ; Membranes* ; Microscopy ; Nylons* ; Osteogenesis ; Polytetrafluoroethylene* ; Tibia*

No abstract available.
Humans ; Somatoform Disorders*

Neurofibromatosis type 1, an autosomal dominant disorder, is clinically characterized by the presence of cafe-au-lait spots and cutaneous neurofibromas. Malignancy is a frequently cited and feared complication of neurofibromatosis. Neurofibromatosis has been reported to be associated with some CNS tumors, neurofibrosarcoma, pheochromocytoma, and nonlymphocytic leukemia. Also malignant lymphoma may develop in patients with neurofibromatosis. In Korea, only a case of lung cancer and a case of pheochromocytoma have been reported to develop in patients with neurofibromatosis type 1. Recently, we experienced a case of malignant lymphoma involving the stomach in a 70-year-old woman with neurofibromatosis type 1. An esophagogastroduodenoscopy revealed a 5 cm sized ulcerofungating mass on the greater curvature of the upper body. Histologic diagnosis of the biopsied specimen was B-cell diffuse small and large cell lymphoma. This case illustrates that malignant lymphoma should be included in the differential diagnosis of gastric tumors in patients with neurofibromatosis type 1.
Aged ; B-Lymphocytes* ; Cafe-au-Lait Spots ; Diagnosis ; Diagnosis, Differential ; Endoscopy, Digestive System ; Female ; Humans ; Korea ; Leukemia ; Lung Neoplasms ; Lymphoma ; Lymphoma, B-Cell* ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1* ; Neurofibrosarcoma ; Pheochromocytoma ; Stomach*

OBJECTIVES: The aim of this study is to find out the effect of ApoE genotype on correlation between head circumference and cognition of the elderly in the community. METHODS: A total of 1,152 subjects (380 men and 772 women) aged 60-91 years were analyzed from preliminary data of GDEMCIS (Gwangju Dementia and MCI Study). The study questionnaire consisted of demographic characteristics, current and past illness history, drug history and K-MMSE (Korean version-Mini Mental State Examination). We also measured the head circumference and examined ApoE genotype. RESULTS: On regression analysis, as head circumference becomes smaller, K-MMSE scores decreased adjusted by age, sex, educational level, ApoE epsilon4 allele, current smoking and alcohol drinking status (beta=0.15, p=0.04). Only in the lowest quartile group, presence of ApoE epsilon4 allele reduced K-MMSE scores adjusted by age, sex, educational level, height, current alcohol drinking and smoking status (beta=-1.39, p=0.008). CONCLUSION: These results suggest that head circumference may have an influence on K-MMSE scores, and presence of ApoE epsilon4 allele may be a medicating factor.
Aged* ; Alcohol Drinking ; Alleles ; Apolipoproteins E* ; Cognition* ; Cognitive Reserve ; Dementia ; Genotype* ; Head* ; Humans ; Male ; Surveys and Questionnaires ; Smoke ; Smoking

PURPOSE: The aim of this study was to investigate the usefulness of mortise angle and fibular length measured in radiologic findings in predicting the ankle stability. MATERIALS AND METHODS: One hundred cases fifty cases were randomly selected volunteers with normal ankle function and the other fifty cases were randomly selected patients whose ankle were treated in our hospital and who were followed for over 1 years with good results. A specific experimental fixture were made to get the even AP and lateral view and objective stress view. RESULTS: The mortise angle and fibular length was not statistically significant to the degree of talar tilt angle under valgus or varus stress and that of displacement under anterior or posterior stress. CONCLUSION: The mortise angle and fibular length was not the objective predicting factors on the ankle stability. Maintenance of constrained talus in dynamic status is most important factors in determining the ankle stability.
Ankle* ; Humans ; Talus ; Volunteers

BACKGROUND/AIMS: ERCP using fluoroscopy should be practiced with an adequate radiation protection. However, the awareness of gastrointestinal endoscopists to radiation protection was considered insufficient. In Korea, a country with a rapid increase the number of ERCP procedures, there is no data about radiation protection practices for gastrointestinal endoscopists. The purpose of this study was to investigate current clinical practices and the awareness on radiation protection in ERCP performing physicians in Korea. METHODS: An anonymous questionnaire regarding radiation protection practices was mailed to 100 members of Korean Pancreatobiliary Association who was porforming ERCP. The questionnaire included ERCP volume of each endoscopist, use of protection devices such as apron, thyroid shield, lead glasses and any mobile shield for scattered radiation, and whether they monitored their own radiation exposure dosage. RESULTS: All respondents wore lead aprons during ERCP. While 52.5% of endoscopists answered that they always wear thyroid guards, 26.9% rarely or never wore it. Only 14% wore lead glasses during the procedure and 69% never wore it. The preparation rates of mobile shields or lead curtains were only 14% and 24%, respectively. Only 10% of endoscopists attached an X-ray badge and 66.7% never used it. Moreover, 75% of endoscopists responded that they did not monitor their own exposure dose to radiation during ERCP. CONCLUSIONS: The lack of radiation protection of ERCP endoscopists in Korea was seemed serious. Awareness of radiation hazard should be more concerned and educated in parallel with the preparation of radiation protection equipments.
*Cholangiopancreatography, Endoscopic Retrograde ; Eye Protective Devices ; Female ; Hospitals ; Humans ; Male ; Occupational Exposure/*prevention & control ; Questionnaires ; Radiation Monitoring ; Radiation Protection/*methods ; Thyroid Gland/radiation effects

OBJECTIVES : The authors have evaluated the validity of four currently used screening tools of cognitive function in Korea for dementia and mild cognitive impairment in a community elderly population. METHODS : We screened 5,085 non-randomly sampled elderly over age 60 in the Gwangju city, Gyeonggi Province. Among those, 927 persons were examined further for evidence of dementia and mild cognitive impairment (MCI). A baseline questionnaire on sociodemographic characteristics and four major screening tests (K-MMSE, MMSE-K, MMSE-KC, and K-HDS) were administered. For the evaluation of validity, we have analyzed the ROC curve and calculated the sensitivity and specificity of each test at its optimal cutoff points. RESULTS : ROC analysis of the 3 MMSEs and K-HDS has shown that area under the curve (AUC) was between 0.897 and 0.923 for dementia. Sensitivity and specificity were 0.768 and 0.870, respectively, when the cutoff line was set at 17/18 in K-MMSE. The other two MMSEs had optimal cutoff lines at 16/17 with sensitivity of 0.768 and specificity more than 0.90. K-HDS had its optimal cutoff line at 18/19 with higher sensitivity (0.874) and lower specificity (0.755). Compared with dementia, the four screening tests showed poor validity on MCI. Sensitivity and specificity was in the range of 0.733-0.756 and 0.840-0.855, respectively. CONCLUSION : The validity of the screening tools which are currently being used in Korea to screen for MCI was not significantly different among tests. Because of the difference in the population norm and z-score estimation, use of the common norm is advisable.
Aged ; Alzheimer Disease ; Dementia ; Humans ; Korea ; Mass Screening ; Mild Cognitive Impairment ; Surveys and Questionnaires ; ROC Curve ; Sensitivity and Specificity