No abstract available.
Dyspnea*

No abstract available.
Gait*

The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of distribution and in identifying changes in the distribution pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physician located countries to whole physicians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1985, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of general surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1985, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 for countries indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.
Censuses ; General Practitioners ; Humans ; Korea ; Ophthalmology ; Pathology ; Preventive Medicine ; Rural Population ; Socioeconomic Factors ; Specialization ; Surgery, Plastic ; Thorax ; Tuberculosis

No abstract available.
Molluscum Contagiosum*

STUDY DESIGN: Thirty-four cases of surgically treated spinal stenosis which were followed up for more than 5 yeras were analysed. OBJECTIVES: To know the relationship between long-term clinical results and various clinical factors. SUMMARY OF LITERATURE REVIEW: Pedicle screw fixation is a common procedure after wide decompression for spinal stenosis. But, there is few report showing its long-term result. MATERIALS AND METHODS: We evaluated the long term results of surgically treated spinal stenosis patients according to the sex, method of fusion, level of fusion, radiologic change of adjacent level, hardware problem and complication. There were 11 males and 23 females. Average age was 53.2 years(range 34-68 years). Radiographically follow up was averaged 72 months(range 60-104 months). Clinically follow up period was averaged 76 months(range 60-113 months). Eight patients were operated with PLIF and 26 patients were with posterolateral fusion. One level surgery was done in 18 patient and more than two level in 16 patients. RESULTS: Twenty-seven patients(79%) showed satisfactory result at 2year and 5 year follow-up. Two patients showed change of clinical result during follow-up. Clinical result was much better in monosegmental surgery and in male sex. Six patients showed narrowing of disc space at non-surgery level and 2 patients had compression fracture. Complications were 1 deep infection, 2 dural tears, 9 donor site pain, 2 metal failures and 1 metal pull-out. CONCLUSIONS: We concluded that there is no significant change of clinical results between two year follow-up and five year follow-up. Clinical complications and metal problems are not related with the unsatisfactory results. Multiple level surgery and female sex are two variables related with the unsatisfactory clinical outcome.
Decompression* ; Female ; Follow-Up Studies* ; Fractures, Compression ; Humans ; Male ; Spinal Stenosis* ; Tissue Donors

It is well known that double contrast knee arthrography is useful in diagnosis of meniscal lesions and other knee pathology, But intra-articular structures become less well delineated shortly after injection into the kneejoint with water soluble contrast media because of rapid absorption and dilution of the injected media. This limits the time when sharply detailed arthrograms are obtainable and precludes repeat delayed arthrogram withougreinjection of contrast media. In order to overcome this major disadvantage, the authors used epinephrine which has vasoconstrictive effect and is expected to reduce fluid movement across the synovial membrane temporarily. The authors attempted to compare epinephrine inhanced double contrast arthrographic group, einephrine(+) group, to thedouble contrast arthrographic group withoug epinephrine, epinephrine(-) group, by statistical evaluation. Eachgroup consisted of 35 cases and 7 lateral films of knee joint were taken sequentially 2,6,10,15,10,20,30, and 60 minutes after injection of contrast media, and were assessed by 5 certified radiologists. The resuls were as follows; 1. The difference of mean score of quality between epinephrine(+) group and epinephrine(-) group was statistically significant at every time interval (p value<0.01 at 2 minutes, p<0.01 at all other time intervals).Epinephrine(+) group was superior to the epinephrine(-) group in quality of film. 2. Numbers of cases above scoreof 2 which was considered to be of diagnostic quality in evaluating meniscal lesions were larger in epinephrine(+)group than epinephrine(-) group in quality of film. 3. Only 43% of cases was above score of 2 at 10 minutes inepinephrine (-) group, but 97% at 10 minutes and 80% at 20 minutes respectively in epinephrine(+) group. Therefore duration for adequate study of arthrogram is prolonged more than two times in epinephrine(+) group. 4. At 30 minuts, 57% of cases was above score of 2 in epinephrine(+) group while at 15 minuts, 80% of cases was below scoreof 2 in epinephrine(-) group. This makes it possible to repeat study without additional injection of contrast media or postponing of the examination in half of cases, if necessary. 5. The use of epinephrine in kneearthrography results in significant enhancement of radiographic quality initially (p<0.01). Therefore we can fluoroscope in good condition and obtain films of fine quality.
Absorption ; Arthrography ; Contrast Media ; Diagnosis ; Epinephrine ; Knee Joint ; Knee ; Pathology ; Synovial Membrane ; Water

Chin ; Humans ; Lip ; Witchcraft

BACKGROUND: The relation between treadmill exercise testing and ambulatory ST segment monitoring in detection of ischemia in patients with coronary artery disease has not been well established, with pathophysiologic mechanisms underlying the development of ischemia in the ambulatory setting not being well elucidated. This study was performed to determine the relation between myocardial ischemic indexes on exercise testing and on Holter monitoring. METHODS: We analized 25 patients with stable angina and angiographically documented coronary artery disease, who exhibited ischemia both on a Bruce protocol exercise test and on 24-hr Holter monitoring while receiving routine antianginal medications. RESULTS: Mean heart rate at the onset of 1mm ST segment depression during exercise testing(74.4 VS 114.1 beats/min, p<0.01). Overall the correlations between ischemic indexes on both test were weak. But heart rate at the onset of ischemic episodes during Holter monitoring had a good correlation with heart rate at 1mm ST depression during exercise test. And the number of ischemic episodes on Holter monitoring revealed a weak negative correlation with duration of exercise during treadmill test. CONCLUSION: Ischemic indexes on exercise testing cannot accurately predict ischemic indexes on Holter monitoring in patients with coronary artery disease. In that regard, Holter monitoring may provide other clinical information in addition to that obtained by exercise testing in selected patients.
Angina, Stable ; Coronary Artery Disease ; Depression ; Electrocardiography, Ambulatory* ; Exercise Test* ; Heart Rate ; Humans ; Ischemia* ; Myocardial Ischemia

Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus

Apert's syndrome is an uncommon, congenital disturbance in the growth of bone and soft tissue affecting principally the head, the hands and the feet. So there is skull malformation, most often oxycephaly, associated with malformation of both hands and feet. This syndrome was first reported by Apert in 1906. Since that time, over 200 cases have been reported. Recently we have experienced two cases of typical Apert's syndrome. We made a brief literature review.
Craniosynostoses ; Foot ; Hand ; Head ; Skull