As Information Technology has developed, there has been a birth of new medical fields including telemedicine, e-Health, and u-Health. The differences between the new terms resulted from renewed definitions with the development of technology. However, aside from the simple change in terminology medical services that use the terms has expanded along with the change in terminology. Currently most countries use telemedicine as a part of their healthcare system. As such, related devices and services have been slated to become a totally new industry. In Korea, due to the advances in IT, Increase in medically vulnerable and aging population, and increase in the number of patients with chronic disease, telemedicine has been widely used in public healthcare system. Several developmental attempts by public and private sectors have had limited success due to legal and institutional limitations but recent changes in medical law and movement to allow tele-diagnosis and treatment in the public sector has brought in a new era. Although development of telemedicine technology may be the key, it is even more important that the development in medical services models as well as their application be on the same track. Furthermore, from the clinical and academic standpoint, the aspects of safety, efficiency, and economic viability must be thoroughly tested and applied. Most importantly, active involvement from the medical community in development of new medical technology as well as new service models for diagnosis and treatment is required. The most advanced technology would be useless if it is not being actively utilized by the medical community in the treatment and management of patients.
Aging ; Chronic Disease ; Delivery of Health Care ; Humans ; Jurisprudence ; Korea ; Parturition ; Private Sector ; Public Sector ; Telemedicine ; Track and Field

OBJECTIVE: Glutamate is a key excitatory neurotransmitter in the brain, and its excessive release plays a key role in the development of neuronal injury. In order to define the effect of nimodipine on glutamate release, we monitored extracellular glutamate release in real-time in a global ischemia rat model with eleven vessel occlusion. METHODS: Twelve rats were randomly divided into two groups: the ischemia group and the nimodipine treatment group. The changes of extracellular glutamate level were measured using microdialysis amperometric biosensor, in coincident with cerebral blood flow (CBF) and electroencephalogram. Nimodipine (0.025 microg/100 gm/min) was infused into lateral to the CBF probe, during the ischemic period. Also, we performed Nissl staining method to assess the neuroprotective effect of nimodipine. RESULTS: During the ischemic period, the mean maximum change in glutamate concentration was 133.22+/-2.57 microM in the ischemia group and 75.42+/-4.22 microM (p<0.001) in the group treated with nimodipine. The total amount of glutamate released was significantly different (p<0.001) between groups during the ischemic period. The %cell viability in hippocampus was 47.50+/-5.64 (p<0.005) in ischemia group, compared with sham group. But, the %cell viability in nimodipine treatment group was 95.46+/-6.60 in hippocampus (p<0.005). CONCLUSION: From the real-time monitoring and Nissl staining results, we suggest that the nimodipine treatment is responsible for the protection of the neuronal cell death through the suppression of extracellular glutamate release in the 11-VO global ischemia model of rat.
Animals ; Biosensing Techniques ; Brain ; Cell Death ; Electroencephalography ; Glutamic Acid ; Glycosaminoglycans ; Hippocampus ; Ischemia ; Microdialysis ; Neurons ; Neuroprotective Agents ; Neurotransmitter Agents ; Nimodipine ; Rats ; Salicylamides

Primary teratomas of bladder are exceedingly rare, it can be easily diagnosed by characteristic symptom, cystoscopy, and X-ray and it can be managed by locally removal of tumor or partial cystectomy. A case of primary teratoma of bladder in a 38 years old woman is presented. The patient was managed by transurethral resection of bladder tumor and followed up for 5 years without recurrence.
Adult ; Cystectomy ; Cystoscopy ; Female ; Humans ; Recurrence ; Teratoma* ; Urinary Bladder Neoplasms ; Urinary Bladder*

BACKGROUND AND OBJECTIVES: Atrial fibrillation is one of the most prevalent arrhythmia with clinical significance. Recently, some subset of paroxysmal atrial fibrillation was reported to be originated from a focal, rapidly firing source inside the large thoracic veins, such as pulmonary veins, superior vena cava and coronary sinus. The pulmonary veins are known to be the most frequent source of this type of atrial fibrillation. The proximal segment of pulmonary vein was reported to be made up with cardiac muscle cells. This study was performed 1)to define the characteristics of action potential of cardiac myocytes inside the rabbit pulmonary vein in single cell preparation, 2)to observe the changes in action potential and current activation to acetylcholine and isoproterenol, and 3)to compare these changes with those in atrial myocytes. METHOD AND RESULTS: In most of rabbit specimens, myocardial tissue extended over the pulmonary vein for a few millimeters(1-2.5mm). Single atrial myocyte and myocyte in pulmonary vein were successfully isolated. With using whole cell patch clamp technique, spontaneous activities of action potentials(APs) with diastolic depolarization were observed in 75% of pulmonary vein myocytes, in contrast to the absence of spontaneous activity in atrial myocytes. During spontaneous APs of pulmonary vein myocytes, the maximal diastolic potential was -50.5+/-6.5 mV and peak potential was 32.5+/-9.5 mV, and the frequency of APs was 1-2.5 Hz. During perfusion of isolated pulmonary vein myocytes with acetylcholine, resting membrane potential was hyperpolarized and spontaneous APs activity was markedly reduced or completely disappeared. These effects were observed in very low concentration of acetylcholine, even with 1-2 nM. The analysis of change of currents by applying step pulse revealed this response was mediated by activation of IK(ACh) and the current change was more prominent in pulmonary vein myocytes than atrial myocytes. The responses of these cells to isoproterenol were variable from increased spontaneous APs to inhibition of APs. CONCLUSION: This study revealed that pulmonary vein myocytes was another automatic pacemaking focus, same as sinoatrial nodal and Purkinje cells. These characteristics explain why focal atrial fibrillation was frequently initiated inside pulmonary veins.
Acetylcholine ; Action Potentials* ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Coronary Sinus ; Fires ; Isoproterenol ; Membrane Potentials ; Muscle Cells ; Myocytes, Cardiac* ; Perfusion ; Pulmonary Veins* ; Purkinje Cells ; Veins ; Vena Cava, Superior

PURPOSE: To find out the proper compression ratios without degrading image quality and affecting lesion detectability on diagnostic images used in dentistry compressed with JPEG 2000 algorithm. MATERIALS AND METHODS: Sixty Digora periapical images, sixty panoramic computed radiographic (CR) images, sixty computed tomographic (CT) images, and sixty magnetic resonance (MR) images were compressed into JPEG 2000 with ratios of 10 levels from 5 : 1 to 50 : 1. To evaluate the lesion detectability, the images were graded with 5 levels (1: definitely absent; 2: probably absent; 3: equivocal; 4: probably present; 5: definitely present), and then receiver operating characteristic analysis was performed using the original image as a gold standard. Also to evaluate subjectively the image quality, the images were graded with 5 levels (1: definitely unacceptable; 2: probably unacceptable; 3: equivocal; 4: probably acceptable; 5: definitely acceptable), and then paired t-test was performed. RESULTS: In Digora, CR panoramic and CT images, compressed images up to ratios of 15 : 1 showed nearly the same lesion detectability as original images, and in MR images, compressed images did up to ratios of 25 : 1. In Digora and CR panoramic images, compressed images up to ratios of 5 : 1 showed little difference between the original and reconstructed images in subjective assessment of image quality. In CT images, compressed images did up to ratios of 10 : 1 and in MR images up to ratios of 15 : 1. CONCLUSION: We considered compression ratios up to 5 : 1 in Digora and CR panoramic images, up to 10 : 1 in CT images, up to 15 : 1 in MR images as clinically applicable compression ratios.
Data Compression ; Dentistry* ; Radiography, Dental, Digital ; ROC Curve ; Tomography, X-Ray Computed

Honey is produced by bees from nectar collected from nearby flowers. Sometimes, honey produced from the Rhododendron species is contaminated by Grayanotoxin (GTX) in Nepal and other countries. There have been reports of GTX intoxication, also known as 'mad honey disease', from honey produced in countries other than Korea. The importation of wild honey has been prohibited by the Korean Food and Drug Administration since 2005, yet it is still distributed within Korea by the occasional tourist. We report a case of GTX intoxication from contaminated honey which included the symptoms of nausea, vomiting, general weakness, dizziness, blurred vision, hypotension and sinus bradycardia. By means of infusion with normal saline and atropine sulfate, the patient's condition fully recovered within 8 hours of hospital admission, and she was discharged without any complications.
Atropine ; Bees ; Bradycardia ; Dizziness ; Flowers ; Honey ; Hypotension ; Korea ; Nausea ; Nepal ; Plant Nectar ; Rhododendron ; United States Food and Drug Administration ; Vision, Ocular ; Vomiting

PURPOSE: The aim of this study was 1) to confirm the reliability and validity of a Korean version of Washington Psychosocial Seizure Inventory (K-WPSI), 2) to investigate the psychosocial functioning of epilepsy patients from Korea, and 3) to compare with other countries. METHODS: The subjects were 302 patients with epilepsy (above 18years). They completed K-WPSI of 132 items including 11 subscales:family background, emotional adjustment, interpersonal adjustment, adjustment to seizures, medical management, overall psychological functioning, Blank, Lie and Rare. We assessed internal consistency, item-subscale correlations, and split-half reliability. Construct validity was assessed by correlating scales of Psychosocial Rating Sheet and K-WPSI. K-WPSI profiles were compared with those from the West Germany, Finland, Canada, the United States, Chile, Dutch, and Japan. RESULTS: The internal consistency estimated by cronbach's alpha coefficient was .934 and split-half reliability coefficient was .876 for adequate reliability (p<.01). Each of subscales in the K-WPSI were high correlated with theoretically similar scales but correlation between theoretically dissimilar subscales was not high. And K-WPSI subscales were significantly related to the PRS subscales. It showed that the Korea epilepsy patients had serious problems in emotional, interpersonal, vocational adjustment, financial status, adjustment to seizure, and overall psycho-social functioning. Comparing the outcomes of various countries, epilepsy patients from Korea and chile had the most serious problem in most areas of psychosocial functioning. CONCLUSIONS: K-WPSI could be a useful test in Korea for reliable determination of the various psychosocial problems of epilepsy patients but modifications of the limitation of the Lie scale may be needed. Comparing the results of other countries, Korea epilepsy patients have been experienced serious psychosocial problem. To solve this problem, social policy and medical and emotional supportive system for persons with epilepsy should need to be established.
Canada ; Chile ; Cross-Cultural Comparison* ; Epilepsy ; Finland ; Germany ; Humans ; Japan ; Korea ; Reproducibility of Results* ; Seizures* ; Social Problems ; United States ; Washington* ; Weights and Measures

OBJECTIVE: Intracavitary injection of beta-emitting radiation source for control of cystic tumors has been tried with a benefit of localized internal radiation. The authors treated cystic brain tumor patients with Holmium-166-chitosan complex (Ho-166-chico), composed of a beta-emitting radionuclide Holmium-166 and biodegradable chit polymer, and evaluated the safety and effective measurement for response. METHODS: Twenty-two patients with recurrent cystic brain tumor and/or located in a deep or eloquent area were enrolled in this pilot study. The cyst volume and wall thickness were determined on CT or MRI to assess radiological response. The activity of Ho-166-chico injected via Ommaya reservoir was prescribed to be 10-25 Gy to the cyst wall in a depth of 4 mm. RESULTS: There was neither complications related to systemic absorption nor leakage of Ho-166-chico in all 22 patients. But, two cases of oculomotor paresis were observed in patients with recurrent craniopharyngioma. Radiological response was seen in 14 of 20 available follow-up images (70%). Seven patients of 'evident' radiological response experienced more than 25% decrease of both cyst volume and wall thickness. Another 7 patients with 'suggestive' response showed decrease of cyst volume without definitive change of the wall thickness or vice versa. All patients with benign tumors or low grade gliomas experienced symptomatic improvement. CONCLUSION: Ho-166-chico intracavitary radiation therapy for cystic tumor is a safe method of palliation without serious complications. The determination of both minimal effective dosage and time interval of repeated injection through phase 1 trial could improve the results in the future.
Absorption ; Brain Neoplasms* ; Brain* ; Chitosan ; Craniopharyngioma ; Follow-Up Studies ; Glioma ; Holmium ; Humans ; Paresis ; Pilot Projects* ; Polymers

The vast majority of schwannomas occur on cranial nerves, and rarely in the retroperitoneum. Solitary schwannoma in the psoas muscle is extremely rare. The authors present a case of retroperitoneal neoplasm in the psoas muscle identified as schwannoma which is not associated with von Recklinghausen's disease. A 68 years old female patient was admitted because of low back pain and weakness at the left leg. CT and MRI revealed a large cystic mass with well-defined margin and multiple internal septation within the left psoas muscle. The tumor was totally extirpated and histologically confirmed as a schwannoma.
Aged ; Cranial Nerves ; Female ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Neurilemmoma* ; Neurofibromatosis 1 ; Psoas Muscles* ; Retroperitoneal Neoplasms

Pyothorax-associated lymphoma is a distinct type of malignant lymphoma composed of lymphocytes, mostly of a B-cell nature. It occurs in patients with a long history of pyothorax and is strongly associated with Epstein-Barr virus infection. We experienced a case of pyothorax-associated lymphoma in a 66-year-old male. The patient had chronic pyothorax after tuberculous pleurisy was treated about 37 years earlier and was hospitalized for a recently occurring chest wall mass. A core needle biopsy of the chest wall mass led to a diagnosis of diffuse large B-cell lymphoma. Pyothorax-associated lymphoma is rare in Korea, but should be considered in patients with chronic pyothorax and a recently occurring pleural mass.
Aged ; B-Lymphocytes ; Biopsy, Large-Core Needle ; Empyema ; Empyema, Pleural ; Herpesvirus 4, Human ; Humans ; Korea ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Primary Effusion ; Male ; Thoracic Wall ; Tuberculosis, Pleural