No abstract available.
Spine*

"Medicine as an art" implies that there is something in medicine beyond the limit of science The practice of medicine is far more than the simple application of scientific principles to a particular biologic aberration The communication between a doctor and a patient is the core component of medical practice but little attention has been generally drawn to it. This study shows three types of doctor's reading on 'patient' as an alternative model to see the doctor-patient communication on the basis of the concept of 'patient as a text' and Bakhtin's narrative theory They are monologic dialogic and discontinuous readings In the monologic reading the doctor has one-sidedly the whole power in communication and it reflects only the doctor's point of view The doctor mainly concerns for the disease and its treatment In the dialogic reading the power of doctor-patient is shared and their views are reflected each other The doctor should consider the patient as a human and understand his social and psychological surroundings If the patient refuses to be treated especially in the case of terminal cancer patient he has nothing to do with his doctor Therefore the discontinuous reading can be applied and in result no communication takes place between them. To evaluate the proposed types of the doctor's reading on patient the three types can be applied to the scene of doctor-patient meeting in the novels The meetings of lieutenant Sung and medical officers in Sending Back by Jung-In Suh are in accordance with the type of monologic reading In Wan-Seo Park's Three Days in the Fall the type of dialogic reading can be applied to that of the doctor I's lives with her patients In Yong-Moon Chun's The Days of Dead Doctors the type of discontinuous reading can be applied to the events between Haeng-Oh Kim and doctors in ICU And the 3 parts of The Heavens of Your Own by Chung-Joon Yi all of reading types can be equal to those of the hero whose figure and relationship with Sorok Island have changed throughout the work. The doctors should have abundant experiences of life to make the dialogic reading possible The dialogic reading can be realized in its true sense only if they see the patient not as a disease but as a man and only if they make efforts to understand his circumstances
English Abstract ; History of Medicine, 20th Cent. ; Korea ; *Medicine in Literature ; Patients/*history ; *Physician-Patient Relations

BACKGROUND: This retrospective comparative study aims to evaluate the surgical outcomes and complications of two surgical methods for simple fractures of the humeral shaft; minimally invasive anterior plating and open reduction combined with internal fixation. METHODS: A total of 26 patients with humeral shaft simple fractures, who had surgery between June 2009 and September 2013 and were followed-up at least 12 months, were included in our analysis. They were divided into two groups; group 1 comprised of 12 patients who underwent minimally invasive anterior plating and group 2 comprised of 14 patients who underwent an open reduction and internal fixation. The clinical outcomes, radiological results, and complications were compared and analyzed. RESULTS: We found that bone union was achieved in all patients, and the mean union periods were 20.7 +/- 3.34 and 20.3 +/- 3.91 weeks for groups 1 and 2, respectively. In most patients, we found that shoulder and elbow functions were recovered. At 12 months post-operation, we found that the Korean Shoulder Scoring system, the University of California at Los Angeles score and Mayo elbow performance score were 91.4 +/- 7.97, 33.4 +/- 1.15, and 90.8 +/- 2.23 for group 1, and 95.2 +/- 1.53, 33.3 +/- 1.43, and 90.17 +/- 1.85 for group 2. In terms of complications, we found that 2 patients had radial nerve palsy after open reduction and internal fixation, but all cases spontaneously resolved within 6 months. Complications such as infection and loss of fixation were not reported. CONCLUSIONS: Both minimally invasive anterior plating and open reduction with internal fixation produced satisfactory outcomes in the treatment of simple fractures of the humeral shaft.
California ; Elbow ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; Humerus* ; Paralysis ; Radial Nerve ; Retrospective Studies ; Shoulder

Primary pyogenic psoas abscess is rare lesion, and often is not suspected. Reasons for delayed diagnosis are unfamility with the lesion and the fact that symptoms often resemble those of primary disease of the hip. We present a case of primary pyogenic psoas abscess in child, which was diagnosed by MRI, and completely recovered after surgical treatment.
Child ; Delayed Diagnosis ; Hip ; Humans ; Magnetic Resonance Imaging ; Psoas Abscess

In order to observe the differences in fixability and stability of the acetabular cup through the differences in cup size in relation to the size of acetabular reaming, we analyzed 75 cases of porous coated acetabular cup of Harris-Galante type which be followed up more that two years. All cases were divided into two group ; the first group (On line fit :45 cases) used with acetabular cup equal in size to the last reaming size and the second group (Press fit : 30 cases) used with acetabular cup 2mm larger than the last reaming size. For initial stability, all cases were fixed with acetabular screws. Both groups were analyzed for presence of gap, change of acetabular inclination, presence of radiolucent line, degree of displacement of vertical distance, stability and clinical results. The results were as follows; 1. The average Harris hip score was improved from 55.8 points preoperatively to 90.2 points postoperatively in the first group, from 56.9 points to 91.2 points in the second group, Clinical results are excellent in 39 cases, good in 4 cases, fair in 2 cases in the first group, and excellent in 29 cases and good in 1 case in the second group. 2. The gap between the acetabular cup and acetabulum was found initially at 17 zones in the first group but no gap at final follow up. In the second group, the gap was found at 23 zones and finally remained less that 1 mm gap was found at 3 cases in zone B1. 3. No radiologic instability of acetabular cup by Martell evaluation was noted in both 1st and 2nd group. Our data suggests that initial gap between acetabular cup and acetabulum in microporous coated acetabular cup were replaced with new bone and also, radiologic stability and good clinical results could be obtained in the second group used with acetabular cup 2 mm larger than the last reaming size.
Acetabulum ; Arthroplasty, Replacement, Hip ; Clinical Study ; Follow-Up Studies ; Hip

Anisakiasis is a parasitic infectious disease caused by eating raw, infected fish. It causes severe abdominal pain-like acute abdomen, but not fatal. Anisakiasis was firstly reported by van Thiel et al. in 1960 in Netherlands and it has subsequently been reported in the Netherlands, Japan, the United states, Korea as well as other nations. Because Koreans like eating raw fish, the anisakiasis of the stomach was occasionally reported, but the case of severe gastric bleeding was very rare. So we report one case of gastric ulcer bleeding due to gastric anisakis larva proven by endoscopy and gastric resection.
Abdomen, Acute ; Anisakiasis* ; Anisakis ; Communicable Diseases ; Eating ; Endoscopy ; Hemorrhage* ; Japan ; Korea ; Larva ; Netherlands ; Stomach ; Stomach Ulcer* ; United States

Chemotherapeutic agents were evaluated for their effect on the development of urinary bladder tumors, induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) in female Sprague-Dawley rats. For 16 weeks, 0.05% BBN was administered orally, and then chemotherapeutic agents (adriamycin and cisplatin) were injected intraperitoneally for 12 weeks. In our preliminary experimental series, an experimental bladder tumor model induced by BBN was useful in evaluating the effectiveness of chemotherapeutic agents. Cisplatin appears to be effective in inhibiting precancerous histologic changes and carcinoma in rat urinary bladder mucosa by BBN. However, the effectiveness of adriamycin was inconclusive.
Animals ; Carcinogenesis* ; Cisplatin ; Doxorubicin ; Female ; Humans ; Injections, Intraperitoneal* ; Mucous Membrane ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neoplasms ; Urinary Bladder*

No abstract available.
Hyperplasia* ; Islets of Langerhans* ; Nesidioblastosis*

The purpose of this study is to evaluate the results of the reconstruction of acetabular bone defect with morselized bone graft in revision of failed acetabular cup, used screw fixed hemispherical cup or bipolar cup as a component. Forty five revisions of an acetabular component that had been performed in 42 patients between 1988 and 1993 at SNUH, and had followed more than two years were included in this study. The revised acetabulum was evaluated by Harris hip score, in terms of osseous union and resorption of the graft, the amount of the migration of the revised components. Cup angle change and radiolucency were also evaluated in screw fixed hemispherical cup. The mean Harris hip score was improved 54 to 87 in screw fixed hemispherical cup and 56 to 78 in bipolar cup. In screw fixed hemispherical cup, osseous union showed within 6 months is 91.3% (21 cases), the graft bone resorption less than 10% of the initial graft thickness is 73.9% (17 cases). In bipolar cup, osseous union within 6 months is 52.2% (12 cases), the graft bone resorption less than 10% of the initial graft thickness is 40.9% (9 cases). The failure of revised acetabular component was five in bipolar cup cases and one in screw fixed hemispherical cup cases. In conclusion, screw fixed hemispherical cup showed better clinical results, earlier graft osseous union, less graft bone resorption and lower failure rate than bipolar cup. There was no significant difference between pure allograft mixed with autograft in clinical and radiological results. So we recommend the technique used morselized allograft with screw fixed hemispherical cup, to reconstruct the acetabular bone defect in acetabular cup revision, though bipolar cup was used in staged operation in severe acetabular bone defect with was unable to fix the acetabular cup with screws.
Acetabulum ; Allografts ; Autografts ; Bone Resorption ; Hip ; Humans ; Transplants

BACKGROUND: The SF-6D, derived from the SF-36, is a preference-based instrument measuring health-related quality of life (HRQOL). Using this tool, we measured the HRQOL of persons disabled by stroke dwelling in Gyeongju city and identified factors affecting the HRQOL. METHODS: As of March 2008, 991 persons who had had a stroke and were aged 50 and over were identified on the Gyeongju city disabled registry. Interviewers specifically trained for this face-to-face survey gathered pertinent information including general and clinical characteristics from June to October 2008. In addition, the health status was measured using the Modified Rankin Scale, the Barthel ADL index, and the SF-36. The SF-6D index was derived from the SF-36. We analyzed the known-group construct validity and convergent validity. Finally, we performed multiple regression analyses to identify factors affecting the HRQOL. RESULTS: Of the 991 potential subjects, 498 persons participated in the interviews (response rate: 50.3%). The SF-6D indices for females and those aged 70 and over were lower than indices for males and those aged 60 and less. Correlation coefficients between the Modified Rankin Scale, the Barthel index, and the SF-6D index were relatively high (-0.533 and 0.555, respectively) and statistically significant (P<0.001). Multiple regression analyses showed that sex, age, smoking, alcohol use, comorbidity, the Modified Rankin Scale, and the Barthel index had an effect on the SF-6D index of persons with stroke, and the Barthel index was the most important factor. CONCLUSIONS: Our results indicate that the SF-6D can be a valid tool for evaluating health states of persons disabled by stroke, and functional limitation was the main factor affecting the HRQOL.
Activities of Daily Living ; Aged ; Comorbidity ; Disabled Persons ; Female ; Humans ; Male ; Quality of Life ; Smoke ; Smoking ; Stroke ; Value of Life ; Surveys and Questionnaires