In 2008, Korea has enacted new ordinances about the role of estheticians, but this law can be interpreted ambiguously, restricting hiring of estheticians in medical clinics. The purpose of the study is to obtain information about medical-esthetic systems in other countries. We have taken a survey of this object from 30 OECD & Asian countries, and the questionnaires returned from a total of 22 countries (Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Japan, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Spain, Switzerland, Turkey, United Kingdom, United States, Singapore, Israel, and Thailand), were used for the final analysis. The results are summarized as follows. In most countries, estheticians working independently deal with only healthy, normal skin. In most countries, estheticians working independently have no right to operate any medical instruments. In all 17 countries that returned the questionnaires medical clinics can employ estheticians, and only theses estheticians who belong to the medical clinics can handle the non-invasive medical instruments under the supervision of doctors. In 17 countries that have related legal regulations, nurses, under the control of doctors, can perform wider range of duties in various settings than estheticians. The survey concludes that the duties of estheticians are closely related with medical skin care services and estheticians can perform various non-invasive medical procedures only under the control of doctors. From consulting a variety of medical-esthetic systems in other countries, we propose that the estheticians be allowed to work in medical clinics to provide better medical services for the patients and to make more chances of employment for themselves.
Asian Continental Ancestry Group ; Austria ; Canada ; Denmark ; Employment ; Finland ; France ; Germany ; Great Britain ; Humans ; Hungary ; Israel ; Japan ; Jurisprudence ; Korea ; Netherlands ; New Zealand ; Norway ; Organization and Administration ; Portugal ; Questionnaires ; Singapore ; Skin ; Skin Care ; Slovakia ; Social Control, Formal ; Spain ; Switzerland ; Turkey ; United States

BACKGROUND: Naringin, one of the flavonoids in citrus fruit peels, is known to have antioxidant and hepatotonic effects in animal studies. We evaluated the effect of naringin on 1) blood lipid profiles, 2) regression of fatty streak of aorta, and 3) liver toxicity in diet-induced hypercholesterolemic rabbits. METHODS: New Zealand White Rabbits (2.0 - 2.5 Kg) were divided to three groups; group without treatment, group treated with 100 mg/kg/d or 500 mg/kg/d naringin, and group treated with 1 mg/kg/d or 20 mg/kg/d lovastatin. They were fed on 0.25% or 1.0% cholesterol-containing diet for 8 weeks and then sacrificed. Blood samples were collected for measurement of total cholesterol, HDL-cholesterol, triglyceride, serum GOT and GPT. Aortas and livers were harvested for evaluation of fatty streak and pathologic examination. RESULTS: 1)Feeding of 1% cholesterol diet for eight weeks significantly increased the cholesterol level upto 20 folds. Neither lovastatin nor naringin did lower these marked hypercholesterolemia. But both naringin (500 mg/kg/d) and lovastatin (1 mg/kg/d) significantly reduced the area of fatty streak by 75% and 58%, respectively. Naringin was more effective in inhibition of fat infiltration into liver than lovastatin which showed hepatotoxicity as increase of serum GPT level (p=0.01). 2)Feeding of 0.25% cholesterol diet for eight weeks significantly increased the cholesterol level upto 17 folds. Total cholesterol and triglyceride levels tended to decrease by treatment with naringin (500 mg/kg/d) and lovastatin (20 mg/kg/d), but this decreases were not statistically significant. However, areas of fatty streak significantly decreased by treatment with naringin and lovastatin by 64 and 82%, respectively (p<0.05). Microscopic analysis revealed that foam cell infiltration into intima was significantly reduced by naringin and lovastatin. In contrast to lovastatin, naringin significantly reduced the level of serum GPT (p<0.05). CONCLUSION: Like lovastatin, naringin has strong antiatherogenic action which may not be associated with its very mild lipid lowering action. In contrast to lovastatin, naringin does have hepatoprotective effect.
Animals ; Aorta ; Cholesterol ; Citrus ; Diet ; Flavonoids ; Foam Cells ; Hypercholesterolemia ; Liver ; Lovastatin ; Rabbits* ; Triglycerides

This study was carried out to evaluate the effect of electrocauterization on corneal astigmatism after cataract operation with temporal incision. Forty-two eyes of patients undergoing routine phacoemulsification with one piece type polymethymethacrylate(PMMA) posterior chamber lens implantation with 6.0mm temporal scleral pocket incision and sutureless method by one surgeon were randomly selected Corneal astigmatism was evaluated for postoperative 3 months and analyzed by Cravy`s vector method. Both groups(electrocauterization group and no electrocauterization group) showed slight with-the-rule change of corneal astigmatism till postoperative 3 months and electrocauterization group showed +0.31D at postoperative 3 months but these differences were not statistically significant(student`s t-test: p=1.10). This results demonstrate that the scleral electrocauterization at temporal incision site induced more with-the-rule change than no cauterization group.
Astigmatism* ; Cataract* ; Cautery ; Humans ; Phacoemulsification

Although joint infection with severe destruction remains a serious problem and severe bone loss is relative contraindication of arthrodesis, knee arthrodesis is most commonly a salvage procedure. Its goals are to relieve pain and restore the patient to functional level of activity. The purpose of this study is to evaluate the results and complications of Ilizarov method for knee arthrodesis in the presence of infection. We retrospectively reviewed the records of twelve patients who had managed with knee arthrodesis with Ilizarov method. Indications for the operation included a infected skeletal defect secondary severe open trauma in four patients, an infection at the site of an arthroplasty in three (with failure of previous arthrodesis with monofixator in one), an infected charcot joint in four and one pyogenic arthritis spreading from osteomyelitis of proximal tibia. The average age of the patients at the time of operation was fifty-three years (range twenty-two to eighty years). Follow-up averaged 17 months. The minimum follow up periods was 9 months. Average duration of Ilizarov fixator application was 7.2 months. In 3 cases we performed corticotomy and internal bone transport to treat large bone defect (17cm, 8cm, 6.5cm). Autoiliac bone graft was done in fusion site in two cases, and in three cases we performed bone graft at the docking site. Solid osseous union occured in each patient. There was no reinfection and nonunion. Average shortening was 3.4 cm. Complications were related to pin tract. When last seen, all patients were free of pain and could walk without cruthes or cane. Despite its pin tract problems, bulky cumbersome and expensive apparatus, the Ilizarov method is one of effective method for knee arthrodesis in the presence of infection and large bone loss especially.
Arthritis ; Arthrodesis* ; Arthropathy, Neurogenic ; Arthroplasty ; Canes ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Joints ; Knee Joint* ; Knee* ; Osteomyelitis ; Retrospective Studies ; Tibia ; Transplants

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

Exposure with the tibial tubercle osteotomy was done for ten revisions and one primary total knee replacements out of 200 total knee arthroplasties performed from 1985 to 1996. The cases were analyzed with regard to complications and technical considerations. The preoperative diagnoses were infected total knee arthroplasty in seven, aseptic loosening in three and one ankylosed knee. Eixtensive exposure was achieved enough for debridement and reimplantation. The tubercle was fixed with two or three 3.5mm screws. The average duration of follow up was 30 months. Post operative knee flexion averaged 87 degrees. There were two complications, one avulsion of the fragment and one tibial fracture. The advantage of this procedure included wide exposure for difficult knee surgeries and more proximal fixation for improved flexion.
Arthroplasty* ; Arthroplasty, Replacement, Knee ; Debridement ; Diagnosis ; Follow-Up Studies ; Knee* ; Osteotomy* ; Replantation ; Tibial Fractures

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

In treating young women for gestational trophoblastic tumor ( G.T.T. ), all efforts are made to preserve fertility and hysterectomy is avoided unless absolutely essential. However, in some cases the operation may be lifesaving. During the last 20 years among the 310 cases of G.T.T. treated at Il Sin Christian Hospital, there were 3 cases in which hysterectomy was avoided by the excision of a localized uterine lesion thus preserving fertility.
Choriocarcinoma* ; Female ; Fertility ; Humans ; Hysterectomy ; Pregnancy ; Trophoblastic Neoplasms

STUDY DESIGN: This case report presents a 50-year-old patient with tabetic Charcoal spinal arthropathy combined with spinal stenosis, and its management. OBJECTIVES: To present the case report and follow-up results of Charcoal arthropathy with spinal stenosis of the lumbosacral spine, which was treated by circumferential fusion with instrumentation and decompressive laminectomy. LITERATURE REVIEW: Most reports of Charcot spine mention the etiology, clinical characteristics, pathology, and management of the condition. Surgical management of Chariot spines with spinal stenosis are rare. There is no report of the two-stage procedure of circumferential fusion and decom-pression for Charcot spine with spinal stenosis. MATERIALS AND METHODS: The patient complained of back pain, radiating pain to both lower legs, and 100m neurologic claudication. Serologic testing was positive in VDRL and FTA-ABS tests. Surgical treat-nent consisted of anterior resection of the L5 body with an autogenous iliad bone graft. It was followed by a posterior wide laminectomy of L5 for spinal stenosis, and CD instrumentation with transpedicular screws was applied to L3-S1 with lateral bone graft. RESULTS: At 27 months follow-up, clinical symptoms of back pain and radiating pain were disappeared. The patient walked without claudication, and satisfied with her condition. Firm bony fusions from L3 to S1 were obtained. There was no evidence of further destruction or neural compromise in the 27 months following surgery. CONCLUSION: A case of Charcoal arthropathy of the lumbosacral spine with spinal stenosis of L3-5 and L5-S1 has been reported, and the pathology, clinical features, and management of this condition were discussed. Circumferential fusion for Charcot spine and wide decompressive laminectomy for spinal stenosis are advisable.
Back Pain ; Charcoal ; Fluorescent Treponemal Antibody-Absorption Test ; Follow-Up Studies ; Humans ; Laminectomy ; Leg ; Middle Aged ; Pathology ; Pathology, Clinical ; Serologic Tests ; Spinal Stenosis* ; Spine* ; Transplants

Prurigo pigmentosa (PP) is a rare inflammatory skin disease of unknown etiology, characterized by recurrent, symmetrical, pruritic, erythematous papules resulting in gross reticular hyperpigmentation. The rash occurs mainly on the back, the chest and the nape of the neck. Vesicular or bullous forms have been reported only rarely. This case report concerns a 15-year-old female with PP, in whom vesicular manifestations appeared recurrently on an existing maculopapular eruption on the trunk.
Adolescent ; Blister ; Exanthema ; Female ; Humans ; Hyperpigmentation ; Neck ; Prurigo ; Skin Diseases ; Thorax