The anatomical structure of vermiform appendix was studied for 124 Korean adult cadavers and the articles were reviewed with special reference to its position and length. The results are as follows ; 1. On the frequency of positional types based on Wakeley (1933), postileal type was recorded most frequently (37.7%) and retrocecal type was found in 19.7% of cases, showing the difference from other ethnic groups whose most frequent position was retrocecal or pelvic type. 2. In the direction of appendix in relation to the clock, the direction between 1 and 3 o'clock was most frequently found. 3. Appendix of fixed form was found in 22.1% of cases, that of free form 77.9%. In free form, postileal type was found most frequently, but retrocecal type was met most frequently in fixed form. 4. The length of appendix was 5.95±1.64 cm (male ; 6.14±1.67 cm ; female 5.59±1.51 cm). Neither significant difference between sex nor positional type was noted. 5. Positions of appendix are seemed to be set up during fetal stage. The Ethnic variation in the positions of appendix is thought to be determined by inherited physical anthropological factor, not by postnatal one.
Adult* ; Appendix* ; Cadaver ; Ethnic Groups ; Female ; Humans

No abstract available.
Animals ; Gene Expression* ; Hypothalamus* ; Immunohistochemistry* ; In Situ Hybridization* ; Rats* ; Vasopressins*

In a jaundiced patient, it is important to ascertain as early as possible whether the bile duct is dilated. Ultrasonography, computed tomography & conventional cholangiography are widely accepted methods of determining the size of the extrahepatic bile ducts. But there is a considerable discrepancy among the size of the bile duct as measured from them. So the author analyzed and compared the respective diameters of the bile ducts in Korean normal adults as measured from cadaver, IV cholangiography, ultrasoud and computed tomography. The materials were 45 cases of cadaver, 38 cases of IV cholangiography, 100 cases of ultrasonography & 55 cases of computed tomography. The results were as follows ; 1. The diameters of the bile ducts were 7.58±2.26mm at CHD & 8.04±2.42mm at CBD from cadaver ; 5.38±1.90mm at CHD & 6.58±2.37mm at CBD from IV cholanglography ; 3.24±1.13mm at CHD & 4.71±1.48mm at CBD from ultrasonography ; and 4.56±1.51mm at CHD & 5.87±1.68mm at CBD from computed tomography. 2. The diameter of the bile duct was greatest in cadaver, and then reduced in IV cholangiography, computed tomography and ultrasonography in this orde.r 3. There were no size discrepancy between the diameter of the common hepatic duct and that of the common bile duct. 4. There were no discrepanry of the diameter of the bile duct by sex.
Adult* ; Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Cadaver ; Cholangiography ; Common Bile Duct ; Hepatic Duct, Common ; Humans ; Ultrasonography

No abstract available.
Umbilical Cord*

We report two very rare cases of postoperative acute spinal subdural hematoma (ASSH) and review the literature. ASSH is usually related to trauma or a previous lumbar puncture, and a review of the literature revealed only a few cases of spinal subdural hematomas occurring secondary to an underlying hematological disorder or to an iatrogenic coagulopathy. However, there have been no reports about the occurrence of ASSH as a complication of uneventful spinal surgery. The authors present two cases of postoperative ASSHs after open lumbar microdiscectomy (OLM) and underline the pitfalls in their diagnosis and treatment modalities. Two patients were treated with surgery, which progressed without sequelae, and their preoperative symptoms were resolved. Postoperative ASSH is an extremely rare complication, but precautions for meticulous hemostasis and careful awareness for minimal manipulation of the dura during lumbar surgery should be considered in all patients, even those who do not require multilevel decompressions and/or who have a preoperative coagulopathy.
Diskectomy ; Hematoma ; Hematoma, Subdural, Spinal ; Hemostasis ; Humans ; Postoperative Complications ; Spinal Puncture

Vascular anomalies are congenital localized abnormalities that result from improper development and maintenance of the vasculature. The lesions of vascular anomalies vary in location, type, and clinical severity of the phenotype, and the current treatment options are often unsatisfactory. Most vascular anomalies are sporadic, but patterns of inheritance have been noted in some cases, making genetic analysis relevant. Developments in the field of genomics, including next-generation sequencing, have provided novel insights into the genetic and molecular pathophysiological mechanisms underlying vascular anomalies. These insights may pave the way for new approaches to molecular diagnosis and potential disease-specific therapies. This article provides an introduction to genetic testing for vascular anomalies and presents a brief summary of the etiology and genetics of vascular anomalies.

This study was performed to described morphology of mitral valve by observing and measuring anatomical structures of mitral valves in Korean which looked normal at autopsy, and to provided basic data the clinical application. The mean circumference of mitral valve annulus was 9.14±1.28cm in males and 8.14±1.18cm in females. The width of anterior cusp was 30.3±0.53cm in males and 2.80±0.53cm in females, and the height was 1.99±0.43cm in males and 1.51±0.39cm in females. The posterior cusp consisted of 3 scallops in 34 hearts and 4 scallops in 4 hearts, and 2 scallops in 2 hearts out of 40 hearts. The middle scallop was largest in 36 hearts out of 40 hearts. The width of posteromedial scallop was 1.18±0.37cm in males and 1.08±0.32cm in females, and the height was 0.97±0.31cm in males and 0.94±0.29cm in females. Thre width of midd1e scallop was 2.08±0.61cm in males and 1.84±0.63cm in feamales, and the height was 1.18±0.32cm in male and 1,11±0.25cm in females. The width of anterolateral scallop was 1.30±0.41cm in males and 1.10±0.43cm in females, and the height was 0.88±0.25cm in males and 0.94±0.33cm in females. In general, the values of male were greater than those of female, although there was no statistical significance. Measurements of this study were generally smaller than those of the Caucasian reported by other investigators. Measurements in male were generally larger than those in female and this result corresponded well to those of other authors.
Adult* ; Autopsy ; Female ; Heart* ; Humans ; Male ; Mitral Valve* ; Pectinidae ; Research Personnel

OBJECTIVES: The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. METHODS: A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudocontrol group. RESULTS: The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. CONCLUSIONS: The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.
Child, Preschool ; Cost Sharing/*legislation & jurisprudence ; *Health Policy ; Health Services/*utilization ; Hospitalization ; Humans ; Insurance Claim Review ; Korea ; Length of Stay

BACKGROUND: A small change in venous capacitance significantly alters venous return and thus cardiac output. It is therefore important to know the effects of intravenous anesthetics on venous capacitance, particularly in a hypovolemic state. As ketamine does not suppress sympathetic activity, it has been suggested that ketamine may be the drug of choice for anesthesia during hypovolemia. The purpose of this study was to examine the effects of ketamine or sodium thiopental on venous capacitance and total vascular compliance in dogs. METHODS: Twenty mongrel dogs, weighing 10~15 Kg, were divided into two group (ketamine group: 10, sodium thiopental group: 10) of 10 each. Venous capacitance was assessed before and after drug (ketamine 1 mg/kg or sodium thiopental 5 mg/kg) injection by measuring mean circulatory filling pressure (MCFP) in the normovolemia and hypovolemia. MCFP was measured after arresting the circulation by tightening of superior vena cava and inferior vena cava snares simultaneously. RESULTS: As compared with MCFP in the normovolemia and hypovolemia, MCFP was significantly increased by ketamine in the normovolemia and hypovolemia. As compared with MCFP in the hypovolemia, MCFP was significantly decreased by sodium thiopental in the hypovolemia. The slope of the regression line relating MCFP and blood volume was not significantly altered by ketamine or sodium thiopental, which suggests that ketamine or sodium thiopental did not alter total vascular compliance. CONCLUSIONS: These results suggest that ketamine decreases venous capacitance in the normovolemia and hypovolemia but sodium thiopental increases venous capacitance in the hypovolemia.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Blood Volume ; Cardiac Output ; Compliance ; Dogs* ; Hypovolemia ; Ketamine* ; SNARE Proteins ; Sodium* ; Thiopental* ; Vena Cava, Inferior ; Vena Cava, Superior

BACKGROUND: Hormone replacement therapy (HRT) is the most effective treatment for climacteric symptoms. It also has definitive role in reducing or preventing the risk of osteoporosis. However, compliance with HRT is very poor. This study was conducted to know the compliance of hormone replacement therapy and investigate the determining factors for compliance. METHODS: Review of charts and telephone questionnaires were completed among 107 women who had received HRT in a family medicine clinic at a university hospital. Compliance was determined by the medication availability ratio (MAR): (HRT treated days)/(total number of observed days). An individual with MAR less than 0.75 was considered as partial compliance, and more than 0.75 was considered as complete compliance group. RESULTS: The average age of 107 subjects was 57.4 years. Among the 107 study subjects, 59 persons (55.1%) were compliant with HRT. Mean observation period was 17.6 months. The compliance with HRT was 60.9%, 55.1%, 49.6% at 12, 24, 36 months, respectively. The compliance was higher in high-perception group compared to low- perception group (P=0.01). Education level, presence of osteoporosis, hysterectomised state, difference in doctor and past fracture history were not associated with compliance. The reasons for starting HRT were physician's recommendation, osteoporosis prevention, treatment of menopausal symptoms, and influence of mass media, in descending order. CONCLUSION: The compliance with HRT was 61% at one- year treatment and 50% at three-year teatment period. Positive attitude for HRT was related to higher compliance with HRT. Patient education on HRT is essential for successful compliance of HRT.
Climacteric ; Compliance* ; Education ; Female ; Hormone Replacement Therapy* ; Humans ; Mass Media ; Osteoporosis ; Patient Education as Topic ; Telephone ; Surveys and Questionnaires