The number of undocumented migrant workers in Korea is increasing. They are not covered by national health insurance, and thus find it difficult to access medical services. A number of medical service teams from religious organizations and some hospitals provide targeted services to migrant workers through special programs, but they face many limitations of scope and resources. In a globalized world, undocumented migrant workers should not be treated as simply passing through. Health care for these guests to our country should be of the quality we would expect for our neighbors and families.
Delivery of Health Care ; Humans ; Korea ; National Health Programs ; Republic of Korea ; Transients and Migrants*

Most foreign bodies in the lower genitourinary tract are self-inserted through the urethra for masturbation. It can be diagnosed by clinical histories and physical examinations of the patient, endoscopy and radiologic evaluations. Extraction should be tailored as the surgery, endoscopic manipulation and dissolution according to the nature of the foreign body and should minimize bladder and urethral injury. We report a case of a long wire in the bladder and urethra with brief review of literatures.
Endoscopy ; Foreign Bodies* ; Humans ; Masturbation ; Physical Examination ; Urethra* ; Urinary Bladder

OBJECTIVE: To determine the dincal significance of placenta previa totalis. METHODS: Maternal and neonatal medical rerords were reviewed retrospectively. Between March 1990 and June 1997, sixty-nine pregnant women with placenta previa totalis delivered at Asan Medical Center. Diagnosis of placenta previa totalis was confirmed during cesarean section. RESULTS: Mean maternal age at diagnosis was 31.7+ 3.9 years and 3 patients(4.3%) were nullipara. Fifty two patients(75%) had the history of vaginal bleeding during their index pregnancy and seventeen of 52 patients were admitted more than once. Median gestational age at the time of initial bleeding episode was 33.2 weeks(range 23.5-41. 1) and median interval from the first admission to delivery was 11 days(range 1-63), Major placental implantation site was posterior uterine wall(64%, 44/69). Six cases(8%) were complicated with placenta accreta or increta and no case was combined with abruptio placentae. Estimated blood loss at the time of cesarean section was 1,510+/-952ml(mean+/-SD) and 43 patients(62%) were transfused. No case was complicated with disseminated intravascular coagulation. Eight patients(11.6%, 8/69) underwent cesarean hysterectomy because of uncontrollable bleeding. Thirty four patients(49.3%) delivered their babies before 37 weeks of gestation. The mean gestational age at delivery was 36.4+/-3.0 weeks(mean+/-SD). Major neonatal morbidity was respiratory distress syndrome(20.3%, 14/69). Perinatal death rate was 4.3%(3/70). CONCLUSION: Because pregnant women complicated with placenta previa totalis have high probability for transfusion and cesarean hysterectomy, these patients should be managed cautiously and thoroughly. The most frequent neonatal morbidity was respiratory distress syndrome due to preterm delivery.
Abruptio Placentae ; Cesarean Section ; Chungcheongnam-do ; Diagnosis ; Disseminated Intravascular Coagulation ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hysterectomy ; Maternal Age ; Mortality ; Placenta Accreta ; Placenta Previa* ; Placenta* ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; Uterine Hemorrhage

A clinical and laboratory study was conducted on 58 children who had been admitted to out pediatric department from February to September 1979, under the clinical diagnosis of septicemia. Following results were obtained: 1. Boys were affected more frequently than girls(1.3:1), and highest incidence was noticed in newborn period, comprising 50% of the total cases. 2. The common clinical manifestations, in order of frequency, were fever, lethargy, jandice, poor sucking and abdominal distension, and hyperbilirubionemia was the most common assocaited disease, followed by anemia and leukemia. 3. Clinical course revealed death in 6 patients(10.3%), discharge against advice in 7cases(21.1%) and complete recovery in the remaining 45 cases(77.6%). 4. Peripheral blood count showed leukocytosie in 40%, leukopenia in 12.1% and thrombocytopenia was seen in 45% of cases. 5. Gram staining of buffy coat smear showed bacteria in 34.5% and especially high ratio was noticed in newborn infants(48.3%). 6. Positive blood culture was seen in 39.7% with highest ratio of 45% in newborn infants. In positive blood culture group, toxic granules were noted in 32.8%, shift to left in 25.9%, hrombocytopenia in 18.9% and positive buffy coat smear in 15.5%. In summary, thrombocytopenia, toxic granules, shift to left were quite helpful in early diagnosis of sepsis. In addition to diagnostic value, examination of buffy coat smear could aid physician to select appropriate antibiotic regimen especially in sepsis of newborn period.
Anemia ; Bacteria ; Child* ; Diagnosis ; Early Diagnosis ; Fever ; Humans ; Incidence ; Infant, Newborn ; Lethargy ; Leukemia ; Leukopenia ; Sepsis* ; Thrombocytopenia

Ophthalmoplegia, ataxia, and areflexia are a classical triad of Miller Fisher syndrome (MFS). The experience of dizziness secondary to ophthalmoplegia is also not uncommon. However, nystagmus is rare and vertigo, a symptom of vestibulocerebellar dysfunction, has not been reported yet. A 56-year-old woman visited our hospital due to sudden vertigo. Initial examination revealed nystagmus evoked by a bilateral horizontal gaze with left side dysmetria. The next day, her symptoms rapidly aggravated to ophthalmoplegia, severe ataxia, areflexia, and quadriplegia. She was diag-nosed with MFS and was treated with intravenous immunoglobulin. On the fourth day, she developed respiratory fail-ure and a ventilator was applied. Twenty-eight days after her admission, she recovered to the point of walking without any aid and was discharged with minimal disability. There are still controversies surrounding the nosology of MFS and many investigators have reported evidence for brainstem involvement. Vertigo can be additional evidence for the involvement of the central nervous system in MFS.
Ataxia ; Brain Stem ; Central Nervous System ; Cerebellar Ataxia ; Dizziness ; Female ; Humans ; Immunoglobulins ; Middle Aged ; Miller Fisher Syndrome* ; Ophthalmoplegia ; Quadriplegia ; Research Personnel ; Ventilators, Mechanical ; Vertigo* ; Walking

A paraffinoma is a type of inflammatory lipogranuloma that develops after the injection of an artificial mineral oil, such as paraffin or silicon, into the foreskin or the subcutaneous tissue of the penis for the purpose of penis enlargement, cosmetics, or prosthesis. The authors experienced a case of macro-paraffinoma associated with sexual dysfunction, voiding dysfunction, and pain caused by a buried glans penis after a paraffin injection for penis enlargement that had been performed 35 years previously. Herein, this case is presented with a literature review.
Foreskin ; Granuloma* ; Male ; Mineral Oil ; Oils ; Paraffin* ; Penis ; Prostheses and Implants ; Silicon ; Subcutaneous Tissue

ERCP may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known and suspected disorders of the pancreas or biliary tract. To our knowledge, there has been rare case of ERCP in children and no reported case of ERCP performed in inf~int less than 2 years old in Korea. We report a case of KRCP performed in 26 month old girl who was admitted to evaluate jaundice. We diagnosed CBD stones and choledochal cyst, Todani type III containiaig stones by ERCP. After endoscopic sphincterotomy(EST), removal of stones, and endoscopic nasobiliary drainage(END) her bilirubin level normalized about 2 months later.
Biliary Tract ; Bilirubin ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde* ; Choledochal Cyst* ; Diagnosis ; Female ; Humans ; Infant* ; Jaundice ; Korea ; Pancreas ; Sphincterotomy, Endoscopic*

PURPOSE: The aims of this study were to compare the expression of sarcosine metabolism-related proteins between invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) and to determine the implications of these results. MATERIALS AND METHODS: Tissue microarrays were constructed, containing 30 samples from normal breast tissue, 114 samples from patients with ILC, and 692 samples from patients with IDC. Immunohistochemical staining was performed to examine the expression of sarcosine metabolism-related proteins [glycine N-methyltransferase, sarcosine dehydrogenase, and l-pipecolic acid oxidase (PIPOX)]. RESULTS: The sarcosine metabolic phenotype differed between ILC and IDC (p<0.001). In IDC, sarcosine metabolic phenotype was distributed as null type (61.7%)>low sarcosine type (30.4%)>high sarcosine type (5.0%)>intermediate type (2.9%). However, in ILC, the sarcosine metabolic phenotype was distributed as low sarcosine type (61.4%)>null type (32.5%)>intermediate type (5.3%)>high sarcosine type (0.9%). PIPOX showed higher expression in ILC than in IDC (p<0.001) and correlated with androgen receptor (AR) positivity (p=0.001) in ILC. CONCLUSION: Expression of sarcosine metabolism-related proteins differed between ILC and IDC. Low sarcosine type was the majority sarcosine metabolic phenotype of ILC. PIPOX expression was predominant in ILC and correlated with AR positivity.
Adult ; Breast/pathology ; Breast Neoplasms/*metabolism/pathology ; Carcinoma, Ductal, Breast/*metabolism/pathology ; Carcinoma, Lobular/*metabolism ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Multivariate Analysis ; Phenotype ; Proportional Hazards Models ; Regression Analysis ; Retrospective Studies ; Sarcosine/genetics/*metabolism ; Tissue Array Analysis

Central venous catheterization through subclavian vein has been used for central venous pressure monitoring, hyperalimentation, and fluid therapy. Its complications are air embolism, infection, vascular injury, pneumothorax, hemothorax and thrombosis that is the most serious complication. At the department of Thoracic and Cardiovascular surgery Chonbuk University Hospital, authors experienced superior vena cava syndrome due to thrombosis of the superior vena cava, internal jugular (left), subclavian(left), and innominate vein. Patients was a 21 years old female who had central venous catheterization through subclavian vein for hyperalimentation and fluid therapy because of enterocutaneous fistula. Thrombectomy on superior vena cava was performed, and pre and postoperative anticoagulation therapy was given. Symptoms were relieved after operation. From the venography, performed 6 weeks after the operation, restenosis was seen at the thrombectomy site of the superior vena cava. S anticoagulant and conservative treatment were done that symptoms relieved by the development of collateral venous channel.
Brachiocephalic Veins ; Catheterization, Central Venous ; Central Venous Catheters* ; Central Venous Pressure ; Embolism, Air ; Female ; Fluid Therapy ; Hemothorax ; Humans ; Intestinal Fistula ; Jeollabuk-do ; Phlebography ; Pneumothorax ; Subclavian Vein ; Superior Vena Cava Syndrome ; Thrombectomy ; Thrombosis ; Vascular System Injuries ; Vena Cava, Superior* ; Young Adult

BACKGROUND: It is well-known that migraineurs frequently have abnormal findings on transcranial Doppler ultra-sound (TCD), but their clinical implications are not clear. We investigated the clinical significance of TCD findings in migraineurs. METHODS: One hundred thirty-seven consecutive migraineurs were prospectively gathered. The following clinical parameters were investigated : 1) age and sex, 2) time from onset of headache to visiting hospital, 3) frequency, duration, laterality, pulsating quality, and severity of headache, 4) presence of nausea, vomiting, photophobia, and phonophobia, 5) aura, and 6) aggravation of headache by routine physical activity. TCD was performed during a headache-free period to measure the mean flow velocities (MFVs) and other parameters of 13 intracranial and 2 extracranial vessels. If MFV of any artery or its side-to-side difference in each migraineur was beyond 2 standard deviations of corresponding age and sex-matched reference subgroups, the TCD result was regarded as abnormal. Correlations between abnormal TCD and clinical parameters were examined by univariate and multivariate analyses. RESULTS: Results of TCD were abnormal in 84 patients (61.3%). Pulsatility of headache and absence of aura were significantly correlated with abnormal TCD on univariate analyses (p=0.003 and 0.049 respectively). On multivariate analysis, pulsatility of headache was the only statistically significant predictor of abnormal TCD (p=0.015). Headache attacks tended to be less frequent in patients with abnormal TCD with marginal significance (p=0.050). CONCLUSIONS: Our study shows that abnormal results on TCD are more frequent in migraineurs with pulsatile headache. An association between abnormal TCD and frequency of headache attacks is suggested.
Arteries ; Epilepsy ; Headache ; Humans ; Hyperacusis ; Migraine Disorders ; Motor Activity ; Multivariate Analysis ; Nausea ; Photophobia ; Prospective Studies ; Vomiting