Transcatheter arterial embolization was applied in 7 cases of hepatic disease including hemobilia of various causes and malignant tumors at Department of Radiology, Seoul National University Hospital during recent several years. The embolic materials were autologous blood clot and Gelfoam particle. Successful control of bleeding or devascularization of tumor vessel was made in 6 of the 7 patients. There was no serious complications; however, post embolization syndrome was found including pain, fever, nausea and vomiting in all cases and subsided after a few days. Transcatheter hepatic arterial embolization is suggested to be a safe and effective treatment in control of hemobilia and devascularization of malignant hepatic tumors.
Fever ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemorrhage ; Humans ; Nausea ; Seoul ; Vomiting

Obstruction of the inferior vena cava(IVC) is an uncommon condition, and the collateral pathway variesaccording to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in itshepatic portion might be one of the principal cause among Korean, though not reported till now. Analytical studywas perfomred in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relativelyeven distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. Themain cause of upper caval obstruction was membranous obstruction . 3. As a whole, the main collateral pathway wasthe central route(22 case:85%). 4. Characteristic collateral pathway unique to upper caval obstruction wastranshepatic vanous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5.Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chestX-ray finding in IVC obstruction.
Collateral Circulation ; Vena Cava, Inferior

BACKGROUND: The aims of medical education have recently been changing in Korea, which has been accompanied by efforts to modify the rotating clerkship courses, improve the quality of clinical education, and make global doctors. We report the experiences of medical students going through an international elective clerkship for during past two years. MATERIALS AND METHODS: Third year medical students could apply to the international elective clerkship course during a 4 week period after their third-year rotating clerkship at a university hospital. This was done twice-in 2008 and in 2009. Applicant students were allowed to select hospitals anywhere in the world. We analyzed their choices including data on nation, state or city, hospital or institute, contacted hospitals by medical college, differences of two years, etc. RESULTS: Twelve students (10.9%) of a total of 75 third-year students applied to 3 nations and 4 hospitals in 2008. Nine students applied to the Tampa General Hospital at the University of South Florida (USF) in the USA, which was arranged by their medical college. In 2009, a total of five (4.2%) of 77 students applied to 2 nations and 3 hospitals, including three at the University of South Florida, one in another city in the USA, and one in another nation because of the increased financial burden due to a higher exchange rate. CONCLUSION: Medical students started their first international elective clerkship courses during the past two years. Experiences were interesting and meaningful to the students and the medical college. Greater effort and support to developing a new paradigm and to enlarge the scope of the program for making global doctors are required in the future.
Education, Medical ; Florida ; Hospitals, General ; Humans ; Korea ; Students, Medical

In 31 cases of abdominal vascular lesions including aorta, inferior vena cava and portal vein, ultrasonographyand angiography were done at departement of radiology, Seoul National University Hospital, for recent 3 years forcomparative analysis of those findings. The results are ad follows: 1. There are 11 cases of abdominal aorticlesion such as atherosclerotic aneurysms and dissecting aneurysms, 12 cases of inferior vena cava lesion such asmembraneous obstruction and 5 cases of portal vein invasion due to hepatoma. 2. Ultrasonography revealed enlargedlumen and extent of the lesions in all cases of aortic aneurysm and showed intraluminal thrombus more accuratelythan aortography. 3. Intimal flap was detected in all case of dissecting aneurysm, however, ultrasonography couldnot show proximal extent and involvement of major branches. 4. In the cases of inferior vena cava obstructionultrasonography revealed obstruction site and extent of the leisons accurately but vena cavography depictedcollateral circulation better. 5. In 5 cases of angiographic portal vein invasion due to hepatoma, portal veinthrombus was detected in 4 cases by ultrasonography. And ultrasonography could not reveal collaterals,arteriovenous shunt and thread and streaks sign.
Abdomen ; Aneurysm ; Aneurysm, Dissecting ; Angiography ; Aorta ; Aortic Aneurysm ; Aortography ; Carcinoma, Hepatocellular ; Portal Vein ; Seoul ; Thrombosis ; Ultrasonography ; Vena Cava, Inferior

PURPOSE: To investigate the effect of high glucose (HG) on the oxidative stress in cultured human trabecular meshwork cells (HTMC). METHODS: Primarily cultured HTMC were exposed to low glucose (5 mM) and HG (25 mM) for 7 days. Additionally, 1 mM L-arginine, 5 mM DAHP, 10 microgram/ml insulin, 100 micrometer L-ascorbic acid, 10, and 100 micrometer sepiapterin were co-exposed. The cellular survival and nitric oxide (NO) production were assessed by MTT assay and Griess assay, respectively. Superoxide production was measured by modified cytochrome c assay. RESULTS: HG did not affect the survival of cultured HTMC significantly. HG decreased NO production. Co-exposed DAHP decreased but DAHP and insulin increased NO production. In addition, HG increased superoxide production, which was decreased by insulin, L-ascorbic acid, and sepiapterin. CONCLUSIONS: HG decreased NO production accompanied with increased superoxide production in HTMC. Thus HG induces oxidative stress in HTMC and may cause cellular dysfunction and damage of the trabecular meshwork.
Arginine ; Ascorbic Acid ; Cytochromes c ; Glucose ; Humans ; Insulin ; Nitric Oxide ; Oxidative Stress ; Pterins ; Sugar Acids ; Superoxides ; Trabecular Meshwork

BACKGROUND: Computer- and web-based simulation methods help students develop problem solving and decision making skills. In addition, they provide reality based learning to the student clinical experience with immediate medical feedback as well as repetitive training, on-site reviews and case closure. MATERIALS AND METHODS: Seventy-five third-year medical students participated in a two-week simulation program. The students selected four modules from eight modules as follows: airway and breathing 1, cardiac arrest 1, cardiac arrhythmia 1, and chest pain 1, and then selected the first case within each of the modules. After 2 weeks, a pass score was obtained and the data analyzed. The average pass score of over 70% was considered a passing grade for each module. If the student did not pass each module, there was no score (i.e., pass score was zero). In addition, when at least one of the four modules was zero, the student was not included in this study. RESULTS: Seventy-five students participated in the simulation program. Nineteen students were excluded based on their performance. The final number of students studied was 56 students (74.7%). The average scores for each module 1 to 4 were 86.7%, 85.3%, 84.0%, and 84.0%, and the average obtained pass score was 88.6 for the four modules in all 56 students. CONCLUSION: Medical simulation enabled students to experience realistic patient situations as part of medical learning. However, it has not been incorporated into traditional educational methodology. Here we describe the introduction and the development of various simulation modules and technologies for medical education.
Arrhythmias, Cardiac ; Chest Pain ; Decision Making ; Education, Medical ; Heart Arrest ; Humans ; Learning ; Problem Solving ; Respiration ; Students, Medical

The diagnosis of dilated cardiomyopathy associated with pheochromocytoma was made in a 24 year old male on the basis of symptoms and signs, measurements of metabolites of catecholamine,echocardiography and radionuclide ventriculography were preformed and demonstrated. The presence of a tumor on both adrenal glands without definite distant metastasis was demonstrated by abdominal ultrasonography, CT scanning and 131I-MIBC scintigraphy. Surgical removal was performed after proper preoperative preparation with a-adrenergic blocker. During the surgery, neither significant arrhythmia nor severe change of blood pressure was observed. After surgery, cardiac function of the patient improved slowly and progressively.
Adrenal Glands ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiomyopathy, Dilated* ; Diagnosis ; Humans ; Male ; Neoplasm Metastasis ; Pheochromocytoma* ; Radionuclide Imaging ; Radionuclide Ventriculography ; Thoracic Surgery ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

The one hundred ninty three patients of epidemic keratoconjunctivitis (EKC) were treated with recombinant human alpha interferon (Re-Hu-INF-a eyedrop, 30,000IU/Vial, Cheil Foods and Chemicals Inc.) at kangnam St. Mary's Hospital, Catholic University Medical College, Chungang University Hospital, Kangdong Sacred Heart Hospital, Hallym University and Kims's Eye Clinic and the following results were obtained after at least 21 days follow-up. 1. The total patients of EKC were 266; 193 of patients were treated with INF and another 73 patients were treated with antibiotic eye drop only as a control group. The age ranged from 3 to 79 year-old and the average age were 29.6 in interferon group and 36.3 in control group. 2. There was no significant difference between two groups in number of eyes involved. The frequencey of infection route was family, swimming pool, and eye clinic order. Adenovirus was the most common causative agent according to the cytopathic effect of HeLa cell inoculation. 3. In most of cases, there was little symptomatic manifestation, if ever, malaise was the most common systemic symptom in both groups. 4. The symptomatic improvement after INF treatment Was began at 3.8 days in INF group comparing to 10.8 days in control group. In INF treated group, the subjective symptom was disappeared in 70.5% of patients within 4 days. But in control gorup, disappearance of subjective symptom was noted in only 17.8% of patients and the results were statistically significant. 5. The eariler INF treatment, the better improvement of EKC and the sign improved first was foreign body sensation. 6. There was little side effect of INF treatment, but ocular pain was occurred in 8% From these results, we suggest that recombinant human alpha interferon eyedrop in EKC treatment is effective and the earlier application is more effective especially.
Adenoviridae ; Aged ; Follow-Up Studies ; Foreign Bodies ; Heart ; HeLa Cells ; Humans* ; Interferon-alpha ; Interferons ; Keratoconjunctivitis* ; Sensation ; Swimming Pools

Actinomycosis is a rare form of disease that is caused by Actinomyces such as A. israelii and A. bovis, which may take the form of an acute or a subacute disease progression. 55% of this disease arises in the head and neck area, and the remaining 45% of the disease occurs in the chest and the gastrointestinal tract, Our cases show the rare routes of invasion of actinomycosis. The first case was a 40-year-old man complaining of headache for 5-6 months and of a recently developed trismus. Soft brownish bulging mass was observed in his posterior nasopharyngeal wall. CT showed the skull base involvement, and biopsy confirmed actinomycosis. The patient was successfully cured with penicillin. The second case was a 49-year-old female presenting a firm and fragile mass in her left nasal cavity. She was treated with endoscopic removal of the mass including the adjacent mucosa followed by ampicillin administration for 8 months. The last case was a 78-year-old female having a painful mass on the right cheek, Diagnosis was confirmed with the fine needle aspiration biopsy. She was successfully treated with surgical excision and antibiotic treatment. We present, with the appropriate review, 3 cases of actinomycosis that developed in three different areas of the head.
Actinomyces ; Actinomycosis* ; Adult ; Aged ; Ampicillin ; Biopsy ; Biopsy, Fine-Needle ; Cheek ; Diagnosis ; Disease Progression ; Female ; Gastrointestinal Tract ; Head* ; Headache ; Humans ; Middle Aged ; Mucous Membrane ; Nasal Cavity ; Nasopharynx ; Neck* ; Penicillins ; Skull Base ; Thorax ; Trismus

We have studied thirty two cases of inappropriately treatable and intractable epileptics to various anti-convulsants. Zonisamide had a definite anti-epileptic activity in eleven subjects(52.4%) of intractble epilepsy. Five patients(45.5%), who were previously inappropriately treatable epileptic patients became seizure free on zonisamide. Two subjects were withdrawn from study because of side effect and two subjects were also withdrawn because of uncontrolled seizure. Zonisamide is not only effective in intractable epileptic patients but also in first trial for untreated epileptic patients.
Epilepsy ; Humans ; Seizures