No abstract available.
Chylothorax*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*

Chronic iron overload is associated with life-threatening complications, such as cardiomyopathy, liver cirrhosis, diabetes, hypothyroidism, hypoparathyroidism and hypogonadism. We experienced a case of secondary hemosiderosis with hepatic fibrosis in a 8-year-old boy who had been transfused 56 pints of packed red blood cells for a supportive therapy of acute myelogenous leukemia for a 27-month period. Intramuscular injection of Desferroxamine (40mg/kg/ day) was done for 9 months, however, there was no sign of improvement in hepatic size, consistency, and in liver biopsy findings. Except for mild thrmobocytopenia which seems to be the result of hypersplenism, the boy remained in remission for 3 2/3 years. We think, the prompt use of Desferroxamine therapy may be needed to avoid iron overload, if patients recieved multiple transfusions and high serum ferritin level.
Biopsy ; Blood Transfusion ; Cardiomyopathies ; Child ; Deferoxamine ; Erythrocytes ; Ferritins ; Fibrosis* ; Hemosiderosis* ; Humans ; Hypersplenism ; Hypogonadism ; Hypoparathyroidism ; Hypothyroidism ; Injections, Intramuscular ; Iron Overload ; Leukemia, Myeloid, Acute* ; Liver ; Liver Cirrhosis ; Male

The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.
Arm ; Axis, Cervical Vertebra ; Busan ; Case Management ; Critical Pathways* ; Diet ; Hospitalization ; Humans ; Hypesthesia ; Laminectomy* ; Leg ; Low Back Pain ; Medical Records ; Neurosurgery ; Patient Discharge

The antihypertensive effect of trimazosin was studied in 24 cases of essential hypertension, which include 9 cases with pretreatment diastolic pressure of 114mmHg or more, for a period of 4 weeks. The average pretreatment systolic and diastolic blood pressures were approximately 175mmHg and 114mmHg, respectively. The treatment was started with 100mg of trimazosin daily in 2 divided doses and and the drug was titrated upward at weekly interval by 100mg up to 400mg/day depending on the response of the blood pressures. Routine blood counts, urinalyses, liver and kidney function tests, electrolyte balance, total serum cholesterol and triglyceride were determined before and at the end of treatment. The diastolic blood pressure fell 10mmHg or more in 20 out of 24 cases(83.3%), and in 12 cases out of 20 favorable responders it fell to 90mmHg or below. The pretreatment diastolic blood pressure in 4 nonresponders was all 115mmHg or more. The antihypertensive effect appeared during the first week of therapy and progressively increased until the end of treatment week without causing postural hypotension. Unpleasant symptoms appeared in 12 cases during treatment, which include dizziness, headache, numbness in the extremities and tinnitus in the decreasing order of frequency. However, these symptoms were mild and transient in all cases disappearing spontaneously despite continued medication. No significant biochemical changes in the blood were recorded after treatment. We conclude that trimzosin seems to be a safe and effective antihypertensive drug particularly useful for the treatment of mild to moderate hypertension.
Blood Pressure ; Cholesterol ; Dizziness ; Extremities ; Headache ; Hypertension* ; Hypesthesia ; Hypotension, Orthostatic ; Kidney Function Tests ; Liver ; Tinnitus ; Triglycerides ; Urinalysis ; Water-Electrolyte Balance

Medical education in North Korea began with 2 medical colleges established during the 1930s and 1940s, and each Province came to have one medical college by the 1970s. It is presumed to exist 14 medical colleges in 1992. Apart from medical colleges, there are several kinds of medical schools. the number of medical practitioners has increased as the number of educational institutes for medicine increased. In 1996, there was 29.7 medical practitioners for 10,000 persons. They have several kinds of academic degrees in North Korea. They include: Wonsa, candidate Wonsa, doctor, vice-doctor, candidate doctor. In the university they have professor, associate professor, associate professor, lecturer, and research assistant. Academic degrees and positions are given not by the university nor research institute, but by the Government Board for Awarding Academic Degree and Position. Concerning research institutes, there is Chosen Institute for Medical Science that once was a medical research center under the Central Science Academy, and became an independent institute in 1963. Besides this institute, universities have their own research institutes, and there are also some other independent institutes.
Education, Medical/*history ; English Abstract ; History of Medicine, 20th Cent. ; Korea

We report magnetic resonance imaging findings of massive spinal subarachnoid hemorrhage (SAH) caused by repeated lumbar punctures during spinal anesthesia in a 36-year-old man. The signal intensities of spinal SAH were similar to those of the conus medullaris on both T1 and T2- weighted spin-echo images. Although spinal SAH is hardly recognized on MR, spinal SAH of sufficient amount may cause alteration of the cerebrospinal fluid signal.
Adult ; Anesthesia, Spinal ; Cerebrospinal Fluid ; Conus Snail ; Humans ; Magnetic Resonance Imaging* ; Spinal Puncture ; Subarachnoid Hemorrhage*

Transcatheter hepatic arterial embolization (THAE) is one of the treatment modalities that can be applied to hepatocellular carcinomas (HCC) and metastatic tumors of the liver. Complications such as cholecystitis and gallbladder necrosis, are common with THAE, but liver and peripheral bile duct necrosis are rare, and intrahepatic stones with main bile duct necrosis have never been reported. To prevent intrahepatic spread during operative manupulation and to decrease the vascularity and size of the tumor, we performed a THAE on a huge-sized HCC five times before performing the hepatectomy. We succesfully undertook a right lobectomy after the THAE with lipiodol, gelform, and adriamycin. However, severe bile duct stricture and intrahepatic stones were confirmed during the operation.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular ; Cholecystitis ; Constriction, Pathologic* ; Doxorubicin ; Ethiodized Oil ; Gallbladder ; Hepatectomy ; Liver ; Necrosis

OBJECTIVE: The purpose of this study was to evaluate the performance of OSTA (Osteoporosis Self assessment Tool for Asian) in Korean peri- and postmenopausal women. DESIGN AND METHODS: Total 1488 peri- and postmenopausal women over 45 years were included from Menopause Clinic in Chung-Ang University Hospital. Femoral neck BMD was measured by using DEXA (Lunar DPXIQ #7055). Three categories of bone status were defined by BMD based on the WHO definition. OSTA index values were calculated by using only 2 components such as age and weight. Three risk categories (high, medium, low) were classified according to index values. RESULTS: Seven hundred thirty women tested comprising 49.1% of all subject had low BMD (10.6% osteoporosis, 38.5% osteopenia respectively). The combined medium and high risk groups had a high prevalence (447/557=80.3%) of low bone mass. The medium and high risk groups had 85.5% of a high specificity, and 61.2% of a good sensitivity for identifying low bone mass. The medium and high risk groups also had 87.9% of a high sensitivity, and 68.5% of a good specificity for identifying osteoporosis. CONCLUSION: OSTA is a simple tool and easy to use, because it requires only age and weight. The OSTA risk tool performed well for identifying low bone mass, especially osteoporosis in Korean peri- and postmenopausal women.
Bone Diseases, Metabolic ; Female ; Femur Neck ; Humans ; Menopause ; Osteoporosis* ; Prevalence ; Self-Assessment* ; Sensitivity and Specificity

BACKGROUND: The combination of psoralen and UVA (PUVA) as a model of photochemotherap, has been used in a wicle variety of cutaneous disorders such as psoriasis, vitiligo, mycosis fungoides and atopic dermatitis. The mechanism of PUVA of psoriasis is based on the fact. that PUVA causes photoconjugation of psoralens to DNA and a subsequent suppression of mitosis, DNA synthesis, and keratinocyte proliferation. Although PUVA apparently inhibits keratinocytie proliferation and is effective therefore in the treatment of psoriasis, PUVA increases pigmentations by stimulating melanocyte proliferation and melanin synthesis in vivo. OBJECTIVE: We tried to investigate the PUVA effects on the proliferation and different,iation in cultured human keratinoc tes and melanocytes. METHODS: We examined morphologic changes, and the number of the cultured human keratinocytes and melanoiytes and melanin contents in a control group and experimental group. (UVA group, 8-MOP group and PUVA group). i.e., UVA group was exposed to UVA at 60mJ, of. 8-MOP group was acJded at dose of 2 x 10 M to medium for 30 minutes. PUVA group was exposed to UVA at 60mJ, of after adding in 8 MOP at Zx 10 M for 30 minutes. RESULTS: 1. Morphologic changes of cultured human keratinocytes and melanocytes. There were no significent changes between the control group and the experimental groups in keratinocytes and melanocytes after 24, 48 and 72 hours culture. The number and length of meianocyte dendrites showecl no significant differences between the groups after 24, 48 and 72 hours culture(p>0.05). 2. Proliferation of cultured human keratinocytes and melanocytes 1) The number of keratinocytes in 8-MOP and PUVA groups decreased significantly more than in the control and LVA groups at 72nd hour after culture (p<0.01). 2) The number of melnocytes showed no differences between the groups at 72nd hour after culture (p>0.05). 3. Melanin contents in iultured human melanocytes The melanin contents increased significantly in the PUVA groups compared to that in the other groups at 72nd hour after culture (p<0.01). CONCLUSION: In culturel human keratinocytes, PUVA has no effect on the morphology and differentiation, hut inhibit proliferation. In cultured human melanocytes, PUVA has no effect on morphology and proliferation, but it increases the melanin contents.
Dendrites ; Dermatitis, Atopic ; DNA ; Ficusin ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes* ; Methoxsalen ; Mitosis ; Mycosis Fungoides ; Pigmentation ; Psoralens ; Psoriasis ; Vitiligo