Medical records and expert opinion are very important in resolving various issues of law. This importance has increased recently as the result of growing number of cases before the courts. Unfortunately, however, the present situation is far less satisfactory, and particularly go with respect to medical reports and expert opinions, The problem is twofold, first, doctors are totally unable to investigate fully the medical history of a patient, when the patient is assigned for their evaluation. Medical records are not available to doctors, except when the records exist at the very hospital where the evaluation takes place. Second, lawyers cannot obtain independent counsel from doctors even for a fee. General criticism is that korean doctors are very much reluctant to give their opinion even when there exists a genuine conflict of medical opinions.
Expert Testimony* ; Fees and Charges ; Humans ; Jurisprudence ; Lawyers ; Medical Records

M-mode echocardiograms were recorded in 268 apparently healthy young male adults and the mitral valve motion during systole was analyzed. In 149 cases( 55.6%) out of 268 the predominant echo of mitral valve closure(CD line) was recorded as smooth line moving slowly anteriorly, in 48 cases(17.9%) the CD line showed an abrupt transient posterior motion during early systole, in 24 cases(9.0%) there were multiple additional echoes posterior to the CD line, 17 cases(6.3%) the mitral valve closure was recorded as pansystolic anteriorly concave echo deviating less than 2 mm from a drawn CD line, and 10 cases(3.7%) as curvilinear and anteriorly convex echo deviating from a drawn CD line. In the remaining 20 cases(7.5%), the mitral valve closure was recorded as pansystolic anteriorly concave echo deviating more than 2 mm from a drawn CD line, which was categorized to have mitral valve prolapse in the current study. However, there were no significant differneces in various echocardiographic dimensions of the heart and the aorta between those with and without mitral valve prolapse.
Adult ; Aorta ; Echocardiography* ; Heart ; Humans ; Male* ; Mitral Valve Prolapse* ; Mitral Valve* ; Systole

No abstract available.
Female ; Meigs Syndrome*

PURPOSE: The purpose of this study is to report the results of artificial hip arthroplasty with minimum five-year follow-up using the Bencox(R) (Corentec) hip stem, the first total hip prosthesis developed in Korea. MATERIALS AND METHODS: We evaluated 27 hips in patients with femoral neck or intertrochanteric fracture (fracture group) and 58 hips in patients with arthritis or osteonecrosis of the femoral head (arthritis group) who underwent hip arthroplasty using a Bencox(R) hip stem in combination with Bencox(R) bipolar cup and Bencox(R) acetabular cup between September 2006 and February 2008. Patients in the fracture group underwent bipolar hip arthroplasty, and those in the arthritis group underwent total hip arthroplasty. RESULTS: During the follow-up period, there were no cases of revision of the femoral stem. Mean Harris hip score was 94 at the latest follow-up in (femoral neck or intertrochanteric) the fracture group, and improved from 57 preoperatively to 98 at the latest follow-up in the arthritis (or avascular necrosis) group. Radiographically, endosteal bone ongrowth was found in 23 of 27 cases in the fracture group (85.2%) and 56 of 58 cases in the arthritis group (96.6%). Stem loosening, infection, dislocation, and ceramic breakage were not noted. CONCLUSION: Clinical and radiographic evaluations of hip arthroplasty using the Bencox(R) hip stem showed excellent outcomes with a minimum of five-year follow-up.
Acetabulum ; Arthritis ; Arthroplasty* ; Arthroplasty, Replacement, Hip ; Ceramics ; Dislocations ; Femur Neck ; Follow-Up Studies* ; Head ; Hip Prosthesis ; Hip* ; Humans ; Korea ; Neck ; Osteonecrosis

Although occasional patients with chronic myeloid leukemia (CML) have chromosomal changes other than Philadelphia chromosome early in the disease, in typical cases the 9;22 translocation remains the sole abnormality throughout the disease course in chronic phase. When disease progression occurs, however, 75-80% develop additional chromosome aberrations. These secondary changes sometimes precede the more aggressive manifestations hematologically and clinically and thus may serve as valuable prognostic indicators. ider (9) (q10)t (9;22) (q34;q11.2) is very rare and a recurrent chromosomal abnormality associated with acute lymphoblastic leukemias (ALL) and lymphoblastic crisis of CML. And ider (9) (q10)t (9;22) (q34;q11.2) is a lymphoid-specific rearrangement and the patients with this abnormality are of older age on average. They commonly show pre-B cell lineage immunophenotype and L2 morphology. We report a case of ider (9) (q10)t (9;22) (q34;q11.2) as secondary aberration in a patient with lymphoblastic crisis of CML.
Blast Crisis ; Chromosome Aberrations ; Disease Progression ; Humans ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cells, B-Lymphoid

A retrospective analysis of 36 cases of petrous pyramid fractures was studied clinically and radiographically during last 5 years. Of 503 patients with skull fractures admitted to the Inha University hospital, of which 7.1% involved the petrous pyramid. The most common mode of injury was a motor vehicle accident and the most common age group was the first decade. The anatomic location of fractures in the petrous pyramid were evaluated by high resolution computed tomography and it disclosed 20 longitudinal and 16 transverse fractures. The principal symptoms and signs, occurring alone or in combination, were a otologic problem, facial paralysis and CSF liquorrhea. The otologic problems were noted in almost every case. The facial palsy and CSF liquorrhea were present in 16 cases(36%) and 9 cases(25%), respectively. The anatomic type of fractures well corresponded to the principal symptoms and signs and the prognosis, the development rate of principal symptoms and signs of the transverse fracture was more higher and the prognosis of that was worse than the longitudinal fracture.
Facial Paralysis ; Humans ; Motor Vehicles ; Petrous Bone* ; Prognosis ; Retrospective Studies ; Skull Fractures

OBJECTIVES: This study was conducted in order to evaluate the association between the working hours of Korean employees and the metabolic syndrome and the effects of long working hours on metabolic syndrome based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012). METHODS: Based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012), 4,456 Korean employees without shift work, aged over 15, who work 30 hours or more per week were targeted in this study. The association between the general characteristics, including age, smoking, alcohol drinking, exercise, and the metabolic syndrome criteria defined by International Diabetes Federation (IDF) and weekly working hours were analyzed. In addition, the association between weekly working hours and the metabolic syndrome of the subjects stratified by gender was analyzed through multiple logistic regression analyses and generalized linear mixed model after adjusting the general characteristics. RESULTS: In the results of stratified analysis by gender, in male subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In female subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In addition, no trend associations were observed among weekly working hour groups in both stratified genders. CONCLUSION: No significant differences in prevalence of metabolic syndrome of the subjects stratified by gender were found according to weekly increasing working hours. However, due to some limitations of this study, further prospective studies may be necessary for verification.
Alcohol Drinking ; Female ; Humans ; Logistic Models ; Male ; Nutrition Surveys* ; Obesity, Abdominal ; Odds Ratio ; Prevalence ; Prospective Studies ; Smoke ; Smoking

Aspergilloma and Allergic Bronchopulmonary Aspergillosis(ABPA) are different types of the pulmonary aspergillosis spectrum of diseases. ABPA is an inflammatory disease that causes hypersensitivity to Aspergillus spores growing in the bronchi, which is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia and central bronchiectasis. Aspergilloma is a simple colonization of fungus within a cavitary lung lesion, but these diseases rarely coexist. A case of ABPA, coexistent with Aspergilloma, was experienced in a 31 year-old female. The diagnosis was confirmed by the immediate cutaneous reactivity to Aspergillus fumigatus, elevated total IgE antibodies, peripheral eosinophilia, bronchiectasis, growth of Aspergillus species in a sputum culture and radiographic infiltration. Treatment, with prednisone and itraconazole, led to improvement of the respiratory symptoms, reduction of the cavitary lesion and in the total serum IgE level.
Adult ; Antibodies ; Aspergillosis, Allergic Bronchopulmonary* ; Aspergillus ; Aspergillus fumigatus ; Asthma ; Bronchi ; Bronchiectasis ; Colon ; Diagnosis ; Eosinophilia ; Female ; Fungi ; Humans ; Hypersensitivity ; Immunoglobulin E ; Itraconazole ; Lung ; Prednisone ; Pulmonary Aspergillosis ; Spores ; Sputum

OBJECTIVE: To investigate whether patterns of dysphagia were associated with the location of the brain lesion and clinical factors in subacute stroke patients. METHOD: One hundred and seventy-eight first-ever subacute stroke patients who underwent videofluoroscopic swallowing study (VFSS) from January 2006 to April 2012 were enrolled in the present study. Swallowing-related parameters were assessed by VFSS. The location of brain lesions were classified into the cortical, subcortical, and brain stem. The degree of cognitive impairment and the independency of activities of daily living were assessed by the Korean version of mini-mental status examination and Korean version of modified Barthel index (K-MBI). Aphasia and hemineglect were assessed by Korean version of Western aphasia battery and line bisection test. These data were collected via retrospective chart review. RESULTS: A reduced laryngeal elevation and prolonged pharyngeal delay time were associated with brain stem lesion. Other swallowing parameters were not associated with lesion topology. Pyriform sinus residue was associated with the presence of aphasia and low K-MBI scores. Prolonged pharyngeal delay time was associated with the patient's age, type of stroke and brain stem lesion. CONCLUSION: Pyriform sinus residue was associated with clinical factors such as aphasia and K-MBI scores rather than with the location of brain lesion. However, reduced laryngeal elevation and prolonged pharyngeal delay time were predominant in brain stem lesions.
Activities of Daily Living ; Aphasia ; Brain Stem ; Brain* ; Deglutition Disorders ; Deglutition* ; Humans ; Pyriform Sinus ; Retrospective Studies ; Stroke*

Pontine hematoma would be diagnosed and made its follow-up readily as the extent of hematoma could be clearly defined since the CT scan was available, especially with MRI in recent. Authors attemped to analyse 20 cases of pontine hematoma clinically, considering factors of influence their prognosis, admitted in Inha hospital from March 1989 to February 1992. Classification of pontine hematoma was made out according to the findings of brain CT scan taken on admission:2 cases of Type T1 to the hematoma localized in the tegmentum unilaterally, 1 case of Type T to those in the tegmentum bilaterally with some extent into the 4th ventricle, 12 in Type T to those in the tegmentum, midbrain and mostly the 4th ventricle, and 5 in Type B to those in the basis pontis mainly with tegmentum and midbrain. Of 219 spontaneous intracerebral hematoma, pontine hematoma was 9.1%. 17 hypertension and 11 previous CVA episodes including 7 cerebral infarction and 4 ICH were endountered. Age distribution was 50% in 6th decade and male to female ratio was 3:2. On admission 14 cases were under 6 in Glasgow coma scale, 6 small reactive pupils and 11 ocular bobbing. Particularly, nuclear facial paralysis was 14 in initial bilateral type, of which 7 dead within 10 days, 5 fixed in left facial paralysis and 1 case into right paralysis later. Four surgical interventions were 1 simple EVD, 1 Urokinase irrigation through EVD, 1 steretactic aspiration and 1 direct hematoma removal. Prognosis was related to various factos:GCS on entry, volume and classification of hematoma, in addition to laterality of nuclear facial paralysis. Clinical course was better in cases over 10 GCS on entry, volume and classification of hematoma, in addition to laterality of nuclear facial paralysis. Clinical course was better in cases over 10 GCS, Type T1 and T2, and unilateral facial paralysis in which the ratio of left to right was 2:1, while it was very poor in patients who were GCS below 6, Type B and bilateral facial paralysis. On the contrary, 7 of 20 cases were dead within 10 days, 13 patients alive for more 3 months after the hemorrhage were observed with fixed facial paralysis in nuclear type, 1 ilateral, 4 right, and 8 left side. It is suggested and requested for further careful follow-up that the hemorrhage may occur from the border zone between paramedian, short and long circumferential arteries supplying transection area of the pons unilaterally, near on around the facial nucleus, more frequent in left side.
Age Distribution ; Arteries ; Brain ; Cerebral Infarction ; Classification ; Facial Paralysis ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Male ; Mesencephalon ; Paralysis ; Pons ; Prognosis* ; Pupil ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator