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

No abstract available.
Female ; Meigs Syndrome*

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

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

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

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

Thirty four patients with diffuse axonal injury, defined as post-traumatic coma for over 24 hours with Glasgow Coma Scale(GCS) score of 8 or less following nonsurgical resuscitation, admitted to Inha Hospital from January to December 1991, were studied in order to identify clinical analysis. The aim of this study was to find out the effects of barbiturates or other intensive therapy or head elevation on the intracranial pressure(ICP), arteriovenous oxygen difference(AVDO2) and outcome. The results were as follows; The ratio of male to female was about 6 to 1. 2) In clinical signs at the emergency room, abnormal pupil size was shown 17 cases(61%) under 8-5 on the GCS, but all cases under 5 on the GCS showed abnormal pupil size. 3) Ventricular compression was shown in 29 cases(85%), 17 cases(50%) was showed the ventricular compression & cisternal obliteration. 4) Post-traumatic cerebral infarction was developed 59% of DAI and occurred in 88% of ventricular compression and cisternal obliteration. 5) On admission, above 5 ml/100 ml in AVDO2 was developed in 32 cases(94%) under 8 on the GCS, but in all cases under 5 on the GCS. Recording of ICP showed above 20 mmHg in 15 cases(44%). On coagulopathy, our cases showed that decrease of platelet was involved in 5 cases(15%), prothrombin time(PT) prolongation in 11 cases(32%), activated partial thromboplastin time(APTT) in 4 cases, fibrinogen in 5 cases. 6) The mean ICP was slightly lower when the patient's head was elevated at 30 degree than at 0 degree. The mean ICP was moderately lower when the patients were taken barbiturates therapy. ICP tends to increase from the 1st to 3rd day after injury. 7) The mean AVDO2 was significantly lower when the patients were taken barbiturates therapy, especially at the 1st day. 8) On the relation between Glasgow Outcome Scale(GOS) and Neurological grading(NG), GOS IV was developed in 8 cases(NG score 3-6), GOS III in 5 cases(NG score 7-9), GOS II in 2 cases(NG score 10). Total mortality rate was 56%.
Axons* ; Barbiturates ; Blood Platelets ; Cerebral Infarction ; Coma ; Coma, Post-Head Injury ; Diffuse Axonal Injury ; Emergency Service, Hospital ; Female ; Fibrinogen ; Head ; Humans ; Male ; Mortality ; Oxygen ; Prothrombin ; Pupil ; Resuscitation ; Thromboplastin

OBJECTIVES: Recently, it was reported that microsurgical fenestration of the lamina terminalis (LT) may reduce the incidence of shunt-dependent hydrocephalus in aneurysmal SAH. The authors investigated the efficacy of the LT opening on the incidence of shunt-dependent hydrocephalus especially in the ruptured anterior communicating artery (ACoA) aneurysms. METHODS: The data of 71 ruptured ACoA aneurysm patients who underwent aneurysmal clipping in acute stage were reviewed retrospectively. The patients were divided into two groups according to the use of intraoperative microsurgical opening of the LT. Group I (n=36) included the patients with microsurgical fenestration of LT during routine pterional approach, Group II (n=35) consisted of patients in whom microsurgical fenestration of LT was not feasible. The rate of shunt-dependent hydrocephalus was compared between two groups by logistic regression to control for confounding factor. RESULTS: Ventriculo-peritoneal shunts were performed after aneurysmal obliteration in 18 (25.4%) patients. Overall conversion rates from acute hydrocephalus on admission to chronic hydrocephalus in each group were 29.6% (Group I) and 58.8% (Group II), respectively. There was no significant correlation between the microsurgical fenestration and the rate of occurrence of shunt-dependent hydrocephalus (p>0.05). CONCLUSION: Although this study cannot provide a definitive answer, the microsurgical fenestration of LT can play a negative role for reducing the incidence of chronic hydrocephalus. Surgeons should carefully decide the concomitant use of LT fenestration during surgery for the ruptured ACoA aneurysms.
Aneurysm ; Arteries ; Humans ; Hydrocephalus* ; Hypothalamus* ; Incidence ; Intracranial Aneurysm* ; Logistic Models ; Retrospective Studies ; Subarachnoid Hemorrhage* ; Ventriculoperitoneal Shunt