No abstract available.

BACKGROUND: Recent advances have been made in the treatment of acute stroke, but the effectiveness of the new therapies is highly time-dependent. The purpose of this study is to investigate the factors that influence the time from symptom onset to hospital arrival and the total arrival delay time for patients with acute stroke. METHODS: A prospective registry of patients presenting to the ED with signs or symptoms of acute stroke was established at Ewha Womans University Mokdong and Dongdaeumn hospitals from March to December 1999. We analyzed the prehospital delay time(reaction interval and total arrival delay) and factors associated with delayed arrival at the hospital. RESULTS: The study included 256 patients(49% were women) with a mean age of 62+/-13 years. 50.9% of the patients arrived within 3 hours, and 94.9% patients arrived within 24 hours after onset of symptoms of acute stroke. The total arrival delay time was 180 minutes(median time), and the reaction interval was 60 minutes(median time). Transportation by 119 or 129 ambulances was linked to shorter delay(47 minutes). Age, mental status, and degree of disability were statistically significant factors associated with delayed arrival at the hospital. CONCLUSION: Age, mental status, and degree of disability were significant factors associated with delayed arrival at the hospital. For effective treatment of acute stroke patients, increased public awareness to use an ambulance with direct transport to the acute-care hospital required.
Ambulances ; Female ; Humans ; Prospective Studies ; Stroke* ; Transportation

BACKGROUND: This study investigated the efficacy and safety of combined subacromial and intravenous patient-controlled analgesia for control of postoperative pain after arthroscopic rotator cuff repair. METHODS: Between May 2012 and August 2014, 60 patients who underwent arthroscopic rotator cuff repair with acromioplasty and received patient-controlled analgesia were studied prospectively. Cases were divided into 2 groups: combined subacromial and intravenous infusion group (group A, 30 cases) and solitary intravenous infusion group (group B, 30 cases). The visual analogue scale was used to record the patient's level of pain every 12 hours during postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia. RESULTS: The mean preoperative visual analogue scale score was 7.8 in group A and 7.6 in group B, and the immediate postoperative visual analogue scale score was 7.9 and 8.1 for each group. At postoperative time (From 12 hours to 72 hours after operation), the scores of combined subacromial and intravenous infusion were significantly lower than those of solitary intravenous infusion. Significant difference in the frequency of supplemental analgesic injections was observed between group A and group B (p=0.008). However, no significant difference in complication rate was observed between the two groups (p=0.562). CONCLUSIONS: Combined subacromial and intravenous patient-controlled analgesia after arthroscopic rotator cuff repair is more effective than solitary intravenous infusion without significantly increasing complications. Therefore, combined subacromial and intravenous patient-controlled analgesia could be a effective pain control method.
Analgesia, Patient-Controlled* ; Humans ; Infusions, Intravenous ; Methods ; Pain, Postoperative ; Prospective Studies ; Rotator Cuff*

The exact incidence of esophagitis in gastroesophageal reflux disease (GERD) remains poorly understood in Korea. To determine incidence of esophagitis in GERD, from August 1988 to July 1993, endoscopy, esophageal manometry with Bernstein test, and ambulatory 24 hour esophageal pH monitoring were carried out in a group of 349 patients with symptoms of heartburn or noncardiac chest pain. Based on these studies, 151(40%) patients had some degree of GERD and pstients were categorized as having: pathologic reflux, 98 patients; symptomatic reflux, 42 patients; and sensitive mucosal reflux, 11 patients. Among 151 patients with GERD, 27 patients(18%) had some degree of esophagitis. In conclusion, 40% of patients with symptoms suggestive of GERD have GERD. GERD is divided into subgroups; pathologic reflux, symptomatic reflux, and mucosal sensitive reflux. Less than 20% of GERD have esophagitis or esophageal mucosal injury and these low incidence of mucosal injury in Korean may be due to increased esophageal mucosal resistance.
Chest Pain ; Endoscopy ; Esophageal pH Monitoring ; Esophagitis* ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Incidence* ; Korea ; Manometry

We evaluated an effect of the distance between the incision line and corneal limbus on surgically induced astigmatism in sutureless cataract surgery with scleral tunnel incision. We made a 6mm scleral tunnel incision 1.0mm from the limbus (Group 1, 24 eyes) and 2.5mm from the limbus (Group 2, 30 eyes) and implanted polymethylmethacrylate (PMMA) intraocular lenses with a round optic of 6mm following phacoemulsification. We employed the Jaffe method and Cravy method of vector analysis to evaluate the change of Surgically induced astigmatism. The mean surgically induced astigmatism using Jaffe method was 1.24 D and 0.98 D one day after surgery in Group 1 and 2, respectively. The difference between them was statistically significant(p<0.01) and became insignificant(p>0.05) after postoperative one week. In the superior incision cases, the difference using Cravy method was not statistically significant for whole followup period. In the temporal incision cases, the surgically induced astigmatism was 0.39 D and 0.02 D one day after surgery in Group 1 and 2, respectively. The difference was statistically significant(p<0.05) and became statistically insignificant(p>0.05) after postoperative one week. In this study it was found that a distance of incision line from corneal limbus longer than 1 mm was not an important factor in influencing the surgically induced astigmatism one week after sutureless cataract surgery using a watertight scleral tunnel incision.
Astigmatism ; Cataract* ; Follow-Up Studies ; Lenses, Intraocular ; Limbus Corneae ; Phacoemulsification ; Polymethyl Methacrylate

29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.
Codon ; Diagnosis* ; Digestion ; DNA ; Isoniazid* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Restriction Mapping ; Tuberculosis

As gastroduodenoscopy performed more frequently, case reports of human echinostomiasis are increasing in Korea. A Korean woman presented at a local clinic with complaints of abdominal pain and discomfort that had persisted for 2 weeks. Under gastroduodenoscopy, two motile flukes were found attached on the duodenal bulb, and retrieved with endoscopic forceps. She had history of eating raw frog meat. The two flukes were identified as Echinostoma hortense by egg morphology, 27 collar spines with 4 end-group spines, and surface ultrastructural characters. This report may prove frogs to be a source of human echinostome infections.
Animals ; Duodenal Diseases/*parasitology ; Duodenum/*parasitology ; Echinostoma/*isolation & purification ; Echinostomiasis/*diagnosis ; Endoscopy ; Female ; Humans ; Korea ; Middle Aged

The purpose of this study is to evaluate the morphologic findings of the labrum and capsuloligamentous structures in the normal and unstable shoulders and to compare the effectiveness of double contrast arthrographic findings which were taken with supine and prone position. We reviewed the computerized tomographic arthrogram in 9 cases of normal shoulder and l3 cases of shoulder instability. We evaluated the shape of the labrum, the attachment of anterior capsule and the amount of capsular laxity. Capsular laxity was compared each others in normal, the unidirectional instability and the multidirectional instability. Among these materials, we simultaneously performed CT arthrogram with supine and prone position and evaluated which is more reliable and accurate. Scapular inclination was ahout 25 degrees in the supine position and ahout 60 degrees in the prone position. Normal glenoid labrum varied in size and shape, so its lack of a classic appearance might not indicate a labral tear. Variations existed in the anterior capsular attachment onto the glenoid. The anterior capsule was used to attach far away from the glenoid rim. but it might not indicate an anterior instability. With the prone position, the labral lesion took more excellent visualization due to the contrast coating on the glenoid labrum in both anterior and posterior. Anterior capsular expansion was seen well with prone position in anterior instability. In summary, for proper interpretation of the instability, awareness of the morphologic variations of the labrum and capsuloligamentous structure is important. CT double contrast arthrography with prone position has made a significant contribution to improving and easing the documentation of variety of anatomic abnormalities. Now we recommend the prone position in CT arthrogram for imaging glenoid labrum pathology in shoulder instability.
Arthrography ; Pathology ; Prone Position ; Shoulder* ; Supine Position

In order to assess the reliability of ultrasonographic criteria of clonorchiasis, a prospective study was performed in 14 patients who were diagnosed as clonorchiasis by ultrasonogram only, using the criteria of peripheral duct dilatation without dilatation of extrah epatic duct. Eleven out of 14 patients were turned out to be clonorchiasis, showing 93% accuracy. Authors in tend to stress these ultrasonographic signs are very well correlated with the CT and E RCP findings and are proved to be highly reliable for clonorchiasis, and thus clonorchiasis could be diagnosed by ultrasonogram only.
Clonorchiasis ; Diagnosis ; Dilatation ; Humans ; Prospective Studies ; Ultrasonography

No abstract available.