No abstract available.
Scleroderma, Localized

Various cancer types have been associated with cancer-related cerebral infarction. In this study, we describe the first case of cancer-related cerebral infarction in which the underlying disease was primary bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke, we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL). Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in patients with abnormal hematologic findings.

BACKGROUND: The present study is undertaken to acquire normative data of health-related physical fitness(HRPF) of Republic of Korea Air Force(ROKAF) aircrews and to provide norm-referenced standard of HRPF. METHODS: From 15 May 1998 through 14 December 1999, 1284 KAF pilots are checked muscular strength, muscular endurance, flexibility, and body fat percentage. RESULTS: The grip strength was relatively maintained, but flexibility, back strength, and muscular endurance were declined according to promotion and aging. And the incidence of obesity determined by bioelectrical impedence analysis was higher than that assessed on the basis of height and weight. CONCLUSION: It is suggested that many pilots who were normal in BMI have abdominal or visceral obesity. Further studies must be made on the health promotion program for the pilots, on the changes in physical fitness, and on the criterion-referenced standard of HRPF of the pilots.
Adipose Tissue ; Aging ; Hand Strength ; Health Promotion ; Incidence ; Obesity ; Obesity, Abdominal ; Physical Fitness* ; Pliability ; Republic of Korea

PURPOSE: Barriers to cardiopulmonary resuscitation (CPR) education are magnified by relative cost and course availability. E-learning has emerged as a viable solution for continuous, on-demand training and organizational learning. We assessed the hypothesis that E-learning is a viable strategy for CPR training of the general public and sought to evaluate its effects on CPR quality compared to traditional classroom-based methods. METHODS: The E-learning program was specifically designed to teach basic life support skills, and consisted of 50 minutes internet lectures and simulation videos. The training session was freely available to twenty two officers in rural South Korea. The trainees were able to practice with a mannequin and an automated external defibrillator (AED) trainer at their place of employment over the course of 3 days. The control group was trained at a hospital by certified instructors using the same equipment during a 2 hour period. At the end of the course, the participant's skills were evaluated using a checklist and a skill performance test. RESULTS: Forty two subjects were enrolled finally with 19 and 23 belonging to the E-learning and the control groups, respectively. One E-learning trainee was excluded because he was absent from the skills test. The mean time to learn CPR and AED techniques was 29.0+/-24.5 minutes in the elearning group. The mean age of the E-learning group was significantly older than that of the control group (32.4+/-4.0 vs. 26.0+/-1.5, p<0.001). However, we did not find any significant differences in their weight, height or CPR educational status. Before the education sessions, the willingness to perform CPR and their confidence in performing CPR were not significantly different among the two groups. Regarding skill performance, there were no significant differences between the groups except the volume of ventilation. The control group showed a higher volume of ventilation than the elearning group (1,031.7+/-521.6 vs. 548.8+/-303.3, p=0.004). CONCLUSION: E-learning accompanied with appropriate practice can be a helpful tool for public CPR training. The demand for E-learning will increase, and this study shows that e-learning programs can be successful, yielding similar results as traditional, classroom-based training.
Cardiopulmonary Resuscitation ; Checklist ; Defibrillators ; Education, Distance ; Educational Status ; Employment ; Hypogonadism ; Internet ; Learning ; Lectures ; Life Support Care ; Manikins ; Mitochondrial Diseases ; Ophthalmoplegia ; Republic of Korea ; Ventilation

PURPOSE: Barriers to cardiopulmonary resuscitation (CPR) education are magnified by relative cost and course availability. E-learning has emerged as a viable solution for continuous, on-demand training and organizational learning. We assessed the hypothesis that E-learning is a viable strategy for CPR training of the general public and sought to evaluate its effects on CPR quality compared to traditional classroom-based methods. METHODS: The E-learning program was specifically designed to teach basic life support skills, and consisted of 50 minutes internet lectures and simulation videos. The training session was freely available to twenty two officers in rural South Korea. The trainees were able to practice with a mannequin and an automated external defibrillator (AED) trainer at their place of employment over the course of 3 days. The control group was trained at a hospital by certified instructors using the same equipment during a 2 hour period. At the end of the course, the participant's skills were evaluated using a checklist and a skill performance test. RESULTS: Forty two subjects were enrolled finally with 19 and 23 belonging to the E-learning and the control groups, respectively. One E-learning trainee was excluded because he was absent from the skills test. The mean time to learn CPR and AED techniques was 29.0+/-24.5 minutes in the elearning group. The mean age of the E-learning group was significantly older than that of the control group (32.4+/-4.0 vs. 26.0+/-1.5, p<0.001). However, we did not find any significant differences in their weight, height or CPR educational status. Before the education sessions, the willingness to perform CPR and their confidence in performing CPR were not significantly different among the two groups. Regarding skill performance, there were no significant differences between the groups except the volume of ventilation. The control group showed a higher volume of ventilation than the elearning group (1,031.7+/-521.6 vs. 548.8+/-303.3, p=0.004). CONCLUSION: E-learning accompanied with appropriate practice can be a helpful tool for public CPR training. The demand for E-learning will increase, and this study shows that e-learning programs can be successful, yielding similar results as traditional, classroom-based training.
Cardiopulmonary Resuscitation ; Checklist ; Defibrillators ; Education, Distance ; Educational Status ; Employment ; Hypogonadism ; Internet ; Learning ; Lectures ; Life Support Care ; Manikins ; Mitochondrial Diseases ; Ophthalmoplegia ; Republic of Korea ; Ventilation

BACKGROUND: In emergency departments, there are many drunken patients with various emergency medical situations. In these patients, evaluation and management of the medical problems are delayed from time to time because of the uncooperative nature of the patients and because of consciousness and sensory changes. A precise evaluation can only be obtained when the patients become sober. For this purpose, most clinicians start IV fluid loading. This study was carried out to evaluate the effect of IV fluid(normal saline and glucose solution) on the rate of ethanol clearance in such patients. METHODS: Ten volunteers(healthy males in their twenties and with a Michigan alcohol screening test below 4) were enrolled in this study. Alcohol intake was restricted to at least 48 hours before the test and food intake to at least 4 hours. For the test, A predetermined dose of ethanol(1gm/kg) was given to the volunteers. Each volunteer was tested on three consecutive times with 3 or more days interval for alcohol wash out period. On the 1st day, the volunteers received ethanol only per os. On the second day, they received ethanol and a liter of IV normal saline. On the third day, they received ethanol and a liter of IV 10% dextrose solution. Each day, blood was drawn from the antecubital vein to measure the ethanol level at the time of ethanol ingestion and at 0.5, 1, 1.5, 2, 3, 4, 5 and 6 hours after ingestion. The repeated measure ANOVA test was used for the statistical analysis. RESULTS: The difference in the blood ethanol level between the 3 test was F=1.7, p=0.184, and the difference corrected by the time factor was F=0.32, and p=0.985. CONCLUSION: There was no significant difference in the blood ethanol level between the tests. In conclusion, the IV normal saline or glucose solution does not accelerate ethanol clearance in suffering from acute alcohol intoxication.
Consciousness ; Eating ; Emergencies ; Emergency Service, Hospital ; Ethanol ; Glucose* ; Humans ; Male ; Mass Screening ; Michigan ; Time Factors ; Veins ; Volunteers

BACKGROUND: There had been few regulations or agreements between medical schools how to teach undergraduate medical students during anesthesiology clerkship. We conducted this survey to figure out the current status of the clerkships of medical schools in Korea, and suggest the direction of development. METHODS: The questionnaires about anesthesiology clerkship were sent to chairpersons or clerkship directors of 42 medical schools in Korea by electric mail. The answers were collected by internet system. RESULTS: 33 schools answered the questionnaires. The clerkships were elective in 19 schools, but 26 schools answered that the anesthesiology clerkship should be included in core clerkships. Only a few schools oriented the students about ethical issues and occupational health during clerkship. Most schools evaluated the students by evaluation sheet or written examination. Oral or skill tests were used at only 8 and 5 schools, respectively. CONCLUSIONS: The answers of survey showed that there were many aspects to be improved in anesthesiology clerkship although the responses of students toward the clerkship were positive.
Anesthesiology ; Humans ; Internet ; Korea ; Occupational Health ; Postal Service ; Surveys and Questionnaires ; Schools, Medical ; Social Control, Formal ; Students, Medical

No abstract available.
Amnion* ; Cyclooxygenase 2*

BACKGROUND: Cardiopulmonary resuscitation (CPR) is one of the most important medical procedures. However, we could not find any survival rates from in-hospital cardiopulmonary resuscitation in Korea. The objective of this study was to report outcomes according to a Utstein template for in-hospital CPR and to use this report as basic material to enhance our CPR skills and outcome. METHODS: We reviewed all medical records of arrest cases in our hospital in 2001, which were coded as CPR, care for arrest, defibrillation/cardioversion, and Ambu. The data was summarized and analyzed in Utstein style. Most of the data was described in percentage, and the t-test was used to compare survival rate by sex. A P-value below 0.05 was considered significant. RESULTS: In 2001, 218 patients was resuscitated in our hospital and 53 patients (24.3%) survived after CPR. Their mean survival was 10 days. Twenty-seven victims died within the first 24 hours after resuscitation. Nobody was discharged alive from our hospital. The time interval from collapse to CPR was 1.7 minutes, to intubation, 5.62 minutes, to epinephrine injection 7.4 minutes and to defibrillation, 23 minutes. Glascow coma scale and cerebral performance category were less than 8 and 4 for a majority of patients. CONCLUSIONS: In our hospital, we had a low survival rate and quality of life. To improve outcome, we should prepare a better education program and more equipment and well-trained personnel for CPR.
Cardiopulmonary Resuscitation* ; Coma ; Education ; Epinephrine ; Humans ; Incidence* ; Intubation ; Korea ; Medical Records ; Quality of Life ; Resuscitation ; Survival Rate*

PURPOSE: To compare the effects of the lateral tarsal strip procedure alone and the lateral tarsal strip procedure combined with silicone tube intubation in the treatment of functional lacrimal duct obstruction. METHODS: The present study investigated 27 eyes of 20 patients underwent lateral tarsal strip procedure (LTS) alone and 29 eyes of 18 patients underwent combined lateral tarsal strip procedure and silicone tube intubation and who were diagnosed with functional lacrimal duct obstruction. The authors retrospectively reviewed patients' medical records for information including age, gender, history, follow-up period, tear meniscus height (TMH), and symptoms. RESULTS: The average age of the LTS alone group was 60.3 years, and that of the combined groups was 65.9 years. The TMHs in the LTS only and combined operation groups were 0.62 +/- 0.23 mm and 0.62 +/- 0.19 mm before the operation and 0.43 +/- 0.20 mm and 0.26 +/- 0.09 mm after the operation, respectively. The postoperative improvement in epiphora was 74.1% after the LTS alone and 86.2% after combined LTS with silicone tube intubation. The postoperative improvement in epiphora and the operative technique of the lateral tarsal strip-canthus sparing or cantholysis were not relevant. CONCLUSIONS: Lateral tarsal strip combined with silicone tube intubation appeared useful in the treatment of epiphora patients without anatomic lacrimal duct obstruction. Determining which operative technique of lateral tarsal strip procedure should be chosen is difficult, and the preoperative syringing and snap back test may be helpful.
Eye ; Follow-Up Studies ; Humans ; Intubation ; Lacrimal Apparatus Diseases ; Lacrimal Duct Obstruction ; Medical Records ; Nasolacrimal Duct ; Retrospective Studies ; Silicones