Human diphyllobolthriasis is chiefly caused by infection with Diphyllobothrium latum(D. latum) through eating raw or unproperly cooked fish such as salmon, trout or perch. D. latum is worldwidely distributed, but not a common parasite of humans, and its prevalence in Korea is not high. The first worm-proven case of D. latum infection was first reported in 1971 and about 30 cases have been reported in Korea until now. However, with the increasing popularity of eating raw salmon, trout and perch, this tapeworm infection tends to increase in Korea. Most of the patients infected by D. latum have not showed the specific symptoms and only non-specific gastrointestinal symptoms(anorexia, nausea, vomiting, diarrhea, abdominal pain). We report a case which includes a chain whitish, threadlike tapeworm segments spontaneously discharged in the patients stool. On reviewing the literature, the present case is the first report of D. latum infection by eating cultured salmon. The patient was treated with 600mg single dose of Praziquantel.
Cestoda ; Cestode Infections ; Diarrhea ; Diphyllobothrium* ; Eating ; Humans ; Korea ; Nausea ; Parasites ; Perches ; Praziquantel ; Prevalence ; Salmon ; Trout ; Vomiting

OBJECTIVE: To evaluate the perinatal prognosis of fetuses with a single umbilical artery. METHODS: From 1992 to 1998, nineteen cases with single umbilical artery(SUA) was observed in 8,704 deliveries at Chonnam University Hospital. RESULTS: Out of nineteen fetuses, thirteen fetuses with single umbilical artery were detected by antenatal ultrasonographic examination and six fetuses were detected after birth. The male to female ratio was 0.9: 1. Congenital malformations were observed in 8 babies(42.1%) and included leg deformity, esophageal atresia, imperforated anus, ventriculomegaly, meningocele, hydronephrosis, ventricular septal defect, joint contracture, cleft lip and palate, toe anomaly, imperforated anus, kyphosis, no urethra and testis, clubfoot, patent ductus arteriosus and rnild mitral regurgitation. Among 10 cases of karyotyping analysis three cases were diagnosed as trisomy 18. Fourteen fetuses(77.8%) showed growth restriction at delivery. Antenatal obstetric complications were hydramnios(n = 3), oligohydramnios(n =2), and severe preeclampsia(n = 3). CONCLUSION: Careful ultrasonographic evaluation for the identification of a SUA is necessary because of its frequent association with congenital anomaly, growth restriction and cytogenetic abnormality.
Anal Canal ; Chromosome Aberrations ; Cleft Lip ; Clubfoot ; Congenital Abnormalities ; Contracture ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Female ; Fetus ; Heart Septal Defects, Ventricular ; Humans ; Hydronephrosis ; Jeollanam-do ; Joints ; Karyotyping ; Kyphosis ; Leg ; Male ; Meningocele ; Mitral Valve Insufficiency ; Palate ; Parturition ; Prognosis* ; Single Umbilical Artery* ; Testis ; Toes ; Trisomy ; Urethra

Twenty five patients (twenty seven hips) who had Chiari osteotomy at Kang Nam St. Marys Hospital between 1980 and 1995 were reviewed to evaluate the factors in the operative technique that contribute to successful outcome and assess the clinical results in various conditions. The length of follow-up ranged from one to fourteen years and the age of at operation ranged from four to twentythree years. Eighteen patients had developmental dysplasia of the hip: four, septic hip: three had another disorders, Prior to the Chiari osteotomy, fourteen hips had an femoral osteotomy and four, trochanteric arthroplasty. We used to the standard osteotomy as described by Chiari with certain modification. A pneumatic saw and osteotome are used instead of Gigli saw. This technique is simple procedure to make the correct level and angle. Bone graft was not performed in all cases even the osteotomy was displaced more than 50 percent of the iliac width. The overall results were 12 excellent, eight good, five fair, and two poor. In eleven patients, the osteotomy had to be displaced more than 50 percent to provide good coverage of the femoral head. Their results were good or excellent. A good result will be obtained if enough attention is paid to displacing the osteotomy. The osteotomy using the pneumatic saw provides accurate level and direction of osteotomy and it is an simple procedure also.
Adolescent* ; Arthroplasty ; Child* ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Osteotomy* ; Transplants

BACKGROUND: The present study estimated healthcare costs of osteoporotic fractures including spine, hip, distal radius and humerus in Koreans over 50 years of age using national claims data. METHODS: Korea National Health Insurance data between 2008 and 2011 was searched for all claims records of outpatient visits or hospital admissions of patients ≥50-year-of-age. Osteoporosis-related fractures were identified using certain the International Classification of Diseases, Tenth Revision codes and site-specific physician claims for procedures in a patient age cut-off value of 50 years. The healthcare costs included acute phase costs accounting for emergency medical care given immediately after fracture, costs due to further hospitalization and surgical procedures, physiotherapy sessions according to the site of the fracture, and outpatient visits in the year after discharge. RESULTS: The total estimated healthcare costs of osteoporotic fractures in 2011 was $722 million. From 2008 to 2011, the total number and healthcare costs of osteoporotic fractures increased 28.9% (from 127,070 to 163,823) and 31.6% (from $549 million to $722 million), respectively. The portion of national health care expenditure was ranged from 2.3% in 2008 to 2.2% in 2011. The mean healthcare cost of osteoporotic fractures per person increased 2.1% from $4,321 in 2008 to $4,410 in 2011.The mean healthcare costs were highest for hip fractures followed by spine, humerus, and distal radius fractures. CONCLUSIONS: Total Healthcare costs of osteoporotic fractures in South Koreans ≥50-year-of-age increased between 2008 and 2011. This trend will likely continue, which is an important health problem in the elderly population and economically.
Aged ; Delivery of Health Care* ; Emergencies ; Health Care Costs* ; Health Expenditures ; Hip ; Hip Fractures ; Hospitalization ; Humans ; Humerus ; International Classification of Diseases ; Korea* ; National Health Programs* ; Osteoporotic Fractures* ; Outpatients ; Radius ; Radius Fractures ; Spine

Gachon Medical School used an oral examination in the pathology course taught during the 2nd semester of the 2000 school year as a performance assessment of students abilities in three areas: comprehension, logic and problem solving. The evaluation instrument was designed in four stages: assessment objectives were determined, abilities to be measured were selected, the assessment instrument was designed, and the examiners' checklist was drafted. The assessment instrument included two gross and two microscopic cases and the checklist was developed using 5 Likert type scales. The students were divided into three groups of 12 to 13 students and two examiners were allocated to each group. The mean score on the oral examination was 3.56(the highest possible score is 5.00). The correlation between examiners was 0.952 while the correlation of gross and microscopic cases was 0.979. Obviously, these data are statistically significant. The correlation between the written examination pathologic-laboratory examination was the highest, that between the oral examination and pathologic-laboratory examination was in the middle, and that between the oral examination and the written examination was the lowest. Students expressed doubts about the objectivity of individual examiners. The high correlation between the examiners' scores and how students scored on other tasks shows that students fears can be assuaged. It is concluded that the oral examination is a powerful tool in measuring students ability, and can be used in a basic medical science course. As an assessment instrument, it is both valid and reliable.
Checklist ; Comprehension ; Diagnosis, Oral ; Humans ; Logic ; Pathology* ; Problem Solving ; Schools, Medical ; Weights and Measures

Background: Long-term glucocorticoid use increases fracture risk by reducing bone mass. This study evaluated the relationship between hip and vertebral fractures and the total amount of systematic glucocorticoid use. Methods: We randomly selected 1,896,159 people aged 20 to 100 years who participated in the National Health Checkup program in 2006. The amount of glucocorticoids prescribed was calculated based on the defined daily dose (DDD). The total DDD was obtained by adding oral and parenteral glucocorticoids for 6 months from the index date. Subjects were categorized into four groups according to total glucocorticoid DDDs: non-users (DDDs=0), low users (0< DDDs ≤45), intermediate users (45< DDDs ≤90), and high users (90< DDDs). We followed them for 2 years. A multivariate Cox proportional hazard model was used to evaluate the effects of the total amount of glucocorticoid use on hip and vertebral fractures. Results: Higher glucocorticoid use was associated with a higher risk of vertebral fracture. Relative to non-users, the vertebral fracture risk was 1.39 times higher in the low-user group, 1.94 times higher in the intermediate-user group, and 2.43 times higher in the highuser group. The risk of hip fracture was 1.72 times higher in intermediate users and 3.28 times higher in high users than in non-users. Conclusion As the amount of glucocorticoid use for 6 months increased, the risk of hip and vertebral fractures became higher. In order to prevent fractures, it is necessary for doctors to evaluate the total amount of glucocorticoid prescribed to the patient and to provide appropriate treatment.

No abstract available.
Urinary Tract*

Background and Objectives: This study aimed to examine factors of poor outcome by analyzing the outcomes of bilateral subthalamic deep brain stimulation in Parkinson’s disease after 3 years. Methods: We assumed that patients who could not manage independent life in their best stimulationon/medication-on condition after a defi ned period might not have been a good surgical candidate. A poor outcome is defi ned as a failure to maintain functional independence at three years during a stimulation-on/medication-on state. Results: A total of 84 patients underwent bilateral subthalamic deep brain stimulation and all were followed up for 3 years. We excluded one patient who had intracranial hemorrhage. Twenty-one patients of the 83 patients could not keep up independent life even during their best condition for the following reasons: freezing in 15 patients, dementia in 5, depression in 3, musculoskeletal problems in 7, and cancer in one patient. Conclusions: Many patients could not keep up independent life during their best condition as early as three years after deep brain stimulation. Musculoskeletal problems were one major cause of disabilities, as were freezing and dementia. We emphasize that musculoskeletal problems need more attention in the preoperative screening of deep brain stimulation candidates and during the follow up.

There are 3 basic methods for surgical treatment of axillary osmidrosis; 1) method that removes only subcutaneous cellular tissue without removing skin 2) method that removes skin and subcutaneous cellular tissue en bloc, and 3) method that partially removes skin and subcutaneous cellular en bloc as well as removing the subcutaneous cellular tissue of the adjacent region. We studied the results of partial removal of the skin and subcutaneous cellular tissue en bloc, as well as the removal of subcutaneous cellular tissue of the adjacent region to compare the results of the bipedicled flap with the graft conversion method. There was no difference between two methods in results and complication rates. There are 3 advantage to this procedure. First, about 70-80% of apocrine glands were centrally distributed among the axillary hairbearing region therefore, resection of the central portion of axillary hair distribution area is important for good result. Second, the preservation of the subdermal plexus with careful excision of adjacent underlying subcutaneous tissue under the aid of the magnifying surgical loupe, is important for good wound healing. Third, the central excision of the axillary hair distribution area provides good exploration for undermining and defatting of the undersurface of the adjacent area, therefore it tooks a shorter operation time.
Apocrine Glands ; Hair ; Skin ; Subcutaneous Tissue ; Transplants ; Wound Healing

Epithelioid smooth muscle tumor is relatively rare and potentially malignant, especially in retroperitoneum. Distinct criteria for malignancy still have not been clarified in this epithelioid variant arising in retroperitoneum. We report a deceptively benign-appearing epithelioid leiomyosarcoma in a 50-year-old female. She was admitted with abdominal discomfort and dysuria. Abdominal CT showed a well-demarcated, 10 10 cm sized, solid mass in retroperitoneum. Concomitant metastatic lesions were noted in right lung field. Surgical excision of retroperitoneal mass and right lung lobectomy were performed. The retroperitoneal mass showed yellowish-tan, well-delineated and lobulated appearance. Histologically, this tumor was composed of predominantly epithelioid, round to oval cells with distinct clear cytoplasm and slightly atypical nuclei. Mitosis was rare (0~1/50 HPF). Lung lesions were morphologically similar to that of retroperitoneum.
Cytoplasm ; Dysuria ; Female ; Humans ; Leiomyosarcoma* ; Lung ; Middle Aged ; Mitosis ; Smooth Muscle Tumor ; Tomography, X-Ray Computed