Recent developments in medicine in our society have drawn attention to various phenomena related to death, such as brain death, cardiac death, vegetative death, euthanasia, death with dignity, near-death experiences, hospice, and suicide. The definition and conception of death is significant because its reductionist determination may bring about a denial or taboo of death and a certain limitation on the modes of life and death. As religious traditions like Christianity and Buddhism and life and death studies show, human death cannot and should not be explained by physical and biological criterion of death like brain death or cardiac death alone. In a society with such a reductionist definition of death there can be no space for a mature culture of death and only a colossal number of miserable deaths like suicide. Therefore, as Kubler Ross argues, death should be defined in terms of considering the continued existence of certain realities as to psyche, spirit, and the meaning of life beyond physical and biological aspects. The medical and legal approach to death is greatly incomplete and restricted in taking into account the physical and biological aspect of death. Thus, it is necessary to precisely and deeply reconsider the definition and understanding of death from a broader and more comprehensive perspective rather than concentrating solely on the physical and biological criterion of death such as brain death or cardiac death.
Brain Death ; Buddhism ; Christianity ; Death ; Denial (Psychology) ; Euthanasia ; Fertilization ; Hospices ; Humans ; Right to Die ; Spirituality ; Suicide ; Taboo ; Thanatology

No abstract available.

We analysed the 16 cases of the perilunate dislocations (PLD) and fracture-dislocations (PLFD) to study the distribution of the different forms and provides additional information about the perilunate pattern of injury. The cases were followed at least 1 year and an average of 2 years and 3 months. The results were as follows: l. All of the cases, the direction of the dislocation was dorsal. The PLD was 4 cases (25%) and PLFD was 12 cases (75%). The transscapholid perilunate fracture-dislocation (TS-PLFD) was the most common type. 2. Scaphoid fracture was present in 9 cases (56%), It was transverse fracture in the middle 1/3. 3. Missed or delayed diagnoses were noted in 3 cases (18%). 4. Overall functional results were graded as exellent in 2 cases (13%), good in 9 cases (56%), fair in 3 cases (18%) and poor in 2 cases (13%).
Delayed Diagnosis ; Dislocations

BACKGROUND: Osteoporosis is becoming major health problem in old age and menopausal women, and osteoarthritis is most common joint disease in both ages. The inverse relationship between osteoporosis and osteoarthritis was first noticed 20years ago. However the subject had not been studied in korea. Thus, our objectives is to examine the influence of osteoarthritis on bone density measurements. METHODS: The study group consisted of 120 women, aged over 40 years, who visited for health examination in Health Center of Poondang Jesaeng general hospital from October 1998 to April 1999. Bone mineral density(BMD) of the lumar spine was measured, using dual energy X ray absorptiometry(Lunar, Expert XL), and lateal lumbar spine radiograph was taken. Severity of osteoarthritis were scored on osteophytes, disk space narrowing and vertebral body sclerosis. RESULTS: Postmenopausal women had signifcantly lower BMD than premenopausal women(p<0.001). Age(r= 0.545, p<0.001), body mass index(r=0.264, p<0.01) and education(r=0.284, p<0.01) were significantly correlated with BMD, but smoking, exercise, radiogrphic OA variables not correlated. However, stepwise multiple regression analysis using osteoporosis related variables and OA variables is indicated that menopausal status, body mass index, age, osteophytes were significantly associated factor with BMD, and lumbar osteophytes explained 2.7% of variation in lumbar spine BMD. CONCLUSION: We conclude that, among women, lumbar BMD is highier in those with osteophytosis of the lumbar spine. The effect is largely directed by osteophytes being included in the BMD measurement.
Body Mass Index ; Bone Density* ; Female ; Hospitals, General ; Humans ; Joint Diseases ; Korea ; Osteoarthritis* ; Osteophyte ; Osteoporosis ; Sclerosis ; Smoke ; Smoking ; Spine*

No abstract available.
Acoustic Stimulation* ; Acoustics* ; Pregnancy, High-Risk*

Fordyce's spots are ectopically located sebaceous glands, clinically characterized by minute orange or yellowish pinhead-sized macules or papules on the mucosa of the lips, cheeks, and less often, on the gums. Similar lesions may occur on the areola, glans penis, and labia minora. Because it is asymptomatic and inconsequential, treatment should be undertaken only if there are significant cosmetic problems. We could not find any remarkable therapeutic modality in textbooks or literatures satisfying both patients and physicians. We report herein the combination use of CO2 laser and chemical agent (Trichloroacetic acid) as new therapeutic modality.

PURPOSE: Assess the appropriate level of electrocardiography (EKG) education that should be incorporated into the curriculum of emergency medical technician (EMT) students. METHODS: Consensus by EMT professors and emergency medicine specialists was obtained using two rounds of the Delphi survey. The questionnaire consisted of 70 items; 12 related to demographic information, 8 related to general interpretation of EKG, 26 related to interpretation of arrhythmia, 20 related interpretations of structural anomaly, infarction and systemic disease, and 4 related to interpretation of EKG findings used for advanced cardiac life support. We considered consensus to be agreement of greater than 7 of 9 (66.7%). RESULTS: 59 and 24 subjects were included in the first and second rounds of the Delphi survey, respectively. The response rate was 59% for the first round and 40.7% for the second round. Of 70 items, 40 items came to a consensus by the panel. All items related to interpretation of EKG and advanced cardiac life support and most (10 of 12) items related to basic content were felt to be important by both EMT professors and emergency medicine specialists. However, for items related to arrhythmia and related to structural anomaly, infarction and systemic disease, less than half of the items examined were felt to be necessary in the curriculum of EMT students (12 of 26 and 6 of 20). CONCLUSION: We identified 40 items that should be included into the EKG curriculum of EMT students. These findings should be used to create more effective educational programs for EMT students.
Advanced Cardiac Life Support ; Arrhythmias, Cardiac ; Consensus ; Curriculum ; Delphi Technique ; Electrocardiography ; Emergencies ; Emergency Medical Technicians ; Emergency Medicine ; Humans ; Infarction ; Porphyrins ; Surveys and Questionnaires ; Specialization

PURPOSE: We evaluate the short-term clinical outcome of arthroscopic rotator cuff tendon repair with suture-bridge technique in patients with full thickness rotator cuff tear. MATERIALS AND METHODS: 29 (male:17, female:12) consecutive shoulders treated with this index procedure and early rehabilitation were enrolled. Mean age was 56.4 years (range, 34~73 years) and mean follow-up period was 13 months (range, 12-15 months). Clinical outcomes were evaluated by using the University of California Los Angeles (UCLA) score, the Korean Shoulder Scoring System (KSS) and Visual Analogue Scale (VAS). Postoperative cuff integrity was evaluated through magnetic resonance imaging (MRI) and categorized by Sugaya classification. RESULTS: Postoperative UCLA scores improved from16.4 to 31.6 (p< 0.05) and KSS scores showed 88 at 6 months and 92 at last follow up. Preoperative VAS score was 8.6, which was decreased to 2.1 at 3 months and 1.4 at 6 months postoperatively. 28 patients (96.5%) had increase in range of motion. The follow up MRI was taken in 15 shoulders and the cuff integrity was type I in 6 cases, type II in 7, type III in 1 and type V in 1 by Sugaya classification. CONCLUSION: Arthroscopic suture-bridge technique resulted in good or excellent clinical outcome in 96.5% of the cases, so we think this technique is one of the reliable procedure for full-thicknes rotator cuff tear.
California ; Follow-Up Studies ; Humans ; Los Angeles ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Rotator Cuff ; Shoulder ; Sutures ; Tendons

PURPOSE: We investigated whether there are independent intradaily changes in bilirubin levels in normal neonates. METHODS: During the period of January 1996 till July 1996, 100 healthy newborn infants were studied for at least 3 consecutive days. Starting from the third day of life, consistent intradaily changes of bilirubin concentration were observed. And obstetric history, birth history, weight change at 3 days were recorded from chart review. A complete blood cell count was obtained from each subject at the beginning of the study. RESULTS: The mean bilirubin concentrations at morning were 10.4 +/- 1.8mg/dl (3rd day), 11.6 +/- 2.1mg/dl (4th day) and 11.2 +/- 2.7mg/dl (5th day). The mean bilirubin concentrations at evening were 11.1 +/- 2.1mg/dl (3rd day), 11.3 +/- 2.2mg/dl (4th day) and 10.8 +/- 2.8mg/dl (5th day). Interdaily changes of bilirubin levels were found: morning levels were higher compared with those of the evening. CONCLUSION: We showed a consistent diurnal rhythm in bilirubin levels, with higher levels in the morning than in the evening. This diurnal rhythm in serum bilirubin concentration affects endogenous factors as well as exogenous. Mechanism of diurnal variation was unknown.
Bilirubin* ; Blood Cell Count ; Circadian Rhythm ; Humans ; Hyperbilirubinemia, Neonatal ; Infant, Newborn* ; Reproductive History

PURPOSE: In the current study, the relation between the clinicopathological parameters and levels of the amplification of the c-met and E-cadherin genes were investigated in patients with an advanced gastric carcinoma. METHODS: The levels of amplification of the c-met and E-cadherin genes in 44 advanced gastric carcinoma patients were retrospectively investigated using RT-PCR. The relationships between the levels of amplification of these genes and the clinicopathological parameters were evaluated using univariate and multivariate analyses. RESULTS: Seventeen (38.6%) and 13 (29.5%) of the 44 advanced gastric carcinoma patients were evaluated as having amplification of the c-met gene and down-regulation of the E-cadherin gene, respectivly. The amplification of c- met gene was significantly correlated with serosal invasion, lymph node metastasis and neural invasion, whereas the down-regulation of the E-cadherin gene was significantly correlated with the diffuse type of gastric carcinoma by Lauren's calssification, and neural invasion. CONCLUSION: The levels of the c-met and E-cadherin gene amplifications may be a powerful aids in evaluating the metastatic potential and prognosis in patients with advanced gastric cancer.
Cadherins* ; Down-Regulation ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms*