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

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

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*

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

Evaluation of the sacrum in anorectal malformations (ARMs) is important because of the frequent association with ARMs and functional outcome after correction of ARMs. Sacral defects are not easily detected because of immaturity of sacrum in children and overlooking of pediatric surgeons. The authors utilized the sacral ratio in normal children and patients with ARMs. In normal children, the mean true sacral ratio and mean sacrococcygeal ratio were 0.60+/-0.08 and 0.72+/-0.13 respectively. Sacral ratio was not correlated with age and did not changed with age in same patient. However, true sacral ratio and sacrococcygeal ratio were significantly lower in patients with high type ARMs than those of normal children (p<0.001). There was no difference between patients with low type ARMs and normal children. These results suggest that abnormal sacrums are more frequently encountered in patients with high type ARMs than in normal children, and that true sacral ratio and sacrococcygeal ratio can be used in the evaluation of the abnormal sacrum.
Arm ; Child* ; Humans ; Sacrum

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*

Acrodermatitis enteropathica is classified as a congenital autosomal recessive type and an acquired transient type. This disease manifests as acral and periorificial dermatitis, alopecia, intractable diarrhea, and failure to thrive. Whereas the autosomal hereditary type is caused by malabsorption of zinc in the intestine, the acquired type is caused by low nutritional support or decreased peripheral release of zinc from blood. We experienced a case of a 5-month old, breast feeding, full-term female presenting with only acral bullous dermatitis without diarrhea, periorificial dermatitis and an abnormal serum zinc level.
Acrodermatitis ; Alopecia ; Breast Feeding ; Dermatitis ; Diarrhea ; Failure to Thrive ; Female ; Foot ; Hand ; Humans ; Intestines ; Nutritional Support ; Zinc

Lichen aureus appears usually as asymptomatic golden to purpuric colored lesion and consists of lichenoid papules, patches, and plaques. This disease is regarded as a variant of pigmented purpuric dermatitis. The main cause remains largely unknown. It is common on the lower extremity, and generally occurs as a solitary lesion, however, also rarely occurred as a zonal, bilateral or segmented form. We present a 28-year-old man who had multiple, variable sized, red-brownish to purpuric colored papules and patches on both lower extremities, ankles and forearms. On histopathological examination, the lesion revealed features of lichen aureus. This patients condition was improved by treatment with oral and topical corticosteroid agent. Since this case appeared to be a very unique case of multiple lichen aureas, we reported the case herein.
Adult ; Ankle ; Dermatitis ; Fluconazole ; Forearm ; Humans ; Lichens* ; Lower Extremity