This treatise summarizes the medical facts about the persistent vegetative state(PVS) and the associated issues. In August 1998, the opinions of the 380 neurologists and the 1007 neurosurgeons are inquired about the diagnostic criteria of PVS, the degree and the withdrawal of treatment on PVS patients. The response rate is 18.8%. The diagnostic criteria of PVS is determined by the items approved above 5007o of responses. (1) no evidence of cerebral function and an inability to interact with visual, auditory stimuli and follow commands. (2) maintaining the respiratory function with spontaneous respiration and normal respiratory pattern. (3) spontaneous eye opening and eye ball movements without sustained tracking. (4) variably preserved brain stem reflexes. (5) presence of sleep-wake cycles. (6) (1)-(5) symptoms should be persist for 6 months after the development of vegetative state. (7) the diagnostic criteria of PVS should be applied more than 3 times during the minimum observation period. (8) this diagnostic criteria of PVS could be applied to adults over 7 ages. As to the degree of treatment, nasogastric tube feeding and air-way keeping through the tracheostomy are approved over 9007b. Also antibiotics can be used in infection. As to the withdrawal of treatment, do not resuscitate order of patient s family is accepted by 46.1% in an emergency condition like cardiac arrest. But discharge against medical advice by the patient s family is accepted by 73.107o in non-emergency condition. In the case of neonates, parents decision is more determinative than any other thing.
Adult ; Anti-Bacterial Agents ; Brain Stem ; Emergencies ; Enteral Nutrition ; Heart Arrest ; Humans ; Infant, Newborn ; Korea* ; Parents ; Persistent Vegetative State* ; Reflex ; Respiration ; Tracheostomy

We present 20 medicolegal autopsies performed at the Department of Forensic medicine, Seoul National University Medical College during the year of 1996. In Korea Postmortem Invesigation (PI) system is not established and is needed greatly provide the basic considerations on PI system, we detailed the cases with impediments to be overcome. Among the 20 cases, 13cases were unusual deaths and 6 cases were natural. For unusual deaths, 7 were by mechanical injuries, four by asphyxia. Test for toxic stance was the most needed part to be solved.
Asphyxia ; Autopsy* ; Forensic Medicine ; Humans ; Korea ; Seoul

No abstract available.

PURPOSE: To evaluate the effects of occlusion therapy on anisometropic amblyopia and investigate the factors that influence on the final vision. METHODS: Fifty two patients with anisometropic amblyopia, whose age ranged from 3 to 12 years, were treated with full and partial occlusion therapy. RESULTS: The degree of anisometropia was 3.23+/-1.99 D in hyperopia group and 2.00+/-0.98 D in myopia group. The best corrected visual acuity and final vision were 0.29+/-0.14 and 0.52+/-0.22 in hyperopia group, while 0.34+/-0.16 and 0.63+/-0.16 in myopia group. But statistically significant difference was not found between two groups. The best corrected visual acuity was significantly correlated with the degree of anisometropia. The final vision was also significantly correlated with the degree of anisometropia. As expected, the final visual acuity was strongly correlated with the best corrected visual acuity. But no statistically differences were found based on the age of initial treatment and sexual difference. CONCLUSIONS: The severity of amblyopia and the effect of occlusion therapy were more correlated with the degree of anisometropia than the age of initial treatment and the type of anisometropia.
Amblyopia* ; Anisometropia ; Humans ; Hyperopia ; Myopia ; Visual Acuity

BACKGROUND: Epidermal grafting using cryotherapy for recipient sites is in widespread use. However the peripheral hypopigmented haloes that occur around the recipient sites require prolon gation of the treatment period. OBJECTIVE: We used a CO2 laser to remove the epidermis of the recipient sites for betteri results. METHODS: We treated lie localized vitiligo patients with CO2 laser to remove t.he epidermis and grafted suction blister rooves. We observed repigmentation and complications 1 month later. RESULTS & CONCLUSIONS : The superiority of this method is demonstrated by the fact 1) all prodedures can be completed on the day of operation 2) the incidence of hypertrophic scar and peripheral hypopigmented halos can be observed.The problems of this method are 1) uneven repigmentation of recipient. sites 2) hyperpigrnentation of recipient sites
Blister ; Cicatrix, Hypertrophic ; Cryotherapy ; Epidermis* ; Humans ; Incidence ; Lasers, Gas* ; Suction ; Transplants* ; Vitiligo*

No abstract available.
Animals ; Ethanol* ; Rats*

Multiplex PCR for three STRs of same repetition unit [GATA]n, 4804LR[D12S66], 27H39LR[DYS19] and 4815LR[D12S67] loci, was constructed for forensic application DNA was extracted from 200 unrelated Koreans and amplified with a mixture of polyacrylamide gel electrophoresis, so called Amp-FLP procedure. Three loci could be co-amplified in a reaction with easy, and reaction condition was not so quite different from that of each locus. The PCR products of each locus could be separated bp, and 4815LR from 241 bp to 281 bp, so these alleles of each locus could be separated on a single electrophoresis. A total of six alleles was noted in 4804LR and heterozygosity was 0.5764. The allele 11 and allele 12 were frequently noted with the frequency of 0.6225 and 0.1775, respectively. Sequencing was done for 2 alleles, and the exact size of the alleles and the repetition unit were confirmed. Through statistical analysis forensic applicability of the STR 4804LR locus was confirmed. For 4815LR and heterozygosity was 0.5764. The allele 11 and llele 12 were frequently noted with the frequency of 0.6225 and 0.1775, respectively. Sequencing was done for 2 alleles, and the exact size of the alleles and the repetition unit were confirmed. Through statistical analysis forensic applicability of the STR 4804LR locus was confirmed. For 4815LR locus the amplification was successful, but the separation of the alleles on routine polyacrylamide gel was not successful. Some alleles was hardly separable, some alleles did not match the allelic ladder exactly, so the interallele was suspicious. On sequencing gel the electrophoresis pattern was quite different with that of routine polyacrylamide gel. A total of 11 allele was noted in 4815LR and heterozygosity was 0.765. For the routine use of the 4815LR locus, more meticulous method for the separation of the alleles such as using automatic DNA sequencer was necessary.
Alleles ; DNA ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Multiplex Polymerase Chain Reaction* ; Polymerase Chain Reaction

To know the amplification pattern according to relative concentration ratio in mixed samples, two STRloci, vwF locus and MBP locus and two VNTR loci, D1S80 locus and d17S5 locus were amplified in DNA with various concentration of two individuals were easily identified. But when the concentration of one person were lowered to 1/20-1/40 of the other's the intensity of product bands diminshed and hardly discernible. Also different amplification efficiency according to the template length was noted, especially in VNTR loci. Using automatic sequencer and RFLP scan program, the intensity OD of each PCR product band could be calculated, and this correlates the felative amplification efficiency of each allele. By using this we could construct quantitative PCR for the mixed samples. This could be used in practical case work for forensic purpose, and also be a valuable candidate for 'chimerism detection' in case of bone marrow transplatation.
Alleles ; Bone Marrow ; DNA ; Humans ; Minisatellite Repeats ; Polymerase Chain Reaction* ; Polymorphism, Restriction Fragment Length

As the need for medical services increases, interest in the quality improvement of healthcare and patient safety is also increasing. This study aimed to propose a surgical hospitalist or surgicalist system in Korea. Specifically, it has been suggested that the essential capacities of the surgicalist, including their understanding of surgery, wound management, emergency management, surgical nutrition, and education, may be useful in improving the quality of healthcare and patient safety. The key characteristic of the surgicalist system is that surgeons are “readily available” in the hospital ward to provide primary care for hospitalized patients. Surgicalists provide both perioperative and advanced primary care. As the population ages, the number of high-risk patients who are undergoing major operations increases. The surgicalist system, which is responsible for the perioperative management and advanced primary care of inpatients, is expected to expand rapidly. The shift from the vertical surgeon-resident-centered system to the horizontal surgeon-surgicalist-centered system can help provide high-quality care for patients, and a systematic training system for residents. In addition, it is necessary to define the essential capacities of the surgicalist, and to determine the research and education that can promote them.
Delivery of Health Care ; Education ; Emergencies ; Hospitalists ; Humans ; Inpatients ; Korea ; Patient Safety ; Primary Health Care ; Quality Improvement ; Quality of Health Care ; Surgeons ; Wounds and Injuries

Purpose: The aim of this study is to investigate the effect of the surgical hospitalist system on postoperative outcomes and hospital costs for surgical patients. Methods: We reviewed the medical records of 522 patients who were admitted to the divisions of colorectal and gastrointestinal surgery for operation from September to December 2017 at Severance Hospital, Yonsei University College of Medicine in Seoul, Korea. All patients were divided into 2 groups; one that was managed by surgical hospitalists group (HG) and another that was managed by non-hospitalist residents group (NHG) after elective surgery. Postoperative outcomes and hospital costs were analyzed for each group. Results: Two hundred ninety-eight patients were managed by HG and 189 patients were managed by NHG after surgery. The length of hospital stay in the first group was shorter (9.6 ± 5.8 days vs. 12.2 ± 7.9 days, P < 0.001), the incidence of complications was lower (44.6% vs. 55.6%, P = 0.019), and the readmission rate was lower (3.0% vs. 6.9%, P = 0.046) in the HG than in the NHG. The difference in total hospital costs was not significant between the HG and the NHG (₩8,381,304 vs. ₩9,242,493, P = 0.559), but surgery-independent hospital costs were lower in the HG than in the NHG (₩3,020,873 vs.₩3,923,308, P = 0.001). Conclusion The surgical hospitalist system reduced the length of hospital stay, the incidence of postoperative complications, and the readmission rates of surgical patients. This led to the effect of a reduction in total hospital costs.