No abstract available.
De Lange Syndrome*

Background: Appropriate physician workforce projection through reasonable discussions and decisions with a broad view on supply and demand of the workforce, thus, is very important for high-quality healthcare services. The study expects to provide preliminary research data on the workforce diagnosis standard model for Korean physician workforce policy decision through more flexible and objective physician workforce projection in reflection of diverse changes in healthcare policy and sociodemographic environments. Methods: A low flow rate through the causal map was developed, and an objective workforce demand projection from 2019 to 2040 was conducted. In addition, projections by scenarios under various situations were conducted with the low flow rate developed in the study. Lastly, the demand projection of the physician workforce by region of 17 cities and provinces was conducted. Results: First, demand of physicians in 2019 was 110,665, 113,450 in 2020, 129,496 in 2025, 146,837 in 2030, 163,719 in 2035, and 179,288 in 2040. Second, the scenario for the retirement of baby boomers led to a decrease in the growth rate due to time delay. Third, Seoul and Gyeonggi-do account for a high percentage of demand, a very high upward trend was identified in Gyeonggi-do, and as a result, the projection showed that the demand of the physician workforce in Gyeonggi-do would worsen over time. Conclusion This study is meaningful in that rational and collective physician workforce supply and demand and its imbalance in workforce distribution were verified through various projections by scenarios and regions of Korea with System Dynamics.

Chordomas are maligaant tumors which arise in the remnants of the embryonic notochord, and exhibit a definite predilection for the extremes of the spinal axis, the great majority arising either in the basioccipital or in the sacrococcy geal regions. Particularly, complete surgical removal is almost impossible, therefore, local recurrence after the surgical removal of this tumor is common or rule. This report describes a csse of chordoma arising sacrococcygeal region treated with block resection.
Chordoma ; Notochord ; Recurrence ; Sacrococcygeal Region

No abstract available in English.
Enterocolitis, Pseudomembranous

No abstract available.
Carotid Artery, Common* ; Rupture*

Authors analylsed 384 hips of 269 patients with osteonecrosis of the femoral head in adult, who were diagnosed and treated between August 1976 and March 1986 at the Department of ()rthopaedic Surgery, Kyung Hee University Hospital. These are investigated in terms of history, clinical data and reontgenogram, retrospectively. In 269 patients, nontraumatic femoral head necrosis (NTFHN) were 199 patients (74.0%) and traumatic femoral head necrosis (TFHN) were 70 patients (26.0%). The male was more affected in ratioof 3.1: 1, especially higher in NTFHN about 4: l. In alcohol-induced necrosis all were male patients, but in polyvinyl pyrrolidone(PVP)-storaged cases 63% were female patients. The peak incidence of age distribution was at 6th decade(average 53.9 years) in the TFHN ahd 5th decade(average 44.2 years) in NTFHN). The most frequent probable etiologic frctor in NTFHN was idiopathic (71 patients, 35.8%), followed by alcohol-induced (68 patients, 34.2%), steroid-induced (27 patients, 13.6%) and PVP-storaged (19 patients, 9.5%). The bilateral involvement in NTFHN was 112 patients (53.6%). The idiopathic cases (42.0%) were lower than steriod-induced (81.9%), alcohol-induced (76.5%) or PVP-storaged (63.2%) in the bilaterality. The associated diseases in NTFHN were hepatopathy (12 patients), diabetes (7 patients), pulmonary tuberculosis (6 patients) and dermatopathy (5 patients). And the underlying diseases in steroid-induced were nephrotic syndrome (4 patients), arthralgia (4 patiehts), rhematiod arthritis (3 patients), dermatopathy (4 patients) and systemic lupus erythematosus (1 patient). 61.4% of TFHN was diagnosed within 2 years after trauma, 56.7% of NTFHN had the duration of symptom over one year. The initial reontgenogram stage according to Ennekings classification was average stage 1V. In NTFHN cases, there were no significant relationship between etiologic factors and initial reotgenographic stage or duration of symptom. But there were significant corelation between Enneking's reontgengraphic stage and clinical findings (range of movement of joint, Harris hip score, duration of symptom). In more severe cases than Enneking's radiologic stage IV, Harris hip score not provide any information to select a proper treatment.
Adult ; Age Distribution ; Arthralgia ; Arthritis ; Classification ; Epidemiologic Studies ; Epidemiology ; Female ; Head ; Hip ; Humans ; Incidence ; Joints ; Lupus Erythematosus, Systemic ; Male ; Necrosis ; Nephrotic Syndrome ; Osteonecrosis ; Polyvinyls ; Retrospective Studies ; Tuberculosis, Pulmonary

Surgical endarterectomy has been shown to be superior to medical treatment in the management of severe carotid stenosis. Endarterectomy, although effective, does have limitations, and percutaneous transluminal angioplasty with stent may offer an alternative modality of treatment. We report on a patient with severe coronary disease that femoral arterial cannulation was not possible due to aorto-femoral shunt operation and absent pulse. The transradial approach was used for aortography, bilateral carotid angiography and successful elective stent deployment in the left internal carotid artery. The transradial approach might be useful alternative in case of problems with femoral approach.
Angiography ; Angioplasty* ; Aortography ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Catheterization ; Coronary Disease ; Endarterectomy ; Humans ; Stents*

No abstract available.
Korea*

Coronary artery bypass grafting (CABG) technique has been much developed but CABG under cardiopulmonary bypass has the unavoidable deficits such as generalized inflammatory reaction from cardiopulmonary bypass and myocardial ischemia from aortic-cross clamp. There has been remarkable advancement of CABG without cadiopulmonary bypass. We performed CABG successfully without cardiopulmonary bypass. We performed CABG successfully without cardiopulmonary bypass in two patients with multivessel coronary disease who were failed to intervene with percutaneous transluminal coronary angioplasty. We herein report the two cases.
Angioplasty, Balloon, Coronary ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Disease* ; Humans ; Myocardial Ischemia ; Surgical Procedures, Minimally Invasive ; Transplants*

Coronary stent embolization is a rare event but may result in clinically relevant cardiac ischemia or peripheral embolization during the procedure. We report a case of systemic embolizations of two coil stents during the primary PTCA in acute myocardial infarction, who were treated successfully with a double wire helix technique and a gooseneck snare. Although in our experience this rare complication did not produce any clinical complications, care should be taken to prevent this possibility, especially in patients with significant vessel tortuosity, calcification, total occlusion, or mild stenosis proximal to the target lesion.
Constriction, Pathologic ; Humans ; Iliac Artery* ; Ischemia ; Myocardial Infarction ; SNARE Proteins ; Stents*