No abstract available.
Adult* ; Epiglottitis* ; Humans

No abstract available.
Endometriosis* ; Female

No abstract available.
Facial Nerve* ; Paralysis*

No abstract available.
Cystadenocarcinoma, Mucinous* ; Mucins*

The purposes of this study were to survey the present state and problems related to curriculum and clinical clerkship of diagnostic radiology and to find out alternatives for the improvement of curriculum design in diagnostic radiology. The results of this study are as following: First, 43.3% out of professors, 70.6% out of residents and 69.4% out of students reply that they don't attain the objectives of classwork, although they finish all their classwork successfully. Second, most of them reply that classwork is oriented by professors and least participated in by students. Third, PBL(Problem-based Learning) by small group is very effective to learning. Fourth, the reasons why clinical clerkship isn't systematic are that there aren't professors-in-charge of clinical clerkship and that the schedule of clinical clerkship is irregular. Fifth, students' participation in clinical clerkship is not substantial participation, such as interpretation and procedure, but simple observation. Based on these results the points which the improvement is called for are as follows: First, professors must achieve the objectives of classwork by thorough analysis on those within limited class hours. Second, it is desirable that they apply learning methods to improve students' thinking by small group activities to their classwork. Third, professors-in-charge of clinical clerkship are surely needed.
Appointments and Schedules ; Clinical Clerkship ; Curriculum* ; Humans ; Learning ; Thinking

Wegener's granulomatosis is an uncommon idiopathic, multisystem disease characterized by necotizing granuloma and vasculitis affecting small to medium sized vessels. It is classified into a classic form and a limited(localized) form based on the anatomic site of involvement by Carrington and Liebow in 1966. Recently, it has been made possible for the diagnosis of this disease to be carried out in an earlier stage by measurement of the ANCA(Antineutrophil cytoplasmic antibodies) and the result of treatment has improved since cyclophosphamide therapy. Wegener's granulomatosis in children has been extremely rare. The authors have observed 1 case of limited form of granulomatosis in a 12 year-old female child and report this with a literature review.
Antibodies, Antineutrophil Cytoplasmic ; Child* ; Cyclophosphamide ; Cytoplasm ; Diagnosis ; Female ; Granuloma ; Humans ; Methotrexate ; Vasculitis ; Wegener Granulomatosis*

Oral anticoagulant therapy is frequently and increasingly prescribed for patients at risk of arterial or venous thromboembolism (VTE). Although elective surgical or invasive procedures have necessitated temporary interruption of anticoagulants, managing these patients has been performed empirically and been poorly investigated. This study was designed to evaluate the adequacy of perioperative anticoagulation using enoxaparin. This was a retrospective, single-center study that evaluated the efficacy and safety of therapeutic-dose enoxaparin for bridging therapy in patients on long-term warfarin at Soonchunhyang University Hospital in Korea between August 2009 and July 2011. Warfarin was discontinued 5 days before surgery, and enoxaparin was administered twice daily by subcutaneous injection at a dose of 1 mg per kg from 3 days before the procedure to the last dose 24 hours before the procedure. Anticoagulation was restarted if proper hemostasis had been confirmed. There were 49 patients, of whom 25 (51%) were men, and the mean age was 63 years. Thirty-four (69%) received warfarin therapy for VTE, and 9 (18%) for atrial fibrillation. Twenty-nine patients (59%) underwent major surgery and 20 (41%) minor surgery. The mean postoperative duration of enoxaparin was 4 days. No patients had thromboembolic complications through 30 days after the procedure. The overall 30-day mortality rate was 0%. In conclusion, our findings demonstrate that bridging therapy with therapeutic-dose enoxaparin is feasible and associated with a low incidence of major bleeding and no thromboembolic complications. However, the optimal approach to managing patients perioperatively is uncertain and requires further evaluation.
Anticoagulants ; Atrial Fibrillation ; Enoxaparin* ; Hemorrhage ; Hemostasis ; Heparin, Low-Molecular-Weight ; Humans ; Incidence ; Injections, Subcutaneous ; Korea ; Male ; Minor Surgical Procedures ; Mortality ; Retrospective Studies ; Thromboembolism ; Venous Thromboembolism ; Warfarin

OBJECTIVE: To evaluate the effect of complex decongestive physiotherapy (CDPT) on malignant lymphedema patients. METHODS: Patients (n=22) with malignant lymphedema of the upper or the lower limb were assigned to this study. CDPT without manual lymphatic drainage (MLD) was used five times per week for two weeks. The main outcome measurements included measurement of the circumference of the limb (proximal, distal, and total) to assess volume changes. We also employed the visual analog scale (VAS) to evaluate pain, and the short form-36 version 2 questionnaire (SF-36) to assess quality of life (QOL). All items were assessed pre and post-treatment for each patient. RESULTS: There was a statistically significant difference in the volume change of the upper limbs (3.7%, p=0.001) and the lower limbs (10.9%, p=0.001). A 1.5 point reduction on the ten-point VAS was noted after CDPT. The scores on the physical and the mental components of the SF-36 showed statistical improvement after treatment (p=0.006, p=0.001, respectively). CONCLUSION: These results suggest that all components of the CDPT program except MLD are helpful in treating malignant lymphedema in terms of pain reduction and reduction of the volume of the affected upper or lower limb. This treatment regimen also has positive effects on QOL.
Drainage ; Extremities ; Humans ; Lower Extremity ; Lymphedema ; Pilot Projects ; Quality of Life ; Upper Extremity

PURPOSE: To inform on shoulder pathology and to identify the disabilities and level of quality of life (QOL) associated with shoulder pain in patients with breast cancer-related lymphedema (BCRL). MATERIALS AND METHODS: Using patient history, physical examination, and ultrasound (US), we classified patients with BCRL into the following three groups: no pain with normal ultrasound (US), pain with normal US, and pain with abnormal US. We evaluated shoulder pathology using US, pain intensity using a visual analogue scale (VAS), and functional disability using the Korean version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire. For assessment of QOL, we used the Korean version of the brief form of the World Health Organization Quality of Life Assessment Instrument (WHOQOL-BREF). RESULTS: 28.9% of patients had no pain and normal US, 31.6% had pain with normal US, and 39.5% had pain with abnormal US. The US findings for those with pain and abnormal US revealed the following: 53.3% had a supraspinatus tear, 13.3% had biceps tenosynovitis, 13.3% had acromioclavicular arthritis, 13.3% had subdeltoid bursitis, and 53.3% had adhesive capsulitis. Patients with shoulder pain and abnormal US findings had significantly higher mean DASH and pain scores. Pain scores were positively correlated with DASH scores and negatively correlated with QOL. CONCLUSION: We found that BCRL with shoulder pain and evidence of shoulder pathology on US was associated with reduced QOL and increased disability. Proper diagnosis and treatment of shoulder pain are necessary to improve QOL and decrease disability in patients with BCRL.
Adult ; Aged ; Breast Neoplasms/*complications ; Cross-Sectional Studies ; Female ; Humans ; Lymphedema/*complications/ultrasonography ; Middle Aged ; Pilot Projects ; Quality of Life ; Shoulder Pain/*etiology/ultrasonography

OBJECTIVE: To identify the prevalence and risk factors for lower limb lymphedema in the patients after gynecologic neoplasms treatment in Korea. METHODS: We retrospectively reviewed the medical records and interviewed 242 gynecologic neoplasms patients who have managed surgically and medically over a 4 year period between January 2003 and December 2006. We identified the patients with lower limb lymphedema as described by the medical records or reported by the interviews. We obtained demographic characteristics, other medical history, cancer type, stage of cancer, lymph node dissection, chemotherapy, radiotherapy, hormone therapy and laboratory findings. Multiple logistic regression analysis was done to evaluate the risk factors for lower limb lymphedema. RESULTS: Forty eight (19.8%) patients out of two hundred forty two had lower limb lymphedema. Those patients with lower limb lymphedema had a higher body mass index, radiotherapy history, chemotherapy history and lymph node dissection history, radical hysterectomy. Multivariate analysis revealed that body mass index, radiotherapy and lymph node dissection were independently risk factors for lower limb lymphedema after gynecologic neoplasms treatment. CONCLUSION: The patients who had radiotherapy, body mass index greater than 25 or lymph node dissection must be considered as potential candidates to have lower limb lymphedema in the patients after gynecologic neoplasms treatment. Therefore, these patients should be informed during the follow-up period about this morbidity, the preventive measures, and the treatments.
Body Mass Index ; Female ; Follow-Up Studies ; Genital Neoplasms, Female ; Humans ; Hysterectomy ; Korea ; Logistic Models ; Lower Extremity ; Lymph Node Excision ; Lymphedema ; Medical Records ; Multivariate Analysis ; Prevalence ; Retrospective Studies ; Risk Factors