No abstract available.
Humans ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder*

No abstract available.
Iontophoresis* ; Musculoskeletal Diseases*

In contrast to the nodular renal blastema which is defined by nests of primitive metanephric cells after 36 weeks of gestation, the nephroblastomatosis is characterized by neoplastic proliferation of the primitive cells. This lesion is presumed to be closely related to the development of Wilms' tumor. We report a case of bilateral nephroblastomatosis associated with Wilms' tumor in a child. This 4 1/2 year-old girl was admitted because of a 10 cm-sized round mass in the right kidney, and smaller nodules in the left kidney and the lung. After three cycles of chemotherapy and subsequent disappearance of the nodules in the left kidney and lung, she underwent a right nephrectomy and a wedge resection of the left kidney. A round Wilms' tumor mass was seen in the lower pole of the right kidney. Remaining right renal cortex showed multiple, slightly depressed gray-white nodules associated with multiple samll cysts. They were comprised of multifocal subcapsular nests of primitive nephrogenic cells with focal tubular or glomerular differentiation. They resembled fetal renal tissue. In the left kidney, similar nests of primitive cells were also noted. These lesions were interpreted as multifocal perilobar type of nephroblastomatosis.
Child ; Male ; Female ; Humans

No abstract available.
Animals ; Gene Expression* ; Hypothalamus* ; Immunohistochemistry* ; In Situ Hybridization* ; Rats* ; Vasopressins*

No abstract available.
Umbilical Cord*

BACKGROUND: This study aims at making a survey on health care service providers' cultural competence and making an appraisal of Chinese medical tourists on service quality, health care service providers' cultural competence, perceived value, and satisfaction. METHODS: The data was collected from August until November, 2014 and 150 health care service providers and 65 Chinese medical tourists from 12 medical institutions in Daegu were enrolled in analysis. RESULTS: The results showed that health care service provider's knowledge on Chinese culture was very low with 33.5% of correct answer. Health care service providers were found to get 3.82 point on a 5 point-scale in cultural perception, 3.53 points in cultural sensitivity, and 2.85 points in cultural skills. Chinese medical tourists were analyzed to give 4.08 points on a 5-point scale to satisfaction on health care service, followed by 4.01 points to health care service quality, 4.00 points to perceived value of health care service, and last 3.85 points to a health care service providers' cultural skills. However, there was a difference in points in cultural skills between health care service providers and Chinese medical tourists. Chinese medical tourists' satisfaction with health care service in Daegu was found to be comparatively high, but in relation to satisfaction with communication, it was found to be relatively low. CONCLUSION: Through this research, health care service providers' knowledge level of Chinese culture and cultural skills were low while they seemed to take a half-hearted attitude towards educational experience for building up cultural competence and foreign patient service response.
Asian Continental Ancestry Group* ; Cultural Competency* ; Daegu* ; Delivery of Health Care* ; Health Personnel* ; Health Services Research ; Humans

We report two very rare cases of postoperative acute spinal subdural hematoma (ASSH) and review the literature. ASSH is usually related to trauma or a previous lumbar puncture, and a review of the literature revealed only a few cases of spinal subdural hematomas occurring secondary to an underlying hematological disorder or to an iatrogenic coagulopathy. However, there have been no reports about the occurrence of ASSH as a complication of uneventful spinal surgery. The authors present two cases of postoperative ASSHs after open lumbar microdiscectomy (OLM) and underline the pitfalls in their diagnosis and treatment modalities. Two patients were treated with surgery, which progressed without sequelae, and their preoperative symptoms were resolved. Postoperative ASSH is an extremely rare complication, but precautions for meticulous hemostasis and careful awareness for minimal manipulation of the dura during lumbar surgery should be considered in all patients, even those who do not require multilevel decompressions and/or who have a preoperative coagulopathy.
Diskectomy ; Hematoma ; Hematoma, Subdural, Spinal ; Hemostasis ; Humans ; Postoperative Complications ; Spinal Puncture

BACKGROUND: A small change in venous capacitance significantly alters venous return and thus cardiac output. It is therefore important to know the effects of intravenous anesthetics on venous capacitance, particularly in a hypovolemic state. As ketamine does not suppress sympathetic activity, it has been suggested that ketamine may be the drug of choice for anesthesia during hypovolemia. The purpose of this study was to examine the effects of ketamine or sodium thiopental on venous capacitance and total vascular compliance in dogs. METHODS: Twenty mongrel dogs, weighing 10~15 Kg, were divided into two group (ketamine group: 10, sodium thiopental group: 10) of 10 each. Venous capacitance was assessed before and after drug (ketamine 1 mg/kg or sodium thiopental 5 mg/kg) injection by measuring mean circulatory filling pressure (MCFP) in the normovolemia and hypovolemia. MCFP was measured after arresting the circulation by tightening of superior vena cava and inferior vena cava snares simultaneously. RESULTS: As compared with MCFP in the normovolemia and hypovolemia, MCFP was significantly increased by ketamine in the normovolemia and hypovolemia. As compared with MCFP in the hypovolemia, MCFP was significantly decreased by sodium thiopental in the hypovolemia. The slope of the regression line relating MCFP and blood volume was not significantly altered by ketamine or sodium thiopental, which suggests that ketamine or sodium thiopental did not alter total vascular compliance. CONCLUSIONS: These results suggest that ketamine decreases venous capacitance in the normovolemia and hypovolemia but sodium thiopental increases venous capacitance in the hypovolemia.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Blood Volume ; Cardiac Output ; Compliance ; Dogs* ; Hypovolemia ; Ketamine* ; SNARE Proteins ; Sodium* ; Thiopental* ; Vena Cava, Inferior ; Vena Cava, Superior

PURPOSE: To ascertain the factors associated with the proportion of death certificate only (DCO) cases contained in the Kwangju Cancer Registry (KCR) that are not as yet in the good range. MATERIALS AND METHODS: The distribution of DCO cases was analyzed by sex, age, cancer site, histological verification (HV) as well as the physician's death certificate status. RESULTS: All cases (n=4,243) in Kwangju diagnosed as having cancer between 1997 and 1998 were registered with the KCR. Death certificates (n=2,390) reporting cancer as the causes of death were collected from the National Statistics Office and reviewed with hospital data linkage and a total of 590 cases were registered as DCO. DCOs accounted for 12.2% (male 12.8%, female 11.5%) of all registrations in Kwangju, 1997~1998. The proportion of DCO cases was high in subjects under 15 (male13.5%,female 9.4%) as well as those 75 and over (male 20.3%, female 27.2%). For cancer sites, the proportion of DCO cases was high (over 10%) for liver, bronchus-lung, esophagus and pancreas and low (under 3%) for skin, bladder, uteri cervix and breast. The proportion of DCO cases was inversely associated with HV%. When the death certificate was issued by physician, the possibility of DCO decreased. CONCLUSION: The proportion of DCO is positively associated with increasing age and negatively associated with HV% and the issuance of a physician's death certificate. These findings suggest that further socio-cultural efforts are required to reduce the DCO proportion.
Breast ; Cause of Death ; Cervix Uteri ; Information Storage and Retrieval ; Death Certificates* ; Esophagus ; Female ; Gwangju* ; Humans ; Korea ; Liver ; Pancreas ; Skin ; Urinary Bladder ; Uterus

PURPOSE: Reversible posterior leukoencephalopathy syndrome(RPLS) is a complex condition affecting gray/white matter of parieto-occipital lobes from multiple and different etiologies. This study was aimed to analyze clinical characteristics of this condition in Korean children. METHODS: A total of 36 patients from tertiary care medical centers were involved in the study. They were diagnosed as RPLS mainly by clinical and radiological manifestations. Their medical records and radiological features of brain MRI were retrospectively analyzed. RESULTS: Thirty six patients were involved in the study(21 males and 15 females, mean age: 9.8+/-4.1 years of age). Main underlying causes included drug induced(47%), renal diseases(28%), neurogenic tumors(8%) and so on. Initial manifestations were seizures, headache, visual disturbance, mental change, and nausea/vomiting. 13 patients(36%) had two or more symptoms. The brain MRI showed typical pattern of fairly symmetric, high T2 signal intensity in both parieto-occipital regions in 23 patients(64%) and various, atypical pattern in 13 patients(36%). 26 patients had the lesions affecting predominantly white matter, but 10 patients had the lesions affecting predominantly gray matter. 34 patients(94 %) had bilateral lesions, but 2 patients(6%) had unilateral lesion. This complex syndrome was associated with acute rise of blood pressure from a variety of conditions. A patient ended up a visual deficit despite the good prognosis. CONCLUSION: RPLS in Korean children seems to be complex, but a better understanding of this complex syndrome will lead to better clinical outcome by avoiding unnecessary investigations and appropriate management.
Blood Pressure ; Brain ; Child ; Female ; Headache ; Humans ; Leukoencephalopathies ; Male ; Medical Records ; Posterior Leukoencephalopathy Syndrome ; Retrospective Studies ; Seizures ; Tertiary Healthcare