No abstract available.
Fistula*

BACKGROUND: Korea Academy of Family Medicine recommands HBsAb and HBsAb test in youth health promotion program. Adequate management are necessary for prevention of vertical transmission at perinatal period, especially girls' high school students as a future's conceivable woman. Health examination program for the first grade students of high school which was established by the Educational Ministry has been acted since 1998. So, through the students health examination we'd like to find an adequate method of prevention and management in hepatitis B. METHODS: Our study examines HBs Ag/Ab about girls' high school students at two high schools in a city. According to the results of hepatitis B, active intervention in carrier group, passive intervention in candidate were done. And then a year later, hepatitis B management was investigated through the questionnaire. RESULTS: In active intervention group, regular check up of hepatitis B is 21.4%, hepatitis B blood test in family is 39.3% and in passive intervention group, hepatitis B vaccination rate after health examiantion is 9.1%. CONCLUSION: More active intervention such as mass vaccination are required in health examination for the purpose of hepatitis B management at youth.
Adolescent ; Female ; Health Promotion ; Hematologic Tests ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Mass Vaccination ; Vaccination ; Surveys and Questionnaires

BACKGROUND: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. METHODS: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. RESULTS: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. CONCLUSIONS: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.
Acromioclavicular Joint ; Acromion ; Clavicle* ; Dislocations ; Humans ; Joints ; Osteolysis ; Outcome Assessment (Health Care) ; Retrospective Studies ; Shoulder ; Statistics as Topic

PURPOSE: Despite the increased number of patients visiting emergency rooms on weekends, the level of staffing is often lower than it is on weekdays. It is uncertain whether in-hospital mortality rates among patients depend on when they visited the hospital on a weekend or on a weekday. METHODS: We analyzed 21,645 patients who visited our emergency department in 2003. We compared death within 48 hours after a visit to the emergency room between patients who visited on weekends and those with visited on weekdays. The odds of death within 48 hours for patients who visited on a weekend were analyzed by using a multivariate logistic regression. The severity of illness was adjusted by using triage and the Charlson comorbidity score. RESULTS: Compared with patients who visited on weekdays, the number of patients who visited on weekends was increased in 30%. The mortality rates were not statistically different for patients who visited on weekends and patients who visited on weekdays (3.1% vs 2.8%, p=0.399). However, two diagnoses (pneumonia and spontaneous subarachnoid hemorrhage) were associated significantly with a weekend effect. CONCLUSION: Visiting the emergency department on weekends was not associated with a higher mortality than visiting the emergency department on weekdays.
Comorbidity ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Hospital Mortality ; Humans ; Logistic Models ; Mortality ; Prognosis* ; Triage

OBJECTIVE: It is known that normal follicular growth and pregnancy are possible using Follicular stimulating hormon(FSH) alone during controlled ovarian hyperstimulation(COH) for IVF-ET. The purpose of this study was to compare and analize the results of COH for IVF-ET between a group using only FSH-HP and a group using FSH/hMG METHOD: 111 cycle of the total 280 COH for IVF-ET cycles belonged to the FSH-HP group, and the FSH/hMG group accounted for remaining 169 cycles. The amount of gonadotropin administered, the duration of hormonal therapy, the number of embryos transfered, the endometrial thickness, and the pregnancy rate were compared between the two groups and statistically analized using the t-test. p values less than 0.05 deemed statistically significant. RESULT: There were no statistical differences on the amount of gonadotropin administered, the duration of hormone therapy, number of oocytes retrieved, nor the endometrial thickness between the two groups. However,the serum E2 level was significantly lower, and the number of embryos of high quality(GradeIandII) significantly higher in the FSH-HP group. In pregnancy rate, FSH-HP group shows higher than FSH/hMG group(38.8% VS 34.2%). but the difference was not large enough to be considered statistically significant. CONCLUSION: The results of this study show that compared to using FSH/hMG, treatment with FSH-HP alone allowed the retrieval of more embryos of high quality, and although not statistically significant, achieved a higher pregnancy rate, thus indicating that it can be used as an effective method for COH.
Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro* ; Gonadotropins ; Oocytes ; Pregnancy ; Pregnancy Rate

PURPOSE: Paraquat is a deadly chemical which may cause death in 70~90% of patients even after small ingestion. In this study, the authors gathered initial information which could be obtained from paraquat-poisoning patients, and attempted to identify factors which might influence the prognosis, and used those factors in determining the prognosis. METHODS: The authors conducted a retrospective study of 44 patients who had been admitted with paraquat ingestion between January 2000 and December 2001. Based on the initial information obtained in the emergency room, through an analysis of mono-factor studied factors which might influence death, and using the obtained factors, the authors used the discriminant analysis. When new patients occurred, the authors conducted discriminant function found in this study in order to determine prognosis. RESULTS: Among the examinations conducted in the emergency room, potassium, BUN, creatinine, HCO3-, proteinuria, glycosuria, urinalysis of paraquat, glucose, PaCO2, pH, blood-paraquat concentration, and O2 saturation were factors which might affect the prognosis for paraquat poisoning.The discriminant functional equation which utilizes these factors is as follows: Z= -5.885 + 0.560A + 0.481B - 0.980C + 0.036D + 1.648E -0.076F- 0.052G - 0.023H + 0.775I + 0.002J + 0.077K +0.239L(A; urine paraquat, B; serum paraquat, C; potassium, D;PaCO2, E; pH, F; HCO3-, G; O2 Saturation, H; BUN, I; creatinine, J; glucose, K; proteinuria, L; glycosuria) This discriminant function for the actual group was 88.6%, which was a relatively high level of discrimination. CONCLUSION: The hit ratio of the discriminant function obtained through this study was 88.6%, so it should help in categorizing patients early on and in determining their prognosis.
Creatinine ; Discrimination (Psychology) ; Eating ; Emergency Service, Hospital ; Glucose ; Glycosuria ; Humans ; Hydrogen-Ion Concentration ; Mortality* ; Paraquat ; Potassium ; Prognosis* ; Proteinuria ; Retrospective Studies ; Risk Factors* ; Urinalysis

Adult ; Connective Tissue ; Extremities ; Head ; Histiocytoma, Malignant Fibrous ; Humans ; Maxilla ; Neck ; Radiotherapy ; Sarcoma

Giant cell tumor (GCT) of the spine is a rare benign tumor, but can be aggressive and can exhibit a high local recurrence rate. Furthermore, GCT of the upper thoracic spine may pose diagnostic and management difficulties. Here, we report a rare case of GCT of the upper thoracic spine with soft tissue extension to the spinal canal. The patient was managed by decompressive laminectomy and posterolateral fusion followed by an injection of polymethylmethacrylate into the vertebral lesion. The patient recovered clinically and showed radiological improvement after surgical treatment without tumor recurrence at his last follow-up of postoperative 7 years. We present this unusual case of GCT and include a review of the literature.
Follow-Up Studies ; Giant Cell Tumors* ; Humans ; Laminectomy ; Polymethyl Methacrylate ; Recurrence ; Spinal Canal ; Spine*

OBJECTIVE: The purpose of this study was to evaluate the clinical presentation and surgical outcome in patients with symptomatic discal cyst. METHODS: The authors reviewed consequent 9 patients in whom microscopic excision of the discal cyst with or without additional discectomy for discal cyst from 2005 to 2012. Diagnostic imagings including simple radiographs, computed tomography with discogram and magnetic resonance images were performed in each case. The patients were reviewed to evaluate the clinical presentation, surgical outcome and related complications. RESULTS: In all patients, discal cyst was located in the lumbar region and they presented with back pain and unilateral radiating pain. The preoperative magnetic resonance images (MRI) and computed tomography (CT) scan with discogram showed a connection between the cyst and the involved intervertebral disc. All patients obtained immediate relief of symptoms after microscopic excision of discal cyst. There were no recurrent lesions during follow-up period. The mean preoperative visual analogue scale (VAS) was 7.8 when compared with 2.6 in preoperative assessment. All patients obtained excellent or good outcome according to modified MacNab's criteria. CONCLUSION: Discal cysts are rare lesions that can lead to back pain and refractory sciatica. Microscopic excision of the cyst can achieve remarkable improvement of symptoms.
Back Pain ; Dental Cements ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Lumbosacral Region ; Magnetic Resonance Spectroscopy ; Sciatica

Pancreatic cancer is well known as a relentlessly progressive and fatal disease. Although distant metastasis is common at the time of diagnosis, brain metastasis originating from pancreatic cancer is rare and its clinical manifestation remains poorly described. Additionally, it is generally known that the prognosis for patients with pancreatic cancer and brain metastasis is very poor. Surgical resection of brain metastasis may play a limited role or may allow long-term survival in patients for whom the primary pancreatic cancer is well controlled. We present a case of brain metastasis in patient with pancreatic cancer after pylorus-preserving pancreaticoduodenectomy and complete response to chemotherapy for hepatic metastases. Brain metastasis was resected successfully, but survival period was relatively short, even though the patient received curative treatment for pancreatic cancer. This case demonstrated that resection of brain metastatic lesion from pancreatic cancer being controlled may be helpful, but the timing of resection is also important.
Brain* ; Diagnosis ; Drug Therapy ; Humans ; Neoplasm Metastasis* ; Pancreas ; Pancreatic Neoplasms* ; Pancreaticoduodenectomy ; Prognosis