No abstract available.

461 cases of renal biopsy specimens were summerized correlated with their light microscopic and immunofluorescence findings, which obtained from Jan. 1981 to Jul. 1986 at Department of Pathology, Kyung Hee School of Medicine, The results were as follws: 1) The incidence of IgM nephropathy was about 5.8% of the primary glomerulopathy. 2) Sex distribution showed male preponderance with male: female ratio of 1.7:1. 3) Age distribution were 0-9 years 7.4%, 10-19 years 29.6%, 20-29 years 37.0%, 30-39 years 7.4%, 40-49 years 7.4% and 50-59 years 11.1%. 4) The clinical symptoms were gross hematuria 7.4%, microscopic hematuria 59.2%, proteinuria (nonnephrotic) 37.0%, nephrotic syndrome 55.5%, hypertension 7.8% and edema 59.2%. 5) 9 cases (33.3%) had past histories of upper respiratory infections. 6) The distributions of the light microscopic deagnosis were minimal histologic change 11 cases (40.7%), focal glomerulonephritis 7 cases (25.9%), measangial proliferative glomerulonephritis 5 cases (18.5%), focal and segmental glomerulosclerosis 1 case (3.7%) and poststreptococla glomerulonephritis 1 case (3.7%). 7) Immunofluorescence study showed significant diffuse mesangial granular deposits of IgM and C3 in all of the 27 cases. 8) It was demonstrated that in the patients with nephrotic syndrome, the prognosis for the patients with IgM deposition were less favorable than those without IgM deposition.
Female ; Male ; Humans ; Incidence ; Biopsy

No abstract available.
Information Management* ; Occupational Health*

OBJECTIVE: The clinical features and prognosis of intraductal papillary mucinous tumor (IPMT) of the pancreas are diverse. We reviewed the clinicopathologic features and surgical results of patients who were treated for IMPT. METHODS: WE retrospectively reviewed seven cases that were surgically resected and pathologically diagnosed. RESULTS: The mean patient age was 63.7 years and there were 6 (85.7%) symptomatic patients. The diagnostic accuracy of abdominal CT was 57.1% (n=4) and the was 71.4% (n=5). (Ed note: the last part made no sense. Put in the correct terms.) The final diagnosis was benign IPMT in 4 cases (57.1%), malignancy in 3 cases (42.9%, and borderline malignancy, carcinoma in situ and invasive carcinoma in one case each, respectively). Three cases each of pylorus preserving panreaticoduodectomy (42.9%) and distal pancreatectomy were performed (42.(%), respectively, and 1 pancreatic wedge resection (14.3%) was performed for 1 case. Three patients (42.9%) were found to have associated malignancies. The median follow-up duration was 10 months (range: 3-25). Four patients are still alive and 3 patients have died, but only one patient died of systemic metastasis. CONCLUSION: The clinicopathological features, treatment, and prognosis of IPMT are still unclear, but the significant possibility of malignancy and associated malignancies should always kept in mind and further study is required
Carcinoma in Situ ; Diagnosis ; Follow-Up Studies ; Humans ; Mucins* ; Neoplasm Metastasis ; Pancreas* ; Pancreatectomy ; Pancreatic Neoplasms ; Prognosis ; Pylorus ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: The expansion and strengthening of primary care is approved as the only method to revise the ineffective health care system in Korea. In such a system, we intended to analyze the functional and regianal distribution of specialists by investigating and classifying the hospitals where residents who completed their training in a university hospital located in Seoul for seven years are working and by acquiring the distribution of the subjects who are practicing as primary care physicians by year, specialties and location. METHODS: We selected 384 specialists, all of whom were trained as residents at a university hospital located in Seoul from 1987 to 1993. The hospitals they worked at were classified as primary, secondary and tertiary care hospitals according to the classification in the health care administration. The location of primary care hcspitals among them was plotted an two maps; one of Seoul, the other of Korea. RESULTS: The number of females in the subjects was 68(17.7%) and that of males 316(82.3%). The number of practitianers was 156(40.6%) and that of specialists working at the secondary care hospitals was 55(14.3%), and 147 specialists were working at the tertiary care hospitals(38.3%). With regard to the pereentage of practitioners, dermatologic specialists presented with 60%, and relatively high group included obstetrics and gynecology(59.2%), family medicine(54.5%), plastic surgery(52.6%), otolaryngology (52.0%), pediatrics(51.7%), and orthopedics(48.6%).In tertiary care hospital, chest surgery showed 72.7% as highest. Radiologic ancology presented with 66.7% and anatamical pathology with 66.7%. As to the location of primary care hospitals, 41.0% were in Seoul and 38.5% in Kyungkido. And the rest of the 20. 5% were located in other areas of Korea. CONCLUSIONS: Considering the results of the study that show a great number of specialists are actually practicing as primary care physicians after their specialists training, the present training system of specialists needs to be revised and cantrolled in structure.
Classification ; Delivery of Health Care ; Female ; Gyeonggi-do ; Humans ; Korea ; Male ; Obstetrics ; Otolaryngology ; Pathology ; Physicians, Primary Care ; Primary Health Care ; Secondary Care ; Seoul ; Specialization ; Tertiary Healthcare ; Thorax

Iodine in physiological dosage is necessary for thyroid hormone. But insufficient or excessive intake of iodine could affect on thyroid function. However, little study is available on the current iodine state in Korea. To evaluate the current state of iodine intake and its effects on thyroid function, we measured the iodine intake, urinary excretion and thyroid status in 67 normal controls and 110 patients with thyroid disease from June 1991 to August 1993.The result were as follows; 1) There were no differences in the physical and daily intake of calorie between controls and patients with thyroid disease. 2) The mean daily intake of iodine was 391.4 ug in normal controls, 695.0 ug in patients with simple goiter, 672.0 ug in hypothyroidism, 453.5 ug in hyperthyroidism, and 297.4 ug in thyroid nodule. 3) The mean urinary iodine excretion was 640 ug/L in normal controls, 875 ug/L in patients with hyperthyroidism, 612 ug/L in thyroid nodule, 563 ug/L in hypothyroidism, and 549 ug/L in simple goiter. 4) There was decreasing tendency of the serum T_3, t_4 and significant increase in TSH concentration in subjects who ingest the dietary iodine above 1000 ug/day compared with the subjects who ingest below 150 ug/day(p<0.05). 5) Subjects who live in coastal area had much intake of iodine(1.8-2.5 times)than those of subjects live in inland area.In conculsion, Korean ingested more iodine than Europian and American but fewer than Japanese. Some of the patients with simple goiter and hypothyroidism patients may associated with excessive ingestion of iodine, but further systemized study will be required.
Asian Continental Ancestry Group ; Eating ; Goiter ; Humans ; Hyperthyroidism ; Hypothyroidism ; Iodine ; Korea ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule

Melanosis ilei is an extremely rare condition in which black pigment, consisted of aluminum, magnesium, or silicon, accumulate in the terminal ileal mucosa. Medical treatment with charcoal enhances the neutralization of the toxic material and elimination of many drugs. In addition, it has been used as a traditional remedy in some oriental countries to relieve chronic diarrhea, abdominal pain, or acute enterocolitis, which is made up carbon, oxygen, aluminum, magnesium, silicon, calcium, and palladium. Two patients taking the charcoal for a long time underwent a colonoscopy to evaluate chronic diarrhea or abdominal pain. The colonoscopy revealed a normal colonic mucosa and multiple geographic black-pigmented mucosal changes at the terminal ileum. Therefore, it was assumed that melanosis ilei can develop in patients with long-standing charcoal ingestion. To the best of our knowledge, this is the first case of melanosis ilei associated with the ingestion of charcoal.
Abdominal Pain ; Aluminum ; Calcium ; Carbon ; Charcoal ; Colon ; Colonoscopy ; Diarrhea ; Eating ; Enterocolitis ; Humans ; Ileum ; Magnesium ; Melanosis ; Mucous Membrane ; Oxygen ; Palladium

A gastrocolic fistula is a fistulous communication between a segment of colon and the stomach. It is a rare complication and is caused most commonly by a carcinoma of the colon or the stomach. Among the less common causes of a gastrocolic fistula are a benign gastric ulcer, chronic ulcerative colitis, Crohn's disease, a carcinoid tumor, syphillis, an intraabdominal abscess, a lymphoma, trauma, intestinal tuberculosis, and iatrogenic factors. Recently, the incidence of gastrocolic fistulas has decreased due to earlier diagnosis and treatment of stomach and colon cancer. The classic triad of symptoms are lienteric diarrhea, feculent vomiting, and foul eructations, but all patients do not necessarily present with these symptoms. A gastrocolic fistula is usually diagnosed by using a barium enema, but occasionally can be detected by using an upper gastrointestinal series or endoscopy. Here, we report experience with a fistula between a cancerous transverse colon and the stomach and give a review of the literature.
Abscess ; Barium ; Carcinoid Tumor ; Colitis, Ulcerative ; Colon* ; Colon, Transverse ; Colonic Neoplasms* ; Crohn Disease ; Diagnosis ; Diarrhea ; Endoscopy ; Enema ; Eructation ; Fistula* ; Humans ; Incidence ; Lymphoma ; Stomach ; Stomach Ulcer ; Tuberculosis ; Vomiting

This case presents a 34-year-old man who had a huge parasagittal meningioma. Initial treatment consisted of preoperative external carotid artery embolization and partial tumor resection. During the resection, we found that the tumor invaded the adjacent calvarium, and due to massive hemorrhage, total removal of the tumor was impossible. The patient was treated with intraoperative radiation therapy (IORT) (25 Gy via 16 MeV) as an adjunctive therapy. Eight months after IORT, we were able to remove the tumor completely without surgical difficulties. IORT can be considered an useful adjunctive therapy for the superficially located, huge, and highly vascular meningioma.
Adult ; Journal Article ; Human ; Intraoperative Care* ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms/surgery ; Meningeal Neoplasms/radiotherapy* ; Meningeal Neoplasms/pathology ; Meningioma/surgery ; Meningioma/radiotherapy* ; Meningioma/pathology ; Vascular Neoplasms/surgery ; Vascular Neoplasms/radiotherapy* ; Vascular Neoplasms/pathology

BACKGROUND: Laparoscopic cholecystectomy (LC) has become the treatment of choice for patients with symptomatic gallbladder (GB) stones. About 10% of patients with symptomatic GB stones may have common duct (CD) stones at the same time. For patients with symptomatic GB stones and suspected CD stones, an endoscopic retrograde cholangiopancreaticography (ERCP) should be performed. The preferred approach to these patients is an ERCP, an endoscopic sphincterotomy (EST), and removal of the CD stones, followed by a LC. The aims of this study were to test the safety and to evaluate the efficacy of the endoscopic and laparoscopic procedure in patients with symptomatic GB stones associated with CD stones. MATERIAL AND METHODS: A retrospective review was conducted on 522 patients who had been treated surgically for GB stones with or without CD stones between Jul. 1994 and Jun 1997. Among them, an ERCP followed by a LC was performed in 57 (67.1%) of the 85 patients who had CD stones, a LC in 377, an open cholecystectomy in 60, and an open cholecystectomy and CD exploration in 28. RESULTS: There were significant differences in operation times, hospital stays, and postoperative complications between the group with an EST followed by a LC and the group with an open cholecystectomy and CD exploration, but no significant differences between the LC group and the group with an EST followed by a LC. CONCLUSIONS: An EST followed by a LC is a good and safe treatment mordality for patients with symptomatic GB stones associated with CD stones.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Choledocholithiasis* ; Gallbladder ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Sphincterotomy, Endoscopic*