No abstract available.
Pregnancy*

No abstract available.
Female* ; Humans

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: Senior medical students agreed to undergo gastrofibroscopy testing in the same manner as patients would in order to assess if the experience affects their understanding of patients' discomfort and their recommendation of this test. METHODS: 27 senior medical students rotating through family medicine underwent gastrofiberscopy. The level of discomfort experienced by these students was evaluated by using the Visual Analogue Scale(VAS). Each student's recommendation of gastrofibroscopy or upper gastrointestinal series to asymptomatic and symptomatic adults with upper GI complaint was recorded. And we assessed the need of patient experience for recommendation of gastrofibroscopy. RESULTS: Before having experienced a gastrofibroscopy, 21 students recommended gastrofibroscopy (21 cases, 77.8%) and 6 recommended upper gastrointestinal series(6 cases, 22.2%) as screening tests in asymptomatic adults. After having had a gastrofibroscopy, gastrofibroscopy was recommended in 16 cases(59.3%) and the upper gastrointestinal series in 11(40.7%), again in asymptomatic adults. However in symptomatic adults, there was no change. The degree of discomfort after having had a gastroscopy was less than they thought(5 cases, 18.5%), the same (5 cases, 18.5%), and more than they thought(17 cases, 63.0%), 25(92.5%) students thought experiencing gastrofibroscopy would help them explain the procedure to patients in the future. 26(96.3%) students expressed that doctors who recommend gastrofibroscopies should experience having the test so that they can better empatize and understand patients' discomfort. CONCLUSION: Senior medical students' experience being a patient is a significant learning opportunity for understanding the patient discomfort. This experience will help doctors understand patient's discomfort.
Adult ; Gastroscopy ; Humans ; Learning ; Mass Screening ; Students, Medical

A 72-year-old woman presented with generalized edema and proteinuria. Renal biopsy disclosed highly organized fibrillary deposits in subendothelial area by electron microscopy. The microfibrils were 14 nm in diameter and randomly arranged. They did not have a microtubular appearance. These materials were negative for Congo red staining. Cryoglobulinemia or paraproteinemia including light chains was not found. So we can diagnose her as fibrillary glomerulonephritis (GN). In fibrillary GN serum complement levels are usually normal except in rare cases with systemic disease. Here we present a rare case of fibrillary GN with unusual hypocomplementemia.
Aged ; Biopsy ; Complement C3 ; Complement System Proteins ; Congo Red ; Cryoglobulinemia ; Edema ; Female ; Glomerulonephritis ; Humans ; Light ; Microfibrils ; Microscopy, Electron ; Paraproteinemias ; Proteinuria

BACKGROUND: Pleural effusion is one of most common clinical mainifestations associated with a variety of pulmonary disease such as malignancy, tuberculosis, and pneumonia. However, there are no useful laboratory tests to determine the specific cause of pleural effusion. Therefore, an attempt was made to analyze the various types of pleural effusion and search for useful laboratory tests for pleural effusion in order to differentiate between the disease, especially between a malignant pleural effusion and a non-malignant pleural effusion. METHODS: 93 patients with a pleural effusion, who visited the Severance hospital from January 1998 to August 1999, were enrolled in this study. Ultrasound-guided thoracentesis was done and a confirmational diagnosis was made by a gram stain, bacterial culture, Ziehl-Neelsen stain, a mycobacterial culture, a pleural biopsy and cytology. RESULTS: The male to female ratio was 56:37 and the average age was 47.1±21.8 years. There were 16 cases with a malignant effusion, 12 cases with a para-malignant effusion, 36 cases with tuberculosis, 22 cases with a para-pneumonic effusion, and 7 cases with transudate. The LDH2 fraction was significantly higher in the para-malignant effusion group compared to the para-pneumonic effusion group [30.6±64.% and 20.2±7.5%, respectively (p<0.05)] and both the LDH and LDH2 fraction was significantly in the para-malignant effusion group compared to those with tuberculosis [16.4±7.2% vs. 7.6±4.7%, and 30.6±6.4% vs. 17.6±6.3% respectively (p<0.05)]. The pleural effusion/serum LDH4 fraction ratio was significantly lower in the malignant effusion group compared to those with tuberculosis [1.5±0.8 vs. 2.1±0.6, respectively (p<0.05)]. The LDH4 fraction and the pleural effusion/serum LDH4 fraction ratio was significantly lower in the para-malignant effusion group compared to those with tuberculosis [17.0±5.8% vs. 23.5±4.6% and 1.3±0.4 vs. 2.1±0.6, respectively(p<0.05)]. CONCLUSION: These results suggest that the LDH isoenzyme was the only useful biochemical test for a differential diagnosis of the various disease. In particular, the most useful test was the pleural effusion/serum LDH4 fraction ratio to distinguish between a para-malignant effusion and a tuberculous effusion.
Biopsy ; Diagnosis ; Diagnosis, Differential* ; Exudates and Transudates ; Female ; Humans ; Lung Diseases ; Male ; Pleural Effusion* ; Pleural Effusion, Malignant ; Pneumonia ; Tuberculosis

The criteria for the evaluation of spinal impairment are diverse, complex, and have no standardized form. This makes it difficult and somewhat troublesome to accurately evaluate spinal impairment patients. A standardized guideline was studied for the evaluation of spinal impairment, based on the American Medical Association (AMA) Guides and the McBride method. This guideline proposal was developed by specialty medical societies under the Korean Academy of Medical Sciences. In this study, the grades of impairment were assessed by dividing patients into three different categories: spinal cord impairment, spinal injury impairment and spinal disorder impairment. The affected regions of the spine are divided into three: the cervical region, the thoracic region, and the lumbosacral region. The grade of impairment was differentially evaluated according to the affected region. The restricted range of motion was excluded in the evaluation spinal impairment because of low objectivity. Even though the new Korean guideline for the evaluation of spinal impairment has been proposed, it should be continuously supplemented and revised.
*Disability Evaluation ; Humans ; Korea ; Program Development ; Severity of Illness Index ; Spinal Cord Injuries/classification/diagnosis ; Spinal Diseases/classification/*diagnosis