TO evaluate the histopathologic features of gastric mucosa by Helicobacter pylori (HP), we reviewed 70 endoscopically biopsied chronic gastritis and peptic ulcer. The results are as fonows. l. HP was detected in 923% (48/52) of active gastritis, 8l8% (9/l l) of peptic ulcer and l43% (1/7) of chronic gastritis. The prevalence of HP infection was significantly higher in active gastritis and peptic ulcer than chronic gastritis (P<0005). 2. The infiltration of intraepithelial neutrophil of the 58 HP-positive cases was significantly more than of the l2 HP-negative cases (P<0005). 3. The infiltration of neutrophil and chronic inflammatory cells in the lamina propria of the 58 HP positive cases were significantly more than of 12 HP-negative cases (P<0.005, P<0.01) 4. The gastric epithelium of 58 HP positive case showed characteristic degenerative change, such as epithelial pits (93.l%), irregular surface (84.4%), individua1 cell drop-out (46.5%) and microerosion (27.6%). The similiar changes were not seen in l2 HP-negative cases. In summary, HP is significantly correlated with inflammatory reaction of the gastric mucosa. It is also significantly correlated with the epithelial degenerative changes that is considered to the precursor of peptic ulcer.

No abstract available.
Free Tissue Flaps* ; Head* ; Neck*

No abstract available.
Free Tissue Flaps* ; Mouth* ; Oropharynx* ; Rectus Abdominis*

BACKGROUND: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. METHODS: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. RESULTS: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. CONCLUSION: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.
Busan ; Coronary Artery Bypass ; Daegu ; Health Facilities ; Hospitals, University ; Humans ; Korea* ; National Health Programs ; Seoul ; Statistics as Topic ; Thoracic Surgery*

Obesity-Hypoventilation syndrome (OHS) is characterized by morbid obesity, hypoxia, and hypercapnea during wakefulness without parechymal lung disease or severe obstructive sleep apnea. A woman was admitted because of mental deterioration and diagnosed as OHS on the basis of obesity and hypoventilation, while awake, after ruling out other causes. By bilevel positive airway pressure (BiPAP) therapy, hypercapnea and hypoxia were resolved. We report that BiPAP can be an effective treatment for severe hypercapnea and hypoxia in OHS, which obviate the need for invasive endotracheal intubation.
Anoxia ; Female ; Humans ; Hypoventilation ; Intubation, Intratracheal ; Lung Diseases ; Obesity ; Obesity Hypoventilation Syndrome* ; Obesity, Morbid ; Sleep Apnea, Obstructive ; Wakefulness

BACKGROUND: This study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions. METHODS: To develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts. RESULTS: After partitioning the plan into two parts (the operational autonomy and the functional comprehensiveness), three models were developed: the ‘independent regional cardiac surgery center’ model, the ‘satellite cardiac surgery center within hospitals’ model, and the ‘extended cardiac surgery department within hospitals’ model. Proposals on personnel and facility management for each of the models were also presented. A regional cardiac surgery center model that could be applied to each treatment area was proposed, which was developed based on the anticipated demand for cardiac surgery. The independent model or the satellite model was proposed for Chungcheong, Jeolla, North Gyeongsang, and South Gyeongsang area, where more than 500 cardiac surgeries are performed annually. The extended model was proposed as most effective for the Gangwon and Jeju area, where more than 200 cardiac surgeries are performed annually. CONCLUSION: The operation of regional cardiac surgery centers with high caliber professionals and quality resources such as optimal equipment and facility size, should enhance regional healthcare accessibility and the quality of cardiac surgery in South Korea.
Delivery of Health Care ; Education ; Gangwon-do ; Health Facilities ; Health Services Accessibility ; Humans ; Korea ; Quality of Health Care ; Thoracic Surgery*