The number of Internet users is rapidly increasing in Korea. Because of the busy modern life style, demands for the convenient medical services using the Internet are also increased. There are about 10,000 medical Internet sites in Korea. However, several surveys on the Internet medical information in Korea have shown disapointing results. As in other nations medical information is often inappropriate for the questions and some might be even harmful. Somewhat insufficient role of the Internet medical consultation do not satisfy the people' needs. There are eseveral movements for the improving medical Internet information system in Korea but are still at the beginning state. By using the Internet technology, telemedicne for the remote area, for the dementia patients, for the emergency care, and for the elderaly have been tried in Korea. But legal problems, insufficient evidence for its efficiency, and several other drawback make telemedicine be still remaining at the experimental state. However, increasing demands for the better medical services, developing inforamtion technology, expanding high-velocity network system, and fucure capacity mobile communication systems will obviate these problems in the near future.
Dementia ; Emergency Medical Services ; Humans ; Information Systems ; Internet* ; Korea ; Life Style ; Telemedicine*

Endoscopic variceal band ligation requires the incertion of over tube. Since adopting EVL, we encountered pharyngeal trauma and complaints of severe pain during over tube insertion. So We compared the safety and efficacy of EVL according to the method of scope insertion, as over tube and free hand method. We studied 49 patients who require EVL due to grade 3 esophageal varices. The group l consist of 26 patients who undergone EVL without over tube and group 2 consist of 23 patients who undergone EVL with over tube. There were no differences in basal arterial oxygen saturation by pulse oxymeter, basal heart rate and EKG by EKG monitor, hemoglobin concentration, and Child class between 2 groups. The changes of arterial oxygen saturation and EKG were not different between 2 groups during EVL. And the symptom score and speed of single band ligation were similar in over tube and free hand method of EVL. The complication induced by scope insertion methods is minor pharyngeal trauma only in over tube group. We suggest that over tube method of EVL can be replaced by free hand method in patients who complain of severe pain during over tube insertion, and with anatomical abnormality of oropharynx and urgent cases in which require good vision.
Child ; Electrocardiography ; Esophageal and Gastric Varices ; Hand ; Heart Rate ; Humans ; Ligation* ; Oropharynx ; Oxygen

No abstract available.
Child* ; Humans

High dose intravenous gammaglobuline (IVLG) therapy is effective in some of the autoimmune diseases. Although the exact mechanism of action of IVIG is uncertain, the action as a neutralizing antibody against unknown etiologic agents, the action of blocking of Fc receptors of effector cells, or the action as a antiidiotypic antibody are suggested. We report a case of 12 year old girl with systemic juvenile rheumatoid arthritis who was treated with high dose IVIG and got a remission. In August 1990 she was admitted to our hospital. because of intermittent fever, transient rash and multiple arthralgia. Under the diagnosis of systemic juvenile rheumatoid arthritis, aspirin (4.0g/day) had been given with symptom improvement. She was readmitted in October 1990 because of aspirin intoxication and acute fulminant hepatitis. She was discharged after recovery and any medicine was not prescribed. In November 1990 she was admitted because of epigastric pain, vomiting, intermittent fever, multiple arthritis, and mild hepatomegaly. Total parenteral alimentation had been given under the diagnosis of superior mesenteric artery syndrome and gold sodium thiomalate (Myochrysine, 5 and 10 mg, two weekly IM injection) was given in conjunction with prednisolone (30 mg/day) and naproxen (375 mg/day). She was admitted again in February 1991 due to the fever, coughing, rash, and hepatosplenomegaly. Pneumonia and leukopenia (2100/mm(3)) were found and gold sodium thiomalate injection was discontinued. Gammaglobulin 1 g/kg/day was given intravenously for 2 consecutive days with dramatic symptom improvement. Five more monthly IV gammaglobulin had been given and the side reaction of injection were nausia, fever, and headache which were controlled by the decrease of infusion rate. Four months after the last IVIG injection she had no symtom of arthritis and the hepatosplenomegaly was decreased. Hemoglobin level was increase to 12.2 mg/dL form 6.2mg/dL and ESR was decrease to 15mm/h. The oral prednisolne and ibuprofen were stopped one year after th last IVIG injection. All the laboratory parameters of arthritis and physical examinations had been normal for more than two year after the stop of all the medications until March of 1994. We suggest that high dose intravenous gammaglobulin can be one of treatments for severe systemic juvenile rheumatoid arthritis.
Antibodies, Neutralizing ; Arthralgia ; Arthritis ; Arthritis, Juvenile ; Aspirin ; Autoimmune Diseases ; Child ; Cough ; Diagnosis ; Exanthema ; Female ; Fever ; Gold Sodium Thiomalate ; Headache ; Hepatitis ; Hepatomegaly ; Humans ; Ibuprofen ; Immunoglobulins, Intravenous ; Leukopenia ; Naproxen ; Physical Examination ; Pneumonia ; Prednisolone ; Receptors, Fc ; Superior Mesenteric Artery Syndrome ; Vomiting

Sweets syndrome has 4 cardinal features, that is, fever, neutrophil polymorphonuclear leukocytosis of the blood, raised painful plaques on the limbs, face and neck, histologically a dense dermal infiltration with mature neutrophil polymorphs. Hematologic malignancies are associated with 10-15% of cases, but gastric adenocarcinoma associated case is very rare. A 57-year-old male patient admitted to Korea University affiliated hospital because of fever and painful erythematous plaques of both limbs. No response to antibiotics and antihistamines for 1 week, so we referred to dermatologic department for skin biopsy. After then under the impression of Sweet's syndrome, oral prednisolone 60 mg/day prescribed and skin lesions were progressively regressed. For the purpose of screening of associated disease, we did abdominal CT scan and panendoscopy with biopsy which revealed adenocarcinoma of stomach. We couldn't find out any other etiologic agents.
Adenocarcinoma* ; Anti-Bacterial Agents ; Biopsy ; Extremities ; Fever ; Hematologic Neoplasms ; Histamine Antagonists ; Humans ; Korea ; Leukocytosis ; Male ; Mass Screening ; Middle Aged ; Neck ; Neutrophils ; Prednisolone ; Skin ; Stomach ; Sweet Syndrome* ; Tomography, X-Ray Computed

It has been generally believed that the continuous flow of blood characterised by arterial inflow and venous outflow is essential for the survival of flaps. Since Baek et al.(1985) demonstrated the survival of a flap based on only a single vein without arterial inflow, there have been a lot of reports of successful skin flaps that depend on only venous blood flow. The location of pedicle is one of the important factors on the survival of flaps, but there have not been an effective study on the survival rates of venous island flaps according to their location of pedicles. In this study, we compared the survival rates of proximally based venous island flaps with those of distally based ones and attempted to decrease the difference, if any, in the survival rates between them. Distally or proximally based 4x3 cmvenous island flap, whose pedicle was a marginal branch of central vein, was elevated from the auricular cartilage of New Zealand white rabbit. IN the half of 20 rabbits, superoxide dismutase (SOD, 20,000 U/kg) was injected intravenously 30 minutes and 60 minutes after the flap elevation. On the 7th postoperative day, survival areas of the flaps were measured by image analysis system and the vascular network with the flaps were examined by micro fil cast. 40 flaps were divided as follows: proximally based venous flaps, distally based venous flaps, SOD treated proximally based venous flaps, SOD ttreated distally based venous flaps. The results were as follow: 1. The survival rate(79.39+/-9.24%) of the proximally based venous flaps were significantly higher than those(60.79+/-14.10%) of the distally based ones (p< 0.01). 2. SOD improved survival of the flap significantly (p< 0.05), and there was no statistical difference in the survival rates between proximally based venous flaps and SOD treated distally based venous flaps (p = 0.1785). 3. Revascularization was actively developed in the proximally based venous flaps and those flaps treated with SOD, but was minimal in the distally based venous flaps. These results suggested that the vascular pedicle would rather be located proximally than distally in designing the venous island flaps and that SOD treatment may be effective for the enhancement of survival of venous island flaps, especially in distally based ones.
Ear Cartilage ; New Zealand ; Rabbits ; Skin ; Superoxide Dismutase* ; Superoxides* ; Surgical Flaps ; Survival Rate ; Veins

Colorectoanal intussusception is a rare and distinct entity that differs from the more common rectal prolapse. Typically the intussusception occurrs with tumor at the apex of the intussuscepted segment acting as lead point. Here we present a case and review the literature of colorectoanal intussusception. The case presented here is that of an elderly woman with a proximal sigmoid colon cancer at its apex. Anterior resection was electively performed after reduction of the intussusception. It is important to differentiate a colorectoanal intussusception from the more common rectal prolapse because treatment may differ. The anorectum remains in its normal anatomic position in colorectoanal intussusception, whereas the anal canal is effaced with the prolapsed segment of bowel in rectal prolapse. Identification of a tumor at the apex of the intussuscepted bowel should also arouse suspicion that the condition is not a rectal prolapse.
Aged ; Anal Canal ; Colonic Neoplasms ; Female ; Humans ; Intussusception* ; Rectal Prolapse ; Sigmoid Neoplasms

No abstract available.
Plummer-Vinson Syndrome*

No abstract available.
Diagnosis* ; Leptospirosis* ; Scrub Typhus*

The diagnosis of death by drowning is one of the hardest challenges in forensic pathology. Circumstantial factors and physical evidence such as autopsy findings are both important in drowning. However, drowning findings are not specific and no laboratory tests can specifically detect drowning. It has been suggested that fluid in the paranasal sinuses, especially the sphenoid sinuses, is a sign of drowning, in conjunction with other autopsy findings. This study aimed to determine the frequency of detection of fluid in the sphenoid sinuses in cases of death by drowning. From 2003 to 2012, 54 autopsied cases of drowning were selected and reviewed in the Department of Forensic Medicine, Kyungpook National University School of Medicine, Daegu. The most common autopsy findings were foaming at the mouth and nostrils (13%), frothy fluid in the airways (28%), pulmonary edema with overexpansion of lungs (87%), drowning liquid in the stomach and duodenum (52%) and hemorrhages in the petromastoid part of the temporal bone (93%). Fluid in the sphenoid sinuses was detected in 45/54 cases (83%). The plankton test was positive in 33/54 cases (87%), however, in 26 of these cases, plankton was found only in the lung tissue. In conclusion, detection of fluid in the sphenoid sinuses could be a diagnostic sign for death by drowning. The sphenoid sinuses are easily accessible on autopsy, so it is highly recommended to look for fluid in the sphenoid sinuses when performing an autopsy on bodies recovered from water.
Autopsy ; Cause of Death ; Drowning ; Duodenum ; Forensic Medicine ; Forensic Pathology ; Hemorrhage ; Humans ; Lung ; Mouth ; Paranasal Sinuses ; Plankton ; Pulmonary Edema ; Sphenoid Sinus ; Stomach ; Temporal Bone