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*

No abstract available.
Child* ; Humans

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

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

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

No abstract available.
Plummer-Vinson Syndrome*

No abstract available.
Hypocalcemia*

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

Alleles and genotype frequencies and its distribution pattern for the highly polymorphic D1S80 locus were determined in a Korean population sample, especially in Kwangju and Chonnam, by using PCR followed by agarose gel electrophoresis with ethidium bromide staining, a procedure called the amplified-fragment-length polymorphism(Amp-FLP) technique. And the data were compared with the alleles and genotype frequencies of Finnish population, North American Caucasian, and Korean population(Seoul) which had been reported. In 203 unrelated Korean individuals 27 alleles and 84 genotypes were observed. The highest allele frequency was in allele M24(0.128) and tne next orders were inalleles M18(0.126), M29, M30, M31, and M28 and the other alleles showed relatively low frequencies. The highest frequency of genotype was in M18/M24 and the next order frequencies were M18/M30, M19/M27 M29/M29, and M18/M29. The homozyous genotypes were in 9 alleles such as M29, M24, M31, and M18, and most of heterozygous genotypes were composed of alleles of each homozygous genotypes and /or the other alleles, its composition of genotypes was 0.881(74/84), 183(0.901) of the 203 individuals alleles, its composition of genotypes was 0.881(74/84), 183(0.901) of the 203 individuals alleles, its composition of genotypes was 0.881(74/84), 183(0.901) of the 203 individuals were included. The VNTR D1S80 locus demonstrated a heterozygosity of 0.872. From the above results, VNTR D1S80 locus may be a powerful locus to identify individuals, however, the allele frequencies was not closely related to the genotype pattern, and the alleles of homozygous genotypes influenced on the chance of the recombination of the various genotypes. It is necessary to analyze the genotype distribution and the recombination pattern of alleles as well as alleles and genotype frequencies in each populations for statistical test at most highly polymorphic loci.
Alleles* ; Electrophoresis, Agar Gel ; Ethidium ; Gene Frequency ; Genotype* ; Gwangju ; Jeollanam-do ; Polymerase Chain Reaction ; Recombination, Genetic