PURPOSE: This study was done to determine the suitable level of energy for the elimination of saphenous veins. METHODS: A randomized comparative study was done to determine the optimal linear endovenous energy density (LEED) for EVLT of incompetent great saphenous veins. Between October 2009 and September 2010, in 268 (173 women, 95 men) patients with a mean age of 43.1 (range 20~80) were treated, using a 1,470 nm diode laser at 10 watts in continuous mode. Patients were randomized to undergo EVLT with 100 J/cm (Group A) or 80 J/cm (Group B), respectively. They were evaluated clinically and by duplex at 1, 3, and 6 months and 1 year. RESULTS: There was no significant difference concerning gender, age, C of CEAP or diameter of the treated veins. Successful occlusion rates of the GSV, defined as the absence of flow on color doppler imaging, were 92% in Group A and 91% in Group B. There was no deep vein thrombosis, superficial burns or thrombophlebitis. In group A, visual analog scale was 3.7.6, which was higher than group B (2.3.2). The area of ecchymosis was 37.5% in group A, but 12.5% in group B. CONCLUSION: There was no significant difference between 80 J/cm group and 100 J/cm group in terms of occlusion rate within 1 year. Long-term results will be required to determine the optimal level of energy.
Burns ; Ecchymosis ; Female ; Humans ; Lasers, Semiconductor* ; Saphenous Vein ; Thrombophlebitis ; Varicose Veins* ; Veins ; Venous Thrombosis ; Visual Analog Scale

Multiple Choice Question(MCQ) method of examination has long been used as the national medical licensing examination in Korea. If properly used, the MCQ method of examination has considerable value fo r evaluation, and in fact, it has become popular due to its economy of scale, ease of marking and consistency. Moreover, with this method of examination, a large number of candidates can be tested at once and the marking can even be read by automatic readers. However, MCQ does not lend itself so well to problem-solving, which is a far more real-life situation than having to choose between a number of pre-formed alternatives. This, again, however, can be much improved by increasing the proportion of question items associated with interpretation and problem solving level of cognitive domain, and adopting various types of MCQ. This study was planned to examine the proportions of question items by their levels of cognitive domains and the types MCQ together with the contents of medical knowledge of the Korean National Medical Licensing Examinations (NMLE) conducted in 1992 and 1993. All 880 question items (440 question items in each year) were reviewed one by one by three medical education specialists and the levels of cognitive domains, types of MCQ and contents of questions were judged by test subjects. Major findings obtained from the study are as follows: 1) In both years of 1992 and 1993, recall level question items formed 68.0% of all MCQ question items of NMLE. Problem-solving level question items were only 77.% in 1992 and 11.1% in 1993. 2) Major types of MCQ were 'best answer type' one correct answer type'. They were 40.7% and 30.9% of all respectively in 1992, and 35.0% and 32.0% respectively in 1993. Some subjects such as urology and internal medicine were adopting more 'combined response type' MCQ than other subjects. 3) Knowledge contents asked in the NMLE varied very much from subject to subject. However, the names of diseases were the most prevalent answers asked and they were 21.6% in 1992 and 18.2% in 1993. This study suggests that the Korean NMLE should increase the proportion of question items measuring the interpretation and/or problem-solving level of knowledge, and adopt several different types of MCQ.
Education, Medical ; Internal Medicine ; Korea ; Licensure* ; Problem Solving ; Specialization ; Urology

The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system (RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.
Cause of Death ; Humans ; Nasopharyngeal Neoplasms ; Nasopharynx ; Neck ; Radiotherapy ; Recurrence

OBJECTIVES: To investigate the effects of recognition on the restructuring of the psychosocial well-being of the workers. METHODS: 302 employees were recruited by a stratified random sampling method, from a company located in Seoul, which undergoing an administrative evaluation, in 2001. Subjects were asked to fill out questionnaire sheet on their recognition of the restructuring, and were questions on their psychosocial well-being. A one-way ANOVA and a multiple regression analysis were used to analyze the data. RESULTS: For the psychological well-being, the levels of social performance and self-confidence were significantly different relation to age, educational attainment, marital status, insecurity recogni-tion, and competency recognition. According to the result of the multiple regression analysis, the insecurity recognition was found to significantly affect the social performance and self-confidence, depression, sleep disturbance and anx-iety, general well-being and vitality, whereas the competency recognition affected the social perfor-mance and self-confidence, sleep disturbance and anxiety, and overall psychosocial well-being. CONCLUSION: The insecurity and competency recognitions against the restructuring were found to be the major factors affecting the workers psychosocial well-being. It is suggested that a decreased worker's insecurity recognition of the restructuring, and the competency recognition for the workers psychosocial health needs require promoting.
Anxiety ; Depression ; Marital Status ; Questionnaires ; Seoul

The localizations and morphological characteristics of gonadotropes in the adenohypophy-sis of Korean native goat were investigated with double immunohistochemistry. The gonadotropes were present in the pars distalis and pars tuberalis, but not in the pars intermedta. Gonadotropes occupied about 49.0% of the cells in the pars distalis in females, and about 40.8% in males. Three types of gonadotropes ; FSH immunoreactive cells[FSH cells], LH immunoreac-tive cells[LH cells], and FSH and LH immunoreactive cells[FSH/LH cell], were identified according to their immunoreactivities for FSH and LH antisera. The possessional perce-ntages of FSH cells, LH cells and FSH/LH cells were 1.1%, 40.6%, 58.3% in females and 1.8%, 30.0%, 68.8% in males, respectively. FSH/LH cells were large and oval or round in shape. These cells were distributed throughout the pars distalis, but were more abundant on the dorsal part adjacent to the hypophyseal cavity and along the lateral and ventral peripheral regions. LH cells were smaller than other gonadotropes and were observed throughout the pars distalis, but predominant in the central region. FSH cells were large and oval in shape. These cells were intercalated between FSH/LH cells.
Female ; Goats* ; Gonadotrophs ; Humans ; Immune Sera ; Immunohistochemistry ; Male

The present study has been performed to investigate the neural axis of rat digastric muscle using viral tracer, pseudorabies virus. The upper nuclei to innervate digastric muscle were in accumbens nucleus, agran-ular insular cortex, central nucleus of amygaloid, lateral septal nucleus, frontal cortex, and subfornical organ etc, in telencephalon ; arcuate hypothalamic nucleus, lateral hypot-halamic area, medial preoptic nucleus, bed nucleus of stria terminalis, dorsomedial hypot-halamic nucleus, suprachiasmatic nucleus, paraventricular nucleus, and retrochiasmatic area etc, in diencephalon ; nucleus Darkschewitsch, interstitial nucleus of the medial logitudinal fasciculus, parabrachial nucleus, locus ceruleus, Kolliker-Fuse nucleus, trigeminal mesencephalic nucleus, red nucleus, substantia nigra, nucleus of posterior commissure, Edinger-Westphal nucleus, and dorsal raphe nucleus etc, in mesencephalon ; giganto-cellular reticular nucleus, raphe magnus nucleus, raphe pallidus nucleus, raphe obscuous nucleus, nucleus of solitary tracts, lateral reticular nucleus, parvocellular reticular nucleus, area postrema, facial nucleus, pontine reticular nucleus, pontine nucleus of trigeminal nerve and spinal nucleus of trigeminal nerve etc, in rhombencephalon. There are significant difference of numbers of PRV-Ba immunoreactive cells between right and left sides of brain in almost nuclei[P< 0.05]. But PRV-Ba immunoreactive cells were observed only ipsilaterally in accessory trigeminal motor nucleus, accessory facial nucleus and agranular insular cortex. Frontal cortex was the only area which were shown contralateral immunoreactivity. The results of this study provide anatomical support that both the cranial and caudal bellies are innervated by the same upper nuclei. The results also support the suggestion that the lower nuclei of digastric muscle, accessory trigeminal motor nucleus and accessory facial nucleus consist of somatotopic motor complex.
Animals ; Area Postrema ; Axis, Cervical Vertebra* ; Brain ; Diencephalon ; Herpesvirus 1, Suid ; Hypothalamic Area, Lateral ; Immunohistochemistry ; Locus Coeruleus ; Mesencephalon ; Paraventricular Hypothalamic Nucleus ; Raphe Nuclei ; Rats* ; Red Nucleus ; Rhombencephalon ; Septal Nuclei ; Subfornical Organ ; Substantia Nigra ; Suprachiasmatic Nucleus ; Telencephalon ; Trigeminal Nerve ; Trigeminal Nuclei

If one can measure the actual angle of the bowing and rotation of a long bone three-dimensionally, it will be a great help in fracture reductions, operative treatments of the congenital snomalies, determination of the fusion angles in arthrodeses, and so on. We developed a computer program that gives us the actual bowing and rotation angle when we input the angles from the two X-ray films with known angle between them. We measured anteversion and neck-shaft angle of the femur, the amount of bowing and rotation in fracture model, and the fusion angles in arthrodeses. The angles calculated from the computer program were same as those from another X-ray that showed the actual angle taken by derotating the subject.
Arthrodesis ; Femur ; X-Ray Film

PURPOSE: This treatment planning study was undertaken to evaluate the impact of beam angle configuration of intensity-modulated radiotherapy (IMRT) on the dose of the normal liver in hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The computed tomography datasets of 25 patients treated with IMRT for HCC were selected. Two IMRT plans using five beams were made in each patient; beams with equidistance of 72degrees (Plan I), and beams with a 30degrees angle of separation entering the body near the tumor (Plan II). Both plans were generated using the same constraints in each patient. Conformity index (CI), homogeneity index (HI), gamma index, mean dose of the normal liver (Dmean_NL), Dmean_NL difference between the two plans, and percentage normal liver volumes receiving at least 10, 20, and 30 Gy (V10, V20, and V30) were evaluated and compared. RESULTS: Dmean_NL, V10, and V20 were significantly better for Plan II. The Dmean_NL was significantly lower for peripheral (p = 0.001) and central tumors (p = 0.034). Dmean_NL differences between the two plans increased in proportion to gross tumor volume to normal liver volume ratios (p = 0.002). CI, HI, and gamma indices were not significantly different for the two plans. CONCLUSION: The IMRT plan based on beams with narrow separations reduced the irradiated dose of the normal liver, which would allow radiation dose escalation for HCC.
Carcinoma, Hepatocellular ; Humans ; Liver ; Radiotherapy, Intensity-Modulated ; Tumor Burden

From April 1986 to Dec. 1988, fifty one patients with carcinoma of lung were treated by radiation therapy in Department of Therapeutic Radiology, Yeungnam University Hospial. Of the 51 patients, 31(61%) were squamous cell ca, 8(15.7%) were small cell ca, and remained 4(7.9%) were other cell types. Total radiation dose was average 64 Gy (60~75 Gy) for group A and 45 Gy (40~59 Gy) for group B. The mass regression and the response of airway obstruction to radiation therapy was established on the basis of follow up chest X-ray. The mass regression above 50% of total volume was noted in 23 patients (74.2%) among 31 patients and the difference between two groups was not seen. In squamous cell ca, however, the mass regression rate(above 50% of total volume) was 83.3%(10/12) in group A compared to 50%(3/6) in group B(p<0.05). The alleviation of airway obstruction was noted as follows. In group A, CR 42.9%, PR 35.7%, no response 21.4% and in group B, CR 55.6%, PR 33.3%, no response 11.1%. But, in squamous cell ca, responsiveness is higher than group B. The study indicates that the importance of higher radiation dose in the management of primary tumor mass and airway obstruction caused by lung cancer especially squamous cell ca. So, meticulous treatment plaining and multimodality combination therapy without increasing side effect or complication is recommended in management of inoperable bronchogenic carcinoma.
Airway Obstruction* ; Carcinoma, Bronchogenic ; Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Radiation Oncology ; Radiotherapy ; Thorax

A 20-year-old man developed necrotizing fasciitis of the left chest wall complicating acupuncture. Necrotizing fasciitis is a highly morbid soft tissue infection that rarely involves the upper torso. In the past, there has been few report on necrotizing fasciitis complicating acupunture in the English literature (based on a MEDLINE search covering 1966 to 2005). We present this extremely unusual case of a patient after taking acupuncture who survived severe necrotizing fasciitis of the chest wall following wide debridement of the necrotic tissue and broad-spectrum antibiotic therapy.
Acupuncture* ; Debridement ; Fasciitis, Necrotizing* ; Humans ; Soft Tissue Infections ; Thoracic Wall* ; Thorax* ; Torso ; Young Adult