No abstract available.
Nursing Homes* ; Nursing* ; Nutritional Status*

No abstract available.
Aortic Stenosis, Supravalvular*

Polymyositis(PM) is one of idiopathic inflammatory myopathy, characterized by proximal muscle weakness, myalgia and muscle enzyme elevation. Currently the main pathogenesis is well documented, the cell-mediated immunity. We experienced a case of polymyositis associated with hepatitis, developed after hepatitis B virus(HBV) infection. This virus-induced autoimmunity seems to result from the cross-reactivity between muscle protein and B-viral antigen, so called antigenic mimicry. This relation of PM and HBV is more significant in Korea because of the epidemicity of HBV infection.
Autoimmunity ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Immunity, Cellular ; Korea ; Molecular Mimicry ; Muscle Proteins ; Muscle Weakness ; Myalgia ; Myositis ; Polymyositis*

No abstract available.
Hospitals, Community* ; Humans

For the physical characterization of neutron beam, dosimetric measurements had been performed to obtain physical data of KCCH cyclotron-produced neutrons for clinical use. The results are presented and compared with the data of other institutions from the literatures. The central aixs percent depth dose, build-up curves and open and wedge isodose curve values are intermediate between that of a 4 and 6 MV X-ray. The build-up level of maximum dose was at 1.35 cm and entrance dose was approximately 40%. Flatness of the beam was 9% at Dmax and less than+/-3% at the depth of 80% isodose line. Penumbra begond the 20% line is wider than corresponding photon beam. The output factors ranged 0.894 for 6 x 6 cm field to 1.187 for 30 x 30 cm field. gamma contamination of neutron beam was 4.9% at 2 cm depth in 10 x10 cm field.
Cyclotrons ; Neutrons*

PURPOSE: This study was to report our experience of the brief survey for teaching journal writing by medical students in a clinical curriculum of family medicine. METHODS: Brief surveys performed by medical students in clinical clerkship of department of family medicine from 1998 to 2000. Medical students determined theme without rein for brief surveys. Lecture about meaning and process of survey was given for sufficient understanding of students, and then surveys were conducted. The subjects of survey were outpatients, nursing person, medical students, nursing students, and other general persons. The subjects of theme were classified to 17 chapters 7 components by international classification of primary care(ICPC). RESULTS: In analysis of brief surveys according to ICPC, the reasons for surveys by components were diagnostic, screening prevention(89.0%), treatment, procedures, medication(5.7%), symptoms, complaints(5.3%). By chapters, there were social(64.6%), psychological(12.6%), metabolic and endocrine(6.5%). Among social problems, there were other social problem(35.4%), health care system/access(20.9%), problem with education(13.9%), relation problems partner(12.7%). Majority of medical students had affirmative response for survey conduction. In conclusion, our finding suggest that teaching journal writing as brief survey seems to be useful in understanding of journal writing of medical students.
Classification ; Clinical Clerkship ; Curriculum* ; Delivery of Health Care ; Education, Medical ; Humans ; Mass Screening ; Nursing ; Outpatients ; Social Problems ; Students, Medical* ; Students, Nursing ; Writing*

Von Hippel-Lindau (VHL) disease is an autosomal dominant disorder that results from a germline mutation of the VHL gene. The affected individuals might develop several benign or malignant tumors such as central nervous system or retinal haemangioblastomas, endolymphatic sac tumors, renal cell carcinomas, pheochromocytomas or pancreatic cysts and neuroendocrine tumors. We report here on a case of a 21 year old female with von Hippel-Lindau disease and she presented with only pancreatic neuroendocrine tumor and no evidence of haemangioblastomas or other visceral complications. Further, direct sequencing of the VHL gene reveals a novel germline frameshift mutation of codon 198 from the deletion of nucleotide 592 (cytosine), leading to truncation of the VHL protein.
Carcinoma, Renal Cell ; Central Nervous System ; Codon ; Endolymphatic Sac ; Female ; Frameshift Mutation ; Germ-Line Mutation ; Humans ; Neuroendocrine Tumors ; Pancreas ; Pancreatic Cyst ; Pheochromocytoma ; Retinaldehyde ; von Hippel-Lindau Disease

PURPOSE: To evaluate the efficacy and safety of fluoroscopy-guided, radiologic placement of a tunneled central venous catheter into the superior vena cava (SVC). MATERIALS AND METHODS: Thirty five patients underwent tunneled central venous catheter placement to facilitate long-term chemotherapy. They included 33 leukemicpatients, one colon cancer patient, and one multiple myeloma patient. After confirming central venous patency witha injection of contrast media via the peripheral cephalic or basilic vein in the wrist joint, the subclavian veinwas punctured under fluoroscopic guidance. A 7F double lumen TPN catheter was placed into the SVC through asubcutaneous tunnel in the anterior chest wall. RESULTS: Catheter placements were successful in all patients. The mean procedure time was 17.2 minutes, mean fluoroscopy time was 1.3 minutes, mean number of punctures was 1.4, and mean volume of injected contrast media was 43.5 cc. Only two of all leukemic patients developed mild hematomas atthe puncture site, but these soon resolved themselves. None of the patients developed pneumothorax or hemothorax.but late complications included local infection in two patients (6%) and thrombotic occlusion of the catheter inone (3%). The occluded catheter was successfully recanalized with Urokinase infusion. CONCLUSION: Fluoroscopy-guided, radiologic placement of a tunneled central venous catheter is an easy and safe method, anduseful for patients requiring long-term venous access.
Catheters ; Central Venous Catheters* ; Colonic Neoplasms ; Contrast Media ; Drug Therapy ; Fluoroscopy ; Hematoma ; Humans ; Multiple Myeloma ; Ocimum basilicum ; Pneumothorax ; Punctures ; Subclavian Vein ; Thoracic Wall ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Superior ; Wrist Joint

Background: Implant-based immediate breast reconstruction surgery with nipple-sparing mastectomy has recently been favored by patients. However, in patients who do not wish to undergo balancing procedures, it is difficult to select the appropriate implant size, making it challenging to achieve a symmetrical breast shape. Therefore, this study investigated the differences in breast asymmetry and other complications in patients who underwent a two-stage procedure or direct-to-implant (DTI) breast reconstruction to determine whether the two-stage procedure can produce more favorable outcomes. Methods: The participants of this study were patients who underwent immediate two-stage breast reconstruction or DTI breast reconstruction from May 2018 to April 2022, did not receive postoperative radiotherapy, and did not wish to undergo any balancing procedures. An acellular dermal matrix was used for breast reconstruction in all patients, and a single reconstructive surgeon performed all the operations. Statistical significance was set at P<0.05. Results: No significant differences in complications were found between the patients who underwent DTI breast reconstruction and those who underwent two-stage breast reconstruction. In the two-stage breast reconstruction group, breast volume asymmetry was observed in 18.4% (seven patients), which was significantly lower than the percentage of 44.7% (17 patients) observed in the DTI group. Conclusions Breast asymmetry was observed in a significant proportion of the patients in both groups. However, because breast volume asymmetry was more common in the DTI group than in the two-stage breast reconstruction group, two-stage breast reconstruction may be a favorable method for patients who do not wish to undergo balancing procedures.

STUDY DESIGN: Retrospective case analyses.PURPOSE: To investigate the causes, diagnosis, and management of esophageal perforation, depending on the time of diagnosis.OVERVIEW OF LITERATURE: To date, few studies have addressed these issues.METHODS: A total of seven patients were included in this study. The patients were classified into three groups based on esophageal perforation diagnosis time: intraoperative (diagnosed during surgery), perioperative (diagnosed within 30 days postoperatively), and delayed (diagnosed >30 days postoperatively) groups.RESULTS: In the intraoperative group (N=2), infectious spondylitis was the main cause of esophageal perforation. Anterior plate and screw removal, followed by posterior instrumentation, was performed. The injured esophagus was managed by omentum flap repair in one patient and primary repair in one patient. In the perioperative group (N=2), revision surgery for infection and metal failure were the main causes of esophageal perforation. In both cases, food residue was drained on the third postoperative day. The injured esophagus was managed conservatively. In the delayed group (N=3), chronic irritation caused by metal failure was the main cause of esophageal perforation. In all patients, there was no associated infection. The anterior instrumentation was removed, and the two patients were treated by primary repair, and one patient was treated using sternocleidomastoid muscle flap. One patient in intraoperative group died of sepsis.CONCLUSIONS: The main cause of intraoperative esophageal perforation was esophageal adhesions because of infectious spondylitis. However, perioperative and delayed esophageal perforations were caused by chronic irritation because of metal failure. Anterior plate and screw removal was necessary, and posterior instrumentation and fusion may be considered, depending on the fusion status.
Diagnosis ; Esophageal Perforation ; Esophagus ; Humans ; Omentum ; Retrospective Studies ; Sepsis ; Spine ; Spondylitis