BACKGROUND: As the pleural inflammation progresses, exudative pleural fluid becomes loculated rapidly with pleural thickening. Complete drainage is important 13 prevent pleural fibrosis, entrapment and depression of lung function Intrapleural urokinase instillation therapy has been advocated as a method to facilitate drainage of gelatinous pleural fluid and to allow enzymatic debriment of pleural surface. This study was designed to investigate the Predictors of effeotiveness of intrapleural urokinase in treatment of loculated pleural effusion METHOD: Thirty-five patients received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French Twenty-two patients had tuberculous pleural effusions, and 13 had non-tuberculous postpneumonic empyemas. A total of 240,000 units of urokinase was dissolved in 240 ml of normal saline and the aliquots of 80mL was instilled into the pleura1 cavity via pig-tail catheter per every 8hr. Effectiveness of intrapleural urokinase instillation therapy was assessed by biochemical markers, ultrasonography, and technical details. A greater than 50% improvement on follow-up chest radiographs was defined as success group. RESULT: Twenty-seven of 35 (77.1%) patients had successful outcome to urokinase instillation therapy. Duration of symptoms before admission was shorter in sucess group (11.8α6.9day) than in failure group (26.62α16.5day) (P<0.05). Amount of drained fluid during urokinsse therapy was larger in success group (917.1α392.7ml) than in failure group (613.8α259.7ml) (P<0.05). Pleural fluid glucose was higher in success group (89.7 α35.9mg/dl) than in failure group (41.2α47.1mg/dl) (P<0.05). Pleural fluid LDH was lower in success group (878.4α654.31U/L) than in failure group (2711.1α973.1IU/L) (P<0.05). Honeycomb septated pattern on chest ultrasonography was observed in six of eight failure group, but none of success group(P<0.05). CONCLUSION: Longer duration of symptoms before admission smaller amount of drained fluid during urokinase therapy, lower glucose value, higher LDH value in pleural fluid examination and honeycomb septation pattern on chest ultrasonography were predictors for failure group of intrapleural urokinase instillation therapy.
Biomarkers ; Catheters ; Depression ; Drainage ; Empyema ; Fibrosis ; Follow-Up Studies ; Gelatin ; Glucose ; Humans ; Inflammation ; Lung ; Pleural Effusion* ; Radiography, Thoracic ; Thorax ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

No abstract available.
Estrogens* ; Progesterone* ; Receptors, Progesterone*

In 2008, Korea has enacted new ordinances about the role of estheticians, but this law can be interpreted ambiguously, restricting hiring of estheticians in medical clinics. The purpose of the study is to obtain information about medical-esthetic systems in other countries. We have taken a survey of this object from 30 OECD & Asian countries, and the questionnaires returned from a total of 22 countries (Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Japan, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Spain, Switzerland, Turkey, United Kingdom, United States, Singapore, Israel, and Thailand), were used for the final analysis. The results are summarized as follows. In most countries, estheticians working independently deal with only healthy, normal skin. In most countries, estheticians working independently have no right to operate any medical instruments. In all 17 countries that returned the questionnaires medical clinics can employ estheticians, and only theses estheticians who belong to the medical clinics can handle the non-invasive medical instruments under the supervision of doctors. In 17 countries that have related legal regulations, nurses, under the control of doctors, can perform wider range of duties in various settings than estheticians. The survey concludes that the duties of estheticians are closely related with medical skin care services and estheticians can perform various non-invasive medical procedures only under the control of doctors. From consulting a variety of medical-esthetic systems in other countries, we propose that the estheticians be allowed to work in medical clinics to provide better medical services for the patients and to make more chances of employment for themselves.
Asian Continental Ancestry Group ; Austria ; Canada ; Denmark ; Employment ; Finland ; France ; Germany ; Great Britain ; Humans ; Hungary ; Israel ; Japan ; Jurisprudence ; Korea ; Netherlands ; New Zealand ; Norway ; Organization and Administration ; Portugal ; Questionnaires ; Singapore ; Skin ; Skin Care ; Slovakia ; Social Control, Formal ; Spain ; Switzerland ; Turkey ; United States

No abstract available.
Echocardiography* ; Heart Defects, Congenital* ; Prenatal Diagnosis*

Pars interarticularis fracture is a common finding in young soccer players with low back pain. Spondylolysis in young adults involves a defect of the pars interarticularis, occurring as a result of repeated hyperextension and rotation. Here, we describe the case of a 26-year-old male elite soccer player who was diagnosed with L3 spondylolysis 2 years previously. He visited Incheon Himchan Hospital again because of low back pain. Radiographs showed consecutive spondylolysis at the L3 and L4 levels. Physicians should be aware that repeated performance of athletic movements, such as those during soccer, might lead to consecutive levels of spondylolysis.
Adult ; Athletes ; Fractures, Stress ; Humans ; Incheon ; Low Back Pain ; Male ; Soccer* ; Spondylolysis* ; Sports ; Young Adult

Inflammatory fibroid polyp is a relatively rare, benign lesion of gastrointestinal wall which is composed of fibrous connective tissue, blood vessels, and infiltration of eosinophils, These occur mainly in two sites, the distal stomach and the distal ileum. The gastric lesions are almost always situated in the antral region, frequently adjacent to the pyloric sphincter. they have been found in patients from the third through the ninth decades with a medial age in the midsixth decade. There seems to be a sligbt male predominance. The majority of inflammatory fibroid polyps had been reported with pathologic specimen in stomach. These reveal polypoid masses originated mainly in the submucosa of the stomach, As to the diagnosis of submucosal tumor of the stomach, a newly developed diagnostic modality of endoscopic ultrasonography allows us to visualize the structures underlying the gasointestinal wall in a noninvasive manner, and has the great advantage over the conventional modalities such as endoscopy and X-ray examination. We report 4 cases of inflammatory fibroid polyp in ithe stomach, which was diagnosed by the gastrofiberscopy and endoscopic ultrasonography, and treated by surgical operation in 1 case and endoscopic resections in 3 cases, These lesions were demonstrated as hypoechic tumors mainly in the third layer of the gastrie wall with irregular margin and unclear bouadary by endoscopic ultrasonqgraphy. The findings of endoscopic ultrasonography are discussed with the review of the literature.
Blood Vessels ; Connective Tissue ; Diagnosis ; Endoscopy ; Endosonography* ; Eosinophils ; Humans ; Ileum ; Leiomyoma* ; Male ; Polyps* ; Pylorus ; Stomach*

No abstract available.
Diagnosis* ; Maternal Age*

OBJECTIVE: Uterine sarcomas are rare and characterized by rapid clinical progression and poor prognosis. The manegement of uterine sarcoma has been challenged. The purpose of this study was to investigate the clinicopathologic findings and outcome of patients with uterine sarcoma METHODS: From Sep. 1990 to July. 1999, 8 patients with histologically proven uterine sarcoma at department of obstetrics and gynecology of Chonbuk University Hospital were evaluated for their clinical profiles and survival retrospectively RESULTS: The age of patients with uterine sarcoma ranged 31 to 60, and the mean age was 46 years. The most common pathologic type of uterine sarcoma was leiomyosarcoma. The common presenting symptom were irregular uterine bleeding, hypermenorrhea and lower abdominal palpable mass. The patients with uterine sarcoma were treated by surgery, post-operative radiotherapy and adjuvant chemotherapy. The mean follow up duration was 34.1 months. The 2 year survival rate was 50%. Distant metastasis were reveled at two patients, and the sites are lung and brain. CONCLUSIONS: Uterine sarcomas are aggressive tumor with a poor prognosis. The Major treatment is surgery and the effect of chemotherapy and radiotherapy were undetermined.
Brain ; Chemotherapy, Adjuvant ; Drug Therapy ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Jeollabuk-do ; Leiomyosarcoma ; Lung ; Menorrhagia ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Radiotherapy ; Retrospective Studies ; Sarcoma* ; Survival Rate ; Uterine Hemorrhage

No abstract available.
Amniocentesis* ; Cytogenetics* ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

Clinical trial of cyclosporines produced from two different manufacturers were performed in thirty three renal transplant patients for 16 months divided into 2 phases. A 1:1 conversion on a milligram-to- milligram basis was used for switching from Sandimmune(Sandoz Pharma Ltd, Switzerland) to Implanta(Hanmi Pharma Co, Korea) as the first phase and from Implanta to its microemulsion formulation, Neoplanta, as the second phase. Throughout two phases, the cyclosporine dose, blood pressure and hemoglobin were not changed significantly. Serum creatinine was reduced from the baseline(1.76+/-0.5mg/dL) only during the middle 2 months of the first phase(month 3 : 1.57+/-0.4mg/dL, P<0.05, month 5 : 1.58+/-0.4mg/dL, P<0.05), but it was not changed significantly during the second phase at all. However, blood urea nitrogen(BUN) was increased from baseline throughout the second phase, significantly. Cyclosporine trough level was reduced from baseline(180.87+/-57.5 ng/mL) during the late 3 months of the first phase(month 6 : 131.69+/-61.2ng/mL, P<0.05, month 7 : 137.27+/-82.1ng/mL, P<0.05, month 8 : 135.06+/-58.2ng/mL, P<0.05), while those were increased from baseline to during the early 2 months (month 1 : 172.48+/-64.1ng/mL, P<0.05, month 2 : 170.12+/-49.6ng/mL, P<0.05) and returned to baseline during the remaining 6 months of the second phase. No one developed rejection, but 8 admissions in 7 patients occurred due to cyclosporine nephrotoxicity related elevation of serum creatinine(n=2 in the first phase, n=3 in the second phase), cellulitis in leg(n= 1), partial colectomy for colon cancer(n=1) and reduction of fractured arm(n=1), respectively. Mild abdominal discomfort in 2 patients and nausea with fishy smell on cyclosporine intakes in 3 patients during the early first phase were noted transiently, but no one developed such adverse side effects during the second phase. In conclusion, there were no discernible differences in safety and effectiveness in cyclosporine products from two different manufacturers. Furthermore, the comparable effects between the conventional cyclosporine(Implants) and the microemulsion formulation(Neoplanta) were noted without requiring the dose reduction after the 1:1 conversion.
Blood Pressure ; Cellulitis ; Colectomy ; Colon ; Creatinine ; Cyclosporine* ; Cyclosporins ; Humans ; Kidney Transplantation ; Nausea ; Smell ; Urea