Bornstein and plate (1911) and Bassoe (1913), followed by many European and American, described the radiographic appearance of avascular necrosis of the bone in compressed air worker. Divers bone lesions was described for the first time by Grutzmacher in 1941. There is not any report of information on the caisson disease and divers bone lesions in this country. Inview of these considerations, during the period from March to June 1981, 124 traditional civilian divers and 132 Naval divers, were observed in eight Korean coastal cities (In-cheon, Sam-chun-po, Sin-hae, Pu-san, Ul-san, Ku-ryung-po, joo-moon-jin and Sok-cho). For each divers, a record was made of his medical history, diving experiences and frequencies of bends attacks. The clinical examination included blood pressure, body weight, a chest radiograph and routine checks of the shoulders, hips and knees, but an X-ray examination extended to the spines, ankles, elbows when symptoms existed. The results were as follow: l. Out of 256 divers, 113 (44.2%) had bone lesions, seventy-five traditional divers (60.5%) had bone lesions out of 125 divers, but naval divers, only thirty eight (28.8%) of 132 had such lesions. 2. Divers bone lesion incidence is increased with diving experience especially over 10 years. 3. The most frequent bone lesions occured in the upper end of the humerus, the upper end of the femur, the lower end of the femur and proximal tibia. 4. The most frequent divers bone lesions in X-ray was dense areas (Bl). 5. There was a high incidence (93.1%) in man with a history of the bends and significantly relate between the sites of the bends and those of the lesions. 6. Divers bone lesions incidence was increased with the length of diving experiences, diving depth, diving time, ages and with bends experiences.
Ankle ; Blood Pressure ; Body Weight ; Compressed Air ; Decompression Sickness ; Diving ; Elbow ; Femur ; Hip ; Humerus ; Incidence ; Knee ; Korea ; Necrosis ; Radiography, Thoracic ; Shoulder ; Spine ; Tibia

No abstract available.
Hyperoxaluria, Primary* ; Kidney Transplantation* ; Kidney*

The pregnancy-associated breast cancer is one of the most common malignancy developed during pregnant period and occupies 1-2% of the all breast cancer patients. There is no evidence to implicate pregnancy or lactation in either the etiology and the progression of breast cancer. Careful breast examination early in the pregnancy is very important to find solid masses before breast engorgement hides them. But unfortunately, delay in the diagnosis is common and most of patients with operable primary lesions have positive axillary lymph nodes. The treatment of choice is the modified radical mastectomy and adjuvant chemotherapy. The authors report a patient of breast cancer diagnosed and treated during pregnancy with review of literature.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Diagnosis ; Female ; Humans ; Lactation ; Lymph Nodes ; Mastectomy, Modified Radical ; Pregnancy*

PURPOSE: To compare the radiologic and clinical results of patients who had primary total knee arthroplasty(TKA) with 3 different arthrotomy technique: quadriceps-sparing approach(group Ia), minimal incisional approach(group Ib), conventional parapatellar approach(group II). MATERIAL AND METHODS: We assessed 114 patients(142 knees) treated between December 2003 and March 2005(minimal follow-up was one year). Group Ia, Ib and II consisted of 24 patients(32 knees), 23 patients(30 knees) and 67 patients(80 knees). The evaluation included radiologic alignment, skin incision, tourniquet time, blood loss, ambulatory ability and knee score of Hospital for special surgery(HSS). RESULTS: Group Ia and Ib had the results that indicate increased range of motion, shorter length of hospital stay, less skin incision and more tourniquet time. There were no differences between the groups in radiologic alignment, blood loss, and HSS score. CONCLUSION: Although total knee arthroplasty using a minimal incision may provide some early advantages, minimal incision can impede a surgeon's visual field and may influence component alignment. Therefore, these minimal incision approaches should be performed in limited patients with strict indication.
Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Length of Stay ; Range of Motion, Articular ; Skin ; Tourniquets ; Visual Fields

BACKGROUND: There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes. METHODS: We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation. RESULTS: We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). CONCLUSION: Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.
APACHE ; Budgets ; Critical Care ; Humans ; Critical Care ; Intensive Care Units ; Logistic Models ; Prospective Studies ; Respiration, Artificial ; Weaning

Purpose: This study aimed to review the history and examine the current service system of the Korea Counseling Center for Fertility and Depression (KCCFD) by analyzing the characteristics of its users, and to suggest measures to improve the system. Methods: Data on 883 infertile patients counseled through the KCCFD’s counseling service over the last 2 years were collected for a demographic analysis. The clinical information of 396 female subjects who received regular counseling after registration were analyzed to investigate factors influencing depression. Finally, a matching sample t-test was conducted to verify the effects of the counseling service. Results: The screening test showed that 50.7% of the infertile patients in our study were registered at our centers and received registered counseling. A total of 27.6% of the subjects was identified as being at high-risk for depression, and 71.3% of those at high-risk received registered counseling. The logistic regression analysis showed that being a homemaker, having a history of psychiatric disorder, and having undergone in vitro fertilization three or more times were significant factors that predict moderate or more severe depression. The female infertility patients who underwent counseling showed a significant decrease in depression, anxiety, general stress, and infertility stress. Conclusion Screening tests need to be performed prior to assisted reproductive technology if any of the 3 risk factors is present. The rate of registered counseling, regular follow-up using psychological tests, and cross-linkages with affiliated agencies should serve as the metrics for the quality control of the counseling service. Early detection of individuals at high-risk for depression calls for an activated liaison among affiliated agencies and expanded regional centers.

Mediastinal tuberculous lymphadenitis is rare in adults, and it is even rarer for dysphagia to be the presenting symptom of mediastinal tuberculous lymphadenitis. Mediastinal tuberculous lymphadenitis with esophageal symptoms has been presented as esophageal ulceration, mucosal or submucosal mass with ulceration, fistula or sinus formation, extrinsic compression, or displacement of the esophagus. An exaggerated form of extrinsic compression may be presented as a submucosal tumor, radiologically or endoscopically. A barium esophagography of a 34 year-old woman with painful dysphagia revealed a large submucosal tumor-like mass on the mid-esophagus. The symptom was spontaneously improved over a 3-week period together with reduction of the mass size. A computed tomography of the chest disclosed an enlarged subcarinal lymph node and histologic examination of the specimen obtained by thoracoscopic biopsy brought about a diagnosis of tuberculosis. We herein report a case of mediastinal tuberculosis with unusual manifestations.
Adult ; Case Report ; Deglutition Disorders/*etiology ; Diagnosis, Differential ; Esophageal Neoplasms/*diagnosis ; Esophagoscopy ; Esophagus/pathology/radiography ; Female ; Human ; Mediastinal Diseases/*complications/*diagnosis ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node/*complications/*diagnosis

Renal disease includes conditions affecting the glomeruli, tubules, interstitium, pelvis, and vasculature. Diseases of the kidney include glomerular diseases, diseases of the tubules and interstitium, diseases of renal pelvis, and developmental abnormalities. Renal tissue samples (n = 70) submitted to the Department of Veterinary Pathology of Konkuk University from 2003 to 2008 were included in this study. Tissue histopathology was performed using light microscopy with hematoxylin and eosin stains. Masson's trichrome, Congo Red, and Warthin starry silver staining were applied in several individual cases. Glomerular diseases (22.9%), tubulointerstitial diseases (8.6%), neoplastic diseases (8.6%), conditions secondary to urinary obstruction (24.3%), and other diseases (35.7%) were identified. Glomerulonephritis (GN) cases were classified as acute proliferative GN (5.7%), membranous GN (4.3%), membranoproliferative GN (4.3%), focal segmental GN (2.9%), and other GN (4.2%). The proportion of canine GN cases presently identified was not as high as the proportions identified in human studies. Conversely, urinary obstruction and end-stage renal disease cases were relatively higher in dogs than in human populations.
Animals ; Dog Diseases/*pathology ; Dogs ; Female ; Humans ; Kidney/*pathology ; Kidney Diseases/pathology/*veterinary ; Male ; Republic of Korea ; Retrospective Studies

The localized eosinophilic granulomatous lesions of the stomach are rare benign tumorous conditions resembling submucosal tumors. They can be divided into two types. One is an inflammatory fibroid polyp. The other is an eosinophilic granuloma due to migration of Anisakis-type larva in the alimentary tract. The latter is usually found in the gastric body and anterior wall of the angle, and appears as a submucosal tumor. Histologically, the granuloma exhibits a characteristic lamellated structure consisting of a necrotic center with or without the worm, surrounded by layers of granulation tissue and eosinophilic infiltration. The present case is a 50 year-old male presenting with an episode of profuse melena. An emergency esophagogastroduodenoscopy revealed a 2x1.5cm sized, irregularly shaped ulcerative lesion with elevated margins and prominent folds convergence. Despite the endoscopic injection of hypertonic saline-epinephrine solution due to a recent bleeding stigmata, the patient experienced a rebleeding during hospitalization, The locally excised specimen showed an eosinophilic granuloma having a central necrosis. Although the larval body of Anisakis was not found, the lesion was diagnosed as a parasitic eosinophilic granuloma of the stomach.
Anisakis ; Christianity ; Emergencies ; Endoscopy, Digestive System ; Eosinophilic Granuloma* ; Eosinophils* ; Granulation Tissue ; Granuloma ; Hemorrhage* ; Hospitalization ; Humans ; Larva ; Leiomyoma ; Male ; Melena ; Middle Aged ; Necrosis ; Polyps ; Stomach* ; Ulcer

OBJECTIVES: Diplophonia is the voice of two separate tones through quasi-periodic variations in the vocal cord vibration when an imbalance in the tension and the level applied to the vocal cords. The purpose of this study is to investigate the relationship between the occurrence of the diplophonia and the endoscopic findings in the unilateral vocal cord paralysis. MATERIALS AND METHOD: A retrospective review was employed using video recorded images of larynx with unilateral vocal cord paralysis. A total 104 patients selected for this study complained of voice change due to unilaterally paralyzed vocal cord. Video-recordings were obtained using a laryngeal telescope. The paralyzed positions, bowing, shapes of the paralyzed arytenoids and level differences between two vocal folds were evaluated according to whether diplophonia. existed or not. RESULTS: A large number of patients of paramedian paralysis showed diplophonia when the bowing of paralyzed vocal fold was shown. However, diplophonia was shown in a small number of patients with median and intermediate paralysis. Diplophonia also seems to occur when the vertical mismatch was shown. CONCLUSION: Occurene of diplophonia depends largely on the paralyzed position, adequate glottal gap such as paramedian position, with the presence of bowing of paralyzed vocal cord.
Endoscopy ; Humans ; Larynx ; Paralysis* ; Retrospective Studies ; Telescopes ; Vibration ; Vocal Cord Paralysis ; Vocal Cords* ; Voice