BACKGROUND: Recently the number of elderly gallstone patients has increased, in Korea. The aim of this study is to analyze and to measure the risk factors associated with operation on elderly gallstone patients. METHODS: We reviewed the medical records of 206 gallstone patients who had been admitted and operated on in the department of general surgery. Konkuk University Hospital, between January, 1993 and December, 1999. The patients were divided into 2 groups, over and under age 65. In each group, analysis was done on sex distribution, the ratio according to location of gallstone, duration of hospital stay, duration of general anesthesia and operative mortality, and then the above factors of each group were compared. RESULTS: 1) The ratio of common bile duct stones in patients over age 65 was two times of that in patients under age 65(48%,24%) 2) The overall operative mortality was 1.9% and has no correlation with old age. 3) Severe coexisting disease may seem the risk factor for operative mortality. CONCLUSION: In the diagnosis and management of gallstones in the elderly, the possibility of common bile duct stone should be suspected. And in order to reduce the operative mortality, careful preoperative evaluation and treatment of coexisting disease should be done.
Aged ; Anesthesia, General ; Common Bile Duct ; Diagnosis ; Gallstones* ; Humans ; Korea ; Length of Stay ; Medical Records ; Mortality ; Risk Factors ; Sex Distribution

No abstract available.
Trigeminal Nerve*

BACKGROUND: The hypertension is known to be the most important risk factor for the intracerebral hemorrhage. We analyzed other risk factors associated with hypertension that may contribute in the episode of hypertensive intracerebral hemorrhage. METHODS: Medical records of 100 patients with hypertensive intracerebral hemorrhage between January 1995 and December 2000 were reviewed and analyzed for age, sex, serum total cholesterol level, regular management of hypertension, systolic and diastolic blood pressure, arrhythmia and left ventricular hypertrophy in ECG. RESULTS: 1) Mean age was 64.1+/-11.3 years old and there were 35 males and 65 females. 2) Mean systolic and diastolic blood pressure were 176.9+/-35.9 mmHg and 106.3+/-20.7 mmHg. 3) Mean serum total cholesterol level was 182.6+/-46.4 mg/dL. 35.5% of the patients had serum total cholesterol levels less than 160 mg/dl and 33.4% were between 160-199 mg/dL. 4) Only 16% of the patients had any kind of treatment for hypertension. CONCLUSION: The high blood pressure and the treatment for hypertension were most important risk factors for hypertensive intrace- rebral hemorrhage. Also, 68.9% of the patients with hypertensive intracerebral hemorrhage had normal to low serum total cholesterol level. Thus low to normal serum total cholesterol level could be a risk factor of hypertensive intracerebral hemorrhage.
Arrhythmias, Cardiac ; Blood Pressure ; Cerebral Hemorrhage ; Cholesterol ; Electrocardiography ; Female ; Hemorrhage ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Intracranial Hemorrhage, Hypertensive* ; Male ; Medical Records ; Risk Factors

BACKGROUND: There were a lot of problems in the health care system of Korea, which was divided into Western and Korean Traditional Medicine since 1951. In 1976 WHO published program of The promotion and development of traditional medicine. In 1977, Korean Medical Association(KMA) asked unification of health care system to government. But there was no progress because there were the lacks of mutual respect and understanding be-tween doctors of Western and Korean Traditional Medicine. As one health care group competed with the other, so KMA proposed the unification of health system again in 1997. The objectives of this research are to analyze attitude and opinions of western medical doctors on Korean Traditional Medicine and to analyze the opinions on the unification of medical care system in Korea. METHODS: A list of western medical doctor in Seoul and Incheon was obtained from Korean Medical Association. We sampled 937 doctors by stratified random sampling method. We sent them a postal questionnaire with a prepaid return envelope two times during March and April 1997. Of the 937 questionnaire, 266 replies were received. We analyzed the preference score related referral, Korean Traditional Medicine education and unification of medical care system We analyzed the data by Chisquare test, t-test, ANCOVA. RESULTS: This study shows that the western doctors have negative attitude on Korean Traditional Medicine(M=1K8, SD=5.2). They thought Korean Traditional Medicine was not reliable because it was not scientific(79.4%). Doctor, who didn't take oriental medical education, preferred unification of health care system, but it was not statistically significant. Those who experienced oriental medical education used oriental medical treatment more frequently(F=1.17, p=0.04). The more positive attitude they have about Korean Traditional Medicine, the more frequently they refereed the patient to oriental medical doctor(t =3.57, p =0.0004). CONCLUSIONS: Western medical doctors have a negative attitude on Korean Traditional Medicine. Doctors, who did not have oriental medical education, preferred unification of health care system, but it was not statistically significant. In summary, the lack of mutual respect and understanding between doctors of the Western and Korean Traditional Medicine prevent unification of medical care system.
Delivery of Health Care ; Education ; Education, Medical ; Humans ; Incheon ; Korea ; Medicine, Korean Traditional* ; Medicine, Traditional ; Referral and Consultation ; Seoul ; Surveys and Questionnaires

BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

No abstract available.
Gangwon-do* ; Rehabilitation*

Primary malignant neoplasms of the heart are very rare disorders, which are found at less 1/1000 necropsies. These malignancies are almost exclusively sarcomas and histologically assume a wide veriety of morphological subtypes, angiosarcomas, rhabdomysarcomas, and fibrosarcomas(or MFH) being the most frequent. We experienced a case in which left atrial myxoma was suspected by 2-D echocardigraphy and the histologic diagnosis of promary MFH was confirmed by operation. A 45-year old woman with primary MFH arising from posterior wall of left atrium, interatrial septum and mitral annulus is presented with a brief view of the literatures. The patient was admitted to our hospital on March 1988, because of exertional dyspnea and intermittent palpitation resction of the masses. To date, more than thirteen months after surgery, the patient is alive and well in state of NYHA class II.
Diagnosis ; Dyspnea ; Female ; Heart ; Heart Atria* ; Hemangiosarcoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Middle Aged ; Myxoma ; Sarcoma

A spinal epidural hemangioma is rare. In this case, a 51 year-old female patient had low back pain and right thigh numbness. She was initially misdiagnosed as having a ruptured disc with possible sequestration of granulation tissue formation due to the limited number of spinal epidural hemangiomas and little-known radiological findings. Because there are no effective diagnostic tools to verify the hemangioma, more effort should be put into preoperative imaging tests to avoid misdiagnosis and poor decisions).
Diagnostic Errors ; Female ; Granulation Tissue ; Hemangioma ; Humans ; Hypesthesia ; Low Back Pain ; Thigh

Neonatal diabetes mellitus (NDM) is defined as hyperglycemia that presents clinical symptoms within the first month of life and requires insulin therapy to maintain euglycemia. The diabetic condition may be transient, permanent, or transient with recurrence later in life. NDM is a rare clinical disorder. Three cases of NDM have been reported in Korea so far. We experienced two cases of NDM in twin brothers who were born with small for gestational ages. Their HLA typings were DR9 and DR14, and insulin autoantibody, islet cell antibody, GAD-reactive autoantibody, and insulin receptor antibody were not found. The genetic analysis with polymorphic DNA markers for chromosome 6 indicated paternal uniparental isodisomy.
Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Gestational Age ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Insulin ; Islets of Langerhans ; Korea ; Receptor, Insulin ; Recurrence ; Siblings* ; Twins* ; Uniparental Disomy

PURPOSE: To reconstruct a cultured conjunctival equivalent that closely resembles normal conjunctival epithelium in three-dimensional culture systems. METHODS: Human conjunctival epithelial cells were cultured on dead de-epidermized dermis in the air-exposed state. After 2 weeks of culture, the sections were stained with hematoxylin and eosin. Immunohistochemical and electron microscopic studies were performed. The results were compared with those of normal conjunctiva and cultured eyelid skin equivalent. RESULTS: In the cultured conjunctival equivalent, nonkeratinizing stratified epithelium was formed similarly to normal conjunctival epithelium. Keratin 13 was expressed, but not keratin 10, in the cultured conjunctival equivalent, similarly to normal conjunctival epithelium. However, in the cultured eyelid skin equivalent, keratinizing stratified epithelium was formed. In addition, keratin 10 was expressed, but not keratin 13, contrary to those of the cultured conjunctival equivalent. In the cultured conjunctival equivalent, ultrastructurally, keratin intermediate filaments and desmosomes were found. In addition, microvilli were seen in the uppermost epithelial cells. CONCLUSIONS: These findings demonstrate that the cultured conjunctival equivalent resembles normal conjunctival epithelium morphologically, biochemically and ultrastructurally, thereby suggesting that the cultured conjunctival equivalent may have a great potential in the study of conjunctival epithelium.
Conjunctiva ; Dermis ; Desmosomes ; Eosine Yellowish-(YS) ; Epithelial Cells ; Epithelium* ; Eyelids ; Hematoxylin ; Humans ; Intermediate Filaments ; Keratin-10 ; Keratin-13 ; Microvilli ; Skin