BACKGROUND: It is expected that the demand for the information about the primary medical service in the forthcoming supersede age of communication will be on the increase. For that reason, family doctors who are in charge of the primary medical service have to play an important part in constructing a data-base for furnishing the medical information. This article presents a model which includes the roles of family doctors, constructing medical-related information site of family medicine in the communications net with PC to gat,her fundamental data in operating the system of medical information and elucidating the formation of medical-related information site and the effect of operating that system. METHODS: Since Aug. 20 in 1996, the site of family medicine, the program of medical information, has been set up in Unitel. The medical information of the site of family medicine is to be classified into two parts : for doctors and for the public. The former is composed of medicine documents, several kinds of medical data, a linkage with medicine site in Internet, movements of an academic society and information exchanges for friendship. The latter is mainly made up of some practical medical sense and medical counsel. RESULTS: From the opening the medical information site to Jul. 30 in 1997, 250 persons a day have connected with medical information site and this fact implied 15 hours connection a day in terms of the daily mean. The cases of health counsel averaged 6 cases connection a day and the annual statistics of those cases were about, 1980 cases. The major content of health counsel was related to common symptoms that could be settled in primary medical problem. According to the survey for connectors, most of connectors answered that the medical information through communications net was much more effective t.han that from other media in the educational aspects and very helpful in the prevention of diseases and in the medical expenditure. Above all, the medical information through communications net was very effective in correcting the mistaken practical medical sense. CONCLUSIONS: It is necessary for family doctors to give thought to the connection of both information communication and medicine and to have correct understanding of medical domain in the cyberspace. On the foundation of these necessities, all the family doctors have to make the best of their way to construct a database with rnedical data and to transfer these data into the computer sites.
Friends ; Health Expenditures ; Humans ; Internet

No abstract available.
Animals ; Dietary Fats* ; Rats*

Lumbar hernias are rare posterolateral abdominal wall defects that may be congenital or acquired. There are two types of lumbar hernia, the superior lumbar hernia through Grynfeltt triangle, and the inferior lumbar hernia through Petit triangle. Many techniques have been described for the surgical repair of lumbar hernias including primary repair, local tissue flaps, and conventional mesh repair. But these open techniques require a large skin incision. We report a case of superior lumbar hernia, which was successfully repaired using a laparoscopic approach.
Abdominal Wall ; Hernia ; Skin

No abstract available.
Diazepam* ; Hemodynamics* ; Morphine* ; Pancuronium* ; Respiration, Artificial*

Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma of the bone are merely different clinical expressions of one disease. Lichtenstein grouped these three clinical syndromes and proposed that this disease be termed histiocytosis X. This grouping was based on the histologic similarities and the possibility of transformation of one syndrome into another. The cause of histiocytosis X remains unknown. Histiocytosis X is a condition that presents single or multiple lesions, distributed in the soft tissue, lymph nodes, various organ and bones, especially in the areas of marked reticuloendothelial activity. The authors reviewed the clinical findings, radiographs and the treatment of the twenty-six patients with histiocytosis X diagnosed on the base of pathologic findings at Severance Hospital, between January, 1971 and December, 1980. Among the twenty-six patients, twenty-one patients could be followed, ranging from one month to six years, with an average follow-up of 1.6 years. The results obtained were as follows: 1. There was a slight male predominance (61.6%). The age ranged from 2 months to 42 years (average 8.2 years). Sixty-five percents of patients were the child under 4 years of age. 2. Hand-Schuller-Christian disease (50%) was the most common form of this disease. Letterer-Siwe disease developed in the youngest (average 1.2 years) and eosinophilic granuloma in the eldest (average 20.4 years). 3. The common manifestations were hepatomegaly, skin rashes and anemia in Letterer-Siwe disease; palpable mass, pain and exophthalmos in Hand-Schuller-Christian disease; pain and mass in eosinophilic granuloma. 4. The common sites of the skeletal lesions were skull, spine and femur, etc. 5. The patients with single skeletal lesion improved regardless of the methods of treatment. 6. Vinblastine, methotrexate and/or prednisone were valuable agents for the multiply involved patients. 7. Prognosis was poor for the patients who were young at onest, or who had multiple systemic involvements, but in case only with skeletal involvement the prognosis was good. Eosinophilic granuloma is the most benign variant, while Letterer-Siwe disease is the most malignant type.
Anemia ; Child ; Clinical Study ; Eosinophilic Granuloma ; Exanthema ; Exophthalmos ; Femur ; Follow-Up Studies ; Hepatomegaly ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Lymph Nodes ; Male ; Methotrexate ; Prednisone ; Prognosis ; Skull ; Spine ; Vinblastine

We have mnanaged the anesthetic and postoperative care in 9 patients with myasthenia gravis who underwent thymectomy and obtained following resultsa : 1) Premedication was glycoprrrolate 0.004mg/kg or atropine 0.01mg/kg and hydroxyzine 1~2mg/kg, I.M. Anesthetic induction was by thiopental 4~5mg/kg with 7he inhalation of halothane 1~2 % or enflurane 4~5%, and followed by endotracheal intubation. Anesthetic maintanance was done by N2O and halothane or enflurane. 2) Mean duration from the end of operation to intubation was 11.83+/-3.37hrs. 5 patients required reintubation. The mean duration from the extubation to reintubation was 33.11+/- 21.06hrs for these 5 patients. Over all this entire group of patients were placed on the respirator for a mean of 5.33+/-1.46dara. 3) Complication occured were 2 cases of cholinergic crisis, 1 cases of lung abscess, 2 cases of dyspnea and 1 case of tension pneumothorax 4) Abstinence of muscle relaxants, adequate respiratory care and the protection from cholinergic crisis were the most important factora for successful management.
Anesthesia* ; Atropine ; Dyspnea ; Enflurane ; Halothane ; Humans ; Hydroxyzine ; Inhalation ; Intubation ; Intubation, Intratracheal ; Lung Abscess ; Myasthenia Gravis* ; Pneumothorax ; Postoperative Care ; Premedication ; Thiopental ; Thymectomy* ; Ventilators, Mechanical

OBJECTIVE : To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in recurrent spontaneous abortion associated with hyperhomocysteinemia. MATERIAL AND METHOD: The blood Sample of habitual aborter with high fasting homocysteine level was tested by PCR-RFLP method. RESULTS: The patient was found to be a homozygosity for MTHFR gene mutation that was confirmed by the finding which is consistent with the mutation at the nucleotide 677 C to T, Corresponding to Ala to Val. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the MTHFR mutation should be examined in the workup of recurrent spontaneous abortion showing hyperhomocysteinemia.
Abortion, Spontaneous* ; Fasting ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

No abstract available.
Animals ; Dietary Fats* ; Radiotherapy ; Rats*

No abstract available.
Humans ; Infant, Newborn*

To evaluate the detection of HPV DNA according to subtype of lesions of uterine cervix and its clinical applicability, in situ hybridization (ISH) and immunohistochemistry for HPV were performed in 189 cases of uterine cervical lesion, including 23 cases of low grade squamous intraepithelial lesion (SIL), 115 cases of high grade SIL and 51 cases of invasive carcinoma. Positive immunostaining, brown precipitate, was mainly noted in the nucleus of koilocytes in the superficial and intermediate layer. Positivity of immunostaining was 21.7% in low grade SIL, 13.0% in high grade SIL and 9.8% in invasive carcinoma. Positive reaction in ISH, red precipitate, was noted in the nucleus of not only koilocytes but also non-koilocytes in the superficial and intermediate layer, and dot precipitate was rarely identified in the nest of squamous cell carcinoma. Based on HPV subtype, 6/11 was 21.7% in low grade SIL, 16/18 was 32.2% and 39.2% in high grade SIL and invasive carcinoma, respectively. With regard to their associated HPV types, low grade SILs were heterogeneous and high grade SILs and invasive carcinomas were related with the high oncogenic risk group only. The correlation of HPV subtypes with panHPV was 91.3% in low grade SIL, 91.3% in high grade SIL and 98.0% in invasive carcinoma. These results suggest that detection of HPV infection by ISH may be a more useful method than immunohistochemistry and application of the HPV subtype probe with the panHPV probe could improve the sensitivity of ISH.
Carcinoma, Squamous Cell ; Cervix Uteri* ; DNA ; Female ; Humans* ; Immunohistochemistry* ; In Situ Hybridization*