Various anatomical defects have been described in the surviving co-twin who had stillborn, macerated monozygotic co-twin with disseminated intravascular coagulation. The suggested mechanism was the transfer of emboli or thromboplastic materials of dead fetus to co-twin through placental vascular anastomoses. Multicystic encephalomalacia is the condition defined anatomically by the presence of multiple cavities in the great part of both cerebral hemispheres. The most common pathogenesis is circulatory disturbance caused by neonatal asphyxia during the perinatal period. We experienced two cases of monozygotic twin with deceased co-twin at 26 weeks, 33 weeks of gestation and confirmed the diffuse multicystic encephalomalacia by cranial ultrasonography and MRI in a surviving co-twin. Only one patient has been followed who showed spastic cerebral palsy and severe mental retardation. We report two cases of multicystic encephalomalacia in a surviring co-twin with a intrauterine fetal death and its related literatures.
Asphyxia ; Cerebral Palsy ; Cerebrum ; Disseminated Intravascular Coagulation ; Encephalomalacia* ; Fetal Death* ; Fetus ; Humans ; Intellectual Disability ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy, Twin ; Twins, Monozygotic ; Ultrasonography

PURPOSE: The number of glyphosate and glufosinate intoxication cases are increasing in Korea. This study was undertaken is to compare the clinical manifestations of poisoning by these two herbicides and to document severities and clinical outcomes. METHODS: We retrospectively evaluated cases of glyphosate or glufosinate intoxication among patients that visited our emergency department between January 1, 2013, and December 31, 2017. Incidences of intoxications were analyzed over this five year period, and underlying diseases, transportation, mental state, shock occurrence, inotropics, gastric lavage, charcoal administration, intubation and ventilator therapy, and hemodialysis were investigated. In addition, we included transfer to the intensive care unit, incidences of pneumonia and of other complications, death, and hopeless discharge. RESULTS: There were 119 cases of glyphosate intoxication and 42 of glufosinate intoxication. Levels of consciousness were lower for glufosinate and vasopressor usage was higher due to a high shock rate (p=0.019). In addition, many patients were referred to the ICU for intubation and ventilation. The incidences of pneumonia and of other complications were significantly higher for glufosinate. CONCLUSION: Overall glufosinate intoxication was found to be more severe than glyphosate intoxication as determined by complication and ICU admission rates.
Charcoal ; Consciousness ; Emergency Service, Hospital ; Gastric Lavage ; Herbicides ; Humans ; Incidence ; Intensive Care Units ; Intubation ; Korea ; Pneumonia ; Poisoning* ; Renal Dialysis ; Retrospective Studies ; Shock ; Transportation ; Ventilation ; Ventilators, Mechanical

In order to evaluate the genotoxic hazard among workers potentially exposed to low level petrochemical substances, the analyses of micronuclei (MN) and sister chromatid exchanges (SCEs) in lymphocytes were performed in 46 male workers (as exposed group) and 46 nonexposed subjects (as control group). Mean frequencies of MN and SCEs (respectively, 12.9/1000 cells and 6.5/cell) in exposed group were very significantly higher than those (10.2/1000 cells and 5.4/cell) in control group. And there were also significant differences in mean frequencies of MN and SCEs adjusted for age, employment duration, smoking, and drinking between two groups. Median frequencies of MN and SCEs in exposed group were very significantly higher than those in control group. Frequencies of SCEs were higher in smokers than in non-smoker. Frequencies of MN in smokers, however, were similiar to those of non-smoker. Interaction between exposure and smoking on MN and SCEs induction was not observed. The results suggest that there is genotoxic hazard in high risk group like workers handling carcinogens in petrochemical plants and the analyses of MN and SCEs are useful biomarkers for the exposure to hazard substances even at the level below the exposure limit.
Biological Markers ; Carcinogens ; Drinking ; Employment ; Humans ; Lymphocytes ; Male ; Sister Chromatid Exchange ; Smoke ; Smoking

BACKGROUND: It seems that herpes zoster is caused by reactivation of the varicella-zoster virus and its incidence is increasing. The reactivation of the varicella zoster virus is thought to be associated with the disturbance of the state of immunity in patients with herpes zoster. OBJECTIVE: The purpose of this study was to elucidate the state of immunity in patients with herpes zoster in its acute phase(less than 7 days). METHODS: 1. Thirty patients with acute phase herpes zoster matched by age and sex against a control group, were checked for Helper/Inducer T cell(CD4), Suppressor/Cytotoxic T cell(CD8), NK cell, B cell and activated T cell by three color flow cytometric analysis. 2. Forty patients with herpes zoster measured delayed cutaneous hypersensitivity by means of Multitest' CMI. 3. Thirty patients with herpes zoster measured Ig G, M, A by means of N-antisera method.
Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Hypersensitivity ; Immunity, Cellular ; Immunity, Humoral* ; Incidence ; Killer Cells, Natural

The Oriental countries have had long histories and large populations. While they were the civilized country with the profound culture and thoughts, they were backward in material civilization bacause of their delayed development of science. Extending from the end of the 18th century to the 19th century the Western countries perturbed the Eastern countries with their sudden appearance. The Western countries visited the East with their threatening attitudes by giant war vessels and guns. They also strongly demanded to import their advanced daily commodities and the studies including the medical science. Since the most of the Eastern countries were too conservative, they resisted and rejected the Western forces at first. At that time, most Eastern countries located in the southern region of Asian continent were colonized by the West. The other countries in the nortern region came to realize that they were behind the West in material civilization, so had to open their door to the West through the foreign contact. China, Japan and Korea had to accept the Western culture and urged the civilization. Especially Japan adapted herself to new circumstances before others. She accepted the Western culture, thoughts and all studies actively with even reforming her political system. Starting from the yesr of 1868, Japan not only was reborn and formed independent position in the cultural region of China and Korea but also succeeded to construct the first westernized country among the Eastern countries and weekened the influence of China and Russia. Japan provoked and won wars such as the Sino-Japanese War {1894} and the Russia-Japanese War (1904). Follwing up these victories, Japan also occupied Korea in 1910, and the period of colonization had continued for 35 years until 1945 when Japan surrendered to the Allies at the end of the World War II. With these historical cirumstances, the purpose of this research paper is to collect the medical data, especially that of the anesthesia, and show its historical contributions through the documents. The long history of Korea had developed with the traditional and peculiar medical science, such as a herb medical science and a medical science in acupuncture and moxibustion. Korean medical science, however, has been greatly changed since 1876, the year of opening her door to Japan. There were two ways of introducing the Western medical science in Korea. As the indirect import, the japanese Western medical scince through the city of Busan was one. As the direct imports, the American medical science by an American missionary, Allen through the city of Incheon was the other. In these two currents of the Western medical science, it was natural that the Japanese one formed the main stream after 1910, the year of japanese occupation. The field of anestheia science was not an exception. Its developing process was no better than following the path of Japanese anesthesia science history. Comparing the Western developing history of anesthesia to that of Japan in general, there were a few ears difference in the level of quality between the East and the West until about 1930. Japanese anesthesia, however, fell behind over 20 years, comparing to the Western one, in the period from the late of 1930s to 1945. I believe that it is beyond the scope of this paper to explain and it leaves us with meaningful lessons.
Acupuncture ; Anesthesia* ; Asian Continental Ancestry Group ; Busan ; China ; Civilization ; Colon ; Ear ; Firearms ; Humans ; Incheon ; Japan ; Korea* ; Missions and Missionaries ; Moxibustion ; Occupations ; Political Systems ; Rivers ; Russia ; World War II

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason for the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium irate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.
Hand ; Health Expenditures ; Humans ; Insurance ; Insurance Carriers ; Insurance, Health* ; Korea* ; Outpatients ; Public Health ; Tertiary Healthcare

The T cell responses to hepatitis B surface antigen (HBsAg) were analyzed in acute hepatitis patients, chronic active hepatitis (CAH) patients and asymptomatic carriers. Neither proliferative responses nor substantial cytokine production of peripheral blood mononuclear cells (PBMC) in response to HBsAg was detected. For further studies, HBsAg- reactive T cell lines were prepared from PBMC of the hepatitis patients and asymptomatic carriers. No proliferative response of the T cell lines was observed. Interestingly, however, T cell lines obtained from acute hepatitis patients were found to produce IFN-r, but not IL- 4, in response to HBsAg stimulation, whereas T cell lines obtained from CAH patients and carriers were not. Results of this study suggest that HBsAg-reactive T cells producing Thl type cytokines may play an important role in the viral clearance during acute infections, while defects in those T cells may be responsible for the viral persistency.
Cell Line ; Cytokines ; Hepatitis ; Hepatitis B Surface Antigens* ; Hepatitis, Chronic ; Humans ; T-Lymphocytes*

No abstract available.
Knee* ; Ligaments*

Polyarteritis nodosa (PAN) is a necrotizing angitis that predominantly affects small-and medium-sized arteries in which microaneurysm or occlusion of the visceral arteries can be seen by arteriography. Patients with PAN may have non-specific symptoms at the beginning of their illness, but progression can be sudden and result in severe, even life threatening, complications. These include central nervous system hemorrhages, gastrointestinal hemorrhages or perforation, acute appendicitis, liver infarcts, acute renal failure, renal perirenal hematomas, and cardiac failure. A diagnosis of PAN should be considered when multiple small-sized aneurysms are detected by angiography, even if a biopsy is negative. Involvement of gastrointestinal and renal arteries is frequent in polyarteritis nodosa. The most common complications of gastrointestinal involvement are mucosal ulceration, bowel infarction, perforation, cholecystitis and hepatitis. Another rare but potentially life-threatening complication is perirenal hematoma caused by spontaneous rupture of renal aneurysm. Because of this possibility, rapid evaluation of these patients is necessary to make early diagnosis and treatment possible. We describe an extremely rare case of polyarteritis nodosa with development of spontaneous perirenal hematoma due to rupture of renal aneurysm, which was evaluated with immediate angiography and treated by coil embolization.
Acute Kidney Injury ; Aneurysm* ; Aneurysm, Ruptured ; Angiography ; Appendicitis ; Arteries ; Biopsy ; Central Nervous System ; Cholecystitis ; Diagnosis ; Early Diagnosis ; Embolization, Therapeutic ; Emergencies* ; Emergency Service, Hospital* ; Gastrointestinal Hemorrhage ; Heart Failure ; Hematoma ; Hemorrhage ; Hepatitis ; Humans ; Infarction ; Liver ; Polyarteritis Nodosa* ; Renal Artery* ; Rupture* ; Rupture, Spontaneous ; Ulcer

Anterior or lateral neck mass that appears on straining should be differentiated from laryngocele, jugular phlebectasia and superior mediastinal cysts or masses. The most common cause of aneck masses which that appears on straining is alaryngocele. The jugular phlebectasia may present itself in a similar manner, although it occurs rarely. The cause of the jugular phlebectasia is unclear. The diagnosis is made on a clinical basis and confirmed by the less invasive radiological technique. No treatment is indicated because of its self-limiting, benign condition. However, the surgical removal is needed for cosmetic purposes by a unilateral excision of the jugular vein. We experienced two cases of jugular phlebectasia, one anterior and the other internal. One case of The anterior jugular phlebectasia was successfully treated by surgical excision, and the other case of internal jugular phlebectasia was treated conservatively.
Diagnosis ; Jugular Veins ; Laryngocele ; Mediastinal Cyst ; Neck