There have been various surgical methods to treat the carotid cavernous fistula such as the carotid ligation, trapping procedure, embolization with muscle, gelfoam and polyurethane foam, balloon technique and direct transcavernous approach. Each method has its own merits and disadvantages. The ideal treatment of the illness would be the selective closure of the fistula with preservation of carotid patency. The authors are reporting a case of C-C fistula in which selective muscle embolism preserving carotid flow was attempted at first, but the closure was incomplete that polyurethane foam embolization was done in addition with success.
Carotid-Cavernous Sinus Fistula ; Embolism ; Fistula* ; Gelatin Sponge, Absorbable ; Ligation ; Polyurethanes*

PURPOSE: This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea. METHODS: The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity. RESULTS: The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators. CONCLUSION: This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.
Home Care Agencies ; Home Care Services ; Long-Term Care ; Nursing Homes ; Quality Indicators, Health Care

A 44-year-old woman who comlpained of dizziness and generalized weakness was admitted. The hemoglobin was 6.6g/dL, hematocrit 25.5%, and serum ferritin 2.14 ng/mL Stool occult blood was positive and microcytic hypochromic anemia was found on periyheral blood smear. Gastroscopic examination showed about 2 x 1 cm sized hemispherical sebmucosal tumor on antrum. The patient underwent operatioh for confirmatory diagnosis and treatment. The final pathologic diagnosis of the resected lesion was hemangioma of stomach. Cavernous hemangioma of stomach is a rare disease.Mostly, it has a benign course clinically, but early diagnosis is important because massive hemorrhage and anemia by chronic blood loss can occur. We report a case of hemangioma of stomach with review of literature.
Adult ; Anemia ; Anemia, Hypochromic ; Diagnosis ; Dizziness ; Early Diagnosis ; Female ; Ferritins ; Hemangioma ; Hemangioma, Cavernous* ; Hematocrit ; Hemorrhage ; Humans ; Occult Blood ; Stomach*

BACKGROUND: Donors with acitretin medication history are deferred for three years in Korea, because acitretin has teratogenic effect. Authors tried to evaluate the cost-effectiveness of the donor screening measures for acitretin medication. METHODS: From January 2006 to May 2007, the numbers of screened donors and accepted donors were 10,098,868 and 7,867,019, respectively. Although there was no single case of reported congenital malformation due to transfusion of blood donated by donors on acitretin medication, we assumed one case had occurred to contect the cost-effectiveness analysis. Also, the quality of life (QOL) of fetus with congenital malformation was assumed to be 0. The expected life-span of average Korean people was 78.6 years. RESULTS: The cost-effectiveness of electronic inquiry of computer database and blood test for acitretin were calculated to be 173,453,840 won/QALY and 8,780,333,865/QALY, respectively. They equaled $188,537/QALY and $9,543,841/QALY, respectively. CONCLUSION: The cost-effectiveness of electronic inquiry of computer database and blood test for acitretin were 3.8 and 190 times of $50,000/QALY, which is usually accepted to be reasonable in medical field. Electronic inquiry of computer database could be reasonable measure, if we deal with the problem protecting donor privacy, while blood test for acitretin could not be enforced because of unacceptably expensive cost.
Acitretin ; Blood Donors ; Donor Selection ; Electronics ; Electrons ; Fetus ; Hematologic Tests ; Humans ; Korea ; Privacy ; Quality of Life ; Tissue Donors

BACKGROUND: Donors with acitretin medication history are deferred for three years in Korea, because acitretin has teratogenic effect. Authors tried to evaluate the cost-effectiveness of the donor screening measures for acitretin medication. METHODS: From January 2006 to May 2007, the numbers of screened donors and accepted donors were 10,098,868 and 7,867,019, respectively. Although there was no single case of reported congenital malformation due to transfusion of blood donated by donors on acitretin medication, we assumed one case had occurred to contect the cost-effectiveness analysis. Also, the quality of life (QOL) of fetus with congenital malformation was assumed to be 0. The expected life-span of average Korean people was 78.6 years. RESULTS: The cost-effectiveness of electronic inquiry of computer database and blood test for acitretin were calculated to be 173,453,840 won/QALY and 8,780,333,865/QALY, respectively. They equaled $188,537/QALY and $9,543,841/QALY, respectively. CONCLUSION: The cost-effectiveness of electronic inquiry of computer database and blood test for acitretin were 3.8 and 190 times of $50,000/QALY, which is usually accepted to be reasonable in medical field. Electronic inquiry of computer database could be reasonable measure, if we deal with the problem protecting donor privacy, while blood test for acitretin could not be enforced because of unacceptably expensive cost.
Acitretin ; Blood Donors ; Donor Selection ; Electronics ; Electrons ; Fetus ; Hematologic Tests ; Humans ; Korea ; Privacy ; Quality of Life ; Tissue Donors

OBJECTIVE: Our purpose was to estimate the prevalence of hepatitis C virus seropositivity and define the risk factors for HCV infection in a group of pregnant women and the effect of HCV infection to mother and baby at the time of delivery. METHODS: From March 1997 to February 1998, 5655 women who delivered over 20 gestational weeks at our hospital were screened for HCV-Antibody(RIA), and the samples of most of HCV-Ab positive cases were analyzed for HCV-RNA by polymerase chain reaction(PCR). We also studied the risk factors for HCV infection, the effect of HCV infection to mothers and neonates at delivery. RESULTS: Of 5655 mothers 25 (0.44%) were HCV-Ab positive, and 20 of HCV-Ab positive mothers were analyzed for HCV-RNA by PCR. Of 20 HCV-Ab positive mothers 12 cases (60%) were HCV-RNA positive. Risk factors significantly more prevalent among HCV-seropositive patients were : a history of habitual intraveneous drug use, a history of smoking, alcohol drinking during pregnancy, having liver cirrhorsis. The proportions who had received a blood transfusion, had a history or ongoing syphilis or were positive for hepatitis B virus surface antigen were not significantly different between seropositive and seronegative women. Liver function test at delivery was abnormal in 4 cases(16%) of HCV-Ab positive group. And the number of abnomal liver function test cases in HCV-Ab negative group were 47(0.83%). This had statistical difference. In neonates at delivery, all 20 neonates of 20 ones having HCV-Ab positive mother were HCV-Ab positive. But only 2 cases of 20 babies were HCV-RNA positive. CONCLUSION: Mothers who have risk factors such as injecting drug use, smoking, alchohol drinking and liver cirrhorsis, should undergo HCV-Ab testing and quantitative HCV-RNA testing by PCR. More advanced studies about vertical transmission of HCV infection are needed.
Alcohol Drinking ; Antigens, Surface ; Blood Transfusion ; Drinking ; Female ; Hepacivirus* ; Hepatitis B virus ; Hepatitis C* ; Hepatitis* ; Humans ; Infant, Newborn ; Liver ; Liver Function Tests ; Mothers ; Polymerase Chain Reaction ; Pregnancy* ; Pregnant Women ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Syphilis

This study investigated effect of extract containing quercetin-3-O-beta-D-glucuronopyranoside from Rumex Aquaticus Herba (ECQ) against chronic gastritis in rats. To produce chronic gastritis, the animals received a daily intra-gastric administration of 0.1 ml of 0.15% iodoacetamide (IA) solution for 7 days. Daily exposure of the gastric mucosa to IA induced both gastric lesions and significant reductions of body weight and food and water intake. These reductions recovered with treatment with ECQ for 7 days. ECQ significantly inhibited the elevation of the malondialdehyde levels and myeloperoxidase activity, which were used as indices of lipid peroxidation and neutrophil infiltration. ECQ recovered the level of glutathione, activity of superoxide dismutase (SOD), and expression of SOD-2. The increased levels of total NO concentration and iNOS expression in the IA-induced chronic gastritis were significantly reduced by treatment with ECQ. These results suggest that the ECQ has a therapeutic effect on chronic gastritis in rats by inhibitory actions on neutrophil infiltration, lipid peroxidation and various steps of reactive oxygen species (ROS) generation.
Animals ; Body Weight ; Drinking ; Gastric Mucosa ; Gastritis* ; Glutathione ; Iodoacetamide* ; Lipid Peroxidation ; Malondialdehyde ; Neutrophil Infiltration ; Peroxidase ; Quercetin* ; Rats* ; Reactive Oxygen Species ; Rumex ; Superoxide Dismutase

Purpose: To evaluate the effectiveness of an instrument devised for slit-lamp examination of donor corneas suspended in preservation medium. Methods: The study examined two donor corneas received at Yeouido St. Mary's Hospital in February 2023 and March 2023. The instrument has three main components: a plastic holder to hold the preservation medium bottle, a cube with a mirror for reflecting the slit beam, and a stand to attach the device to the slit-lamp. Using the instrument, the donor corneas were examined via slit-lamp: microscopy with the endothelium facing upward and downward. Specular microscopy and anterior segment optical coherence tomography (OCT) were also performed on the preserved donor corneas. Results: Slit-lamp examination of donor corneas in preservation medium using the instrument showed overall corneal buttoning and optical sections of the donor cornea. Using specular reflection and retroillumination, the endothelial layer was partially visible. However, specular microscopy and anterior segment OCT could not examine the donor cornea in preservation medium using the instrument. Conclusions The devised instrument facilitates slit-lamp examination of donor corneas in preservation medium, enabling a qualitative assessment of donor corneas before corneal transplantation surgery.