The appendiceal tuberculosis is a rare from of skeletal tuberculosis in child and adults, arising from a focus or foci in posterior compartment of spine. This from may be unilateral and may be isolated or present at multiple levels, characterieed by slight change of the disk space and deformity, but large psravertebral abscess are invariable. Extradural extension may lead to the development of paraplegia. We had experienced one case of appendiceal tuberculosis at L1 and treated with antituberculosis medication and radical curettage, followed with body jacket cast.
Abscess ; Adult ; Child ; Congenital Abnormalities ; Curettage ; Humans ; Paraplegia ; Spine ; Tuberculosis

Epidural venography is a relatively simple and highly accurate method in the diagnosis of lumbar disc herniation. Angiographic visualization of the epidural vein has been tried and investigated by intraosseus injection of contrast agent into lumbar spinous process and intravascular injection into iliac vein since first report in 1954. Recently, lumbar epidural venography is instituted by selective catheterization of ascending lumbar vein or internal iliac vein. Lumbar epidural venography is valuable for the diagnosis of herniated lumbar disc, not demonstrated by myelography. Especially, lumbar epidural venography is more accurate than myelography in the diagnosis of L5-Sl disc herniation and in the case of extreme lateral herniation. Other advantages of epidural venography are low incidence of complication and ease of performance. Epidural venography may be recommended as an alternative rnethod rather than as adjunctive to myelography. We report 20 cases of epidural venography, compared with myelographic and operative findings.
Catheterization ; Catheters ; Diagnosis ; Iliac Vein ; Incidence ; Methods ; Myelography ; Phlebography ; Veins

Intertrochanteric fractures frequently occur in elderly patients. Early mobilization after rigid internal fixation of unstable intertrochanteric fractures has recently reduced the mortality and morbidity. Between March, 1976 and February, 1980, eighteen patients over 60 years old with unstable intertrochanteric fractures were treated by Jewett nailing after Dimon & Hughstons reduction at the department of Orthopaedic Surgery, Chung Nam University. Among the eighteen patients, twelve patients could be followed, ranging from 6 months to 2.1 years, with an average follow-up of 11 months. The results were obtained as follows: 1. The main causes of fractures were falling down and slip down. 2. In treatment of unstable intertrochanteric fractures by medial displacement and valgus nailing with Jewett nail, early ambulation and early weight bearing were possible with satisfactory results. 3. The average time for fracture union in twelve cases who were followed up were 17.1 weeks, but two cases with severe comminution of posterior and medial fragment of the trochanter revealed delayed union. 4. The medial displacement of distal fragment and valgus nailing in unstable intertrochanteric fracture shortened the operation time and reduced complications by early ambulation, but had disadvantages such as some limitation of motion of affected hip joints, shortening of affected extremities and delayed union.
Accidental Falls ; Aged ; Early Ambulation ; Extremities ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip Joint ; Humans ; Mortality ; Weight-Bearing

The purpose of this study is to investigate domestic and international research trends in studies of medical students' characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.
Cross-Sectional Studies ; Humans ; Korea ; Longitudinal Studies ; Mental Health ; Research Design ; Research Subjects ; Schools, Medical ; Sociological Factors ; Students, Medical

Purpose: Today's students have distinctive generational characteristics and increased psychopathology and generational tension. The authors investigated the negative experiences of Late Millennial students in medical school to draw implications for student support. Methods: The authors explored medical students’ negative experiences using the critical incident technique. The authors conducted semi-structured in-depth interviews with 13 medical students, between February and May 2016. The authors focused on occurrences that significantly influenced medical students’ school lives negatively from the students’ perspective. All interviews were recorded and transcribed. The authors classified incidents into frames of reference for the use of faculty development for student support. Results: The authors extracted 22 themes from a total 334 codes and classified them into eight subcategories. Finally, four categories emerged from frames of reference. Students manipulate relationships and colluding for better specialty choice. They experience uncontrolled rifts in interpersonal relationships between peers including lawsuits, sexual assaults, and social network service conflicts. Today’s students feel resentment towards dependent hierarchical relationships with seniors. They struggle with gender discrimination but perpetuate outdated gender role toward the opposite gender. Conclusion Faculty members should understand today’s students’ level of career stress and desire for work life balance. They should motivate students’ professional identity, promote assertiveness against unfair authorities, and focus on mental health, teamwork, and relationship building. All generations need to understand other generations and develop appropriate leadership and gender sensitivity.

Glycoprotein (GP) IIb/IIIa inhibitors, such as abciximab, are used as adjunctive therapy for percutaneous coronary intervention (PCI) in high-risk non-ST-elevation myocardial infarction (NSTEMI) and in ST-elevation myocardial infarction (STEMI), although their effects when used for STEMI are less clear. As the use of GP IIb/IIIa inhibitors becomes more widespread, determining the risks associated with them becomes more important. The major risks associated with the use of GP IIb/IIIa inhibitors are the potential for major bleeding and thrombocytopenia. This is the first reported case in Korea of hemorrhagic pericarditis resulting in cardiac tamponade associated with the use of abciximab, a commonly used GP Ilb/IIa inhibitor, following PCI.
Aged ; Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects ; Antibodies, Monoclonal/*adverse effects ; Anticoagulants/*adverse effects ; Cardiac Tamponade/*etiology/therapy ; Emergency Medical Services ; Hemorrhage/*etiology/therapy ; Humans ; Immunoglobulin Fab Fragments/*adverse effects ; Korea ; Male ; Pericardiocentesis ; Pericarditis/*etiology/therapy ; Platelet Aggregation Inhibitors/*adverse effects ; Risk Factors

OBJECTIVE: Recently, workers' mental health has become important focus in the field of occupational health management. Depression is a psychiatric illness with a high prevalence. The association between job stress and depressive symptoms has been demonstrated in many studies. Recently, studies about the association between sleep quality and depressive symptoms have been reported, but there has been no large-scaled study in Korean female workers. Therefore, this study was designed to investigate the relationship between job stress and sleep quality, and depressive symptoms in female workers. METHODS: From Mar 2011 to Aug 2011, 4,833 female workers in the manufacturing, finance, and service fields at 16 workplaces in Yeungnam province participated in this study, conducted in combination with a worksite-based health checkup initiated by the National Health Insurance Service (NHIS). In this study, a questionnaire survey was carried out using the Korean Occupational Stress Scale-Short Form(KOSS-SF), Pittsburgh Sleep Quality Index(PSQI) and Center for Epidemiological Studies-Depression Scale(CES-D). The collected data was entered in the system and analyzed using the PASW (version 18.0) program. A correlation analysis, cross analysis, multivariate logistic regression analysis, and hierarchical multiple regression analysis were conducted. RESULTS: Among the 4,883 subjects, 978 subjects (20.0%) were in the depression group. Job stress(OR=3.58, 95% CI=3.06-4.21) and sleep quality(OR=3.81, 95% CI=3.18-4.56) were strongly associated with depressive symptoms. Hierarchical multiple regression analysis revealed that job stress displayed explanatory powers of 15.6% on depression while sleep quality displayed explanatory powers of 16.2%, showing that job stress and sleep quality had a closer relationship with depressive symptoms, compared to the other factors. The multivariate logistic regression analysis yielded odds ratios between the 7 subscales of job stress and depressive symptoms in the range of 1.30-2.72 and the odds ratio for the lack of reward was the highest(OR=2.72, 95% CI=2.32-3.19). In the partial correlation analysis between each of the 7 subscales of sleep quality (PSQI) and depressive symptoms, the correlation coefficient of subjective sleep quality and daytime dysfunction were 0.352 and 0.362, respectively. CONCLUSION: This study showed that the depressive symptoms of female workers are closely related to their job stress and sleep quality. In particular, the lack of reward and subjective sleep factors are the greatest contributors to depression. In the future, a large-scale study should be performed to augment the current study and to reflect all age groups in a balanced manner. The findings on job stress, sleep, and depression can be utilized as source data to establish standards for mental health management of the ever increasing numbers of female members of the workplace.
Depression* ; Female* ; Humans ; Logistic Models ; Mental Health ; Multivariate Analysis ; National Health Programs ; Occupational Health ; Odds Ratio ; Prevalence ; Reward ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: A cerebrospinal fluid (CSF) gusher during cochlear implantation can produce surgical difficulties and postoperative life threatening morbidities such as meningitis. Authors reviewed cases of CSF gushers during cochlear implantation, and assessed the radiologic characteristics of CSF gushers. SUBJECTS AND METHOD: From November 1988 to March 2004, 72 congenital deaf children with inner ear malformation underwent cochlear implantation in Seoul National University Hospital. Among these, 15 patients showed CSF gush intraoperatively. The medical records, the preoperative tem-poral bone HRCT and IAC MRI were reviewed retrospectively. RESULTS: Eighty percent (12/15) of CSF gushers had cochlear malformation. One case with a common cavity (100%), 6 of 15 cases of cochlear hypoplasia (32%) and 5 of 27 cases of incomplete partition (18.5%) showed CSF gush. The total or a partial defect of the modiolus significantly increased the risk of CSF gush. During the surgery, promontory mucosa around the cochleostomy opening was removed by electrocauterization and soft tissue pieces were packed in the posterior tympanum around the cochleostomy site after insertion of the active electrodes. Some additional procedures such as mastoid or middle ear obliteration were performed in two patients with intractable CSF gush. No lumbar drains were used. Postoperative meningitis developed in one case 7 months after cochlear implantation without a history of CSF leak. However, there were no evidences of CSF leak in all cases during the postoperative follow-up period (3-49 months, mean 24 months). CONCLUSION: Cochlear implant surgeons should be prepared to cope with CSF gusher during the cochlear implantation procedure in cases with congenital inner ear malformation, particularly if the patient has radiological evidence of modiolar defect.
Cerebrospinal Fluid* ; Child ; Cochlear Implantation* ; Cochlear Implants* ; Ear, Inner ; Ear, Middle ; Electrodes ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Mastoid ; Medical Records ; Meningitis ; Mucous Membrane ; Retrospective Studies ; Seoul

BACKGROUND AND OBJECTIVES: An experimental model of bacterial rhinosinusitis is essential to study the pathogenesis of rhinosinusitis. To our knowledge, there hasn't been an experimental model using rats for bacterial rhinosinusitis, where Staphylococcus aureus is directly inoculated to the rat nose. Staphylococcus aureus is also a predominantly isolated bacterial pathogen in the episode of acute rhinosinusitis. The aim of this study was to develop a rat model of rhinosinusitis induced by Staphylococcus aureus, ATCC 25923. SUBJECTS AND METHOD: The infected Sprague-Dawley rats (4-6 week-old male) were applied intranasally with 40 microliter of Staphylococcus aureus, ATCC 25923, which corresponds to 108 colony-forming units per milliliter, which in turn corresponds to a No. 1 McFarland turbidity by spectrophotometer (VITEK, USA). After the 2nd, 5th, and 14th day, the rats were killed respectively. RESULTS: Nasal sinuses were then observed at low power field (x40) for changes in the amount of inflammatory cell clusters in the sinus cavity. There were significant differences in the number of inflammatory cell clusters between the infected and control rats (p<0.05). The infected rats killed at the 5th day had significantly more inflammatory cell clusters within the sinus cavities (p<0.05). CONCLUSION: Staphylococcus aureus induces acute bacterial rhinosinusitis in rats as measured by increased inflammatory cell clusters. This study demonstrates the efficacy of a rat model of acute bacterial rhinosinusitis.
Animals ; Models, Animal* ; Models, Theoretical ; Nose ; Paranasal Sinuses ; Rats* ; Rats, Sprague-Dawley ; Staphylococcus aureus* ; Staphylococcus* ; Stem Cells

Background: There is a need to update the cardiovascular (CV) Sequential Organ Failure Assessment (SOFA) score to reflect the current practice in sepsis. We previously proposed the modified CV SOFA score from data on blood pressure, norepinephrine equivalent dose, and lactate as gathered from emergency departments. In this study, we externally validated the modified CV SOFA score in multicenter intensive care unit (ICU) patients. Methods: A multicenter retrospective observational study was conducted on ICU patients at six hospitals in Korea. We included adult patients with sepsis who were admitted to ICUs. We compared the prognostic performance of the modified CV/total SOFA score and the original CV/total SOFA score in predicting 28-day mortality. Discrimination and calibration were evaluated using the area under the receiver operating characteristic curve (AUROC) and the calibration curve, respectively. Results: We analyzed 1,015 ICU patients with sepsis. In overall patients, the 28-day mortality rate was 31.2%. The predictive validity of the modified CV SOFA (AUROC, 0.712; 95% confidence interval [CI], 0.677–0.746; P < 0.001) was significantly higher than that of the original CV SOFA (AUROC, 0.644; 95% CI, 0.611–0.677). The predictive validity of modified total SOFA score for 28-day mortality was significantly higher than that of the original total SOFA (AUROC, 0.747 vs. 0.730; 95% CI, 0.715–0.779; P = 0.002). The calibration curve of the original CV SOFA for 28-day mortality showed poor calibration. In contrast, the calibration curve of the modified CV SOFA for 28-day mortality showed good calibration. Conclusion In patients with sepsis in the ICU, the modified SOFA score performed better than the original SOFA score in predicting 28-day mortality.