No abstract available.
Autografts*

No abstract available.
Skull Base* ; Skull*

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

There have been many reports on cerebrovascular disease in Korea, almost all of which were done at the Department of Neurosurgery, Neurology, and Internal Medicine. It is established that hemorrhagic stroke(HS) occurs at a higher rate than ischemic stroke(IS) compared to Western societies. However, many patients with IS visit to Oriental Medicine in Korea. Because of the paucity of published information including stroke data of Oriental Medicine, it was our purpose to analyse characteristic pattern of stroke occurrence, clinical data, and outcome for 762 patients visited to emergency room or admitted to the University Hospital and Oriental Medicine for a twelve month period. The incidence of IS was at least 1.5 times that of HS(IS: 309, HS: 453). Among age groups, those in sixties and seventies were the most predominant. The distribution of patients according to each Departments and Oriental Medicine was 118(HS: 2, IS: 116) in Department of Internal Medicine, 286(HS: 251, IS: 35) in Neurosurgery, and 358(HS: 56, IS: 302) in Oriental Medicine. The overall outcome for HS are much poorer than those for IS: in HS, 69.6% good, 10.7% morbidity, and 19.7% mortality, and in IS, 83.2%, 13.0% and 3.8%, respectively. Considering the fact that many IS patients with mild symptoms and signs tend to visit private clinics, these results suggest the actual incidence of Is is much higher than HS in Korea, compared with previous reports. We expect that a multicentered cooperative study including Oriental Medicine will be motivated by this study for establishing more accurate characteristics of stroke in Korea in the future.
Emergency Service, Hospital ; Hemorrhage ; Humans ; Incidence ; Internal Medicine ; Ischemia ; Korea ; Medicine, East Asian Traditional ; Mortality ; Neurology ; Neurosurgery ; Stroke

No abstract available.
Abortion, Spontaneous* ; Female ; Humans ; Incidence* ; Pregnancy

Hemangiopericytoma is a rare vascular tumor arising from pericytes. The tumor usually develops in the skin or subcutaneous tissue, particularly in the extremities.4 pulmonary origin of hemangiopericytoma is known to be quite rare. It has the potential to become a highly malignant lesion, so wide excision is the treatment of choice. We present a case of primary malignant hemangiopericytoma of the lung and discuss the clinical symptoms, diagnosis, therapy and prognosis within the context of a brief review.
Diagnosis ; Hemangiopericytoma* ; Lung* ; Pericytes ; Prognosis ; Skin ; Subcutaneous Tissue

A twenty four-year-old female patient had suffered progressive dyspnea for 6 years until death. She denied any symptoms suggestive of connective tissue disease, or deep vein thrombosis. She suffered an episode of pontine infarct in 1995. Four years after diagnosis of primary pulmonary hypertension, she died of sudden death during hospitalization. Gross features of pulmonary arteries at autopsy were as follows: left main pulmonary artery showed dilation of the lumen and thickening of the wall, and right main pulmonary artery was markedly dilated and contained fresh thrombus. Hematoxylin and eosin-stained sections of lung tissue showed plexiform lesions of pulmonary arteries, complete luminal obliteration of pulmonary arterioles and dilated lesion of pulmonary arterioles, and capillaries. This patient represents a typical case with a primary pulmonary arteriopathy with plexiform lesions with thrombotic lesion, demonstrating the importance of thrombosis in situ in the pathogenesis of primary pulmonary hypertension. To our knowledge, this is the first autopsy report on the primary pulmonary hypertension in Korea.
Arterioles ; Autopsy ; Capillaries ; Connective Tissue Diseases ; Death, Sudden ; Diagnosis ; Dyspnea ; Female ; Hematoxylin ; Hospitalization ; Humans ; Hypertension, Pulmonary* ; Korea ; Lung ; Phenobarbital ; Pulmonary Artery ; Thrombosis ; Venous Thrombosis

PURPOSE: The ureteral stent is very effective for the drainage of urine and maintenance of renal function in patients with ureteral strictures. Retrograde ureteral stunting is a common procedure. However, there is a need for antegrade ureteral stunting with percutaneous nephrostomy in cases of severe ureteral strictures. In these cases, retrograde exchange of ureteral stent is very difficult. Hence, we tried an easier and more efficient exchanging method available in these cases and also assessed its clinical results. MATERIALS AND METHODS: We performed retrograde ureteral scent exchange In the patients using the following procedure. First, the distal tip of the previously Inserted ureteral stunt was pulled out 2cm beyond the external meatus. Second, a guide-wire was inserted into the scent through the hole upto the kidney and then the stunt was completely removed. Third, a cystoscopic sheath without obturator was introduced into the bladder passing over the guide-wire. Fourth, a new ureteral stent was introduced into the ureter over the guide-wire with pusher. RESULTS: We experienced successful exchange of ureteral steno 95 times on 9 ureters in 8 patients with severe ureteral strictures who had antegrade ureteral stenting performed. CONCLUSIONS: From these results, we conclude that this exchanging method is very safe and effective.
Constriction, Pathologic* ; Drainage ; Humans ; Kidney ; Nephrostomy, Percutaneous ; Stents* ; Ureter* ; Urinary Bladder

No abstract available.

OBJECTIVE: Because endometriosis is difficult to diagnose and has a high recurrence rate after treatment, a reliable serum marker of endometriosis is necessary. Therefore, the aim of this study is to measure the serum levels of CA125 and CA19-9 in patients with endometriosis before and after treatment and during recurrence, and to assess the usefulness of these levels in the diagnosis, clinical follow up and prediction of recurrence in endometriosis. METHODS: Eighty-eight patients who visited the department of Obstetrics and Gynecology of Ewha Mokdong Hospital from January 1994 to December 1998 and were diagnosed as endometriosis by laparoscopy or explo-laparotomy were enrolled as subjects. A retrospective analysis of serum CA125 and CA19-9 levels at 1 month before and 3 to 6 months after initiation of treatment was done. RESULTS: The serum CA125 and CA19-9 levels of endometriosis group(81.0+/-252.5, 36.6+/-53.4 ; mean+/-2SD, U/ml) before treatment was significantly higher than control group(11.6+/-12.8, 9.4+/-8.6)(p<0.05). Overall sensitivity rate for CA125, CA19-9 levels and both was 53.4%, 42.9% and 64.3% respectively. The sensitivity rate for endometriosis, stage 3 and 4(85.4%, 55.0%) was significantly higher than that, stage 1 and 2(p<0.05). The serum CA125 level in endometriosis group showed a significant increment according to stages(p<0.05) while the serum CA19-9 level showed an increasing trend(p=0.055) and both levels decreased significantly after treatment(p<0.05). The serum CA125 level was also higher at recurrence after treatment(p<0.05). CONCLUSIONS: The serum CA125 and CA19-9 levels are a useful marker for diagnosing severity of disease, monitoring efficacy of treatment and predicting recurrence in endometriosis.
Biomarkers ; Diagnosis ; Endometriosis* ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Laparoscopy ; Obstetrics ; Recurrence ; Retrospective Studies