A statistical study on medical students who entered certain college of medicine during 10 years ('73 to '82) was performed in order to evaluate medical educational wastage. The obtained results summerized were as follows; 1. The normal promotion rate of 10 cohorts(CI-CX) was 83.4,% and 5 cohorts(CI to CV) whose members had already graduated(including dropouts) was 77.50. 2. The mean repetition rate in 1st grade was 15.596/, in 2nd grade 5.4%, in 3rd grade 1.4% and in 4th grade 0.60. 3. The predicted number of repetion(spell base) which are attendance at the college in 1st grade was 31.6, in 2nd grade 28.9, in 3rd grade 18.6 and in 4th grade 22.7; 4. The total wastage of 10 cohorts was 224.8 SY, which corresponded to educational resources of 56.2 out-puts for normal demand. 5. The mean unit cost of 10 cohorts was 4. 62 and the mean Input/Output ratio was 1.06.
Cohort Studies ; Humans ; Statistics as Topic* ; Students, Medical

Leiomyoma is a neoplasm of smooth muscle relatively common in the stomach, but very rare in the duodenal location. Recurrent bouts of severe melana remain the most frequent presenting symptom for leiomyoma. A 69-year-old man presented to us with a 4-day history of melena. Endoscopy revealed norinal mucosa covered ovoid elevated lesion with central linear depression and ulcer at the second portion of duodenum. Endoscopic biopsy showed chronic inflammation only. Duodenal mass was excised through a duodenotomy. Pathological diagnosis was leiomycena.
Aged ; Biopsy ; Depression ; Diagnosis ; Duodenum ; Endoscopy ; Esophagus* ; Hemorrhage* ; Humans ; Inflammation ; Intestines* ; Leiomyoma* ; MART-1 Antigen ; Melena ; Mucous Membrane ; Muscle, Smooth ; Stomach* ; Ulcer

Brain stem hematomas, expecially due to ruptured angiographically occult vascular malformation(AOVM), are of great interest because they are potentially curable. Preoperative diagnosis has been difficult due to poor resolution of CT scans in the posterior fossa region. The advent of MRI has made the identification of the angiographically occult vascular malformation possible before surgical excision. We preset 3 cases of brainstem hematoma due to vascular malformations which wre not visualized by angiography but were diagnosted by MRI. The patients were treated surgically and vascular malformations were confirmed.
Angiography ; Brain Stem* ; Diagnosis ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Vascular Malformations

Malignant CNS lymphoma is a malignant intracranial tumor and in most cases they run a fulminating course if left untreated, with 3 to 5 months survival after appearance of the initial symptoms. Sixteen patients with malignant lymphoma were treated in Asan Medical Center from 1989 to 1994. All patients were underwent tissue diagnosis with subtotal resection or stereotactic biopsy and followed by cranial or craniospinal irradiation with or without systemic chemotherapy. One and three year survival rate of the patients was 88% and 78% respectively. In conclusion, addition of chemotherapy and/or cranial radiation for treatment of the CNS lymphoma may improve survival.
Biopsy ; Chungcheongnam-do ; Craniospinal Irradiation ; Diagnosis ; Drug Therapy ; Humans ; Lymphoma* ; Survival Rate

Vertebral artery injury is a rare complication of anterior cervical approach. We report two patients who suffered injury to vertebral artery during anterior cervical spine surgery. The mechanism of injury, their operative management, and the subsequent outcome were assessed and relevant literatures reviewed. The awareness of the possibility of vertebral artery injury is most important to prevent and it's occurrence is best avoided by a thorough understanding of the anatomical relationships of the artery, the spinal canal, and the vertebral body and careful use of surgical instruments.
Arteries ; Humans ; Spinal Canal ; Spine* ; Surgical Instruments ; Vertebral Artery*

The authors analyzed the surgical results of posterior C1-C2 fusion in 18 cases of atlantoaxial instability. Posterior C1-C2 wiring with bone fusion(11 cases), C1-C2 transarticular screw fixation(6 cases), and occipitocervical fusion(1 case) have been performed for unstable odontoid process fractures(10 cases), transverse ligament injury(4 cases), os odontoideum(3 cases), rheumatoid C1-2 instability(1 case). Follow-up examination was performed in all patientts after a mean postoperativeduration of 39.9 months. Follow-up x-rays showed successful stabilization in 17 cases(94%). Postoperative neurological evaluation showed improvement in 16 cases(89%), stabilization in 2 cases(11%) and there was no major operative complication.
Follow-Up Studies ; Ligaments ; Odontoid Process

No abstract available.
Ecological Systems, Closed* ; Osteoblasts* ; RNA, Messenger* ; Sodium Fluoride* ; Sodium*

OBJECTIVE: This study was undertaken to review the mortality, complications, risk factors and the surgical outcome in long-term follow-up cases of brain abscess. METHODS: The authors studied medical records and radiological findings in patients with brain abscess who underwent operations in our hospital from 1990 to 1997. RESULTS: There were 44 cases and the ratio of male to female was 32:12 which shows predominance in male. The ages of patients ranged from 2 to 73(average: 40). Lesions were located at frontal lobe in 16 cases, temporal in 8, parietal in 7, occipital in 5, cerebellum in 6, and multiple in 2. The ranges of follow-up periods were from 1 month to 96 months(average: 20.5 months). The primary origins of infection were found in only 15 cases(34%) and in 32 cases(73%), the organisms were identified from culture. The operative modalities were as follows; abscess aspiration (stereotactic or sono-guided) in 42 times and abscess excision in 13 times. There were 2 operations in 7 cases and 3 in 2 cases. In 2 cases, recurrences were occurred during antibiotics therapy after first operation. Three patients(6.8%) died due to sepsis in 2 cases, increased intracranial pressure in 1 case. We analysed 19 cases who were followed-up more than 12 months. In this group, there were intermittent seizures in 2 cases, antibiotics(metronidazole) induced polyneuropathy in 1 case, and avascular necrosis of hip in 2 cases which were suspected to have relation to long-term high dose steroid therapy. But there were no other sequalae or neurological deficits. CONCLUSION: The complication rate from long-term follow-up was high(26%) but the mortality rate was low(6.8%). Additionally, the findings such as multiple lesions, empyema, and fungal infection are suspected to be risk factors in mortality cases.
Abscess ; Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Cerebellum ; Empyema ; Female ; Follow-Up Studies ; Frontal Lobe ; Hip ; Humans ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Necrosis ; Polyneuropathies ; Rabeprazole ; Recurrence ; Risk Factors ; Seizures ; Sepsis

We aimed to develop a cloud-based telemedicine platform for patients with intracerebral hemorrhage (ICH) at local hospitals in rural and underserved areas in Gangwon-do using artificial intelligence and non-face-to-face collaboration treatment technology. This is a prospective and multi-center development project in which neurosurgeons from four university hospitals in Gangwondo will participate. Information technology experts will verify and improve the performance of the cloud-based telemedicine collaboration platform while treating ICH patients in the actual medical field. Problems identified will be resolved, and the function, performance, security, and safety of the telemedicine platform will be checked through an accredited certification authority. The project will be carried out over 4 years and consists of two phases. The first phase will be from April 2022 to December 2023, and the second phase will be from April 2024 to December 2025. The platform will be developed by dividing the work of the neurosurgeons and information technology experts by setting the order of items through mutual feedback. This article provides information on a project to develop a cloud-based telemedicine platform for acute ICH patients in Gangwon-do.

Previously, we reported the concept of a cloud-based telemedicine platform for patients with intracerebral hemorrhage (ICH) at local emergency rooms in rural and medically underserved areas in Gangwon state by combining artificial intelligence and remote consultation with a neurosurgeon. Developing a telemedicine ICH treatment protocol exclusively for doctors with less ICH expertise working in emergency rooms should be part of establishing this system. Difficulties arise in providing appropriate early treatment for ICH in rural and underserved areas before the patient is transferred to a nearby hub hospital with stroke specialists. This has been an unmet medical need for decade. The available reporting ICH guidelines are realistically possible in university hospitals with a well-equipped infrastructure. However, it is very difficult for doctors inexperienced with ICH treatment to appropriately select and deliver ICH treatment based on the guidelines. To address these issues, we developed an ICH telemedicine protocol. Neurosurgeons from four university hospitals in Gangwon state first wrote the guidelines, and professors with extensive ICH expertise across the country revised them. Guidelines and recommendations for ICH management were described as simply as possible to allow more doctors to use them easily. We hope that our effort in developing the telemedicine protocols will ultimately improve the quality of ICH treatment in local emergency rooms in rural and underserved areas in Gangwon state.