No abstract available.
Lung* ; Neoplasm Metastasis* ; Sarcoma* ; Thorax*

BACKGROUND: Without available medical policy, up until now discharges against medical advice have occurred in th field of medicine in Korea. Seoul district court had convicted two physicians of crime because they had allowed a patient to discharge against medical advice, referred to as the Boramae incident in May of 1998. This shocked people in medical field as well as people and appeared in almost all newspapers and created a debate especially to physicians. The purpose of this study was to evaluate the differences of opinion of this incident between physicians and common people. METHODS: Ninety-nine physicians and ninety-nine common people were questioned from September 1 to September 30, 1998 about sociodemographic characteristics and opinion of this event. RESULTS: The mean age of the physician group, the non-physician group was 38.12+/-11.2, 38.5+/-11.1, respectively. Each group consisted of 87.9 percent, men and 12.1 percent, women. There were no differences between physicians and common people in experiences of discharges against medical advice in their families, decisions on Boramae-like incidents that could occur in the near future, and causes of discharges against medical advice. The physician group had more awareness rate of this incident than the non-physician group, and insisted more on the needs of methods to prevent recurrence. In opinion of the judgement, 5.1 percent of non-physician group agreed to conviction of Seoul district court. 22.2 percent of the non-physician group was of the opinion that this incident will affect patient care positively, about patient wifes decision, 21.2 precent of non-physician group considered that she made an imprudent decision. CONCLUSION: There were significant, differences between physicians and common people in the awareness of this incident, opinion on th judgement, needs of methods to prevent recurrence, the influence of this incident on patient care in the future, opinion of patient wifes decision, exceptional experiences of discharges against medical advice in a family, decisions on Boramae-like incidents that can occur in the near future, and causes of discharges against medical advice.
Crime ; Female ; Humans ; Korea ; Male ; Periodicals ; Patient Care ; Recurrence ; Seoul ; Shock ; Spouses

This investigation was evaluated for in vitro antibacterial activity against 169 Helicobacter pylori strains isolated from patients with gastric cancer in Pusan, Korea. The minimum inhibitory concentration (MIC) of 6 antibiotics was determined by broth microdilution method. The isolation rate of H. pylori was 39.3% in the patients with gastric cancer, and which was not observed any differences between male and female or age group. The MIC50amoxacillin, clarithromycin, and amoxacillin plus clarithromycin against H. pylori isolates was 4.0, 2.0, 0.5, 0.5, 0.5, 1.0, and 1.0 microgram/ml, respectively. The MIC50 of the metronidazole, erythromycin, ciprofloxacin, tetracycline, amoxacillin, clarithromycin, and amoxacillin plus clarithromycin against H. pylori isolates was 32.0, 16.0, 1.0, 1.0, 4.0, 16.0, and 8.0 microgram/ml, respectively. The prevalence of one kind of antibiotic resistant strains of H. pylori was 31.9% for metronidazole, 31.9% for erythromycin, 23.1% for clarithromycin, 11.2% for amoxacillin, 6.5% for ciprofloxacin, and 9.5% for amoxacillin and for clarithromycin. The prevalence of two kinds of antibiotic resistant strains of H. pylori was 8.3% for amoxacillin and clarithromycin, 4.1% for metronidazole and erythromycin, 1.3% for metronidazole and ciprofloxacin, 1.3% for erythromycin and ciprofloxacin. The prevalence of three kinds of antibiotic resistant strains of H. pylori was 5.9% for metronidazole, amoxaciltin, and ciprofloxacin, 2.4% for metronidazole, erythromycin, and ciprofloxacin. The prevalence of four kinds of antibiotic resistant strains of H. pylori was 1.3% for metronidazole, erythromycin, tetracycline, and ciprofloxacin.
Anti-Bacterial Agents ; Busan ; Ciprofloxacin ; Clarithromycin ; Erythromycin ; Female ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Male ; Metronidazole ; Microbial Sensitivity Tests ; Prevalence ; Stomach Neoplasms* ; Tetracycline

Nevus cell inclusion in the lymph node is an uncommon histologic finding and usually is an incidental finding in the capsule, fibrous trabeculae, perinodal adipose tissue, and parenchyma of the axillary, inguinal, or cervical lymph nodes which are removed as part of cancer diagnostic or therapeutic procedures. The aggregated pigmented nevus cells in the lymph node resemble the cells of the cutaneous nevi. It is important to differentiate them from metastatic carcinoma or malignant melanoma. The characteristic features of nevus cell inclusions are presence of nevus cells within the capsule and supporting stroma, without presence in the marginal sinus of the lymph node, and the absence of cytological atypia or mitosis of nevus cells. We report two cases of nevus cell inclusions, in the axillary lymph nodes in a patient with breast carcinoma and in an enlarged inguinal lymph node in a patient without a malignant tumor.
Adipose Tissue ; Breast Neoplasms ; Humans ; Incidental Findings ; Lymph Nodes* ; Melanoma ; Mitosis ; Nevus* ; Nevus, Pigmented

Cytomegalovirus(CMV) rarely causes cutaneous rnanifestations. But since the recent development of organ transplants and the increased prevalence of AIDS, various skin manifestations of CMV infection such as varicelliform eruptions, perineal hulcerations, papular, purpurc and vesiculobllous lesions are increasing in immunocompromised subjects, Perineal ulceration is a typical cytomegalovirus-induced skin manifestation which exhibits similar morphology to herpes simplex viral infection. We describe a case of CMV-induced ulcer on labia majora in an AIDS patient, proven by histologic findings and immunohistochemistry. The patient was treated with ganciclovir and the lesion improved two months later.
Cytomegalovirus* ; Ganciclovir ; Herpes Simplex ; Humans ; Immunohistochemistry ; Prevalence ; Skin Manifestations ; Transplants ; Ulcer*

PURPOSE: The purpose of this study is to determine the correlation between the correction loss of hallux valgus angle and the severity of valgus angle of the second toe. MATERIALS AND METHODS: We selected 312 cases from 268 surgical patients with hallux valgus deformity receiving distal chevron osteotomy. For a radiological evaluation, we analyzed the changes in the hallux valgus angles, first to second intermetatarsal angles, and valgus angle of the second toe post index operations. All patients were women; the mean age was 46 years. The mean follow-up period was 17 months. RESULTS: The mean hallux valgus angle was 33.6° preoperatively (range, 25.7°~44.8°), 13.1° (range, 8.4°~16.4°) after 4 weeks of postoperative period, and 17.1° (range, 9.4°~28.5°) at their final follow-up. The mean valgus angle of the second toe was 8.4° preoperatively (range, 2.0°~25.8°) and 8.3° (range, 1.7°~24.9°) at the final follow-up. Preoperatively, there was a positive correlation between the valgus angle of the second toe and hallux valgus angle (r=0.747, p=0.001). The correction loss of hallux valgus angle had a significant correlation with the severity of valgus angle of the second toe (r=0.802, p=0.001). CONCLUSION: The existence of the second toe valgus deformity may present itself as a cause of correction loss of hallux valgus angle. The preoperative measurement of the second toe valgus angle may be a good predictor of correction loss; therefore, thorough preoperative warning on the possibility of correction loss should be conducted to maximize patient satisfaction after the procedure.
Congenital Abnormalities ; Female ; Follow-Up Studies ; Hallux Valgus* ; Hallux* ; Humans ; Osteotomy ; Patient Satisfaction ; Postoperative Period ; Toes*

Background: The application of biportal endoscopic spinal surgery (BESS) in spine surgery is increasing. However, the clinical results of related studies have been inconsistent. In this study, the perioperative and clinical outcomes of two techniques in singlelevel lumbar decompression surgery were compared using the perspective of a spine surgeon experienced in microscopic surgery but inexperienced in BESS. Methods: This is a retrospective study performed with prospectively collected data. From April 2019, 50 consecutive patients who underwent a single-level lumbar decompression surgery with BESS were evaluated. Additionally, the data of 150 consecutive patients who underwent the same microscopic surgery before April 2019 were collected. We performed 1 : 1 ratio propensity score matching for these two groups to adjust for baseline variables. The postoperative patient-reported outcome measures included the Oswestry Disability Index (ODI) and numeric rating scale for the back and leg preoperatively and at 6 months after surgery. The laboratory data (C-reactive protein [CRP, mg/L] and hemoglobin [Hb, g/dL]) were measured preoperatively and 3 times (1, 2, and 3 or 4 days) postoperatively. In these periods, the peak and lowest CRP and Hb concentrations were evaluated. The perioperative outcomes, operation time (from skin incision to dressing), length of hospital stay, drainage (for 24 hours after surgery), and surgeryrelated complications were also evaluated. Results: Forty-seven patients (27 men and 20 women) were included in each group. The postoperative 6-month ODI was significantly lower in the BESS group than in the microscope group (6.90 ± 5.98 vs. 11.54 ± 9.70). The peak CRP concentration (16.63 ± 19.41 vs. 42.40 ± 37.73, p < 0.001) and CRP increment (peak CRP minus preoperative CRP, 14.69 ± 19.47 vs. 40.71 ± 37.32, p < 0.001) were significantly higher in the microscope group. Operation time (83.72 ± 35.71 vs. 70.27 ± 23.24, p = 0.047) was significantly longer in the BESS group. Surgery-related complications were found in 6 and 3 cases in the BESS group (3 revisions, 2 dural tears, and 1 conversion to open surgery) and microscope group (2 revisions and 1 hematoma), respectively. Conclusions BESS as a new technique resulted in satisfying short-term outcomes. It was a well-tolerated option for surgical treatment of single-level lumbar degenerative disease. The relatively high incidence of recurrence at the index level and incidental dural tears should be considered for surgeons new to BESS; however, these were manageable complications.

The term "vascular ectasia" is defined to include angiodysplasia, gastric antral vascular ectasia (GAVE) and telangiectasis, and these are the leading causes of acute or chronic gastrointestinal bleeding. We describe here the first 2 Korean cases of GAVE with rectal vascular ectasia in patients with liver cirrhosis. A 70-year-old woman was admitted to the hospital with hematochezia. The finding on endoscopy showed diffuse nonconfluent spots with oozing bleeding on the antrum and several vascular spots with oozing bleeding on the rectum. The lesions were successfully treated by argon plasma coagulation (APC). We report on another case of rectal vascular ectasia in a patient with liver cirrhosis. A 77-year-old man was admitted to the hospital with hematochezia. The findings on colonoscopy showed diffuse vascular spots with oozing bleeding on the rectum. The lesions were successfully treated by APC. These two patients have had no bleeding since their treatment, and they are currently being evaluated by follow-up studies at the outpatient department.
Aged ; Angiodysplasia ; Argon ; Argon Plasma Coagulation ; Carbamates ; Colonoscopy ; Dilatation, Pathologic ; Endoscopy ; Female ; Follow-Up Studies ; Gastric Antral Vascular Ectasia ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Liver ; Liver Cirrhosis ; Organometallic Compounds ; Outpatients ; Rectum ; Telangiectasis

Hypotensive anesthesia is widely used in an operation since 1) it minimizes bleeding and provides a good operation field, 2) it prevents massive hemorrhage in an operation which otherwise involves a large amount of b1ood loss and 3) it is useful in an operation for hypertensive patients. This procedure also involves a number of risks such as delayed awakening, reactionary bleeding, decrease in urine output and tissue hypoxia. The most dangerous complication can be hypoxia especially in the vital organs. 1t is therefore necessary to treat dehydration or blood loss before hypotensive anesthesia is induced. Since hypotensive anesthesia was introduced by Gardner (1947) for an operation of olfactory groove meningioma, various methods of deliberate hypotension have been developed. The most common method of hypotensive anesthesia in the present day is to use drugs, such as trmetaphan, nitroprusside and halothane. The effect of hypotensive anesthesia an various physiological functions of animals have been investigated is the past. Giffiths and Gillies (1948) reported that, in the hypotension induced by sympathectomy, an arterial systolic pressure of 32 mmHg is the minimum to overcome peripheral resistance. Chung (19743 observed in the halothane-induced hypotensive dogs that a systolic pressure of 30mmHg was required to assure adequate cerebral oxygenation. In the present study, we have investigated the effect of halothanie-induced hypotension on the renal function of dogs. The arterial systolic pressure was successively reduced to 60 and 30mmHg for 30min. each, and changes is various renal functions were studied during 100min. of the recovery period. The results are summarized as follows: 1. The systolic blood pressure was completely reeovered 80min. after the cessation of halothane inhalation. 2. Average renal blood flow Cestimated by Cppe) and glomerular filtration rate (estimated by Cg) during the first 20min. of the recovery phase were 26% ind 45% of the control level. However after 100min. of thy recovery period, repal blood flow was recovered to 63% and glomerular filtration rate to 74%of the control leveL 3. Average urine flow during the first 20min. of that recovery phase was approximately 40% of the control. 4. U/P osm. ratio was reduced to 90% the control level during the first 20min. of recovery, but it exceeded the control value after 20min. of recovery. 5. Thero was only 24% of the-tml value in the first 20min. of receavery phese, but there- after it gradually returned to the control level. 6. FEH2O (fractional excretion of N2) was and significantly changed- by halothane inhalation although there was a tendency to slight reduction at the beginning of the recovery phase. 7. FEK was 47% of the control value dqring ghe initial phase of recovery, but it returned to the control level after 40min. of the recovery period. 8. FE, and FEH2O were reduced to 56% and 50% of the control level after the hypotensive period, but returned to 70% and 82% of the control level after 40min. of the recovery period. These results indicate that although the systemic blood pressure completely recovered after halothane-induced hypotension, renal hemodynamics are not completely recovered with 100min. of the recovery period. However renal functions are mostly reversible, suggesting that halathane -induced hypotension did not induce irreversible damage of renal tissue.
Anesthesia ; Animals ; Anoxia ; Blood Pressure ; Dehydration ; Dogs ; Glomerular Filtration Rate ; Halothane ; Hemodynamics ; Hemorrhage ; Humans ; Hypotension ; Inhalation ; Kidney* ; Meningioma ; Nitroprusside ; Oxygen ; Renal Circulation ; Sympathectomy ; Vascular Resistance

Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015. Among 2,313 potential studies of interest, 25 randomized controlled trials (RCTs) and 21 systematic reviews (SRs) were included in the analysis. The selection was decided based on the agreement of two orthopedic surgeons. There was a lack of evidence about medication for radiculopathy arising from disc herniation and stenosis, but intervention procedures, including epidural block, showed positive efficacy in radiculopathy and also limited efficacy in spinal stenosis. There was some evidence based on the short-term follow-up regarding surgery being superior to conservative treatments for radiculopathy and stenosis. There was limited evidence regarding the efficacy of pharmacological and electric or magnetic stimulation therapies for neuropathic pain after spinal cord injury. This review of RCTs and SRs with high-quality evidence found some evidence regarding the efficacy of various treatment modalities for neuropathic pain related specifically to spinal disorders. However, there is a need for much more supportive evidence.
Constriction, Pathologic ; Follow-Up Studies ; Humans ; Librarians ; Magnetic Field Therapy ; Natural History ; Neuralgia* ; Orthopedics ; Peripheral Nervous System Diseases ; Radiculopathy ; Spinal Cord Injuries ; Spinal Stenosis ; Surgeons