BACKGROUND: Pain is among the most prevalent symptoms experienced by patients with cancer. Severe pain is incompatible with quality of life. Although cancer pain can be effectively treated in 70-90% of patients with the principle of pain management, between 60% and 70% of cancer patients pain is inadequately treated. Both knowledge and attitudes of medical professionals are important for effective pain management. This study was designed to survey residents knowledge and attitudes toward cancer pain management in order to offer the basic data for researching the problems and education program of cancer pain management. METHODS: In February 1997, we surveyed 116 residents practising in 7 departments of one university hospital, including physicians and surgeons, with a case-oriented questionnaire assessing knowledge and attitudes toward cancer pain management. RESULTS: The percentage of residents choosing the correct answer for knowledge about pain management was, pain in the drug abuser(42.2%), equianalgesic dosing(47.4%), physical dependence(50.9%), WHO analgesic ladder(61.2%), neuropathic pain(62.9%), around the clock dosing(69.8%). The percentage of residents choosing answer for attitude toward cancer pain management ; upper limit to opioid prescription(46.5%), reluctance to prescribe morphine(45.7%), need of education for pain management(99.1%). Fear of side effects was the most frequent reason of their reluctance to prescribe opioids(80.4%.) Physicians had higher level of knowledge than surgeons(P=0.004). CONCLUSIONS: This study shows the presence of barriers to adequate pain control in Korea as identified in other countries. There is the lack of konwledge about cancer pain management and doctors are reluctant to prescribe because of negative attitudes towards pain management. This suggests a need for not simply offering knowledge but problemsolving education and training of pain management.
Education ; Humans ; Korea ; Pain Management* ; Quality of Life ; Surveys and Questionnaires

The effect of thiamphenicol on hematopoietic system has to be evaluated. One hundred and fifteen male patients had been given oral 2. 5 gm thiamphenicol for uncomplicated gonococcal infection. ln this study, hemoglobin, WBC, hematocrit, reticulocyte and differential WBC counts were evaluated before, R days, 10 days and 1 month after the treatment. Hemoglobin, WBC, reticulocyte and differential WRC counts did not show any differences between pre and 3 days, l0days and 1 month post-treatment. In jailed cases, WBC count was found to be raiseri pretreatment(7,500 1-1.700, n='30) and 3 days after the treatment(v, 1pp+1,6p0, n=Rp) from normal value (Ii,100.:>1,600 in NMC biochemistry). In cured cases, WBC count was also found to be raised pre-treatment(7,50Q-i- 2,100, n=54) from normal value(6, 1001, 500), but returned to norrna1 3 days (6, 100 ! 1, 500, n = 54) and 10 days after the treatment, no cases showed any significant changes for WBC count(v,ppp-+1,gpp, n=7) from normal value(6,1%)- 1,500). Other side effect of thiamphenicol, such as hematologic toxicity and aplastic anemia had not been observed. Therefore, thiamphenicol 2. 5 gm p.o. is well tolerated and non-toxic treatment.
Anemia, Aplastic ; Gonorrhea* ; Hematocrit ; Hematopoietic System ; Humans ; Male* ; Reference Values ; Reticulocytes ; Thiamphenicol*

During the period of 9.5 years from September, 1985 to March, 1995, 32 cases with spontaneous closure in simple ventricular septal defect(VSD) were observed and evaluated at Yeungnam University Hospital, and those were confirmed by 2D-echocardiogram. The results were as follows: 1. Among these 32 cases, there were 23 cases(71.9%) of perimembranous VSD, 8 cases(25.0%) of muscular VSD and 1 case(3.1%) of subarterial VSD. Septal aneurysms appears to be main mechanism of spontaneous closure of VSD because of the presence of septal aneurysm in all cases with spontaneous ',;losure of a perimembranous VSD. 2. The size of the defect was variable in diameter, but 27 cases(81.2%) were less than 5 mm. 3. The mean age was 12.1 months at spontaneous closure with the range from 1 month old to 72 months. 4. The mean weight was 9.0 kg at spontaneous closure. 5.--Among these 32 cases, 3 cases had the clinical evidence of cardimegaly or congestive hert -failure during infancy. 6. Male to female sex ratio was 1.5:1
Aneurysm ; Estrogens, Conjugated (USP) ; Female ; Heart Septal Defects, Ventricular* ; Humans ; Male ; Sex Ratio

No abstract available.
Candidiasis* ; Drug Therapy* ; Lymphoma, Non-Hodgkin*

No abstract available.
Candidiasis* ; Drug Therapy* ; Lymphoma, Non-Hodgkin*

The extent of excision and necessity of hepatectomy in type IVa choledochal cyst has not been clarified. We performed left lobectomy of the liver for complete excision of the cyst in a thirty-year-old male patient with type IVa choledochal cyst. Postoperative recovery was untroubled and outcome was satisfactory. Complete excision of the cyst including hepatectomy is an acceptable operative management for patients with type IVa choledochal cyst. This procedure can eliminate the possibility of subsequent cancer arising from remaining cyst.
Choledochal Cyst* ; Hepatectomy ; Humans ; Liver ; Male

No abstract available.
Fractures, Spontaneous* ; Humerus* ; Replantation* ; Sarcoma, Ewing*

Primary repair of anterior cruciate ligament is superior to late reconstruction procedures for two reasons; objective stability is more easily restored due to intact secondary restraints not subjected to chronic stress, and the quality of the joint is superior with greater chance of intact menisci and normal articular cartilage not yet damaged through recurrent subluxation. We present the result of thirty-eight kness in thirty-seven patients who had been treated with primary repair of augmented repair for acute ACL rupture from March, 1984 to August, 1990. Twenty-one knees were treated with primary repair and seventeen knees augmented repair. At an average 33 months follow up, the results obtained were as follows: 1. The patients were 23 males and 14 females with an average age of 27.1 years. 2. Twenty four knees were injuried during athletic endeavors, 9 knees by automobile accident, and 5 knees by landing from height. In 18 knees anterior cruciate ligament was ruptured at the proximal attachment, in 17 knees at the midsubstance tear and in 3 at the near distal attachment. 3. The average interval from injury to operation was 7.5 days (ranged from 1 to 14 days). 4. The results were evaluated by Hospital for Special Surgery knee rating scale (modified by Marshall) at an average 33 months (range from 13 months to 7 years and 6 months) follow-up study. 16 (76%) out of 21 knees treated with primary repair were rated as good or excellent. 12 (86%) out of 14 knees treated with augmented repair were rated as good or excellent. As the result of this study, acutely torn anterior cruciate ligaments appear to be successfully treated with primary repair or augmented repair according to torn site and shape of ligaments.
Anterior Cruciate Ligament ; Automobiles ; Cartilage, Articular ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Ligaments ; Male ; Rupture ; Sports ; Tears

We experienced one case of severe pituitary dwarfism in a 16 years old male boy that magnetic resonance image(MRI) revealed transection of the pituitary stalk with the ectopic location of posterior pituitary gland and hypoplastic anterior pituitary gland. The serum growth horrnone(GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient revealed normal response in TSH, prolactin and LH, FSH to TRH and LHRH respectively. So far, the primary cause of idiopathic pituitary dwarfism in many patients was due to hypoxic injury to hypothalmus by perinatal insults. In this patients, there was no history of perinatal insults and postnatal head trauma. We report a case of severe dwarfism due to hypogenesis of anterior pituitary gland.
Clonidine ; Craniocerebral Trauma ; Dwarfism ; Dwarfism, Pituitary ; Gonadotropin-Releasing Hormone ; Humans ; Levodopa ; Male ; Pituitary Gland ; Pituitary Gland, Anterior ; Pituitary Gland, Posterior ; Prolactin

Gliomas of the optic nerve are relatively uncommon. We have experienced one case of glioma of the optic nerve recently. The patient was 17 year old boy who had exophthalmos and visual disturbance in his left eye for three years. The vision was CF/30cm. in his left eye and the optic nerve head was extremely atrophic. The eyeball was displaced infero-temporally. The exophthalmic value was 14mm. in right and 18mm. in left eye. On July 31, 1986, the left eyeball was exposed through Kroenlein method and the tumor mass was excised totally but the eyeball remained intact. The gross appearance of the tumor was large fusiform shape(3.5 X 2.0 X 1.8cm.) with well encapsulated grayish-white surface. The cut-section of the tumor revealed grayish-white solid area and hemorrhagic cystic area. The histopathologic slides showed that the tumor was composed of multiple pilocytic astrocytic cells in the solid area and in microcystic area. The cytoplasm of the tumor cells were bipolar spindle shape and the nucleus was uniform in general and there was no sign of mitotic figure. Numerous dense and amorphous eosinophilic materials so called "Rosenthal fibers" were also seen in the microcystic areas. Finally we have diagnosed this tumor as the Optic nerve glioma.
Adolescent ; Cytoplasm ; Eosinophils ; Exophthalmos ; Glioma ; Humans ; Male ; Optic Disk ; Optic Nerve Glioma* ; Optic Nerve*