PURPOSE: In spite of preventive measures and excellent prognosis with immediate treatments, drowning and drowning- related injuries remain as one of the leading causes of accidental death in Korea. However, abundant statistical data for drowning has yet to be collected. Thus, this study aimed to describe the epidemiologic characteristics of drowning in terms of demographic characteristics, geopolitical factors and socio-economic status. METHODS: This study was conducted with drowning patients who either visited hospitals or died between January 2001 and December 2003. Of these patients, we enrolled individuals registered for such coverages as automobile insurance, national health service and work injury insurance and we reviewed death records reported to the Korea National Statistical office. NISS (New Injury Severity Scale) and EMR-ISS (the Excessive Mortality Ratio -adjusted Injury Severity Score) values were calculated for each patients and the results were classified 4-into four different severity groups. After analysis, we drew conclusions in terms of year, gender, age, region, insurance type, daily rate of incidences and severity. RESULTS: The incidences of drowning-related injury were 2,486 in 2001, 2,364 in 2002, and 2,595 in 2003 (average of 2,482). The average annual death were 1,954. Victims were more likely to be male and especially high incidence rates were found for two groups: (1) Children aged 5-9 years, (2) Adults aged 40 and older. Seoul and Gyeonggi had the largest total numbers of injury cases, while JeJu had the highest per capita incidence rate (106 per 1,000,000 population). The seasonal distribution of incidence rates showed that predictably, incidents were most frequent between the beginning of July and September. CONCLUSION: The average number of incidents was 55.73 per 1,000,000 population, which constitutes approximately 0.02% of all injuries. Based on this data, we recommand continuing studies and further evaluations in order to develop specific measures to combat drowning.
Adult ; Aged ; Automobiles ; Child ; Death Certificates ; Drowning ; Humans ; Incidence ; Insurance ; Korea ; Male ; National Health Programs ; Prognosis ; Seasons

A case of congenital diaphragmatic eventration on the right and central tendinous portion with accessory hepatic lobe causing direct compression of the right heart is presented. We have performed the video assisted thoracoscopic plication of the right hemidiaphragm and eliminated the mass effect of the accessory hepatic lobe.
Diaphragmatic Eventration* ; Heart ; Thoracoscopy

BACKGROUNDS: There have been controversies about the association between essential tremor (ET) and Parkinson's disease. To examine the nigrostriatal dopaminergic neurons in patients with ET, we measured the striatal dopamine transporter levels with [123I] N-(3-iodopropene-2-yl)-2?-carbomethoxy-3?-(4-chlorophenyl) tropane(IPT) single photon emission computed tomography (SPECT). METHODS: This study included nine patients with postural tremor, six patients with postural and rest tremor, 11 patients with idiopathic Parkinson's disease, and 21 age matches controls. Using triple headed gamma camera, brain SPECT scans were performed at 115 and 120 minutes after the injection of 6.23?1.37mCi(range 5-10mCi) of I123 labeled IPT. We averaged two images. Regions of interest were drawn on the middle set image at the level of basal ganglia (BG) for each subject. Amounts of striatal dopamine transporter were measured by calculating the ratio between the average counts of the basal ganglia minus occipital cortex (OCC) and the counts of the OCC((BG-OCC)/OCC). RESULTS: The mean of (BG-OCC)/OCC ratios of 9 isolated postural tremor patients (3.60?0.83) was not statistically different from that of the controls (P>0.05). However, the mean of (BG-OCC)/OCC ratios of 4 patients with postural and rest tremor (2.61?0.18) was significantly lower than that of the controls (P<0.01). Four of the six patients with postural and rest tremor had mean ratios lower than 2.0 standard deviations from the mean of the controls. CONCLUSION: In their later clinical courses, some patients with postural tremor may develop rest tremor in association with a damage in the nigrostriatal dopaminergic system.
Basal Ganglia ; Brain ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Dopaminergic Neurons ; Essential Tremor* ; Gamma Cameras ; Head ; Humans ; Parkinson Disease* ; Tomography, Emission-Computed, Single-Photon ; Tremor

No abstract available.
Etoposide* ; Fluorouracil* ; Stomach Neoplasms*

BACKGROUND AND PURPOSE: A carboxy-O-methyl transferase inhibitor entacapone has been introduced as an adjuvant drug for Parkinson disease (PD) patients. Although clinical trials reported beneficial role of entacapone, a long-term trial over 3 years failed to show significant effect. The goals of this study were to evaluate the clinical benefit and the efficacy of entacapone in an open clinical practice. METHODS: After the completion of a double-blind placebo-controlled entacapone study, 149 patients from 4 centers were included. Antiparkinsonian medications were optimized by the judgment of the neurologists in charge. The clinical global impression (CGI) scale was obtained at 6 months and 1 year after the initiation of entacapone treatment. RESULTS: Of the 149 patients, 117 patients chose to try entacapone in an open-label fashion. Sixty-nine (59%) patients completed the 1-year trial. Twenty-nine patients discontinued entacpaone before 6 months, and 19 between 6 months and 1 year during trial. Twelve patients out of 48 patients discontinued entacapone because of its poor efficacy. The CGI scale was 3.9 (+/-1.5) at the beginning of the trial, 4.3 (+/-1.1) at 6 month, and 3.8 (+/-1.3) at 1 year, respectively. The CGI scale of those who discontinued between 6 month and 1 year was 3.4 (+/-1.7), which was worse, but insignificantly, than that of the continuer. CONCLUSIONS: The dropout at 1 year of our study was very high at 41%. Even though entacapone is indicated for advanced PD patients with motor fluctuation, the fluctuators commonly have dyskinesia and mental symptoms, which can become more troublesome with entacapone. In the patients with advanced PD, the clinical efficacy and side effects should be carefully considered in a long-term use of entacapone.
Dyskinesias ; Humans ; Judgment ; Parkinson Disease* ; Patient Dropouts ; Transferases

BACKGROUND AND OBJECTIVES: Although there are many different reasons for rhinoplasty, there has not been any been systematic research conducted about different motivations patients have. The motivation for the surgery, the preferred shape of nose, the concerns about surgery, the terms needed to make the decision were different and greatly depended on the circumstances. MATERIALS AND METHODS: Two hundred and seventeen persons who have been operated in the Inha Hospital from 1996 to 2000 have been consulted. The survey paper is constituted by fifty-one multiple-choice questions. RESULTS: For the question asking the main reason for wanting rhinoplasty, the majority answered it was to restore their injured nose. The next popular answer was the desire to have a better-shaped nose. For male patients, their deviated nose was caused by injury or accident, and thus desired to have the normal or the original shape of nose by operation. The survey revealed a different result for the opposite sex. The main reason for female patients' wanting rhinoplasty was to have a good-looking nose, and for that purpose they expressed their desire to heighten their nose. Interestingly, the concern about the side effects after the surgery was the greatest reason for avoiding rhinoplasty. CONCLUSION: Every surgery should be well-prepared with the exact analysis of the patient's nasal history and his special request.
Esthetics ; Female ; Humans ; Male ; Motivation ; Nasal Surgical Procedures* ; Nose ; Psychoanalysis* ; Rhinoplasty

We report a case of acquired hemophilia A following endoscopic sinus surgery. The patient was a 64-year-old man whose preoperative activated partial thromboplastin time (aPTT) was slightly prolonged. He underwent endoscopic sinus surgery for chronic rhinosinusitis with nasal polyp. Nasal bleeding occurred spontaneously on the postoperative day 3. The aPTT was prolonged at 58.9 s, with factor VIII activity of 21% and a positive factor VIII inhibitor. Treatment with factor VIII and methylprednisolone resulted in remission within 1 month. This is the first of such case reported in Korea; the patient was treated by recombinant factor VIII replacement and steroid therapy.
Diagnosis* ; Epistaxis ; Factor VIII ; Hemophilia A* ; Hemorrhage* ; Humans ; Korea ; Methylprednisolone ; Middle Aged ; Nasal Polyps ; Partial Thromboplastin Time

Parkinson's disease(PD) is characterized clinically by bradykinesia, rigidity, tremor, and disturbance of posture and equilibrium. A higher incidence of fractures in PD patient has been reported, however the studies of musculoskeletal complications in PD have been negligible. The purposes of this study were to investigate the incidence of osteoporosis and spinal compression fracture in PD patients and to evaluate whether the incidence were affected by the severity of PD. Bone mineral density(BMD) in 21 patients(5 males and 16 females) with idiopathic PD was measured by dual energy X-ray absorptiometry(DXA) and compared with an age adjusted control group(32 females). The patients were divided into two groups according to the Hoehn and Yahr(H-Y) stage as mild or severe and the BMD was compared. Simple x-ray studies of thoracolumbar spine were performed to find out the presence of spinal compression fractures. The results showed that the BMD of PD patients was significantly lower than control subjects. The PD patients with high H-Y stage(severe group) had lower BMD scores with no statistical significance. The spinal compression fractures were noted mainly at mid-thoracic area and thoraco-lumbar junction. Spinal t-score in patients with a compression fracture was significantly reduced. No significant correlation exists between back pain and a compression fracture.
Back Pain ; Bone Density ; Fractures, Compression ; Humans ; Hypokinesia ; Incidence ; Male ; Osteoporosis* ; Parkinson Disease* ; Posture ; Spine ; Tremor

PURPOSE: This study was conducted to assess the frequency and severity of upper extremity injuries in Korea through a retrospective epidemiological study. METHODS: For this study, we retrospectively reviewed nation-wide upper extremity injury data compiled from 2001 to 2003 from the National Injury Database, which includes the National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance. NHIC consists of the medical aid population, the self-employed insured population and the employer-insured population. Data was standardized in terms of demographic characteristics, region and socioeconomic status by NHIC. To assess the degree of the injuries, we used the International Classification of Disease-10 (ICD-10) code and the Modified Abbreviated Injury Scale (MoAIS). Afterwards, we classified the degree of the severity into 4-four categories-mild, moderate, severe and critical- using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS). RESULTS: Frequency of cases of upper extremity injuries per 1,000,000 persons was 58,663, and the incidence rate is 26.9% of total injuries. In fact, the incidence rate remained stable. Yet, there was a steady increase in total injuries from 2001 to 2003. Injuries in men outnumbered women regardless of the severity. In terms of severity, mortality was higher for the elderly aged 60 and over. The Seoul and Kyeonggi-areas showed the highest incidence rate while Jeju was the lowest. Furthermore, injuries were more frequent among the medical aid population. The daily incidence rate for non-critical cases was higher in the months of June, September and October. CONCLUSION: The data indicated that upper extremity injuries comprised a major portion of all injuries. Moreover, the result were affected by differences in gender, location and socioeconomic status. All in all, it is critical that sophisticated research and clinical data be compiled in order to develop more effective prevention strategies.
Abbreviated Injury Scale ; Aged ; Female ; Humans ; Incidence ; Injury Severity Score ; Insurance ; Korea ; Male ; National Health Programs ; Retrospective Studies ; Social Class ; Upper Extremity

Coronary artery fistula to pulmonary artery is common. However, to the best of our knowledge, a case of coronary artery fistula to pulmonary artery associated with aortopulmonary fistula remains unreported. We herein report a 64-year-old female with a left anterior descending coronary artery and ascending aorta to pulmonary artery fistulas, and conduct a brief review of the literature.
Aorta ; Arterio-Arterial Fistula ; Coronary Vessels ; Echocardiography ; Female ; Fistula ; Humans ; Middle Aged ; Pulmonary Artery