No abstract available.
Ethics, Professional*

The first half of this article deals with the concept of informed consent. There are three important elements in practice. First, the consent must be specific as to the proposed intervention. Second, sufficient information must be provided so that a patient can fully understand the matter. For the criterion of sufficiency, this article proposes what might be called as 'the hypothetical self-test' with which physicians can self-evaluate the sufficiency of the information that they provide to the patient. Third, the consent must be given in a fashion to meet the patients' intellectual capabilities. In case the patient is not intellectual enough incapable, the consent, which is still required, can be obtained from a substitute decision maker. This article also suggests patients to prepare advanced directives when they are still competent, so as to avoid having their family members be left with moral quandaries of making the life with moral quandaries of making the life-and-death decision. The second half of this article deals with medical confidentiality. Why should a physician keep the medical record confidential? First, if the physician fails to keep medical confidentiality, hardly can trust be built between physicians and patients. Second, once the trust breaks down, physicians would face difficulties in taking the patients' medical histories, which are crucial to the diagnosis of the patient, because the patients obviously are reluctant to give information in that setting. Third, each individual should have control over information about him/herself. This article concludes with cataloging seven circumstances in which medical confidentiality is excused. (237 words).
Cataloging ; Confidentiality* ; Diagnosis ; Humans ; Informed Consent* ; Medical Records

No abstract available.
Ethics* ; Genomics* ; Humans*

No abstract available.
Carcinoma, Squamous Cell* ; Tuberculosis, Laryngeal*

Descending Necrotizing Mediastinitis (DNM) is a complication of oropharyngeal infections that can spread to the mediastinum. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. late diagnosis is the principal reason for the high mortality in DNM. An 18-year-old female admitted with Ludwig's angina from dental caries. Despite of combined antibiotics, dental extraction and drainge of submental abscess, infection spread to the cervical area. Chest computed tomogram revealed extension of the abscess to the pretracheal and periaortic space and development of bilateral pleural empyema. We performed bilateral cervical mediastinotomy and thoracotomy for drainage and debridement. Tracheostomy to secure the airway and postoperative pleural irrigation were performed. Postoperative course was uneventful and patient was discharged on the 40th postoperative day. It is important to perform chest CT scanning for early diagnosis of DNM when oropharyngeal infection spreads to the cervical area. Improved survival of patients with DNM implies early and radical surgical drainage and debridement via a cervical mediastinomy and thoracotomy.
Abscess ; Adolescent ; Anti-Bacterial Agents ; Debridement ; Delayed Diagnosis ; Dental Caries* ; Drainage ; Early Diagnosis ; Empyema, Pleural ; Female ; Humans ; Ludwig's Angina ; Mediastinitis* ; Mediastinum ; Mortality ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed ; Tracheostomy

The aim of this study is to determine the correlation between any histological changes in the human testis after vasectomy and fertility after subsequent vasectomy reversal. A sample of 21 previous fertile, vasectomized, healthy volunteers with a mean age 35 years( range, 29 to 47) underwent open, unilateral testicular biopsy at the time of vasectomy reversal. The mean duration of obstruction was 3.8 years(range, 1 to 12). The vasovasostomy was performed by means of same technique. The qualitative and morphometric quantitative analysis were performed for the data obtained. Vasal patency was determined by the presence of sperm in the postoperative semen analysis in 18 patients. Pregnancy occurred in 9 of 18 couples( 50%). Statistical analysis was performed to compare the morphological findings in both fertile and infertile patients. No significant correlation was observed between the histologic changes and fertility in two groups. Similarily there was no significant correlation between the obstructive interval. We concluded that morphologic changes occurred in the human testis after vasectomy does not affect the fertility rate after successful vasectomy reversal.
Biopsy ; Birth Rate ; Fertility* ; Healthy Volunteers ; Humans* ; Pregnancy ; Semen Analysis ; Spermatozoa ; Testis* ; Vasectomy* ; Vasovasostomy*

We reviewed our medical records of primary retnal detachment(239 patients, 243 eyes) to compare the clincal findings of phakic retinal detachment(206 eyes) and pseudophakic retinal detachment(37 eyes). Pseudophakic retinal detachment was more common in male(73.0%) than in female(27.0%) and occurred more frequently in aged 60 years or more than phakic retinal detachment(10.4%)(P<0.001). Associated ocular finding such as high myopia(35.0%), peripheral retinal degeneration(23.3%0, retinal tear in fellow eye(5.8%) were more commonly seen in phakic retinal retinal detachment. Rupture of posterior capsule(40.5%), high myopia(18.9%), small pupil(13.5%) were associate with pseudophakic retinal detachment. In pseudophakic retinal detachment, more than 3 quadrant retinal detachment(73.0%) and macular involvement(78.4%) were more common than in phakic retinal detachment(P<0.01), but atropic hole(29.7%), or 2 or more retinal break(10.8%) were less common than in phakic retinal detachment(P<0.01) where the success rate of first operation(59.5%) and the overall success rate(81.1%) were lower in paeudophakic retinal detachment than phakic retinal detachment. The degree of visual recovery was nearly equal between two.
Humans ; Medical Records ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Rupture

About 10-15% of hypertension is secondary to renal disease. Cause of renal hypertension is renal parenchymal disease or renovascular problem. Hypertension in children which estimate at 1-2 % of all hypertension is very rare. We experienced a ease of renal parenchymal hypertension due to unilateral chronic reflux pyelonephritis in 10 year old boy, treated by nephrectomy.
Child* ; Humans ; Hypertension* ; Hypertension, Renal ; Male ; Nephrectomy ; Pyelonephritis

Efficient management of human tissue samples is a critical issue; the supply of samples is unable to satisfy the current demands for research. Lack of informed consent is also an ethical problem. One of the goals of the 2012 revision of Korea's Bioethics and Safety Act was to implement regulations that govern the management of human tissue samples. To remain competitive, medical institutions must prepare for these future changes. In this report, we review two tissue management models that are currently in use; model 1 is the most common system utilized by hospitals in Korea and model 2 is implemented by some of the larger institutions. We also propose three alternative models that offer advantages over the systems currently in use. Model 3 is a multi-bank model that protects the independence of physicians and pathologists. Model 4 utilizes a comprehensive single bioresource bank; although in this case, the pathologists gain control of the samples, which may make it difficult to implement. Model 5, which employs a bioresource utilization steering committee (BUSC), is viable to implement and still maintains the advantages of Model 4. To comply with the upcoming law, we suggest that physicians and pathologists in an institution should collaborate to choose one of the improved models of tissue management system that best fits for their situation.
*Bioethics ; Biomedical Research/*legislation & jurisprudence ; Humans ; Models, Biological ; Republic of Korea

BACKGROUND: Analysis of body fluids provides important information for assessing various medical conditions. We aimed to validate the analytical and diagnostic performance of the Sysmex UF-5000 (Sysmex, Japan) system for the analysis of different body fluids. METHODS: Eighty body fluid samples were analyzed using the UF-5000 system in the body fluid mode and light microscopy. Body fluids included ascitic, pleural, and cerebrospinal fluid (CSF), as well as other fluid samples. RESULTS: A comparison between the UF-5000 system and manual counting demonstrated good correlations with regard to red (r=0.6555) and white blood cell (r=0.9666) counts. The UF-5000 system also demonstrated good performance for differential cell counting (r=0.9028). CSF particularly showed a good correlation. CONCLUSIONS: The use of the UF-5000 system for cell counting and differential analysis of body fluid samples might be an effective and automated alternative to chamber counting in laboratory routine analysis, thereby enhancing laboratory workflow and clinical effectiveness.
Automation ; Body Fluids ; Cell Count ; Cerebrospinal Fluid ; Erythrocytes ; Leukocytes ; Methods ; Microscopy ; Treatment Outcome