No abstract available.
Sertoli-Leydig Cell Tumor*

BACKGROUND: The aim of this study was to compare the efficacy of ketorolac, paracetamol, and paracetamol plus morphine on pain relief after thyroidectomy. METHODS: Eighty patients were randomly allocated to one of the 4 groups: normal saline (group C), ketorolac 30 mg (group K), paracetamol 1 g (group P), and paracetamol 700 mg plus morphine 3 mg (group PM). Each regimen was administered intravenously (IV) 30 min. before the end of surgery. If pain was not relieved, patients received an IV bolus of pethidine hydrochloride 25 mg. Pain intensity using a visual analogue scale (VAS) was recorded at 0.5, 1, 2, 4, and 6 hr after the end of surgery. RESULTS: VAS at 0.5 and 1 hr after the end of surgery were significantly lower in group K, group P, and group PM than in group C (P < 0.05). The number of patients receiving pethidine hydrochloride at 0.5 and 1 hr after the end of surgery was significantly lower in group K, group P, and group PM than in group C (P < 0.05). There was no significant difference among the groups in the incidences of adverse events associated with study medications and patient satisfaction (P > 0.05). CONCLUSIONS: Paracetamol 1 g IV possesses a similar analgesic efficacy to ketorolac 30 mg IV after thyroidectomy. Paracetamol may represent an alternative to ketorolac for pain prevention after mildly to moderately painful surgery in situations where the use of NSAIDs is unsuitable.
Acetaminophen ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Incidence ; Ketorolac ; Meperidine ; Morphine ; Patient Satisfaction ; Thyroidectomy

No abstract available.
Hernia* ; Pneumoperitoneum*

To evaluate the diagnostic efficacy of dacryoscintigraphy, we examined Hones dye test and dacryoscintigraphy in 24 eyes of 18 patients who were suspected to have junctional block in lacrimal drainage system. Among 18 eyes that were negative to Jones I dye test, 3 showed punctal stenosis and 6 typical pattern of lax lid and 2 partial obsturction of nasolacrimal duct on dacryoscintigraphy. In evaluation of lacrimal drainage system, physiological aspect is as important as anatomical information since lacrimal pumping action of lid and tear flow as well as the patency of lacrimal passage contribute to the lacrimal drainage. Compared to Jones dye test, dacryoscintigraphy is more useful with certain advantages : It gives less discomfort to patients, provides anatomical information and does not depend on examiner`s skills.
Constriction, Pathologic ; Drainage* ; Humans ; Nasolacrimal Duct

The antiphospholipid antibodies are characterized by prolonged phospholipid-dependent coagulation test (known as APTT or Russel viper venom), thrombosis, thrombocytopenia, and fetal loss. The association of antiphospholipid antibodies with one or more of these characteristic clinical features has been termed the i antiphospholipid syndrome. We have experienced a case of successful live birth after treated a woman with heparin and aspirin who has experienced spontaneous abortion four times with antiphospholipid antibodies and present it with the review of literature.
Abortion, Spontaneous ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Aspirin ; Female ; Heparin ; Humans ; Live Birth* ; Pregnancy ; Thrombocytopenia ; Thrombosis

PURPOSE: To evaluate the effectiveness and complication rate of our modified continuous buried suture technique for the correction of the upper lid epiblepharon. METHODS: This retrospective study included 132 eyes of 66 patients, who were diagnosed with upper lid epiblepharon from March 2000 through April 2002 After the followup of over 6 months, we evaluated the improvement and recurrent rate of epiblepharon after the procedure. RESULTS: In 131 of 132 eyes with the mean followup period of 12.9 months, the epiblepharon was corrected successfully with cosmetically satisfactory Results. In 1 eye, we experienced the disappearance of a double fold without the recurrence of the epiblepharon. CONCLUSIONS: This modified continuous buried suture Method appears to be an effective treatment of lash inversion in upper lid epiblepharon with good aesthetic Results.
Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies ; Suture Techniques* ; Sutures*

Carcinoid tumors of the appendix are common incidental findings, but appendiceal tumors with histologic features of both carcinoids and adenocarcinomas are rare, and their biologic behavior and histogenesis are still unclear. We report a case of goblet cell carcinoid of the appendix in a 54-year-old male, who exhibited pain in the right lower abdomen. Microscopically, the tumor contained smooth-bordered, widely separated nests composed of tumor cells with abundant mucin. The principal tumor cell type had a close resemblance to the normal goblet cell. Histochemically, the tumor cells revealed positive reaction for PAS and alcian blue stain. Immunohistochemically, the tumor showed strong reactivity for carcinoembryonic antigen, chromogranin and, neuron specific enolase but none for cytokeratin and epithelial membrane antigen.
Adenocarcinoma

The mesenteric lipoma is rare in chilcren. A 2 years and 8 months old female child was admitted to department of Pediatrics in Inchon Christian Hospital on the 17 th Dec., 1974, because of abdominal distention and dyspnea. Operation revealed a soft yellowish mass, measuring 25x23x19cm. In size and 4,000gm. In weight. The pathologic diagnosis confirmed lipoma of the mesentery. The patient was discharged without any complications on the 8 th postoperative day. A brief review of literatures was made.
Child ; Diagnosis ; Dyspnea ; Female ; Humans ; Incheon ; Infant ; Lipoma* ; Mesentery ; Pediatrics

BACKGROUND: OSCE was conducted to measure the immediate outcome of ICM. The measurement focused on basic clinical skills. METHODS: The subject of study was 115 third year medical students who took ICM course. The examination consisted of ten 5-minute stations with nine cases that represented commonly encountered problems in primary care. OSCE stations were duplicated into two sites. Therefore, same OSCE was performed six times in each sites. We evaluated the reliability of OSCE scores and compared the mean scores according to the examination sites and time sequences. Also, we got feedback from all participants by questionnaires. RESULTS: Mean of total OSCE score was 52.1. Cronbach alpha of total station was 0.559. For blood pressure check, lung physical examination, and neck mass physical examination station, there was a significant difference in mean scores as the time sequences(p<0.05). Both students and examiners evaluated the OSCE positively, and felt that OSCE was meaningful experience to prepare clinical skills. CONCLUSION: We can confirm that OSCE is a reasonable evaluation tool for ICM. However, further trials to develop the more reliable and valid examinations will be warranted.
Blood Pressure ; Clinical Competence ; Clinical Medicine* ; Humans ; Lung ; Neck ; Physical Examination ; Primary Health Care ; Students, Medical ; Surveys and Questionnaires

BACKGROUND: One of major weakness in medical education in Korea is clinical skills has not been uniformly well taught during undergraduate period. To reinforce the basic clinical skill education, we developed introduction to clinical medicine(ICM) course In this study, we described the ICM course development process and the experience. METHODS: We performed comprehensive literature review related to ICM and doctoring curriculum. ICM/OSCE sub-commitee members discussed several time to develop the course. To assess the level of accomplishment of this course, we got feedback from 115 third year medical students by questionnaires. RESULTS: ICM was composed of 9 topics which covers the basic clinical skills. For each topic, three hours per week was allocated, one hour for didactic session and the other 2 hours for practical exercise. Standardized patients were used to teach interview skill. Most of students revealed history taking, abdominal examination, musculo-skeletal system, and interview skill session were valuable learning experience. However, for Gynecology and Pediatric session which were taught by mainly lectures, students evaluated them negatively. INTERPRETATION: This year, we focused on teaching basic clinical skills at ICM. However, our ultimate goal is to develop the ICM course which can allow the students to learn both the art and the science of Medicine.
Clinical Competence* ; Clinical Medicine* ; Curriculum ; Education ; Education, Medical ; Gynecology ; Humans ; Korea ; Learning ; Lectures ; Students, Medical ; Surveys and Questionnaires