Since laparoscopic liver resection was first introduced in 2001, Korean surgeons have chosen a laparoscopic procedure as one of the treatment options for benign or malignant liver disease. We distributed and analyzed a nationwide questionnaire to members of the Korean Laparoscopic Liver Surgery Study Group (KLLSG) in order to evaluate the current status of laparoscopic liver resection in Korea. Questionnaires were sent to 24 centers of KLLSG. The questionnaire consisted of operative procedure, histological diagnosis of liver lesions, indications for resection, causes of conversion to open surgery, and postoperative outcomes. A laparoscopic liver resection was performed in 416 patients from 2001 to 2008. Of 416 patients, 59.6% had malignant tumors, and 40.4% had benign diseases. A total laparoscopic approach was performed in 88.7%. Anatomical laparoscopic liver resection was more commonly performed than non-anatomical resection (59.9% vs 40.1%). The anatomical laparoscopic liver resection procedures consisted of a left lateral sectionectomy (29.3%), left hemihepatectomy (19.2%), right hemihepatectomy (6%), right posterior sectionectomy (4.3%), central bisectionectomy (0.5%), and caudate lobectomy (0.5%). Laparoscopy-related serious complications occurred in 12 (2.8%) patients. The present study findings provide data in terms of indication, type and method of liver resection, and current status of laparoscopic liver resection in Korea.
*Hepatectomy/statistics & numerical data ; Humans ; *Laparoscopy/statistics & numerical data ; Liver/*surgery ; Liver Diseases/pathology/surgery ; Liver Neoplasms/pathology/surgery ; Postoperative Complications/epidemiology ; Questionnaires ; Republic of Korea

OBJECTIVE: Appropriate placement of thoracic epidural catheter provides an adequate postoperative analgesia in chest and upper abdominal surgery. Usually, when thoracic epidural puncture is performed, both scapular lower tips and the thoracic (T)7 spinous process is assumed to be at the same horizontal level. The aim of this study is to identify the thoracic epidural puncture in the sitting position, with the neck flexed and arms crossed, may change the relationship between the thoracic vertebrae and the scapular lower tips. METHODS: One hundred patients with postoperative patient controlled epidural analgesia using thoracic epidural catheters were enrolled. It is presumed that the both scapular lower tips and T7 spinous process is at the equal level when performing thoracic epidural puncture. The actual insertion level of the Tuohy needle was examined by radiography when the patient was in the sitting position. RESULTS: Out of 100 patients, there were 62% that were in the same level as the scapular lower tips and T7 spinous process. However, 1% of the patients leveled at T4, 1% at T5, 25% at T6, 18% at T8, and 1% at T9. CONCLUSION: When performing the thoracic epidural puncture under the sitting position, the relationship of the T7 and the scapular lower tips may change. The change of position of scapular lower tips varied among T6.82+/-0.70. Therefore, to be precise, it is advised to utilize C-arm guide when epidural puncture is carried out.
Analgesia ; Analgesia, Epidural ; Arm ; Catheters ; Humans ; Neck ; Needles ; Punctures ; Thoracic Vertebrae ; Thorax

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization

PURPOSE: To evaluate the distribution of color flow signals on color Doppler ultrasonography of vascular leiomyomas and to correlate them with pathologic findings. MATERIALS AND METHODS: We retrospectively analyzed color Doppler ultrasonographic images and pathologic slides of six vascular leiomyomas. We classified the patterns of distribution of color flow signals into localized compact cluster types and non-cluster types, and the pathologic findings into three subtypes: solid, venous and cavernous. RESULTS: All cases showed well-defined homogenous hypoechoic subcutaneous masses on gray-scale ultrasonography. Three cases showed localized compact cluster types on color Doppler ultrasonography, one in each subtype (solid, venous and cavernous). For the three non-cluster types, again there was on in each subtype. In addition, on pathologic analysis the zone of the localized compact cluster of color flow signals coincided with a cluster of larger, vascular caliber masses. CONCLUSIONS: Localized compact clusters of color flow signals on color Doppler ultrasonography were seen in 50% of our cases and correlated with a cluster of larger vascular caliber in the mass. But the pattern of distribution of color flows didn't show a correlation with pathologic type.
Angiomyoma ; Retrospective Studies ; Soft Tissue Neoplasms ; Ultrasonography, Doppler, Color

STUDY DESIGN: A retrospective study OBJECTIVES: To evaluate postoperative muscle damage after microendoscopic discectomy (MED) and open discectomy (OD), using analysis of serum creatine phosphokinase (CPK) levels. SUMMARY OF LITERATURE REVIEW: Paravertebral muscle damage after retraction during posterior lumbar surgery can cause postoperative back pain. Serum CPK level is elevated in these patients and may indicate postoperative muscle damage. MATERIALS AND METHODS: We examined 35 cases with MED (group 1) and 11 cases with OD (group 2). Serum CPK levels were checked preoperatively and postoperatively at day 1 and day 3. We analyzed intra-group and inter-group differences in CPK levels according to sex, age, and operation time. Surgical outcomes were evaluated with a visual analog scale (VAS) preoperatively and 1 year postoperatively. RESULTS: CPK levels at postoperative 1 day were increased significantly and decreased significantly at postoperative 3 day in both groups (p<0.05), with levels in group 1 significantly lower than in group 2 (p<0.05). There were no differences in CPK levels according to sex, age, or operation time, except between the 3rd and 5th decades of age at postoperative 1 day in group 2. VAS was significantly different in intra-group analysis (p<0.05) with no significant differences in intergroup analysis. CONCLUSIONS: MED induced a lower increase in serum CPK than OD with similar VAS outcomes. MED results in less postoperative muscle damage than OD, with similar surgical outcomes.
Back Pain ; Creatine Kinase* ; Creatine* ; Diskectomy* ; Humans ; Retrospective Studies ; Visual Analog Scale

PURPOSE:To investigate the impact of dietary pattern on the risk of asthma development, we undertook a nation-wide study with ISSAC written questionnaire. METHODS:We analyzed the relations between the previous 12-month dietary patterns (16 food groups) and asthma symptom prevalence, using the ISSAC written questionnaire and a domestically developed dietary questionnaire in 24,260 elementary school children. RESULTS:Odds ratios (OR) were significantly decreased by increased food intake of natural seafood (OR:0.88, P=0.0126, 95% CI:0.795-0.973), fruit (OR:0.785, P<0.0001, 95% CI:0.715-0.861), vegetables (OR:0.825, P<0.0001, 95% CI:0.764-0.891), and cow's milk (OR:0.9, P=0.0451, 95% CI:0.811-0.998). Compared to children that seldom consumed natural seafood, ORs of symptom development were lower in children that ate natural seafood 1-2 times per week (OR:0.863, P=0.028, 95% CI:0.761-0.978) and almost everyday (OR:0.802, P=0.0755, 95% CI:0.630-1.023), respectively. For green vegetables, ORs were significantly lower than in children who also ate gree vegetables 1-2 times per week (OR:0.753, P=0.0416, 95% CI:0.595-0.950) and almost everyday (OR:0.674, P=0.0179, 95% CI:0.408-0.752), respectively. Fruits showed the same pattern as green vegetables. CONCLUSION:Taken together, our study shows that the increased intake of natural seafood, fruit, and vegetables is significantly related to reduced asthma symptom prevalence in Korean children.
Asthma* ; Child* ; Eating ; Fruit ; Humans ; Milk ; Prevalence* ; Surveys and Questionnaires ; Risk Factors* ; Seafood ; Vegetables

The aim of this study was to establish a multi-center birth defects monitoring system to evaluate the prevalence and the serial occurrence of birth defects in Korea. Ten medical centers participated in this program. A trained nurse collected relevant records from delivery units and pediatric clinics in participating hospitals on a monthly basis. We observed 1,537 cases of birth defects among 86,622 deliveries, which included live births and stillbirths. The prevalence of birth defects was 1.8%, and the sex distribution of the birth defect cases was 55.2% male and 41.6% female. The highest proportion of birth defects was in the cardiovascular system (17.5%), followed by birth defects involving in the genitourinary system (15.6%). Chromosomal anomalies were detected 30.0 per 10,000 births. Of these chromosomal anomalies, Down syndrome was most frequently observed. This study led to an establishment of a multi-center active monitoring system for birth defects. To better understand the serial occurrence of birth defects in Korea, it is necessary to increase the number of participating hospitals and to launch on a nation-wide multi-center study.
Abnormalities/*epidemiology ; Child ; *Chromosome Aberrations ; Female ; Humans ; Korea/epidemiology ; Male ; *Population Surveillance ; Pregnancy ; Pregnancy Outcome ; Research Support, Non-U.S. Gov't

BACKGROUND: In western countries the proportion of deaths in the hospital has somewhat decreased. While that of Korea has continuously increased, it is interesting things that the hospital death rate in Korea is less than that in western countries. Therefore we tried to find the factors associated with the place of death in Korea. METHODS: We obtained the data from the National Statistical Office. They are composed of address, occupation, cause of death, marital status, and level of education. Causes of death were classified by ICD 10. Univariate and Mutivariate analysis were done to find the effect of each variable for the place of death. RESULTS: Total number of the study population was 242,362 (male;136,063, female;106,299). Female died more in the hospital. The younger are more likely to die in the hospital. People having lived in metropolitan, having educated to higher level and professionals died more in the hospital. And the people having had ischemic heart disease and cancer death were more likely to die in the hospital. The single(unmarried, divorced) died more in the hospital. In multivariate analysis, the place of death was significantly different by sex, age, address, occupation, cause of death, and level of education. CONCLUSION: In Korea sex, age, address, occupation, cause of death, and level of education are helpful in predicting the palce of death.
Cause of Death ; Education ; Female ; Humans ; Korea* ; Marital Status ; Mortality ; Multivariate Analysis ; Myocardial Ischemia ; Occupations

OBJECTIVE: The TDX analyzer, an automated fluorescence polarimeter, has been utilized to assess surfactant content in amniotic fluid. Amniostat-FLM is an immunologic semiquantitative agglutination test for determining the presence of phosphatidylglycerol in human amniotic fluid at concentration indicative of fetal lung maturity. We evaluated the usefulness of the recently introduced TDx-FLM assay in determining fetal lung maturity. METHODS: Seventy-three samples of amniotic fluid were analyzed. Among them, 18 samples were compared with Amniostat-FLM assay. RESULTS: Surfactant/albumin ratio using TDx-FLM assay increased with longer gestational age. And the concordance rate between Amniostat-FLM assay and TDx-FLM assay was 66.9%. CONCLUSION: The TDx-FLM assay appears to be a useful test in the field of fetal lung maturity testing.
Agglutination Tests ; Amniotic Fluid ; Female ; Fluorescence ; Gestational Age ; Humans ; Lung*

OBJECTIVE: The TDX analyzer, an automated fluorescence polarimeter, has been utilized to assess surfactant content in amniotic fluid. Amniostat-FLM is an immunologic semiquantitative agglutination test for determining the presence of phosphatidylglycerol in human amniotic fluid at concentration indicative of fetal lung maturity. We evaluated the usefulness of the recently introduced TDx-FLM assay in determining fetal lung maturity. METHODS: Seventy-three samples of amniotic fluid were analyzed. Among them, 18 samples were compared with Amniostat-FLM assay. RESULTS: Surfactant/albumin ratio using TDx-FLM assay increased with longer gestational age. And the concordance rate between Amniostat-FLM assay and TDx-FLM assay was 66.9%. CONCLUSION: The TDx-FLM assay appears to be a useful test in the field of fetal lung maturity testing.
Agglutination Tests ; Amniotic Fluid ; Female ; Fluorescence ; Gestational Age ; Humans ; Lung*