BACKGROUND: Medical skin care is essential for the treatment of skin diseases all over the world. Medical skin care is also part of medical practice and this must be differentiated from the simple skin care that is given for normal healthy skin. OBJECTIVE: We wanted to discuss medical skin care and the related medical devices and legal issues. METHODS: We reviewed the related laws and regulations, we consulted experts and associations and we analyzed the result of the survey. RESULTS: Legally, medical skin care and simple skin care are well classified. However, many illegal procedures are still performed by non-medical personnel and many adverse effects have been reported as a result. Furthermore, there are no legal restrictions for the performer based on the grade of each medical skin care procedure. CONCLUSION: For the best results and safe procedures, medical skin care must be performed by approved medical equipment under the supervision of a physician or medical personnel. Continuous control and guidance by the government is strongly needed.
Jurisprudence ; Organization and Administration ; Skin ; Skin Care ; Skin Diseases ; Social Control, Formal

Inguinal hernia is the most common disease treated by the pediatric surgeon. There are several controversial aspects of management 1)the optimal timing of surgical repair, especially for preterm babies, 2)contralateral groin exploration during repair of a clinically unilateral hernia, 3)use of laparoscope in contralateral groin exploration, 4)timing of surgical repair of cord hydrocele, 5)perioperative pain control, 6)perioperative management of anemia. In this survey, we attempted to determine the approach of members of KAPS to these aspects of hernia treatment. A questionnaire by e-mail or FAX was sent to all members. The content of the questionnaire were adapted from the "American Academy of Pediatrics (AAP) Section on Surgery hernia survey revisited (J Pediatr Surg 40, 1009-1014, 2005)". For full-term male baby, most surgeons (85.7 %) perform an elective operation as soon as diagnosis was made. For reducible hernia found in ex-preterm infants already discharged from the neonatal intensive care unit (NICU), 76.2 % of surgeons performed an elective repair under general anesthesia (85.8 %). 42.9 % of the surgeons performed the repair just before discharge. For same-day surgery for the ex-premature baby, the opinion was evenly divided. For an inguinal hernia with a contralateral undescended testis in a preterm baby, 61.9 % of surgeons choose to 'wait and see' until 12 month of age. The most important consideration in deciding the timing of surgery of inguinal hernia in preterm baby was the existence of bronchopulmonary dysplasia (82.4 %), episode of apnea/bradycardia on home monitoring (70.6 %). Most surgeons do not explore the contralateral groin during unilateral hernia repair. Laparoscope has not been tried. Most surgeons do not give perioperative analgesics or blood transfusion.
Analgesics ; Anemia ; Anesthesia, General ; Blood Transfusion ; Bronchopulmonary Dysplasia ; Child* ; Cryptorchidism ; Diagnosis ; Electronic Mail ; Groin ; Hernia ; Hernia, Inguinal* ; Herniorrhaphy ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea* ; Laparoscopes ; Male ; Pediatrics ; Surveys and Questionnaires

To report cases of metastasectomy for metastatic gynecologic malignancies, we reviewed the medical records of all patients who have undergone metastasectomy for metastatic gynecologic malignancies in Center for Uterine Cancer from June 2001 to October 2002. Six patients were identified with median age of 55 years (range 52-66 years). The metastatic sites and primary sites were as follows: 3 liver metastasis from ovary; 1 abdominal wall metastasis from uterus (endometrial cancer), 1 brain metastasis from ovary, 1 lung metastasis from uterus (sarcoma). The median disease free interval was 48 months (range 10 months-13 years). There was no perioperative mortality. Postoperative morbidity was tolerable with 1 case of bile leakage. In three patients with hepatectomy, one patient was dead of disease after 15 months, one patient is alive with disease at 20 months of follow up, one patient have no evidence of recurrence at 7 months follow up. The patient with brain metastasis was dead due to lung metastsis after 9 months later postoperatively. Remaining two patients with abdominal wall and lung metastasis have no evidence of tumor recurrence at 4, 7 months follow up respectively. Metastasectomy for metastatic gynecologic malignancies can be performed safely and may help prolong survival in carefully selected patients.
Abdominal Wall ; Bile ; Brain ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver ; Lung ; Medical Records ; Metastasectomy ; Mortality ; Neoplasm Metastasis ; Ovary ; Recurrence ; Uterine Neoplasms ; Uterus

BACKGROUND: Liver cirrhosis may be considered one of the most common cause of acquired immunodeficiency. Alcohol abuse may be predisposing factor to infections in patients with liver cirrhosis, so we compared the rate of spontaneous bacterial peritonitis (SBP) and other bacterial infections in alcoholic and viral liver cirrhosis. METHODS: We studied 188 patients who had been diagnosed with liver cirrhosis from January 1995 to June 2000 and evaluated the frequency of bacterial infections (SBP, pneumonia, urinary track infection, bacteremia, infectious colitis) retrospectively according to cause and degree of cirrhosis. RESULTS: Among 188 patients (alcoholic 76, viral 112), 64 patients (34%) presented with bacterial infection at hospitalization, 33 (43%;33/76) of 64 subjects were alcoholic and 31 (28%;31/112) of 64 subjects were viral liver cirrhosis. The rate of bacterial infections was higher in alcoholic liver cirrhosis than viral cirrhosis (p<0.05). The rate of SBP and other bacterial infections were more frequent in patients of Child-Pugh class C than in those of Child-Pugh class A and B (p<0.01, p<0.05) respectively. Patients of alcoholic liver cirrhosis were more susceptible to bacterial infection than those of viral liver cirrhosis with Child-Pugh class A/B (p<0.05), but no difference was noted in patients of Child-Pugh class C (p>0.05). CONCLUSION: This results suggest that the rate of bacterial infections are more common in alcoholic than viral liver cirrhosis in relatively early stage and it may be influence the prognosis of liver cirrhosis.
Alcoholics* ; Alcoholism ; Bacteremia ; Bacterial Infections* ; Causality ; Fibrosis* ; Hospitalization ; Humans ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Peritonitis ; Pneumonia ; Prognosis ; Retrospective Studies

BACKGROUND/AIMS: In clinical practice, among the technique to detected Helicobacter pylori (H. pylori) infection, IgG serological test is noninvasive, safe, quick, widely available, and inexpensive. We studied that whether the titers of anti-H. pylori IgG antibody were correlated with endoscopic finding, and the degree of microscopic gastric damage and H. pylori density in dyspeptic patients. METHODS: Gastric biopsy specimens were obtained in 109 patients with H. pylori infection undergoing upper gastric endoscopy. The titers of serum IgG antibodies to H. pylori were measured by enzyme immunoassay. Macroscopic gastric damages and histologic grades were scored by the Sydney system. RESULTS: Endoscopic findings showed no significant association with H. pylori antibody titers (p=0.111). There was significant correlation between H. pylori antibody titers and lymphocyte infiltration (p=0.002), neutrophil infiltration (p=0.002), H. pylori density (p=0.0001), respectively. There was no significant correlation between H. pylori antibody titers and atropy (p=0.142), intestinal metaplasia (p=0.368), respectively. CONCLUSIONS: H. pylori antibody titer has significant association with the H. pylori density, neutrophil and lymphocyte infiltration. The serological test using EIA method is a useful in detecting H. pylori infection and it may be used as a predictor for the H. pylori density and degree of inflammation.
Antibodies ; Biopsy ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoenzyme Techniques ; Immunoglobulin G ; Inflammation ; Lymphocytes ; Metaplasia ; Neutrophil Infiltration ; Neutrophils ; Serologic Tests

Nonparasitic true splenic cyst is a rare disease and the epidermoid cyst accounts for the majority of the cases. And the epidermoid cyst producing CA19-9 is extremely rare. We present a case of true splenic cyst with high cystic fluid CA19-9 level. A 26-year-old woman complained left upper quadrant abdominal pain. Abdominal ultrasonography and CT depicted a 17 x 13 cm sized cystic lesion in the left upper abdomen. The aspirated cystic fluid showed high concentration of CA19-9, but serum CA19-9 level was normal. Spleen with huge unilocular cyst was removed surgically. The cyst was lined with single layered cuboidal epithelial cells and negative for immunohistochemical staining with anti-CA19-9 antibody.
Abdomen ; Abdominal Pain ; Adult ; Epidermal Cyst ; Epithelial Cells ; Female ; Humans ; Rare Diseases ; Spleen* ; Splenic Diseases ; Ultrasonography

BACKGROUND: Gastroesophageal reflux disease (GERD) is considered to be less common in the Orient compared to the West, but epidemiological data on GERD in Korea are rare. The aim of this study was to determine the prevalence of symptoms of gastroesophageal reflux in routine check-up subjects. METHODS: We analyzed 2243 subjects (male 716, female 1527; age range 20-69 yr) visited health promotion center for routine check-up. Subjects were given a validated self-reported questionnaire, which measured the presence, duration and severity of typical symptoms (heartburn, acid regurgitation); and the presence of atypical symptoms. At least weekly symptoms of heartburn and/or acid regurgitation were characterized as the definition of GERD. RESULTS: The prevalence of heartburn for at least monthly, at least weekly and at least daily episodes was 6.2%, 3.4% and 3.1%, respectively. The corresponding figures for acid regurgitation were 6.1%, 2.1% and 0.7%. The prevalence of GERD was 8.5%, and was more common in female (p< 0.01). Sixty eight percent of subjects with GERD reported the symptoms as having been present for less than 5 years. Seventy four percent of subjects with GERD reported these symptoms to be mild to moderate in severity. Heartburn and acid regurgitation were significantly associated with dyspepsia, chest pain, dysphagia and globus sensation (p< 0.01), but not with hoarseness or chronic cough. CONCLUSION: The prevalence of heartburn and/or acid regurgitation experienced at least weekly is 8.5% in routine check-up subjects. Heartburn and acid regurgitation were associated with epigastric pain, chest pain, dysphagia and globus sensation.
Chest Pain ; Cough ; Deglutition Disorders ; Dyspepsia ; Epidemiology ; Female ; Gastroesophageal Reflux* ; Health Promotion ; Heartburn ; Hoarseness ; Humans ; Korea ; Prevalence* ; Sensation ; Surveys and Questionnaires

OBJECTIVE: This study was aimed to characterize the clinical features and course of acute hepatitis A in Korean adults. METHODS: One-hundred and thirteen cases of acute hepatitis A, diagnosed between Jan. 1995 to July 1998 at 6 medical centers in Korea, were reviewed retrospectively. The clinical course of 94 cases with follow-up duration longer than 3 months were analyzed. RESULTS: The median age was 26 (16-65) years and 97.3% of the patients were under 40 years. The presumed sources of infection were identifed in 62 cases (54.9%). Among those, the leading source was ingestion of raw food. All patients showed normalization of bilirubin level within 8 weeks. The ALT levels normalized within 8 weeks in all patients except three patients (3.2%). Three patients with prolonged elevation of ALT showed second rise of ALT, suggesting a possibility of relapsing hepatitis. Prolonged fever (>38 degree C) more than 10 days was observed in 3 patients (3.2%). One case showed prolonged elevation of alkaline phosphatase (> x3 upper normal limit). No case of fulminant hepatic failure or death was observed. CONCLUSION: The majority of cases with acute hepatitis A in Korean adults showed self-limited course with full recovery.
Adult* ; Alkaline Phosphatase ; Bilirubin ; Eating ; Fever ; Follow-Up Studies ; Hepatitis A* ; Hepatitis* ; Humans ; Korea ; Liver Failure, Acute ; Retrospective Studies

BACKGROUND: Gamma-glutamyl transferase(GGT) has found wide application as a diagnostic test in hepatobiliary disease, and has been used as the best single marker of alcohol intake. In spite of the wide use of GGT in clinical practice, knowledge concerning the distribution and the determinants of this risk factor in the normal population is spared in Korea. We tried to obtain a better evaluation of specificity of serum GGT by analysis of a large population of health examination. METHODS: GGT was measured in 17,140 males aged 17-86 years and 12,125 females aged 18-90 years screened in a health survey program. RESULTS: In multiple regression analyses, serum GGT level showed strong positive association with fatty liver, body mass index, serum levels of AST, ALT triglyceride, uric acid, alkaline phosphatase, systolic blood pressure, and diastolic blood pressure, and weakly positive association with serum levels of creatinine, total cholesterol, and fasting blood sugar. In females, menopause were positively associated with GGT. CONCLUSIONS: An elevated serum GGT levels is a strong indicator of hepatobiliary dysfunction or fatty liver. However, proper interpretation of a serum GGT elevation should be carefully considered in correlation with clinical data and laboratory findings.
Alkaline Phosphatase ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Creatinine ; Diagnostic Tests, Routine ; Fasting ; Fatty Liver* ; Female ; Health Surveys ; Humans ; Korea ; Male ; Menopause ; Risk Factors ; Sensitivity and Specificity ; Transferases* ; Triglycerides ; Uric Acid

BACKGROUND: LV chamber obliteration(COB) during dobutamine stress echocardiography indicates a vigorous inotropic response to dobutamine stress. This may suggest the absence of coronary artery disease, but a small LV cavity may also preclude recognition of wall motion abnormalities. METHODS: Chamber obliteration was defined by contact of the opposite walls in the apical 4 chamber views during dobutamine stress echocardiography. To detect of chamber obliteration and coronary artery disease, dobutamine stress echocardiography was performed in 132 patients with chest pain. To confirm of coronary artery disease, coronary angiography was performed in 64 patients among 132 patients. RESULTS: 1) Chamber obliteration during dobutamine stress echocardiography occurred in 37 patients(28%) among 132 patients. 2) Chamber obliteration during dobutamine stress echocardiography was more common in patients with hypertension(p<0.05) and left ventricular hypertrophy during baseline echocardiography(p<0.005). 3) Coronary angiography was performed in 64 patients(48 patients without chamber obliteration, 16 patients with chamber obliteration). The sensitivity of dobutamine stress echocardiography in the diagnosis of coronary artery disease was 88% in patients without chamber obliteration, 71% in patients with chamber obliteration. But, the difference of sensitivity of both groups was not significant. CONCLUSION: These results suggest that chamber obliteration during dobutamine stress echocardiography will not affect results of the sensitivity of dobutamine stress echocardiography in the diagnosis of coronary artery disease.
Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Diagnosis ; Dobutamine* ; Echocardiography, Stress* ; Heart Ventricles* ; Humans ; Hypertrophy, Left Ventricular