• The Academic Congress of Korean Shoulder and Elbow Society
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• 1995.05a
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• pp.22-22
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• 1995

One hundred and forty-eight cases of tennis elbow were treated by conservative managements firstly such as rest, medication, immobilization, physical therapy and local steroid injection, from Jan. 1985 to Jun. 1994 at Department of Orthopaedic Surgery, National Medical Center. Among the 148 cases, 16 cases who failed conservative managements, were treated with Nirschl & Pettrone operation. The results were summarized as follows, 1. Among the 148 cases, 110 cases$(74\%)$ were female, and 61 cases$(41.2\%)$ were in the age group 41 to 50, and mean age was 42.3 2. Ninety-nine cases were housewives and only 15 cases were related to sports. 3. The results 116cases$(78\%)$, of conservative treatment were excellent and good 10 fair and failure in 32 cases$(22\%)$, by Nirschl and Peettrone assessment. 4. Among the 16 cases who were treated with Nirschl and Pettrone operation, excellent result was obtained 10 7cases, good in 3 cases, fair in 4cases and failure in 2 cases. 5. Recurrence was developed in 18 cases$(12.2\%)$, and we obtained excellent & good result in 17 cases with both conservative and operative treatment. Above results suggest that the term, tennis elbow is a misnomer because it occurs more commonly in non-athletes such as housewives than in tennis players. So it seems to be a occupational disease rather than sports injury. Now, we propose eliminate of the term, elbow and substitute with terminology that described the true understanding and therapeutic orientation of it.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.1-6
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• 2004

Purpose: We studied the diagnostic value of ultrasonography to confirm the presence of the syndesmosis injuries in the ankle. Materials and Methods: Pre-operative ultrasonography were taken in 42 cases of ankle fractures to determine injury of syndesmosis between February 2000 and August 2003. Tear of syndesmosis was confirmed when they met the following criteria; widening of distal tibiofibular clear space greater than 7 mm on pre-operative AP X-rays, leakage of contrast dye during intra-operative arthrography, and operative findings revealing syndesmosis rupture. We compared these diagnoses with those made by pre-operative ultrasonography. Results: Syndesmosis injuries were confirmed in 23 cases among the total 42 cases. Ultrasonography revealed syndesmosis tear in 25 cases, with 20 cases corresponding with confirmed tear and 5 cases without tear in confirm. Syndesmoses were found to be intact in 17 cases of ultrasonograph, but 3 cases were actually confirmed tear. In ankle ultrasonography, the sensitivity was 90.9%, the specificity was 75.0%. Conclusion: Preoperative ultrasonography is a non-invasive and useful study to determine the syndesmosis injury in ankle fractures.

• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.586-591
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• 2001

Objective : Transseptal or sublabial transsphenoidal surgery has been standard teatment for pituitary tumors for decades. However, as an alternative to this surgery endonasal endoscopic technique has been reported with encouraging results. We have started endoscopy-assisted transsphednoidal surgery from May 1998. In this paper we analyzed the methods, outcome, advantage and disadvantage of this surgical approach for the purpose of planning optimal treatment of pituitary tumors. Methods : This study consisits of 13 cases of pituitary tumors who were treated by endoscopy-assisted transsphenoidal surgery using one nostril from May 1998 to July 1999. Mean follow up period was 12.9 months. Results : There was no septal or sublabial incision and little surgical damage to nasal structure. With this technique, rapid surgical approach and short hospital day were possible, being 3-6 days in patients without CSF leakage. Using various angled endoscope, good surgical view was obtained. Initially it was difficult to use various instruments in narrow nasal cavity, but became feasible after several procedures. Among 13 cases, total removal was possible in 11 cases. One of two cases in whom tumor was incompletely removed underwent gamma-knife radiosurgery and second underwent reoperation through subfrontal approach. There were 6 cases of hormone secreting tumors and hormonal remission was achived in all of these cases. Postoperative complications were CSF leakage(6 cases), diabetes insipidus(2 cases) and panhypopituitarysm(1 case). Lumbar drainage was done in all cases of CSF leakage. Conclusion : The advantage of endoscopy-assisted transsphenoidal surgery are rapid surgical approach, low postoperative morbidity, short hospital day and good surgical view. The disadvantage of this appoach are difficulty in manupulating various instruments in narrow nostril and difficulty in distance perception but these problems can be overcome by practice and using stereoscopic endoscope.

• Journal of Preventive Medicine and Public Health
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• v.18 no.1
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• pp.41-50
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• 1985

To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows : 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.239-244
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• 2015

Background: One of the causes of acute leukemia can be exposure to certain chemicals such as pesticides. This study determined the relationship between exposure to pesticides and the occurrence of acute leukemia in Fars province, south of Iran. Materials and Methods: Between April 2011 and April 2013 in a case-control study conducted in Nemazee Hospital in Shiraz, Southern Iran; 314 subjects diagnosed with acute leukemia (94 pediatric cases and 220 adults) were enrolled to determine any correlation between exposure to pesticides and the occurrence. Controls (n=314) were matched by sex and age. Results: There was a history of exposure to pesticides among 85% of pediatric cases and 69% of their controls and 83% of adult cases and 75% of their controls while 87.5% of pediatric cases and 90% of adult cases reported exposure to intermediate and high doses of pesticides and among the controls, the exposure to low doses of pesticides was 70.5% and 65%, respectively. Exposure to indoor pesticides was seen among most of cases and controls. Being a farmer was at a significantly more increased risk of developing acute leukemia in comparison to other jobs, especially for their children. Conclusions: Exposure to pesticides was shown to be one of the most important causes of acute leukemia. It seems that there is a need to educate the people on public health importance of exposure to pesticides especially during school time to reduce the risk of malignancies during childhood.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1620-1627
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• 2000

Objectives : DAMA cases were analyzed to examine what the main casual factors of DAMA were and how to deal with these cases effectively in hospital with the DAMA interdisciplinary team including medical social worker whose role is to perform psycho-social assessment, family counsel, to evaluate family's DAMA need. Patients and Methods : The content analysis of medical record and social work record were reviewed in 37 cases referred by medical doctor to DAMA team. These cases were reported by patients' self discharge request or family's request for discharge from September 1998 to February 2000. The DAMA team consists of Assistant Director of Hospital as team leader, medical staff in-charge, social worker, QI nurse, other staff members who are not involved in direct treatment for patient, and administrative clerk. Results : The results of content analysis are as follows : 1) The most causal factors of DAMA consist of combination of more than 2 factors. 2) The major decision-maker is revealed to be son and daughter of patient. 3) In 59.4% of cases, family was not informed of patients' prognosis, alternatives, the consequence of DAMA at all. 4) In cases of DAMA report, the rapid intervention of social worker is carried out. Conclusion : In this study, we propose the interdisciplinary team approach to make decision legitimately and ethically for DAMA. The suggestions from this study are as follows : 1) To deal with DAMA case properly, the interdisciplinary team approach should be considered. 2) The criteria for DAMA case should be formed carefully. For the explicit selection of DAMA case, preliminary system for high-risk patient screening is recommended. 3) The medical social worker is available for the psycho-social problems of the patient once family members. For the effective family counselling, discharge planning and nursing home placement, the participation of medical social worker should be mandatory.

• The Korean Journal of Cytopathology
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• v.19 no.2
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• pp.99-106
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• 2008

Background : Second opinion diagnosis of outside pathology slides is a common practice for efficient and proper patient management. We analyzed cytology slides from outside hospitals submitted for a second opinion diagnosis to determine whether the second opinion diagnosis had any influence on patient care. Methods : We reviewed 1,153 outside cytology slides referred to Asan Medical Center for second opinions from January, 2007, to December, 2007. All cases were categorized into three groups; no diagnostic discrepancy, minor diagnostic discrepancies (no impact on the management), and major diagnostic discrepancies (significant impact on the management and subsequent follow-up). Results : The thyroid was the most common organ system (933 cases, 80.9%), Forty cases (3.6%) belonged to the major diagnostic discrepancy group and 149 cases (12.8%) to the minor discrepancy group. For validation of second opinion diagnoses in major discrepancy cases, subsequent biopsy or surgical resection specimens and clinical information were reviewed, which were available in 29 cases. The second opinion diagnoses resulted in alteration of clinical management in 21 of 29 cases. Conclusion : For all referred patients, second opinion diagnosis is important and mandatory for appropriate patient care.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.190-198
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• 2022

Backgrounds/Aims: Traumatic pancreatic injury (TPI) is rare as an isolated injury. There is a trend to perform conservative treatment even in patients with complete duct dissection and successful treatment. This study reviewed our 20 years of experience in the management of TPI and assessed patient outcomes according to age group and treatment strategy. Methods: A retrospective analysis of patients diagnosed and treated with TPI at a level-I trauma center from 2000-2019. Patients were divided into two groups: adults and pediatrics. Conservative treatment cases were subjected to subgroup analysis. Level of evidence: IV. Results: Of a total of 77 patients, the mean age was 24.89 ± 15.88 years. Fifty-six (72.7%) patients had blunt trauma with motor vehicle accident. Blunt trauma was the predominant mechanism in 42 (54.5%) patients. Overall, 38 (49.4%) cases had grade I or II injury, 24 (31.2%) had grade III injury, and 15 (19.5%) had grade IV injury. A total of 30 cases had non-operative management (NOM). Successful NOM was observed in 16 (20.8%) cases, including eight (32.0%) pediatric cases and eight (15.4%) adult cases. Higher American association for the surgery of trauma (AAST) grade of injury was associated with NOM failure (16.7% for grade I/II, 100% for grade III, and 66.7% for grade IV injury; p = 0.001). An independent factor for NOM failure was female sex (69.2% in females vs. 29.4% in males; p = 0.03). Conclusions: High AAST grade TPI is associated with a high rate of NOM failure in both pediatric and adults.

• Journal of Oriental Neuropsychiatry
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• v.17 no.1
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• pp.17-35
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• 2006

Objects : In the present study, we translated Mingyi-leian into modern Korean, and studied the medical records about the disease induced by emotional problem and the psychotherapy in Mingyi-leian for find the possibility of application that established researches did not studied. Methods : It was 197 cases that related to psychotherapy and emotional problem called Seven Passions(七情). We studied these records by statistical methods. Results : The anger(怒) was the most numerous cause into classified to Seven Passions in 197 cases. In the order of frequency of emotional causes, it was worry(憂), surprise(驚), lust(思), fear(恐), sorrow(悲), joy(喜) that classified into Seven Passions. The most disease induced by emotional problem was internal trauma(內傷), 11 cases. There was very numerous diseases induced by emotional problem except internal trauma. In ratio of the sexes, it was 104 cases in female and 93 cases in male from 197 cases. But the number of all case records about male were more than about female in Mingyi-leian, so female ratio was two times to male ratio. Specially, the percentage of cases about disease due to anger high in female. In ratio of the Seven Passions, the anger was most frequent cause of diseases due to emotional problem in 197 cases, and mostly caused bleeder's diseases. In oral medical treatments, various prescriptions were used. On the whole, the ratio of prescriptions about venting grudges(解鬱) records are mostly application of compatibility and incompatibility with the and warmly strengthening(溫補) were high. Psychotherapeutic medical Five Elements(五行) relation. But it also has psychotherapeutic medical record made by detailed and correct analysis can equal to modern psychotherapy, it is worth refer to clinic. Conclusions : Mingyi-leian and its medical records about the disease induced by emotional problem and the psychotherapeutic records have sufficient meaning to not only modern neuropsychiatric physicians but also physicians of all medical fields to treat disease of this kind.

• Korean journal of aerospace and environmental medicine
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• v.30 no.1
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• pp.40-49
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• 2020

In accordance with ICAO SARPs, the states should implement appropriate aviation-related health promotion for airmen subject to an aviation medical examination to reduce future medical risks to flight safety. We aimed to analyze the results of the aviation medical examination to use as objective evidence for establishing an aviationrelated health promotion plan. The results of the final issuance of airmen medical certificate from 2015~2017 were collected from the e-sky computer system. The 30 cases (0.3%) in 2015, 22 cases (0.2%) in 2016, 38 cases (0.3%) in 2017 were unfit for flight duty. The 34 unfit out of the total 90 cases were renewal physical examinations. The cardiovascular disease was most commonly in 11 cases, followed by 8 tumors, 4 psychiatric diseases, 3 ophthalmic diseases, 2 respiratory diseases, 2 neurologic diseases, 2 otolaryngological diseases, 1 endocrine disease and 1 digestive disease. The results of this study can be used as objective data in aviation-related health promotion plan. The health promotion activities based on objective data can contribute to improving aviation safety by improving the lifestyles of airmen.