As the general population ages increase leading to an increase in the demand for therapeutic ERCP interventions. The aims of this study are to assess the outcomes, safety and complications associated with ERCP performed in elderly patients.

ERCP was performed in 287 patients aged 70years or over from Jan. 2000 to Dec. 2005. All the patients were evaluated and retrospectively reviewed. The main indications, complications, success rate, mortality and risk factors of procedure were analysed.

287 patients(162 females and 122 males, mean age 78 years, range 70-94years) underwent diagnostic and therapeutic ERCP. Mortality rate was 0.03% and success rate was 91.7%. Minor complications including procedure-related complications such as pancreatitis(2.8%), minor bleeding(1.4%), and aggravated cholangitis(2.1%), mild hypoxia(SaO₂ < 90%, 15.1%), premature ventral contraction(1.0%), and tachycardia(50.7%) were transient. Major events were presented as severe hypoxia(SaO₂ < 85%) in three pts(1.0%), and atrial fibrillation in one patients (0.03%).

This study showed that diagnostic and therapeutic ERCP is safe in elderly patients. Minor complications are usually transient and mortality is similar to previous reported rate.

Microvascular anastomosis has become an essential technique m reconstructive surgery. A patent microvascular anastomosis is required for the success of a free tissue transfer. As the application of microsurgery grows, the desirability of performing an end to end and end to side anastomosis continues to be debated. This experimental study presents the comparison of patency rate of two types of microvascular anastomosis techniques : side to side anastomosis and end to end anastomosis.

A comparative study was undertaken to evaluate side to side micro anastomosis technique using intraluminal catheter. In this study, two clinical metods of microvascular anastomosis were compared. We compared the patency rate and time required for anastomosis. Histological changes (postoperative 1 weeks) were also invsetigated.

Postoperative patency rate was 90% by side to side technique compared to 100% by end to end technique at immediate postoperative and postoperative two weeks. This study revealed that there was no significant difference in patency rate among end to end suture method group and side to side suture method group. Microscopically, we found the relatively smooth surface of the anastomosis site with endothelial regeneration and partial hyaline degeneration in the group using side to side anastomotic method.

We believe there are many advantages in this side to side technique by using intraluminal catheter in perforater flap field and can be highly competitive to the other microvascular anastomisis techniques.

To present a normative database of hippocampus volume in Korean population.

Seventy-two healthy volunteers(male 31, mean age 38.9years) were enrolled and underwent 1.6mm thickness whole brain SPGR(Spoiled Gradient Recovery) MRI. The volume of the hippocampus(HV) was calculated by the summation of the areas of all slices. The cerebrum, cerebellum and midbrain were included for the intracranial volume(ICV). Whole cerebral volume(WCV) and the ICV were calculated from multiplying total voxel count by the volume of one voxel. Subjects were all right-handed and divided into young age(15-49years, N=57) and old age group(58-83years, N=15). Mean HV, WCV, and ICV's were compared according to age, gender, and laterality.

Mean right HV(3350.8±368.4mm³) was significantly larger than left one(3104.3±365.8mm³) in all ages(p<.05). Women's HVs normalized to ICV in right and left sides were definitely larger than those of men although there was no difference of absolute HV between women and men. Mean WCV and ICV of men were significantly larger than those of women. Negative correlation was observed between the age and the HV, WCV, or ICV (p<.05).

Our results showed that right HV was bigger than left one, and normalized HVs of women were larger than those of men. These findings provide normal database of HV in Korea and are important to detect unilateral or bilateral hippocampal atrophy in various brain diseases including epilepsy.

Undergraduate medical students should learn oral presentation skills, which are central to physician-physician communication. The purpose of this study was to compare checklist scores with global ratings for evaluation of oral case presentation and to investigate interrater agreement in the scoring of checklists.

The study group included twenty-one teams of undergraduate medical students who did clerkship for 2 weeks in the department of Laboratory Medicine of Mokdong Hospital, School of Medicine, Ewha Womans University from January 2005 to October 2006. Three faculty raters independently evaluated oral case presentations by checklists, composing of 5 items. A consensus scores of global ratings were determined after discusssion. Inter-rater agreement was measured using intraclass correlation coefficient(ICC). As the ICC values approaches 1.0, it means higher inter-rater agreement.

The mean of consensus global ratings was significantly higher than that of checklists by three faculty raters(12.6±1.7 vs 11.1±2.0, P<0.001). Spearman's correlation coefficient between global ratings and checklist scores was r=0.82(P<0.01). The overall scores of checklist were significantly different among three raters (12.3±2.0, 10.8±2.8, 10.0±2.7, P<0.05). ICC values in the scoring of checklists were as follows ; for overall scores, 0.750 ; for individual checklist items, 0.350-0.753.

These results suggest that checklist scores by faculty raters could be one of the most useful tools for evaluation of oral case presentation, if checklist would be modified to make less ambiguous and more objective and faculty raters would have opportunities to be educated and trained for evaluation skills of oral case presentation.