No abstract available.
Hematoma* ; Orbit*

No abstract available.
Masticatory Muscles* ; Trismus*

PURPOSE: In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists. RESULTS: For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms. CONCLUSION: The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.
Adrenergic alpha-Antagonists/therapeutic use ; Cholestenone 5 alpha-Reductase/antagonists & inhibitors ; Data Collection ; Humans ; Korea ; Male ; Prostatic Hyperplasia/*diagnosis/*drug therapy ; Urology/statistics & numerical data

This retrospective study was undertaken to provide information when considering aspects of future prevention and quantifying demand fir medical services. And it comprised 835 patients with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, the Yeungnam University Hospital during the past five years from January 1991 to December 1996. The medical records of this 835 patients(1,210 fractures) were reviewed and analyzed in order to obtain the clinical pattern and understand the therapeutic tendency. The following results were obtained; 1. The greatest number of patients were sustained facial bone injuries between midnight and 3:00. The monthly incidence showed in September at the most and at the least in December. The increase of facial bone injuries of 11.3% per year was shown. 2. The mean age of patients was 30 years. The most prevalent age group was at third decade(31.9%). Males were predominated more than female(3.6 : 1). 3. The most common cause was traffic accidents(41.6%) followed by violence, fall, industrial accidents and others. 4. The most common fracture was found in the nose(35.1%) followed by mandible(22.6%), zygoma(21.1%), and maxilla(11.2%). 5. Associated injuries were as following order of frequency; ophthalmologic injury(21.0%), other facial bone fractures(18.2%), head injury(10.2%). 6. Open reduction was used for 53.9% of total cases while 40.6% of total cases required closed reduction, and 5.5% of total cases treated conservatively. The complication rate was 18.5% and complications were as following order of frequency; facial asymmetry(37.2%), diplopia and enophthalmos(19.4%), and local infection(12.8%).
Accidents, Occupational ; Diplopia ; Facial Bones* ; Head ; Humans ; Incidence ; Male ; Medical Records ; Plastics ; Retrospective Studies ; Violence

A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.
Abdomen ; Adult ; Arm ; Autopsy ; Blast Injuries ; Brain ; Cause of Death ; Contusions ; Diving ; Embolism, Air ; Explosions* ; Heart ; Humans ; Jaw ; Lacerations ; Lung ; Pneumocephalus ; Pneumoperitoneum ; Ships ; Subcutaneous Emphysema ; Thorax ; Vital Signs

BACKGROUND/AIMS: Spontaneous bacterial peritonitis (SBP) is one of critical complications in liver cirrhosis patients with ascites. We aimed to review clinical course of SBP patients in a 10-year period from single center. METHODS: This study enrolled SBP patients between 2005 and 2015. Their medical records were reviewed. The laboratory findings of serum and ascites were examined, and characteristics of isolated microorganisms in ascites were analyzed. RESULTS: Total 51 patients were enrolled. Male patients were predominant (64.7%), and mean age was 59.20 years. The most common etiology of cirrhosis was alcohol (41.2%), followed by hepatitis B (39.2%). Microorganism was isolated from the ascites in 31 patients (60.78%). The proportions of Gram negative and Gram positive were 80.64% and 19.36%. The proportions of Escherichia coli, Klebsiella, and Streptococcus species were 29.41%, 19.61% and 11.76%. Among Escherichia colis, 4 cases were ESBL positive (7.84%). The most commonly used first-line antibiotic was cefotaxime (80.40%). Prophylactic antibiotics treatment was performed only in 8 patients, and SBP was recurred in 7 patients (13.72%). When comparing the SBP recurrence group and the non-recurrence group, there were no significant differences in laboratory findings of serum and ascitic fluid. CONCLUSIONS: SBP is still a critical complication in cirrhosis patients with ascites, and the clinical features of SBP have not been altered much compared with those in 1990's. The effective treatment of SBP is still very important for a better prognosis of cirrhosis patients.
Anti-Bacterial Agents ; Ascites ; Ascitic Fluid ; Bacteria ; Cefotaxime ; Escherichia coli ; Fibrosis ; Hepatitis B ; Humans ; Klebsiella ; Liver Cirrhosis ; Male ; Medical Records ; Peritonitis* ; Prognosis ; Recurrence ; Streptococcus

An anomalous left coronary artery from the pulmonary artery(Bland-White-Garland syndrome) is a rare congenital malformation and sometimes fatal. It is caused by an abberant endothelial budding from or an anomalous division of the truncus arteriosus. Echocardiography (transthoracic and transesophageal) and angiographical imaging are essential for the diagnosis of this anomaly. Corrective Surgery is recommended due to its fatal natural course. A case was diagnosed in a 45-year-old man who presented with intermittent palpitation. This patient was successfully treated with closure of anomalous left coronary artery orifice combined with right saphenous vein graft anastomosis.
Bland White Garland Syndrome ; Coronary Vessels* ; Diagnosis ; Echocardiography ; Humans ; Middle Aged ; Pulmonary Artery* ; Saphenous Vein ; Transplants ; Truncus Arteriosus

BACKGROUND: To investigate the mechanisms of myocardial ischemia induced changes of electrophysiological properties, influences of various ischemic-simulated Tyrode's solutions on the changes of action potential characteristics were examined. METHOD: Action potential characteristics were measured during superfusion with various ischemic-simulated solutions (modified physiologic salt solution: MPSS) by the method of conventional microelectrode technique in rat atrial fibers. RESULTS: Hypoxic-, hyperkalemic-, and mixed-MPSS decreased 'maximum diastolic potential' (MDP) and 'action potential amplitude' (APA), however, no significant changes of MDP and APA were observed by acidic- and glucose-free-MPSS. 'Maximum velocity of phase 0 depolarization' (dV/dt(max)) and 'time for 90% repolarization' (APD90) significantly decreased during hypoxic- and mixed-MPSS superfusion, and hyperkalemic-MPSS also decreased the dV/dt(max) and APD90. However, no significant changes in dV/dt(max) and APD90 were observed by acidic- and glucose-free-MPSS. The decreasing effects of dV/dt(max) and APD90 by the MPSSes were attenuated when the MPSSes were replaced with normal Tyrode's solution. DPCPX (2x10(-6)M), a purinergic antagonist, inhibited the decreasing effects of APD90 at 5, 10, and 20 min superfusion of the mixed-MPSS, and glibenclamide (10(-6)M), a K(ATP) channel blocker, inhibited those at 10 and 20 min superfusion of the mixed-MPSS. Diclofenac (10(-6)M), a cyclooxygenase inhibitor inhibited only those at 20 min superfusion of the mixed-MPSS. CONCLUSION: The primary factors for changing the electrophysiological characteristics during ischemic insults could be hypoxia and high-extracellular K+, and the mechanisms of the electrophysiological changes are inferred that adenosine through purinoceptors is involved initially, and followed by K(ATP) channel and prostanoids.
Action Potentials* ; Adenosine ; Animals ; Anoxia ; Diclofenac ; Glyburide ; Ischemia ; Microelectrodes ; Myocardial Ischemia ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Rats* ; Receptors, Purinergic

PURPOSE: Having been disappointed with standard anticoagulation therapy for acute deep vein thrombosis (DVT) in lower extremity, we started catheter-directed thrombolytic therapy. And the aim of this study was to evaluate the effects on venous function of catheter-directed thrombolytic therapy by noninvasive venous tests such as Air plethysmography (APG) and duplex ultrasonography. METHOD: 36 patients with DVT of less than 3 weeks after development into two groups according to treatment modality:Group 1; catheter-directed thrombolysis with Urokinase followed by low-molecular weight heparin (LMWH) and coumadin therapy (n=19, men; 11, women; 8, mean age 47.6 years), Group 2; conventional anticoagulation with LMWH followed by coumadin therapy (n=17; men; 12, women; 5, mean age 47.1 years). The results of lytic therapy were examined by complete phlebography on time of removal of catheter. The location and extent of thrombotic changes were followed-up with duplex scan and venous function was examined with APG. RESULT: Complete clot resolution by lytic therapy was obtained in 12 cases out of 19 cases (63.2%) in Group 1. The residual thrombi at follow-up around 1 year were detected in 4 cases in Group 1, in 11 cases in Group 2. APG parameters that were significantly different (P<0.05) between the two groups were the venous filling index:(Group 1; 1.63+/-1.36 ml/sec, Group 2; 2.66+/-1.58 ml/sec), residual volume fraction (Group 1; 27.54+/-17.40%, Group 2; 49.19+/-20.45%) and outflow fraction (Group 1; 37.79+/-7.05%, Group 2; 32.36+/-6.31 %). The parameters of APG and ultrasonography in Group 1 revealed lesser degree of reflux and smaller amount of residual thrombi. CONCLUSION: Catheter-directed thrombolytic therapy shows better results in complete resolution rate of the acute DVT, reducing remnant thrombi, and preserving venous function such as venous filling index, residual volume fraction and outflow fraction. APG and duplex scanning seem to be useful methods for a complete follow-up evaluation of limbs with DVT.
Catheters ; Extremities ; Female ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Lower Extremity* ; Male ; Phlebography ; Plethysmography ; Residual Volume ; Thrombolytic Therapy ; Ultrasonography ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis* ; Warfarin

We report an unusual case of clitoral hypertrophy due to neurofibromatosis of external genitalia. The patient also had definite skin lesions and family history. The patient was treated successfully by clitorectomy. The patient seems to be the first case of clitoral neurofibromatosis reported in Korean literature.
Circumcision, Female ; Clitoris ; Female ; Genitalia ; Humans ; Hypertrophy ; Male ; Neurofibromatoses* ; Skin