Bladder dysfunction after radical rectal cancer surgery has been well known but there has not been sufficient objective data in Korea. We performed consecutive urodynamic study preoperatvely, postoperative tenth day and postoperativesixth month on 71 patients undergone radical rectal surgery. Compared with preoperative state. each urodynamic parameters changed significantly : maximal flow rate and average flow rate decreased ; voiding sense and residual urine volume increased ; bladder capacity, compliance and detrusor pressure decreased ; and maximal urethral pressure, functional urethral pressure and functional urethral length changed. All in all, we came out with the results that autonomic denervation was developed in 59 (83%) out of 71 in postoperative tenth day and 11 (28%) out of 39 in postoperative sixth month. Except for the residual urine volume and detrusor pressure, no significant recovery was observed in postoperative sixth month. Univariate analysis showed that sex, age, tumor size, distance from anal verge, stage, intraluminal tumor position and mode of operation had no significant influence on urodynamic parameters. However, the higher the stage, the more damages were found in multivariate analysis using logistic regression with correction of sex and age. Bladder dysfunction after rectal cancer operation is caused by partial autonomic denervation where urologic care is necessary, however as a whole, bladder dysfunction is considered to be a temporary change.
Autonomic Denervation ; Compliance ; Humans ; Korea ; Logistic Models ; Multivariate Analysis ; Neck* ; Rectal Neoplasms ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Incontinence* ; Urodynamics

Cryosupernatant which is the residual plasma fraction after removing cryoprecipitate has been used for plasma exchange in thrombotic thrombocytopenic purpura and hemolytic uremic syndrome replacing the fresh frozen plasma. Recently, the unusually large yon Willebrand factor multireefs (ULvWFM) has been observed in patients with refractory or chronic relapsing hemolytic uremic syndrome as well as thrombotic thrombocytopenic purpura which disappeared by infusion or plasma exchange with cryosupernatant, and infusion of fresh frozen plasma, the largest multimers of yon Willebrand factor were replenished that it might be a cause of refractoriness. This study was conducted to investigate the characteristics of home-made cryosupernatant from thawed fresh frozen plasma and its thehrapeutic effect in a hemolytic uremic syndrome patient. The level of fibrinogen, coagulation factor VIII, vWF antigen, and ristocetin cofactor activity was decreased and yon Willebrand factor multimers were barely seen in cryosupernatant than those of in fresh frozen plasma. A hemolytic uremic syndrome patient tried with exchange and infusion of cryosupernatant showed excellent recovery. It is concluded that home-made cryosupernatant shares many of the features of fresh frozen plasma except factor VIII, especially von Willebrand factor multimers, and thus it could be a useful alternative to fresh frozen plasma in case of refractory hemolytic uremic synydrome.
Factor VIII ; Fibrinogen ; Hemolytic-Uremic Syndrome ; Humans ; Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic ; von Willebrand Factor

Treatment of interstitial lung disease (ILD) in rheumatoid arthritis (RA) has been controversial. Although there have been several anecdotal reports on the efficacies of corticosteroids or cytotoxic agents such as methotrexate, cyclophosphamide, azathioprine, and D-penicillamine for the treatment of ILD associated with RA, no controlled studies have been performed. To date, corticosteroids have been a central agent for the treatment of this disease, but their effects are partial and temporary in most cases. In addition, the adverse effects of these agents are considerable. On the other hand, limited information is available on the cyclosporine use in ILD associated with RA. We describe a 49-yr old female patient with RA and ILD that had initially responded to high dose prednisolone and cyclophosphamide intravenous pulse therapy, and the lung disease was aggravated with the tapering of prednisolone. After 10 months of follow-up loss, the patient was successfully treated with low dose cyclosporine without high dose corticosteroids.
Anti-Inflammatory Agents/therapeutic use ; Antirheumatic Agents/*therapeutic use ; Arthritis, Rheumatoid/complications/*drug therapy/radiography ; Cyclophosphamide/therapeutic use ; Cyclosporine/*therapeutic use ; Disease Progression ; Female ; Glucocorticoids/therapeutic use ; Humans ; Lung Diseases, Interstitial/complications/*drug therapy/radiography ; Middle Aged ; Prednisolone/therapeutic use ; Treatment Outcome

Behcet's disease is a nonspecific vasculitis characterized by exacerbations and remissions of unpredictictable duration. The commom clinical features in most patients are orogenital ulcers, uveitis and skin lesions-especially erythema nodosum-like lesions or positive pathergy test. Among the systemic manifestations of Behcet's disease, pulmonary involvement is very rare and only a few cases have been documented. The main event of pulmonary involvement is vasculitis forming multilocular aneurysms and thrombosis of the pulmonary artery. The commom pulmonary manifestations are hemoptysis, dyspnea, pleuritic chest pain, cough and fever. The prognosis of pulmonary vasculitis is very poor. A 30-year-old male patient with Behcet's disease presented with fever and dyspnea for 10 days. In the past years, his vision of the left eye was lost due to chorioretinitis. He took right hemicolectomy because of the perforation of colonic ulcer. Also he has been suffered from left hemiparesis due to multiple cerebral infarction. We describe a case with Behcet's disease with pulmonary infarction improved with prednisolone and cyclosporine.
Adult ; Aneurysm ; Cerebral Infarction ; Chest Pain ; Chorioretinitis ; Colon ; Cough ; Cyclosporine ; Dyspnea ; Erythema ; Fever ; Hemoptysis ; Humans ; Lung Diseases ; Male ; Paresis ; Prednisolone ; Prognosis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Infarction* ; Skin ; Thrombosis ; Ulcer ; Uveitis ; Vasculitis

Liposarcoma of the spermatic cord is a rare tumor. Most are of a low-grade malignancy and recurrences tend to be localized. Preoperative diagnosis is difficult. Wide local excision with radical orchiectomy appears to be adequate treatment. A regional lymph node dissection is usually not advocated since the pattern of spread is hematogenous. We report a case of liposarcoma of the spermatic cord in 49-year-old male with brief review of the literatures.
Diagnosis ; Humans ; Liposarcoma* ; Lymph Node Excision ; Male ; Middle Aged ; Orchiectomy ; Recurrence ; Spermatic Cord*

Background: The purpose of this study is to examine the combined effects of organizational climate (OC) with emotional labor (EL) on turnover intention in Korean firefighters. Methods: The data were obtained from the study Firefighters Research: Enhancement of Safety and Health. A total of 4,860 firefighters whose main duty was providing “emergency medical aid” were included. To examine the effects of OC on the relationships between five subscales of EL and turnover intention, four groups were created using various combinations of OC (“good” vs. “bad”) and EL (“normal” vs. “risk”): (1) “good” and “normal” (Group I), (2) “bad” and “normal” (Group II), (3) “good” and “risk” (Group III), and (4) “bad” and “risk” (Group IV). Multivariate logistic regression analyses were performed to estimate the risk of turnover intention for the combinations of OC and EL. Results: The results showed turnover intention was significantly higher in the group with “bad” OC (17.7%) than in that with “good” OC (7.6%). Combined effects of OC and EL on turnover intention were found in all five subscales with the exception of Group I for emotional demands and regulation. Groups II, III, and IV were more likely to experience risks of turnover intention than Group I (p for trend <0.001). Conclusions A positive and cooperative OC plays a role in decreasing the risk of turnover intention and in attenuating the negative effects of EL on turnover intention in firefighters.

Background: The purpose of this study is to examine the combined effects of organizational climate (OC) with emotional labor (EL) on turnover intention in Korean firefighters. Methods: The data were obtained from the study Firefighters Research: Enhancement of Safety and Health. A total of 4,860 firefighters whose main duty was providing “emergency medical aid” were included. To examine the effects of OC on the relationships between five subscales of EL and turnover intention, four groups were created using various combinations of OC (“good” vs. “bad”) and EL (“normal” vs. “risk”): (1) “good” and “normal” (Group I), (2) “bad” and “normal” (Group II), (3) “good” and “risk” (Group III), and (4) “bad” and “risk” (Group IV). Multivariate logistic regression analyses were performed to estimate the risk of turnover intention for the combinations of OC and EL. Results: The results showed turnover intention was significantly higher in the group with “bad” OC (17.7%) than in that with “good” OC (7.6%). Combined effects of OC and EL on turnover intention were found in all five subscales with the exception of Group I for emotional demands and regulation. Groups II, III, and IV were more likely to experience risks of turnover intention than Group I (p for trend <0.001). Conclusions A positive and cooperative OC plays a role in decreasing the risk of turnover intention and in attenuating the negative effects of EL on turnover intention in firefighters.

The results with management of urethral stricture are disappointing, with a high rate of early and late recurrence. Recently, the success of internal urethrotomy has made us question the role of open urethroplasty in the management of urethral strictures. Thus a clinical evaluation was made on 116 patients with urethral stricture in the Department of Urology, Masan Koryo General Hospital, during the period from May 1985 to July 1991. The or stricture was incomplete in 92 cases and complete in 24 cases. The length of stricture was less than 1cm in 86 cases, 1 to 2cm in 19 cases, more than 2cm in 3 cases and multiple strictures in 8 cases. The treatment modality of incomplete urethral stricture was internal urethrotomy in 68 cases and urethroplasty in 9 cases regardless of length, and dilatation in 15 cases with mild stricture. Incomplete urethral stricture, internal urethrotomy was carried out in 7 cases with less than 1cm long stricture and urethroplasty in 17 cases regardless of length. The overall success rate in incomplete urethral stricture was 88.2 % in internal urethrotomy and 88.9 % in urethroplasty, and in complete urethral stricture, 85.7 % in internal urethrotomy and 82. 4% in urethroplasty. We think that visual internal urethrotomy is a valuable initial method, when stricture is incomplete or less than 1cm in length in cases of complete urethral stricture.
Constriction, Pathologic ; Dilatation ; Hospitals, General ; Humans ; Recurrence ; Urethral Stricture* ; Urology

Growth factor receptors play critical roles in the regulation of normal growth and developement. Some of these molecules have been implicated in the neoplastic process as well. In this study, We examined the expression of the EGF receptor gene family in gastric carcinoma by Ribonuclease protection assay and investigated the relationship between the expression of using a mRNA and clinicopathologic parameters. Expression of EGFR mRNA was found in 34 of 59 cases (57.6%), expression of c-erbB-2 mRNA was found in 27 of 57 cases (64.9%), expression of c-erbB-3 mRNA was found in 47 of 60 cases (78.3%), and expression of c-erbB-4 mRNA was found in 39 of 59 cases (66.1%). The expression of EGFR was correlated with the size of the tumor. The expression of c-erbB-2 was correlated with the presence of endolymphatic tumor emboli, Ming's classification, and lymph node matastasis. The expression of c-erbB-3 was correlated with the macroscopic type. Coexpression of c-erbB-2 and c-erbB-3 was correlated with age. These results suggest that the production of the EGF receptor gene family by various tumor cells it may play an important role in the cellular function. Therefore, further studies are currently being carried out to clarify the role of these oncogenes in tumor behavior and gastric carcinogenesis.
Carcinogenesis ; Classification ; Epidermal Growth Factor* ; Humans ; Lymph Nodes ; Oncogenes ; Receptor, Epidermal Growth Factor* ; Receptors, Growth Factor ; Ribonucleases ; RNA, Messenger ; Stomach Neoplasms*

Aneurysms at the distal branch of the middle cerebral artery may be mycotic or congenital in origin. A 34 year-old male patient was admitted with a seizure and a 7-day history of upper respiratory tract infection. The neurological examination showed no abnormality except for headache and mild dysarthria. There was no intracardiac lesion suggesting infective endocarditis. CT, MRI and cerebral angiograms revealed a partially thrombosed giant aneurysm at the distal branch of the middle cerebral artery. Pathologic examination revealed acute inflammatory cells and focal necrosis in the aneurysmal wall as well as recent thrombus. Here, we are reporting an unusual case with a giant distal middle cerebral artery aneurysm with intramural inflammation, suggesting a congenital giant aneurysm with secondary infectious inflammation.
Adult ; Aneurysm ; Aneurysm, Infected* ; Dysarthria ; Endocarditis ; Headache ; Humans ; Inflammation ; Intracranial Aneurysm ; Magnetic Resonance Imaging ; Male ; Middle Cerebral Artery* ; Necrosis ; Neurologic Examination ; Respiratory Tract Infections ; Seizures ; Thrombosis