A case of retroperitoneal teratoma, found in a ten month old female infant was reported. Twenty four hours after the direct retroperitoneal air insufflation, a retrograde pyelography was performed using B.B. 16F. cytoscope. These two studies were essential to make preoperative diagnosis. Review of retroperitoneal tumor was also added.
Diagnosis ; Female ; Humans ; Infant ; Insufflation ; Teratoma* ; Urography

No abstract available.
Professionalism

Purpose: : We discussed what is needed for ‘Shared decision making (SDM)’ in the digital medical environment. Methods: : We looked at what needs to be considered for remote SDM by examining research data on communication and remote SDM operation in existing digital environments. Results: : The integration of digital technology in medicine has significantly enhanced remote communication between patients and doctors. Notably, both the quantity and quality of information exchanged among participants have markedly improved. Additionally, as patients can obtain information without relying on hospitals and doctors, the flow of information is changing from one-way (from doctor to patient) to mutual exchange between patients and doctors. SDM is a decision-making process that emphasizes patient participation, exchange of medical information and information about patient preferences, and decisions based on sufficient deliberation and consensus, and is premised on multiple meetings. To ensure effective SDM, it is necessary to understand the synchronous and asynchronous communication methods of digital technology and the exchange of expanded information. Conclusion : To facilitate successful remote Shared Decision Making (SDM), it is crucial for both patients and doctors to have digital literacy, health literacy, and maintain an attitude of respectful communication.

OBJECTIVE: To identify the factors which can delay home discharges or transfers to other hospitals of rehabilitation inpatients in a tertiary hospital and the change of discharge destination during past 6 years. METHOD: This was a retrospective study of patients with a diagnosis of stroke, traumatic brain injury or spinal cord injury who were admitted to our hospital in 1996, 1999, 2001 and 2003. Demographic data, length of stay, discharge destination and functional status by the FIM(TM) instrument were studied by a medical record review. RESULT: Patients who were transferred to other hospitals or discharged with delay showed significantly lower admission and discharge FIM scores, lower FIM efficiencies, longer length of stays and longer intervals between the onset and admission to a rehabilitation ward. CONCLUSION: Lower functional outcome was associated with a longer length of stay and discharge to another hospital. It would be necessary to establish the long term rehabilitation care facilities with extended rehabilitation program for the patients with lower functional gains in a rehabilitation unit of the tertiary hospitals.
Brain Injuries ; Diagnosis ; Humans ; Inpatients* ; Length of Stay ; Medical Records ; Rehabilitation* ; Retrospective Studies ; Spinal Cord Injuries ; Stroke ; Tertiary Care Centers*

A case of fetal lobulation with huge hydronephrosis due to aberrant vessel, found in 15 year old boy was reported.
Adolescent ; Humans ; Hydronephrosis* ; Male

On various abdominal X-ray examination, 4 cases of stone-like shadow over kidney area due to swallowed pills were found. Twenty four kinds of tablets in country were investigated in their radiopacity. The causes of these shadows were mainly due to mineral contents(iron, calcium etc.)and coating substances of these tablets. The differentiation between these shadows and the true upper urinary stone can be made easily on the X-ray film with their history and the shape of shadows.
Calcium ; Kidney ; Tablets ; Urinary Calculi* ; X-Ray Film

Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

This study measured the impact of the Decisions on Life-Sustaining Treatment Act by analyzing medical cost data from the National Health Insurance Service-National Sample Cohort. After identifying the patients who died in 2018 and 2019, the case and control groups were set using the presence of codes for managing the implementation of life-sustaining treatment with propensity score matching. Regarding medical costs, the case group had higher medical costs for all periods before death. The subdivided items of medical costs with significant differences were as follows: consultation, admission, injection, laboratory tests, imaging and radiation therapy, nursing hospital bundled payment, and special equipment.This study is the first analysis carried out to measure the impact of the Decision on LifeSustaining Treatment Act through a cost analysis and to refute the common expectation that patients who decided to withhold or withdraw life-sustaining treatment would go through fewer unnecessary tests or treatments.

Background: Nivolumab and pembrolizumab are antagonists of the programmed death-ligand 1 (PD-L1) receptor that function as immuno-oncological agents. This study aimed to evaluate the safety and efficacy of nivolumab and pembrolizumab in elderly patients in outpatient settings. Methods: The safety and efficacy of nivolumab and pembrolizumab were compared retrospectively among patients at the Veterans Health Service (VHS) Medical Center in Seoul, South Korea, from September 1, 2017 to August 25, 2018. Results: Eighty-seven patients were selected for the study. The median progression-free survival was 63 days for nivolumab (95% confidence interval (CI), [14 to 282]) vs. 243 days for pembrolizumab (95% CI, [22 to 348]) (p =0.04). The objective response rate (ORR) was 0% in the nivolumab group vs 5.6% in the pembrolizumab group (p =0.310). All the patients exhibited treatmentrelated adverse effects. More than 89% of the patients exhibited diseases of the gastrointestinal (GI) tract. Pneumonia, of grades three or higher, was the most common adverse effect, followed by weakness and anorexia. Conclusions There was no statistically significant difference between the nivolumab group and the pembrolizumab group with respect to the ORR. The incidence and severity of the adverse effects in this study were higher than those of previous studies; however, these adverse effects are generally manageable in a real-world clinical setting. Further randomized controlled studies will be necessary to confirm these results in elderly patients.