PURPOSE: The outcome of a tubularized incised plate (TIP) urethroplasty for hypospadias was reviewed retrospectively, and compared with other procedures with respected to the success rate, complications and satisfaction. MATERIALS AND METHODS: Between April, 1994 and July, 2001, 51 patients underwent a repair for hypospadias, by the same operator, using a transverse preputial island flap (TPIF; 7), an onlay island flap (OIF; 3), Mathieu (7) and tubularized incised plate (34) procedures. The operation time, period of catheterization, postoperative hospital days and complication rates for each procedure were also compared. RESULTS: The mean operation time in the TIP group was 140 minutes, compared to 230 220 and 160 minutes in the TPIF, OIF and Mathieu groups, respectively. The mean admission periods in the TPIF, OIF, Mathieu and TIP group, were 14, 17, 11 and 10 days, respectively. The mean operation time and admission period was shorter in the TIP group than those of the other procedures. The incidence rate of an urethrocutaneous fistula was lower in the TIP group (23%: 8/34) than in the TPIF (43%: 3/7), OIF (66%: 2/3) and Mathieu groups (57%: 4/7). Postoperative satisfaction for the penis and meatus shapes was highest in the TIP group. CONCLUSIONS: The TIP urethroplasty had better outcomes than the TPIF, OIF and Mathieu procedures with regard to the operation time, catheterization period, admission period and complication rates following the operations. TIP urethroplasty is thought to be the most economic method for the repair of hypospadias, and can be recommended as the first choice for its repair.
Catheterization ; Catheters ; Female ; Fistula ; Humans ; Hypospadias* ; Incidence ; Inlays ; Male ; Penis ; Retrospective Studies ; Urethra

BACKGROUND: The prognosis after an aortic valve replacment can be affected significantly by the transprosthetic pressure gradient which is determined mainly by the size of the patients body and the prosthesis used. We analyzed the hemodynamic feature of two relatively new prosthese the ATS and the evensized Medtronic-Hall(M-H) valves by measuring the transprosthetic pressure gradient in the cases where small sizes (23mm or smaller) were used. MATERIAL AND METHOD: There were 94 patients who received whom aortic valve replacement with prosthesis smaller than 23 mm from October 1994 to June 1998. In these patients the transprosthetic pressure gradient clalculated from the pressure half time during postoperative Dopper echocardiographic examination was compared between the prostheses of different sizes. The body surface area of each patient was also taken into consideration. RESULT: The mean pressure gradient and body surface area in each group were 21.7+/-10.2 mmHg and 1.52+/-0.14m2 in ATS 19mm 11.4+/-6.5 mmHg and 1,57+/-0.20m2 in M-H 20mm 15.2+/-6.3 mmHg and 1.54+/-0.13m2 in ATS 21mm 9.3+/-2.5 mmHg and 1.63 +/-0.14m2 in M-H 22 mm and 12.9+/-5.3 mmHg and 1.69+/-0.13m2 in ATS 23mm. CONCLUSIONS: The 19mm ATS prosthesis showed significant trasprosthetic pressure gradient which is similar to the values previously reported with other bileaflet prosthesesm Close follow-up was needed in terms of exercise capacity and change in left ventiricular geometry. In patients with small aortic valve annulus the 20mm M-H valve is recomendable as an alternative to 19mm bileaflet valves because it has less pressure gradient with similar outer diameter.
Aortic Valve* ; Body Surface Area ; Echocardiography ; Follow-Up Studies ; Heart Valve Prosthesis ; Hemodynamics ; Humans ; Prognosis ; Prostheses and Implants*

BACKGROUND: Positron emission tomography(PEFT) using fluorine-18 deoxyglucose(FDG), showing increased FDG uptake and retention in malignant cells, has been proven to be useful in differentiating malignant from benign tissues. We indertook the prospective study to compare the accuracy of the whole-body FDG PET with that of the conventional chest computed tomography(CT) for nodal staging of non-small-cell lung cancers(NSCLC). MATERIAL AND METHOD: FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each Imaging study was evaluated independently, and nodal stations were localized according to the AJCC regional lymph nodes mapping system. Extensive lymph node dissection(1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Image findings were compared with the histopathologic staging results and were analyzed with the McNema test(p) and Kappa value(k). RESULT: The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilateral mediastinal nodal staging were 38%, 68%, 25%, 79%, and 61%, and those of PET were 88%, 71%, 47%, 95%, and 75%(p>0.05, K=0.29). When analyzed by individual nodal group(superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value, and negative predictive value of CT were 27%, 82%, 22%, 85%, and 73%, and those of PET were 60%, 87%, 92%, and 82%(p<0.05, k=0.27). CONCLUSION: FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancers.
Electrons ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Mediastinoscopy ; Prospective Studies ; Sensitivity and Specificity ; Thoracotomy ; Thorax ; Tomography, Emission-Computed

Background: Previous studies showed that the prognosis for severe trauma patients is better after transport to trauma centers compared to non-trauma centers. However, the benefit from transport to trauma centers may differ according to age group. The aim of this study was to compare the effects of transport to trauma centers on survival outcomes in different age groups among severe trauma patients in Korea. Methods: Cross-sectional study using Korean national emergency medical service (EMS) based severe trauma registry in 2018–2019 was conducted. EMS-treated trauma patients whose injury severity score was above or equal to 16, and who were not out-of-hospital cardiac arrest or death on arrival were included. Patients were classified into 3 groups:pediatrics (age < 19), working age (age 19–65), and elderly (age > 65). The primary outcome was in-hospital mortality. Multivariable logistic regression analysis was conducted to evaluate the effect of trauma center transport on outcome after adjusting of age, sex, comorbidity, mechanism of injury, Revised Trauma Score, and Injury Severity Score. All analysis was stratified according to the age group, and subgroup analysis for traumatic brain injury was also conducted. Results: Overall, total of 10,511 patients were included in the study, and the number of patients in each age group were 488 in pediatrics, 6,812 in working age, and 3,211 in elderly, respectively. The adjusted odds ratio (95% confidence interval [CI]) of trauma center transport on in-hospital mortality from were 0.76 (95% CI, 0.43–1.32) in pediatrics, 0.78 (95% CI, 0.68–0.90) in working age, 0.71(95% CI, 0.60–0.85) in elderly, respectively. In subgroup analysis of traumatic brain injury, the benefit from trauma center transport was observed only in elderly group. Conclusion We found out trauma centers showed better clinical outcomes for adult and elderly groups, excluding the pediatric group than non-trauma centers. Further research is warranted to evaluate and develop the response system for pediatric severe trauma patients in Korea.

No abstract available.
Ambulatory Care ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Female ; Humans ; Outpatients* ; Pyelonephritis*

Since January 2003, two male patients, 60 and 47 years old, with muscle-invasive, organ-confined, transitional cell carcinomas of the urinary bladder underwent laparoscopic radical cystoprostatectomy with extracorporeal ileal conduit urinary diversion (LRCEIC). The surgical time was 8.5 hours in the first patient and 10 hours in the second. The respective blood losses were 350 and 380ml. In the first patient, ambulation resumed on day 2, bowel sounds on day 3 and oral intake on day 4, with a hospital stay of 8 days. In the second patient, due to inadvertent rectal injury, which was discovered on day 3, ambulation, bowel sounds and oral intake could not be determined. A pathological examination revealed a pT1N0M0 transitional cell carcinoma of the bladder, with the surgical margins negative for cancer, in the first patient, and a pT3bN1M0, with the surgical margins positive for cancer, in the second. Immediate postoperative complications included rectal injury and ileus in the second patient. With further experience and refinement in the operative technique, it is believe that LRCEIC can be performed safely and efficaciously in selected muscle-invasive bladder cancers.
Carcinoma, Transitional Cell ; Cystectomy* ; Humans ; Ileus ; Laparoscopy ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion* ; Walking

The purpose of this study was to evaluate the efficacy of the Sonicare Elite(R) power toothbrush in plaque removal and reduction of gingivitis from hard-to-reach sites of the moderate periodontitis compared to regular manual toothbrush in 12 week follow-up. 82 subjects with incipient to moderate periodontitis were randomly assigned to use either the manual or sonic brush, instructed in its use, and asked to brush 2 times a day for 2 minutes. Plaque scores were taken at baseline, 1, 4, 12 weeks using Silness & Loe plaque index and gingival inflammation was assessed by the Loe & Silness gingival index. The results were as follows. 1. The Sonicare Elite(R) power toothbrush showed a significant reduction(p<0.0001) of the plaque( Silness & Loe) and gingival inflammation(Loe & Silness). 2. The Sonicare Elite(R) power toothbrush showed a significant better reduction of plaque and gingivitis(p<0.05) than the manual toothbrush after 1, 4, and 12 weeks. 3. The Sonicare Elite(R) power toothbrush demonstrated a significant reduction(p<0.0001) of the plaque in interproximal sites(p<0.0001), buccal sites(p<0.0001) and the lingual sites(p=0.0018) of the teeth. 4. The Sonicare Elite(R) power toothbrush demonstrated a significant reduction(p<0.0001) of the gingival inflammation in the interproximal sites(p<0.0001), the buccal sites(p<0.0001) and the lingual sites(p<0.0001) of the teeth. The results of this study support the findings that Sonicare Elite(R) power toothbrush has a great potential to remove the plaque and resolve the gingival inflammation during the period of 12 week.
Follow-Up Studies ; Gingivitis ; Inflammation* ; Periodontal Index ; Periodontitis* ; Tooth

Background: The rapid increase in the number of coronavirus disease (COVID-19) patients led to the operation of COVID-19 facilities for patients with mild COVID-19 in South Korea. We analyzed the correlation and effect of risk factors associated with the worsening of patients with mild COVID-19 leading to their transfer from a community treatment center to a hospital. Methods: This retrospective cohort observational study included 1,208 COVID-19 patients with mild symptoms who were admitted to the Namsan Community Treatment Center between June 2020 and January 2021. A chi-square test was performed to examine the differences in the transfer rate by age, sex, nationality, presence of symptoms at admission, and season, and a multivariable logistic regression analysis was performed to examine the association of variables to the hospitalization rate. Results: Of the 1,208 patients, 212 (17.5%) were transferred to a hospital due to clinical deterioration. Increasing odds of hospital transfer were associated significantly with higher age and presentation in autumn, whereas sex and symptomatic illness at admission did not show a statistically significant association. Conclusion The findings indicate the importance of the initial risk classification of COVID-19 patients based on thorough assessment and close monitoring, timely allocation of appropriate resources to high-risk groups that are likely to develop severe disease, and reduction of medical resource wastage and limiting of administrative force to ensure that patients receive the best treatment.

Hepatic portal venous gas (HPVG), a rare radiologic finding, is associated in some cases with severe or lethal conditions requiring urgent surgical intervention. Computed tomography has recently demonstrated a wider range of clinical conditions associated with HPVG, some of which are benign and do not necessarily require surgery. However, HPVG remains an ominous sign in cases of bowel ischemia or necrosis. We report on a case of massive HPVG caused by a fatal intestinal infarction, which showed rapid disease progression, eventually resulting in death due to septic shock. The HPVG in this case was huge and could therefore be confused with an air-biliarygram.
Colitis, Ischemic ; Disease Progression ; Infarction ; Ischemia ; Mesenteric Veins ; Necrosis ; Portal Vein ; Shock, Septic

This study was undertaken to investigate age-dependent and postmenopausal changes in the serum levels of anti-Mullerian hormone (AMH), inhibin B, insulin-like growth factor (IGF)-I, IGF-binding protein-3 (IGFBP-3), and follicle-stimulating hormone (FSH), and to determine which of these markers best reflects the aging process in women. A total of 144 women aged 20-59 yr were enrolled in this cross-sectional study. Blood samples were obtained on cycle day 3 of regularly menstruating women (n=111), or at random in postmenopausal women (n=33). Data were analyzed with respect to premenopausal women age groups and compared in pre- and postmenopausal women. Area under the receiver operating characteristic curve (ROCAUC) analyses were performed to assess the ability of each marker to discriminate between the pre- and postmenopausal status. Serum levels of AMH, IGF-I, and IGFBP-3 decreased and serum levels of FSH increased significantly with age in premenopausal women. Serum luteinizing hormone (LH) was higher and inhibin B was lower in women in their 20-30's than in 40's. Serum levels of AMH and IGF-I showed a consistent decrease with all age groups. ROCAUC analysis showed that the diagnostic accuracy of AMH for menopausal status was similar to those of FSH, LH, and inhibin B, and was better than that of IGF-I. In conclusion, the serum AMH level appears to be the best marker of the aging process in premenopausal women.
Adult ; Age Factors ; Anti-Mullerian Hormone/*blood ; Female ; Follicle Stimulating Hormone/*blood ; Humans ; Inhibins/*blood ; Insulin-Like Growth Factor Binding Protein 3/*blood ; Insulin-Like Growth Factor I/*analysis ; Menopause/*blood ; Middle Aged ; ROC Curve