Clinical and statistical observation was made on outpatient inpatients and operations in Urology Department of the Capital Army Hospital during the period from Jan., 1962 to Dec. 1963 and the results (1) Clinical statistics on outpatients. 1) Total outpatient were 2213 cases, 2179 males and U females, and the male to female ratio was 64.1:1. 2) The number of outpatient increased in winter and decreased in summer. 3) According to age distribution, the majority of the patients (96.2%) where between 21 and 40 years of age. 4) The most common diseases were urethritis (35.7%) showing annual increase, while redundant prepuce, urolithiasis, injury of genito-urinary tract, nonspecific epididymitis and hydrocele, showing annual decrease. 5) Renal tuberculosis showed annual decrease and tuberculous epididymitis, annual increase. (II) Clinical statistics on inpatients. 1) The inpatients during 2 years were 241 cases which comprised10.9% of total outpatients. The male inpatients stood for 11% of total outpatient and the female inpatients, 5.9%. 2) The most common disease were renal tuberculosis, hydrocele, non-specific epididymitis, stones of kidney and ureter, tuberculous epididymitis, urethral rupture and scrotal hematoma. (III) Clinical statistics on operations. The number of total operations were 640 during 2 years. Circumcision comprised 34.0% of total operations, vasectomy, 30.6% Nephrectomy, 6.1% ; epididymectomy, 6.1%, hydrocelectomy, 4.1% and plastic surgery of urethra, 2.3%. One case of Bricker's operation was performed.
Age Distribution ; Circumcision, Male ; Epididymitis ; Female ; Hematoma ; Hospitals, Military* ; Humans ; Inpatients* ; Kidney ; Korea* ; Male ; Nephrectomy ; Outpatients* ; Rupture ; Seoul* ; Surgery, Plastic ; Tuberculosis, Renal ; Ureter ; Urethra ; Urethritis ; Urolithiasis ; Urology* ; Vasectomy

The purpose of this study was to identify the relationship between the levels of foodservice management activities and job satisfaction of the dietitians in elementary schools. Out of 130 questionnaires distributed to elementary school dietitians in In-cheon, 127 were returned and analyzed (98% response rate). The questionnaire included two multipleitem scales for measuring foodservice management activities and job satisfaction, respectively. All the items in the scales were coded 1 to 5 for 'certainly no', 'no', 'neutral', 'yes', and 'certainly yes' and grouped by using factor analyses. Most of the responding dietitians were working for schools in urban areas and have independently managed on-site kitchens. The 19 items on food service management activities were grouped into 6 factors and the mean scores of the levels of Personnel Hygiene Management, Education & Training, Sanitation & Safety Management, Menu Quality Management, Service Management, and Environment Management were 4.76, 4.26, 4.24, 4.05, 3.61 and 3.39, respectively. The 23 items on job satisfaction were grouped into 4 factors and the mean scores of the satisfaction levels of Systematic Environment, Job Duty, Job Condition, and Physical Environment were 3.38, 2.83, 2.53, and 2.08, respectively. Overall, the levels of food service management activities and job satisfaction were positively associated with a correlation coefficient of 0.254 (p < 0.01). In particular, satisfaction levels on job duty itself and systematic environment were positively associated with the levels of overall management activities. The results suggest that improving dietitians' job satisfaction could increase the levels of management activities of school foodservice dietitians, resulting in quality improvement of school food service.
Education ; Food Services ; Humans ; Hygiene ; Incheon ; Job Satisfaction* ; Nutritionists ; Quality Improvement ; Safety Management ; Sanitation ; Weights and Measures

BACKGROUND: The purpose of carotid endarterectomy is to prevent stroke regardless of past neurologic events. Major concern in the carotid endarterectomy is the inadequate blood flow of ipsilateral hemisphere during clamping of the carotid artery. It is well known that internal carotid artery back pressure means collateral cerebral blood flow. Our study is intended to determine the guideline of shunt placement according to the carotid back pressure and electroencephalographic finding. MATERIAL AND METHOD: The study population comprised of 16 consecutive patients who underwent carotid endarterectomy for carotid stenosis in our institution between from February 1996 to March 1999. There were 14 men and 2 women between the ages of 56 and 78 years(mean age 66.25+/-6.53 years). The carotid stenosis in the operative site was ranged from 61% to 95%(mean 73.8+/-12.33%) and the mean carotid stenosis of the contralateral side was 60.99+/-25.03%. During the operation, electroencephalographic monitoring was taken in all cases. The internal carotid artery back pressure was measured to estimate the collateral cerebral blood flow, and in all patients with back pressure below 40 mmHg(11 patients) and patients with complete occulusion of contralateral carotid artery(2 patients), an internal shunt was installed. RESULT: One postoperative death occurred in a patient with large evolving cerebral infarction and severe ipsilateral carotid stenosis, who underwent emergent carotid endarterectomy. The cause of death was hemorrhagic infarction in the corresponding cerebral territory. We observed that immediate operation after a major stroke negatively influenced the postoperative outcome. No intraoperative ischemic neurologic complication developed. During the follow-up upto now(mean follow-up 21.5+/-11.85 months), there has been no early or late recurrence of stroke except one patient ,in whom cerebral infarction developed in the contralateral side on the first postoperative day. CONCLUSION: At least 4-6 weeks stabilization after a stroke is recommended for surgical management. The carotid endarterectomy is an effective surgical intervention for prevention of anticipated stroke and can be performed safely if an internal shunt is used in patients whose internal carotid arterial back pressure is below 40 mmHg.
Carotid Arteries ; Carotid Artery, Internal ; Carotid Stenosis* ; Cause of Death ; Cerebral Infarction ; Constriction ; Endarterectomy ; Endarterectomy, Carotid* ; Female ; Follow-Up Studies ; Humans ; Infarction ; Male ; Recurrence ; Stroke

Purpose: Overactive bladder (OAB) is observed in women with functional bladder outlet obstruction (FBOO), as are lower urinary tract symptoms (LUTS). Therefore, we evaluated the urodynamic characteristics of women with storage LUTS and FBOO diagnosed by urodynamic studies (UDS). Methods: Women (n=108) with storage LUTS and FBOO diagnosed by UDS were included in this study. The urodynamic characteristics of women with FBOO were compared with those of women with OAB (n=34) and stress urinary incontinence (SUI, n=78). FBOO was defined as a maximum flow rate (Qmax) < 15 mL/sec, combined with detrusor pressure at a Qmax (PdetQmax) > 20 cm H2O in a pressure-flow study. The UDS included uroflowmetry, postvoid residual volume determination, a cystometrogram, and a pressure-flow study. Results: Women with FBOO who had storage symptoms showed a higher PdetQmax and maximum urethral closing pressure (MUCP) than women with OAB and SUI. Interstitial cystitis/bladder pain syndrome (IC/BPS) was observed in 17.6% of women with FBOO. MUCP was significantly higher in women with BOO than in women with BOO and IC/BPS (115.6±27.4 and 96.6±14.1 cm H2O, P=0.00). The receiver operating characteristic curve analysis showed that the cutoff values of MUCP in women with FBOO compared to women with OAB and SUI were 87 cm H2O (sensitivity=81.5%, specificity=73.5%) and 36 cm H2O (sensitivity=92.6%, specificity=84.4%), respectively. The cutoff value of MUCP in women with FBOO compared to women with FBOO and IC/BPS was 92 cm H2O (sensitivity=85.4%, specificity=78.9%). Conclusions MUCP could have predictive value for identifying FBOO in women with complex LUTS.

Chronic inflammatory condition associated with metallic implant insertion is a risk factor for diffuse large B-cell lymphoma (DLBCL). Metal ions play a role in the pathogenesis of lymphoma.We report a rare case of DLBCL in a patient who had a metallic implant in the proximal tibia for 15 months. Radiologic studies, including US and MRI, showed disproportionately large extraosseous soft-tissue mass and bone marrow involvement without prominent bone destruction.Multiple complications are associated with metallic implants, and misdiagnosis may lead to inappropriate treatment. Therefore, distinguishing lymphomas caused by a metallic implant-induced chronic inflammatory condition from other periprosthetic benign lesions and malignant soft tissue masses is challenging, but it is critical.

BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.
Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Hygiene ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Occupations ; Serologic Tests ; Vulnerable Populations

Purpose: This study was conducted to update the existing evidence-based nursing clinical practice guideline for indwelling urinary catheterization (IUC). Methods: The guideline have been revised in 22 steps based on international standards. The quality of the practice guidelines to be used for revision was evaluated using the Appraisal of Guidelines for Research and Evaluation II. The evaluation of the content appropriateness and applicability of the draft recommendations of the revised practice guidelines was performed using the RAND/UCLA Appropriateness Method, a decision-making method developed by the RAND Corporation. Four guidelines were used for the revision. Results: The updated nursing practice guideline for IUC consisted of 9 domains and 134 recommendations. The numbers of recommendations in each domain were: 4 Assessment, 20 Equipment, 11 Catheter insertion, 52 Catheter maintenance, 4 Catheter and drainage bag change, 9 Catheter removal, 22 Complications management, 5 Education and consult, and 7 Hospital support. The recommended grade was 8.2% for A, 38.1% for B, and 53.7% for C. Among these, the major revision was done in 11 recommendations (8.2%). A total of 29 recommendations (21.6%) were newly added. 30 (22.4%) recommendations had minor revisions such as changes or addition for some words or sentences, and 13 (9.7%) recommendations were deleted. Conclusion Revised nursing practice guideline is expected to serve as an evidence-based practice guideline for IUC in Korea. This guideline will provide health care providers, patients, and caregivers with information to help manage IUC, leading to improved patient outcomes.

BACKGROUND: B-type natriuretic peptide (BNP) is a cardiac hormone that is primarily synthesized by the ventricular cardiac myocytes. Increased plasma BNP levels have been observed in patients suffering with congestive heart failure, ventricular hypertrophy and myocaridits and also during heart transplantation rejection. We investigated the serum BNP level as a predictive marker for rejection after heart transplantation. MATERIAL AND METHOD: To test the usefulness of measuring the BNP level in cardiac transplant patients, consecutive blood samplings for BNP, right ventricular endomyocardial biopsies, hemodynamic measurements and transthoracic echocardiogram were all done in 10 such patients between January 2004 and August 2005 at the Department of Thoracic and Cardiovascular Surgery in Asan Medical Center. Two groups were identified with using the median value: the low BNP group (n=28, BNP: < or =290 pg/mL) and the high BNP group (n=29, BNP: >290 pg/mL). We retrospectively analyzed rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy, the pulmonary capillary wedge pressure and the right atrial pressure between the 2 groups. RESULT: There were no differences in age, gender, rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy and the right atrial pressure between the 2 groups (p>0.05). However, a higher pulmonary capillary wedge pressure and a higher mean pulmonary atrial pressure were observed in the high BNP group (p<0.05). Further, BNP has linear correlation with the pulmonary capillary wedge pressure (r=0.590, p<0.001). Using the cut-off value of 620 pg/mL, the BNP predicted a high PCWP (>12 mmHg) with a sensitivity of 83.3% and a specificity of 91.1% (AUC: 0.900+/-0.045, p<0.001). CONCLUSION: The BNP level after heart transplantation does not show any significant correlation with rejection, yet it might be a predictive marker of ventricular diastolic dysfunction.
Atrial Pressure ; Biopsy ; Chungcheongnam-do ; Heart Failure ; Heart Transplantation* ; Heart* ; Hemodynamics ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Myocytes, Cardiac ; Natriuretic Peptide, Brain* ; Plasma ; Pulmonary Wedge Pressure ; Retrospective Studies ; Sensitivity and Specificity ; Tricuspid Valve Insufficiency

Postoperative coronary arterial spasm is a rare but potentially fatal complication. A 51-year-old male patient with a history of a reactive ergonovine stress test coronary angiogram developed refractory coronary artery spasm after undergoing minimally invasive direct coronary artery bypass grafting of the left anterior descending coronary artery. The patient was successfully managed with rapid implementation of intra-aortic balloon-pump counter pulsation and extracorporeal membrane oxygenation.
Coronary Artery Bypass ; Coronary Vessels ; Ergonovine ; Exercise Test ; Extracorporeal Membrane Oxygenation ; Humans ; Male ; Middle Aged ; Organothiophosphorus Compounds ; Self-Help Devices ; Spasm

Postoperative coronary arterial spasm is a rare but potentially fatal complication. A 51-year-old male patient with a history of a reactive ergonovine stress test coronary angiogram developed refractory coronary artery spasm after undergoing minimally invasive direct coronary artery bypass grafting of the left anterior descending coronary artery. The patient was successfully managed with rapid implementation of intra-aortic balloon-pump counter pulsation and extracorporeal membrane oxygenation.
Coronary Artery Bypass ; Coronary Vessels ; Ergonovine ; Exercise Test ; Extracorporeal Membrane Oxygenation ; Humans ; Male ; Middle Aged ; Organothiophosphorus Compounds ; Self-Help Devices ; Spasm