Aged ; Geriatric Assessment ; Homes for the Aged ; Humans ; Nursing Homes ; Quality of Health Care ; Singapore

BACKGROUND: If the corrections of the cryptorchid testes are delayed, it may lead the patients to suffer loss of testes or fertility. So we purposed to analyze the present status of correction and the causes of delay and tried to emphasize the needs to educate and inform the ideal age for correction. METHODS: Total 363 cryptorchid patients who visited our hospital in 10 years from January 1987 to December 1996 were divided into 3 groups according to their ages at visit as under 2, 3 to 5 and over 6 years groups. We analyzed the operative findings of the 3 groups, compared the ratio of the over 6 group during the half ten years till 1991 to the same ratio after 1992 and also analyzed the causes of delay in 81 patients for whom the causes of delay could be identified in over 6 years group. RESULTS: The age distributions showed 88 patients(24.2%) of under 2 years group, 118 patients(32.5%) of 3 to 5 years group and 157 patients(43.3%) of over 6 years group. When we compare the former 5 years till 1991 to the latter 5 years after 1992, the number of the patients who underwent orchiopexy under the age of 2 were increased from 34 (19.1%) to 54(29.2%) and those over the age of 6 were decreased from 88(49.4%) to 69 (37.3%) but still in higher proportion. The intraoperative findings showed that the rate of atropic or smaller testes than normal size in over 6 years group(128 testes, 73.1%) were higher than those of under 2 years(10 testes, 9.8%) and 3 to 5 years group(28 testes, 20.2 %). The most common causes of delay in over 6 years group was recommendation by relatives or neighbors(36 patients, 48.1%) and the remainders were advices of doctors other than urologists(27 patients, 33.3%), poor economic status(8 patients, 9.9%) and unawareness of the anomaly(7 patients, 8.6%). CONCLUSIONS: To prevent the loss of testicular function or testis itself in patient with cryptorchidism, the early correction should be performed because the recommended age for the correction tends to be decreased. The public information for the recommended age should be provided and also educational programs for the primary physicians are supposed to be performed.
Age Distribution ; Cryptorchidism ; Fertility ; Humans ; Male ; Orchiopexy ; Testis

The idiopathic hypereosinophilic syndrome (HES) represents a heterogenous group of disorder characterized by prolonged eosinophilia of undetectable cause and multiorgan system dysfunction. Bone marrow is the most frequentry involved organ, but the most severe clinicopathologic involvement is heart. The major cause of death in patients with the HES is cardiac dysfunction especially congestive heart failure resulted from endocardial fibrosis and restrictive cardiomyopathy. We have experienced a case of DES with both cardiac and pulmonary involvements. The patient was an 18-month-old infant with poorly controlled lung abscess who complained of fever and productive cough. On the microscopic examination of pleural effusion, eosinophilic infiltration was noted. M-mode echocardiogram showed diffuse thickening of interventricular septum and left ventricular posterior wall. On the peripheral blood smear, prolonged eosinophilia was observed. We confirmed this case with bone marrow aspiration which showed eosinophilic hyperplasia.
Bone Marrow ; Cardiomyopathy, Restrictive ; Cause of Death ; Cough ; Eosinophilia ; Eosinophils ; Fever ; Fibrosis ; Heart ; Heart Failure ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Infant ; Lung Abscess ; Pleural Effusion

Acanthoma fissuratum is a localized thickening of the skin in response to pressure by an eyeglass frame and usually occurs on the retroauricular fold, superior auricular crease, or bridge of the nose. The definitive diagnosis can be confirmed by characteristic clinical and histopathological features in association with anamnestic data. Herein we report a case of acanthoma fissuratum developing on an unusual site-the mucosa of the upper lip and it was successfully treated with simple excision.
Acanthoma* ; Diagnosis ; Lip* ; Mucous Membrane* ; Nose ; Skin

No abstract available.
Alcohol Withdrawal Delirium* ; Delirium*

OBJECTIVE: The purpose of the present study was to investigate the association between Body Mass Index, suicide, perceived stress, and life dissatisfaction in a general population sample of Korean adults. METHODS: A total of 6,022 nationally representative adults aged 18 to 74 were selected using a multistage cross-sectional cluster sampling method. Questionnaires regarding suicide behaviors, perceived stress, and life satisfaction were completed by the participants. They also reported their heights and weights, which were used to calculate BMI. Psychiatric disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, using the Korean version of the Composite International Diagnostic Interview. RESULTS: The results showed that being underweight was associated with higher risk for suicide ideation [odds ratio (OR), 1.6; 95% confidence interval (Cl), 1.18–2.05] and suicide attempt (OR, 2.0, 95% Cl, 1.23–3.31). Likewise, obesity also increased the risk of suicide ideation (OR, 1.3; 95% Cl, 1.11–1.56) although not suicide attempt. Furthermore, underweight individuals were more likely to report severe level of perceived stress (OR, 1.7; 95% Cl, 1.26–2.17) and life dissatisfaction (OR, 1.3; 95% Cl, 1.07–1.68). All of the results remained significant after adjusting for age, gender, education, and psychiatric illnesses. CONCLUSION: This study found that being underweight is a significant risk factor for suicide and poor subjective wellbeing in Korea. It suggests that BMI status may be an important modifiable factor for improving mental health in Korea.
Adult ; Body Mass Index* ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Korea ; Mental Health ; Methods ; Obesity ; Risk Factors ; Suicide* ; Thinness ; Weights and Measures

No abstract available.
Hemoglobin A* ; Humans ; Mothers* ; Postpartum Period*

Endoscopic nasobiliary drainage(ENBD) has been developed as a safe and effective noninvasive biliary drainage method for initial decompression in the benign or malignant biliary obstruction, dissolution of biliary stones by injection of litholytic agents through the tube, and proper causative diagnosis of biliary obstruction by cytologic, bacteriologic and parasite investigation of drained bile. Generally, endoscopic sphicterotomy (EST) is performed before the insertion of an ENBD tube in order to make the procedure easy and to prevent acute pancreatitis that may develop by compression of the pancreatic orifice of the inserted tube. Nevertheless, in some cases EST is difficult to perform or should not be performed due to their coagulopathy. In such cases, ENBD without EST may be necessary. To evaluate the safety, successfullness and effectiveness of ENBD without EST, ENBD without EST using 5, 6 or 7 Fr pigtail tubes were performed in 81 cases(49 malignant, 32 benign). ENBD without EST was successfully performed in 78 out of 81 cases(96.3%). This effectiveness for decompression of bile duct, evaluated by decreasing total bilirubin values, was good in 66 out of 73 casee (90. 2%). The complications of this procedure were noted in 6 out of 78 cases(7. 7%). e. g. cholangitis in 3, migration of ENBD tube in 2, acute pancreatitis in 1 case. Particularly, regardless of our concern that ENBD without EST may develop acute pancreatitis acute panereatitis was noted in only one case. In conclusion, ENBD without EST is a safe and effective method which can be applied to the cases who have benign or malignant obstructive jaundice.
Bile ; Bile Ducts ; Bilirubin ; Cholangitis ; Decompression ; Diagnosis ; Drainage* ; Jaundice, Obstructive ; Pancreatitis ; Parasites

No abstract available.
Caloric Tests*

Joints ; Mandible ; Maxilla ; Orthognathic Surgery ; Recurrence ; Skull