Proliferating trichilernmal tumor is a rare benign solitary tumor that may be histopathologically misinterpreted as squarnous cell carcinoma. It affects frequently the scalp of elderly women. We present herein a case of proliferating trichilemmal tumor in an 87-year-old male who had had a slowly growing tumor on the scalp for 30 years.
Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Scalp

A comparative observation was done on 139 patients of the lower ureteral stone, those were applied cystoscopic manipulation with 3 different types of stone dislodger at the Department of Urology, Seoul Adventist Hospital, during the periods from Jan. 1982 to June 1985. During that periods, we applied end-loop catheter in 48 patients, blunt-tip Dormia basket in 38 patients. The results were as follows; 1. The success rate of passage of dislodger beyond the stone was the highest in filiform-tip Dormia basket (97.4%) and loop catheter was the lowest (8l.3%). 2. The success rate of the primary stone extraction with filiform-tip Dormia basket was the highest (86.8%). 3. Indwelling of the dislodger in the ureter loop catheter was the most successful method among them(62.5%). 4. Of the cases of passage beyond the stone, the success rates of the stone extraction were very high and similar in their results, as in 92.3% with loop catheter, in 90.9% with blunt-tip Dormia basket, in 91.9% with filiform-tip Dormia basket. 5. The overall success rate of stone extraction was 75.0% in loop catheter, 75.5% in blunt-tip Dormia basket 89.5% in filiform-tip Dormia basket.
Catheters ; Humans ; Seoul ; Ureter ; Urolithiasis ; Urology

Since 1970, the group B streptococcus(GBS) has been a significant cause of neonatal sepsis in the West. Two distinct forms of disease occur in neonates. Early-onset disease which occurs within 7 days after birth is characterized by respiratory distress, apnea, shock, pneumonia, and occasionally meningitis. Late onset disease usually occurs at 3-4 weeks of age(ranging from 7 days to 3 months) and presents occult bacteremia or meningitis. The GBS is thought to be a rare causative agent for neonatal sepsis in Korea. Lately, we experience a case of early-onset GBS sepsis who died at 3rd day of life. We present this case with brief review of literatures.
Apnea ; Bacteremia ; Humans ; Infant, Newborn ; Korea ; Meningitis ; Parturition ; Pneumonia ; Sepsis* ; Shock

No abstract available.

No abstract available.
Autoantibodies* ; DNA*

OBJECTIVE: To determine if basal serom follicle stimulating harmone (FSH) level could be a prognostic factor of the clinical outcome in in vitro fertilization and embryo transfer (IVF-ET) with intracytoplasmic sperm injection (ICSI) in the couples with male factor infertility. Materials and METHOD: From December 1995 to March 1998, total 118 patients with male factor infertility were included in this study. Patients were allocated to the low basal FSH group (>8.5 mIU/ml) and the high basal FSH group (>8.5 mlU/ml). The basal levels of FSH were measured in the 3rd day of menstrual cycle preceding ovarian stimulation cycle in total IVF cycles by immunoradiometric assay (IRMA). Statistical analysis was performed using Student's t-test, Fishers exact test, and x2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: The total dose of exogeneous gonadotropin required in the patients of the high basal FSH group was significantly higher than that of the patients with the low basal FSH poup (p < 0.05). The numbers of retrieved oocytes, oocytes with grade I, II, fertilized oocytes, cleaved oocytes, embryos with grade I, II, and transferred embryos were significantly higher in the low basal FSH group (p < 0.05), The clinical pregnancy rate per cycle in the low basal FSH gmup (15.7%) seemed to be higher than that in the high basal FSH poup (3.4%) (p 0.08), however, there was no statistically significant difference between the two groups. CONCLUSION: These results suggested that the basal FSH levels could be predictive of pregnancy outcome and the results of ovarian stimulation in IVF-ET using ICSL.
Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Female ; Fertilization in Vitro ; Gonadotropins ; Humans ; Immunoradiometric Assay ; Infertility ; Male ; Menstrual Cycle ; Oocytes ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic*

PURPOSE: The length of stay (LOS) for patients in the emergency department (ED) provides an important measure of both ED overcrowding and patient satisfaction. Specialty consultation is one of the major factors that contributes to longer LOS. The aim of the study was to examine the effectiveness of a computer-based emergency auto-consultation system (EACS) in reducing additional LOS caused by specialty consultation. METHODS: The EACS was developed for use in managing specialty consultation in the ED. Each clinical department provides a daily list of 4 residents and 1 specialist as the doctors on duty. The ED doctors then use the EACS to contact the departments required for a specialty consultation: Clicking the department's name on the computer screen activates the short message service (SMS) calling system, which sends a message with the registration numbers and names of the relevant patients every 10 min to the mobile phones of individuals assigned as doctors on duty, in the order listed. The doctors who receive the SMS are asked to arrive at the ED within 10 minutes. If the the firstlisted doctors on duty do not show up in 10 minutes, an SMS is sent to the next group of doctors on duty on the list. In 50 minutes, therefore, 5 groups of doctors on duty will have received the SMS in the order listed. Each clinical department estimated the response time of doctors on duty 2 months before the adoption of the EACS versus afterward. The LOS of patients admitted to the ED was also compared before and after the adoption of the EACS. A questionnaire was used to survey the health professionals working in the ED about the changes in the intensity of labor and the needs of the EACS. RESULTS: The number of patients participating in the study were 2,035 and 2,216, respectively, before and after the adoption of the EACS. The EACS significantly decreased both the response time of doctors on duty (34.8+/-35.5 min vs. 9.7+/-16.8 min, p=0.000) and the LOS (155.3+/-126.7 min vs. 144.6+/-110.7 min, p=0.003). In the survey, 44.7% of ED health care professionals responded that their intensity of labor were improved, and most of them agreed that the EACS should be required in the ED. CONCLUSION: The computer-based EACS decreased LOS by reducing the response time of doctors on duty, and it also increased satisfaction among the ED health professionals.
Adoption ; Aminocaproic Acids ; Cellular Phone ; Delivery of Health Care ; Emergencies ; Health Occupations ; Humans ; Length of Stay ; Patient Satisfaction ; Surveys and Questionnaires ; Reaction Time ; Specialization ; Text Messaging

With the advent of intracytoplasmic sperm injection (ICSI), the fertiliution and pregnancy have been reported even in complete asthenozoospermia. However, the results of ICSI in men with totally immotile sperm was still disappointing. The reasons for the total lack of sperm movement are not yet determined. The immotility of ejaculated spermatozoa is probably caused by sperm degeneration during epididymal transport, therefore higher viable spermatozoa can be obtained by testicular sperm recovery in some cases with low viability and total lack of movement of ejaculated spermatozoa. Recourse to testicular spermatozoa for ICSI is thus an alternative treatment possibility in this kind of pathology. This clinical study was performed to investigate the efficacy of ICSI employing testicular and ejaculated spermatozoa. From December 1995 to March 1998, 35 couples with totally immotile spermatozoa were included in the study. In 14 patients, the ejaculated spermatozoa were used whereas in 21 patients the spermatozoa were recovered from the testis. There were no significant differences in the fertilization and cleavage rates between the testicular sperm group with 62.6%, 52.7% and the ejaculated sperm group with 56.1%, 74.3%. Two pregnancies were achieved, one in the testicular spnm poup and the other in the ejaculated group. A healthy child was delivered at term in the ejaculated sperm group, but a clinical abortion occurred in a pregnancy in the testicular sperm group. In conclusion, it was suggested that ICSI using ejaculated sperm might be a primary treatment in cases with totally immotile spermatozoa and, if failed, testicular sperm could be used as an alternative mode of heatment.
Asthenozoospermia ; Child ; Family Characteristics ; Fertilization ; Humans ; Male ; Pathology ; Pregnancy ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic* ; Spermatozoa* ; Testis

BACKGROUND: In patients with limited cervical spine movement, equipment for orotracheal intubation should achieve sufficient laryngeal exposure with the least cervical spine movement. This study was designed to compare movement of the cervical spine during the orotracheal intubation with various intubating equipment. METHODS: Twelve emergency physicians & residents with a total experience of >50 cases of endotracheal intubation in two emergency centers were assigned to perform orotracheal intubation with four different airway devices, including the Macintosh laryngoscope (ML), DCI video laryngoscope (DCI), Airway Scope (AWS) and Levitan Scope (LS), using the same manikin (Ambu(R) airway management trainer) in random sequences. Movement of the C-spine was examined by measuring the angle formed by two lines which are parallel to the anterior surface of the C2 and C7 vertebrae bodies. The angle was measured when Cormack-Lehane grade II glottis exposure was achieved during intubation. RESULTS: Mean cervical spine movements were 37.6 +/- 9.2degrees, 32.2 +/- 14.2degrees, 32.2 +/- 6.45degrees and 17.4 +/- 10.0degrees with the ML, DCI (p = 0.347), AWS (p = 0.094), and LS (p < 0.001), respectively, compared to that of ML. Cervical spine movement by LS was 54% less than that by ML. LS produced less cervical spine movement in comparison to DCI (p = 0.013) and AWS (p = 0.001). CONCLUSIONS: The Levitan Scope produced less movement of the cervical spine when compared to the Macintosh laryngoscope, DCI video-laryngoscope and Airway Scope during orotracheal intubation in a single airway training manikin model.
Airway Management ; Emergencies ; Glottis ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopes ; Manikins ; Pilot Projects ; Spine

BACKGROUND: There was no difference between the bileaflet mechanical valves on the midterm and longterm clinical outcome. We reviewed the hemodynamic comparison between recently available mechanical valves by Doppler Echocardiography. MATERIAL AND METHOD: We retrospectively reviewed 396 postoperative hemodynamic datas (EOA, MDPG, and MSPG) by doppler echocardiography in 345 patients. Mechanical valves from 5 venders (Sorin Bicarbon, SJM, ATS, On-X, and Edward MIRA) were compared. There were 232 valves in mitral position, 162 in aortic, and 2 in tricuspid. RESULT: There were 178 men (mean age; 50.6+/-13.9 years old) and 167 women (52.6+/-14.6). MDPG/EOA of 27 mm in mitral position was Sorin; 4.2+/-1.5 mmHg/3.0+/-0.9 cm2, SJM; 2.3+/-1.2/3.5+/-0.6. In 29 mm, Sorin, SJM, ATS, On-X, MIRA revealed 3.4+/-1.2/3.1+/-0.6, 3.3+/-1.1/2.7+/-0.4, 3.8+/-0.8/3.2+/-0.6, 4.0+/-3.0/3.1+/-0.9, 2.9+/-0.9/3.0+/-0.8. In 31 mm, Sorin, SJM, ATS, MIRA revealed 3.9+/-1.9/2.9+/-0.6, 3.5+/-1.2/3.0+/-0.6, 3.4+/-0.8/2.8+/-0.2, 3.7+/-1.5/2.7+/-0.7. In 33 mm, Sorin, SJM, MIRA revealed 4.4+/-0.9/2.5+/-0.4, 3.4+/-1.5/3.3+/-0.5, 4.7+/-2.4/3.0+/-0.3. MSPG/EOA of 19 mm aortic position was Sorin, SJM, ATS, On-X, MIRA 18.0 mmHg/1.2 cm2, 25.6+/-8.7/1.1+/-0.3, 25.9+/-12.6/1.2+/-0.3, 23.0/1.3, 27.9+/-7.1/1.2+/-0.1 in that order. In 21 mm, SJM, ATS, On-X, MIRA revealed 18.3+/-6.7/1.5+/-0.5, 13.7+/-2.1/1.7+/-0.3, 17.0/1.4, 17.1+/-5.5/1.8+/-0.5. In 23 mm Sorin, SJM, ATS, On-X, MIRA revealed 14.0+/-4.6/1.7+/-0.6, 12.8+/-3.2/2.0+/-0.2, 16.8+/-12.2/2.1+/-0.9, 14.0/1.5, 15.0+/-5.5/1.8+/-0.5. In 25 mm, SJM and MIRA revealed 14.0+/-5.1/1.8+/-1.0, 11.0/2.3. There was no statistically significant difference in these values between the venders given the same position and size. 2 redo valve replacements were performed, 1 due to severe hemolysis in ATS and 1 due to leaflet immobilization in SJM. CONCLUSION: Postoperative hemodynamic comparison by doppler echocardiography shows no statistically significant difference between recently available mechanical valves in this country.
Echocardiography* ; Echocardiography, Doppler ; Female ; Heart Valve Diseases ; Hemodynamics* ; Hemolysis ; Humans ; Immobilization ; Male ; Retrospective Studies