We made a clinical study on the effectiveness of local anesthesia in 22 cases of intrascrotal surgeries and 25 cases of varicocelectomies at the Department of Urology, C. A. F. G. H during the period from August 1983 to July 1984. The subjective reaction to pain was evaluated: the seven patients experienced slight pain, the four patients, moderate pain and the remaining thirty six patients, no pain. The operations were performed successfully without converting local anesthesia to general or spinal anesthesia by giving supplemental doses of anesthetic solution, demerol, or valium according to the degree of pain whenever the patients complained of pain. The average duration of anesthesia was 3.8 hours which was sufficient for intrascrotal surgeries and varicocelectomies. No specific complications developed during or after anesthesia except for nausea and vomiting in one case postoperatively. Most of the side effects of general or spinal anesthesia were avoided by adopting local anesthesia. It was not only beneficial to high-risk or elderly patients but ambulatory patients.
Aged ; Anesthesia ; Anesthesia, Local* ; Anesthesia, Spinal ; Diazepam ; Humans ; Meperidine ; Nausea ; Urology ; Vomiting

Retroperitoneal liposarcoma comprises 12 to 45 percent of all liposarcoma. It has been a therapeutic dilemma and a less prognosis because of its tendency to attain a tremendous size due to early silent growth and difficult wide en bloc excision in the retroperitoneum. Here in we report a case of retroperitoneal liposarcoma in 51 year old male patient with a brief review of the literatures.
Humans ; Liposarcoma* ; Male ; Middle Aged ; Prognosis

Injury to vertebral vessel is not usually associated with neurologic deficit and a lot of such injuries have not been recognized. Also, vertebral artery injuries are the least common arterial injuries because of their deep location in a bony canal. The incidence of vertebral artery injury occurring in penetration wound of the neck varies from 1.0% in gunshot wounds to 7.4% in stab wounds. But even vertebral artery injuries in penetration wound of the neck rarely results in cerebellar infarction. Authors experienced a case of cerebellar infarction induced by post-vertebral artery injury in penetration wound of the neck with hypoplastic contralateral verterbral artery. We thus report with a review of the related literature.
Arteries ; Cerebellum ; Incidence ; Infarction* ; Neck ; Neurologic Manifestations ; Vertebral Artery* ; Wounds and Injuries ; Wounds, Gunshot ; Wounds, Stab

During the past five years we have treated twenty-seven cases of upper cervical injury among total three hundred and seventeen spine injuries. A follow-up study has done on twenty-one upper cervical injuries and the result is reported. The incidence of upper cervical injury was 8.5% of the total spine injury and 17.5% of the cervical injury. Almost all of the injuries(95.2%) were caused by traffic accidents and falls. The types of injury were odontoid fracture(38.1%), hangman's fracture(28.6%), atlanto-axial instability(19.1%), tear drop fracture of the axis(9.5%), and Jefferson's fracture(4.8%). Chief complaints on admission were motor weakness(57.1%), neck pain with limitted range of motion(42.9%), and sensory disturbance was noted in six cases of the motor weakness group(28.6%). Out of twenty-one cases, operative fixation was performed in eight cases with good result in five(62.5%) and thirteen patients were treated conservatively with eleven cases(84.6%) of good result. In chronic nonunited or malnunited cases, it seems to be safer to fuse the level both by anterior and posterior routes than by either route alone because it is not always stable and needs long period of immobilization.
Accidents, Traffic ; Follow-Up Studies ; Humans ; Immobilization ; Incidence ; Neck Pain ; Spine

Amiodarone is a potent antiarrhythmic agent and can cause potentially life-threatening pulmonary fibrosis. Of the numerous side effects associated with amiodarone therapy, lugn toxicity is one of the most serious adverse reactions. Recently, we experienced a case of amiodarone-induced pulmonary toxicity (APT), which induced severe dyspnea and productive coughing, confirmed by cytologic and electron microscopic examination of the bronchoalveolar lavage (BAL). The symptoms and abnormalities in the chest X-ray were improved after the withdrawal of amiodarone. Cytologic examination of the BAL revealed numerous foam cells with cytoplasmic vacuoles or small particles. Ultrastructurally, the foam cells demonstrated characteristic lysosomal inclusions, which were electron-dense multilamellated bodies, crystalloid bodies, and mixed forms with small lipid vacuoles. It is strongly suggested that only cytologic and electron microscopic examination of the BAL without open lung biopsy is enough for diagnosis of APT, when APT is clinically suspected in a patient who has a history or ingestation of amiodarone.
Amiodarone ; Biopsy ; Bronchoalveolar Lavage* ; Cough ; Cytoplasm ; Diagnosis ; Dyspnea ; Foam Cells ; Humans ; Lung ; Microscopy, Electron ; Pulmonary Fibrosis ; Thorax ; Vacuoles

Most bladder diverticula are associated with a neurogenic bladder or obstructive condition, but a congenital diverticulum is believed to be a congenital failure of normal muscular development. Often solitary and large congenital bladder diverticulum leads to various complications, including recurrent urinary tract infection, vesicoureteral reflux, stone formation, and incontinence. A diverticulectomy, with ureteral reimplantation, is recommended in Hutch's diverticula, as they are usually accompanied with reflux that does not spontaneously subside. We experienced a case of bilateral Hutch's diverticula, without vesicoureteral reflux, in a 15-month-old boy. This patient was successfully treated using only a bilateral diverticulectomy.
Diverticulum* ; Humans ; Infant ; Male ; Muscle Development ; Replantation ; Ureter ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

Steroid myopathy is one of the most common drug-induced myopathy. We report a case of iatrogenic steroid myopathy in a 61-year-old female who had taken herb medication more than 2 months. She presented a slowly progressive proximal muscle weakness and wasting with typical features of cushing syndrome. Needle EMG showed typical myopathic patterns. The muscle biopsy revealed a pronounced muscle fiber atrophy and fatty degenerative change without inflammation. In addition, there was a selective type 2 fiber depletion on ATPase staining in pH 9.4 buffer. Her muscle powers and bulks were slowly improved after discontinuation of herb medication with phenytoin and physical therapy.
Adenosine Triphosphatases ; Atrophy ; Biopsy ; Cushing Syndrome* ; Female ; Humans ; Hydrogen-Ion Concentration ; Inflammation ; Middle Aged ; Muscle Weakness ; Muscular Diseases* ; Needles ; Phenytoin

OBJECTIVES: Psychiatric patients had less access to psychiatric care due to a stigma associated with psychiatric care. However there have been numerous efforts to break down the stigma. One of them was to change the name of the discipline to Mental Health Medicine, which was established nationwide in August, 2011. Authors try to understand the change of concepts by according to the change of the name of psychiatry. Subjects consisted of undergraduate and graduate students, and university faculty members. METHODS: The survey was conducted by the Kyung Hee University mass e-mail system. Mails were delivered to the undergraduate and graduate students, and university faculty members. The contents of the survey consisted of questions regarding awareness of the name change (psychiatry-->mental health medicine), positive or negative impressions of the name change, psychiatric history, and eligibility of access to the psychiatric clinic. RESULTS: Most respondents were not aware of the name change (90.8%), however they generally responded to the changed name positively (92.7%). Also they responded that by changing the name, the possibility of the easy access to psychiatric treatment would be expected. The undergraduate students group, the graduate students group, and the below 22 year old group responded more favorably to the name change compared to the faculty group and the above 22-year-old group. They also responded positively to the improvement of easy access to psychiatric treatment. However, regarding the effects of the name change on deciding to receive the psychiatric treatment, only small numbers were agreed to accept treatment. CONCLUSION: This survey showed that the less-than-22-year-old group, undergraduate students group, and graduate students group thought more positively to the name change (psychiatry->mental health medicine) compared to the group of more than the 22 years old and the faculty group. However, only small numbers of those groups answered that they can visit and receive psychiatric treatment when they are needed. One of the reasons they are reluctant to receive psychiatric care is due to the concern of the discrimination in employment and insurance coverage. Campaigns against stigmas for the psychiatric care via the proper method and time are needed nationwide, and should be enhanced. Practical policy should be re-established.
Surveys and Questionnaires ; Discrimination (Psychology) ; Electronic Mail ; Employment ; Humans ; Insurance Coverage ; Mental Health ; Postal Service ; Young Adult

OBJECTIVES: This study was conducted in order to determine the validity and reliability of the Korean version of the Barratt Impulsiveness Scale-11-Revised (K-BIS-11-R) in Nonclinical Adult Subjects. METHODS: The K-BIS-11-R was tested in non-clinical (n=270) native Korean-speakers. Internal consistency reliability was calculated using Cronbach's alpha and test-retest reliability was measured using Pearson correlations. To see external validity, we performed confirmatory factor analysis for determination of whether the three-factor model, proposed by the previous report, fit the data. RESULTS: According to the results, the K-BIS-11-R had an acceptable test-retest reliability and internal consistency reliability. In addition, the K-BIS-11-R total score and second-order subscale score showed significant correlation with Conners' Adult attention deficit/hyperactivity disorder Rating Scale-Korean and Buss & Durkee Hostility Inventory. In addition, no significant difference was observed between the K-BIS-11-R total score and demographic variables. Thus, the K-BIS-11-R total score was transformed to standard score. CONCLUSION: K-BIS-11-R is a reliable and valid measure and has possible utility for assessment of impulsiveness in nonclinical adult subjects. Further research is needed in order to determine the cutoff score for administration of K-BIS-11-R to clinical adult subjects.
Adult ; Factor Analysis, Statistical ; Hostility ; Humans ; Reproducibility of Results

BACKGROUND: Orientia tsutsugamushi spreads to the entire body through the blood and lymphatics, and it induces vasculitis that results in the patients manifesting symptoms of systemic organ involvement. MATERIALS AND METHODS: We conducted a prospective study to evaluate the clinical manifestations and the change of the laboratory results after instituting treatment for scrub typhus. RESULTS: Most patients presented with fever (100%), malaise (96.1%) and thirst (96.1%). It was remarkable that most patients presented with severe thirst, except for 3 healthy, young patients. This thirst was persistent even after the resolution of fever. The renal and hepatic dysfunction were reversible after the administration of appropriate antibiotics. For the blood testing, it was deteded that the CRP, and LDH were elevated in most patients (95.9% and 100% respectively). DIC could be diagnosed in 95.5% of the patients at the time of admission CONCLUSION: Most patients presented with fever, malaise and severe thirst, and the renal and hepatic dysfunction were reversible after the administration of appropriate antibiotics. DIC was observed in most of our patients, but hemorrhage and infarction were not present. CRP showed a rapid improvement, nonetheless, the LDH and DIC test results improved slowly.
Anti-Bacterial Agents ; Clinical Chemistry Tests ; Dacarbazine ; Fever ; Hematologic Tests ; Hemorrhage ; Humans ; Infarction ; Orientia tsutsugamushi ; Prospective Studies* ; Scrub Typhus* ; Thirst ; Vasculitis