OBJECTIVES: This study was to determine whether drainage after radical hysterectomy and bilateral pelvic lymphadenectomy can reduce the risk of postoperative morbidity as compared with no drainage. METHODS: 165 patients with stage Ia2 to Ilb underwent radical hysterectomy and bilateral pelvic lymphadenectomy between January 1995 and May 1997, and those medical records were analyzed, Closed suction drains were placed in group I (n 102), not in group II (n 67). All surgeries were perforrned by the same surgeon in a uniform method. RESULTS: The characteristics of two groups were similar for mean age, preoperative weight, total protein, serum albumin, tumor cell histology, invasion depth, and tumor stage. There was no difference in mean operation time in two groups. But mean estimated blood loss was more in group I than group lI(p<0.05), Postoperative ileus and postoperative stay was similar in both groups. The incidence of pelvic lymphocyst and febrile morbidity in two groups were comparable with 17% in group I and 27% in poup II, but not statistically significant(p>0.05). Rehospitalization rate was higher in group I than in group II. CONCLUSION: Pelvic drainage didn't reduce the postoperative febrile morbidity and lymphocyst formation. Therefore the author could not find any necessity to perform the drainage following radical hysterectomy and pelvic lymphadenectomy.
Drainage* ; Humans ; Hysterectomy* ; Ileus ; Incidence ; Lymph Node Excision* ; Medical Records ; Serum Albumin ; Suction ; Uterine Cervical Neoplasms*

BACKGROUND: Periungual warts are a therapeutic challenge. Many studies have revealed that intralesional interferon α-2b therapy and pulsed dye laser therapy have numerous advantages over other modalities of theratment. OBJECTIVE: The purpose of this study was to determine if combination therapy with intralesional interferon α-2b and pulsed dye laser might offer an effective treatment for periungual warts. METHODS: Thirty-three patients were randomly assigned to one of three study groups. In group A, the patients received both intralesional interferon α-2b treatment and pulsed dye laser(PDL) therapy (n=13). Group B patients were treated wit intralesional interferon α-2b alone (n=10) and group C was done with PDL therapy only (n=10). RESULTS: The clearance rate was 92.3% for the patients treated with the combination therapy of intralesional interferon α-2b treatment and pulsed dye laser (PDL) therapy. It was 50% for the patients with the intralesional interferon α-2b treatment alone, and 0% for the group with the PDL therpy only. No significant side effects were observed. At 6 months after cessation of the therapy, total 2 cases (one from group A and the other from group B) were recurred. CONCLUSION: The combination therapy with intralesional interferon α-2b treatment and pulsed dye laser therapy was highly effective for the treatment of recalcitrant periungual warts.
Humans ; Interferons* ; Lasers, Dye* ; Warts*

PURPOSE: Penile fracture is a traumatic injury of the tunica albuginea of the corpus cavernosum during the erectile state. The aims of this study were to evaluate whether the differences of clinical manifestations according to age is present or not in the patients with penile fracture. MATERIALS AND METHODS: This study included 52 patients that were admitted to the department of urology after being diagnosed with penile fracture. History taking, physical examination, radiographic study, and operation were performed as needed. We divided patients into two groups on the basis of 40 years old, and we compared clinical manifestations and operative findings between the two groups. RESULTS: The mean age of patients was 41.4, and the most common cause of injury was sexual intercourse in both groups, but the elapsed time from the injury to arrival at hospital was longer in the young age group than the middle age group (p<0.05). In the aspect of the rupture of tunica albuginea, injury to the right and proximal part of the penis was most common in both groups. Transverse rupture was more prevalent, and the length of the rupture line was also longer in the middle and old age group (p<0.05). CONCLUSIONS: This study supports that sexual intercourse is the most common cause of penile fracture in our country, and the majority of both groups have rupture of tunica albuginea at the right proximal part of the penis. However, the degree of rupture is severe, and elapsed time from the injury to arrival at hospital was relatively shorter in the middle and old age group than the young age group.
Adult ; Coitus ; Humans ; Male ; Middle Aged ; Penis ; Physical Examination ; Rupture ; Urology

PURPOSE: The most important independent prognostic factors of breast cancer have been reported to the tumor size and lymph node metastasis, as well as DNA ploidy, proliferation index, and various receptors, including estrogen receptor (ER) and progesteron receptor (PR) and oncogenes, such as c-erbB-2, and the tumor suppressor gene, p53. However, all these prognostic factors are still unable to exactly estimate distant metastasis for breast cancer. Based on this, our aim was to study for the prognostic factors that associated distant metastasis of breast cancer with cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF), which are related to angiogenesis, and Cyclin D1, which participates in cell proliferation in breast cancer. METHODS: A retrospective study was carried out on 95 patients, who has undergone an operation for breast cancer, with or without metastasis between January 1993 and July 2001, at the Department of Surgery, Chungnam National University Hospital. The study was based on the immunohistochemical staining of primary tumors for COX-2, VEGF, Cyclin D1, ER, PR and c-erbB-2, which were obtained from tissue samples of 45 and 50 patients with and with no distant metastatic breast cancer. SPSS for Windows, Version 10.0 was used for the statistical analyses. RESULTS: The expressions of COX-2, VEGF and Cyclin D1 were statistically significant in distant metastatic breast cancer. The clinicopathological parameters associated with distant metastasis were the tumor size and histological grade, and lymph node metastasis, lymphovascular invasion, ER and PR. There were positive correlations between 1) COX-2 and VEGF, 2) COX-2 and Cyclin D1, 3) c-erbB-2 and Cyclin D1 and 4) VEGF and Cyclin D1, COX-2 also had positive relationships with the tumor size and c-erbB-2, VEGF had positive relationships with lymph node metastasis, histological grade and lymphovascular invasion, as well as with ER and PR. The overexpressions of COX-2, VEGF and Cyclin D1 shortened the disease-free survival and survival period. CONCLUSION: The overexpressions of COX-2, VEGF and Cyclin D1 were considered poor prognostic factors for the induction of distant metastasis. Therefore, COX-2, VEGF and Cyclin D1 could be used in the prevention of distant metastasis, and prescribed for the treatment of metastatic breast cancer.
Breast Neoplasms* ; Breast* ; Cell Proliferation ; Chungcheongnam-do ; Cyclin D1* ; Cyclins* ; Cyclooxygenase 2 ; Disease-Free Survival ; DNA ; Estrogens ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Oncogenes ; Ploidies ; Retrospective Studies ; Vascular Endothelial Growth Factor A*

Priapism is a relatively rare condition of persistent painful erection unaccompanied by sexual desire. We report two cases of priapism, one etiology is related to leukemia and the other is idiopathic. The former was treated with continuous Hemo-Vac drainage, the latter with corporal cavernosum spongiosum shunt, and the results were good.
Drainage ; Leukemia ; Priapism*

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

PURPOSE: This study was performed to evaluate association of obesity indices with physiological markers for cardiovascular disease(CVD) in community dwelling middle aged and elderly populations. METHODS: We evaluated cross-sectional association of obesity indices with physiological markers for CVD using the data of Hallym Aging Study(HAS) conducted in 2004. Information on general characteristics and medical histories were collected by trained interviewers. Also obesity indices including waist circumference(WC), waist to hip ratio(WHR), body mass index(BMI), and body fat mass(BFM), and physiological markers of CVD including systolic blood pressure(SBP), diastolic blood pressure(DBP), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), total cholesterol(TC), and fasting blood sugar(FBS) were measured by clinical staffs. 589 out of the 922 participated in HAS were enrolled in the final analysis, excluding 333 who had been diagnosed and medicated due to obesity-related diseases. Age and gender specific correlation coefficients between obesity indices and physiological markers for CVD were calculated by partial spearman correlations using SAS ver 9.1. RESULTS: The strength of correlation of obesity indices and physiological markers of CVD changed with age. The correlations between SBP, DBP, TG and HDL-C and obesity indices were attenuated with age, whereas those of TC, FBS and LDL-C were increased among the elderly. These patterns were similar in both gender. CONCLUSIONS: These findings show that more appropriate obesity indices according to age are needed to evaluate the association between these indices and CVD risks.
Adipose Tissue ; Aged ; Aging ; Biomarkers ; Body Fat Distribution ; Cardiovascular Diseases ; Fasting ; Hip ; Humans ; Lipoproteins ; Middle Aged ; Obesity ; Phenothiazines

Objective: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is suggested as a prognostic biomarker for communityacquired pneumonia (CAP). However, its predictive value for an individual adult and elderly CAP patients has not been fully investigated. Methods: Patients with CAP aged 18 years and older, who visited the emergency department (ED) from March 1, 2016 to March 31, 2019, were included in this study. Patients were divided into the adult group and the elderly group (age ≥70 years). Data was collected from the ED-based registry, and medical charts were retrospectively reviewed. The registry data included sociodemographic and past medical characteristics, as well as laboratory findings including NT-proBNP and C-reactive protein (CRP), Pneumonia Severity Index (PSI), and CURB65 (confusion, urea, respiratory rate, blood pressure, and aged 65 or more). The independent potential of NT-proBNP to predict mortality was assessed in both groups using multivariable logistic regression, and its predictive ability was evaluated in terms of performance (using areas under the curve [AUCs]) and goodness-of-fit (using the Bayesian information criterion [BIC]). Results: Totally, 325 CAP patients were evaluated, of which 208 (64%) belonged to the elderly group. NT-proBNP was identified as an independent predictor of CAP mortality in elderly patients, but not in adult patients. Moreover, AUC of the NT-proBNP for mortality was comparable to AUC of the PSI, but was higher than that of the CURB65, in elderly CAP patients. Similarly, the NT-proBNP had a better overall fit (lower BIC value) compared to the CURB65, for mortality. Additionally, both AUC and overall fit of the NT-proBNP for mortality were significantly superior to values obtained for CRP. Conclusion For elderly CAP patients in the ED, the NT-proBNP is an independent and useful predictor of mortality.

BACKGROUND: To assess and report the outcomes of resuscitation, we apply the 1997 published In-Hospital Utstein Style to an actual emergency department. This study was designed to develope the data base for comparing and studing the outcomes of resuscitation. METHODS: This study was carried out in a tertiary hospital from July 1998 to June 1999. The subjects were adult patients over the age of 20 years who received resuscitation at the emergency department. After making out the protocol for the In-Hospital Utstein Style, we gathered data prospectively. RESULTS: Among 51,347 patients, 36 patients received 42 resuscitations. Forty-two(42) cases(100%) had witnessed arrest. Advance life support(ALS) intervention at the time of cardiac arrest included intravenous catheterization, 41cases(97.6 %); intravenous drug injection, 20 cases(47.6%); endotracheal intubation, 20 cases(47.6%); and artificial ventilation, 12 cases(28.6%). Immediate causes of cardiac arrest were respiratory depression, 11 cases(26.2%); hypotension, 11 cases(26.2 %); metabolic, 9 cases(21.4%); and myocardial ischemia/infarction, 5 cases(11.9%). Initial EKG ryhthms were pulseless electrical activity, 31 cases(73.8 %); ventricular tachycardia/fibrillation, 6 cases(14.3%); and asystole, 5 cases(11.9%). the average interval from cardiac arrest to initial defibrillation was 1.8+/-2.2 minutes, and the average interval from cardiac arrest to epinephrine injection was 2.6+/-3.1 minutes. The average duration of resuscitation was 22.6+/-18.4 minutes. Return of spontaneous circulation occured in 26 cases/42 case(61.9%). Of the 2 survivng patients who were discharged, 1 patient is still alive after 6 months, and the other is still alive after 1 year. CONCLUSION: Although the In-Hospital Utstein Style has many complementary factors, its results were very objective thus use of the In-Hospital Utstein Style is recommended for determining the outcomes of resuscitation.
Adult ; Catheterization ; Catheters ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Epinephrine ; Heart Arrest ; Humans ; Hypotension ; Intubation, Intratracheal ; Prospective Studies ; Respiratory Insufficiency ; Resuscitation* ; Tertiary Care Centers ; Ventilation

BACKGROUND: This study was conducted to compare the accuracy of computered tomography(CT) and sonography(US) in diagnosing acute appendicitis and to analyze the radiologic factors which influence the result. METHODS: We retrospectively studied the cases of 53 patients who were suspected of having appendicitis and who were examined by CT and US covered a three-year period. The final diagnosis was determined from the surgico-pathologic diagnosis and clinical follow-up for two months, as well as from the discharge diagnosis. RESULTS: Thirty-eight(38) patients had acute appendicitis; 15 patients did not. In the analysis, CT and US, respectively, revealed sensitivities of 89.5% and 73.7%, specificities of 93.3% and 60.0%, positive predictive values of 97.1% and 82.4%, negative predictive values of 77.8% and 47.4%. Among patients diagnosed with acute appendicitis, 10 patients were discordant in the US and the CT examinations; CT findings were correct in 8 and US findings in 2. Among non-appendicitis patients, 5 patients were discordant in the US and the CT examinations; CT was correct in 5 and US in 0. Nighteen(19) patients had complications such as an abscess or a perforation. Among these patients, the degree and the extent of the complication were accurately evaluated by CT in 15 patients and by US in 5 patients. CONCLUSION: CT is more accurate than US in diagnosing and excluding acute appendicitis. The use of CT will substantially decrease unnecessary laparotomies and post-operation complications.
Abscess ; Appendicitis* ; Diagnosis ; Follow-Up Studies ; Humans ; Laparotomy ; Retrospective Studies