PURPOSE: To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. MATERIALS AND METHODS: We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. RESULTS: Total patients were 257 with 186(72.4%) paraplegia and 71(27.6%)quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ ;5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows;15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. CONCLUSION: Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4years, and another peak was in 12-16years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation.
Cervix Uteri ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Kidney ; Korea ; Paraplegia ; Quadriplegia ; Rehabilitation ; Retrospective Studies* ; Spinal Cord Injuries* ; Spinal Cord* ; Thorax ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract* ; Urography

PURPOSE: To compare the incidence between author's first and current report on urinary tract stone in patient with spinal cord injury and to evaluate the effectiveness of recent developed in medical technology and care on in treating the patients. MATERIALS AND METHODS: We reviewed urinary tract stone in 257 patients with paraplegia or quadriplegia after spinal cord injury. These patients were diagnosed retrospectively by KUB and intravenous urography at the Korea Veterans Hospital during 10years from January, 1984 to December, 1993. We evaluated and compared the overall incidence, incidence of specific location of urinary tract, recurrent rate, incidence according to the level of spinal cord injury, and the duration of development in urinary tract stone. RESULTS: Total patients were 257 with 186(72.4%) paraplegia and 71(27.6%)quadriplegia. Overall incidence of the stone was 16.0% in this study and 38.1% in the first study. Incidence of the stone in individual organ ;5.5% in kidney, 1.2% in ureter, and 13.6% in urinary bladder. The recurrent rate was 29.3% in this study and 40.6% in the first study. Incidence of the stone according to the level of spinal cord injury was as follows;15.6% in cervix, 17.1% in upper thorax, 17.9% in lower thorax and 13.9% in lumbar. The stone developed during the first 4 years and between 12 to 16 years following spinal cord injury was 28.3% each. CONCLUSION: Overall incidence and recurrent rate of urinary tract stone was obviously decreased since the first study. Highest incidence of the stone occurred in urinary bladder and in patient with lower thoracic spinal cord injury, which is similar to first report. Peak incidence of the stone was in the first 4years, and another peak was in 12-16years after spinal cord injury. The decreased overall incidence of urinary tract stone maybe attributable to the development in medical technology and care, and active rehabilitation.
Cervix Uteri ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Kidney ; Korea ; Paraplegia ; Quadriplegia ; Rehabilitation ; Retrospective Studies* ; Spinal Cord Injuries* ; Spinal Cord* ; Thorax ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urinary Tract* ; Urography

Globozoospermia is a rare type of teratozoospermia. It occurs in 0.1% of all andrological patient's and used to be considered sterile. Globozoospermic patient has 100% round headed spermatozoa, but the spermiogram is normal. The spermatozoa show oval-shape head, the lack of a nuclear envelope, acrosome, and post acrosomal sheath. OBJECTIVE: To report that a couple with infertility secondary to globozoospermia received ICSI treatment. MATERIAL AND METHOD: Case report. RESULTS: In the first trial, fertilization was failed. In the second trial, 40% of oocytes were fertilized and all of these embryos were cleaved, but pregnancy did not achieved. In the third trial, sperm injected oocytes were exposed to 10 micrometer calcium ionophore for 15 min. All of the injected oocytes were fertilized and proceeded to develop. Triplet pregnancy was achieved after the transfer of six embryos in their third cycle. One embryo vanished and the remaining twins (female) were delivered at 33 weeks of gestation by Caesarean section. CONCLUSION: This result shows that assisted activation following ICSI may overcome infertility associated with globozoospermia.
Acrosome ; Calcium ; Cesarean Section ; Embryonic Structures ; Female ; Fertilization ; Head ; Humans ; Infertility ; Male ; Nuclear Envelope ; Oocytes* ; Pregnancy* ; Pregnancy, Triplet ; Sperm Injections, Intracytoplasmic ; Spermatozoa* ; Twins

Correct discrimination of the first and the second twin is important. Case: (1) The first fetus, whose amnionic cavity was closest to the cervix at 19 weeks, even though its body was higher than the second fetus, was found to be closer to the cervix by 23 gestational weeks than its twin. (2) The result of the chromosomal study of dichorionic twins at 17 gestational weeks was male with 9 inversion of the presumed first, and female with trisomy 21 of the presumed second. AT 19 gestational weeks, the sex and order of the two were found to be reversed at sonography for selective termination. In diamnionic twins, the fetus in the amnionic sac closest to the cervix is nominated as the first.
Amnion ; Cervix Uteri ; Diagnosis* ; Discrimination (Psychology) ; Down Syndrome ; Female ; Fetus* ; Humans ; Male ; Pregnancy, Twin* ; Twins*

Three cases of giant hydronephrosis containing 9,800 cc, 3,800cc, and 1,300cc, Developed in the Korean soldiers are presented. The important clinical, laboratory and x-ray features are discussed. Brief review of literature was also made.
Humans ; Hydronephrosis* ; Military Personnel

Nocodazole is an anticancer agent, well-known for its antimetastatic activity that acts on microtubules, microfilaments and extracellular matrix proteins. Hela, Hep G2, A549, L929, and NIH/3T3 cell lines were cultivated in alpha-MEM with 3microM or 30microM nocodazole. To investigate the mechanism of nocodazole preventing tumor cell metastasis, the influences of nocodazole on the amounts of glycoprotein, fibronectin, laminin and actin were investigated using PAS staining and PAP technique at light microscopic level. Two designed models ; coverglass and 3-day-old rat heart fragments models, were used in observing the invasiveness of cancer cells. Partitularly the three-dimensional model coculturing cell lines and heart fragment was used in evaluating the migration and/or proliferation or the invasiveness of cell around the fragment, and observed under inverted or bright field light microscope. The amount of glycoprotein of all cell-lines increased in cells of groups treated with nocedazole for 1, 2 and 3 day. The amounts of fibronectin usually increased in cells of groups treated with nocodazole for 1, 2 and 3 day. The amounts of laminin increased in cells of groups treated with nocodazole. The amounts of actin usually increased in cells of groups treated with nocodazole for 1, 2 and 3 days. With the prolonging of nocodazole-treatment time in two dimensional model using coverglass, the cells of control group except Hep G2 cells formed monolayer in cell-free zone according to migration or proliferation of many cells. But only a few cells of experimental groups migrated or proliferated into cell-free zone. In rat heart fragment model the cells of control group showed the invasiveness into the fragment but few or none of the cells from experimental groups attached around the fragment. Taken together, nocodazole increased the synthesis of fibronectin and laminin in cells in place of depolymerizing microtubules. Therefore, the amounts of extracellular matrix proteins in the extracellular space increased. And the increase amounts of actin connected to the extracellular matrix proteins through the integrin of plasma membrane seemed to strengthen cell attachment because of accordance between the orientation of actin and extracellular matrix proteins. Since it is important for cancer cells` metastasis to secrete various enzymes to pass through extracellular matrix proteins, it is expected more difficult for the cells to metastasize into other regions due to the increase of extracellular matrix proteins. As a result of confirmation of antiinvasive actions using two kinds of model, nocodazole seems to be a valuable anti-metastatic agent by supressing the cell motility and consequently, the invasiveness into the fragment. Nocodazole at concentration of 3microM will be probably anticipated antimetastatic activity reflecting that the effects of nocodazole between 3microM and 30microM groups had no differences.
Actin Cytoskeleton ; Actins ; Animals ; Cell Line* ; Cell Membrane ; Cell Movement ; Extracellular Matrix Proteins* ; Extracellular Matrix* ; Extracellular Space ; Fibronectins ; Glycoproteins ; Heart ; Hep G2 Cells ; Laminin ; Microtubules ; Neoplasm Metastasis ; Nocodazole* ; Rats

Duodenal diaphragm is a rare congenital anomaly among the congenital duodenal obstructions. Its symptom and sign usually appear since birth if obstruction is complete. The clinical manifestations of incompletely obstructive duodenal diaphragm are intermittent vomiting, abdominal pain and poor weight gain. Diagnosis may be delayed in this case. Authors experienced a case of incomplete duodenal diaphragm with a central hole. A 29 months old girl presented failure to thrive, intermittent episodes of bloating, abdominal discomfort and occasional vomiting. The patient vomited every 10-14 days, then the abdominal pain and distention were relieved. She overate for about 10 days until the next projectile vomiting. The vomitus frequently contained food ingested several days previously. Plain x-ray films of abdomen showed marked gastric distention. Upper gastrointestinal series revealed marked distention of the duodenum with windsock configuration and radiolucent line at the third portion of the duodenum. On gastroscopic examination, gastric bezoar impacting the pyloric canal and antrum was noted. At operation, we found mucosal membrane in the third portion of the duodenum and bezoar(Chinese cabbage) above the membrane. Side-to-side duodeno-jejunostomy was performed and bezoar was removed. She was discharged on the 13th postoperative day without any complication.
Abdomen ; Abdominal Pain ; Bezoars ; Bulimia* ; Child, Preschool ; Diagnosis ; Diaphragm* ; Duodenal Obstruction ; Duodenum ; Failure to Thrive ; Female ; Humans ; Membranes ; Parturition ; Vomiting ; Weight Gain ; X-Ray Film

Lung transplantation has been successfully employed for variety of obstructive lung disease. Single lung transplantation has become a therapeutic option for end-stage obstructive lung disease. The patient, a 57 year old man with emphysema, suffered from severe dyspnea, which progressively aggravated him for the last three years. A single lung transplantation was performed from a young brain-dead donor on April 7th, 1999 in the department of thoracic surgery, Respiratory Center, Yongdong Severance hospital, yonsei University. The immunosuppressive regimen was based on cyclosporine A and azathioprine from beginning, adding steroid. Single lung transplantation was feasible and beneficial in patients with end-stage emphysema.
Azathioprine ; Cyclosporine ; Dyspnea ; Emphysema ; Humans ; Lung Diseases, Obstructive ; Lung Transplantation* ; Lung* ; Middle Aged ; Pulmonary Emphysema* ; Respiratory Center ; Thoracic Surgery ; Tissue Donors

No abstract available.
Carcinoma, Adenosquamous* ; Lung*

PURPOSE: The aim of this study was to identify nurses' role in the delivery of health guidance service within the annual health guidance membership service. METHODS: Dynamic job analysis process was applied with vertical job analysis and horizontal job analysis through a focus group workshop and expert survey. RESULTS: As a result of this study, job description was established with 4 duties, 11 tasks, 60 task elements. Major duties consisted of 'professional nurse practice', 'coordination and cooperation', 'education and consultation', and 'administrative work and improvement'. A job process map was also framed. CONCLUSION: The results can be used to establish nurses' role in providing health care service. Ongoing research on nurse's role as a health guider will be a fundamental base for health care service development and will contribute to expansion of common health management services.
Delivery of Health Care ; Education ; Focus Groups ; Health Services ; Job Description ; Nurse's Role