A 63 year old male suffered from a acute huge inferolateral and posterior myocardial infarction with vertricular septal perforation(1x1.5cm). Cardiogenic shock and ventricular tachycardia occured on the 3rd day in hospital. After cardiopulmonary resuscitation the deteriorated condition of the patient was improved by intraaortic balloon counterpulsation(IABP). The invasive diagnostic procedure(LV angiography and coronary angiogram) was carried out under the employment of IABP and artificial ventrilation. The patients has recovered from the operation(coronary artery bypass graft and VSD patch op) and myocardial infarction. Because of recurrent aspiration pneumonia the patient was nourished per gastrostomy. He died 3 month later due to upper gastrointestinal bleeding.
Angiography ; Arteries ; Cardiopulmonary Resuscitation ; Counterpulsation* ; Employment ; Gastrostomy ; Hemorrhage ; Humans ; Inferior Wall Myocardial Infarction* ; Male ; Middle Aged ; Myocardial Infarction ; Pneumonia, Aspiration ; Shock, Cardiogenic* ; Tachycardia, Ventricular ; Transplants ; Ventricular Septal Rupture*

We describe an 22-yeer-old man with polyorchidism whose both ipsilateral testes were located in the inguinal area and scrotum. Polyorchidism is a rare anomaly with approximately 70 cases reported in the literature. In this report the literature is reviewed and the etiology of this anomaly is discussed briefly.
Scrotum ; Testis

PURPOSE: Detrusor instability (DI) is a main cause of persistent voiding difficulty after TURP in patients with benign prostatic hyperplasia (BPH). So we retrospectively estimated the effect of TURP in BPH patients with DI. MATERIALS AND METHODS: Of the 81 patients who had undergone TURP due to prostatism, 35 patients with BPH were followed at 3 weeks and 6 months postoperatively (21 without DI cases vs. 14 with DI; 6 persistent DI, 7 resolved DI, 1 missing case at 3 weeks and 4 persistent DI, 7 resolved DI, 2 missing cases at 6 months). We compared each group using symptom score (IPSS) and urodynamic parameters. RESULTS: Each irritative and obstructive symptoms were significantly improved in both group (p<0.05). The maximal flow rate (from 12.2 to 25.4ml/sec), average flow rate (from 8.9 to 15.2ml/ sec), residual urine volume (from 135.9 to 39.1ml) in patients without DI and maximal bladder volume (from 150.0 to 203.7ml), maximal flow rate (from 12.5 to 18.6ml/sec), residual urine volume (from 65.7 to 26.0ml) in patients with DI were improved significantly (p<0.05) after TURP, but other parameters were not improved (p>0.05). There were no significant differences in all parameters between 3 weeks and 6 months postoperative period (p>0.05). The amplitude of improvement had no significant difference between two group. There were no significant differences in IPSS and urodynamic parameters between persistent and resolved DI group. CONCLUSION: We suggest that TURP is good therapeutic option even in BPH patients with DI at short term postoperative period, but attempt to predict which patients would have persistent DI following TURP was failed.
Humans ; Postoperative Period ; Prostatic Hyperplasia ; Prostatism ; Retrospective Studies ; Transurethral Resection of Prostate* ; Urinary Bladder ; Urodynamics*

We report the case of a 24-year-old man suffering from a pituitary diabetes insipidus associated with massive urinary tract dilatation with infravesical obstruction. The patient had been admitted and diagnosed to bulbous urethral stricture in our department. Endoscopic internal urethrotomy had been performed for his urethral stricture, but his abdominal distention had not been improved. About 1 year later, he was revisited to emergency room due to painful gross total hematuria and abdominal distention after trivial abdominal blunt trauma. On the abdominal CT finding, the right renal pelvis was collapsed, from which the contrast media was extravasated. The right pyeloplasty, nephrostomy, ureteral stent indwelling and suprapubic cystostomy were performed. During immediate postoperative management, extreme fluid and electrolyte imbalances were occurred. However, we overcame these troubles using hypotonic saline and hormonal replacement. So we reported this case with literatures.
Contrast Media ; Cystostomy ; Diabetes Insipidus, Neurogenic* ; Dilatation ; Emergency Service, Hospital ; Hematuria ; Humans ; Hydronephrosis* ; Kidney Pelvis ; Stents ; Tomography, X-Ray Computed ; Ureter ; Urethral Stricture ; Urinary Tract ; Young Adult

In order to define PSA levels by age decade in men without clinical evidence of prostatic adenocarcinoma, so called non-cancer, Tandem-R assay for PSA was performed in male patients older than 40 years who had visited to our department. We defined the non-cancer population as men with a normal PSA value( 4.0ng/ml or less) and negative digital rectal examination findings. Furthermore, patients with an abnormality in either PSA value or suspicious digital rectal examination underwent transrectal ultrasound and pathologically excluded prostatic cancer from the population by transrectal prostate biopsies or transurethral resection. A total of 203 men entered the protocol, of whom 192 satisfied our criteria of non-cancer population. New mean, standard deviation and cutoff serum PSA values by age proposed as mean + 2 standard deviations were derived as follows, 0.84 0.68ng/ml( 2.2ng/ml) in the 40 to 49-year group, 2.03 + 1.36ng/ml( 4.8ng/ml) in the 50 to 59-year group. 2.02 + 1.7lng/ml( 5.4ng/ ml) in the 60 to 69-year group, 3.16 + 1.91ng/ml( 7.0ng/ml) in the 70 to 79-year group and 4.52 + 4.03ng/ml(12.6ng/ml) in the 80 to 89-year group.
Adenocarcinoma ; Biopsy ; Digital Rectal Examination ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Ultrasonography

OBJECTIVE: The goal of this study was to determine the efficacy of prolotherapy in relieving the pain of patients with tendon or ligament laxity. METHOD: The subjects were 67 patients (40 male, 27 female) who were suffering from chronic musculoskeletal pain, excluding those with metabolic diseases that could influence the nature of the pain. The effect of the treatment was evaluated by checking the VAS score after a monthly injection of 15% dextrose solution injected around the patient's ligaments and teno-osseous junction that were suspicious of laxity. This same procedure was followed after a second injection. To make an accurate evaluation before and after the treatment, the use of NSAID, physical therapy or exercise therapy was prohibited. RESULTS: The mean pain duration of the subjects was 5.48+/-7.04 years, and the mean age of the subjects was 49.58+/-16.52 years. The result from VAS showed a statistically remarkable reduction after the injection (p<0.01). The VAS decreased from 7.00+/-0.17 to 4.31+/-0.21 after the first injection and this score further decreased to 2.55+/-0.19 after the second injection. There was no statistically significant relationship between the duration of pain and the effect of the treatment (p>0.05). CONCLUSION: This research demonstrated that prolotherapy is an effective method in treating patients with chronic musculoskeletal pain caused by tendon or ligament relaxation.
Chronic Pain* ; Exercise Therapy ; Glucose ; Humans ; Ligaments ; Male ; Metabolic Diseases ; Musculoskeletal Pain ; Musculoskeletal System* ; Relaxation ; Tendons

PURPOSE: This longitudinal study was done to investigate critical thinking dispositions and critical thinking skills of nursing students enrolled in a 4-year baccalaureate program at a university in Korea. METHOD: The study used a longitudinal design. A convenience sample of 32 nursing students who were completing their 1st, 2nd, 3rd, and 4th year in a baccalaureate program at a selected university was included. The subjects completed the California Critical Thinking Dispositions Inventory (CCTDI), the California Critical Thinking Skill Test (CCTST), and a demographic questionnaire. Data was analyzed by descriptive statistics, repeated ANOVA, adjusted p-values, and Pearson's correlation coefficient with SAS 8.12. RESULTS: There was statistically significant improvement according to academic year in the CCTDI total mean score (F=7.54, p= .0001) and subscales of Open-mindedness, Self-confidence, and Maturity. Contrarily, no statistically significant difference was found in the CCTST total mean score and subscales' score except Analysis. CONCLUSION: There is no significant correlation between critical thinking dispositions and skills, so it will be necessary to repeat a study like this, and the translated instruments should be modified by considering Korean culture.
*Thinking ; Students, Nursing/*psychology ; Longitudinal Studies ; Korea ; Humans ; *Education, Nursing, Baccalaureate ; Adult

In mitral valve disease, mural thrombus in the left atrium is common, particulary in the atrial appendage in patients with atrial fibrillation. Occasionally, the angiographic sign of "neovascularity" and "fistula" in the region of the left atrial appendage during coronary arteriography has been reported to indicate the presence of thrombus in the left atrium, which might not even be revealed by transthoracic two-dimensional echocardiography. We observed coronary neovascularity and fistula formation in two pateints with mitral stenosis and these findings were due to organized mural thrombus that was adherent to the wall of the left atrial appendage. So we report 2 cases with brief review of literature.
Angiography ; Atrial Appendage ; Atrial Fibrillation ; Echocardiography ; Fistula* ; Heart Atria ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Thrombosis*

BACKGROUND: The author surveyed and analyzed the changes of perception and satisfaction about family medicine. So that the outcome may bring us a reference to advance family medicine more. METHODS: 247 in and out patients in one general hospital in Seoul were surveyed by the questionnaire from July 26, 2000 to June 20. The date was analyzed statistically by SAS program. RESULTS: As for the knowledge of family medicine, 61.5% of the patients answered that they knew what it is, and the most of them, 54%, via medical institution. The office workers, married , and highly educated people tend to know more about family medicine (P<0.05). As for attitude, 68% of the group answered that family medicine is necessary, because "family medicine doctors give proper advice and consult through out all fields of medicine"(58.8%). As for the preference so prirate doctor, 56.7% of the group answered that they would register for family medicine clinic, and students and office workers are fond of family medicine(P<0.05). As for the satisfaction, 34.4% were ever been to family medicine clinic, and 35.5% out of them were dissatisfied, mainly due to the lack of knowledge of physicians about their diseases(70.1%). CONCLUSION: The perception of family medicine are still scanty compared to the old studies.
Hospitals, General* ; Humans ; Outpatients ; Seoul ; Surveys and Questionnaires

BACKGROUND: Carotid atherosclerosis has been known to be associated with systemic inflammatory status. The present study aimed to investigate the relationship between hepatitis viral infection or vaccination and carotid atherosclerosis in a relatively healthy population. METHODS: A cross-sectional study was performed in 281 subjects (mean age+/-SD, y; 43.8+/-7.2) in the Chonbuk national university hospital. All the participants were examined for the carotid intima-media thickness (IMT) in both common carotid, carotid bulb, and internal carotid arteries. Hepatitis B surface antigen (HBsAg) and IgG antibodies against hepatitis B and C virus (anti-HBs and anti-HCV) were determined by enzyme linked immunosorbent assays. RESULTS: Twelve subjects (4.3%) were HBsAg seropositive and 6 (2.1%) were anti-HCV positive but the positivity did not affect the mean carotid IMT. However, the hepatitis B-exposure group including both the HBsAg positive and anti-HBs positive without vaccination history showed a significantly higher carotid IMT (mean+/-SD, mm; 0.757+/-0.107 vs. 0.728+/-0.105, P=0.031), even after adjusting for the potential confounders. And, in the subgroup having anti-HBs, the carotid IMT was lower in the hepatitis B vaccinated subjects than in the others (0.725+/-0.103 vs. 0.760+/-0.111, P=0.019). CONCLUSIONS: Subjects exposed to the hepatitis B pathogen, even though they had anti-HBs, showed the higher carotid IMT, and the participants with a vaccination history demonstrated the lower IMT values. Subsequent study in a large representative population might be needed to further delineate the characteristic associations.
Antibodies ; Carotid Artery Diseases ; Carotid Artery, Internal ; Carotid Intima-Media Thickness* ; Cross-Sectional Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis* ; Immunoglobulin G ; Jeollabuk-do ; Vaccination