The major role of treatment for impotence is played by vasoactive intracavernous pharmacotherapy or penile prosthesis during last decades. However, the former has a high risk of cavernosal fibrosis-and priapism, and the latter, also infection. We applied the Vacuum Constrictor Device to fifty of organic, 2 of old age, and 2 of unknown. Of 53 cases, 47 encountered the desirable erection were able to secure the vaginal penetration. Of 5 failed cases, 4 were because of maladjustment due to slim body and 1 was of pain on the pubic area due to previous old pelvic bone fracture. Of 17 cases with poor erection by vasoactive intracavernous pharmacotherapy 15 encountered good erection by means of Vacuum Constrictor Device and no significant complications were observed. Of 14 self-acquired Vacuum Constrictor Davicl which were used in which frequency of 10 to 17 times, 10 cases were shown to be satisfactory and the rest were not. Of 4 unsatisfactory cases, 2 were leakage of congested blood during intercourse, 1 was difficulty in intercourse due to pivot and the other one was of mild suprapubic pain due to previous pelvic bone fracture. Although Vacuum Temescence Enhancement Therapy is cumbersome in manipulation prior to sexual intercourse and has time limitation, it is easy to learn and has less complications than vasoactive intracavernous pharmacotherapy. Therefore Vacuum Tumescence Enhancement Therapy is thought to a preferable therapeutic alternative prior to vasoactive intracavernous pharmacotherapy and surgical treatment in impotence in spite of these disadvantages.
Coitus ; Drug Therapy ; Erectile Dysfunction* ; Estrogens, Conjugated (USP) ; Male ; Pelvic Bones ; Penile Prosthesis ; Priapism ; Vacuum*

Blood gas samples are highly susceptible to preanalytic error due to improper methods of obtaining or handling the sample prior to delivery to the laboratory. The errors in the measurement of blood gas analysis are currently derived from the exposure of sample to atmosphere, effects of anticoagulant itself, temperature difference between the measuring electrode and drawn blood and the delay in running the sample. To study the effects of the delay in measuring the sample and the temperature difference between the measuring electrode and drawn blood on values of blood gases and pH, we analyzed the arterial sampling from the 24 patients who were taking elective surgery or on his/her recovery period with indwelling arterial catheter. The plastic sampling syringes were kept at 4 degrees C (refrigerator) or 22-24 degrees C (room temperature) and analyzed at regular intervals (1, 10, 30, 60,120 min) for 120 minutes. The following results were obtained: 1) When the arterial blood drawn from the anesthetized patients were stored at 4 degrees C, partial pressure of oxygen (PaO2) decreased significantly after 20 min, whereas those stored at room temperature decreased significantly after 10 min. 2) When the arterial blood drawn from the recovery patients were stored at 4 degrees C, PaO2 did not decrease significantly through the experimental period of 120 min. Although those stored at room temperature did not decrease significantly through the period of 120 min. 3) Partial pressure of carbon dioxide in the arterial blood (PaCO2,) drawn from the anesthetized patients increased significantly by 120 min. at 4 degrees C, whereas those at room temperature increased significantly after 20 min. 4) PaCO2, of the recovery patients increased signigicantly by 120 min. at 4 degrees C, whereas those at room temperature increased significantly after 30 min. 5) pH of the arterial blood drawn from either anesthetized or recovery patients decreased significantly by 120 min. at 4 degrees C, whereas those at room temperature decreased significantly after 60 min. 6) No significant changes of arterial oxygen saturation (SaO2) and content (CaO2) were noted in either anesthetized or recovery. patients in accordance with time elapsed at 4 degrees C or room temperature. In summary, as the changes of PO2 in particular higher than physiologic PO2 and PCO2 in the arterial blood stored at room temperature are significant in accordance with the delay in measuring, it would be advisable to analyze the sample in a short period of time or to store it in a cool place when the measuring will be delayed.
Atmosphere ; Blood Gas Analysis ; Carbon Dioxide ; Catheters ; Electrodes ; Gases* ; Humans ; Hydrogen-Ion Concentration* ; Oxygen ; Partial Pressure ; Plastics ; Running ; Syringes

BACKGROUND: Hypothermia is a common complication of anesthesia and surgery. Because maintenance of the body temperature is an important aspect of anesthesia management, various methods have been used to prevent its occurrence. Covering the patient's skin surface with cloth is believed to prevent intra-operative hypothermia. So, we evaluated the efficacy of covering the head and face with a towel and sheet. METHODS: Sixty patients for abdominal surgery were assigned randomly to a control group or a covered group. After the induction of anesthesia, all patients were covered with towels and sheets as usual. In covered group of patients, the head and face were covered fully. Core temperature was measured at the esophagus continuously and recorded at 15 min intervals for 90 min and then at 30 min intervals over 90-240 min. Room temperature was 23-24 degrees C. RESULTS: Esophageal temperature after 90 min in the covered group was higher than in the control group (P < 0.05). Hypothermia occurred after 45 min in the control group and after 90 min in the covered group. CONCLUSIONS: Covering the patient's head and face helps maintain intra-operative core temperature.
Anesthesia ; Body Temperature ; Esophagus ; Head* ; Humans ; Hypothermia ; Skin

Intracranial hemorrhage is one of the fatal complications related to general anesthesia, it can occur in patients with intracranial aneurysm, hypertension, vascular malformation, malignancy and blood dyscrasia. We have experienced a case of death from massive surbarachonoid hemorrhage during general anesthesia. A 38 Years old female patient who had no abnormality in past history, physical examination and laboratory finding preoperatively, admitted for vaginal hysterectomy becauae of secondary uterine prolapse. Anesthesia was performed under tracheal intubation with Halothane-Enflurane, O2,N2O and with induction by pentothal sodium and succinylcholine. After operation, the patient showed delayed recovery from anesthesia and both pupils were dilated without light reflex. In optic fundoscopic view, fundus was furfilled with red-pinkish blood and CSF in spinal tapping was dark bloody colored. Brain C-T showed generalized brain edema and hemorrhage density in sylvian cistern, basal cistern, lateral ventricle. Autopsy finding revealed massive subarachnoidal hemorrhage but not disclosed the site of ruptured intracranial aneurysm. Authors report this case of death from subarachnoid hemorrhage for warning of possible victim during general anesthesia for referencial review.
Adult ; Anesthesia ; Anesthesia, General* ; Autopsy ; Brain ; Brain Edema ; Delayed Emergence from Anesthesia ; Female ; Hemorrhage ; Humans ; Hypertension ; Hysterectomy, Vaginal* ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Intubation ; Lateral Ventricles ; Physical Examination ; Pupil ; Reflex ; Sodium ; Spinal Puncture ; Subarachnoid Hemorrhage* ; Succinylcholine ; Thiopental ; Uterine Prolapse ; Vascular Malformations

Staphylococcus epidermidis is a part of the normal skin flora of humans. However, it can cause serious infections in people exposed to foreign bodies or in immunocompromised patients. A 13-year-old boy was hospitalized with fever and myalgia. Painful nodular lesions were detected on the scalp, arms, and legs. Pancytopenia and blasts were present in the peripheral blood. He was diagnosed with acute myeloid leukemia. Magnetic resonance imaging of the whole body showed multiple peripheral rim-enhancing, cyst-like lesions. Ultrasonography showed echogenic nodules inside the cystic lesions in the intramuscular space of the arms and legs. Therefore, cysticercosis was strongly suggested initially. However, an abscess was confirmed on sono-guided biopsy and S. epidermidis was isolated from a microbial culture of the tissue. We report a case of multiple disseminated lesions caused by S. epidermidis in a leukemia patient, initially mistaken for cysticercosis.

BACKGROUND: The purpose of the research was to find significant factors that were related to the therapeutic compliance of hyper- tension(HT). METHODS: Hypertensive 354 patients from 932 rural elderly were measured blood pressure and administered the questionnaire during August 2003. Operational definition of therapeutic compliance was the state of care and management of HT. The data were analysed by univariate analysis and multivariate regression model. RESULTS: Results of univariate analysis, the seriousness, the barriers, the benefits, and the patients who have family members or friends suffering from HT, the motive of the behavior were significant variables for acceptance rate of the caring HT(p<0.01). Result of multiple logistic regression on participating caring process in HT, significant prediction variable were the subjects who had spouses, long ongoing caring process, no drinking habits, mind set that considers the high blood pressure as a serious disease, families and friends who had complications, didn't feel that taking the medication is not uncomfortable if they haven't experienced the side effect during the caring process. CONCLUSION: According to this result, we should consider major prediction variables to increasing the therapeutic compliance of hypertensive patients and developing the program for controlling hypertensive patients.
Aged* ; Blood Pressure ; Compliance* ; Drinking ; Friends ; Humans ; Hypertension* ; Logistic Models ; Surveys and Questionnaires ; Spouses

BACKGROUND: The purpose of the research was to find significant factors that were related to the therapeutic compliance of hyper- tension(HT). METHODS: Hypertensive 354 patients from 932 rural elderly were measured blood pressure and administered the questionnaire during August 2003. Operational definition of therapeutic compliance was the state of care and management of HT. The data were analysed by univariate analysis and multivariate regression model. RESULTS: Results of univariate analysis, the seriousness, the barriers, the benefits, and the patients who have family members or friends suffering from HT, the motive of the behavior were significant variables for acceptance rate of the caring HT(p<0.01). Result of multiple logistic regression on participating caring process in HT, significant prediction variable were the subjects who had spouses, long ongoing caring process, no drinking habits, mind set that considers the high blood pressure as a serious disease, families and friends who had complications, didn't feel that taking the medication is not uncomfortable if they haven't experienced the side effect during the caring process. CONCLUSION: According to this result, we should consider major prediction variables to increasing the therapeutic compliance of hypertensive patients and developing the program for controlling hypertensive patients.
Aged* ; Blood Pressure ; Compliance* ; Drinking ; Friends ; Humans ; Hypertension* ; Logistic Models ; Surveys and Questionnaires ; Spouses

PURPOSE: We conducted a multi-center, phase II trial to evaluate the efficacy and safety of using Padexol (a paclitaxel formulation) combined with cisplatin for the patients suffering with advanced gastric adenocarcinoma. MATERIALS AND METHODS: 39 patients (median age: 60 years; males: 90%) who were diagnosed with advanced gastric cancer were enrolled from 5 hospitals. Padexol 175 mg/m2 was administered as a 3-hr infusion, and this was followed by cisplatin 75 mg/m2 as an intravenous infusion on day 1, once every 3 weeks. RESULTS: Out of these 39 patients, 34 patients were assessable for treatment efficacy and 39 patients were assessable for the toxicity. Objective responses occurred in 13 patients (33%); 1 patient (3%) had a complete response and 12 patients (31%) had partial responses. 6 patients (15%) achieved a stable disease state. The median duration of response was 7.1 months, and the median time to progression and the overall survival were 4.8 months and 6.7 months, respectively. The major treatment-related adverse events were hematologic toxicity, including WHO grade 3 or 4 neutropenia in 13 patients (33%). However, febrile neutropenia occurred in only 1 patient and the non-hematologic toxicity was usually mild. CONCLUSION: The combination of Padexol and cisplatin was found to be active and it seems to be a relatively well-tolerated regimen for the treatment of advanced gastric cancer.
Adenocarcinoma ; Cisplatin* ; Febrile Neutropenia ; Humans ; Infusions, Intravenous ; Male ; Neutropenia ; Paclitaxel ; Stomach Neoplasms* ; Treatment Outcome

PURPOSE: To compare the differential findings of tuberculous otitis media(TOM) with those of chronic suppurative otitis media with or without cholesteatoma, as seen on high resolution temporal bone CT. MATERIALS AND METHODS: We retrospectively reviewed 14 cases of TOM, 30 cases of chronic suppurative otitis media(CSOM), and 30cases of chronic otitis media with cholesteatoma(Chole). All had been pathologically confirmed. We evaluated thepreservation of mastoid cells without sclerotic change, the location and extension of soft tissue to the externalauditary canal, the erosion of ossicles, the tegmen tympani, scutum, bony labyr inth, facial nerve canal andsigmoid sinus, and the presence of intracranial co mplications. RESULTS: Soft tissue in the mastoid antrum wasseen in all cases of TOM(100%), 29 cases of CSOM(96.7%), and 26 cases of Chole(86.7%). In contrast, the softtissue in the entire middle ear cavity was noted in 13 cases of TOM(92.8%), 7 cases of CSOM(23.3%), and 12 casesof Chole(40%). Soft tissue extended to the superior aspect of the external auditory canal in 4 cases of TOM(28.6%) and 5 cases of Chole (16.7%). Mastoid air cells were seen in 9 cases of TOM (64.3%), 4 cases of CSOM(13.3%), and 3 cases of Chole(10%). Ossicular erosion was noted in 6 cases of TOM (42.9%), 12 cases of CSOM (40%),and 26 cases of Chole(86.7%), while in one case of TOM (7.1%), 5 cases of CSOM (16.7%), and 15 cases of Chole(50%)there was erosion of the scutum. In one case of TOM, follow-up CT study after 9 months of antituberculousmedication without surgery revealed complete clearing of previously noted soft tissue in the middle ear cavity. CONCLUSION: Specific CT findings of TOM were not seen, but if there were findings of soft tissue in the entiremiddle ear cavity, soft tissue extension to the external auditory canal, preservation of mastoid air cells withoutsclerotic change, and intact scutum, TOM may be differentiated from other chronic otitis media.
Cholesteatoma ; Ear ; Ear Canal ; Ear, Middle ; Facial Nerve ; Follow-Up Studies ; Mastoid ; Otitis Media* ; Otitis Media, Suppurative ; Otitis* ; Retrospective Studies ; Temporal Bone* ; Tuberculosis

OBJECTIVES: This study was performed to determine the relationships among Health concern, health practice and health status of the disabled. METHODS: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. RESULTS: Health concern had a significant and positive relationship with health practice(p<0.05) and health practice also had a significant and positive relationship with self-rated health status(p<0.05) in men and women. To determine the structural model of the Health concern, health practice, health status and sociodemographic variables, the covariance structural analysis was used. In men, age, economic status, medical security type, educational level and type of disability had significant direct effects on Health concern(T>2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect on health status(T>2.0). In men and women, health practice was significantly increased with increasing Health concern and the more health practice, the higher health status(T>2.0). CONCLUSIONS: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.
Daegu ; Disabled Persons ; Female ; Health Education ; Health Policy ; Health Promotion ; Humans ; Male ; Models, Structural ; Surveys and Questionnaires