BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

No abstract available.
Femur* ; Hip Fractures* ; Hip*

PURPOSE: Soft tissue defect can occur on the posterior aspect of the elbow after trauma or fracture fixation. To cover the defect and maintain elbow functions, various flap surgeries including latissimus dorsi muscle flap, lateral arm flap and radial forearm flap can be performed. We present the clinical results of transposition lateral arm flap for coverage of the elbow defect and discuss the cause of posterior soft tissue necrosis after fracture fixation. MATERIALS AND METHODS: Two patients who had posterior soft tissue defect of the elbow after open reduction of the fractures around the elbow were treated with transposition lateral arm flap. The mean size of skin defect was 20 cm2. The flap was elevated with posterior radial collateral artery pedicle and transposed to the defect area. Donor defect was covered with split thickness skin graft. The elbow was immobilized for 1 week in extended position and active range of motion was permitted. RESULTS: All two cases of transposition lateral arm flap survived without marginal necrosis. The average range of motion of the elbow was 10~115 degrees. Mayo elbow performance score was 72 and Korean DASH score was 23. CONCLUSION: When elbow fractures are fixed with three simultaneous plates and screws, skin necrosis can occur on the posterior aspect of the elbow around olecranon area. If the size of skin defect is relatively small, transposition lateral arm flap is very useful option for orthopaedic surgeons without microsurgical technique.
Arm ; Arteries ; Elbow ; Forearm ; Fracture Fixation ; Humans ; Muscles ; Necrosis ; Olecranon Process ; Range of Motion, Articular ; Skin ; Tissue Donors ; Transplants

Anatomy is a foundational subject in medicine and serves as its language. Hippocrates highlighted its importance, while Herophilus pioneered human dissection, earning him the title of the founder of anatomy. Vesalius later established modern anatomy, which has since evolved historically. In Korea, formal anatomy education for medical training began with the introduction of Western medicine during the late Joseon Dynasty. Before and after the Japanese occupation, anatomy education was conducted in the German style, and after liberation, it was maintained and developed by a small number of domestic anatomists. Medicine in Korea has grown alongside the country’s rapid economic and social development. Today, 40 medical colleges produce world-class doctors to provide the best medical care service in the country. However, the societal demand for more doctors is growing in order to proactively address to challenges such as public healthcare issues, essential healthcare provision, regional medical service disparities, and an aging population.This study examines the history, current state, and challenges of anatomy education in Korea, emphasizing the availability of medical educators, support staff, and cadavers for gross anatomy instruction. While variations exist between Seoul and provincial medical colleges, each manages to deliver adequate education under challenging conditions. However, the rapid increase in medical student enrollment threatens to strain existing anatomy education resources, potentially compromising educational quality. To address these concerns, we propose strategies for training qualified gross anatomy educators, ensuring a sustainable cadaver supply, and enhancing infrastructure.

No abstract available.
Follow-Up Studies* ; Hydronephrosis*

In adults, it is known that the choroid is the most eyeball common site of metastasis. However, only a few cases have been reported. The authors have experienced a case of pulmonary squamous cell carcinoma metastasis in the Lt. choroid in a 57 year old Korean male patient. We report this case and a review of the literature.
Adult ; Carcinoma, Squamous Cell* ; Choroid* ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis

The cardiovascular manifestations in hyperthyroidism are sinus tachycardia, paroxysmal supraventricular tachycardia, atrial flutter, atrial fibrillation, atrioventricular block, bundle branch block(especially right bundle branch block), angina pectoris, heart failure and cardiomyopathy. Of these, angina pectoris is commonly seen in hyperthyroidism with coronary artery disease and the potential mechanisms have been attributed to the increased metabolic demand and consequently increased cardiac work which result in the more demand of coronary blood flow than that can be delivered via a fixed atherosclerotic coronary artery stenosis. Hyperthyroidism associated anginas without underlying coronary artery stenosis have also been reported where the mechanism of these was suspected to be the coronary vasospasm. Ventricular fibrillation may occur in the thyrotoxic patients due to myocardial ischemia such as variant angina, but it is very rare in the condition without previous heart disease. A 30-year-old male was admitted to the hospital because of palpitation, weight loss and proptosis for the previous 3 months. There was no history of effort related chest pain, syncope, drug abuse or medical illnesses such as diabetes mellitus, hypertension. The laboratory results were, TSH: 0.38uU/mL(0.4~5,0 uU/mL), free T4: 8.9ng/dL(0.8~1.9ng/dL), TSH receptor antibody: 43.6%(-15~15%), antiTPO antibody: 5000 IU/mL(0~100 IU/mL). The initial EKG showed normal sinus rhythm. He was diagnosed as Graves disease with ophthalmopathy, class 3a and was put on propylthiouracil 200 mg po tid, propanolol 40 mg po tid and started solumedrol pulse therapy for the exophthalmos on the first day of admission. He was found to have generalized tonic seizure with apnea attack on second hospital day and twice thereafter. Ventricular fibrillation was documented at that time. DC cardioversion was performed with successful response. After the attack, he was treated as accelerated hyperthyroidism namely with increased dosage of propylthiouracil, dexamethasone and Lugols solution, The echocardiogram, treadmill test, ergonovine echocardiography, coronary angiography and electrophysiologic study disclosed no abnormalities. Further episodes of ventricular fibrillation didnt occur after being euthyroid state. In conclusion, we report a case of ventricular fibrillation associated with hyperthyroidism itself without underlying coronary artery disease with brief review of literatures.
Adult ; Angina Pectoris ; Apnea ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block ; Cardiomyopathies ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vasospasm ; Dexamethasone ; Diabetes Mellitus ; Echocardiography ; Electric Countershock ; Electrocardiography ; Ergonovine ; Exercise Test ; Exophthalmos ; Graves Disease ; Heart Diseases ; Heart Failure ; Humans ; Hypertension ; Hyperthyroidism ; Male ; Methylprednisolone Hemisuccinate ; Myocardial Ischemia ; Propranolol ; Propylthiouracil ; Receptors, Thyrotropin ; Seizures ; Substance-Related Disorders ; Syncope ; Tachycardia, Sinus ; Tachycardia, Supraventricular ; Ventricular Fibrillation* ; Weight Loss

PURPOSE: This study was to identify the relationship among clinical nurse's job overload, self-efficacy, emotional exhaust and turnover intention. METHODS: The study was conducted through a survey on 537 clinical nurses in five general hospitals. The data were collected by self-reporting questionnaires and analysed by the SPSS/WIN 17.0 program using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression. RESULTS: The mean score of turnover intention was 3.04. Turnover intention according to age, total career, job objective, and work off showed significant differences. The significant positive correlations between emotional exhaust and turnover intention (r=.531, p<.001), job overload and turnover intention (r=.514, p<.001) were found. The significant factors influencing turnover intention were emotional exhaust (beta=.488, p<.001), career (beta=.175, p<.001), job overload (beta=.119, p=.003), and number of night (beta=.117, p=.002), which accounted for 40.3% of the variance. CONCLUSION: Thought this result, nursing managers should analyze the reasons for high turnover intention, focusing on the main factors affecting turnover intention and consider the solutions to decrease the turnover intention.
Hospitals, General ; Intention ; Personnel Turnover ; Surveys and Questionnaires

OBJECTIVES: This study is to explore the frequency of basic symptoms and their relationship with current clinical variables in patients with schizophrenia. METHODS: Eighty-eight schizophrenic patients diagnosed with SCID were interviewed with the Bonn Scale for the Assessment of Basic Symptom (BSABS) and Positive and Negative Syndrome Scale (PANSS). RESULTS: Most frequent basic symptoms were related to abnormalities in perception, cognition and stress reactivity. After controlling age effect, number of admission was correlated negatively with cluster 3 (impaired tolerance to normal stress). Onset age was correlated positively with cluster 3 and cluster 4 (disorders of emotion and affect) and total score. Scores of cluster 1 (thought, language, perception, motor disturbances), and cluster 2 (impaired bodily sensations), and total score of BSABS were significantly lower in paranoid type than residual type of schizophrenia. Scores of cluster 1, cluster 2, and total score of BSABS were correlated positively with subscales for positive and negative symptoms and general psychopathology and total score of PANSS. Cluster 3 was correlated positively only with general psychopathology score and cluster 4 with both positive symptoms and general psychopathology score. CONCLUSION: These findings suggest that certain basic symptoms aggregate significantly in schizophrenia, especially in paranoid type schizophrenia and that systemic evaluation of basic symptoms can be used for the prediction of onset and progress of schizophrenia.
Age of Onset ; Cognition ; Humans ; Psychopathology ; Schizophrenia

OBJECTIVES: This study is to explore the frequency of basic symptoms and their relationship with current clinical variables in patients with schizophrenia. METHODS: Eighty-eight schizophrenic patients diagnosed with SCID were interviewed with the Bonn Scale for the Assessment of Basic Symptom (BSABS) and Positive and Negative Syndrome Scale (PANSS). RESULTS: Most frequent basic symptoms were related to abnormalities in perception, cognition and stress reactivity. After controlling age effect, number of admission was correlated negatively with cluster 3 (impaired tolerance to normal stress). Onset age was correlated positively with cluster 3 and cluster 4 (disorders of emotion and affect) and total score. Scores of cluster 1 (thought, language, perception, motor disturbances), and cluster 2 (impaired bodily sensations), and total score of BSABS were significantly lower in paranoid type than residual type of schizophrenia. Scores of cluster 1, cluster 2, and total score of BSABS were correlated positively with subscales for positive and negative symptoms and general psychopathology and total score of PANSS. Cluster 3 was correlated positively only with general psychopathology score and cluster 4 with both positive symptoms and general psychopathology score. CONCLUSION: These findings suggest that certain basic symptoms aggregate significantly in schizophrenia, especially in paranoid type schizophrenia and that systemic evaluation of basic symptoms can be used for the prediction of onset and progress of schizophrenia.
Age of Onset ; Cognition ; Humans ; Psychopathology ; Schizophrenia