Urinary retention is a common complication after abdominal surgery. Urinary retention causes infection and damage to the urinary system, prolonging hospital stays and increasing health care costs in the end. Because medical personnel tend to regard urinary retention as not being a serious problem, it is hard to find any method which decrease the postoperative urinary retention. There are few papers reporting the incidence and the factors which influence the postoperative urinary retention. The purpose of this study is to evaluate the incidence of postoperative urinary retention and to identify the factors which affect the postoperative urinary retention. We retrospectively reviewed 296 patients out of 338, who had been undergone laparotomy under spinal or general endotracheal anesthesia during a three month period from January to March 1998. We reviewed nursing, anesthetic and operative records. Among the 296 patients, male were 189(63.9%) and female were 107(36.1%). Postoperative urinary retention occurred in 71 patients(24%). The incidence rate was higher in female patients than in male (M : F=18% : 35%). Factors that in fluence the incidence of postoperative urinary retention were sex, duration of operation, the amount of fluid given the patient, preoperative history of dysuria, and preoperative insertion of a urinary catheter. Among those factors, preoperative urinary catheter insertion is the most effective preventive measure in lowering the incidence of postoperative urinary retention (Spearman correlation coefficient, r=-.462). Shortening the operation time and sparing the fluid which is infused during operation are important in preventing postoperative urinary retention. Preoperative urinary catheter insertion may be helpful in lowering urinary retention in those patients who have a possibility of postoperative urinary retention.
Anesthesia ; Dysuria ; Female ; Health Care Costs ; Humans ; Incidence ; Laparotomy* ; Length of Stay ; Male ; Nursing ; Retrospective Studies ; Urinary Catheters ; Urinary Retention*

Although there are many peri-operative measures to reduce core temperature loss during operation, rapid drop has been experienced in the first sixty minutes following induction of general anesthesia. Recently, preoperative warming has been emphasized to prevent inadvertant hypothermia during operation. The purpose of this study is to find the effect of preoperative warming on reducing rectal temperature drop in surgical patients. With informed consent, 46 female adult patients, scheduled for total abdominal hysterectomy or salpingo-oophorectomy in the Seoul National University Hospital from September 3, 1996 to September 19, 1996 were divided into two groups. The variables of age and body surface were matched between the two groups as possible. Among them, 24 patients were preparatively covered up to the shoulders with a forced-air warming blanket(WARM TOUCHTM). set between 36-40degrees C for prewarming, and the other 22 patients(control group)were not before the induction of anesthesia. Rectal temperature was measured by mercury thermometer for rectum after admission to the operating room and by rectal probe which was inserted in the rectum just before the induction during the operation. The rectal temperature was monitored and recorded at every fifteen minutes for the first sixty minutes after the induction and each step during the surgery(intubation, surgical draping, peritoneum opening, one hour and the end of the operation) Collected data were analyzed by means of t-test, Repeated Measures Analysis of Variance with PC-SAS. The results of this study are as following. (1) There was no significant difference between the two groups in age, weight, height, room temperature, basal rectal temperature, operation time. (2) Temperature gradient of the rectal temperature in the warming group was less steeper than that in the control roup during the first sixty minutes after general anesthesia. (3) The rectal temperature measured at every fifteen minutes for the first sixty minutes and the end of surgery after the general anesthesia showed the difference between the two groups during surgery. (4) There was no rectal temperature difference during the intubation, however there was significant temperature difference between the two groups from draping to the end of surgery. In conclusion, prewarming of the surgical patient before induction resulted in increased the skin temperature and heat content, which relieved the dangerous core temperature drop which is potential to be provoked within one hour after induction of the surgical patients and kept the rectal temperature higher than that of the control group during surgery. The suggestions from this study shown below : First, further study is needed to find the preventive effect of the core temperature drop in the first sixth minutes after anesthetic induction by preoperative warming for gastrorectal, thoracic surgery patients who man have the core temperature drop during the operation. Second, in other to keep patient normothermia during the surgery, it needs to study whether using pre-and peri-operative warming can prevent hypothermia or not. Finally, the study of the peroperative warming effect on surgical patients' relaxation and thermal discomfort before the operation is needed because most patients in the case group said to have felt thermal comfort ; 'comfortable' and 'good'.
Adult ; Anesthesia ; Anesthesia, General ; Female ; Hot Temperature ; Humans ; Hypothermia ; Hysterectomy ; Informed Consent ; Intubation ; Operating Rooms ; Peritoneum ; Rectum ; Relaxation ; Seoul ; Shoulder ; Skin Temperature ; Thermometers ; Thoracic Surgery

DiGeorge syndrome, a developmental defect of the third and fourth pharyngeal pouches, is characterized by aplasia or hypoplasia of the thymus and parathyroid glands and by conotruncal cardiac malformation. This syndrome is usually associated with deletion of long arm in chromosome 22 (22q11-). We experienced a case of partial DiGeorge syndrome in a 2-month-old male who had hospitalized because of recurrent hypocalcemic tetany and tetralogy of Fallot. Immunologic studies revealed the decreased percentage of T lymphocyte and increased percentage of B lymphocyte. Chromosomal study with high resolution banding, showed 46, XY, 22q13 deletion. We report a case of partial Digeorge syndrome with a brief review of literatures.
Arm ; Chromosomes, Human, Pair 22 ; DiGeorge Syndrome* ; Humans ; Infant ; Lymphocytes ; Male ; Parathyroid Glands ; Tetany ; Tetralogy of Fallot ; Thymus Gland

To determine size and shape discrepancy between the bone of Korean women and the prostheses in total knee arthroplasty, the height(antero-posterior length) and width(medio-lateral length) of the distal femur and the proximal tibia were measured at the bone resection level for 104 knees of 62 female patients who underwent primary total knee arthroplasty and compared with the same parameters of the total knee prostheses designed by five different companies. On the condition that the height of the prostheses matched with each cases of the bone were optimal, the difference in the width was evaluated, and the criteria of the discrepancy were overhang if the width of the prosthesis was larger than bone, optimal if width of the prosthesis was same or smaller and difference was within 5 mm, and down-size if smaller and difference was over Smm. In femoral prostheses, 34.6% of all were optimal, 13.1%, overhang and 52.3%, down-size. In tibial prosthesis, 54.1% of all were optimal, 13.9%, overhang and 32%, down-size. In conclusion, although further investigation for clinical application is needed, there were discrepancies in size and shape between the femur and tibia of Korean women and total knee prostheses and improvement in design should be considered.
Arthroplasty* ; Female ; Femur ; Humans ; Knee Prosthesis ; Knee* ; Prostheses and Implants* ; Tibia

We investigated proprotein convertase subtilisin/kexin type 9 (PCSK9) concentrations in individuals with normoglycemia, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT). This was a pilot, cross-sectional study including 92 individuals who had not been diagnosed with or treated for diabetes. We measured PCSK9 levels in three groups of subjects; namely, normoglycemia (n=57), IFG (n=21), and IGT (n=14). Individuals with IFG and IGT showed higher PCSK9 concentrations than those in the normoglycemic group, with the highest serum PCSK9 concentrations found in individuals with IGT (55.25±15.29 ng/mL for normoglycemia, 63.47±17.78 ng/mL for IFG, 72.22±15.46 ng/mL for IGT, analysis of variance P=0.001). There were no significant differences in high- or low-density lipoprotein cholesterol among groups. Serum PCSK9 levels are increased in patients with prediabetes compared to subjects with normoglycemia.

Pilar sheath acanthoma is one of the benign follicular hamartoma, with a level of differentiation between trichofolliculoma and dilated pore of Winer. It differentiates toward infundibulum, isthmus, and rarely, sebaceous duct, apocrine, inner root sheath, and hair bulb components. It is a dome-shaped, symmetrical, sharply-circumscribed neoplasm that measures about 1cm in diameter. We herein report a case of pilar sheath acanthoma on the forehead of a 62-year-old male patient.
Acanthoma* ; Forehead ; Hair ; Hamartoma ; Humans ; Male ; Middle Aged

A contour change induced by a subcutaneous depleting disorder such as lupus or morphea can be corrected by filling the defect with an artificial or natural materials of the types of fillers, autologous fat is popularly utilized for volumetric correction. Autologus fat has many advantages, such as easy harvesting, free volume, and non-immunogenicity. Herein, we report a case who of a bilateral atrophic scar on the temple area induced by morphea which was successfully treated by autologous fat transplantation.
Cicatrix* ; Scleroderma, Localized*

No abstract available.
Chediak-Higashi Syndrome* ; Hyperpigmentation*

BACKGROUND: Today, the eradication of H. pylori represents a generally accepted and beneficial therapeutic strategy for treatment and prevention of peptic ulcer relapse. Major factors that have affected H. pylori eradication are eradication rate of regimen, compliance of patients and complications of drugs. Recently, the combination of omeprazole, amoxicillin and clarithromycin has been accepted as one of the most effective treatment for the eradication of H. pylori. The primary aim of this study was to evaluate the efficacy of this therapeutic modality in Korean patients. METHODS: Two hundred twenty three patients with peptic ulcer and H. pylori infection were taken two types of triple therapy. Group A were treated with omeprazole 20 mg bid, amoxicillin 500 mg tid, clarithromycin 500 mg tid daily for 14 days. Group B were treated with omeprazole 20 mg bid, amoxicillin 1g bid, clarithromycin 500 mg bid daily for 7 days. Endoscopy with H. pylori tests was repeated 4 weeks after the end of treatment and then biopsy specimens were taken in antrum and body. CLO test and Warthin Starry silver stain were conducted concordantly. RESULTS: The H. pylori eradication rate was 92.5% in group A, 90.4% in group B. There was no significant difference in eradication rate. More than 50% of ulcer size reduction was observed 90.5% in group A, 86.3% in group B. There was no significant difference in ulcer healing(p > 0.05). The incidence of all side effects in both group were as follows; 22.6% in group A, 19.1% in group B. But major side effect was found only group A, of whom the symptom was too serious for the treatment to continue. CONCLUSION: We concluded that the seven days regimen was more favorable, because the eradication rate was almost the same as the 14 days regimen. And drug compliance and cost effectiveness were better than 14 days treatment regimen.
Amoxicillin* ; Biopsy ; Clarithromycin* ; Compliance ; Cost-Benefit Analysis ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Omeprazole* ; Peptic Ulcer ; Recurrence ; Silver ; Ulcer

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis