No abstract available.
Lymphoma*

A clinical evaluation was made on patients with urethral strictures, who had been admitted to the Department of Urology, Kyungpook National University Hospital during 7 years periods from January, 1977 to December, 1983. The results were as follows: 1. Out of total 1979 inpatients, 105 were male patients with urethral strictures, giving rate of 5.4% 2. The most frequently involved age group was the 4th. decade being 24.7% of total and 64.6% was seen in age group of 20 to 49 years. 3. Trauma was the most frequent cause of urethral strictures(81%), followed in order of frequency by iatrogenic(11.4 %), inflammatory and post-operative cause. 4. Out of 121 patients with urethral trauma during the study period, urethral strictures were developed in 85 (70.2 %). According to the initial managements of urethral trauma, the incidence of stricture was 74.5% in the suprapubic cystostomy, 78.6% in the primary realignment and 55.9% in the Foley`s catheterization. 5. The treatment modality was surgical intervention in 54 patients and conservative management in 51. Success rates were 90.7% in surgical intervention and 84.3% in conservative managements. Success rate according to the permanent urethroplasty was 93.7% in the perineal end to end anastomosis (30 out of 32 patients), 70% in the transpubic urethroplasty (7 out of 10) and 100% in the Badenoch pull through procedure(4) and realignment(5). 6. As to the late complications, restructure was observed in 7 patients, impotence in 4, false tract in 3 and incontinence in 1.
Catheterization ; Catheters ; Constriction, Pathologic ; Cystostomy ; Erectile Dysfunction ; Gyeongsangbuk-do ; Humans ; Incidence ; Inpatients ; Male ; Urethral Stricture* ; Urology

Acute necrotizing pancreatitis often progresses into infection, sepsis, multiorgan failure and then, mortality and morbidity which are very high. From January 1988 to December 1996, 14 patients with surgically proved acute necrotizing pancreatitis at the Department of Surgery, Catholic University were analysed. 1) The patients consisted of 12 men and 2 women ranging in age from 27 to 74 years. 2) The ethiological factors included excessive alcohol abuse in 8 patients, biliary tract disease in 2 patients and unknown in 4 patients. 3) In clinical findings, the majority of the patients complained of sudden severe upper abdominal pain, nausea and vomiting, tachycardia, and abdominal distension. 4) Serum amylase level did not increase in 50% although the necrosis was severe, but aspartate transaminase increased in 13 cases. The lactic dehydrogenase and C-reactive protein increased in all tested cases. 5) In regards to diagnostic methods, computerized tomography was highly effective in getting early diagnosis and in finding the complications. 6) Early necrosectomy and drainage procedure was safe and effective. 7) Postoperative complications included pulmonary complications in 3 patients, pancreas fistula in 2, pancreas pseudocyst in 2, acute renal failure in 2, Diabetes mellitus in 2, gastrointestinal bleeding 1, and subphrenic abscess in 1 case. 8) Mortality rate was 36 %. In conclusion, computerized tomography may be used for early detection of acute necrotizing pancreatitis;. Aspartate transaminase, Lactate dehydrogenase and C-reactive protein may be good diagnostic and prognostic indicators upon admission. Necrosectomy and drainage should be chosen as the best surgical treatment in acute necrotizing pancreatitis patients.
Abdominal Pain ; Acute Kidney Injury ; Alcoholism ; Amylases ; Aspartate Aminotransferases ; Biliary Tract Diseases ; C-Reactive Protein ; Diabetes Mellitus ; Drainage ; Early Diagnosis ; Female ; Fistula ; Hemorrhage ; Humans ; L-Lactate Dehydrogenase ; Male ; Mortality ; Nausea ; Necrosis ; Oxidoreductases ; Pancreas ; Pancreatitis, Acute Necrotizing* ; Postoperative Complications ; Sepsis ; Subphrenic Abscess ; Tachycardia ; Vomiting

BACKGROUND: Excessive iodine intake increases the occurrence of autoimmune thyroid disorders by enhancing immunogenecity of iodine-rich thyroglobulin, In Korea, most of postpartum women take a large amount of iodine-rich seaweed. Although the excessive iodine intake may affect the thyroid function, only a few reports were available concering iodine intake, especially on postpartum period. METHODS: A prospective study was undertaken in 146 of normal delivered postpartum women. Dietary intake and urinary excretion of iodine, serum T3, T4, TSH, anti-TPO Ab and anti-Tg Ab were measured before and 1, 6, 12 and 24 weeks after delivery. Iodine intake was analyzed by one-to-one interview using 24hr recall and food frequency questionnaire. RESULTS: 1. PPT was occurred in 6 (10.3%) postparturn women, It presented as hypothyroidism alone in 1 (16.7%), transient thyrotoxicosis followed by hypothyroidisrn in 3 (50.0%), and thyrotoxicosis alone in 2 (33.3%) of the follwed-up patients. 2. During pregnancy, no difference was found in age, serum T3, T4 and TSH between PPT and normal thyroid function group. 3. In PPT group, anti-TPO and anti-Tg Ab were significantly higher than those of normal thyroid function group during pregnancy, and their sensitivity for PPT was 40% and 33%, respectively. But there was no correlation between dietary iodine intake and the titer of thyroid auto-antibodies. 4. There was no correlation between pre and post-partum dietary iodine intake and occurrence of PPT. CONCLUSION: In Korea, the incidence of PPT was slightly higher than other nations. The sensitivity of thyroid auto-antibodies was too low to use for prediction of PPT. Pre and post-partum iodine intake had no effect on the occurrence of PPT and post-partum thyroid function.
Female ; Humans ; Hypothyroidism ; Incidence ; Iodine ; Korea ; Postpartum Period ; Postpartum Thyroiditis* ; Pregnancy ; Prospective Studies ; Surveys and Questionnaires ; Seaweed ; Thyroglobulin ; Thyroid Gland ; Thyrotoxicosis

Fibroblast growth factor 21 (FGF21) is an endocrine hormone that is primarily expressed in the liver and exerts beneficial effects on obesity and related metabolic diseases. In addition to its remarkable pharmacologic actions, the physiological roles of FGF21 include the maintenance of energy homeostasis in the body in conditions of metabolic or environmental stress. The expression of FGF21 is induced in multiple organs in response to diverse physiological or pathological stressors, such as starvation, nutrient excess, autophagy deficiency, mitochondrial stress, exercise, and cold exposure. Thus, the FGF21 induction caused by stress plays an important role in adaptive response to these stimuli. Here, we highlight our current understanding of the functional importance of the induction of FGF21 by diverse stressors as a feedback mechanism that prevents excessive stress.
Autophagy ; Fibroblast Growth Factors ; Homeostasis ; Insulin Resistance ; Liver ; Metabolic Diseases* ; Mitochondria ; Obesity ; Pharmacologic Actions ; Starvation

A vesical diverticulum is an abnormal pouch or sac lined with vesical mucosa protruding through the bladder wall. Most vesical diverticula are seen in elderly men in association with bladder outlet obstruction. Occasionally in children, primary or congenital vesical diverticulum is developed with no underlying disease, which produce many urologic problems. Herein we recently experienced one case of the congenital vesical diverticulum in 8-day-old male infant with hydronephrosis and dysuria.
Aged ; Child ; Diverticulum* ; Dysuria ; Humans ; Hydronephrosis ; Infant* ; Male ; Mucous Membrane ; Urinary Bladder ; Urinary Bladder Neck Obstruction

PURPOSE: To evaluate regional differences in relative metabolite ratios in the normal human brain by 1H MRspectroscopy (MRS), and compare the spectral quality obtained by the automated prescan method (PROBE) and themanual method. MATERIALS AND METHODS: Localized 1H MRS was performed on a GE 1.5T SIGNA MRI/MRS system (version5.5) with active shielded gradients. For 20 normal volunteers aged 8-47 years, spectral parameters were adjustedby the auto-prescan routine provided by a PROBE package(N=34)and manually (N=33). Five regions of the human brainwere examined (N=PROBE,manual): frontal white matter(N=6,10), parietal white matter(N=8,9), basal ganglia(N=6,5),thalamus(N=4,5), and cerebellum(N=4,4). For all spectra, a STEAM localization sequence with three-pulse CHESS H2Osuppression was used, with the following acquisition parameters: TR=3.0 sec, TE=30 msec, TM=13,7 msec, SW=2500Hz,SI=2048 pts, AVG=48, and NEX=2. RESULTS: A total of 61 reliable spectra were obtained by PROBE (28/34=82%success) and by the manual method (33/33=100% success). Regional differences in the spectral patterns of the fiveregions were clearly demonstrated by both PROBE and the manual methods. For prescanning, the manual method tookslightly longer than PROBE (3-5 mins and 2 mins,respectively). There were no significant differences in spectralpatterns and relative metabolic ratios between the two methods. However, auto-prescan by PROBE seemed to be veryvulnerable to slight movement by patients, and in three cases, an acceptable spectrum was thus not obtained. CONCLUSION: PROBE is a highly practical and reliable method for single voxel 1H MRS of the human brain; the twomethods of prescanning do not result in significantly different spectral patterns and the relative metaboliteratios. PROBE, however, is vulnerable to slight movement by patients, and if the success rate for obtainingquality spectra is to be increased, regardless of the patient's condition and the region of the brain, it must beused in conjunction with the manual method.
Brain* ; Healthy Volunteers ; Humans* ; Magnetic Resonance Spectroscopy* ; Rabeprazole ; Steam

Anterior temporal lobectomy is the most popular surgical method for mesiobasal temporal lobe epilepsy. The key point in anterior temporal lobectomy is to resect lateral neocortex as little as possible, and mesiobasal structures as much as possible without surgical complication. We analyzed surgical anatomy on MRI scans of 20 persons to evaluate the relationships of anatomical structures related with surgical steps in anterior temporal lobectomy. On the oblique axial scan, the distance from temporal pole to anterior margin of hippocampus was 29.8+/-1.5mm. The length of hippocampus to the level of posterior margin of cerebral peduncle was 25.6+/-2.4mm. On the oblique coronal image through hippocampal head, the distance between the surface of superior temporal sulcus and lateral margin of temporal horn roof was 32.5+/-2.2mm. The angle between middle fossa base line and the line connecting superior temporal sulcus and lateral margin of temporal horn roof was 33.6+/-5.2 degree. The distance between lateral temporal surface and brain stem, and that between lateral temporal surface and collateral sulcus was 49.9+/-1.9mm and 40.6+/-3.3mm, respectively. The distance between collateral sulcus and lateral margin of temporal horn roof was 14.2+/-1.8mm, and the angle between middle fossa base line and the line connecting lateral margin of temporal horn roof and collateral sulcus was 60.4+/-7.4 degree. On the sagittal image, the angle between superior temporal sulcus and hippocampal axis was 18.8+/-1.1 degree. In conclusion, surgical complication of anterior temporal lobectomy can be reduced by careful consideration of anatomical relationships between anatomical structures encountered in each surgical steps in anterior temporal lobectomy.
Animals ; Anterior Temporal Lobectomy ; Axis, Cervical Vertebra ; Brain Stem ; Epilepsy, Temporal Lobe* ; Head ; Hippocampus ; Horns ; Humans ; Magnetic Resonance Imaging* ; Neocortex ; Tegmentum Mesencephali ; Temporal Lobe*

PURPOSE: The aims of this paper are to develop a student evaluation format as a part of core clinical clerkship (student internship) program at Gachon Medical School, and to identify its impeding factors in implementation. METHODS: Both rating scale of Likert type and check list for student's clerkship assessment were designed; the rating scale format was developed into two parts, namely attendance and the clinical competence demonstrated during the clerkship in which 3 domains of knowledge, skills and attitude were included in balance; the professional competence was made of 9 items, each being designed to accommodate 3 degrees by learner's performance. The clinical instructors in charge were requested to sit a short feedback session on the evaluation results with students who were signed at the end. Nursing staff was also asked to participate in evaluation of the student attitude in a limited area. RESULTS: Despite the full acceptance of the evaluation approach theoretically, its practical implementation was not successful because of difficulties related to adjustment of their department-based scoring system to the comprehensive assessment, or unfamiliarity with face-to-face feedback system. CONCLUSION: The authors assume that this Likert type of the rating scale is a simple, more comprehensive and strong tool to meet the learning objectives, and easy to enhance the feedback effect. It is, however, advised that the formative reporting system is crucial to transform the traditional evaluation approach into the pass/fail format so that unnecessary conversion risk is eliminated.
Clinical Clerkship* ; Clinical Competence ; Humans ; Learning ; Nursing Staff ; Professional Competence ; Schools, Medical*

Although subtemporal amygdalohippocampectomy is the ideal approach for pure mesial temporal lobe epilepsy from the view point that it can resect amygdala, hippocampusis, and parahippocampal gyrus selectively, this approach has not gained wide popularity due to shortcomings such as temporal lobe retraction and possible injury to temporal lobe draining veins. We analized surgical anatomy on MRI scan of 20 persons for the purpose of modifing the subtemporal approach to overcome the inherent shortcomings. The distance from temporal pole to anterior margin of temporal horn was 29.8+/-5mm(range, 28.5-31mm). Anterior margin of hippocampus was located 1.8+/-9mm(range, 1-3mm) anterior to dorsum sella. The length of hippocampus to the level of posterior margin of cerebral peduncle was 25.6+/-4mm. External auditary meatus divided the hippocampus, from anterior to the level of posterior margin of cerebral peduncle, in the ratio of 1.52: 1. On the coronal image through interpeduncular cistern, the distance between lateral margin of temporal lobe and collateral sulcus was 40.6+/-.3mm(37-45mm). On the coronal image through interpeduncular cistern and through the external auditary meatus, the height from temporal base to the choroidal fissure was 30.0+/-.7mm and 21.3+/-.5mm, respectively, and the angle between temporal base line and a line from collateral sulcus to choroidal fissure was 45.7+/-.6 degree and 33.2+/-.9 degree, respectively. In conclusion, our results indicate that external auditary meatus(EAM) is anatomical landmark for subtemporal amygdalohippocampectomy, and skull base approach focused on either EAM or anterior to EAM is necessary to minimize morbidity due to temporal lobe retraction and draining vein injury.
Amygdala ; Animals ; Choroid ; Epilepsy ; Epilepsy, Temporal Lobe ; Hippocampus ; Horns ; Humans ; Magnetic Resonance Imaging* ; Parahippocampal Gyrus ; Skull Base ; Tegmentum Mesencephali ; Temporal Lobe ; Veins