PURPOSE: There are various methods for distal hypospadias repair. Although meatal advancement-glanuloplasty (MAGPI) has been popularly used, it is not suitable in cases of megameatus intact prepuce (MIP) or hypospadias with a wide, deep, glanular groove. We assessed the reliability, cosmesis and complication rates of the glans approximation procedure (GAP). MATERIALS AND METHODS: 22 patients with distal hypospadias, who had undergone a GAP, were evaluated based on their charts. The cases of MIP, glanular hypospadias and coronal hypospadias were 10, 10 and 2, respectively. All the patients had wide, deep, glanular grooves or wide fish-mouth meatus. Two patients had mild ventral skin chordee. The mean age of the patients was 13 years old, ranging from 1 to 40 years, and the mean follow up period was 26 months ranging from 3 to 48 months. A Foley catheter was inserted in 18 cases, for a mean of 4.2 days. The surgical outcomes were retrospectively evaluated. RESULTS: In the 22 patients, there was one urethro-cutaneous fistula, which was repaired, with a good result. There were 2 temporarily weak streams, 2 urine retentions and one wound infection, which were all resolved with appropriate treatments. All patients were pleased with the cosmetic results, and had good straight urinary streams. CONCLUSIONS: The GAP was technically easy and reliable, and showed low complication rates in selected patients with MIP hypospadias and hypospadias, with a deep glanular groove.
Adolescent ; Catheters ; Female ; Fistula ; Follow-Up Studies ; Humans ; Hypospadias* ; Male ; Retrospective Studies ; Rivers ; Skin ; Wound Infection

The Reconstructive techniques of palatal defect are palatal island flap, palatal mucoperiosteal expansion, buccal flap, tongue flap, pushback palatoplasty, free flap and so on. We report a reconstruction of palatal defect using palatal flap. Excellent results were obtained by palatal connective tissue island flap and split thickness pedicle flap. Healing of defect occured rapidly. There were no postoperative complications except dull pain.
Connective Tissue ; Free Tissue Flaps ; Postoperative Complications ; Tongue

PURPOSE: The purpose of this study was to find the predictors for successful arthrocentesis for anterior disc displacement without reduction(ADD without Reduction) of the temporomandibular joint (TMJ). PATIENTS AND METHODS: Arthrocentesis and lavage was carried out in 25TMJs of 22patients whose MRI findings were all anterior disc displacement without reduction. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predectors which was analyzed were age, duration of painful locking, MMO, the degree of pain, perioperative clicking and the amounts of irrigation fluid. RESULTS: 18cases (72%) was included to criteria for success. There were no significant differences in age, duration of locking, MMO and the degree of pain statistically. But In 15cases(83%) of successful cases, amouts of irrigated solution recovered to normal MMO were less than 150ml. And In 8cases (44%) of successful cases, perioperative clicking was appeared. CONCULSION: Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.
Humans ; Magnetic Resonance Imaging ; Mouth ; Pain, Postoperative ; Temporomandibular Joint Disorders* ; Temporomandibular Joint* ; Therapeutic Irrigation*

Parovarian cysts constitute 10% of adnexal masses. They were found in broad ligament and mostly arise from mesothelium and less commonly from paramesonephric element and rarely from mesonephric element. In most cases parovarian cysts were asymptomatic. So, they were found incidentally at surgery for other conditions. Torsion is infrequent and it is difficult to distinguish it from torsion of other adnexal masses, appendicitis, etc. Recently, we experienced a voluminous parovarian cyst undergoing torsion, 25 cm in diameter. The case is presented with a review of literature.
Appendicitis ; Broad Ligament ; Epithelium ; Female ; Parovarian Cyst*

No abstract available.

BACKGROUND: The primary outcome of sugammadex reversal for rocuronium-induced neuromuscular block (NMB) is a train-of-four ratio (TOFR) of 0.9, not first twitch (T1) height. We investigated whether the recovery of TOFR or T1 differs based on the reversal of NMB with neostigmine or sugammadex. METHODS: The acceleromyographic responses from 0.6 mg/kg of rocuronium were monitored supramaximally in 80 patients after induction of anesthesia. The TOFR and T1 height were recorded, and saved in a personal computer using TOF-Watch SX Monitor software in all patients. Patients were randomly assigned to 2 groups to receive either neostigmine 50 µg/kg with glycopyrrolate 10 µg/kg (neostigmine group, n = 40) or sugammadex 2.0 mg/kg (sugammadex group, n = 40). The primary objective was to determine the difference of recovery time between TOFR to 0.9 and T1 to 0.9 after sugammadex or neostigmine administration during moderate rocuronium-induced NMB. RESULTS: The recovery pattern of the TOFR 2 min after sugammadex administration was 1.0 or more, but that of T1 was less than 90% (T1 / control value) up to 6 min after drug was injected. The recovery pattern of TOFR and T1 was similar during the 20 min after reversal with neostigmine. CONCLUSIONS: If you have not performed the T1 monitoring, both TOFR and T1 should be considered to confirm suitable recovery during the 6 min after reversal with sugammadex during rocuronium-induced moderate NMB.
Anesthesia ; Depression* ; Glycopyrrolate ; Humans ; Microcomputers ; Neostigmine ; Neuromuscular Blockade* ; Neuromuscular Monitoring

No abstract available.
Heart Septal Defects, Atrial* ; Mitral Valve Insufficiency* ; Myxoma*

No abstract available.
Anesthesia, Spinal*

BACKGROUND: H. pylori-associated gastrointestinal diseases have been widely recognized. The aim of this study was to investigate the seropositivity of H. pylori in health check-up subjects and to find out the relating factors. METHODS: From November 2004 through June 2005, total 7,676 health check-up subjects (age > or =20) responded to the self administered questionnaires. The prevalence of H. pylori was assessed by measuring anti-H. pylori IgG antibodies. RESULTS: The overall seropositivity was 56.7% in 7,676 and 1,137 (14.8%) has been found to have history of H. pylori eradication therapy. The seropositivity rate of H. pylori was 61.3% (2,653) in 4,328 subjects without history of H. pylori eradication and current gastrointestinal symptoms. Seroprevalence of H. pylori was significantly lower in 20~29 years old, female, high income and subjects from Seoul respectively. CONCLUSIONS: The seropositivity of H. pylori in 2004~2005 is found to be 61.3% in subjects without history of H. pylori eradication and current gastrointestinal symptoms. This seems to be lower than 66.9%, the seroprevalence rate in asymptomatic Korean population in the age of > or =16 years in 1998. This decrease might be caused by improvement of socioeconomic status.
Antibodies ; Female ; Gastrointestinal Diseases ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Prevalence ; Seoul ; Seroepidemiologic Studies* ; Social Class ; Surveys and Questionnaires

Leaflet escape of prosthetic valve is rare but potentially life threatening. It is essential to make timely diagnosis in order to avoid mortality. Transesophageal echocardiography and cinefluoroscopy is usually diagnostic and the location of the missing leaflet can be identified by computed tomography (CT). Emergent surgical correction is mandatory. We report a case of fractured escape of Edward-Duromedics mitral valve 27 years after the surgery. The patient presented with symptoms of acute decompensated heart failure and cardiogenic shock. She was instantly intubated and mechanically ventilated. After prompt evaluation including transthoracic echocardiography and CT, the escape of the leaflet was confirmed. The patient underwent emergent surgery for replacement of the damaged prosthetic valves immediately. Eleven days after the surgery, the dislodged leaflet in iliac artery was removed safely and the patient recovered well.
Echocardiography, Transesophageal ; Heart Failure ; Heart Valve Prosthesis ; Humans ; Iliac Artery ; Mitral Valve ; Prosthesis Failure ; Shock, Cardiogenic ; United Nations