From April to October, 1988, 34 patients with ureteral calculi more than O.5 cm or smaller but impacted ureteral stone underwent pulsed dye laser lithotripsy under ureteroscopy. The results were as follows : 1. The locations of stone were upper ureter in 9(26.5%), mid ureter in 8(23.5%), lower ureter in 11(32.4%), and UVJ in 6(17.6%). 2. The success rates according to location were 66.7% in upper ureter, 87.5% in mid ureter, 91% in lower ureter, and 100% in UVJ and the average success rate was 85.3%. 3. The success rates according to stone size were 83% in 0.3-0.5 cm, 90% in 0.5-1.0 cm, and 75% in 1.0-2.3 cm. 4. The average procedure time was about 85 minutes, with a range of 30 to 120 minutes and the average hospitalization after laser therapy was about 3 days, with a range of 1 to 6 days. 5. There were 5 cases (14.8%) of failure due to upward migration of stone in 3 cases, ureteral injury in 1 case and ureteral stricture in 1 case. 6. Complications occurred in 10 patients (29.5 %), almost by ureteroscopy but laser induced complication was not found. Therefore, we confirm that laser lithotripsy is a safe and effective method for treatment of ureteral stone.
Constriction, Pathologic ; Hospitalization ; Humans ; Laser Therapy ; Lasers, Dye* ; Lithotripsy ; Lithotripsy, Laser ; Ureter* ; Ureteral Calculi* ; Ureteroscopy* ; Urinary Calculi

No abstract available.
Case-Control Studies* ; Placenta Previa* ; Placenta* ; Risk Factors*

PURPOSE: This study was made to evaluate the clinical characteristics and the treatment of the gangrene of the male genitalia manifested with progressive life threatening disease. MATERIALS AND METHODS: Between June 1992 and December 1998, medical records for patients with Fournier's gangrene were reviewed with respect to age at presentation, associated disease, and clinical course and the treatment. RESULTS: The age of patients ranged from 29 to 92 years. The prodromal sign noted were usually low abdominal and inguinal pain. There were no differences in the causative pathogens compared to those of previous reports. The common underlying diseases were diabetes and chronic liver disease. Hypoalbuminemia and leukocytosis were found in all. Early radical debridement and aggressive antibiotics therapy were performed in all cases. Reconstructive surgery of defected skin was performed 7 to 45 days(mean 33.6) after debridement and period of hospital stay ranged from 14 to 123 days(mean 35.8). The motality rate was 13.3%. CONCLUSIONS: It is thought that the motality rate of Fournier`s gangrene is reduced by early aggresseve debridement of the wound and empirical triple antibiotic therapy, and the comprehension of clinical course is important as well.
Anti-Bacterial Agents ; Comprehension ; Debridement ; Fournier Gangrene ; Gangrene* ; Genitalia, Male ; Humans ; Hypoalbuminemia ; Length of Stay ; Leukocytosis ; Liver Diseases ; Male ; Medical Records ; Prodromal Symptoms ; Skin ; Wounds and Injuries

No abstract available.
Humans ; Siblings*

Acardiac twinning affects 1 in 100 monozygotic twin pregnancies and 1 in 35,000 pregnancies overall. This condition is characterized by the absence or rudimentary development of fetal heart, and associated with various anomaly. The presence of an acardiac twin requires the normal (or "pump") twin to provide circulation for itself, as well as the acardiac sibling. The acardiac malformations are uniformly fatal in the affected twin, and mortality in the co-twin is as high as 55%. The principal perinatal problems associated with acardiac twinning are pump-twin congestive heart failure, maternal hydramnios, and preterm delivery. We recently experienced a case of acardius anceps associated with a normal male infant, so present with a brief review of the literature.
Fetal Heart ; Heart Failure ; Humans ; Infant ; Male ; Mortality ; Polyhydramnios ; Pregnancy ; Siblings ; Twins, Monozygotic

Verrucous carcinoma of the larynx is a distinct and uncommon variant of well-differentiated squamous cell-carcinoma. The authors hybridized in situ a case of laryngeal verrucous carcinoma with DNA prebes to humman papillomavirus (HPV) 6, 11, 16, 18, 31, 33 and 35. The DNAs from the verrucous carcinoma of larynx hybridized with mixed DNA probes HPV-16/18 and 31/33/35. In addition, there was an evidence of HPV infection based on hybridization with mixed DNA probe HPV-6/11 in the adjacent papilloma tissue. By in situ DNA hybridization techniques, we clearly demonstrated human papillomavirus (HPV-16/18, and 31/33/35) related sequences in this neoplasm. These findings suggest the role of HPV-6/11 in the development of laryngeal papilloma ad HPV-16/18 and 31/33/35 probably on the progression to verrucous carcinoma.
Humans

As the incidence of acute myocardial infarction been increasing with prolongation of life spans, improvement in foods and life styles in Korea, rapid diagnosis and treatment is critical in survival of acute myocardial infarction patient. Most of the acute myocardial infarction result from atherosclerotic plaque forming thrombus and occlusion of coronary artery. Because early thrombolytic therapy is important to maintain the left ventricular function and survival rate, there have been many trials to reperfuse the occluded coronary artery. We have studied the many aspects of acute myocardial infarction such as sex, age, infarction site, chief complaints, change of ECG, change of serum enzyme, time delay on emergency room arrival, and compared the effectiveness of thrombolytic therapy. Total number of patient was 212, and males were 141(66.5%) and females were 71(33.5%). The most common infarction site was ant, fuel wall(102 cases,48%)of the heart and the most common chief complaint was chest pain(204 cases,97%). Among the 106 patients who received thrombolytic therapy, 101 patients(95%) had survived and 5 patients(5%) had died. Among the 64 patients who didn't receive thrombolytic therapy, 56 patients (87.5%) were alived and 8 patients(12.5%) were dead.
Ants ; Coronary Vessels ; Diagnosis* ; Electrocardiography ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Incidence ; Infarction ; Korea ; Life Style ; Life Support Care ; Male ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Survival Rate ; Thorax ; Thrombolytic Therapy ; Thrombosis ; Ventricular Function, Left

In modem medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time In the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized ; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meetings among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours (from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree (p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Leadership ; Medical Staff ; Modems

Neuroblastoma originate in neural crest and is one of the most frequent tumor next to leukemia and brain tumor in child. The tumor is most highly malignant tumor due to early metastasis at diagnosis. It could be diagnosed by various diagnostic modalities such as roentgenologic examination, laboratory data and confirmed by pathologic diagnosis. Management of neuroblastoma is surgery, radiotherapy and chemotherapy. We experienced a case of adrenal neuroblastoma at age of 20-month male child and report with a brief review of literature
Adrenal Glands ; Brain Neoplasms ; Child ; Diagnosis ; Drug Therapy ; Humans ; Leukemia ; Male ; Neoplasm Metastasis ; Neural Crest ; Neuroblastoma* ; Radiotherapy

No abstract available.
Alcoholics* ; Erythrocyte Indices* ; Humans