We reviewed 28 patients admitted due to urologic complications after obstetric & gynecologic operation and management since May 1972. The age distribution, developed urologic complications and it`s treatment are discussed. The prevalent age groups of urologic complications were 30`s and 40`s. The most common urologic complication was urinary fistula : 8 ureterovaginal, 8 vesicovaginal and 4 other fistulas. The results after 1st operation of urinary fistula showed an over-all success rate of 72.6%.
Age Distribution ; Female ; Fistula ; Genital Diseases, Female* ; Humans ; Urinary Fistula

We have experienced a 50-year-old male patient, who died of multiple metastatic nodular melanoma which had the primary lesions on the right hallux and forefoot with eventual involvement of skin and internal organs. An autopsy was performed for the evidence of metastatic features of the internal organs and their spreading routes, with concurrent histopathologic findings. The autopsy findings revealed diffuse metastases to the ipsilateral femoral and inguinal lymph nodes via ascending vascular channels and to the internal organs: 1. The heart had multiple metastatic lesions on the pericardium and right ventricular wall. And the mediastinal, periaortic and periesophageal lymph nodes were also involved. 2. The both lungs were moderately indurated and focally discolored, and showed metastatic lesions in the right lower lobe and hilar areas, Melanoma cells were diffusely invaded to the interstitia and alveoli. 3. The right 5th and 6th ribs showed the invsion of melanoma cells on their bone marrows, periostia, and Haversians canals. 4. The liver was enlarged and showed multiple various sized nodules on the surface with adesion to the parts of peritoneum, omentum and diaphragm. Melanoma cells were seen mostly on and around the sinusoidal spaces and parenchyma. 5. The stomach wall had an ulcerated metastatic lesion and the melanoma cells invaded deeply into the muscle layer. 6. The pancreas was normal in its size and shape but had multiple metastatic lesions on the head and body with melanoma celi infiltration. 7. The both kidneys were grar ular surfaced and showed two metastatic lesions on the right renal cortex and two on the left. Renal tubules and parenchyma were widely invaded by melanoma cells but the glomerular tufts were intact. 8. The adreral and thyroid glands showed four and two metastatic lesions respectively and diffuse invasion of melanoma cells into the parenchyma. 9. The brain was normal in gross appearance, but the cortex was edematous and showed settered melanoma cell infiltration.
Autopsy* ; Bone Marrow ; Brain ; Diaphragm ; Hallux ; Head ; Heart ; Humans ; Kidney ; Liver ; Lung ; Lymph Nodes ; Male ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Omentum ; Pancreas ; Pericardium ; Peritoneum ; Ribs ; Skin ; Stomach ; Thyroid Gland ; Ulcer

Emphysematous pyelonephritis is a rare, life-endangering suppurative infection of the renal parenchyma and perirenal tissues. The disease is encountered mainly in the diabetic patient with or without ureteral obstruction and is characterized by the production of intrarenal and occasionally, perirenal gas. We report a case of emphysematous pyelonephritis, treated by left nephrectomy, in 55-year-old diabetic woman.
Female ; Humans ; Middle Aged ; Nephrectomy ; Pyelonephritis* ; Ureteral Obstruction

UUse of the gastrocnemius muscle flap has proven to be highly effective in reconstruction of knee and lower leg defect due to its easy procedure, anatomical consistency, and less donor site morbidity.The gastrocnemius muscle is anatomically spindle shape, the volume of the distal part of the muscle for coverage is actually quite small and also even smaller when disuse atrophy is accompanied due to trauma. Although the defect is inside flap's arc of rotation, it is out of gastrocnemius muscle flap's indication when the defect size is extensive, and even though the defect is small, it is also out of indication when the defect is a bit out of arc of rotation. There has been a lot of modification to increase the flap's arc of rotation or dimension. However, it is difficult to achieve satisfactory results due to limitation and expense in clinical application. Authors used, for soft tissue reconstruction on broader area, gastrocnemius musculo-adipofascial flap, rather than classical gastrocnemius muscle flap, based on the fascial plexus of gastrocnemius muscle. We obtained a good result in lower extremity reconstruction of 7 cases from March 1999 to July 2000 and report this result with several cases.
Humans ; Knee ; Leg ; Lower Extremity* ; Muscle, Skeletal ; Muscular Disorders, Atrophic ; Tissue Donors

PURPOSE: The study was done to identify turnover intention in new nurses according to characteristics of the nurses and other factors affecting turnover and to provide data to set up a strategy to reduce the turnover. METHODS: Data were collected from 1,077 new nurses who had less than 12 months employment experience and worked in one of 188 hospitals. Eight research instruments were used. Data analysis was done using SPSS WIN 15.0 program. RESULTS: Several factors influence new nurse turnover intention. The average score for turnover intention was 2.12. The scores for subscales were self efficacy, 3.76, nursing performance, 3.90, job satisfaction, 2.09, organization commitment, 1.28, stress, 1.32, burnout, 2.82 and nursing organizational culture, 3.29. Turnover intention was related to self efficacy, nursing performance, job satisfaction, organization commitment, stress, burnout, nursing organizational culture, duration of in-class training, duration of on the job training, number of hospital beds, length of employment and duration of employment in current workplace. The predicting factors for turnover intention were burnout, stress, duration of employment in the current workplace, self efficacy and nursing performance. Those factors explained 51.6% of turnover intention. CONCLUSION: New nurse turnover intention can be reduced by mitigating the factors affecting this intention.
Adult ; Attitude of Health Personnel ; Burnout, Professional ; Female ; Humans ; Intention ; Job Satisfaction ; Nursing Staff, Hospital/*psychology ; Organizational Culture ; *Personnel Turnover ; Self Efficacy ; Stress, Psychological ; Workload ; Young Adult

In general, excision of a constriction ring is not difficult when performed several months after birth, but care should be taken to excise the scar tissue in newborns so as to avoid neurovascular damage. Although Hall et al. and Greene described successful one-stage operations in cases of forearm and leg constriction rings, a two staged Z-plasty around the circumference of the constriction is recommended in neonatal balloon. The authors in this article excised constriction ring through a single operation with Z-plasty, and restored digital contour. In order to preserve neurovascular structures, the authors employed loupe(x3.5) and prevented inadequate sensation and cold intolerance, which may occur after surgery. A one-stage release of congenital constriction ring was performed for 5 constriction rings in four extremities(one patient). No wound problems occurred, even when there had been marked congestion of the extremity distal to the constriction ring. The one-stage release facilitated postoperative care, and there was no need for additional anesthesia or for additional operations, which are necessary when this problem is treated with a release performed in two or three stages.
Anesthesia ; Cicatrix ; Constriction* ; Estrogens, Conjugated (USP) ; Extremities ; Forearm ; Humans ; Infant, Newborn ; Leg ; Parturition ; Postoperative Care ; Sensation ; Wounds and Injuries

A Clinical observation was made on 10 cases of childhood urolithiasis under 15 year-old who were admitted to the department of urology, Hanyang University Hospital during the period from May, 1972 to Dec, 1983. The results were as follows: 1. of 3482 cases hospitalized, 10 cases were urolithiasis in childhood giving ratio of 0.29%. 2. The favorable age was absent, but showed even distribution. 3. Congenital anomalies 2, metabolic cause 1, idiopathic cause 7 were recognized as etiologic causes. 4. Incidence of lower urinary stone was high, 70%. 5. The most frequent symptoms and signs were voiding difficulty, 4 cases. Hematuria, flank pain and bladder irritative symptoms were also noted. 6.The urine cultures were showed Klebsiella pneumonia in 1 case, Enterobacter aerogens in 1 case, Enterococci in 1 case and combined infection of E. coli and Enterococci in 1 case. 7. Stone analysis was showed calcium oxalate in 3 cases, combined stone of calcium oxalate and ammonium phosphate in 1 case and fibrinoid calculi in 1 case. 8. Recurred rate cannot be estimated because of the patient was not revisited to out-patient-department at all after discharge.
Adolescent ; Ammonium Compounds ; Calcium Oxalate ; Calculi ; Enterobacter ; Flank Pain ; Hematuria ; Humans ; Incidence ; Klebsiella ; Pneumonia ; Urinary Bladder ; Urinary Calculi ; Urolithiasis* ; Urology

During revascularization after ischemia, oxygen free radicals and cytotoxic enzymes are released and they have a role in pathogenesis of ischemia-reperfusion injury. Glucocorticoid decreases oxygen free radical formation by inhibition of arachidonic acid metabolism, and alpha-lipoic acid scavenges nitric oxide(NO) with inhibition of hydroxy radical formation. Author investigated the role of glucocorticoid and alpha-lipoic acid to decrease ischemia reperfusion injury in 24 anesthetized rats (normal saline-injected, n= 8; dexamethasone-injected, n=8; alpha-lipoic acid-injected, n= 8), subjecting a soleus muscle to 4 hours of tourniquet ischemia followed by 2 hours of reperfusion, and evaluated the concentration of NO, tissue edema, and neutrophil count of rat skeletal muscle as a indicator of tissue damage by ischemia- reperfusion injury. We obtained the results that glucocorticoid and alpha-lipoic acid treatment decreased the increase of NO concentration, tissue edema, and neutrophil count significantly. These results support that pretreatment with glucocorticoid or alpha-lipoic acid has a beneficial effect on the preventive management of ischemia-reperfusion injury.
Animals ; Arachidonic Acid ; Edema ; Free Radicals ; Ischemia ; Metabolism ; Muscle, Skeletal ; Neutrophils ; Oxygen ; Rats ; Reperfusion ; Reperfusion Injury* ; Thioctic Acid* ; Tourniquets

Dieulafoy lesion is an uncommon cause of gastrointestinal bleeding, reported to be only 2% of acute or chronic upper gastrointestinal bleeding episodes. Bleeding occurs from a small mucosal erosion involving an unusually large submucosal artery in an otherwise normal mucosa. It is associated with massive, life threatening hemorrhage and is difficult to diagnosis. In most cases the lesion is encountered in the proximal stomach, antrum, duodenum, colon and rectum. In particular, extragastric Dieulafoy lesion is an extremely rare source of intestinal bleeding. In Korea, no case of bleeding from a Dieulafoy lesion of the small intestine has been previously reported. We experienced one case of bleeding from a jejunal Dieulafoy lesion, which was confirmed by the pathologic examination of the resected specimen, and report here.
Adult ; Arteries/abnormalities* ; Case Report ; Female ; Gastric Mucosa/blood supply* ; Gastrointestinal Hemorrhage/etiology* ; Human ; Intestinal Mucosa/blood supply*

PURPOSE: The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. MATERALS AND METHODS: We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4+/-7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class I , II). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6+/-19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propagation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis RESULTS: CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=0.01) and age (p=0.02) were related to the development of CCH. CONCLUSION: Crossed cerebellar hyperperfusio ictal brain SPECT did not help differentiate mesial from lateral temporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.
Brain* ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Logistic Models ; Retrospective Studies ; Technetium Tc 99m Exametazime* ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon*