Traumatic rupture of the corpus cavernosum of the penis is rare and has been reported infrequently. We experienced 4 cases of penile fracture for recent 2 years. They occurred during coitus(1 case), masturbation(2 cases), and through blunt trauma(1 case). The former 3 cases were treated with immediate surgical intervention about 12 hours after injury. When the last case patient visited hospital 5 days after injury, the penile abscess treated immediately with surgical intervention had developed. Surgery consisted of complete evacuation of the hematoma or pus and repairing of the tear at the tunica albuginea. The results were excellent, with complete early recovery of erectile function. Delayed wound healing was observed only in a patient who underwent surgery about 5 days after injury, but this did not cause any complication afterward. In our experiences, immediate surgical treatment is recommended in patients with fracture of the penis.
Abscess ; Hematoma ; Humans ; Male ; Penis ; Rupture ; Suppuration ; Wound Healing

BACKGROUND: A cream made from mucus secreted by snails contains 80% mucin, as well as glycosaminoglycan, allantoin for skin rejuvenation, glycolic acid for keratin removal, and collagen and elastin, which are components of dermis. OBJECTIVE: The goal of the present study was to evaluate the efficacy of using cream containing mucus secreted by snails to reduce wrinkles, improve skin elasticity, restore dermal density, and lift the skin. METHODS: Cream containing mucus secreted by snails was applied to the lateral epicanthal areas and the left cheek of 10 subjects for 4 weeks twice per day. Wrinkles, skin elasticity, dermal density, and skin tightening were evaluated at baseline and 2 and 4 weeks. A patient survey was conducted at 4 weeks. RESULTS: There were statistically significant differences between baseline and 4 weeks after applying the cream in terms of wrinkles, skin elasticity, dermal density, and skin tightening (p<0.05). CONCLUSION: Use of cream containing mucus secreted by snails seems to be effective for anti-aging of the skin. Long term follow up studies, such as 3 or 6 months, to confirm the efficacy of the cream should be conducted involving a larger number of patients.
Allantoin ; Cheek ; Collagen ; Dermis ; Elasticity ; Elastin ; Humans ; Mucins ; Mucus* ; Rejuvenation ; Skin* ; Snails*

Stroke in young adults has been known to show a lower incidence and a better prognosis. Only a few studies have examined the epidemiology and outcomes of ischemic stroke in young adults and compared them with the elderly in Korean population. All consecutive patients with ischemic stroke visiting 29 participating emergency departments were enrolled from November 2007 to October 2009. Patients with less than 15 yr of age and unknown information on age and confirmed diagnosis were excluded. We categorized the patients into young adults (15 to 45 yr) and elderly (46 yr and older) groups. Of 39,156 enrolled all stroke patients, 25,818 with ischemic stroke were included and analyzed (young adult; n=1,431, 5.5%). Young adult patients showed lower prevalence of most chronic diseases but significantly higher prevalence in exercise, current smoking, and alcohol consumption. Hospital mortality was significantly lower in young adults than elderly (1.1% vs. 3.1%, P<0.001). Higher number of patients in elderly group (68.1%) showed worsening change of modified Rankin Scale than young adults (65.2%). Young adults ischemic stroke showed favorable hospital outcomes than the elderly in Korean population.
Adolescent ; Adult ; Age Factors ; Aged ; Chronic Disease ; Demography ; Disability Evaluation ; *Emergency Medical Services ; Female ; Humans ; Male ; Middle Aged ; *Outcome Assessment (Health Care) ; Prevalence ; Prognosis ; Republic of Korea/epidemiology ; Stroke/*diagnosis/epidemiology/mortality ; Young Adult

PURPOSE: The length of a patient's stay in a hospital is an indication of the patient's recovery rate. The length of the hospital stay has an important economic factor for hospitals. This study was conducted to determine the relationship of the nutritional status at the time of admission to mortality and the length of the hospital stay (LOHS). METHODS: The study subjects were 1,619 patients who suffered with cancer, were admitted to Kosin University Gospel Hospital during 2005 and they met the study criteria. The patients were classified to the not at risk group, the patients having one risk factor for malnutrition were the I group, the patients having two risk factors for malnutrition were the II group, the patients having three risk factors for malnutrition were the III group and the patients having 4 risk factors for malnutrition were the IV group, based on the established criteria of serum albumin <3.0 g/dl, a total lympocyte count of <1,500 cells/mm3, a cholesterol level of > or =240 mg/dl or < or =130 mg/dl, weight for height > or =120% or <90% ideal body weight. RESULTS: 24.3% of the patients were classified into the not at risk group, 37.6% were classified into the at risk group I, 24.2% were classified into the at risk group II, 10.3% were classified into the at risk group III and 3.6% were classified into the at risk group IV. The at risk group (at risk III, at risk IV) had a significantly higher prevalence of liver disease. The relationship between liver disease and low serum albu-min levels may have confounded the data. Although the estimated LOHS was similar in all the groups, the average length of stay was 14.4+/-16.38 days in the malnourished group (at risk group IV) compared to approximately 2.8 days in the not at risk group. The more nutritional risk factors the patients had, the longer was the LOHS and the mortality rates were higher. Correlation was not observed between the risk factors and the length of the hospital stay, as well as the lack of correlation with the mortality rate. CONCLUSION: These results suggest that a patient's nutritional status upon admission has an effect on the length of the hospital stay for patients with carcinoma.
Cholesterol ; Humans ; Ideal Body Weight ; Length of Stay* ; Liver Diseases ; Malnutrition ; Mortality* ; Nutritional Status* ; Prevalence ; Risk Factors ; Serum Albumin

BACKGROUND: The majority of patients undergoing stem cell transplantation (SCT) require a blood transfusion until the complete engraftment. Because blood transfusion rules for patients with ABO-incompatible SCT are complicated, we developed an ABO-incompatible transfusion management system (ABO-ITMS) for accurate blood transfusion and improved manageability. METHODS: A committee composed of medical doctors, technicians, and a programmer developed ABO-ITMS during the eight months from July 2013 to February 2014. The program has been linked with other databases, including clinical and laboratory databases and resulted in a new subsystem of the health information system. Server computer's operating system was Window Server 2008, and the database manager program was Oracle 11g. Programming language was ASP.Net (VBScript, C #), and the server and client computer were used to connect to the web server using a web browser. RESULTS: ABO-ITMS was designed to follow three main steps by hematologic oncology clinic, laboratory physician, and blood bank. In the first step, a hematologic-oncology clinic doctor inputs SCT recipients' data and appropriate ABO group for each phase of post-transplantation. Laboratory physician enters the isoagglutinin titer and ABO group at the second step. Finally, blood bank workers enter the results of type, screening, and antibody identification. The patient's SCT information and the previous immunohematologic test results are shown on the screen. CONCLUSION: ABO-ITMS can replace the existing complicated system and workflow. ABO-ITMS will contribute to reducing medical error and improving quality of SCT recipient care.
Blood Banks ; Blood Transfusion* ; Health Information Systems ; Humans ; Mass Screening ; Medical Errors ; Programming Languages ; Stem Cell Transplantation* ; Web Browser

BACKGROUND: Malnutrition is one of the important factors influencing morbidity and mortality in elderly patients with gastric carcinoma. METHODS: Since September to December 2001, we investigated the nutritional parameters of 44 elderly patients with gastric carcinoma by measuring anthropometric and biochemical blood indices and assessing dietary intake along with subjective global assessment. RESULTS: The mean body mass index of subjects was below the physical average of korea on the base of 64 years old. The ratio of carbohydrate, protein and lipid to energy intake was 74.0:13.5:12.5(%). There were significantly positive correlations between three groups according to subjective global assessment and height, body weight, 1 month weight loss %, 6 month weight loss %, body mass index, transferrin and nutrient intake, such as energy, protein and niacin. CONCLUSION: Mean nutrient intake, such as total energy, protein and niacin appear to be related of subjective global assessment in elderly subjects. Nutritional assessment by nutrient intake should be done in elderly patients with gastric carcinoma and be supplied with adequate nutrition for them.
Aged* ; Body Height ; Body Mass Index ; Energy Intake ; Humans ; Korea ; Malnutrition ; Middle Aged ; Mortality ; Niacin ; Nutrition Assessment ; Nutritional Status* ; Transferrin ; Weight Loss

Anaphylactic transfusion reaction is caused by deficiency of certain protein(s) in the recipient. We report on the experience of platelet count recovery using washed platelets for transfusion in a patient who developed an anaphylactic transfusion reaction. A 50-year old male diagnosed with angioimmunoblastic T-cell lymphoma was treated with chemotherapy followed by autologous hematopoietic stem cell transplantation. Immediately after starting transfusion of apheresis platelets, he began sweating and complained of visual impairment, chest discomfort, and abdominal pain. Both systolic and diastolic blood pressures and oxygen saturation monitored by pulse oximetry were decreased. Platelet transfusion was discontinued immediately and hydrocortisone was administered, and the symptoms and signs were resolved within two hours. Laboratory test using post-transfusion blood showed no apparent evidence of hemolysis. Platelet washing procedure using normal saline three times was newly set to prevent anaphylactic reaction in the patient. Transfusions of washed platelets were performed 20 times for 60 days, and the patient showed no anaphylactic reaction during this period. He showed no evidence of immunoglobulin A, haptoglobin, C3, or C4 deficiencies. We confirmed that washed platelet transfusion is highly effective for prevention of anaphylactic transfusion reaction.
Abdominal Pain ; Anaphylaxis ; Blood Component Removal ; Blood Group Incompatibility* ; Blood Platelets* ; Drug Therapy ; Haptoglobins ; Hematopoietic Stem Cell Transplantation ; Hemolysis ; Humans ; Hydrocortisone ; Immunoglobulin A ; Lymphoma, T-Cell ; Male ; Oximetry ; Oxygen ; Platelet Count ; Platelet Transfusion* ; Sweat ; Sweating ; Thorax ; Vision Disorders

BACKGROUND AND OBJECTIVES: We investigated the expression of glucose uptake transporter-1 (GLUT-1) and epidermal growth factor receptor (EGFR) in the head and neck squamous cell cancer (HNSCC) and their influence on survival rate. We also aimed to demonstrate the relationships between the expressions of GLUT-1 and EGFR and the maximal standardized uptake values (mSUV) of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET). SUBJECTS AND METHOD: Surgical specimens from 50 patients with HNSCC, who had undergone surgical intervention, were first processed for tissue array and then for immunochemistry for GLUT-1 and EGFR. Expressions of GLUT-1 and EGFR were analyzed according to the differentiation of tumor, T & N stage and invasiveness of the tumor etc. The relationship between PET-mSUV and the expressions of EGFR and GLUT-1 was evaluated as well as its possibility as a prognostic factor of SUV. RESULTS: The expression of EGFR was significantly high in the lymph node of the positive group. Associated with the expression of GLUT-1, a tendency of increased index score (IS) values in the advanced T stages was observed but it was not statistically significant. The mSUV in FDG-PET showed statistically significant association with the maximal tumor size (pearson correlation 0.569, p=0.023); however, no association with GLUT-1 and EGFR was observed. A universal strong expression of GLUT-1 could have made it difficult to figure out statistically significant correlations. Disease free survival was to be influenced by T stage, moderate and poor differentiation and GLUT-1 expression. Only the T stages had independent significance in the multivariate analysis using the Cox regression model. CONCLUSION: We found that the expression of GLUT-1 could not show statistically significant correlation with PET-mSUV. Since the expression of EGFR has significant correlation with lymph node metastasis, EGFR may have the possibility of being a target for anticancer molecular therapy.
Collodion ; Disease-Free Survival ; Glucose ; Head ; Humans ; Immunochemistry ; Lymph Nodes ; Multivariate Analysis ; Neck ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Positron-Emission Tomography ; Receptor, Epidermal Growth Factor ; Recurrent Laryngeal Nerve ; Survival Rate ; Thyroid Gland

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.