No abstract available.
Female ; Labor, Induced* ; Pregnancy*

BACKGROUND: Since the herniorrhaphy was performed by Bassini, that method has been the standard for herniorrhaphy for over a hundred year, although it has been modified by other surgeons. During recent decades, biomaterials were introduced to the medical field, and polypropylene mesh was applied to reconstruct the defective abdominal wall of an inguinal hernia in an adult. The Lichtenstein Hernia Institute is regarded as the leading group for the tension-free herniorrhaphy using Marlex mesh under local anesthesia. METHODS: We designed this study prospectively to investigate the characteristics of groin hernias and the results, including complications and recurrence after surgery. The primary method of surgery was a Lichtenstein's tension-free herniorrhaphy using Prolene mesh. We performed 196 hernioplasties in 180 patients having a groin hernia, which included 16 bilateral hernias. RESULTS: 139 indirect hernias, 51 direct hernias, and 3 femoral hernias were included; there were 15 recurrent hernias. A Lichtenstein's tension-free herniorrhaphy was performed in 84.2% of the cases, a preperitoneal mesh graft in 10.2%, and a Bassini's method in 4.6%. There were four recurrences; three were through the femoral canal after the repair of a direct hernia in a female, and one was a recurrent direct hernia in a male patient. CONCLUSIONS: With the use of a mesh prosthesis, a tension-free herniorrhaphy is possible with neither distortion of the normal anatomy nor suture-line tension. However, it should be carefully applied to a direct hernia only after thorough exploration of the groin through the retroinguinal space of Bogros to rule out coexisting intraparietal or femoral hernias. It is necessary to provide enough laxity for the mesh because prolene mesh can shrink up to 20%, and recurrence might be caused by the tension in the applied mesh.
Abdominal Wall ; Adult* ; Anesthesia, Local ; Biocompatible Materials ; Female ; Groin ; Hernia ; Hernia, Femoral ; Hernia, Inguinal* ; Herniorrhaphy* ; Humans ; Male ; Polypropylenes ; Prospective Studies ; Prostheses and Implants ; Recurrence ; Transplants

PURPOSE: Most students choose the same option to questions in course evaluation surveys. Identical answers to each question render the results unreliable. The purpose of this study was to analyze the trend of medical student' consistent responses to course evaluations. METHODS: The data of this study were the results of a course evaluation over 3 years (from 2006 to 2008) at the School of Medicine at A University. RESULTS: The proportion of students who replied with the same answers to each question was below 20%. This result was consistent in freshmen, sophomores, and junior students. Using a 5-point Likert scale, more than 40% of the students gave 5 points consistently. CONCLUSION: We conclude that student' responses to evaluations do not have a significant impact on the reliability of course evaluations at Medical School at A University. These results differ significantly from those of previous research. Hence, future studies are required to analyze course evaluations in medical schools using diverse aspects.
Humans ; Schools, Medical

A clinical observation was made on 19 patients of renal cell carcinoma who were treated by radical nephrectomy with extended retroperitoneal lymphadenectomy in the Department of Urology, Catholic Medical College during the period from May, 1980 to August, l985. Results were as follows; 1. Clinical stages by Robson`s staging system were 7 cases of stage I, 6 cases of stage II, 5 cases of stage III and 1 case of stage IV. Acuracy rate of clinical staging was 68.4%. 2. Pathologic stages were 8 cases of stage I, 5 cases of stage II, 4 cases of stage HI and 2 cases of stage IV. 3. Metastatic sites were perirenal fat(5 cases), regional lymphnode (2 cases), vessel(4 cases) and lung (2 cases). The rate of regional lymphnode involvement was 10.5%. 4. Postoperative complications were colocutaneous fistula (1 case), prolonged ileus (1 case) and pleural effusion (1 case). 5. Out of 19 cases 13 cases were alive without recurrence, 2 cases were alive with metastasis, 3 cases died with recurrence and 1 case died with other cause. 1 year survival rate was 77.8%.
Carcinoma, Renal Cell* ; Fistula ; Humans ; Ileus ; Lung ; Lymph Node Excision* ; Neoplasm Metastasis ; Nephrectomy* ; Pleural Effusion ; Postoperative Complications ; Recurrence ; Survival Rate ; Urology

NSAID-induced upper gastrointestinal (GI) damage occurs easily in people with a prior history of complicated or uncomplicated ulcers. Many recent clinical studies have proved the benefit of Helicobacter pylori eradication in NSAID users; however, the exact pathophysiologic relationship between concomitant H. pylori infection and NSAID use has not yet been fully elucidated. Testing and eradication of H. pylori are generally recommended in patients who are at a high risk for NSAID-induced GI damage. However, in high-risk patients, ulcer prophylaxis with proton pump inhibitor or misoprostol is needed even if H. pylori has been successfully eradicated. In low-risk patients, it is still questionable whether or not eradication of H. pylori can reduce upper GI damage. However, in western countries, due to its cost effectiveness, testing and eradication of H. pylori is recommended before starting aspirin or NSAID irrespective of the risk level. In regions with a high prevalence of H. pylori infection (>20%), the usefulness of testing and eradication of H. pylori has not yet been determined.
Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Aspirin/therapeutic use ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Humans ; Peptic Ulcer/*etiology ; Proton Pump Inhibitors/therapeutic use ; Risk Factors

PURPOSE: To summarize and review the methodological quality of the evidence from trials examining the effectiveness of physical exercise in patients undergoing allogeneic hematopoietic stem cell transplantation (Allo-HSCT). METHODS: Six randomized clinical trials (RCTs) were identified, reviewed for substantive results, and assessed for methodological quality. RESULTS: Six trials met all methodological criteria on the modified Jadad score above 3 out of 5 points. Failure to blind the outcome assessor, and failure to describe the method of blinding of outcome assessor appropriately were the most prevalent methodological shortcomings. Various exercise modalities have been applied, differing in content, frequency, intensity, and duration. Positive results have been observed in part for a diverse set of outcomes, including physical and psychological performance. CONCLUSION: The trials reviewed in this study were of moderate methodological quality. They suggest that exercise in patients undergoing Allo-HSCT may be safe and feasible, and in part patients benefit from increased physical performance both during and after transplantation. Future RCTs should use larger samples, appropriate comparison groups, and a standard of outcome measures, and examine what kind of exercise intervention (aerobic vs. resistance vs. combined) is the most effective for Allo-HSCT patients. It would be necessary to define contraindication for exercise to guarantee its safety.
Exercise ; Exercise Therapy ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Outcome Assessment (Health Care) ; Quality of Life ; Transplants

PURPOSE: The purpose of this study was to verify the relationship among depression, school adjustment, parent-child bonding, parental control and smartphone addiction, and to identify factors which influence smartphone addiction in adolescents. METHODS: A cross-sectional design was used, with a convenience sample of 183 middle school students from 3 middle schools. Data collection was conducted through self-report questionnaires from April to May, 2017. Data were analyzed using χ² test, Fisher's exact test, t-test, one-way ANOVA, correlation coefficient analysis, and binary logistic regression with SPSS Ver. 21.0. RESULTS: The mean score for smartphone addiction was 29.40. Of the adolescents, 21.3% were in the smartphone addiction risk group. Logistic regression analysis showed that gender (OR=7.09, 95% Cl: 2.57~19.52), school life (OR=0.86, 95% Cl: 0.79~0.93), smartphone usage time (OR=1.32, 95% Cl: 1.04~1.66), and parental control (OR=4.70, 95% Cl: 1.04~21.29) were effect factors for the smartphone addiction risk group. CONCLUSION: Findings indicate that school satisfaction was an important factor in adolescents' smartphone addiction. Control oriented parent management of adolescents' smartphone use did not reduce the risk of smartphone addiction and may have worsen the addiction. Future research is needed to improve understanding of how teachers and parents will manage their adolescents' use of smartphones.
Adolescent* ; Behavior, Addictive ; Data Collection ; Depression ; Humans ; Logistic Models ; Parents ; Smartphone*

We present a case of acquired tracheoesophageal fistula (TEF) which was found during induction of general anesthesia for clipping of aneurysm. The patient had been intubated with endotracheal tube for 10 days and then done tracheotomy for 45 days. Thereafter, TEF was confirmed by MRI and treated with fistula repair and tracheal fenestration. Acquired TEF can occur under the condition of prolonged tracheal intubation with high cuff pressure (>30 mmHg) and can also result from intratracheal neoplasm, mediastinitis, and other tracheal or esophageal damages. If unrecognized during anesthetic induction, TEF can cause gastric dilatation and rupture, pulmonary aspiration and respiratory failure. So early diagnosis and proper management is very important whenever TEF is suspected during anesthetic induction.
Anesthesia, General ; Aneurysm ; Early Diagnosis ; Fistula ; Gastric Dilatation ; Humans ; Intubation ; Magnetic Resonance Imaging ; Mediastinitis ; Respiratory Insufficiency ; Rupture ; Tracheoesophageal Fistula* ; Tracheotomy

We performed pars plana vitrectomy combined with anterior capsule-sparing lensectomy on forty three eyes WJth coexisting cataract and vitreoretinal disease and followed up more than 6 months. Preoperative vitreoretinal diseases consisted of nondiabetic vitreous hemorrhage (thirteen eyes), retained metallic intraocular foreign bodies (nine eyes), posterior uveitis (nine eyes), proliferative diabetic retinopathy (seven eyes) and rhegmatogenous retinal detachment (five eyes) . Thirty six eyes (84%) revealed the visual acuity of 0.1 or less before operation. Thirty eight eyes (88%) could get a better visual acuity after operation than before operation. Posterior chamber intraocular lenses were implanted to thirty eight eyes. The severity of anterior capsular opacity showed a statistically significant difference between the eyes with injection of intraocular gas or silicone oil and them without injection of that (p=0.004). In this study, we can find that the technique of pars plana vitrectomy combined with anterior capsule-sparing lensectomy would be recommendable and the anterior capsular opacity may have relation with intraocular gas or silicone oil.
Cataract ; Diabetic Retinopathy ; Foreign Bodies ; Lenses, Intraocular ; Retinal Detachment ; Silicone Oils ; Uveitis, Posterior ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

PURPOSE: Following the first in 1990, the use of course evaluations(CE) by medical schools across the Republic of Korea has grown steadily since 1997. The purpose of this study was to investigate these CE programs and to make general recommendations for further implementation. METHODS: A questionnaire survey was conducted by mail. From June 20 to September 22, 2006, data was obtained from 38 of the 41(93%) medical schools in the country. Of those who responded, 27 schools also sent their CE forms as requested. RESULTS: There was little difference among the 38 medical schools in the main body, methods, frequency, grades, systems of evaluation, and types of survey. Evaluation criteria such as instructor effectiveness, course management efficiency, and student satisfaction showed high frequency, whereas issues concerning learning objectives and workload were less common. In contrast, the stated purposes of employing CE varied from school to school. While 92% of the respondents regarded improvement to the quality of instruction as the goal of their programs, 32% indicated that CE results also factored in administrative decisions concerning promotion, tenure, and salary increases. CONCLUSION: In addition to embracing the expanding role and influence of CE in Korean medical education, schools must proactively enact measures to enhance further implementation. First, evaluation criteria should be better formulated to increase the consistency, reliability, and validity of CE results. Next, to promote efficiency, the scheduling and methodology of CE administration should carefully consider the medical curriculum. Finally, professional attitudes should be fostered to recognize the value of CE as a tool for raising educational standards overall.
Curriculum ; Surveys and Questionnaires ; Education, Medical ; Humans ; Learning ; Postal Service ; Republic of Korea ; Salaries and Fringe Benefits ; Schools, Medical*