This study was designed to evaluate the clinical manifestations and results of operative treatment in penile injury during erection. We reviewed 18 cases of penile injury during erection from December 1992 to June 1996. Of 18 patients, 14 patients were treated with early operation, 3 patients with conservative treatment and followup was 1 to 31 months (mean: 14.1 months). Patients age ranged from 23-76 years old (mean: 39.6 years), common cause of the injury was sexual intercourse (8 cases), masturbation (3 cases) and finger-pressure (2 cases) in order. Of 8 patients who occurred during sexual intercourse, 7 patients were married. The injury developed at midnight in 8 cases (44%), early morning in 7 cases (39%) and the other times in 3 cases (~7%). Of 14 patients who received with early operation, 13 patients revealed rapture of the corpus cavernosum and 1 patient revealed rupture of superficial dorsal vein. The site of penile fracture showed proximal shaft in 8 cases (62%), midshaft in 3 cases (23%) and distal shaft in 2 cases (15%) in order. The overall complication rate of early operative treatment was 15% (2 of 13 cases) compared to a complication rate of 100% (2 of 2 cases) for conservative treatment. In conclusion, our experience demonstrates that the most common cause and site of penile injury are sexual intercourse and proximal shaft, early operative treatment would be an effective treatment of penile injury to prevent complications.
Coitus ; Follow-Up Studies ; Humans ; Masturbation ; Rupture ; Veins

OBJECTIVES: The purpose of present study was to explore the differences of ego defense mechanisms between South Koreans, North Korean defectors in South Korea and Korean-Chinese in South Korea, and the correlations between ego defense mechanisms and perceptions of socio-cultural characteristics of these three groups. METHODS: The Defense Style Questionnaire and the Socio-Cultural Characteristic Questionnaire were administered to 100 South Koreans, 93 North Korean defectors and 86 Korean-Chinese. 21 North Korean defectors and 10 Korean-Chinese in South Korea were interviewed regarding the questionnaire results of the study. RESULTS: North Korean defectors used more active defense styles and emotion repressive defense styles than South Koreans. Korean-Chinese used more passive defense styles than North Korean defectors and South Koreans. North Korean defectors scored significantly higher than South Koreans on 'denial', 'splitting', 'withdrawal', 'suppression', 'altruism', 'task orientation' and 'anticipation' in the Defense Style Questionnaire. The defense styles were significantly related to the socio-cultural characteristics of the three countries. CONCLUSION: From our results it was inferred that there are differences in the defense styles among three groups, and the socio-cultural characteristics have effects on defense mechanisms. On the gasis of the results of this study, the direction of future study was discussed.
Defense Mechanisms ; Ego* ; Korea* ; Surveys and Questionnaires

BACKGROUND: Studies of immune response for cancer have demonstrated that the antitumor immune response plays a role in competing against the growth of cancer cells and is frequently altered in advanced cancer. METHODS: We evaluated the changes of peripheral blood lymphocytes and their subsets during preoperative and postoperative periods according to the time sequence of the postoperative condition in gastrointestinal carcinoma patients. Lymphocyte surface markers were determined in 39 stomach cancer patients and 33 colon cancer patients by using the indirect immunofluorescence technique with monoclonal antibodies. The patient's body weights, hemoglobin, hematocrits, total protein, and albumin were also measured preoperatively at and 1, 3, 6, 12, 18, and 24 months postoperatively. RESULTS: There were significant differences of clinico-laboratory findings between the preoperative and the postoperative periods except for hemoglobin, total protein, and albumin in postoperative course. The total leukocyte count significantly decreased from the postoperative 6th month. The lymphocyte count significantly increased from the postoperative 3rd month. The granulocytes decreased significantly in the postoperative 6th month. The T cells and B cells decreased in the postoperative 3rd month and 1st month, respectively. CD8 increased in the postoperative 3rd month and NK cells also increased in the postoperative 3rd, 6th and 24th months. Other peripheral lymphocytes and their subsets showed no significant differences. The changes in the lymphocyte subsets according to stage were not statistically significant (p<0.005). CONCLUSIONS: The postoperative changes in lymphocytes, granulocytes, and NK cells were significantly different compared with preoperative levels, but these results did not correlate with postoperative survival and recurrence rate because of the short postoperative follow-up periods.
Antibodies, Monoclonal ; B-Lymphocytes ; Body Weight ; Colonic Neoplasms ; Fluorescent Antibody Technique, Indirect ; Follow-Up Studies ; Granulocytes ; Hematocrit ; Humans ; Killer Cells, Natural ; Leukocyte Count ; Lymphocyte Count ; Lymphocyte Subsets ; Lymphocytes* ; Postoperative Period ; Recurrence ; Stomach Neoplasms ; T-Lymphocytes

PURPOSE: This research is to describe and identify the difficulties of compliance to medical regimen, by implementing interviews with hemodialysis patients. METHODS: The research data was collected from July, 2017 to October, 2017. In-depth interviews were implemented using a semi-structured questionnaire. The data were analyzed by qualitative content analysis method. RESULTS: The fourteen subjects diagnosed with chronic renal failure were attended. The difficulties of adherence to medical regimen that the hemodialysis patients feel consisted of 14 themes and they were categorized into five subjects; ‘Difficulty in practicing self-care’, ‘Repetition of Negative feelings’, ‘Withdrawal of Social activity’, ‘Lack of expertise’, ‘Uncertainty about the future’. CONCLUSION: To facilitate the hemodialysis patients' adherence to medical regimen, the change of their basic life style is required. Also, tailored nursing intervention considering not only their physical characteristics but also their psychological and affective characteristics is required to increase their self-management and adaptation to the disease.
Adult* ; Compliance ; Humans ; Kidney Failure, Chronic ; Life Style ; Methods ; Nursing ; Renal Dialysis* ; Self Care

Purpose: The purpose of this study was to construct and test a structural model of nursing students’ performing communication skills. Methods: The data collection was conducted from October 13 to October 20, 2020. The participants were 286 students from nursing colleges located in three cities. The data analysis method was a covariance structure analysis with using IBM SPSS statistics version 23.0 and AMOS 21.0 statistical programs. Results: The hypothetical model showed a proper fit with the data: root mean square error of approximation=.08, standardized root mean square residual=.06, adjusted goodness of fit=.85, normed fit index=.91, and comparative fit index=.94. The model fit indices were normed to fit index=2.96. Statistically significant explanatory variables for the performing communication skills of nursing students were peer support, emotional intelligence, ethical sensitivity, and communication self-efficacy. The variables accounted for 66.1% of the performing communication skills of nursing students. Conclusion Based on the above results, it appears necessary to develop strategies for improving the performing communication skills of nursing students, and having positive effects on health outcomes of the subjects by considering the variables of peer support, emotional intelligence, ethical sensitivity, and communication self-efficacy. Such strategies could potentially have positive effects on the health outcomes of the patients.

Acute appendicitis in children under the age of 12 has remained the surgical emergency condition with the highest percentage of misdiagnosis leading to removal of a normal appendix. From January 1994 to April 1997, 312 children (176 boys, 136 girls) were admitted to Jun-ang Gil Hospital with the impression of acute appendicitis. The average age was 8.6 years (2 to 12 years). We reviewed medical records retrospectively for demographics, presenting signs, symptoms, findings of abdominal ultrasonography (USG) and barium enemas, and surgical results. The patients were divided in 2 groups as follows: group I (n=144) received immediate operations without further evaluation, group II (n=168) was treated after a delay for observation and/or special studies (USG and/or barium enema). Group II was subdivided into Group IIa (n=119) (treatment after study) and Group IIb (n=49)(treatment by clinical observations only). In group I, 124 patients were confirmed intraoperatively as having acute appendicitis, and 20 cases were not. In IIa, 36 patients underwent exploratory surgery and 30 cases revealed acute appendicitis. The remaining 83 patients were discharged because of symptomatic relief. In group IIb, 43 patients underwent exploratory surgery and acute appendicitis was revealed in 35. The diagnostic accuracies of groups were 86%, 95% and 84%. The sensitivity, specificity and diagnostic accuracy of an abdominal ultrasonography (n=105) were 96.1%, 82.1% and 92.4%, respectively. Those of a barium enema (n=63) were 94.7%, 100%, and 95.2% respectively. When both modalities were used (n=49), the results were 95.6%, 100% and 95.9%, respectively. The frequencies of a perforated appendicitis had no difference among the groups. In conclusion, in a child suspected of having acute appendicitis, if there are no apparent toxic signs or panperitonitis, surgical observation, USG, and/or a barium enema can decrease the number of unnecessary appendectomy without increasing the risk of perforation.
Appendectomy ; Appendicitis* ; Appendix ; Barium ; Child* ; Demography ; Diagnostic Errors ; Emergencies ; Enema ; Humans ; Medical Records ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium*

Being described first 1912 by Hashimoto, Chronic lymphocytic thyroiditis has been most commonly diagnosed as inflammatory thyroid disease. Despite of worldwide reports about the concomitant malignancy with Hashimoto's thyroiditis, the definite incidence of coexsiting malignancy and the etiologic relationship between these different pathologic conditions remains to be brought out. Analyzing 18 cases of coexisting thyroid carcinoma among 80 cases of Hashimoto's thyroiditis, confirmed by pathologic study at Presbyterian medical center in Chonju between 1991 and 1995, the authors intended to make guideline of management for them. The results are as follows: 1. The incidence of coexisting carcinoma with HT was 18/80(22.5%). 2. The average age of patients with coexisting carcinoma was 44.1 years and all of them were female.3. Cold nodules on thyroid scan were noticed in 23 cases(22.7%) of HT and 7 cases(33.8%) of coexisting carcinoma with HT. 4. Calcified lesions on thyroid sonography were detected in 0 cases of HT and 4 cases(50%) of coexisting carcinoma. 5. The pathologic types of carcinoma were papillary(17/18, 94.4%) and follicular(1/18, 5.6%). 6. 3 cases of coexisting carcinoma had metastatic lesions on peritracheal lymph nodes and another 3 cases had on ipsilateral jugular nodes. 7. The carcinoma of smaller than 0.5cm were 7 cases, of 0.6-1.0cm were 3 cases, of 1.1-1.5cm were 5 cases, and so 15 cases(83.3%) were occult carcinoma. Only 3 cases were larger than 1.6cm. 8. Coexisting carcinoma patients with HT underwent subtotal thyroidectomy (4 cases), subtotal thyroidectomy & anterior compartment dissection (ACD, 6 cases), subtotal thyroidectomy & modified RND (2 cases), thyroid lobectomy & ACD (4 cases), thyroid lobectomy & modified RND (1 cases), or near total thyroidectomy & ACD (1 case).
Hashimoto Disease ; Humans ; Incidence ; Jeollabuk-do ; Lymph Nodes ; Protestantism ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyroiditis*

Extramammary Pagets disease(EMPD) of the vulva is an uncommon neoplasm which accounting for 2.5% of all vulvar malignancies and 0.02% of all female cancer. Several hundred cases have been reported worldwide since the first description by sir James Paget in 1874, It generally affects postrnenopausal age poup and presents high rate of recurrence but the precise incidence remines unclear, Although Paget's disease of the breast and the vulva are histologically similar, their histogenesis and biological behavior are considered to be significantly different and EMPD has gcnerally perceived rnore benign compared to that of the breast. Four histologic forms of vulvar EMPD have been recognized and treated vulvar EMPD in according to the 4 histologic classification. The high rate of recurtence disease remains a challenge for optimal management. Recently we experienced a case of Paget's disease of the vulva, diagnosed as an intraepithelial Pagets disease preoperatively and underwent radical vulvectomy and superiomedial thigh(SMT) flap, and present with a brief review of literature.
Breast ; Classification ; Female ; Humans ; Incidence ; Paget's Disease, Mammary ; Recurrence ; Vulva*

Objective: In September 2018, the traffic law revision has enforced all passengers in cars to wear seatbelts. Our study aims to investigate the effects of this law revision on fellow passengers involved in car accidents by considering their seatbelt-wearing rate and severity score. Methods: This study is a retrospective observational study. Data were collected from the Emergency Department-based Injury in-depth Surveillance (for the years 2017 and 2019), Korea Disease Control and Prevention Agency. Candidates were patients who visited emergency rooms (ERs) of 23 hospitals from January to December in the years 2017 and 2019. Patients under the age of 15 years or without Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS) data or having accidents on highways were excluded. Results: The total number of patients who visited ERs during the study periods was 91,506 and 14,806 in 2017 and 2019, respectively, and were included in our study. There were more fellow female passengers than male passengers during both the study periods: 5,559 in 2017 (67.9%) and 4,341 in 2019 (66.8%). Compared to 52.2% in 2017, the rate of wearing seatbelts increased to 54.5% in 2019. However, after adjusting for age, sex, use of ambulance, injury time, alcohol use, type of road, and counterpart, multivariate logistic regression revealed that compared to the 2017 group, the odds ratio of severe injuries in the 2019 group was 1.10 (95% confidence interval, 0.98-1.24). Conclusion Increased rate of wearing seatbelts after imposing the traffic law revision was not satisfactory. Therefore, it is necessary to tighten regulations on fellow passengers without seat belts and improve awareness through public relations.