BACKGROUND: Computerized topography(CT) is the method of choice for establishing patients with abdominal and/or pelvic trauma. However, the sensitivity of CT far detecting bladder rupture has been questioned. We investigated the roles of CT as the initial evaluation of abdominal and pelvic trauma in diagnosis of bladder rupture. METHODS: We reviewed the medical records and radiographs of 53 patients with bladder rupture for last 5 year. And among them, all radiographs of 30 patients who underwent both CT and retrograde cystography were evaluated independently by two urologists who had no knowledge of the patients' final diagnosis. RESULTS: Among 30 patients, all of patients were correctly diagnosed by retrograde cystography, but the CT diagnosis was correct in only 23 patients(76.7%), who were 17 patients(85.0%) with intraperitoneal rupture and 6 patients(60%) with extraperitoneal rupture. And of the 7 patients who were negative by the CT, all showed the sign of inadequate bladder distension. CONCLUSION: We suggest that CT, if properly performed with adequate bladder filling, is as sensitive for detection of bladder injuries as conventional cystography. Especially, in trauma patients with hematuria and suspected other organ injury, CT-cystography with retrograde filing may be as accurate as conventional cystography and obviate the need for an additional plain film cystography,
Diagnosis* ; Hematuria ; Humans ; Medical Records ; Rupture ; Urinary Bladder*

The displaced femoral neck fracture continues to be a difficult problems such as high percentage of avascular necrosis and non-union. Compression hip screw was designed to aliow firm impaction at the time of operation and secondarily, for continued impaction if resorption occurs at the fracture line during healing. 22 cases of femoral neck fracture treated by compression hip screw in the department of orthopaedic surgery at National Medical Center were analyzed, and results were as follow. 1. The average of patient was fifty-three years, and man was predominant. 2. Average 8.9 days was elapsed from initial injury to hospital, and good results were observed in the cases of operation within 3 days. 3. The end results were good when the fragment was reduced within 165°–180° of Garden's angle in A-P film and 20° of anterior and posterior angulation in lateral film. 4. The good results were observed in the position of the screw center and low in A-P film, and center and posterior in lateral film. 5. The positive findings of the intraosseous-venogram was observed in 6 weeks from operation and apparent in all cases done after 6 months. 6. Bony union was obtained within 5.9 months, and avascular necrosis was established in 29 months. 7. Developed 3 avascular necrosis, 1 non-union, and 2 degenerative arthritis of 22 cases.
Femoral Neck Fractures ; Femur ; Hip ; Humans ; Neck ; Necrosis ; Osteoarthritis

No abstract available.
Melanosis*

Primary carcinoma of the uterine tube is one of the least common gynecologic malignancies with a reported incidence of approximately 0.3%. As a result of it, the experience of any one physian is limited. Almost all cases are adenocarcinoma and the cilinical presentation is generally nonspecific, of which the most common symptom is postmenopausal vaginal bleeding. Primary fallopian tube carcinima is infrequently diagnosed before explolatory laparotomy and the majority of patients have extensive disease at diagnosis. We have experienced a case of fallopian tube cancer and report with brief review of literature
Adenocarcinoma ; Diagnosis ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Humans ; Incidence ; Laparotomy ; Uterine Hemorrhage

BACKGROUND: There are many rating scales for assessment of geriatrics. But each of these scales were not sufficient to evaluate comprehensive geriatric assessment, physical and psychologic efforts for care. METHODS: We developed new scales to comprehensive geriatric assessment for care of geriatric patients. The Geriatrics Physical Support Scale(GPSS) evaluates physical effort consists of 10 areas and the Geriatrics Global Support Scale(GGSS) evaluates general condition of patients consist of 6 areas. Eighty probable and possible AD patients received the Clinical Dementia Rating Rating Scale(CDR), Korearn version of Mini-Mental State Examination(K-MMSE), Barthel Activity of Daily Living Index(B-ADL) GPSS, GGSS. We tested internal consistency, correlation among dementia rating scales. RESULTS: The GPSS correlated to CDR -0.63(p<0.01), B-ADL -0.90(p<0.01) and the GGSS correlated to CDR -0.60(p<0.01), B-ADL -0.75(p<0.01). The internal consistency were 0.69(GGSS), 0.92(GPSS). CONCLUSION: The Geriatrics Global Support Scale evaluate general condition of patients and the Geriatrics Physical Support Scale evaluate physical efforts needed for care of geriatric patients. These scales an also brief and easy rating scales to grade degree of caregiver`s burden.
Dementia ; Geriatric Assessment ; Geriatrics* ; Humans ; Physical Exertion ; Reproducibility of Results* ; Weights and Measures

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

The inverted nipple presents many problems including both cosmetic and functional aspects and impairment in breast feeding. the histopathologic characters of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. Many surgical and non-surgical techniques have been designed for correction of the inverted nipple. But most of these techniques have produced unsatisfactory problems. especially undesirable recurrence is most important problem. We experienced 19 inverted nipples in 12 patients between March 1995 and January 1998. We combined modified Teimourian method, purse-string suture and Z-plasty. and had good result for 3weeks to 30months follow up. This method was effective for correction of the inverted nipple with low recurrence rate and simple techniques.
Breast Feeding ; Follow-Up Studies ; Humans ; Nipples* ; Recurrence ; Sutures

PURPOSE: To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions. METHODS: The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. RESULTS: The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. CONCLUSION: Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists.
Clinical Decision-Making ; Curriculum ; Diagnosis ; Humans ; Job Description* ; Korea ; Learning* ; Licensure* ; Physical Therapists*

BACKGROUND: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. MATERIAL AND METHOD: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. RESULT: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186+/-40cc, control group:409+/-69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317+/-53cc, control group: 671+/-133cc, P=0.024). CONCLUSION: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.
Adult* ; Aprotinin* ; Cardiopulmonary Bypass ; Creatinine ; Hemorrhage ; Humans ; Retrospective Studies ; Thoracic Surgery