We investigated whether early catheter removal after operation could affect the result and morbidity or TURP. We reviewed 99 charts of 118 consecutive BPH patients who underwent TURP during 1991. Since August 1991 we changed our philosophy and started to remove the catheter on postoperative day 1. Prior to that time catheter was removed three to five days postoperatively. There were 42 patients in early catheter removal group and 57 patients in traditional group. Nine- teen cases were ruled out due to the protocol violation or loss during follow-up. All operations were performed by the same surgeon. There was no significant differences between two groups in terms of patient`s age, symptom scores, operation time, resected specimen weight and the amount of used irrigating solution. No statistical differences between the complications of both groups was seen. Of the early removal group 6(14%) required reinsertion of the catheter following initial removal and 4 (10%) required blood transfusions. In conventional group 5(9%) required recatheterization and 5 (9%) required transfusion. Other complications were not remarkable. The average hospital stay postoperatively was 2.2 days in early removal group and 6.2 days in traditional group. The average costs saving for patients in early removal group was about won 140,000(about dollers 200). These results suggest that early removal of the catheter could be allowed as a routine postoperative management following TURP, thereby reducing the length of hospital stay and costs.
Adolescent ; Blood Transfusion ; Catheters* ; Catheters, Indwelling ; Follow-Up Studies ; Humans ; Length of Stay ; Philosophy ; Prostate* ; Prostatic Hyperplasia ; Transurethral Resection of Prostate

To evaluate the efficacy and safety of topical NSAIDs and topical anesthetics on post-PRK pain control, we performed a prospective, randomized, paralle group, placebe-controlled study of 105 consecutive eyes having excimer laser PRK, that were divided into 7 pain management groups. The groups were arranged in order, Group 1: Suprofen(Profenal), Group 2: Diclofenac I(Naclof), Group 3: Diclofenac II (Decrol), Group 4: diluted proparacaine, Group 5: Diclofenac I(Naclof)+diluted proparacaine, Group 6: Fluorometholone, Group 7(conrol): Tears Naturale. Results were evaluated by several types of questionnaires and pain score was recorded using visual analogue scale. Corneal epithelial defect area was measured on post-operative day 1, 2, 3, 4 and 1 week. Diclofenac-treated groups showed the best analgesic effect and the least discomfort at instillation. Diclofenac, used with diluted proparacaine, had some additive effect on pain control, but not statistically significant. Full epithelial closure occurred in all eyes within 4 days without any clinically significant complications. Topical diclofenac and combinatin with diluted proparacaine can be used in post-PRK pain management effectively and safely.
Anesthetics ; Anti-Inflammatory Agents, Non-Steroidal* ; Diclofenac ; Fluorometholone ; Lasers, Excimer ; Pain Management ; Prospective Studies ; Surveys and Questionnaires

Spinal fixation using pedicle screws has recently been the focus of increased attention, but the adequate size of pedicle screw and maximum percentage fill as related to the pedicle diameter and are not well known. The objects of this study were to determine the ideal ratio among pedicle, drill and screw diameter, and to determine the maximum percentage fill of the screw without significant decrease of pull-out strength. The materials used for the experiments were 376 thoracic pedicles obtained from the 38 young pigs, and the diameters of pedicles ranged from 3.0 to 8.5mm. After 40% to 100% drilling as compared to pedicle diameter, screws were inserted carefully, and measurements were taken of the outer pedicle changes and pull-out strengths, and adequate drill and screw sizes as related to the diameters of given pedicles were determined. It was found that pull-out strength was the strongest after 60% drill, and the larger the drill diameter, the smaller the holding power, and the larger the screw diameter, the greater the holding power. Maximum pull-out strength was seen at 80-90% fill with 60% drill. After sequentially drilling each pedicle with increasingly larger drill bits, larger screws could be inserted with pedicle changes such as expansion, cutout, split fracture, and comminuted fracture. after larger drilling up to 100%, pedicle screws with diameters smaller than 115% of measured pedicle diameters could be safly inserted without fracture and significant decrease of pull-out strength. It is concluded that effective percentages of drill and screw diameters to the pedicle diameter are 60% and 80-90% respectively, and pedicle screw up to 115% of measured pedicle diameter can be safely inserted into pedicle without significant decrease of pull-out strength. It is thought that fresh pedicle has elasticity and larger screw can be inserted to the pedicle with strong holding after larger drilling.
Elasticity ; Fractures, Comminuted ; Pedicle Screws ; Swine

Objective: This study aimed to investigate the impact of reduced bed capacity in the intensive care unit (ICU) on emergency department (ED) length of stay (LOS) and prognosis of critically ill patients. Methods: This retrospective observational study included patients who presented to a university hospital ED and were admitted to the ICU between August 2017 and July 2019. In our center, the number of beds in the traumatic ICU was maintained, while the number of beds in the non-traumatic ICU was reduced. We comparatively assessed ED LOS and the mortality rate between traumatic and non-traumatic patients over 2 years (1 year before and after the reduced number of beds in the non-traumatic ICU) to determine the impact of reduced ICU bed capacity. Also, a multivariate logistic regression analysis was performed to identify the risk factors related to in-hospital mortality. Results: A total of 2,945 patients were included in this study. In the traumatic ICU patient group, the ED LOS did not change (2.62 [1.95-3.72] hours vs. 2.78 [2.01-3.92] hours, P=0.079) after reducing the number of ICU beds; and no significant difference in mortality rate was noted (19.5% vs. 17.6%, P=0.417). In the non-traumatic ICU patient group, both ED LOS (prolonged by 1.69 hours, 3.46 [2.17-5.66] hours vs. 5.15 [3.43-8.37] hours, P<0.001) and mortality rate (21.6% vs. 25.8%, P=0.003) were significantly increased after reducing the number of ICU beds. In the multivariate logistic regression analysis, ED LOS was identified as a risk factor for in-hospital mortality (odds ratio, 1.035; P<0.001). Conclusion In this study, the reduced ICU bed capacity resulted in prolonged ED LOS of critically ill patients, which consequently contributed to increased in-hospital mortality.

Objective: This study aimed to investigate the impact of reduced bed capacity in the intensive care unit (ICU) on emergency department (ED) length of stay (LOS) and prognosis of critically ill patients. Methods: This retrospective observational study included patients who presented to a university hospital ED and were admitted to the ICU between August 2017 and July 2019. In our center, the number of beds in the traumatic ICU was maintained, while the number of beds in the non-traumatic ICU was reduced. We comparatively assessed ED LOS and the mortality rate between traumatic and non-traumatic patients over 2 years (1 year before and after the reduced number of beds in the non-traumatic ICU) to determine the impact of reduced ICU bed capacity. Also, a multivariate logistic regression analysis was performed to identify the risk factors related to in-hospital mortality. Results: A total of 2,945 patients were included in this study. In the traumatic ICU patient group, the ED LOS did not change (2.62 [1.95-3.72] hours vs. 2.78 [2.01-3.92] hours, P=0.079) after reducing the number of ICU beds; and no significant difference in mortality rate was noted (19.5% vs. 17.6%, P=0.417). In the non-traumatic ICU patient group, both ED LOS (prolonged by 1.69 hours, 3.46 [2.17-5.66] hours vs. 5.15 [3.43-8.37] hours, P<0.001) and mortality rate (21.6% vs. 25.8%, P=0.003) were significantly increased after reducing the number of ICU beds. In the multivariate logistic regression analysis, ED LOS was identified as a risk factor for in-hospital mortality (odds ratio, 1.035; P<0.001). Conclusion In this study, the reduced ICU bed capacity resulted in prolonged ED LOS of critically ill patients, which consequently contributed to increased in-hospital mortality.

Since Wands et al. reported for the first time in 1975 the reactivation of the hepatitis B virus in hematologic disease patients who had been receiving chemotherapy, the efficacy of chemotherapy and immunosuppressants has improved. As a result, the frequency of the reactivation of hepatitis B is increasing. Reported herein is a case of a non-Hodgkin lymphoma patient in her 70s who was suspected to have had HBsAg negative/anti-HBs negative occult HBV infection. The patient experienced fulminant hepatitis caused by the reactivation of hepatitis B, and died three months after the R-CHOP regimen was completed. In the HBsAg negative plus HBV DNA-negative case, there were few instances of viral activation of HBV. In this case, antiviral therapy was needed when the patient was confirmed to have become HBV DNA positive through regular monitoring, but its necessity is often overlooked, unlike the preemptive antiviral treatment in the HBsAg positive cases.
DNA ; Drug Therapy* ; Hematologic Diseases ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Virus Activation ; Rituximab

PURPOSE: Autogenous cartilage is generally first choice in rhinoplasty because of its biocompatibility and resistance to infection. On the other hand, allogeneous cartilage graft might preferred over an autogenous graft to avoid additional donor site scars, morbidity and lengthened operating time. Allogenous costal cartilage(Tutoplast(R)) not only have the advantage of averting donor site morbidity but also are resistant to infection, resembling autogenous cartilage graft. We report here a technique for rhinoplasty by using allogenous costal cartilage graft. METHODS: Through open rhinoplastic approach, alar cartilage is released from upper lateral cartilage and relocated caudally. After relocation of alar cartilage, allogenous costal cartilage is immobilized by nonabsorbable suture material at caudal aspect of septal cartilage. Caudal end of allogenous costal cartilage is sutured between medial crura of alar cartilage. Tip projection is improved by using interdormal suture, transdormal suture and shield-shape cartilage graft which is harvested from concha RESULTS: No significant resorption and infection was detected in any of patients. Aesthetic and functional results were satisfactory. CONCLUSION: The low incidence of major complication and versatility of allogeneous costal cartilage graft make safe and reliable source of cartilage graft in rhinoplasty
Cartilage ; Cicatrix ; Hand ; Humans ; Imidazoles ; Incidence ; Nitro Compounds ; Nose ; Rhinoplasty ; Succinates ; Sutures ; Tissue Donors ; Transplants

PURPOSE: Autogenous cartilage is generally first choice in rhinoplasty because of its biocompatibility and resistance to infection. On the other hand, allogeneous cartilage graft might preferred over an autogenous graft to avoid additional donor site scars, morbidity and lengthened operating time. Allogenous costal cartilage(Tutoplast(R)) not only have the advantage of averting donor site morbidity but also are resistant to infection, resembling autogenous cartilage graft. We report here a technique for rhinoplasty by using allogenous costal cartilage graft. METHODS: Through open rhinoplastic approach, alar cartilage is released from upper lateral cartilage and relocated caudally. After relocation of alar cartilage, allogenous costal cartilage is immobilized by nonabsorbable suture material at caudal aspect of septal cartilage. Caudal end of allogenous costal cartilage is sutured between medial crura of alar cartilage. Tip projection is improved by using interdormal suture, transdormal suture and shield-shape cartilage graft which is harvested from concha RESULTS: No significant resorption and infection was detected in any of patients. Aesthetic and functional results were satisfactory. CONCLUSION: The low incidence of major complication and versatility of allogeneous costal cartilage graft make safe and reliable source of cartilage graft in rhinoplasty
Cartilage ; Cicatrix ; Hand ; Humans ; Imidazoles ; Incidence ; Nitro Compounds ; Nose ; Rhinoplasty ; Succinates ; Sutures ; Tissue Donors ; Transplants

The presently available neuroradiological techniques including computed tomography and 4-vessel angiography, fail to identify any causes in 13% to 22% of patients with a subarachnoid hemorrhage. Recently, we experienced two small unexpected internal carotid artery aneurysms during the anterior communicating artery aneurysm and basilar tip aneurysm surgery respectively. In general, the approach for aneurysm surgery was confined to the local aneurysm site with local cisternal opening. But we had performeda wide cisternal opening for the anterior communicating and basilar tip aneurysm surgery and we found unexpected angiogrram-negative aneurysm. These findings lead us to propose to a surgical approach of usual intracranial aneurysms. Therefore we recommend the approach of opening predilection sites(including MCA knee portion, ICA bifurcation area) of intracranial aneurysms during all intracranial aneurysm surgery.
Aneurysm* ; Angiography ; Carotid Artery, Internal ; Humans ; Incidental Findings* ; Intracranial Aneurysm ; Knee ; Subarachnoid Hemorrhage

PURPOSE: To assess clinical features of sensory exotropia with distant-near disparity, surgical outcome, and compare according to amount of medical rectus resection. METHODS: Authors retrospectively reviewed medical records of patients of sensory exotropia with follow-up over 6 months. We defined patients with over 10 prism diopter (PD) disparity as distant-near disparity sensory exotropia (DND-XT) and without disparity as basic sensory exotropia (B-XT). First, we analyzed and compared data of visual acuity, cause and age of visual loss, amount of deviation. Second, Surgical failure was analyzed with dividing DND-XT into conventional surgery group as Parks' formula and reduced medial rectus resection group in accordance with disparity. Surgical success was defined as less than 10 PD deviation in distant, near fixation. RESULTS: B-XT consisted of 58 patients (40 males) and DND-XT of 33 patient (13 males). There was no significant difference between 2 groups in onset and cause of visual loss, deviation at distant fixation. But, log MAR visual acuity of worse eye was better in DND-XT than B-XT (1.74 +/- 0.78, vs. 2.10 +/- 0.74, p = 0.039). Average deviation in distant fixation in DND-XT was 46.55 +/- 16.59 PD in distant and 14.93 +/- 8.91 PD in near fixation. All patients underwent surgery of medial rectus resection and lateral rectus recession and average deviation was 6.83 +/- 7.71 PD at distant fixation, 3.02 +/- 0.69 PD at near fixation at last follow-up. Among 33 patients, 16 patients underwent conventional amount of surgery and 17 patients with reduced medial rectus resection. In patient with conventional surgery, 9 patients were surgical failure (8 patients of over-, 1 patient of under-correction) but in patient with reduced amount of resection, only 1 patient was under-correction. CONCLUSIONS: As a result of medial rectus resection and lateral rectus recession in DND-XT, more surgical failures due to over-correction were observed with conventional resection and higher surgical success was attained in consideration of disparity.
Exotropia* ; Follow-Up Studies ; Humans ; Medical Records ; Retrospective Studies ; Visual Acuity