No abstract available.
Urachus*

No abstract available.
Biopsy*

PURPOSE: A varicocele is the most common correctable cause of infertility in men. Conventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, varicoele persistence and recurrence. The inguinal approach with classic Palomo technique was used to be simplified the procedure and to get the same good results with the Palomo technique. MATERIALS AND METHODS: From March 1990 to March 1997, we experienced surgical corrections of 54 patients with varicocele(A mean age 20.3 years) The most of patients were left-sided(96.3%). Until March 1996, surgical correction with Palomo(6 patients) and modified Palomo(13 patients) technique by retroperitoneal approach and Ivanissevich techrique(20 patients) by inguinal approach have been performed, and since April 1996, Palomo technique(15 patients) with inguinal approach has been performed, in which the entire vascular pedicle is ligated superior to the entrance of the was deferens through the inguinal incision. RESULTS: The postoperative recurrences in the modified Palomo technique occurred In two of the 13 patients(15%) and in the Ivanissevich technique in three of the 20 patients(15%). But there were no recurrences In the retroperitoneal Palomo and modified inguinal Palomo techniques. The modified inguinal Palomo technique was completed within 45.3minutes in mean duration, but the standard retroperitoneal Palomo technique within 55.2minutes, modified Palomo technique within 57.2minutes and Ivanissevich technique within 51.4minutes. There was no varicocele recurrence, hydrocele and atrophy of testis in modified inguinal Palomo techniques. CONCLUSIONS: The modified inguinal Palomo technique was easily approachable and relatively fast in our experience and had no recurrence.
Atrophy ; Humans ; Infertility ; Male ; Recurrence ; Testis ; Varicocele*

In this study, the number of physicians presently living in Korea thoroughly estimated by several means and, on this bases, their productivity and level of supply were estimated. The results were as follows : First, the number of physicians who did not notify the Korea Medical Association in May 1987 were 10,110, including 4,093 emigrant physicians(40.5%), 861 military medical officers, 745 public health doctors, and 107 decreased physicians. A total of 1,330 physicians could not be identified by any effort. Second, among the 34,897 registered physicians as of May 1987, 29,933(85.8%) were residing in Korea, 4,115 physicians(11.8%) had emigrated to other countries, and 849 physicians(2.4%) were decreased. Practicing physicians defined as those in Korea who were not retired, serving in the military, or completing residencies or internships, comprised 78.6%(27,414 physicians) of the total number of registered physicians. Third, it is estimated that in the year 2000 the number of registered physicians, physicians residing in Korea, and practicing physician will be 75,040, 64,038 and 57,655, respectively and these are increases of 115.0%, 113,9%, and 110.3%, respectively, compared to 1987. Fourth, the population physician ratio will be 759 to one physician in the year 2000. Fifth, the productivity of physicians, as calculated by relative values defining the productivity of 35 to 44 year-old male physicians as 10, will increase 110.7% in the year 2000 compare to that of 1987, and this increment is almost the same level as that of physicians supply. From the results of the present analysis of physicians manpower and supply projection, it can be recognized that the development of a regular notification system is necessary in order to identify precisely the number of physicians. Also a policy a physician supply is essential in order to adjust in advance the number of physicians, otherwise there will be surplus to the medical demand.
Adult ; Efficiency ; Emigrants and Immigrants ; Humans ; Internship and Residency ; Korea* ; Male ; Military Personnel ; Public Health

The World Health Organization (WHO) announced the emergence of a novel influenza on April 24, 2009, and they declared pandemic on June 11. In Korea, the proportion of influenza-like illness and the consumption of antiviral agents peaked in early November. The government established the Central Headquarters for Influenza Control and operated the emergency response system. In the quarantine stations, we checked the body temperature and collected quarantine questionnaires from all the arrivals from infected countries. We also isolated the confirmed cases in the national isolation hospitals. However, as the community outbreaks were reported, we changed strategy from containment to mitigation. We changed the antiviral agent prescription guideline so that doctors could prescribe antiviral agents to all patients with acute febrile respiratory illness, without a laboratory diagnosis. Also the 470 designated hospitals were activated to enhance the efficacy of treatment. We vaccinated about 12 million people and manage the adverse event following the immunization management system. In 2010, we will establish additional national isolation wards and support hospitals to establish fever clinics and isolation intensive care unit (ICU) beds. We will also make a computer program for managing the national isolation hospitals and designated hospitals. We will establish isolation rooms and expand the laboratory in quarantine stations and we will construct a bio-safety level 3 laboratory in each province. In addition, we plan to construct a bio-safety level 4 laboratory at a new Korea Centers for Disease Control and Prevention (KCDC) facilities in Ossong.
Antiviral Agents/therapeutic use ; Disaster Planning/*organization & administration ; *Disease Outbreaks ; Humans ; *Influenza A Virus, H1N1 Subtype ; Influenza, Human/drug therapy/*epidemiology ; Quarantine/organization & administration ; Republic of Korea/epidemiology ; World Health Organization

PURPOSE: Mesenteric vascular disease is a rare group of diseases including dissection, embolism, atherosclerosis, and venous thrombosis. Technical advances have led to increased diagnostic rates and new treatments with improved outcomes. The purpose of this study was to analyze the characteristics, methods of diagnosis, treatments, and outcomes of patients with mesenteric vascular diseases at our institution. METHODS: Between November 2003 and April 2010, 30 patients with mesenteric vascular disease diagnosed and treated at Seoul National University Bundang Hospital were reviewed retrospectively. Demographic data, etiology, treatment modality, and outcomes, including complications and mortalities, were analyzed. RESULTS: The mean age of the patients was 63.2 years (range, 43~91 years) and there was a male predominance (21 males vs. 9 females). The etiologies were superior mesenteric artery (SMA) dissection (n=13), SMA embolism (n=8), SMA atherosclerosis (n=5), and superior mesenteric vein thrombosis (n=4). Eleven patients underwent surgical treatment, while 11 patients underwent endovascular intervention and ten patients underwent conservative therapy with or without medication. No recurrence of symptoms or thrombosis was observed, except for one case of surgical thrombectomy, which underwent an endovascular aspiration thrombectomy with thrombolysis 9 days after the surgery. Two cases of technical endovascular treatment failure occurred, and one case of mortality after an endovascular stent insertion was observed. CONCLUSION: The incidence of mesenteric vascular diseases is increasing, and clinical manifestations and prognosis may vary from minor to life-threatening conditions. Early diagnosis is very important and the appropriate choice between endovascular intervention and a surgical approach may lead to good treatment results.
Atherosclerosis ; Early Diagnosis ; Embolism ; Humans ; Incidence ; Ischemia ; Male ; Mesenteric Arteries ; Mesenteric Artery, Superior ; Mesenteric Veins ; Prognosis ; Recurrence ; Retrospective Studies ; Stents ; Thrombectomy ; Thrombosis ; Treatment Failure ; Vascular Diseases ; Venous Thrombosis

The loss of penile skin, either traumatic or iatrogenic, is sometimes difficult to treat. The classical modes of surgical treatment are a thick split thickness graft and burial beneath the scrotal skin. Apron method, one stage penoplasty using the scrotal skin flap in the treatment of penile denudation, is reported herein.
Burial ; Male ; Penis* ; Skin ; Transplants

Although pancreatic leiomyosarcoma (PLM) is a rare malignant pancreatic cancer, it usually shows aggressive biological features such as invasion to an adjacent organ or distant metastasis at the time of diagnosis. Radical resection is the best treatment modality but effective chemotherapies have not been identified. A 58-year-old female was referred to us complaining of intermittent left upper quadrant abdominal discomfort. Imaging studies revealed a 10-cm mass in the pancreatic tail. The patient underwent laparoscopic distal pancreatectomy with splenectomy, and the pathological findings were consistent with PLM. Imaging studies 14 months after surgery revealed multiple liver metastases. Because the patient was young with a sufficient remnant liver, we performed laparoscopic metastatectomy without any postoperative complications. Patients with PLM need frequent check-ups, even after curative resection. The role of laparoscopic resection should be confirmed in the future.
Diagnosis ; Drug Therapy ; Female ; Humans ; Laparoscopy ; Leiomyosarcoma* ; Liver* ; Middle Aged ; Neoplasm Metastasis* ; Pancreatectomy ; Pancreatic Neoplasms ; Postoperative Complications ; Splenectomy ; Tail

Background: The aim of this study was to determine if it was feasible and safe to perform total hip arthroplasty (THA) using the direct anterior approach (DAA) when compared with the conventional posterolateral approach (PA) in patients with femoral neck fractures. The time required to start walking was investigated to identify advantages of the muscle-sparing approach. Safety of the approach was judged based on the incidence and nature of all complications. Methods: We retrospectively reviewed 67 THA cases due to femoral neck fractures from October 2015 to January 2019. The PA was used in 31 cases, and the DAA was used in 36 cases. The average operative time and amount of bleeding were evaluated. Cup inclination, anteversion, and leg length discrepancy (LLD) were also measured on radiographs. The time to start walking and complications (e.g., intraoperative fracture, infection, and dislocation) were recorded. Results: The mean operative time was 84.35 ± 13.95 minutes in PA group and 99.22 ± 20.33 minutes in DAA group (p = 0.010). But after experiencing 20 cases using the DAA, there was no statistically significant difference in the operative time between the groups. The mean volume of bleeding was 428.73 ± 207.26 mL in the PA group and 482.47 ± 150.14 mL in the DAA group. There was no difference in the acetabular cup position between two groups. Ambulation was started at 3.94 days after surgery on average in the PA group and 3.14 days in the DAA group, showing a statistically significant difference. Intraoperative fracture and infection were not observed in either group. The incidence of LLD was 1 in each group. The dislocation rate was 3.2% (1 case) in the PA group and 5.5% (2 cases) in the DAA group. Conclusions Although the DAA for THA was similar to the PA in terms of operative time, volume of bleeding, and complications, the DAA showed a great advantage in early rehabilitation as a muscle-sparing procedure in the elderly with femoral neck fractures.

OBJECTIVE: To investigate the mode of the development of osteoporosis in hemiplegic stroke patients and to study the change in bone mineral density (BMD) in relation to stroke duration and affected sides. METHOD: The subjects were 79 hemiplegic stroke patients (39 males, 40 felames, mean age 61.9 years). We measured the BMD of the subjects, compared the BMD of affected sides with that of unaffected sides, and evaluate the BMD in connection with stroke duration and affected sides. RESULTS: The reduction of the BMD in affected sides was highly correlated with the duration of hemiplegia, but the correlation was not shown in the case of those in unaffected sides. In addition, the difference of BMD in affected sides between those in unaffected sides had an obvious negative correlation with the stroke duration of left hemiplegia, but not with that of right hemiplegia. CONCLUSION: Stroke patients have a high prevalence of osteoporosis and this findings were particularly prominent in people who suffer from left hemiplegia. Early rehabilitative care, including weight-bearing exercise and outdoor ambulation, is essential for left side hemiplegic patients in order to prevent possible complications.
Bone Density ; Hemiplegia ; Humans ; Male ; Osteoporosis ; Prevalence ; Stroke ; Walking ; Weight-Bearing