The primary urethral calculi are rare and usually associated with urethral strictures or diverticulum. We report a case of primary giant urethral calculus in 79-year old man who has had no significant urinary and sexual symptom for 48 years.
Aged ; Calculi* ; Diverticulum ; Humans ; Urethra ; Urethral Stricture

PURPOSE: Korean women are likely to experience symptoms of depression, possibly due to socially fixed limitations on the roles that Korean women are expected to perform. Also if a Korean woman experinces negative relationship problem or stress in her family, she would feel responsible, which will worsen her depression. Nonetheless, much of the research on depression among Korean women has focused on menopausal women. This study aims to understand the depression of Korean women to provide fundamental data to develop nursing intervention method for promoting women's health. METHODS: The present investigation assessed the prevalence and correlates of depression in a large sample of Korean women, aged 18 or older, from the general population. With a probability sample of 3312 women drawn from two areas in Korea, a survey, which contains the Center for Epidemiological Studies Depression Scale (CES-D) and background, was completed. RESULTS: According to CES-D classification criteria, 36.5% of the women in the sample displayed either no depression or mild depression, 55.6% exhibited moderate depression, and 7.8% manifested severe depression. Significant bivariate relationships were observed between depression and each measured background variable except alcohol use. Logistic regression analysis indicated that the strongest combination of predictors of depression included income, menopausal, and marital status. CONCLUSION: The data support the premise that Korean women disproportionately experience elevated levels of depression. Consistent with the theory, depression may be related to social pressures to conform to the traditional roles. The study suggests the need for further research, primary prevention activities, and increased access to treatment.
Adult ; Age Distribution ; Depressive Disorder/diagnosis/*ethnology/etiology/nursing ; Female ; Gender Identity ; Guilt ; Health Promotion ; Health Surveys ; Humans ; Logistic Models ; Male ; Marital Status ; Models, Psychological ; Multivariate Analysis ; Nurse's Role ; Prevalence ; Psychiatric Status Rating Scales ; Questionnaires ; Risk Factors ; Severity of Illness Index ; Sex Distribution ; Social Support ; Social Values ; Socioeconomic Factors ; *Women/education/psychology

PURPOSE: Laparoscopic pyeloplasty is an alternative, minimally invasive approach for the repair of an ureteropelvic junction obstruction (UPJO). However, it has a technical difficulty, and various laparoscopic approaches are available. We present our initial experience of laparoscopic pyeloplasty using a transperitoneal approach in patients with an UPJO. MATERIALS AND METHODS: Between January 2002 and January 2004, 11 patients underwent laparoscopic pyeloplasty using a transperitoneal approach. Of these 11, 10 patients were followed up and enrolled in this study. They were comprised of 6 males and 4 females, with a mean age of 44 years (19-62). The chief complaints were flank pain in 8 patients, with a further 2 incidental detected. Three patients had had previous abdominal surgeries. The mean length of stricture was 1.1cm in the radiologic studies, and the degree of hydronephrosis was grade 3/4 in 6 patients and grade 4/4 in 4. An obstructive pattern in the 99mTc-MAG3 renal scan was present in 9 patients. RESULTS: Eight patients were treated with dismembered Anderson-Hynes pyeloplasty and 2 patients with Fenger pyeloplasty. The mean operating time and hospital stay were 225 minutes (120-450) and 7.4 days (5-10), respectively. During the operation, crossing vessels were found in 4 patients and an ureteral polyp in 1. One patient had an ascending colon injury, which was postoperatively detected and repaired. The mean follow- up period was 42.5 weeks (26-135). Follow-up excretory urography and a 99mTc-MAG3 renal scan showed improvements in 8 of the 10 patients (80%) at the 3 month follow-up. The flank pain disappeared in all the patients (100%) who had previously complained of this symptom. CONCLUSIONS: Laparoscopic pyeloplasty could be an alternative treatment for an ureteropelvic junction obstruction, especially using a transperitoneal approach, which seems to have a technical convenience over that of the retroperitoneal approach.
Colon, Ascending ; Constriction, Pathologic ; Female ; Flank Pain ; Follow-Up Studies ; Humans ; Hydronephrosis ; Kidney Diseases ; Laparoscopy ; Length of Stay ; Male ; Polyps ; Technetium Tc 99m Mertiatide ; Ureter ; Ureteral Obstruction ; Urography

A complicated urachal cyst requires surgical excision to prevent symptom recurrence and complications, most notably malignant degeneration. However, a traditional open excision is associated with significant morbidity and prolonged convalescence, especially in children. A seven year old male, with a complicated urachal cyst, underwent a laparoscopic excision of the urachal remnant. Through a transperitoneal approach, using three ports, the urachus was excised and separated from the bladder dome. We report our experience of a laparoscopic excision of an urachal cyst, with a review other reports, to find the efficacy and outcome of this approach as a minimally invasive alternative.
Child* ; Convalescence ; Humans ; Laparoscopy ; Male ; Recurrence ; Urachal Cyst* ; Urachus ; Urinary Bladder

BACKGROUND: It is difficult to treat patients with hepatolithiasis because of recurrent or residual stones and serious postoperative complications. This study was done to compare the operation method and postoperative progression related to location of the hepatolithiasis. METHODS: Retrospective analysis was done in 234 patients who underwent operation due to hepatolithiasis from Jan. 1989 to Dec. 1998 in Chonnam University Hospital. RESULTS: The patients with left intrahepatic duct stones were 135, with right intrahepatic duct stones were 30 and with both intrahepatic duct stones were 69. In cases of resection of the liver, left lobectomy, left lateral segmentectomy, right posterior segmentectomy or right lobectomy was done. In a patient with stone in caudate lobe, caudate lobectomy was done. In non-resected group choledocholithotomy was done. Of 135 patients with left intrahepatic stones, 117 patients(86.7%) underwent hepatic resection and 18 patients(13.3%) underwent choledocholithotomy. Of 30 patients with right intrahepatic stones, 6 patients(20.0%) underwent hepatic resection and 24 patients(80.0%) underwent choledocholithotomy. Of 69 patients with both intrahepatic stones, 36 patients(52.2%) underwent resection and 33 patients(47.8%) underwent choledcholithotomy. Overall incidence of remnant stone was 28.2%. In resected group of left intrahepatic stones, the incidence of remnant stones was 8.5% and in non-resected group 33.3%. In resected group of right intrahepatic stones, the incidence of remnant stones was 0% and in non-resected group 37.5%. In resected group of both intrahepatic stones, the incidence of remnant stones was 55.6% and in non-resected group 63.6%. Incidence of postopertive complications was 22.6% and wound complication was most common. There was no postoperative mortality. CONCLUSIONS: Hepatic resection for hepatolithiasis confined to one lobe has an advantage of low incidence of remnant stone without increasing the morbidity and mortality rate. In both intrahepatic stones, the treatment is difficult, but if operation is performed with proper selection of extent of hepatic resection, favorable result would be expected.
Humans ; Incidence ; Jeollanam-do ; Liver ; Mastectomy, Segmental ; Mortality ; Postoperative Complications ; Retrospective Studies ; Wounds and Injuries

PURPOSE: This study was done to explore communication between nurses during preceptorship. METHODS: A qualitative study, using content analysis was conducted. Semistructured interviews were held with 10 nurses working in urban hospitals. RESULTS: A total of 226 significant statements were selected from the data and classified into 4 categories and 23 subcategories. Communication experiences of new nurses' own performance were responses to reproach - acceptance and apology, and unresponsiveness due to feeling small and uncomfortable; responses to questions - misanswer; responses to directions - unconditional acceptance. Communication experiences of new nurses' performance by nurse preceptors were kindness, stigmatization, talking behind one's back, criticism and reproach, impolite words, and emotional expression. Communication experiences of nurse preceptors's own performance were directives, sympathy, reproach, unkindness, authoritative strictness, and nonverbal expression: being cold, and lessening of tension. Communication experiences of nurse preceptors' performance by new nurses were response to criticism - recognition and apology for mistakes, evasion of responsibility, and excuses; responses to explanations-active acceptance, and difficulty with communication due to lack of comprehension. CONCLUSION: These results provide deep understanding of nurses' communication during preceptorship and should help in developing comprehensive education programs for preceptor nurses and new nurses.
Comprehension ; Education ; Hospitals, Urban ; Preceptorship* ; Qualitative Research ; Stereotyping

BACKGROUND: Cardiopulmonary exercise test is a useful test for the evaluation of the cardiovascular and respiratory systems. Obese subjects have an increased resting metabolic rate (VO2) compared to non-obese subjects and the increase is more marked during dynamic exercise, which results in the limitation of maximal exercise in obese subjects. In this study, the influence of the obesity and fat distribution on the maximal exercise capacity were evaluated. METHODS: Maximal exercise capacity was represented by maximam maximum oxygen uptake and VO2 max in the cardiopulmonary test. Obesity, total fat content and abdominal obesity(waist to hip ratio, WHR) were measured by bioelectrical impedence method. Total of 42 volunteers(male 22, female 20) were evaluated. RESULTS: 1) Weight to height ratio(mean±SD) was 110%±14.9% in men and 100±11.1% in women. 2) Fat ratio(mean±SD) was 23.3±5.2% in men and 27.55±3.9% in woman. 3) Waist to hip ratio(mean±SD) was 0.85±0.04 in men and 0.8±0.03 in woman. 4) In men, VO2max/min/Kg was negatively correlate with obesity, fat ratio, and abdominal fat distribution. 5) In woman, VO2max/Kg was negatively correlated with obesity and fat ratio, but did not show significant relationship with abdominal fat distribution. CONCLUSION: Obesity was a limiting factor for maximal exercise in both men and women. Abdominal obesity was a limiting factor for maximal exercise in men but its implication to women needs further evaluation.
Abdominal Fat ; Exercise Test* ; Female ; Hip ; Humans ; Male ; Obesity ; Obesity, Abdominal ; Oxygen ; Respiratory System

BACKGROUND: Diffuse panbronchiolitis(DPB) is a chronic inflammatory lung disease of unknown etiology which has characteristic clinical, radiological and pathological features, and is distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. Clinically, patients with DPB have chronic cough, purulent sputum, exertional dyspnea, and finally respiratory failure. Until a few years ago, the prognosis of DPB had been thought to be very grave, because there had been no effective treatment for the disease. But recently, low-dose long-term erythromycin was found to be very effective on DPB. Even though DPB is prevalent in Japan, and is known to be rare outside of Japan, we have already reported the clinical features of 16 DPB cases in Korea. We tried low-dose long-term erythromycin on DPB patients and analyzed the clinical effect of erythromycin. METHODS: We analyzed the changes of subjective symptoms, physical signs, pulmonary function tests and chest X-rays on 14 DPB patients with more than 6 months erythromycin treatment during the period from September 1989 to August 1992 in Seoul National University Hospital. RESULTS: 1) Subjective symptoms improved in all patients within 2-3 months, and 54.5% of the patients shorted no symptom after one year of treatment. 2) Crackles and wheezing decreased in 92.9% of the patients after 3 months and completely disappeared in 63.5% of the Patients after one year of treatment. 3) FVC and FEV1 increased remarkably during the first 3 months, and slowly increased thereafter, reaching normal level after one year of treatment. 4) Small nodular lesions on chest X-ray decreased in all patients, and chest PA was normal in 36.4% of the patients after one year of treatment. 5) There was side effect in one patient, stopping medication because of dyspepsia. One patient stopped medication because of no symptom after 16 months of treatment, but her symptom recurring after one month, improving again after retreatment. CONCLUSION: Low-dose long-term erythromycin showed ramarkable effectiveness on DPB. Further studies are needed on the mechanism of the drug and the duration of the treatment.
Asthma ; Bronchiectasis ; Bronchitis, Chronic ; Cough ; Dyspepsia ; Dyspnea ; Erythromycin* ; Humans ; Japan ; Korea ; Lung Diseases ; Prognosis ; Pulmonary Emphysema ; Respiratory Function Tests ; Respiratory Insufficiency ; Respiratory Sounds ; Retreatment ; Seoul ; Sputum ; Thorax

Most adenocarcinomas of the colorectum arise in a visible benign precursor lesion, the adenoma, which is a monoclonal proliferation of dysplastic nonmalignant epithelial cells. Adenoma-adenocarcinoma sequence has been represented as the predominat pathogenetic pathway. But a small flat depressed colon cancer is characterized by non-polypoid growth pattem with no association of adenomatous tissues, which has tendency to early submucosal invasion and lymph node metastasis even in very small lesion (<10 mm). It supports de novo carcinogenesis of colorectal cancer, although most colorectal cancerarise in pre-existing adenoma. We report a case of small float colon adenocarcinoma arising in normal colonic epithelium rather than adenomatous polyp in familial adenomatous polyposis syndrome.
Adenocarcinoma* ; Adenoma ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Carcinogenesis ; Colon* ; Colonic Neoplasms ; Colorectal Neoplasms ; Epithelial Cells ; Epithelium ; Humans ; Lymph Nodes ; Neoplasm Metastasis

BACKGROUND: Since tumor necrosis factor was discovered in 1975, TNF has been well known about its cytotoxic effect on tumor cells in vivo and in vitro. According to the recent improvement of molecular biological techinques, it is possible that exogenous TNF gene is transferred to tumor cells and is expressed in theirs. By virtue of TNF gene transfer, we have expected that TNF expressed in TNF-gene-transferred tumor cells would kill tumor cells in vivo without systemic side effect. The expected mechanisms in which antitumor effects of TNF expressed in TNF-gene-transferred tumor cells are working would be as followings. In the first mechanism, TNF expressed in TNF-gene-transferred tumor cells would kill tumor cells around (like homicide). In the second mechanism, TNF expressed in TNF-gene-transferred tumor cells would kill themselves (like suicide). In the third mechanism, TNF expressed in TNF-gene-transferred tumor cells would recruit immune effector cells and kill tumor cells indirectly. In the last mechanism, TNF expressed in TNF-gene-transferred tumor cells would augment cytokine such as interferon-γ to kill tumor cells. Among these four mechanisms of antitumor effect, only the second mechanism has not been established yet. Therefore, to elucidate the second mechanism, We performed this study. METHOD: We transferred TNF-α gene to NCI-H2058, a human mesothelioma cell line and WEHI164, a murine fibrosarcoma cell line by using retroviral vector(pLT12SNTNF). And, We determined by using MTT assay whether TNF expressed in TNF-gene-transferred tumor cell lines would kill themselves like suicide or not. Then, if TNF-gene-transferred tumor cell lines would not suicide themselves, 1 would know more about the TNF sensitivity of TNF-gene-transferred tumor cell lines to exogenous TNF also by MTT assay. RESULT: NCI-H2058 and WEHI164 which were sensitive to TNF, became far less sensitive to endogenous and exogenous TNF after being transferred TNF-α gene to. CONCLUSION: TNF-gene-transfer to NCI-H2058 and WEHI164 gaffe them resistance to TNF.
Cell Line ; Cell Line, Tumor* ; Fibrosarcoma ; Humans ; Mesothelioma ; Necrosis* ; Retroviridae* ; Suicide ; Tumor Necrosis Factor-alpha ; Virtues ; Zidovudine