Persistent cloaca in a female newborn is one of the most complex and challenging developmental malformations. The incidence is about 10% of all anorectal anomalies. Treatment of cloacal malformations has evolved during the past 40 years; however, it still remains one of the most difficult operations. In 1997, Pe a reported that a new technical variant called "Total urogenital mobilization" We also repaired cloacal anomaly using "Total urogenital mobilization" in 3 patients. The operations were performed between age 15- and 28-month. The length of the common channels was 2.5-3.0 cm. Two cases had double vaginas and one of them also had double uterus. The operation time was 4-5 hours and no major complications occurred. A satisfactory functional and cosmetic results were obtained.
Cloaca ; Female ; Humans ; Incidence ; Infant, Newborn ; Uterus ; Vagina

A case of incontinentia pigmenti without any developmental defect has been presented. And literatures have been reviewed. The patient was a 20 year old female and had been affected with numerous dark brownish linear streaks of pigmentation on the entirebody. No familiar traits were noted. Diagnosis was confirmed by characteristic clinical picture, laboratory and histopathologic findings.
Diagnosis ; Female ; Humans ; Incontinentia Pigmenti* ; Pigmentation ; Young Adult

No abstract available.

A Case of prurigo nodularis in 47-year-old female was presented with brief review of literatures. This is one of relatively rare dermatoses and still has many disputes in etiology and classification. Multiple erythematous brownish hyperkeratotic lichenified nodules were scattered on the back and extremities associated with intolerable itching trouble. Histopathologically, severe hyperkeratosis with focal neutrophile infiltration and pseudoapitheliomatous hyperplasia of acanthotic lesion in the epidermis is presented. Diagnosis was confirmed by characteristic clinical pictures and histopathological features. Treatment with corticosteroids, sediatives and tranquilizers revealed of favorable results.
Adrenal Cortex Hormones ; Classification ; Diagnosis ; Dissent and Disputes ; Epidermis ; Extremities ; Female ; Humans ; Hyperplasia ; Middle Aged ; Neutrophils ; Prurigo* ; Pruritus ; Skin Diseases

No abstract available.
Evoked Potentials, Somatosensory* ; Transcutaneous Electric Nerve Stimulation*

This study was undertaken to elucidate the short-term effect of iron on the hyperplastic lesions of experimental hepatocarcinogenesis. The Solt-Farber's resistant hepatocyte model was chosen for the experiment, and Sprague-Dawley rats wee divided into six groups: normal control, iron-rich diet administration with or without hydroxyquinoline. The iron content, microscopic changes, bromodeoxyuridine(BrdU) labelling index and the DNA polidy were studied. In the carcinogen administered group, oval cell proliferation and consecutive hyperplastic lesions of hepatocyte developed regardless of iron administration. The hepatic iron content was increased rimarkably by iron administration, but gradually decreased as the hyperplastic lesions developed in carcinogen administered groups. Although the administration of iron without carcinogen induced hepatic accumulation of stainable iron, the hyperplastic lesions appeared to be lack of it. BrdU labelling indices of the oval cells and the hyperplastic lesions of hepatocyte were very high and were not significantly altered by iron administration. Most liver cells had diploid or tetraploid DNA content, but there was an increase of diploidy as the development of hyperplastic lesions regardless of iron administration. The results indicate that the chemical carcinogen-induced hyperplastic lesions of hepatocyte do not accumulate iron, and that short-term iron administration does not affect the development of hyperplastic lesions and their proliferative activity and DNA ploidy.
Rats ; Animals ; Carcinogens

The authors report two cases of arare post-spinal complication which were hypertension, tachycardia, hyperpyrexia and localized clonic convulsion of the back and lower extremities. Spinal anesthesia was performed with Tetocaine(Tetracaine made in Japan) and 10% dextrose ampule (made by Dongindang, Korea) and by multiple heat sterilization. One recovered well in 14 days with intensive care and medication, and was discharged in one month without any sequelate. The other died 3 hours following spinal anesthesia. We consider the probable causes of the complication as contamination the spinal anesthetic, 10% dextrose and spinal tray, OR deterioration of the spinal anesthetic or the 10% dextrose due to multiple heat sterilization.
Anesthesia, Spinal ; Glucose ; Hot Temperature ; Hypertension* ; Critical Care ; Lower Extremity ; Seizures* ; Sterilization ; Tachycardia*

We have had a case of unilateral vocal cord paralysis following endotracheal anesthesia for abdominal surgery. Electromyographic examination of the intrinsic laryngeal muscle to study the nerve injury was not done but we have considered that the recurrent laryngeal nerve was injured following endotracheal anesthesia according to the post-operative laryngeal view and recovery progress. Som factors of nerve injury such as overrotation of the neck during the operation, pressure on the nerve by an overexpanded cuff, vulnerability and the anatomy of the nerve were all deemed to do possible causes, and we considered the interaction of this combination responsible for the nerve injury. The recovery were relatively good and healed within 80 dyas after operation.
Anesthesia* ; Laryngeal Muscles ; Neck ; Recurrent Laryngeal Nerve ; Vocal Cord Paralysis*

Purpose: To develop a Korean version of the practice environment scale that can verify the practice environment of advanced practice registered nurses (APRN) by verifying the validity and reliability of the Nurse practitioner's primary care organizational climate questionnaire developed by Poghosyan et al. Methods: After translation using a committee approach and an expert group’s verification of the content validity, items were classified as 'professional visibility', 'APRN-administration relations', 'APRN-physician relations', 'independent practice and support' A total of 29 questionnaire items were developed for the four factors. Data were collected from 200 advanced practice registered nurses working at two advanced general hospitals and six general hospitals. Results: In the confirmatory factor analysis, CFI, TLI, and RMSR evaluation indices were appropriate except for RMSEA. Partial validity was shown in convergent validity, and discriminant validity. Exploratory factor analysis revealed that the questions were well organized with four factors. Cronbach's ⍺ of the whole instrument was .93. Conclusion As a first attempt to measure the practice environment of the APRN in Korea, the results show that this questionnaire provides basic data for correct role setting and improvement of practice environment. This research will ultimately serve as a basis for cost-effective quality care.

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported. METHODS: Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame. RESULTS: During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. CONCLUSIONS: This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission.
Aged ; Clinical Coding ; Critical Care* ; Diffusion ; Disease Outbreaks ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Enterobacteriaceae ; Hand ; Humans ; Infection Control ; Intensive Care Units* ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Male ; Methods ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Sputum