Urinary retention is a common complication after abdominal surgery. Urinary retention causes infection and damage to the urinary system, prolonging hospital stays and increasing health care costs in the end. Because medical personnel tend to regard urinary retention as not being a serious problem, it is hard to find any method which decrease the postoperative urinary retention. There are few papers reporting the incidence and the factors which influence the postoperative urinary retention. The purpose of this study is to evaluate the incidence of postoperative urinary retention and to identify the factors which affect the postoperative urinary retention. We retrospectively reviewed 296 patients out of 338, who had been undergone laparotomy under spinal or general endotracheal anesthesia during a three month period from January to March 1998. We reviewed nursing, anesthetic and operative records. Among the 296 patients, male were 189(63.9%) and female were 107(36.1%). Postoperative urinary retention occurred in 71 patients(24%). The incidence rate was higher in female patients than in male (M : F=18% : 35%). Factors that in fluence the incidence of postoperative urinary retention were sex, duration of operation, the amount of fluid given the patient, preoperative history of dysuria, and preoperative insertion of a urinary catheter. Among those factors, preoperative urinary catheter insertion is the most effective preventive measure in lowering the incidence of postoperative urinary retention (Spearman correlation coefficient, r=-.462). Shortening the operation time and sparing the fluid which is infused during operation are important in preventing postoperative urinary retention. Preoperative urinary catheter insertion may be helpful in lowering urinary retention in those patients who have a possibility of postoperative urinary retention.
Anesthesia ; Dysuria ; Female ; Health Care Costs ; Humans ; Incidence ; Laparotomy* ; Length of Stay ; Male ; Nursing ; Retrospective Studies ; Urinary Catheters ; Urinary Retention*

Undifferentiated sarcoma of the liver is a highly malignant neoplasm that occurs almost exclusively in children. We present a case of adult undifferentiated sarcoma in a 33-year-old man. The neoplasm was typically hypovascular on hepatic angiography and a globular, cystic and mucoid mass separated from the adjacent liver by a psedocapsule was removed from the left lobe of the liver. Necrosis and hemorrhage were found. Microscopically the neoplasm consisted of myxoid and cellular areas and the basic neoplastic cells were stellate cells showing variable degree of anaplasia and pleomorphism. Eosinophilic globules were PAS-positive and immunohistochemically negative for alpha-fetoprotein. Extramedullary hematopoiesis was present and normal-appearing bile ducts and hepatic cell cords were noted.
Child ; Adult ; Male ; Female ; Humans

No abstract available.
Amnion* ; Cell Line* ; Cyclooxygenase 2* ; Protein Kinases*

Letterer-Siwe disease occurred in a 3 year 7 month old male child showing severe emaciation, hepatosplenomegaly, otitis media, hemorrhagic and impetiginous crusted patches on the body, and seborrheic dermatitis like skin rashes in the scalp. Also showed are severe anemia, thrombocytopenia, bronchopneumonia and multiple bony defects in skull. The child expired in a month after admission.
Anemia ; Bronchopneumonia ; Child ; Dermatitis, Seborrheic ; Emaciation ; Exanthema ; Histiocytosis, Langerhans-Cell* ; Humans ; Infant ; Male ; Otitis Media ; Scalp ; Skull ; Thrombocytopenia

No abstract available.
Cardiotocography* ; Meconium* ; Pregnancy*

Hemangiopericytoma is a rare vascular tumor arising from pericytes. The tumor usually develops in the skin or subcutaneous tissue, particularly in the extremities.4 pulmonary origin of hemangiopericytoma is known to be quite rare. It has the potential to become a highly malignant lesion, so wide excision is the treatment of choice. We present a case of primary malignant hemangiopericytoma of the lung and discuss the clinical symptoms, diagnosis, therapy and prognosis within the context of a brief review.
Diagnosis ; Hemangiopericytoma* ; Lung* ; Pericytes ; Prognosis ; Skin ; Subcutaneous Tissue

OBJECTIVES: The Berlin Questionnaire (BQ) has been used to help identify patients at high risk of having sleep apnea in primary care. But it has not been validated in a sleep clinic for Korean patients. The aim of this study is to evaluate the usefulness of the BQ as a screening tool for obstructive sleep apnea (OSA) for Korean patients in a sleep clinic. METHODS: The BQ was prospectively applied to 121 subjects with OSA suspicion who visited to our sleep clinic. All subjects performed overnight polysomnography. OSA was defined as an apnea-hypopnea index (AHI) > or =5. We investigated the sensitivity, specificity, positive and negative predictive values of the BQ according to severity by AHI. RESULTS: In 121 subjects, 73.6% were males, with a mean age of 48.8+/-13.0 years. Twenty-five (20.6%) patients did not have OSA (AHI<5), 30 (25%) patients had mild OSA (AHI> or =5 and <15), 26 (21.4%) had moderate (AHI> or =15 and <30), and 40 (33%) had severe OSA (AHI> or =30). The BQ identified 69.4% of the patients as being at high risk for having OSA. The sensitivity and specificity of the BQ were 71.9% and 40%, for AHI> or =5, 75.8% and 38.2% for AHI> or =15, 77.5% and 34.6% for AHI> or =30, respectively. The positive and negative predictive values of the BQ were 82.1% and 27.0% for AHI> or =5, respectively. Positive and negative likelihood ratios were 1.2 and 0.7, and the overall diagnostic accuracy of the BQ was 65.3%, using an AHI cut-off of 5. CONCLUSION: Due to modest sensitivity and low specificity, the BQ does not seem to be an appropriate tool for identifying patients with obstructive sleep apnea in a sleep clinic population.
Berlin ; Humans ; Male ; Mass Screening ; Polysomnography ; Primary Health Care ; Prospective Studies ; Surveys and Questionnaires ; Sensitivity and Specificity ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

Little has been reported concerning post-operative hypoglycemia in previously asymptomatic individuals. Post-operative hypoglycemic coma is one of the most perplexing problems and must be differentiated from other conditions accompaning coma. We experienced a case of hypoglycemia following emergency cesarean section in primigravida with cephalopelvic disproportion on the fourth post operative day. The comatous state appeared abruptly and developed repeatedly. The causes of post-hypoglycemic coma are discussed and the prolonged starvation before and after operation was suspected to be the cause of coma.
Cephalopelvic Disproportion ; Cesarean Section* ; Coma ; Emergencies ; Female ; Hypoglycemia* ; Pregnancy ; Starvation

Maternal and fetal effects of anesthesis for 781 cases ceasarean sections, performed during the past 10 years (1965~1974) in Hanil Hospital have been evaluated clinically. It is emphasized that the selection of anesthetic agents and methods, should depend upon the physical status of the patients and the ability of both obstetricians and anesthesiologists. Optimal results require effective teamwork amongst obstetricians, anesthesiologists and nursing personnel. The anesthesiologist should be fully infermed of obstetric aspects. A variety of anesthetic techniques can be used for elective and emergency Caesarean sections. Each technique has its own advantages, disadvantages and limitations which must be thoroughly understood for proper application. The choice of anesthesia should be determined primarily by the experience of the operator, the degree of ugency, condition of the monther and the fetus, the physiopathology, the skill of the obstetrician and the desires and the emotional state of the monther.
Anesthesia ; Anesthetics ; Cesarean Section* ; Emergencies ; Female ; Fetus ; Humans ; Nursing ; Pregnancy

BACKGROUND: N-acetylcysteine(ACE) is used both orally and intravenously in a variety of experimental pathologies resembling human disease states which exhibit endothelial toxicity as a result of oxidative stress, including acute pulmonary oxygen toxicity, septicemia and endotoxin shock. Despite these observations in vivo, it is not certain how this thiol drug produces its protective effects. ACE is a cysteine derivative which is able to directly react with oxygen radicals and may also act as a cysteine and glutathione(GSH) precursor following deacetylation. In this paper, we tried to know whether the therapeutic doses of ACE can modify the inflammatory function of the neutrophils and can increase the glutathione level of plasma in chronic obstructive pulmonary disease(COPD) patients. In addition, the effect of ACE to the purified neutrophil in terms of superoxide release and glutathione synthesis were observed. METHOD: Firstly, we gave 600mg of ACE for seven days and compare the release of superoxide, luminol-enhanced chemiluminescence from the neutrophils, neutrophil chemotaxis, and plasma GSH levels before and after ACE treatment in COPD patients. Secondly, we observed the dose dependent effect of ACE to the purified neutrophil's superoxide release and GSH levels in vitro. RESULTS: 1) Usual oral therapeutic doses(600mg per day) of ACE for seven days did affect neither on the neutrophils superoxide release, chemiluminescence, chemotaxis, nor on the plasma GSH concentration in the COPD patients. 2) ACE decreases the purified neutrophil's superoxide release and increase the GSH production in dose dependent fashion in vitro. CONCLUSION: Despite the fact that oral ACE treatment did not affect on the neutrophil's inflammatory function and plasma GSH concentration in COPD patients in usual therapeutic doses, it decreases the superoxide release and increases the GSH production from the isolated neutrophils in high molar concentrations. These findings suggest that to obtain an antioxidative effects of ACE, it might be needed to increase the daily dosage of ACE or therapeutic duration or change the route of adminisration in COPD patients.
Acetylcysteine* ; Chemotaxis* ; Cysteine ; Glutathione* ; Humans ; Luminescence ; Molar ; Neutrophils* ; Oxidative Stress ; Oxygen ; Pathology ; Plasma* ; Pulmonary Disease, Chronic Obstructive ; Reactive Oxygen Species ; Sepsis ; Shock ; Superoxides*