Acute scrotum is any pathologic condition of the scrotum or intrascrotal contents that requires emergency medical or surgical management. Management of each disease entity is different, but the differential diagnosis is very difficult. So many testes were lost due to delay of the adequate diagnosis or unnecessary explorations had been taken under the misdiagnosis. A study was done to evaluate the differential diagnostic value of clinical symptoms and signs, physical examinations, laboratory data and radiologic studies including scrotal Doppler ultrasonography on acute scrotum patients. During the two years, thirty patients were visited to emergency medical center of Ajou university. There were 5 patients with testicular torsion, 16 acute epididymitis, 5 orchitis, 3 edema of scrotum, 1 infected hydrocele, the mean age of total patients was 17 years old. Symptoms and signs, laboratory data showed no specific ability to differentiate each disease entities, but radiographic evaluations were useful to differentiate testicular torsion from non-torsion acute scrotum. We could suggest that scrotal Doppler ultrasonography is useful for early differential diagnosis of the acute scrotum, especially in emergency department.
Adolescent ; Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Edema ; Emergencies ; Emergency Service, Hospital ; Epididymitis ; Humans ; Male ; Orchitis ; Physical Examination ; Scrotum* ; Spermatic Cord Torsion ; Testis ; Ultrasonography, Doppler

No abstract available.

The fine structure of cells in the trigeminal mesencephalic (Me5) nucleus in the rat was studied by transmission electron microscopy. This nucleus located in the mid-brain and the rostral portion of the pons, most neurons in the caudal part of Me5 nucleus were sufficiently large (40~50micrometer) and appeared as round-shaped unipolar cells. The Me5 neurons had a large, round, centrally located nucleus, and their cytoplasm contained numerous mitochondria, dense granular endoplasmic reticulum, abundant Golgi apparatus, groups of free ribosomes, some heterogeneous particles and neurofilaments. Cell surfaces were studded irregularly with small spinouts processes, and they contained a few fine irregularly arranged neurofilaments and some granular endoplasmic reticulum. Boutons contacting the soma of Me5 neurons were defined as axosomatic synapses and bostons contacting dendrites located between the Me5 neurons were defined as axodendritic synapses. Based on differences in bouton and vesicle morphology, the four synaptic bouton types were identified. 1. Asymmetrical as well as symmetrical synapses with small round vesicles. 2. Asymmetrical synapses with pleomorphic admixture contained predominantlyspherical vesicles. 3. Symmetrical synapses with pleomorphic vesicles of flattened, spherical and dense-core vesicles. 4. Asymmetrical as well as symmetrical synapses with heterogeneous and large dense-core vesicles. Synaptic boutons containing round vesicles and large dense-core vesicles were most frequently observed.
Animals ; Carisoprodol ; Cytoplasm ; Dendrites ; Endoplasmic Reticulum, Rough ; Golgi Apparatus ; Microscopy, Electron, Transmission ; Mitochondria ; Neurons ; Pons ; Presynaptic Terminals ; Rats* ; Ribosomes ; Synapses

BACKGROUND: The goal of this study is to identify the factors that predict mortality in elderly trauma patients. METHOD: We reviewed retrospectively the medical record of 144 cases of geriatric trauma admitted to Kyungpook National University Hospital firm January 1998 to December 1998. We evaluated the general characteristics, mechanisms of injury, Revised Trauma Score(RTS), Injury Severity Score(ISS), Probability of survival(Ps) by TRISS(Trauma and Injury Severity Score) method, amount of blood transfused, preexisting disease, complications, length of stay, and mortality. RESULTS: 1. The mean age was 75.39+/-7.89 years old, and male to female ratio was 0.89 : 1. 2. The mechanisms of injury were primarily frills(56.3%) followed by bicycle or motorcycle(13.9%), and pedestrian injuries(13.2%) and motor vehicle accidents(6.9%). 3. The mean Glasgow Coma Scale(GCS), RTS and ISS ate 13.3+/-3.5, 7.2+/-1.4 and 14.2 +/-11.6 respectively. 4. The actual mortality rate was 18.1% (26/144). But by TRISS method, predicted mortality rate was 9.3%(12.5/144), excess mortality rate was 108% and Z score was 3.99 indicating that actual number of death exceed predicted number of death. 5. Between the survivors and nonsurvivors, the insults were significantly different as follows ; systolic blood pressure(141.9+/-28.3 vs. 116.8+/-48.7 mmHg), GCS(14.3+/-2.0 vs. 9.0 +/-5.1), RTS(7.8+/-0.7 vs 5.4+/-2.3), ISS(11.3+/-5.6 vs 27.2+/-20.2), Ps by TRISS(0.97+/-0.06 vs 0.65+/-0.37), preexisting diseases(50.8 vs 69.8%). CONCLUSION: Geriatric patients are more likely to die after trauma than other age groups. The cause of higher actual mortality rate compared to predicted mortality rate was considered as the higher incidence of delayed death due to sepsis or multiple organ failure. In order to reduce the mortality, even with relatively stable initial vile sign, invasive hemodynamic monitoring and intensive treatment are recommended and also, prevention and treatment of nosocomial infection are very important.
Aged ; Coma ; Cross Infection ; Female ; Gyeongsangbuk-do ; Hemodynamics ; Humans ; Incidence ; Length of Stay ; Male ; Medical Records ; Mortality* ; Motor Vehicles ; Multiple Organ Failure ; Preexisting Condition Coverage ; Retrospective Studies ; Sepsis ; Survivors

BACKGROUND: In order to treat obese individuals, control of caloric intake after determination of patient's energy expenditure and recommendation of exercise program with possible use of specific medication is advised. There are many limitations in measuring all individuals energy expenditure by calorimetry, thus estimation is made using many variables such as weight, height, age, and gender. But, commonly used equations to predict resting energy expenditure(REE) are thought to result in overestimation of energy expenditure for use with obese individuals. This study investigated difference between measured and predicted resting energy expenditure in obese individuals. METHODS: Subjects were 133 adults who were admitted either to Internal Medicine Department and ENT Department of Yeung Nam University Hospital and their resting energy expenditure was measured by indirect calorimetry. According to age, sex, smoking habits and body mass index, Measured REE by indirect calorimetry between groups was compared. Predicted REE estimated by 6 equations to measured REE was compared in the two groups by body mass index 27kg/m2 under 65 years old individuals. RESULTS: There was no significant difference of measured REE between groups according to smoking habits(p>0.05). In the older group(> or =65 years old), REE was lower compared to the younger groups(<65 years old)(p<0.05). In the obese group(body mass index>27kg/m2) measured REE was higher than the normal weight group(BMI<27kg/m2)(p<0.05). Among 108 individuals under 65 years old, other equation except for Fleish equation and Robertson and Reid equation were inaccurate when applied to the obese group. CONCLUSIONS: These commonly used prediction equations tend to overestimate the REE in obese individuals, and the best estimates for the obese seem to be derived from the Fleish and Robertson and Reid equations.
Adult ; Aged ; Body Mass Index ; Calorimetry ; Calorimetry, Indirect* ; Energy Intake ; Energy Metabolism* ; Humans ; Internal Medicine ; Obesity ; Smoke ; Smoking

The authors report a case of monostotic eosinophilic granuloma which occured in the skull. A 37 year-old woman was presented with headache and soft mass in the occipital region. Plain skull X-ray showed a "punched out" osteolytic lesion in the right paramedian posterior parietal bone. Computed tomography shows a soft tissue mass and irregular bone destruction in corresponding region. On magnetic resonance image, the mass was of high signal intensity, with subgaleal extension and looks like a shirt stud or "collar button" on T2-weighted image. Total excision of the tumor and postoperative radiotherapy(1000cGy) were performed. The woman had no headache complains nor showed any focal neurologic deficit during the six months follow-up period. We report a case of monostotic eosinophilic granuloma of the skull with review of the pertinent literatures.
Adult ; Eosinophilic Granuloma* ; Eosinophils* ; Female ; Follow-Up Studies ; Headache ; Humans ; Neurologic Manifestations ; Parietal Bone ; Skull*

The auther studied 54 lumbar spondylolisthesis patients diagnosed and treated with transpedicular screw fixation and bony fusion at our Hosptial between January 1990 and December 1994, and analysed the outcome. The results may be summarized as follows: 1) Of the 54 cases, 17 were degenerative spondylolisthesis and 37 were spondylolytic spondylolisthesis. Occurrence peaked during the fifth and sixth decades. 2) Posterolateral fusion(P.L.F) was performed in 37 cases and posterior lumbar interbody fusion(P.L.I.F) in eight ; P.L.F and P.L.I.F in combination was performed in nine cases. The mean follow-up period was 25 months. 3) In no patients was significant neurologic injury or functional root loss seen. Complications included two instrument failures and one wound infection. 4) Radiologic and clinical outcome was better in degenerative than in spondylolitic spondylolisthesis. 5) The radiologic and clinical outcome of bony fusion types P.L.F and P.L.I.F was the same. 6) The surgical result as evaluated by Mc.Nab's criteria was satisfactory in 81% of patients.
Follow-Up Studies ; Humans ; Spine* ; Spondylolisthesis* ; Wound Infection

OBJECTIVES: This study was performed to determine the self-perceived fatigue and its association with job stress and psychosocial factors among white collar male workers. METHODS: The self-administered questionnaires were given to 872 workers employed in 42 work places located in Daejeon City and Chungnam Province during the period from February 1st to April 30th, 2009. The questionnaire surveys included socio-demographic characteristics, job-related characteristics, health-related behaviors, a Job Content Questionnaire (JCQ), psychosocial factors (type A behavior pattern, locus of control, self-esteem) and the Multidimensional Fatigue Scale (MFS). RESULTS: Concerning the correlation of self-perceived fatigue with various factors, while the level of self-perceived fatigue was positively correlated with the job demands, a type A behavior pattern and self-esteem, it was negatively correlated with job autonomy and supervisor support. With the analysis of the covariance structure, JCQ (job demand, job autonomy, supervisor support and coworker support) had more of an influence on the level of self-perceived fatigue than the psychosocial factors (type A behavior pattern, locus of control, self-esteem). The inter-relational effects were that the higher the JCQ and psychosocial factors, the higher the level of self-perceived fatigue. CONCLUSIONS: The study results indicated that the level of self-perceived fatigue was more influenced by the JCQ than the psychosocial factors. Thus, an effective strategy for fatigue reduction among workers requires additional programs that will focus on innovated job specifications and managed psychosocial factors.
European Continental Ancestry Group ; Fatigue ; Humans ; Internal-External Control ; Male ; Questionnaires ; Workplace

PURPOSE: The 2018 PyeongChang Winter Olympic Games involved 2925 elite athletes, and providing proper health care services for these elite athletes was a critical priority. We established an emergency department (ED) in the Pyeongchang Mountain Polyclinic during the Olympics, which served staff and athletes from many countries. This experience, as well as a description of illnesses and injuries encountered during the games, may provide useful information for planning medical care at similar events in the future. MATERIALS AND METHODS: The polyclinic ED operated from January 25 to February 27, 2018. All cases were enrolled in this study, and their data were analyzed by date and category. In addition, the number of injuries by body part, number of illnesses by organ system, and illness symptoms and causes were analyzed. RESULTS: In total, 288 patients were encountered in the ED. These included 113 injuries and 175 illnesses. We consulted with 153 staff members and 75 athletes, and reported that the fingers were the most commonly injured body part, followed by the knee. The respiratory system was the most commonly involved organ system, and the most common cause of illness was infection. Thirty-eight influenza tests were performed, among which the results of seven were positive. We performed 17 norovirus tests, among which the results of four were positive. CONCLUSION: Our analysis of our ED experience will aid arrangements for medical services in future Winter Games. Additionally, given our new experience, we will now be able to provide better medical services for future winter sports events.
Athletes ; Delivery of Health Care ; Emergencies ; Emergency Service, Hospital ; Fingers ; Humans ; Influenza, Human ; Knee ; Norovirus ; Respiratory System ; Sports

To investigate the effects of cardiovascular risk factors on hearing loss, hearing threshold and cardiovascular risk factors such as blood pressure, hematologic values, and serum lipid levels of 3,827 persons who visited the Health Center of a University Hospital in Kumi for health examination from January 1, 1995 to July 31, 1997 were analysed. The results were summarized as follows ; 1. Hearing threshold was shifted highly in both sex groups with age increased. Smoking did not influence increase of hearing loss, but drinking alcohol amount increased hearing threshold when sex was adjusted. The most highly increased hearing threshold showed among farmers group, but next was blue collars group. Hearing threshold increasing basis with BMI increased. 2. Systolic and diastolic blood pressure and hematocrit value increased the hearing threshold in both sex groups, but hemoglobin value did not related to the hearing threshold. 3. Total cholesterol, LDL-cholesterol, triglyceride, and atherosclerosis index were significantly increased with the grade of hearing lose increased, when age was adjusted. 4. In the logistic regression analysis, the atherosclerosis index, age, and hematocrit value revealed risk factors which contributed in that orders, though the values were small they showed statistical significances, but the risks were lowered when hemoglobin values increased, in both sex groups. Consequently, hyperlipidemia was significantly related to the hearing loss when age was adjusted.
Atherosclerosis ; Blood Pressure ; Cholesterol ; Drinking ; Gyeongsangbuk-do ; Hearing Loss* ; Hearing* ; Hematocrit ; Humans ; Hyperlipidemias ; Logistic Models ; Risk Factors* ; Smoke ; Smoking ; Triglycerides