A case of bilateral ureterocele developed in the 23 years old Korean male soldier was presented with review of literatures. It was not accompanied any secondary complications and the treatment was conservative rather than surgical intervention.
Humans ; Male ; Military Personnel ; Ureterocele* ; Young Adult

No abstract available.
Epilepsy* ; Occipital Lobe* ; Rabeprazole*

Two cases of necrotic penile skin treated with scrotal skin graft are hereby reported. These cases revealed scrotal swelling and complete loss of penile skin which might have been due to ischemic tissue necrosis under local anesthesia withmixed solution of 1% procaine HC1. 2% Lidocain HCl and 0.5% epinephrine. Epinephrine was administered with over dosage to control bleeding during circumcision implantation of the penis into the scrotum for the purpose of plastic reconstruction of penile skin, i.e. scrotal tunnel method, was performed successfully under spinal anesthesia.
Anesthesia, Local ; Anesthesia, Spinal ; Circumcision, Male ; Epinephrine ; Female ; Hemorrhage ; Male ; Necrosis ; Penis ; Plastics ; Procaine ; Scrotum ; Skin* ; Transplants*

A consecutive series of 34 severe head-injured patients (DAI) were studied prospectively. Patients were categorized according to a new, simple classification system comprised of four lesion types according to the compression or obliteration of the ventricles or cisterns. Five patients belonged to type II and 19 patients to type IV. Each type was further subdivided into two GCS score ranges (5 to 8 and below 5). The distribution of the posttraumatic infarction was mainly in the frontal and temporal lobes (60% of all cases). Our data demonstrated that the ICP was significantly lower at a 30 degrees head elevation than at 0 degree (18.6 +/- 7.21 mmHg vs 23.0 +/- 10.60 mmHg. t = 4.22 p< 0.001), but head position did not statistically affect CPP (69.4 +/- 19.86 mmHg vs 68.2 +/- 19.87 mmHg. t = -0.54, p< 0.59). The effect of intensive therapy on ICP, CPP and AVDO2 was studied in all cases, employing steroids and diuretics in a modified intensive care scale. In cases where barbiturates were employed, there were statistically significant changes in ICP and AVDO2 (p< 0.001), but CPP was not affected (p< 0.59). Surviving patients were analyzed by using the GOS and the neurological grading score (NGS, Nihon University) of the persistent vegetative state. Our data suggests that head elevation of 30 degrees and barbiturate therapy are more effective on ICP and AVDO2, and NGS more exact than GOS in vegetative patients.
Adolescent ; Adult ; Aged ; Cerebrovascular Circulation ; Craniocerebral Trauma/*physiopathology/radiography ; *Glasgow Coma Scale ; Human ; Intracranial Pressure ; Middle Age ; Oxygen/blood ; Posture ; Prospective Studies ; Tomography, X-Ray Computed

A statistical observation ryas made on Genito-Urinary-Tract injuries of Korean Army Personnel in Vietnam War during the period of November, 1965 to November, 1966. and the following results were obtained. 1. The Genito-Urinary-Tract injuries were 15 cases(5.3 per cent) among 825 war causalities. 2. As for the causes of injuries, 25 cases (55.5 per cent) were caused by gunshot, 9(20.O per cent) by booby trap, 5(11. O per cent) by mortar, 3(6.6 per cent) each by crush and grenade. 3. Concerning the frequency of injuries in each organ, 12 cases (6. 6 per cent) each were observed in urethra, in scrotum and testis, 10 (22.2 per cent) in kidney, 8 (17.7 per cent) in bladder, and 3 {6. 6 per cent) in penis. 4.The incidence of Genito-Urinary-Tract injuries associated with the other organs was as follows. In kidney injuries, Z cases were associated with intestine, 4 with liver, 3 with spleen and one each with radial nerve and iliac vessel. In bladder injuries. 2 cases were associated with pelvic bone, and one with spleen. In urethra injuries, 6 cases were associated with pelvic bone and 2 with intestine. 5. As for the multiplicity of Genito-Urinary-injuries, 4 cases were observed in scrotum, testis and urethra, and 3 each in urethra and bladder, and scrotum and testis. 6. The evacuation time from battle fields to the evacuation hospital was one hour in average by helicopter
Aircraft ; Humans ; Incidence ; Intestines ; Kidney ; Liver ; Male ; Military Personnel ; Pelvic Bones ; Penis ; Radial Nerve ; Scrotum ; Spleen ; Testis ; Urethra ; Urinary Bladder ; Vietnam*

Despite concentrated basic and clinical research efforts including the initial successful combination of surgery, radiotherapy and chemotherapy with BCNU, significant progress in the treatment of human brain tumors have been slow and looks for more successful strategies developed based upon the information from animal model system. It is to recreate in the laboratory under experimental condition a model of human brain tumors. Although no unique model of the numerous animal tumors resembling the spontaneous human brain tumors developed in these days, experimental animal models to have own specific adventages can be induced by exposure to oncogenic viruses or chemical carcinogens. Intracerebral injection of oncorna viruses can produce glioblastoma mutiformes, astrocytomas and sarcomas, while medulloblastoma, choroids plexus papilloma and ependymomas can be induced by papova viruses, and human adenovirus may cause neuroblastoma, medulloepithelioma and retinoblastomas. Chemical induction in adult animals and transplacental chemical induction were ependymoblastomas, glioma, gliosarcoma and malignant neurinomas. Reproducibility of location, cell type, and time of tumor appearances;expense;growth in tissue culture;trauma to brain;nature of vasculature, and amount of brain and tumor tissue available for examination are the variables to be considered in choosing a model to use in evaluating drug and other therapies, cell kinetics and immunological studies.
Adenoviruses, Human ; Adult ; Animals ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Carcinogens ; Carmustine ; Choroid ; Drug Therapy ; Ependymoma ; Glioblastoma ; Glioma ; Gliosarcoma ; Humans ; Kinetics ; Medulloblastoma ; Models, Animal ; Neurilemmoma ; Neuroblastoma ; Neuroectodermal Tumors, Primitive ; Oncogenic Viruses ; Papilloma ; Radiotherapy ; Retinoblastoma ; Sarcoma

A clinical analysis was carried out with 108 cases of head injuries under 15 years of age, admitted at the Department of Neurosurgery, In Ha University Hospital in 11/2 years between Jan., 1987 and June., 1988. The material was classified into three groups according to main lesions, i.e. 1) simple cerebral contusion without skull fractures. 2) various types of skull fractures. 3) intracranial hemorrhagic lesions, representing such lesions as follows:a) epidural hematoma b) subdural hematoma. c) intracerebral hematoma, intraventricular and subarachnoid hemorrhage. The results were as follows: 1) The age incidence was greatest in 7 years of age, and 51 cases(47.2% of total) were included in the age group between seven and ten. 2) The accident occurred mostly between March and May. 3) Males outnumbered females by almost 2:1. 4) The head injuries were caused by traffic accident(52 cases:48%), fall down(47 cases:43%), hit(9 cases:9%). 5) In clinical picture, vomiting(57 cases:53.7%) and convulsion(8 cases:7.4%) and neck sprain(55 cases:50.9%) were developed and at accident, forty seven cases(43.5%) had the history of loss of consciousness. 6) Of the patients between GCS 5 and 14, 57 cases(92%) were included in the simple cerebral contusion. Of the patients below GCS 13, 45 cases(98%) were included in the skull fracture or intracranial hemorrhagic lesions but eighteen cases of the patients below GCS 13 were taken operation. 7) In skull fracture patients, the location in the order of frequency was parietal, occipital, temporal and frontal bone. The vault skull fracture was about twelfth fold as frequent as basal skull fracture and the incidence of linear skull fracture was higher than that of depressed skull fracture, the ratio being about 7:1. 8) Among the intracranial hemorrhagic lesions, the epidural hematoma was most common lesion. Twenty one cases(81%) of the patients with intracranial hemorrhagic lesions were accompanied by skull fracture but of the patients with skull fracture, 21 cases(47%) were accompanied by intracranial hemorrhagic lesions. Seventeen cases(46%) with the linear skull fracture involved in the intracranial hemorrhagic lesions. 9) Contre coup injury was developed in 6 cases(12%) and Lucid interval was observed in 4 cases(5%) of the cases with intracranial hemorrhagic lesions. 10) Associated injuries were found in about 27% of the total patients. The frequent ones were clavicle fracture, femur fracture, tibia/fibular fracture, pelvic fracture and so on order. 11) Sequelae were noticed in about 20% of the total patients. The most frequent one was post traumatic syndrome. 12) The period of hospitalization was about 2 weeks on an average in non-surgical cases(83%) and 4-6 weeks on an average in surgical cases(70%).
Child* ; Clavicle ; Contrecoup Injury ; Contusions ; Craniocerebral Trauma* ; Female ; Femur ; Frontal Bone ; Head* ; Hematoma ; Hematoma, Subdural ; Hospitalization ; Humans ; Incidence ; Infant* ; Male ; Neck ; Neurosurgery ; Rabeprazole ; Skull Fracture, Depressed ; Skull Fractures ; Subarachnoid Hemorrhage ; Unconsciousness

With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U. S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U. S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the difference in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated for its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed ad payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U. S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.
Classification ; Clinical Coding ; Delivery of Health Care ; Diagnosis* ; Diagnosis-Related Groups* ; Health Expenditures ; Health Personnel ; Health Services ; Humans ; Inpatients* ; Insurance ; Insurance Carriers ; Korea

The authors report a case of pterional meningioma invading the sphenoid bone, orbital roof and lateral orbit, and temporal bone with hyperostosis, which extended into temporal muscle. Extensive removal of orbital, sphenoid and basal skull bone was carried out with total excision of tumor mass in and out of the cranium. Preoperative exophthalmos still remained postoperatively. The mode of extension, result of surgery and CT findings are discussed.
Exophthalmos ; Hyperostosis ; Meningioma* ; Orbit ; Skull ; Sphenoid Bone ; Temporal Bone ; Temporal Muscle