Eleven patients underwent posterior sagittal anorectoplasty(PSARP) as a secondary procedure. Two of them had rectovaginal fistula and another two had rectocutaneous fistula. Six of the rest complained of frequent fecal soiling and the last one had severe anorectal stricture after perineal anoplasty. Five patients had lived with colostomy until the second operations were carried out. The ages at the time of the secondary PSARP were between 7 months and 29 years. Distal colostogram and MRI were taken to evaluate distal colon, position of the rectum and voluntary muscle. All patients had normal sacrum except one who had anorectal stricture. Seven patients, six with fecal incontinence and the other one with rectovaginal fistula had mislocated anorectums. Three patients, two with rectocutaneous fistula, the other one with anorectal stricture, had abdominal approach to obtain enough length of colon for pull-through procedure. With the posterior midsagittal approach, we could manage all the problems, rectovaginal fistulas, rectocutaneous fistulas, strictures and malpositioned rectums, without difficulty. No patients had serious complications except wound infection in one. All patients were satisfied with the results after redo-PSARPs even though normal continence has been achieved in only one patient. Seven patients who had continuous soiling or rectocutaneous fistula, needed no more diapers even though four of them showed fecal staining under stressful condition and the other three showed intermittent fecal leaking less than once a day. The rest three of the patients maintained their continence with support of drugs and/or enemas because of constipation. The PSARP is a popular procedure as a primary operation; however, our results suggested that this procedure also gave us a good opportunity for management of serious complication developed after primary anoplasties.
Colon ; Colostomy ; Constipation ; Constriction, Pathologic ; Enema ; Fecal Incontinence ; Fistula ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Rectovaginal Fistula ; Rectum ; Sacrum ; Soil ; Wound Infection

The purpose of this study was to investigate the gaps of bone-acetabular component interface, the initial mechanical stability and the effects of adjuvant screw fixation in the press-fitted two different shaped porous-coated acetabular components. Semi-hemispherical Harris-Galante II cup and full hemispherical Trilogy cup were press-fitted with or without adjuvant screw fixation in 40 bovine femur. The gaps of bone-implant interface were measured in each radiography of all specimen and axial compression tests and rotational stability tests were performed using servohydraulic tension-compression machine. There was significantly smaller gap at polar 1/3 region in the specimen implanted with Trilogy cup. But the adjuvant screw fixation did not affect the amount of gap. There was no significant statistical difference in axial load and rotational stability test in each situations of fixation. This study demonstrates that the initial mechanical stability is not influenced by the shape of semi-hemispherical Harris-Galante II cup and full hemispherical Trilogy cup and also independent of adjuvant screw fixation. But smaller gap of Trilogy cup at the polar 1/3 region indicates the possibility that less amout of wear debris of polyethylene or metal will be deposited and therefore less osteolysis or cup loosening will occur, but this hypothesis should be confirmed by the long-term clinical follow-up.
Acetabulum* ; Arthroplasty, Replacement, Hip* ; Femur ; Follow-Up Studies ; Osteolysis ; Polyethylene ; Radiography

To Evaluate the clinical characteristics of childhood-onset systemic lupus erythemoatosus (SLE) and analyse the factors related to outcome of renal function in lupus nephritis, we reviewed medical records of 18 cases of SLF diagnosed at the Department of Pediatrics. Pusan National University Hospital from January 1981 to December 1990. The results were as follow: 1)Male to female ratio was 1:2.6. 2) Nephropathy was the most common initial impression, and 8 cases were diagnosed as SLE at first. 3) The clinical menifestation. was ANA (+), malar rash, renal disorder, hematologic disorder in frequency. 4) Diffuse proliferative lupus nephritis was the most common in renal histopathologic studies. 5) Among the follow-up cases, active lupus was 39%, remission was 28%. 6) As factors related to outcome of lupus nephrits were, hypertension and proteinuria were siginificant statistically.
Busan ; Exanthema ; Female ; Follow-Up Studies ; Humans ; Hypertension ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Medical Records ; Pediatrics ; Proteinuria

Kawasaki disease is generally diagnosed base on its clinical features. Sometimes unusual or atypical presentations make the diagnosis of Kawasaki disease difficult. We experienced an unusual case of Kawasaki disease presented with unilateral parotitis in a 23-month old girl. Despite of intravenous antibiotics treatment, fever and unilateral parotid swelling persisted. Skin rashes, conjunctival injections, and coronary abnormalities showed up on the 8th day of fever. After the intravenous immunoglobulin and salicylates treatment, all symptoms disappeared. Although unilateral parotitis is very unusual presentation of Kawasaki disease, in case of no response to antibiotics, Kawasaki disease should be included in the differential diagnosis.
Anti-Bacterial Agents ; Child* ; Diagnosis ; Diagnosis, Differential ; Exanthema ; Female ; Fever ; Humans ; Immunoglobulins ; Mucocutaneous Lymph Node Syndrome* ; Parotitis* ; Salicylates

Purpose: : Communication skill of healthcare providers is important in quality care. The purpose of this study are to identify intervention its outcome for improving communication skills among nurses. Methods: : This is a literature review databases were searched, including RISS, KISS, KMbase, KoreaMed in Korea. The strategy was established in search terms included nurses, communication, programs and literature reviewed during published in the last 10 years. Results: : We including 9 studies, conducted mainly in hospital settings. Most communication programs consist of lecture, role play, feed-back, discussion. As a results of, communication programs appear to be effective in improving communication skills for nurses. We found evidence to support a beneficial effect of communication programs on nurses’ communication skills, self-efficacy, interpersonal relationship, emotional intelligence and intershift performance. Conclusion : Study results indicate that educational and training programs are needed to increase communication skills for nurses within various clinical contexts. Based on the results of this study, it is necessary to conduct systematic review, meta-analysis research so that the effects of communication programs of clinical nurses can be systematically identified.

Background: This study aims to investigate the relationship between clinical practice stress, communication skills, and clinical performance of nursing students who have engaged in virtual online practicum due to coronavirus disease-19 (COVID-19). The findings will serve as foundational data for developing education programs to enhance nursing students’ clinical performance. Methods: The data were collected from 111 third- and fourth-year nursing students at a nursing school in Busan Metropolitan City who experienced virtual online clinical practice due to COVID-19, from October 4 to October 15, 2021. Instruments to measure clinical practice stress, communication skills, and clinical performance were used. The collected data were analyzed using descriptive statistics, independent t-test, one way analysis of variance, and Pearson’s correlation coefficients. Results: Among nursing students who have engaged in a virtual online clinical practice, the mean clinical practice stress score was 2.49±0.53, and the mean communication skills score was 4.01±0.43. The mean clinical performance score was 3.80±0.56. Clinical performance was significantly positively correlated with communication skills (r=0.62; P<0.001). Conclusions Based on these results, it is important to develop and implement education programs that enhance communication skills in order to improve clinical performance in nursing students who have experienced virtual online practice. As this study was conducted on nursing students at a single school, interpretation of the results requires caution. Thus, future research should recruit a larger study population and identify relevant variables.

Leiomyoma is one of the rarest solid tumor of the ovary. Approximately 50 cases have been published to date. However, most reported leiomyoma of the ovaries were small and rarely induced serious symptoms. We report a case of ovarian leiomyoma in 57-year-old woman which has been experienced in our haspital with brief review of literature.
Female ; Humans ; Leiomyoma* ; Middle Aged ; Ovary*

PURPOSE: To evaluate the surgical results of segmental scleral buckling procedures in pseudophakic retinal detachments. METHODS: We retrospectively analyzed the surgical results of 35 patients (35 eyes) undergoing only segmental scleral buckling procedures in pseudophakic retinal detachments, who had been postoperatively followed up 6 months or longer. RESULTS: The average age of patients was 58.4 +/- 14.8 and twenty-five of the 35 patients were male. Posterior capsule was ruptured in 14 eyes, and among the 14, 5 eyes had vitreous prolapse. The primary success rate of segmental scleral buckling procedures was 100% (21/21 eyes) in intact posterior capsules, and 64.3% (9/14 eyes) in ruptured posterior capsules. The causes of failure were proliferative vitreoretinopathy (2 eyes) and failure to close the retinal breaks (3 eyes). CONCLUSIONS: We suggest that segmental scleral buckling procedure may be an effective method for the management of retinal detachments in pseudophakia if without posterior capsule ruptures.
Capsules ; Humans ; Male ; Prolapse ; Pseudophakia ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Rupture ; Scleral Buckling* ; Vitreoretinopathy, Proliferative

No abstract available.
Hyperthyroidism*

OBJECTIVES: Psychiatry in North Korea is believed to seem very different from psychiatry in South Korea. However, there is nearly no information regarding psychiatry in North Korea until now. Our study aimed to get information about North Korean psychiatry. METHODS: Three North Korean defectors in South Korea, whose clinical experience as medical doctors in North Korea was over 10 years, were recruited. They underwent the semi-structured interview, content of which included the clinical experience with psychiatric patients, the details of psychiatry, the treatment of psychiatric patients, the stigma of mental illness, and the suicide, in North Korea. RESULTS: In North Korea, psychiatric department was called as 49th(pronounced as Sahsip-gu-ho in Korean). Only patients with vivid psychotic symptoms came to psychiatric department. Non-psychotic depression or anxiety disorders usually were not dealt in psychiatry. The etiology of mental illness seemed to be confined to biological factors including genetic predisposition. Psychosocial or psychodynamic factors as etiology of mental illness appeared to be ignored. Psychiatry was apparently separated from political or ideological issues. The mainstay of psychiatric treatment is the inpatient admission and out-of-date therapy such as insulin coma therapy. Stigma over mental illness was common in North Korea. Suicide is considered as a betrayal to his/her nation, and has been reported to be very rare. CONCLUSION: The situation of psychiatry in North Korea is largely different from that of South Korea. Although some aspects of North Korean psychiatry are similar to psychiatry in former socialist countries, North Korean psychiatry is considered to have also its unique characteristics.
Anxiety Disorders ; Biological Factors ; Convulsive Therapy ; Democratic People's Republic of Korea ; Depression ; Genetic Predisposition to Disease ; Humans ; Inpatients ; Porphyrins ; Republic of Korea ; Suicide