Needs of Home Care Nursing Services for Hospital Patients

PURPOSE: The purpose of this study was to investigate the needs of home care nursing services in relation to the patients in hospital. METHOD: Subjects were 129 patients who admitted hospital and were selected through convenience sampling. Data were collected using the Home Health Care Need Assessment Questionnaire constructed by the Korea Health Industry Development Institute. Data were analyzed using SAS 8.12 program by applying percentage. RESULTS: 1. According to the diagnosis of the subjects, the majority had cancer (25.0%), followed by musculoskeletal disease (15,6%), neuro/cerebral vascular disease (14.1%), digestive (10.9%) and respiratory disease (10.9%). 2. With regard to fundamental nursing service, subjects wanted to receive home care services for the following reasons: Problem identification and diagnosis (77.5%), vital sign check (49.6%); and intake and output measure (20.9%). 3. With regard to clinical laboratory tests, 62.8% wanted to receive blood tests, and followed by urine tests 26.4%, and wound drainage 26.4%. 4. With regard to medication and treatment service, 40.3% of the subjects wanted to receive intravenous fluid therapy, 26.4% intravenous antibiotics, and 26.4% the monitoring of fluid therapy. 5. With regard to therapeutic nursing service, 33.3% wanted to receive wound care, 26.4% ROM exercise, and 27.9% foley catheter change and care. 6. With regard to educational needs, 42.6% wanted education on infection monitoring, 41.4% on medication, and 34.9% on diet. 7. With regard to counseling needs, 65.9% wanted to receive telephone counseling about patient condition, 52.7% counseling about re-admission and 51.9% direct counseling about patient condition. In the group of injury and toxicity, and cardiovascular/circulatory diseases, 100% wanted telephone and direct counseling about the patient condition. CONCLUSION: Therefore, in order to improve the quality of hospital based home health care services, various factors that affect to the need of home health care should be analyzed and specified nursing care should be looked into.

Spiritual Care and Spiritual Wellness of Hospice Team Members / 기본간호학회지

PURPOSE: This study was conducted to identify the spiritual well-being and spiritual care of hospice team members. METHOD: Between December 2005 and February 2006, a questionnaire was given to 192 hospice team members. The instruments used in this study were the Spiritual Well-Being Scale(SWBS) developed by Paloutzian, & Ellison(1984), and a Spiritual Care Performance Scale developed by the authors. RESULTS: The levels of spiritual well-being were relatively high: significantly lower in the 25-29 years old, in the unmarried, and in the 1-2 million won income groups, and significantly higher in Protestants, Catholics, clergy, and volunteers. The levels of performance of spiritual care were intermediate; significantly higher in clergy, and those with 10 or more years of experience. There was a positive correlation between: levels of spiritual well-being and age; levels of spiritual well-being and performance of spiritual care; and levels of performance of spiritual care and age. The factors affecting the levels of spiritual well-being included religion, age, and performance of spiritual care. The factors affecting the levels of performance of spiritual care were the years of hospice experience and spiritual well-being. CONCLUSION: Because there was a positive correlation between levels of spiritual well-being and performance of spiritual care, there is a need to develop a strategies to increase the spiritual well-being of hospice team members.

A Professional Nursing Practice Environment and Its Impact on Nurses' Task Motivation / 간호학회지

PURPOSE: This study was aimed at (a) describing professional nursing practice environments embedded in nursing care units and (b) examining its relationships to nurses' task motivation. METHOD: Using the Nursing Work Index Revised (NWI-R) and the Work Preference Inventory (WPI), a descriptive study was conducted with a sample of 320 registered nurses on 26 nursing care units in one University hospital in Korea. RESULT: Mean scores were 12.9 on a 5-20 score range of an autonomous environment scale, 7.3 on a 3-12 score range of a collaborative environment, and 15.8 on a 7-28 score range of control over nursing practice. Nurses' age, educational level, job position, working period at the hospital and employment status were significantly related to the degree of a professional practice environment. The extent to which a professional practice environment accounted for task motivation was 19.5%. CONCLUSION: There is a certain degree of professionalism in the workplace environment that nurses perceived within the nursing care units. When nurses care for patients, the degree of task motivation depends on the work environment supporting the professional nursing practice.

A Study on the Organ Transplantation According to the Law of Organs Transplantation / 대한이식학회지

PURPOSE: 2003, Advances in medical-surgical technologies, histo-compatibility and immunosuppressive drugs, such as FK-506, MMF, have caused a dramatic increase in the rates of successful organ transplantation (TP). As the waiting list of patients requiring TP grows, there is a subtle donation. What is worse, its increased issues of ethics, for instance, definition of brain death, consent of living donation, paid organ donation, decreased altruism, living will, justice of sharing organ. Therefore, This study was done to develop on legal, ethical and philosophical for whole procedure of organ transplantation which is a life-saving treatment improvement the quality of life. METHODS: A survey questionnaire was used and received responses from TP doctors(59) and nursing coordinators(46) at 53 hospitals where TP were being done for this study. The basic data in TP were collected, 1) to identity the staffs in charge of TP and their jobs in the hospital, 2) committee of hospital ethics (CHE), 3) committee of brain death confirmation definition (CBDCD), 4) to research what consideration are appropriate donors and recipients, 5) the facility of hospital for TP, 6) to analyzed awaiting solution the problems for TP. The data were analyzed using SAS-program by descriptive statistics, t-test, ANOVA and Pearson correlation coefficient. RESULTS: The jobs of TP nursing coordinators were not only to give nursing information but also to take care of donors and recipients (62.8~84.4%). The job of TP has not been identified between CHE and CBDCD (62.8%). The mean score of CHE's members was 6.33 persons. The mean scores of the problems regarding the law of TP was 2.88 (full score:4). The high items of the problems regarding the law of TP were "the decreased TP, donation and brain death because of KONOS (Korea Network for Orgen Sharing) which operated TP". The mean score of the improvements regarding the law of TP was 2.97 (full score:4). The highest item of the improvements regarding the law of TP was "Compensation of loss should be paid by the KONOS. The procedure of confirm is a loose legal. Therefore that is concern about commercialization of human organ. Definition of brain death is rigid regulation. Sharing organs are a fair dealing. The problems were significantly correlated with the improvements (P<0.0001). CONCLUSION: The finding of the study suggested that a TP should manage donors and recipients in line with legal, ethical, philosophical, humanistic aspects. Various viewpoints, the CHE should be enacted from the principle of human dignity, conducted by CBDCD of professional members and the nursing coordinators played an important role. It is suggested that TP might meet the request of the time so that KONOS should be changed with the other organization of newly methods and responsibility.

Molecular Epidemiology and Risk Factors of Staphylococcus epidermidis Isolated from Patients with Acute Leukemia / 병원감염관리

BACKGROUND: The purpose of this study is to define the risk factors of S. epidermidis acquisition and the epidemiology of strain variation in acute leukemia patients. METHODS: The participants were 155 patients of acute leukemia admitted in a University hospital for 11 months. 83 patients are the isolated group who had isolated S. epidermidis from body sites (blood, oral cavity, nares, rectum) and 72 patients are the not isolated group who had not isolated S. epidermidis. Isolates were analysed by CHEF and cluster analysis with dendrogram. Differences In proportions were tested with the Chi-square and Fisher's exact test. RESULTS: Ninety-one S. epidermidis were obtained from blood, oral cavity, nares, and rectum. The major proportion of positive culture was 81.3% from nares. Eight-nine S. epidermidis were isolated from healthcare workers. There were significant development of bacteremia in patients with S. epidermidis from nares. Resistance rate of S. epidermidis was 75.8% to methicillin, 86.3% to erythromycin, 81.l% to gentamicin, 68.9% to ciprofloxacin, 0% on vancomycin. There was significant difference on resistance rate between patients and healthcare workers' group. There was no relation between the strain of patients and those of healthcare workers. Sex age, diagnosis, length of stay, type of chemotherapy, duration of chemotherapy, Type of central venous catheter. duration of central venous catheter, prior antibiotic therapy, number of antibiotics, site of nosocomial infection, neutropenic period were not significantly different between S. epidermidis isolated group and not isolated group. Significant risk factors included duration of central venous catheter. hyper-alimentation, and folliculitis. CONCLUSION: Our result suggests that S. epidermidis in nares can be a risk factor of bacteremia. This research would be helpful for decreasing the S. epidermidis of immunocompromised patients.

Nurse Managers' Moral Self Concept and Ethical Sensitivity / 간호학회지

PURPOSE: This descriptive study was designed to find out the relationship between moral self concept and ethical sensitivity of nurse managers. METHODS: Study data were collected from Aug 6, 2001 to Aug 24, 2001. Study subjects were 283 nurse managers working in university hospitals. Moral self concept was measured with questionnaire developed by Chung (1965) and ethical sensitivity was measured with the questionnaire developed by the researchers. RESULTS: 1. The score for degree of nurse managers' moral self concept was shown to be an average of 3.06 out of 4.00, which is relatively high. The score for degree of nurse managers' ethical sensitivity was shown to be an average of 2.84 out of 4.00 2. Analysis of correlation between moral self concept and ethical sensitivity showed a statistically significant positive correlation (r= .34, p=.00). 3. In general characteristics, a variable that caused significant difference in moral self concept was the total period of experience as a nurse (F=3.52, p=.02). A variable that caused significant difference in ethical sensitivity was the current working department (F=3.91, p=.01). 4. Nurse administrator's moral self concept was significantly related to ethical sensitivity (r= .34, p= .00). CONCLUSION: It is important to intensify individual moral self concept in order to improve ethical sensitivity of nurse managers. Also, it is recommended that investigate variables affected moral self concept and develop a nursing education program to promote moral self concept in nurse administrators.

Korean Nursing Students' Experience of Ethical Problems and Use of Ethical Decision-Making Models / 간호학회지

PURPOSE: This study was conducted to study on 1) What is nursing students' experience of ethical problems involving nursing practice? 2) What is nursing students' experience of using ethical decision-making models? METHOD: In order to answer these two questions, we selected 97 senior baccalaureate nursing students from two Korean universities using a conceptual framework and method of content analysis. RESULT: From 97 ethical problems emerged five content categories, the largest being ethical problems involving health professionals (69%); the basic nature of the nursing students' experience of ethical problems consisted of conflict, resolution, and rationale; 94% of the students stated that using an ethical decision-making model was helpful. CONCLUSION: Although additional research is needed, these findings have important implications for nursing ethics education and practice.

A Comparison between Home Care Nursing Interventions for Hospice and General Patients / 간호학회지

PURPOSE: The purpose of the study was to compare home care nursing intervention activities analyzed by the Nursing Intervention Classification (NIC) system for hospice and general patients. METHOD: For the descriptive survey study, data was collected by reviewing charts of 151 hospice patients and 421 general patients who registered in the department of home health care nursing at K Hospital. RESULTS: According to the NIC system application, there were 2380 total nursing interventions used for the hospice patients and 8725 for the general home care patients. For both sets of patients (hospice vs. general), the most frequently used nursing intervention in level 1 was the Physiological: Complex domain (40.13 vs. 31.06 percent), followed by the Safety domain; in level 2, the Risk Management class (28.4 vs. 27.70 percent), followed by Tissue Perfusion Management; and in level 3, Vital Sign Monitoring (6.18 vs. 4.84 percent), followed by Health Screening. CONCLUSION: The study showed that there was a lack of specialized hospice nursing interventions such as emotional, family and spiritual support, and care for dying hospice patients.

A Study on the Development of an Independent Hospice Center Model / 간호학회지

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. For the organizational structure, the center is represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

Model Development of Korean Professional Hospice Care Education / 간호학회지

This study was conducted to develop an education program of hospice care for the professional in order to care for nurses for terminally ill patients facing death and their families. The Modified Tyler-Type Ends-Means model was used to guide the curriculum development of the study. The curriculum include a philosophical conception of hospice education, fundamental concepts, purpose, objective and the educational contents. The content was developed based upon a 70% or more demand in educational demand analysis. The education program has a total of 360 hours consisting of 172 hours of theoretical study and 188 hours of practice including fundamental nursing care for hospice.

Organ Transplantation and Biomedical Ethics: An Analysis of Hospital Organ Transplantation Policy and a Proposal of Ethical Guideline / 대한이식학회지

AIMS: This study was done to develop an ethical guideline for organ transplatation, a life-saving treatment which helps improve the quality of life. METHODS: This study begins with a survey of the Korean current state of affairs concerning organ transplantation. This study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. After this survey, followed by a discussion of ethical considerations in arranging organ transplants. Before proposing an ethical guideline, this study discusses a series of interesting ethical issues in transplanting(both living and cadaveric)organs including ethical foundations of organ transplantation, distributive justice and matters of donor's consent in organ transplatation. RESULTS: The foremost research for this study boils down to a survey paper titled, "An Analysis of the Current State of Affairs Concerning Organ Transplantation and Ethical Considerations in Domestic and International Hospitals." Based upon data collected from various hospitals, this work analyzes items, such as the frequency and types of organs transplanted in a hospital, the existence of organ transplant coordinator, the performance of the hospital ethics committee, and ethical considerations in obtaining consents from the living donor. Although thousands of organs are annually transplanted in domestic hospitals, virtually none of them are found to meet ethically proper standards. The paper points out the need to institutionalize a nationwide cadaveric organ distribution organization like UNOS(United Network for Organ Sharing) in the U.S., and proposes to stretch out the national health insurance to extensively cover transplanting expenses. "The Ethical Foundation of Organ Transplantation", the author counts three key ethical principles in organ transplantation: the principle of respect for autonomy; the principle of beneficence; and the principle of justice. He argues that in cases of living donor no principle should take precedence over the principle of respect for autonomy and thus it is very important for a hospital to obtain the donor's consent. As for cadaveric organ transplantation, he holds reservation because he is worried that serious shortage of organs for transplantation in conjunction with pure utilitarian considerations could change the definition of death so that the brain death gains more popularity than ever. In addition, the author claims that the proponent of organ transplantation must distinguish the moral dimension of the discussion from the legal one because otherwise she would hardly be able to defend herself from the slippery slope argument against organ transplantation. This paper concludes with a note that we must implement restrictions to avoid undesired effects if organ transplantation could ever be justified. "A Discussion of Distributive Justice in Organ Transplantation" comprises two parts. The first half delineates above mentioned ethical principles in the context of organ transplantation, while the second half goes generally over the UNOS Point System. This work is focused entirely upon cadaveric organ transplants, because the vast majority of organs available for transplants comes from cadavers and the number is still increasing. The UNOS allocates cadaveric organs based upon both medical and justice criteria. Following are summaries of the UNOS policy on organ distribution. Every potential recipient of organ transplants must be listed on the UNOS computer system waiting list. Allocation of cadaveric kidneys consider factors such as waiting time, six antigen match, panel reactive antibody, blood group and age. The UNOS Point System allocates livers to the local patients first, followed by regional and national patients respectively, in order to limit ischemic time. A recipient of liver transplant belongs to one of five(0~4) medical status levels where status 4 is the most medically urgent. At the regional and national levels pancreas are allocated first to patients with excellent HLA matches, while at the local level waiting time is the sole factor. The intestinal organ allocation system is based on two(1~2) patient status codes, ABO blood type identity and time waiting. In heart or lung tranplants ischemic time seriously matters. "A Biomedical Study of Informed Consent from the Organ Donor" investigates several topics: the relevance of the principle of respect for autonomy as the basic principle of informed consent; how the autonomy of the organ donor to be respected; and the role of the hospital ethics committee in obtaining informed consent from the donor. The author finds the principle of respect for patient's autonomy not sufficient for the basic principle of the living donor's informed consent because there is some danger in which the patient may be left uncared-for, and thus she suggests that the principle of nonmaleficence and the principle of care also be considered. That the principle of respect for autonomy turns out not sufficient even for cadaveric organ donation, and so judgment based upon the best interest of the deceased may seem appropriate for people from some special groups. A medical team must make efforts to identify the donor's competence and voluntariness, i.e., preconditions of informed consent. All the relevant medical information should be disclosed to the living donor. Once the donor makes a judgment, medical experts should respect the donor's decision. This article puts an emphasis on the role of the hospital ethics committee in such activities as identifying donor's voluntariness, confirming the disclosure, and evaluating the minority's benefit. The last work in this paper, "A Moral Theological Investigation of the Presumed Consent in Organ Transplantation" talk about Principium Riflexum(the principle of reflection) in an attempt to explain the possibility that we may harvest cadaveric organs from the deceased who while alive had never expressed their wishes concerning organ donation. To apply the principle in the context of presumed consent, the author, a Catholic priest, introduces two elements of the principle. Probabilismus allows us to feel free to choose when we face dubious matters(in dubio libetas), and by the rule of selection we are justified in choosing whatever our consciousness mandates. He takes both elements to support the presumed consent of the deceased because he believes the good that people may contribute to their neighbors by donating organs would obviously override opposing reasons. Although the author argues for the presumed consent from the deceased, he does not overlook the family grief in donating the cadaveric organs. He concludes with a suggestion that we should work to keep the public aware of cadaveric organ donation and to form public opinions education should play a key role. CONCLUSION: Researcher suggest an Ethical Guideline for Organ Transplantation as our study conclusion. 1) Body organs may be transplanted to protect the health and well-being of the patient, but not for the medical or scientific research. 2) Body organs may be taken for transplantation, only with the consent from the donor. In cases of cadaveric donors who have left no formal consent in the lifetime, they are to be presumed to refuse to donate body organs. 3) In principle, cadaveric transplantation is preferred. Living donors are limited to competent adults who have blood ties with the patient, e.g., parents, children, or siblings of the patient. However, reversible tissue like bone marrows donation may be an exception to this limitation. In particular, no living donors may be put under inappropriate pressure or influences. Body organs may be taken from the living donor only if based upon sufficient and easy-to-understand information provided, the donor voluntarily consents after (s)he deliberately balances benefits against harm. 4) Under no circumstances human bodies, organs, or tissues may be sold or purchased for transplantation. A physician should not participate in any transplanting operations if (s)he becomes to know that the transplant has been obtained through a transaction. 5) Recipients of organs for transplantation should be determined in accordance with the principle of justice on the allocation of limited medical resources. 6) When a vital, single organ is to be transplanted, the death of the donor shall have been determined by at least one physician other than the recipient's physician. 7) Transplant procedures of body organs should be undertaken (a) only by physicians who possess special medical knowledge and technical competence developed through special training, study, and laboratory experience and practice, and (b) in medical institutions with adequate facilities. 8) All decision procedures in transplanting body organs should be objective, open to parties involved, kept accurately on record, and maintained for a given period of time.

A Study on the Curriculum Development for the Professional Hospice Nurse in Korea / 간호학회지

The purpose of this study is to develop the first domestic professional hospice educational program. We investigated the present condition of Korean hospice education and analyzed the prerequisite need for a dedicated hospice course in the professional education process. Research was conducted between June and November 1996 for nursing professors teaching at each nursing education institute to find out how much hospice is being discussed and by whom, in which course it is being discussed, and also to find out the contents that needed to be include in the professional education process. From a total of 49 colleges(29 three year colleges, 20 four year colleges) out of 99, 162 nursing professors replied, the collection rate was 49.5%. The conclusions are as follows: 1. The present condition of the hospice nursing education. 1) Whether hospice is included in the education program. (1) 89-65% of 3 year colleges and 90% of 4year colleges included hospice education in their education program. (2) In graduate studies three schools included hospice their program and three schools expressed their plans to include hospice education. 2) Hospice related education were commonly discussed in adult nursing(26.3%), fundamental nursing(22.8%), and psychiatric nursing(20.2%). In 3 year colleges its commonly discussed in the first and second year and in 4 year colleges it is taught in the second and third year. 3) Hospice related theory/practical education hours were averages of 6.5/7.0 hrs in 3 year colleges and 14.2/11.3 hrs in 4 year colleges. 4) The majority of professors in charge of hospice education were in the following order adult nursing, psychiatric nursing, and fundamental nursing. 5) The courses that are thought to be adequate to manage hospice related education were adult nursing(29.3%), community health nursing(21.7%) and the described method education was the method currently being used(36.5%). 2. The demand for hospice nursing education. 1) Over 70% demanded professional hospice education program, the highest demand was for the value and meaning of life followed by the role and qualification of the hospice team and the mental maintenance of a dying patient. 25 categories showed over 90% demand. 2) The highest demand was for the value and meaning of life(98.2%) and the lowest demand were for danjeon breathing(71.0%) and acupuncture(71.0%). 3) Other contents that need to be discussed in the professional hospice education program were hospice nursing, the attitude and reaction of death, bereavement care, and the prospect of hospice.

A study of the current ethical situation in organ transplantations in Korea / 간호학회지

This primary study was done to develop an ethical guideline for organ transplantation, a life-saving treatment which helps improve the quality of life. This study tried to identify the current situation in Korea, in terms of ethical considerations in organ transplantations. This study collected basic data in organ transplantations, in the hope that procedure of organ transplantations could be developed that would be fair to both organ donors and recipients. The immediate goals of this study were : 1)to identify staff in charge of organ transplantations and their jobs in the hospital, 2) to survey whether there exists a Hospital Ethics Committee(HEC), 3) to research what consideration are formally taken in selecting recipients, and 4) to accumulate data on how consent from donors are currently obtained. The study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. Organ transplantation coordinators were found in 16 hospitals, but the job description varied among hospitals. The survey showed that all 16 hospitals with and HEC that health care personnel unnecessarily dominate the committee. The study notes that HECs should be vitalized by recruiting, as members, ethicists, theologians, patients, guardians, as well as the general public outside of the hospital. The study revealed that in selecting recipients the hospital take into account ABO blood type, histocompatibility, age, waiting time, and level of patient compliance. Finally, it was shown that in the cases of living donors the transplanting hospitals seek a formal consent, whereas there are no common consenting practice established for cadaveric donors. The study concludes with three proposals. First, a nationwide institution responsible exclusively for procurement and distribution of cadaveric organs for transplantation should be established. Second, we should rebuild the national health insurance system so that have costly organ transplantation expenses are substantially covered. Last, but certainly not least, there is a need to emphasize the HEC's committment to prepare a proper ethical guideline for organ transplantation in general.

Renal Parenchymal Change Before and After Treatment in Vesicoureteral Reflux / 대한비뇨기과학회지

The combination of reflux and infection may produce progressive renal damage. If the V-U reflux is corrected, normal renal growth can be resumed in most cases, but some cases remain with reduced renal growth. 70 kidneys with V-U reflux during the past 5 years was reviewed clinically, so the following results were obtained; 1. The incidence of renal scar was noticed in 50% among 70 VUR cases, and the incidence and the severity of renal scar was increased according to the grade of VUR. 2. 33 cases (94.3%) of 35 cases with renal scar was associated with UTI, and in these cases the grade of renal scar was higher than no UTI cases. 3. Under the age of 4 years the incidence of renal scar was high as 23 (60.5%) out of 38 VUR cases. and over the age of 4 years the incidence of renal scar was low as 12 (37.5%) out of 32 VUR cases. 4. The length & width in VUR cases compared to normal for age was within normal limit, but the renal parenchymal thickness compared to normal was lower. In the higher grade of VUR the parenchymal thickness was thinner than in he lower grade. 5. In most cases of successfully treated VUR medically and surgically, renal parenchymal thickness was grown into the normal level. Although the VUR was treated successfully, renal parenchymal growth was retarded in the higher grade of VUR (more then IV) or more severe renal scar (more than b).

Sexual Function in Patients with Spinal Cord Injury / 대한비뇨기과학회지

One important aspect for patients with spinal cord injury is adjustment to altered sexual activity. We studied for the evaluation of the sexual function in patients with spinal cord injury. The following results were obtained. l. 46 spinal cord injury patients were interviewed concerning erections, coitus, ejaculation and orgasm. 32 (69.6%) of t6 spinal cord injury patients were returned erections: 14 (30.4%) patients attempt coitus were successful, 7 (15.2%) patients could ejaculate, and 3 (6.5%) patients had orgasm. Psychogenic erection occur more with LMN lesions. Reflexogenic erection was shown at a higher incidence in patients with LMN lesion. In incomplete UMN lesions, both psychogenic and reflexogenic erection occur with the reflexogenic erection being more predominat. 2. In 8 impotent patients due to spinal cord injury, PBI, BCRLT and Papaverine test were measured. 1) In all patients PBI were greater than 0.75. This result was thought to be not related with vasculogenic factor in the impotence due to spinal cord injury. 2) In BCRLT LMN lesion and mixed type showed no response and delay, UMN lesion was within normal limit. 3) In 5 impotent patients due to spinal cord injury, 30mg papaverine was injected into the corpus cavernosum. One patient showed partial erection, and in 4 patient the penile rigidity was lasted upto 60-90 minutes. There was no complication. 3. The Jonas Silicone silver penile prosthesis was implanted in 3 spinal cord injury patients associated with the impotence and neurogenic bladder. There was no complication, no change of previous voiding pattern and no increased residual urine after implantation of penile prosthesis.

Bilateral Congenital megacalicosis: A Case Report / 대한비뇨기과학회지

Megacalicosis is a primary disease of renal calyces which were dilated without evidence of obstruction. Since its first description by Puigvert in 1963, megacalicosis has been described in many literatures. Recently we experienced a case of bilateral congenital megacalicosis with right lower ureteral obstruction. Herein we report our case with brief review of literatures.

A Case of Dysgenetic Male Pseudohermaphroditism / 대한비뇨기과학회지

Dysgenetic male pseudohermaphroditism is a disorder of sexual differentiation in which patient with bilateral dysgenetic tests, persistent Mullerian structures, cryptorchidism and inadequate virilization. We experienced one case of dysgenetic male pseudohermaphroditism with 45,XO/46,XY mosaicism and hypothalamic dysfunction, so we reports this case with a brief review of the literatures.

A Case of Renovascular Hypertension in Child / 대한비뇨기과학회지

The hypertension in children is relatively rare disease and renal arterial disease does constitute a relatively more common cause of hypertension in children. Recently, we experienced a case of renovascular hypertension due to left renal artery stenosis in 11-year-old boy, corrected by splenorenal bypass and good result was obtained. Herein we report a reconstructive vascular procedure with some literatures.

Two Cases of Malignant Lymphoma with First Manifestation in the Testis / 대한비뇨기과학회지

Although involvement of the testis by a generalized malignant lymphoma is not infrequent, especially in the terminal stages of this disease, testicular involvement as a first manifestation of malignant lymphoma is uncommon, comprising 1 to 7 percent of testicular tumors and accounting for 25 to 50 percent of testicular tumors in men over 50 years of age. The prognosis of malignant lymphoma with first manifestation in the testis is generally poor, with progression to systemic lymphomatous involvement within 6 to 12 months, and reported 5-year survival rates ranging from 10 to 30 percent. Herein we report 2 cases of malignant lymphoma with first manifestation in the testis and review the literature.

Therapeutic Effects of Norfloxacin(Neutam-400 / 대한비뇨기과학회지

Norfloxacin is a new broad spectrum of antibacterial activity against both Gram-positive and Gram. negative bacteria. After oral administration of Norfloxacin, it produces high concentrations in the urine, so it has the excellent effect for the treatment of urinary tract infection. Norfloxacin was studied with respect to clinical effect in 115 patients with the urinary tract infection and the following results were obtained. 1. Excellent efficacy was 53% and efficacy rate was 90% in upper urinary tract infection(UTI). Efficacy rate for 20 patients with upper UTI without the underlying disease was 100%, and in 29 patients with underlying disease efficacy rate was 83%. 2. In upper UTI resistant for other antibiotics, efficacy rate was 78%. 3. In lower UTI excellent efficacy rate was 36% and efficacy rate was 71%. In gonococcal urethritis excellent efficacy rate was 76% and efficacy rate was 88%. 4. Eliminated rate of bacteria on culture findings were E. coli 93%, pseudononas 89%, proteus 100%, klebsiella 80%, gonococcus 88% and staphylococcus 80%. 5. Mild side effects such as epigastric pain, nausea, dizziness and itching sensation were seen in 5 cases. We consider Neutam-400 is one of the most effective agents in urinary tract infection.