Background: Flail chest is a severe condition of thoracic trauma, and it requires diagnosis and treatment as soon as possible. From year 2000, we developed an improved technique of open fixation in order to adapt the situations of Vietnam health settings. Objectives: To report preliminary results of application of improved open fixation technique in Viet Duc Hospital from 2001 to 2006. Subjects and method: This descriptive, prospective and retrospective study involved 19 patients with flail chest due to closed thoracic trauma or multiple traumas, treated by open fixation technique. The parameters included features of patients, characteristics of this technique and postoperative progression.Results: Of 19 patients, there were 16 males and 3 females, mean age: 47.8 years. All patients presented obvious signs of flail chest preoperatively, but only 9 cases were treated by open fixation technique and pleural drainage immediately. This technique canbe applied in all sugical settings with single local anaesthesia, and any kind of common surgical threads. The most suitable initial pulled weight is 2000 g. All cases of flail chest required pleural drainage. All patients had good outcomes with open fixation technique, no death. There were 3 patients with postoperative complications, all were severe multiple trauma patients. Conclusion: Improved open fixation technique applied in Viet Duc Hospital is simple, effective and safe, and can be widely used in all surgical settings.
Flail Chest ; Flank Pain/ therapy ;

Renal vein thrombosis is a rare, renal disease in adults that is related to hypercoagulability. We experienced a case of renal vein thrombosis in a 30-years old woman who presented with fever, chills and left flank pain after delivery. She was treated with catheter-directed thrombolytic therapy and oral anticoagulants.
Adult ; Anticoagulants ; Chills ; Female ; Fever ; Flank Pain ; Humans ; Pregnancy ; Renal Veins* ; Thrombolytic Therapy ; Thrombophilia ; Thrombosis*

PURPOSE: The aim of this presentation is to analyze the factors influencing on retrograde insertion of double-J catheter in urethral obstruction due to malignancy and to predict the possibility of stunting with double-J catheter. MATERIALS AND METHODS: A retrospective analysis of 43 patients who had underwent retrograde double-J catheter insertion for urethral obstruction secondary to pelvic malignancy, from January 1993 to April 1997, was performed to evaluate the success rates of double-J ureteral stenting according to the factors such as age, sex, presence or absence of flank pain, degree of hydronephrosis, renal function, stage of tumor, laterality of ureter, past history of radiotherapy, operation and chemotherapy. RESULTS: According to the degree of hydronephrosis, the success rate was 100, 73.7 and 50% in grade I II and III, respectively(p<0.05). According to the renal function, the success rate was 81.3% in the group with normal renal function and 45.5% in the group with abnormal venal function(p<0.05) According to the stage of disease, the success rate was 100, 70.7 and 58.3% in stage I, II and III, respectively. According to the absence or presence of flank pain, the success rate was 56.3% in the group with flank pain and 81.5% in the group without flank pain. According to the past history of radiotherapy, the success rate was 65.6% in the group treated with radiotherapy and 90.9% in the group not treated with radiotherapy. The age, sex, laterality of ureter, past history of operation and chemotherapy were not significantly correlated to the success rates. CONCLUSIONS: The factors influencing on double-J ureteral slanting were the degree of hydronephrosis, renal function, absence or presence of flank pain, stage of disease and past history of radiotherapy Further study will be needed to demonstrate the accurate timing of urethral stenting with doublets ureteral catheter.
Catheters* ; Drug Therapy ; Flank Pain ; Humans ; Hydronephrosis ; Radiotherapy ; Retrospective Studies ; Stents ; Ureter* ; Ureteral Obstruction* ; Urethral Obstruction ; Urinary Catheters

A 54-year-old woman visited Gangnam Severance Hospital for left side flank pain. She had a history of total removal of malignant melanoma on the left eye ball 20 years prior. No evaluation had been performed since then. A paravertebral mass at thoracic ninth level (T9) was discovered on spinal magnetic resonance imaging, and pathology confirmed malignant melanoma. Following positron emission tomography-computed tomography, no other metastasis was discovered. After removal of the paravertebral mass, palliative chemotherapy (dacabarzine + tamoxifene) was administered in 3 cycles over 2 months. Radiotherapy with simultaneous integrated boost technique was performed at 4,350 cGy total over 15 days, 290 cGy per delivery, and was administered with the first cycle of palliative chemotherapy. Despite this treatment, multiple metastases developed throughout her body 7 months later, and the patient is continuing chemotherapy.
Choroid* ; Drug Therapy ; Electrons ; Female ; Flank Pain ; Humans ; Magnetic Resonance Imaging ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Pathology ; Radiotherapy ; Spine*

A clinical and statistical study was made on 196 cases of urinary tract tuberculosis seen during the period from January 1972 to December 1976. The results are summarized as follows: 1) Of the 196 patients, the most frequent age group was 21-40 years old, giving ratio of 64.8% 2) Sex distribution of male to female was 1.3 : 1. 3) The most frequent finding of urine was pyuria(88. 5%), in order of hematuria(79.6%) and proteinuria(82. 2%). The most common symptom was frequency, in order of dysuria, flank pain and scrotal pain. 4) By acid-fast stain and culture of urine, tubercle bacilli were demonstrated in 52.6% cases. 5) According to the result of urinary finding during chemotherapy, tubercle bacilli were not detected in 64.3% after chemotherapy for 6 months, and in 80 % after chemotherapy over 6 months. 6) The involved genitourinary tuberculosis were kidney(76. 9%). ureter(26.9%) and epididymis (11. 5%). 7) Tuberculosis in other organ combined with G-U tract Tb were 42.3%, such as pulmonary tuberculosis(30. 7%), pleura(6.4%) and lymph-node(2.6%) and pulmonary tuberculosis with urinary tuberculosis patients were 7.2%. 8) The positive roentogenographic finding in positive urine AFB was 75.6% and negative urine AFB was 86.5%.
Drug Therapy ; Dysuria ; Epididymis ; Female ; Flank Pain ; Humans ; Male ; Sex Distribution ; Statistics as Topic ; Tuberculosis* ; Tuberculosis, Pulmonary ; Urinary Tract*

A clinical observation was made on 46 cases of renal tuberculosis who were admitted to the Department of Urology, Eul Ji General Hospital, Seoul, Korea, during the period from January 1978 to December 1982. Following results were obtained. 1. The most common symptoms were urinary frequency (47.8%), gross hematuria (43.5%) flank pain (32.6%) and dysuria (21.7%). 2. Tubercle bacilli were demonstrated in 37% of patients by Ziehl-Neelson staining. The most common findings of urine were hematuria (73.9%), Pyuria (54.4%) and proteinuria (32.6%). 3. Excretory urographic findings in 46 cases of renal tuberculosis were non visualization (45.7%), calyectasis (28.3%), delayed visualization (15.2%), ureteral deformity (10.9%). 4. The most common finding of cystoscopy was hemorrhagic patches (44.4%), followed by sealed off ureteral orifice (s) in 30.6%, ulceration and tubercle formation in 25.0%. 5. Patients were managed by chemotherapy only in 47.8%, chemotherapy with nephrectomy in 43.5%, chemotherapy with reconstructive surgery in 8.7%.
Congenital Abnormalities ; Cystoscopy ; Drug Therapy ; Dysuria ; Flank Pain ; Hematuria ; Hospitals, General ; Humans ; Korea ; Nephrectomy ; Proteinuria ; Pyuria ; Seoul ; Tuberculosis, Renal* ; Ulcer ; Ureter ; Urology

A clinical observation was made on 35 patients with renal tumor who had been admitted to the Department of Urology, Kyungpook University hospital during the period from January, 1975 to December, 1979. The following results were obtained; 1) The incidence of renal tumor among total 1, O29 inpatients was 3.4% and 16.3% among the 214 genitourinary tumors. The most prevalent age group was fifth decade. There were 22 men and 13 women, for a ratio of 1.7`1. 2) histopathological analysis showed renal cell carcinoma in 16 cases, transitional cell carcinoma in 5 cases and Wilms` tumor in 4 cases, in order of frequency. 3) The most frequent symptoms and signs were palpable mass in 51.4%, flank pain in 45.7% and gross hematuria in 42.8%, but these were seen as the classical symptom triad in 11.4% of the patients. 4) Renal angiography was performed in 14 patients with renal tumor. 7 renal cell carcinomas, 2 Wilms` tumors, 3 transitional cell carcinomas and 2 renal cysts were accurately diagnosed. S) At the time of diagnosis distant metastases were found in 6 patients with renal cell carcinoma. 6) Treatment of renal tumors consisted of surgery and adjuvant radiation and/or chemotherapy. In renal cell carcinoma 3 simple nephrectomies, 9 radical nephrectomies and l pedicle ligation only were done. Post-operative radiation or chemotherapy was performed in 2 cases. It patients with Wilms` tumor 1 simple nephrectomy, 3 radical nephrectomies were performed and in all the patients combined radiation and/or chemotherapy after surgery were Jone for cure of tumor. In 5 patients with transitional cell carcinoma, 2 patients underwent simple nephrectomy and 3 patients nephroureterectomy with bladder cuff resection.
Angiography ; Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Diagnosis ; Drug Therapy ; Female ; Flank Pain ; Gyeongsangbuk-do ; Hematuria ; Humans ; Incidence ; Inpatients ; Ligation ; Male ; Neoplasm Metastasis ; Nephrectomy ; Urinary Bladder ; Urology

A clinical observation was made on 25 cases of renal adenocarcinoma admitted to the Department of General Surgery and Urology, National Medical Center, Seoul, Korea, during the period from January. 1963 to December. 1977. The following results were obtained : 1) The range of age was from 25 to 66. The most prevalent age group of renal adenocarcinoma was 50 to 59 (36%). The male and female ratio was 1.8 : 1. 2) 6 cases or 248 of 25 cases visited to hospital from one to six months after the occurrence of initial disturbance and 5 cases from 1 year to 2 years. 3) Among the symptoms on admission, hematuria was in 15 cases (60%), mass in 10 cases (40%) and flank pain in 7 cases (28%) 4) On the physical examination, abdominal mass was in 13 cases (52%), abdominal tenderness in 9 cases (36%) and hypertension in 8 cases (32%). On the laboratory examination, anemia was in 9 cases (36%), erythrocytosis in 2 cases and elevation of ESR in 8 cases (32%) 5) On the urograms , the non-visualization of the kidney was found in 6 cases (20%) and poor visualization in 7 cases (28%), Flattening , elongation, narrowing, and irregular filling defect of the pelviocalyces were found in 9 cases (36%) while elongation of one or more calyces noted in 2 cases . 6) The degree of vascularity on angiography revealed avascularity in 1 case, minimal vascularity in 2 cases, moderate vascularity in 3 cases and marked vascularity in 19 case (76%). 7) The right kidney was involved in 12 cases and left kidney in 13 cases. The upper pole was involved in 9 cases (36%), lower pole in 7 cases (28%), midportion in 4 cases and diffuse involvement was 5 cases. 8) The pathological staging was done in 22 of 25 cases. The Results revealed stage I in 5 cases, stage II in 2 cases, stage III in 6 cases and stage IV in 9 cases. 9) The histological type of 20 cases revealed clear cell in 10 cases, granular cell in 4 cases and mixed variety in 6 cases. 10) There were 4 cases of lung metastasis which were the most common metastatic involvement and 2 cases of vone metastasis. 11) Nephrectomy was performed on 18 cases, combined treatment with nephrectomy and chemotherapy was undergone in 2 cases and palliative treatment in 5 cases. 12) 1-year survival rate was 43.1%(7/16) and 5-year survival rate 7.7%(1/13).
Adenocarcinoma ; Anemia ; Angiography ; Drug Therapy ; Female ; Flank Pain ; Hematuria ; Humans ; Hypertension ; Kidney* ; Korea ; Lung ; Male ; Neoplasm Metastasis ; Nephrectomy ; Palliative Care ; Physical Examination ; Polycythemia ; Seoul ; Survival Rate ; Urology

A clinical observation was made on 78 cases of renal tuberculosis, admitted to the Department of Urology, Hanil Hospital during the period of 10 years from Jan 1, 1968 to December 31 1977. The results were summarized as follows. 1. During this period, the total number of in-patients were 907 among which 78 cases had renal tuberculosis, giving a rate of 8.6 % to total in-patients. 2. The most common age groups showed that 83.3 % of the cases in 11 to 40 years of age, and male to female ratio was 1.2: 1. 3. The site of the lesion showed right to left ratio of 48.7 % to 42.3 % and bilateral in 9.0 %. 4. Common symptoms were gross hematuria in 48.7 %, frequent urination in 46.2 %, painful urination in 35.9 %, flank pain in 34.6 % and scrotal swelling in 9.0 %. 5. 56.4 % of the cases admitted to in one month to one year period after onset of the symptoms. 6. The most common complication was pul tbc in 36 %. 7. Laboratory findings were as follows : acid urine in 83.3 %, proteinuria in 91.0 %, microscopic hematuria in 73.1 %, pyuria in 74.4 % and increased ESR in 67.9 %. 8. Urine AFB Positive findings were 25.7% in smear and 35% in culture. 9. Of blood nitrogen level of 30 patients, over 60% of cases showed normal level, and the highest level was shown by a bilateral renal tuberculosis case. 10. The excretory urographic changes in 50 cases of renal tuberculosis were nonvisualization in 44%, delayed visualization in 32%, caliectasis in 26%, narrowing or dilatation of ureter in 18% and contracted bladder in 4%. 11. Cystoscopic findings were active lesion of cystitis in 48.7% and fibrosis with trabeculation of bladder wall in 20.5%. 12. Method of treatment include chemotherapy only in 55.1%, nephrectomy in 38.5%, nephrostomy in 1.3%, cutaneous uretrostomy in 1.3% and untreated in 3.8%.
Cystitis ; Dilatation ; Drug Therapy ; Female ; Fibrosis ; Flank Pain ; Hematuria ; Humans ; Male ; Nephrectomy ; Nitrogen ; Proteinuria ; Pyuria ; Tuberculosis, Renal* ; Ureter ; Urinary Bladder ; Urination ; Urology

Clinical observation of renal tuberculosis was made on 44 cases who were admitted to the Department of Urology. Seoul Adventist Hospital, during the period from January 1973 to December 1978. The results are summarized as follows: 1. During this period, the total number of in-patients was 782 among which 44 cases had renal tuberculosis. giving a rate of 5.6% of total in-patients. The ratio of the annual number of renal tuberculosis cases against total number of urologic in-patients is decreasing significantly. 2. 24 cases (54.5%= out of 44, were in the age group of 21 to 40, and male to female ratio was 1.6: 1. 3. Both kidneys were affected in 21 cases (47.8%), while l3 cases (29.5%) involved the left kidney and 10 cases (22.7%) the right one. 4. The frequent subjective complaints were as Follows: Frequency in 70.5%, gross total hematuria in 68.2%, painful urination in 56.8% and flank pain or dullness in 52.3%. 5. 43.2% of the cases visited the hospital within 6 months after onset of the symptoms. 6. 68.2% of the cases were associated with active or healed pulmonary tuberculosis. 7. Other presenting tuberculous lesions and combined diseases were as follows: Tuberculous epididymitis in 5 cases, tuberculous lymphadenitis in 3 cases, contracted bladder in 11 cases. Uremia in 4 cases and urinary stone in 3 cases. 8. Normal ranges of BUN and Creatinine were found in 34 cases and 37 cases respectively and in creased ESR was found in 28 cases. 9. Urinalysis findings revealed proteinuria in 72.7%, hematuria in 93.2% and pyuria in 84.1%. Urine AFB was found in 61.4% by Ziehl Neelsen`s method and in the 38.6% of negative stains, urine AFE culture revealed positive in 6.8%. 10. On the excretory urogram of 65 kidneys, functional changes are as follows. Nonvieualization in 41.6%, caliectasis in 3O.8%, hydrourettronephrosis in 23.6%. moth-eaten appear ance in 18.5% and contracted bladder in 25.0%. 11. Retrograde or antegrade pyelographic changes of the l9 non-visualized kidneys on excretory uro-gram are as follows: hydronephrosis in 52.6%, caliectasis in 36.8%, parenchymal destruction in 3l.6 % and cavity with pyonephrosis in 21.1%. l2. The patients were managed by chemotherapy only in 11 cases and combined chemotherapy and nephrectomy in 28 cases, nephrostomy in 13 cases and ileocystoplasty in 4 cases. 13. Histopathologic findings of 28 nephrectomized kidneys disclosed parenchymal tuberculous granulomas in all cases and severely atrophic changes in 1 cases.
Coloring Agents ; Creatinine ; Drug Therapy ; Epididymitis ; Female ; Flank Pain ; Granuloma ; Hematuria ; Humans ; Hydronephrosis ; Kidney ; Male ; Nephrectomy ; Proteinuria ; Pyonephrosis ; Pyuria ; Reference Values ; Seoul ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary ; Tuberculosis, Renal* ; Uremia ; Urinalysis ; Urinary Bladder ; Urinary Calculi ; Urination ; Urology