Tissues obtained by transurethral prostatectomies were evaluated histologically and correlated with the clinical findings and the transrectal ultrasonographic pictures of 104 patients with benign prostatic hyperplasia (BPH). The patients were divided into 3 groups according to the following histology. predominantly glandular types (30 patients), predominantly stromal types (35 patients) and mixed types which have equal proportions of glandular and stromal hyperplasia (39 patients). The average age was highest in the glandular group. Postoperative obstructive symptom scores were significantly lower in the stromal type as compared to the glandular and the mixed type. The maximal flow rates at three months following the operations were highest in the stromal type. In comparison of the histologic findings with preoperative transrectal echographic pictures, the transverse and the longitudinal diameter of the transitional zone were significantly lower in the stromal type than in the glandular and the mixed type. The weight of transitional zone was significantly smaller in the stromal type than in the glandular and the mixed type. The echogenicity showed hyperechoic and isoechoic pattern in the stromal and the mixed type and hypoechoic and isoechoic pattern in the glandular type. The echographic homogeneity, the frequency of prostatic calculi and cyst formation, and the margination of the transitional zone did not show any significant difference among each group. In conclusion, the histologic types of BPH have correlations with the clinical findings and the transrectal ultrasonographic pictures. Furthermore precise interpretation of the histologic types of BPH by transrectal ultrasonography will be helpful in decision making about the treatment modality and in prediction of the clinical progress after some treatment for the patients with BPH.
Calculi ; Decision Making ; Humans ; Hyperplasia ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate ; Ultrasonography

Retroperitoneal lipoma probably constitute the group of the most massive solid abdominal tumors; their etiology is unknown; their symptoms insidious; and recurrence and sarcomatous change frequent. The clinical diagnosis was made by clinical symptoms, physical findings and radiologic evaluation such as intravenous urography, ultrasonography, computed tomography, angiography and so on. Abdominal CF scan provided clinically the most useful information regarding the state of tumors and also their effect on adjacent structures and shows homogenous appearing fat tissue with a low attenuation coefficient identical to that found in the subcutaneous fat. We present a case of treatment for a huge retroperitoneal lipoma in a 46-year-old man.
Angiography ; Diagnosis ; Humans ; Lipoma* ; Middle Aged ; Recurrence ; Subcutaneous Fat ; Ultrasonography ; Urography

Renal leiomyoma, a rare benign tumor, is a challenging diagnostic and therapeutic condition. The preoperative diagnosis of renal leiomyoma is very difficult, and the only definite method to distinguish between a leiomyoma and other renal tumor is postoperative microscopic evaluation. We report a case of leiomyoma of the kidney which was managed by radical nephrectomy under the impression of malignant renal mass which was incidentally found by ultrasonographic examination for health check in a 43-year-old woman.
Adult ; Diagnosis ; Female ; Humans ; Kidney* ; Leiomyoma* ; Nephrectomy

We report our experience with the diagnostic, clinical and biochemical findings, complications and maternal-perinatal outcome in a case of acute fatty liver of pregnancy. A 31-year-old multipara presented herself at 35 weeks' gestation with general malaise, gastroesophageal reflux, jaundice, hepatorenal dysfunction and disseminated intravascular coagulation. An abdominal ultrasound revealed a mild fatty liver. A tentative diagnosis of acute fatty liver of pregnancy was made, and immediately a healthy male infant weighing 2330 gm was delivered by emergency cesarean section. On 1, 2 and 6 days after delivery, oliguria, acute respiratory distress syndrome and pancreatitis developed, respectively. Abnormal levels of AST/ALT, creatinine, fibrinogen, PT/PTT and platelet recovered to normal ranges 7-10 days after delivery. Serum amylase and lipase became normal 24 days after delivery with conservative treatment. Ventilator care for acute respiratory distress syndrome continued up to 49 days after delivery, when total bilirubin, ammonia, alkaline phosphatase, r-GT, and AST/ALT began to normalize. The discharge was recommended on the 88th postpartum day. Our result suggests that acute fatty liver of pregnancy can be diagnosed on the basis of clinical and laboratory findings. Prompt delivery, intensive supportive care and awareness of its complications can markedly improve maternal and perinatal outcome.
Adult ; Alkaline Phosphatase ; Ammonia ; Amylases ; Bilirubin ; Blood Platelets ; Cesarean Section ; Child* ; Creatinine ; Diagnosis ; Disseminated Intravascular Coagulation ; Emergencies ; Fatty Liver* ; Female ; Fibrinogen ; Gastroesophageal Reflux ; Humans ; Infant ; Jaundice ; Lipase ; Male ; Mothers* ; Oliguria ; Pancreatitis ; Postpartum Period ; Pregnancy* ; Reference Values ; Respiratory Distress Syndrome, Adult* ; Ultrasonography ; Ventilators, Mechanical

Marfan syndrome is a hereditary disorder of connective tissue fibers, involving skeleton, eye and cardiovascular system. The cardiovascular complications, directly related to the cause of death, are associated with about 90% of the Marfan syndrome. The cardiovascular complications are aortic and mitral insufficiency, mitral valvular prolapse, bacterial endocarditis, arrhythmia and aneurysm of interatrial septum and aorta. Among the cardiovascular complications, bacterial endocarditis is unusual. The aortic valve, though commonly abonormal in Marfan syndrome, was rarely involved by endocarditis. In contrast the mitral valve was the favoured site of infection in these patients. The low incidence of aortic valve involvement remains unexplained. There is extreme mortality in Marfan patients affected by endocarditis. A 22-year-old man was admitted to Wallace Memorial Baptist Hospital because of intermittent fever with chill, dyspnea and orthopnea. He had characteristic Marfanoid features such as a slender body with sparsity of subcutaneous fat, arachnodactly and disproprtionate long extremities, axial myopia as well as suspicious family history. Three blood cultures produced a slowly growing gamma-hemolytic streptococcus sensitive to penicillin. Chest X-ray revealed increased C-T ratio and generalized congested lung parenchyme and increased lung markings with multiple dense, horizontal lines, so called Kerley's B lines. Echocardiogram showed thickened bicuspid arotic valve with vegetation and enlarged left ventricular cavity, grade 3/4 mitral and aortic regurgitation. The authors have experienced a rare case of Marfan syndrome with subacute infective endocarditis.
Aneurysm ; Aorta ; Aortic Valve ; Aortic Valve Insufficiency ; Arrhythmias, Cardiac ; Bicuspid ; Cardiovascular System ; Cause of Death ; Connective Tissue ; Dyspnea ; Endocarditis ; Endocarditis, Bacterial ; Endocarditis, Subacute Bacterial* ; Estrogens, Conjugated (USP) ; Extremities ; Fever ; Humans ; Incidence ; Lung ; Marfan Syndrome* ; Mitral Valve ; Mitral Valve Insufficiency ; Mortality ; Myopia ; Penicillins ; Prolapse ; Protestantism ; Skeleton ; Streptococcus ; Subcutaneous Fat ; Thorax ; Young Adult

PURPOSE: To compare the sedation outcome according to the dose of per os chloral hydrate in children who underwent laceration repair in the emergency department (ED). METHODS: This retrospective study was performed to the children who underwent sedation using chloral hydrate for laceration repair in the ED from January 2015 through November 2015. A total of 370 children aged younger than 6 years underwent the sedation. We compared the induction time, duration of sedation, and ED length of stay (EDLOS) between the single dose (50 mg/kg) and additional dose (plus 25 mg/kg) groups. RESULTS: Of 370 children, 335 (90.5%) were sedated successfully, 284 (76.8%) were sedated with initial dose (the single dose group), and 51 (13.8%) were sedated with additional dose (the additional dose group). The induction time and EDLOS were longer in the additional dose group (induction time: 31.0 ± 17.2 minutes vs. 96.2 ± 25.4 minutes, P < 0.001; EDLOS: 137.2 ± 35.5 minutes vs. 193.0 ± 36.0 minutes, P < 0.001). The duration of sedation showed no difference between the 2 groups (44.4 ± 24.0 minutes vs. 42.0 ± 20.8 minutes; P = 0.500). No one had serious adverse reactions. CONCLUSION: Additional dose of chloral hydrate can increase the induction time and EDLOS without increasing the duration of sedation and causing serious adverse reactions. This information may improve the efficiency of ED workflow when shared with parents of the children.
Child* ; Chloral Hydrate* ; Conscious Sedation ; Emergency Service, Hospital ; Humans ; Lacerations* ; Length of Stay ; Parents ; Retrospective Studies

The present study evaluated the effect of various dosages of soybean isoflavone extract on body weight changes, glucose tolerance and liver function in streptozotocin-induced diabetic rats. One group of normal rats (normal control) was fed an AIN-76-based experimental diet and four groups of diabetic rats were fed the same diet supplemented with four different levels of soybean isoflavone extract for seven weeks. The daily dosages of pure isoflavone for four diabetic groups were set to be 0 mg (diabetic control), 0.5 mg (ISO-I), 3.0 mg (ISO-II) and 30.0 mg (ISO-III) per kilogram of body weight, respectively. The daily consumption of isoflavone at the level of 3.0mg per kilogram of body weight resulted in the suppression of body weight loss and increased the survival rate of diabetic animals one and half times compared to that of the diabetic control group. Blood glucose levels in a fasting state and after the oral administration of glucose were significantly lower in the ISO-II group during the oral glucose tolerance test. The ISO-II group showed a tendency to elongate the gastrointestinal transit time. The activity of serum aminotransferases, indicator of liver function, was not negatively affected by any intake level of isoflavone. The present study demonstrated that the soybean isoflavone extract may be beneficial to diabetic animals by improving their glucose tolerance and suppressing weight loss without incurring hepatotoxicity at the daily dosage of 3.0 mg per kg of body weight.
Administration, Oral ; Animals ; Blood Glucose ; Body Weight ; Body Weight Changes ; Diet ; Fasting ; Gastrointestinal Transit ; Glucose Tolerance Test ; Glucose* ; Liver ; Rats* ; Soybeans* ; Streptozocin ; Survival Rate* ; Transaminases ; Weight Loss

BACKGROUND: Aplastic anemia is an uncommon disease characterized by marrow hypocellularity, resulting in a reduction of the counts of circulating red blood cells, neutrophils, and platelets. The etiology of aplastic anemia remains unknown in the majority of cases. An association of aplastic anemia with pregnancy has been reported but the strength of such a relationship remains somewhat controversial. OBJECTIVE: To evaluate the association of aplastic anemia with pregnancy and the optimal management of patients with aplastic anemia during pregnancy. METHODS: This retrospective study was done by review of medical records of 18 patients with aplastic anemia, of whom 8 patients were diagnosed before pregnancy and 10 patients were diagnosed during pregnancy, who had a total of 25 pregnancies after the diagnosis from January, 1990 to October, 1997 at the Seoul National University Hospital, RESULTS: The incidence of aplastic anemia during pregnancy was one in 806 persons(18/14, 507) in this study. During pregnancy, the circulating blood cell levels decreased in all pregnancies. In all 7 cases that showed a relapse during pregnancy the remission occurred following the termination of pregnancy. 12 patients presenting with severe aplastic anemia during pregnancy had poorer hematological improvement than patients with mild aplastic anemia after termination of pregnancy. CONCLUSION: In all patients with aplastic anemia during pregnancy the circulating blood cell levels decreased. The successful outcome in these cases illustrates the benefit of modern supportive care in the management of such patients. The present observations suggest that a pregnancy which occurs during the long-term remission of aplastic anemia may be allowed to progress to birth.
Anemia* ; Anemia, Aplastic ; Blood Cells ; Bone Marrow ; Diagnosis ; Erythrocytes ; Female ; Humans ; Incidence ; Medical Records ; Neutrophils ; Parturition ; Pregnancy ; Pregnant Women* ; Recurrence ; Retrospective Studies ; Seoul

The aim of this study was to investigate the prevalence and correlates of depressive symptoms in the largest number of Korean individuals examined to date. We analyzed cross-sectional data collected from 229,595 Korean adults aged 19 yr and above who participated in a Korean Community Health Survey conducted in 2009. The Center for Epidemiologic Studies Depression Scale (CES-D) was used as the measurement tool for depressive symptoms (CES-D score over 16) and definite depression (CES-D score over 25). Multivariate logistic regression analysis was performed to identify associations between sociodemographic factors and depressive symptoms. The percentages of depressive symptoms and definite depression in the total study population were 11% (7.8% for men, 14.0% for women) and 3.7%, (2.4% for men, 5.0% for women), respectively. Female gender, older age, disrupted marital status, low education and income level, multigenerational household composition and metropolitan residence were associated with greater risk of depressive symptoms. The present study provides a valid prevalence and correlates of depressive symptoms, using the largest representative sample of the Korean general population to date. Various sociodemographic factors contribute to the prevalence and effects of depressive symptoms in Korea.
Adult ; Age Factors ; Aged ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Depression/*epidemiology ; Female ; Health Surveys ; Humans ; Logistic Models ; Male ; Marital Status ; Middle Aged ; Odds Ratio ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Social Class ; Socioeconomic Factors ; Young Adult

PURPOSE: We examined the success rate and adverse effects of ultrasound-guided axillary and supraclavicular approach brachial plexus block. METHODS: From December 2013 to February 2014, 580 cases of patients received ultrasound-guided axillary approach or supraclavicular approach brachial plexus block. All blocks were performed by one anesthesiologist under ultrasound visualization using 0.2% or 0.75% ropivacaine 1% lidocaine with epinephrine in 1:200,000 as the anesthetic mixture. RESULTS: Failure rate of ultrasound-guided brachial plexus block was 1.2% and 0.2% in axillary and supraclavicular approach, respectively. In supraclavicular approach brachial plexus block, Honer's syndrome was observed in 17.9%, chest discomfort in 14.9%, and arterial puncture in 1%. There was no adverse effect in axillary approach brachial plexus block. CONCLUSION: Ultrasound-guided brachial plexus block serves higher success rate and lower occurrence rate of adverse effect and makes it useful for hand and upper extremity surgery. Supraclavicular approach has relatively higher success rate and lower rate of adverse effect than axillary approach.
Brachial Plexus* ; Epinephrine ; Hand ; Humans ; Lidocaine ; Punctures ; Thorax ; Ultrasonography ; Upper Extremity