PURPOSE: Retrospective studies were carried out to clarify the incidence of contralateral occurrence after unilateral repair of hydrocele in children and the role of ultrasonography in preoperative recognition of asymptomatic hydrocele. MATERIALS AND METHODS: 452 patients of under 14 years old who underwent unilateral hydrocele repairs between January, 1990 and December, 1997 were reviewed. Patients with contralateral occurrence were defined as those who had previous unilateral hydrocele repairs and no clinical or historical evidence of contralateral hydrocele at the time of the initial repair Patients with simultaneous presence of bilateral hydrocele on their initial visit were excluded from this study. 36 patients who visited lately underwent ultrasonographic examination of both side of the groin and scrotum prior to surgery to identify asymptomatic contralateral hydrocele. RESULTS: The incidence of contralateral occurrence after unilateral hydrocele repairs was 5.4%(24 patients). When the left side was repaired initially, 13(7.4%) patients showed contralateral occurrence and when the right side was repaired initially, 11 (4.0%) patients showed contralateral occurrence. In the 36 patients who underwent ultrasonography, 2 patients(5.6%) had asymptomatic contralateral hydrocele and exploration revealed the presence of a patent processus vaginalis. On the other hand, 2 patients(5.6%) with negative ultrasonographic findings had contralateral repairs 1 month after clinically apparent hydrocele repair. CONCLUSIONS: Although the incidence was low, contralateral occurrence after unilateral repair of hydrocele in children was noted. Therefore, preoperative thorough history taking and physical examination in unilateral hydrocele patients should be performed. Also, in suspicious cases, inguinal or scrotal ultrasonography is helpful for the detection of the clinically occult contralateral hydrocele in children.
Adolescent ; Child* ; Groin ; Hand ; Humans ; Incidence ; Physical Examination ; Retrospective Studies ; Scrotum ; Ultrasonography

Early diagnosis and prompt surgical exploration in blunt scrotal trauma is mandatory to save the affected testis and decrease the morbidity. We reviewed 25 cases of blunt scrotal trauma evaluated with ultrasonography as a result of violence, sports, traffic accident from March, 1989 to February, 1997. The right side was affected slightly more often than the left side. Sonography identified scrotal hematocele in 21 out of 25 cases and 4 cases had no evidence of scrotal hematocele. In 7 out of 21 cases with scrotal hematocele, ultrasonography showed rupture sites of the tunica albuginea (5) and intratesticular radiolucency displacing the normal echogenicity of the testicular parenchyina (2). In the other 14 cases ultrasonography showed no evidence of rupture. In 4 cases without scrotal hematocele, one was diagnosed as traumatic orchitis due to testicular enlargement and two had focal intratesticular hematoma so that these cases didn't undergo explorations. And 1 case had rupture of the tonics albuginea combined with testicular torsion at the time of exploration. Surgical explorations were performed in 19 (76.0%) out of 25 cases, who showed definitive rupture sites of the tunica albiginea (8), large hematoma and/or persistent severe pain without being seen rupture sites of the tunica albuginea (11) on ultrasonography and their operative methods were orchiectomy in 9 (36.0%), evacuation of the hematocele in 6 (24%), partial orchiectomy in 2 (8.0%) and simple closure of the tunica in 2 cases (8.0%). There was a direct relationship between salvageability and early surgery. In 13 out of 19 cases who underwent explorations within 3 days after trauma, the surgical managements comprised evacuation of the hematocele in 5 (38.5%), orchiectomy in 4 (30.8%), partial orchiectomy in 2 (15.4%), and simple closure of the tunica in 2 cases (IS.4%). However, in 6 cases who underwent explorations 4 days later after trauma, the surgical managements comprised orchiectomy in 5 (83.3%) and evacuation of the hematoma in 1 case (16.7%). In comparison with operative findings, 5 of the 14 cases, in which ultrasonography showed large hematocele without rupture of the tunica, had rupture of the tunica. Also, 7 cases, in which ultrasonography showed rupture of the tunica, all had rupture of the tonics. All patients with a history of blunt scrotal trauma, followed by a large hematocele without lure of the tunica or severely distorted testis on ultrasonography should have early surgical exploration to exclude injury to the testicle. A delayed treatment decreases the salvage rate due complications, such as ischemic necrosis and severe inflammatory reaction.
Accidents, Traffic ; Early Diagnosis ; Hematocele ; Hematoma ; Humans ; Male ; Necrosis ; Orchiectomy ; Orchitis ; Rupture ; Spermatic Cord Torsion ; Sports ; Testis ; Ultrasonography ; Violence

Wegener`s granulomatosis (WG) is a multisystem disorder of unknown origin characterized by necrotizing granulomatous vasculitis. WG usually affects the upper respiratory tract, lungs, and kidneys with focal glomerulonephritis, but almost any organ can be affected. The ureter is primarily an unusual location for lesions of WG. A 30-year-old woman presented with intermittent right flank pain and hematuria. A renal ultrasound demonstrated unilateral hydronephrosis and a retrograde pyelography revealed a filling defect at right mid ureter and a computed tomography displayed marked concentric thickening of the right ureteral wall which was mimicking ureteral tumor. At nephroureterectomy, the right ureter was found to be obstructed by dense, intramural fibroinflammatory reaction. There was a necrotizing granulomatous vasculitis in the muscle layer of the ureter. Our case represents the rare occurrence of WG presenting ureteral bstruction.
Adult ; Female ; Flank Pain ; Glomerulonephritis ; Hematuria ; Humans ; Hydronephrosis ; Kidney ; Lung ; Respiratory System ; Ultrasonography ; Ureter* ; Urography ; Vasculitis

No abstract available.
Lithotripsy*

No abstract available.
Lithotripsy*

BACKGROUND: Bisphosphonates are now well established as successful antiresorptive agents for the prevention and treatment of osteoporosis. We investigated the effect of cyclic intravenous treatment with an aminobisphosphonate, pamidronate in cases of primary osteoporosis. METHODS: Eighteen patients with primary osteoporosis (bone mineral density BMD t-score < -2.5) received four courses of pamidronate (30 mg with 500 mL normal saline over 2 hours every 3 months). The serum biochemical parameters and bone turnover markers were measured before each treatment. The bone pain score, medication score, and the side effects were also monitored. BMD and simple spine X-ray were performed before and 1 year after of treatment. RESULTS: BMD at the lumbar spine (L2-4) significantly increased from 0.798+/-0.110 g/cm2 to 0.860+/-0.107 g/cm2 after 1 year of treatment with pamidronate: by +8.3+/-9.4% of baseline. BMDs at the femoral neck, Ward s triangle and the trochanter also increased, but not significantly. Serum total alkaline phosphatase (p<0.05) and urine deoxypyridinoline/creatinine (p=0.069) decreased with treatment. Other bone turnover markers were unchanged. The bone pain score decreased significantly. None of the patients experienced a new fracture during treatment. The frequency of the side effects following the first infusion was 61.1% (a transient fever and myalgia with flu-like symptoms in 10 patients and mild phlebitis in 1 patient). However, only two patients complained of flu-like symptoms after second infusion, and no patient complained following the third infusion. CONCLUSION: Cyclic intravenous treatment of pamidronate every three months was effective in increasing BMD and in the decreasing bone turnover rate, and was relatively well tolerated in primary osteoporotic women.
Alkaline Phosphatase ; Bone Density ; Bone Density Conservation Agents ; Diphosphonates ; Female ; Femur ; Femur Neck ; Fever ; Humans ; Myalgia ; Osteoporosis ; Phlebitis ; Spine

BACKGROUND: Alcohol use is a major source of health problem. The social and economic costs related to alcohol use are enormous. Thus, alcohol use is a public health issue. Previous studies on alcohol use were based on hospitalized patients(especially alcoholics) or community subjects, but national survey is lacking. In this study, we describe alcohol use among the Koreans. METHODS: Household telephone survey was carried out using multistage stratified random sampling methods from April to May, 1997. fifteen to sixty-nine year old subjects were randomly selected from household and asked to report type, quantity and frequency of alcoholic beverage consumption. RESULTS: The prevalences of alcohol drinking during the last month were 64.0% for mea 37.8% for women and 64.7% for those in their and twenties, and it decreased with increasing age. In multivariate logistic regression model, men, the unmarried, those in their twenties, administrative and professional personnel were associated with higher prevalence of alcohol drinking. Proportions of Nearly daily drinker were 16.5% for men, 2.2% for women, and more than 20% for those in their forties and over and in creased with increasing age. Mean alcohol consumption was 56 grams for men, 12 grams for women Heavy drinkers, defined as average intake of 30 grams or more per day, were found in 23.4% of men and 2.4% of women.. The most widely consumed beverages were soju, beer and makuli. In multivariate logistic regression model, men, the unmarried, those in their twenties, and administrative and professional personnel were highly associated with heavy drinking. CONCLUSIONS: The prevalences of alcohol drinking during the last month was 49.0%. The proportion of heavy drinker was 11.4%. Men, the unmarried, those in their twenties, and administrative and professional personnel were highly associated with heave drinking. Therefore, efforts should be made to reduce heavy alcohol drinking among the risk groups.
Alcohol Drinking ; Alcoholic Beverages ; Beer ; Beverages ; Drinking ; Family Characteristics ; Female ; Humans ; Korea* ; Logistic Models ; Male ; Prevalence ; Public Health ; Single Person ; Telephone

Nitric oxide (NO) modulates the activities of various channels and receptors to participate in the regulation of neuronal intracellular Ca2+ levels. Ca2+ binding protein (CaBP) expression may also be altered by NO. Accordingly, we examined expression changes in calbindin-D28k, calretinin, and parvalbumin in the cerebral cortex and hippocampal region of neuronal NO synthase knockout(-/-) (nNOS-/-) mice using immunohistochemistry. For the first time, we demonstrate that the expression of CaBPs is specifically altered in the cerebral cortex and hippocampal region of nNOS-/- mice and that their expression changed according to neuronal type. As changes in CaBP expression can influence temporal and spatial intracellular Ca2+ levels, it appears that NO may be involved in various functions, such as modulating neuronal Ca2+ homeostasis, regulating synaptic transmission, and neuroprotection, by influencing the expression of CaBPs. Therefore, these results suggest another mechanism by which NO participates in the regulation of neuronal Ca2+ homeostasis. However, the exact mechanisms of this regulation and its functional significance require further investigation.
Animals ; Calcium ; Calcium-Binding Protein, Vitamin D-Dependent ; Calcium-Binding Proteins ; Carrier Proteins ; Cerebral Cortex ; Homeostasis ; Immunohistochemistry ; Mice ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Synaptic Transmission

Pregnancy in acromegaly is very rare. Amenorrhea and infertility are common manifestations in acromegaly. The pregnancy may be influenced by acromegaly in many ways and pregnancy itself may influence the course of a pituitary tumor. We report of a case of pregnancy in a woman who was diagnosed with acromegaly during the course of pregnancy. Her pregnancy was uneventful and she delivered a healthy baby at 38 weeks by cesarean section. No treatment was undertaken during the pregnancy and transsphenoidal surgery was performed after the delivery.
Acromegaly* ; Amenorrhea ; Cesarean Section ; Female ; Humans ; Infertility ; Pituitary Neoplasms ; Pregnancy*

BACKGROUND: Leptin has been reported to be correlated with the amount of adipose tissue in humans. The plasma leptin concentrations were not different between diabetics and non-diabetics in Mexican-Americans; however, the leptin might stimulate or diminish insulin secretion and induce insulin resistance. Then, it can be postulated that leptin may one of the key factors in the development of insulin resistance. Therefore we were to note any differences in FPL (fasting plasma leptin levels) between diabetics and normal subjects, and to investigate variables such as PBF (percentage body fat), BMI (body mass index), FPI (fasting plasma insulin) to determine their effects on the variation of FPL. We also were to investigate whether FPL influenced the GUR (glucose utilization rate). METHODS: The subjects were 116 type 2 diabetics and 45 normal subjects in Korean. PBF, BMI, WHR (waist hip ratio) were measured. Fasting plasma insulin and leptin levels were measured by radioimmunoassay. Euglycemic and/or hyperglycemic clamp tests were performed in 19 diabetics and 16 normal subjects. RESULTS: 1. There was no difference in FPL between diabetics and normal subjects. 2. A significant difference was found in FPL between female and male subjects. 3. Gender and body composition such as PBF, BMI contributed plasma leptin levels. 4. FPL was associated with GUR (Insulin resiatance) only in male subjects. 5. During 2h clamp tests, the acute increments of insulin or glucose did not change the leptin levels. CONCLUSION: These data suggested that there was no difference in FPL between diabetics and normal subjects, whereas gender, body composition such as PBF, BMI contributed leptin levels.
Adipose Tissue ; Body Composition ; Fasting ; Female ; Glucose ; Hip ; Humans ; Insulin Resistance* ; Insulin* ; Leptin* ; Male ; Obesity* ; Plasma* ; Radioimmunoassay