The clinicopathological study was performed on 80 patients with urinary bladder tumor between 1973 and 1983. The histopathological survey was carried out using preserved tumor specimen slide on the retrospective fashion, that included the growth pattern and vessel invasion. The results were as follows : 1. The tumor histology were papillary and nonpapillary in 70 %, and 30 %, respectively in growth pattern and 74 transitional cell carcinoma(TCC), 3 squamous cell carcinoma(SCC), 2 adenocarcinoma (AC) and 1 mucoepithermoid carcinoma in cell type. 2. The Fade of TCC, Go, G1. G2 and G3 were 1.4%, 36.5%, 39.2% and 22.9% respectively, and the stage of those, in which superficial tumors(pTis-pT1) and invasive tumors( pT2-pT4) were 57.0% and 30.8% respectively. The histopathological mode of local spread was to have strands, nests and individual cells in about one sixth, lymphatic invasion in about one third and venous invasion in about one fifth. 3. The intramural hispathological mode of local spread (INF alpha,beta, and alpha), lymphatic invasion ( lyo, 1 and 2) and venous invasion were highly significant with respect to the hispathological grade and stage, and also within mutual relationship on the other hand.
Adenocarcinoma ; Hand ; Humans ; Retrospective Studies ; Urinary Bladder Neoplasms ; Urinary Bladder*

Sexual impotence from positioning on the fracture table is rare complication. We are reporting a case of pudendal nerve neurapraxia associated with pressure from the perineal post of the fracture table in 42 years old male with hip fracture. Historical reviews and suggestion for prophylactic measures are also reported in this paper.
Erectile Dysfunction ; Hip ; Humans ; Male ; Pudendal Nerve ; Traction

No abstract available.
Liver Abscess* ; Liver*

To determine the concentration and the physiologic role of metal components in blood plasma and seminal plasma in relation to male infertility, the concentrations of twelve metal components in blood plasma and seminal plasma including Na, Mg, K, Ca, Cr, Mn, Fe, Cu, Zn, Se, Cd and Pb were measured by atomic absorbance spectrophotometery or ion selective electrode analysis. Semen and blood samples were obtained from a total of 110 men including 70 male infertility patients, 20 vasectomized persons and 20 fertility proven volunteers visited to the Male Infertility Clinic of Pusan National University Hospital. The concentrations of Ca, Zn, Mg, Cr and Cd in control group were higher in seminal plasma than in blood plasma, and additionally Pb were higher in infertility group. The concentrations of all metal components revealed no significant difference according to patients' age, resident, occupation, sperm density, motility and hormone level in blood plasma, but some metal components including Ca, Mg, Cu, Mn, Cd and Pb revealed a significant difference according to each these parameters except patient's age in seminal plasma. The concentrations of Mn, Cd and Pb in the vasectomy persons were higher than in the infertility group III including testicular and epididymal factors, but not in blood plasma. We conclude that the quantitative changes of metal components in the seminal plasma may have effects on not only spermatogenesis and sperm function, but also contribute to diagnostic parameter according to organ specificity of the metal in the male reproduction.
Busan ; Electrodes ; Fertility ; Humans ; Infertility ; Infertility, Male ; Male* ; Occupations ; Organ Specificity ; Plasma ; Reproduction ; Semen* ; Spermatogenesis ; Spermatozoa ; Vasectomy ; Volunteers

Female pseudohermaphrodities are 46XX genetic females with normal Mullerian derivatives, but have various degrees of ambiguous external genitalia. While most of them are commonly associated with adrenogenital syndrome, some of them have been occasionally associated with maternal ingestion of testosterone or synthetic progestational agent, maternal virilizing tumor or rarely idiopathic. Herein, we present three cases of female pseudohermaphroditism which is unrelated with adrenogenital syndrome. One case is resulted from maternal ingestion of progestational agent during the first trimester of pregnancy, and the other idiopathic.
46, XX Disorders of Sex Development* ; Adrenogenital Syndrome ; Eating ; Female* ; Genitalia ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Testosterone

BACKGROUND: Osteoporosis results from bone loss due to menopause [estrogen(E) deficiency] and aging. Initial skeletal effect of menopause is accelerated bone resorption with an increase in seurm calcium(Ca) and compensatory but inadequate bone formation. Secretion of parathyroid hormone(PTH) is suppressed at this time. Postmenopausal osteoporosis results in fractures predominantly of trabecular bone, i.e., vertebra. With aging, secondary hyperparathyroidism by low serum Ca and vitamin D deficiency superim poses. Senile osteoporosis produces hip fractures, area of cortical bone. The aim of this study was to- examine the association of vitamin D[25(OH)D] and intact(i) PTH with bone mineral density(BMD) after controlling for suggested confounding factors, and the possibility of low serum vitamin D and high serum iPTH concentration could impact bone loss in Korean postmenopausal women. METHODS: Data from 188 postmenopausal Korean women aged 42 to 69 were analyzed through BMD, serum 25(OH)D, iPTH, Ca, phosphorus(P), alkaline phosphatase(ALP) and clinical characteristics. Factors affecting BMD was determined by Pearson correlation and the relationship between lumbar and femoral neck BMD and vitamin D[25(OH)D] and iPTH was assessed by multiple regression analysis after adjus- ting for suggested confounding factors. RESULTS: Lumbar and femoral neck BMD, serum Ca, P were decresaed and serum iPTH was increased with aging. In Pearson`s correlation, significant contributing factors to lumbar BMD was age, height, weight, menarche, year since menopause(YSM) and ALP. And significant contributing factors to femoral neck BMD was age, height, weight, menarche, YSM and iPTH. No relationship could be demonstrated between serum vitamin D[25(OH)D] and lumbar and femoral neck BMD. How ever, after controlling for potential confounding factors, a correlation was found between vitamin D[25(OH)D] and both of lumbar (p=0.013) and femoral neck BMD(p=0.077). iPTH was inversely related to femoral neck BMD(p=0.004) only in multiple linear regression. CONCLUSION: Serum vitamin D[25(OH)D] was influencing both of vertebral and femoral neck BMD, which suggests a significant role of vitamin D deficiency in the pathogenesis of postmenopausal osteo- porosis. In age related remodeling and loss of bone, increased serum iPTH might have additive role in cortical bone of femur. These findings suggest that vitamin D is very important for optimal bone health and a deleterious effect of increased iPTH on cortical bone loss. Adequate calcium and vitamin D status have to be maintained to prevent osteoporosis in postmenopausal Korean women.
Aging ; Bone Density* ; Bone Resorption ; Calcium ; Female ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Hyperparathyroidism, Secondary ; Linear Models ; Menarche ; Menopause ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal ; Parathyroid Hormone* ; Spine ; Tolnaftate ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

Although many kinds of operation for rectal prolapse exist, generally they could be divided into the transabdominal and transperineal approach. The former has low recurrence rate as compared with the latter, but needs laparotomy. Unfortunately, many patients with rectal prolapse are old and debilitated. So they are not suitable candidates for a major abdominal operation. For those patient, a transperineal method may be proper, but the recurrence rate may be high and continence is not always achieved. We reviewed 12 patients who were older than 70 years of age and treated by the Thiersch operation among the 52 cases of rectal prolapse from Feb. 1992 to Mar. 1997 at Kwangju Christian Hospital. The results were summarized as follows; 1) The male to female ratio was 1 : 1.4. 2) Durations of rectal prolapse were distributed from 6 months to 30 years. Seven cases had duration of longer than 10 years. 3) The preoperative incidence of incontience was 8 (67%) of 12 cases. Among the 8 patients with incontinence, the male was 3 (37.5%) and female was 5 (62.5%). 4) Postoperative review of incontinence revealed complete disappearance in 4 cases (50%), improvement in 3 cases (37.5%), and no improvement in 1 case (12.5%). 5) After the Thiersch operation, rectal prolapse recurred in only 1 of the 12 cases (8.3%), a wound infection developed in 1 case (8.3%), defecation difficulty due to the small Thiersch ring was present in 3 cases (25%). The results of this study show that the Thiersch operation may be an effective method in treating rectal prolapse, especially in patient who are old or have poor general condition and manifested incontinence.
Defecation ; Female ; Gwangju ; Humans ; Incidence ; Laparotomy ; Male ; Rectal Prolapse* ; Recurrence ; Wound Infection

As a part of ongoing effort to evaluate alternative treatments for benign prostatic hyperplasia (BPH}. we compared the outcomes of transurethral resection of prostate(TURP) with those of open prostatectomy(OP). To identify effect of TURP on high mortality due to cardiac death. We compared long-term mortality and the causes of death after each surgical procedures. From Jan 1981 to Dec. 1990, surgical management was underwent on 338 patients with BPH in Pusan National University Hospital. Of 338 patients. survival was identified in 70 of OP group and 166 of TURP group. Direct interview was possible in 50 of OP group and 135 of TURP group. Mean age and follow-up were 69.8 years old and 89.5 months in OP group and 68.7 years old and 45.4 months in TURP group. Both OP and TURP were effective in improving subjective voiding symptoms including comprehensive symptom and Boyarsky symptom score, but, no significant difference was observed between them. Postoperative convalescence period was significantly shorter in TURP group compared to OP group. The incidence of sexual dysfunction including loss of libido and poor erection was similar between two surgical groups, but the incidence of retrograde ejaculation was higher in TURP group than OP group. Postoperative mortality and leading causes of death were no difference between two groups. Conclusively, we could not find the significant differences between OP group and TURP group as to symptom improvement, long-term mortality and morbidity, and effectiveness on patient`s consent. Although we confess that further evaluation is needed for precise and objective results, such results show postoperative improvement of voiding symptoms, quality of life and long-term outcomes that may not depend on surgical options.
Busan ; Cause of Death ; Convalescence ; Death ; Ejaculation ; Follow-Up Studies* ; Humans ; Incidence ; Libido ; Male ; Mortality ; Prostatic Hyperplasia* ; Quality of Life* ; Transurethral Resection of Prostate

The role of the periosteum on osteointegration of Bio-Oss(R)(Geistlich, Wolhusen/Switzerland) was studied in rabbit calvarial defect. 12 New Zealand white male rabbits between 2.8 and 4 kg were included in this randomized, blinded, prospective study. Each rabbit was anesthetized with Ketamine HCl(5 mg/kg) and Xylazine HCl(1.5 ml/kg). An incision was made to the bony cranium and the periosteum was reflected. Using a 6-mm trephine bur(3i. USA), four 8-mm defects were created with copious irrigation. The defects were classified into barrier membrane(Tefgen(R), Lifecore Biomedical, Inc, U.S.A.) only group as a control, Bio-Oss(R) with barrier membrane group, Bio-Oss(R) with periosteum covering group, and Bio-Oss(R) without periosteum covering group. There were 2 rabbits in each group. The wound was closed with resorbable suture materials. Rabbits were sacrificed using phentobarbital(100 mg/kg) intravenously at 1, 2, and 4 weeks after surgery. The samples were fixed in 4% paraformaldehyde, and decalcified in hydrochloric acid decalcifying solution(Fisher Scientific, Tustin, CA) at 4degrees C for 2-4 weeks. It was embedded in paraffin and cut into 6 micrometer thickness. The sections were stained with H & E and observed by optical microscope. The results were as follows; 1. The periosteum played an important role in osteointegration of Bio-Oss(R) in bone defects. 2. When the periosteum remained intact and Bio-Oss(R) was placed on the defect, Bio-Oss(R) with periosteum covering has been incorporated into the newly formed bone from 2-week postoperatively. 3. When the periosteum was removed at the surgical procedure, invasion of connective tissue took place among the granules, and new bone formation was delayed compared to periosteum covering group. Therefore, when the bone grafting was performed with periosteal incision procedure to achieve tension-free suture, the integrity of the overlying periosteum should be maintained to avoid fibrous tissue ingrowth.
Bone Regeneration* ; Bone Transplantation ; Connective Tissue ; Humans ; Hydrochloric Acid ; Ketamine ; Male ; Membranes ; New Zealand ; Osteogenesis ; Paraffin ; Periosteum* ; Prospective Studies ; Rabbits ; Skull ; Sutures ; Wounds and Injuries ; Xylazine

Many parameters are available for study and evaluation for patients with benign prostatic hypertrophy (BPH). Of that, symptomatology has classically formed the urologist's initial data base on which to formulate evaluation of potential outlet obstruction, indication for surgery and evaluation of results of treatment. And, to identify surgical efficiency on reducing prostatism and clinical availability of symptom scoring system for quantitative, objective index of symptom status, we undertook long follow-up assessment of BPH with Boyarsky symptom score system on SO cases or open prostatectomy (OP group) and 135 cases of transurethral resection (TUR group) who treated surgically on Pusan National University from Jan. 1981 to Dec. 1990. Both surgical procedures are effective in reducing symptom status and higher preoperative symptom score was, the higher postoperative symptom store improvement resulted. Improvement of obstructive symptoms is significantly higher than that of irritative symptoms in both groups. The presence of acute urinary retention was significantly related with improvement of symptom score (p<0.05), but preoperative urinary tract infection, prostate weight and degree of residual urine were not (p>0.05). Although symptom score improvement did not completely reflex to comprehensive subjective symptom improvement, significant relationship was present. Therefore, it would be used as objective, quantitative index to access the voiding status of patients.
Busan ; Follow-Up Studies* ; Humans ; Prostate ; Prostatectomy ; Prostatic Hyperplasia* ; Prostatism ; Reflex ; Urinary Retention ; Urinary Tract Infections