Tuberous sclerosis is a complex neurocutaneous disease inherited as an autosomal dominant pattern, which is characterized by facial angio-fibroma, mental retardation and seizures. Many cases have been reported in the literatures, but familial cases are relatively rare. We present 9 cases of tuberous sclerois occuring througb 3 generations, which are 3 cases of angiofibroma, mental retardation and seizures, 2 cases of facial angiofibroma and seizures, 1 case of mental retardation and seizures and 3 cases who showed facial angiofibroma only. Two brothers in this family reveald icthyosis vulgaris without tuberous sclerosis.
Angiofibroma ; Family Characteristics* ; Humans ; Intellectual Disability ; Seizures ; Siblings ; Tuberous Sclerosis*

OBJECTIVES: This study was conducted to estimate the incidence of abnormal liver function and risk factors in male employees of an industry in Ulsan City. METHODS: Five hundreds and seventy nine male employees were selected as the study cohort and 533(92.1%) of them were followed after one year. The blood sample was collected to test for AST, ALT, gamma-GTP, total-cholesterol, fasting blood sugar and a self-administered questionnaire on life style was done. General characteristics(age, marital status, educational level), job department, exposure status for organic solvents, life style(alcohol, smoking, exercise, diet), past history of liver disease, family history of liver disease, drug intake, HBsAg, blood glucose, total-cholesterol were considered as risk factors. The result of liver function test after 1 year follow-up was treated as dependent variable. The operational definition of abnormal liver function was as follows; those who had abnormal liver functions in the two repeated tests with one month interval. RESULTS: The annual incidence of abnormal liver function was 9.6 per 100 and age-standardized incidence was 9.5. BMI, alcohol, past history of liver disease, and meat intake were significantly related to the incidence(p<0.05). In multiple logistic regression analysis, BMI(RR=2.70, 95% CI=1.41-5.16) and alcohol(RR=1.98, 95% CI=1.08-3.60) were proved as the significant variables. By stratified analysis considering changing pattern of alcohol and BMI, the relative risk of the BMI normal-normal and alcohol intake high-high group was 2.24(95% CI=1.09-4.62) and that of the BMI obese-obese and alcohol intake high-high group was 5.66(95% CI=2.69-11.88) compared with that of BMI normal-normal and alcohol intake low-low group. CONCLUSIONS: The age-standardized annual incidence of abnormal liver function was 9.5 per 100 in male employees. Thus, an active effort for reducing alcohol intake and controlling BMI should be done to reduce the incidence.
Blood Glucose ; Cohort Studies ; Fasting ; Follow-Up Studies ; Hepatitis B Surface Antigens ; Humans ; Incidence* ; Life Style ; Liver Diseases ; Liver Function Tests ; Liver* ; Logistic Models ; Male* ; Marital Status ; Meat ; Questionnaires ; Risk Factors* ; Smoke ; Smoking ; Solvents ; Ulsan

The application of personal computer (PC) to manage urologic patient data is now popular in many institutes. many users were accustomed to the IBM PC and familiar with the dBASE program in managing urologic records. But in recent days, the number of Macintosh PC users are increasing because it is easy to learn and perform Macintosh which provides the excellent output under the given input data. We developed the patient management system with Excel program in Macintosh PC focusing on minimizing the effort to input the data and maximizing the output. The data fields consist of eight fields. They are chart number. name. sex. date of admission data of discharge. diagnosis and international classification of diseases. There is no need of typing the international classification of diseases because it is automatically registered by previous coding with diagnosis. We think that the application of international classification of diseases is essential to minimize the input errors. The output of data include sex ratio and variable statistics. which ere provided with graphic mode. Another output is the extract of data under the variable criteria. which are provided with worksheet mode.
Academies and Institutes ; Clinical Coding ; Diagnosis ; Humans ; International Classification of Diseases ; Microcomputers* ; Sex Ratio

PURPOSE: Some recent studies have demonstrated that finasteride, a well- known 5alpha-reductase inhibitor, can decrease prostate specific antigen (PSA) by approximately 50% during the first 1 year of treatment. We investigated how long-term treatment with finasteride and alpha-blockers impacts on the serum PSA level of men whose final diagnosis was benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: In a retrospective trial, we evaluated a total of 293 men with lower urinary tract symptoms (LUTS) that were suggestive of BPH. These men were divided into two treatment groups: group A was treated with alpha-blockers and group C was treated with a combination of finasteride and alpha-blocker. Comparisons of the two groups were performed by using independent t-tests. The changes in the PSA concentrations from baseline to the time of the final measurements were determined by repeated measures of ANOVA. RESULTS: There was no significant difference in the baseline PSA between the two groups. A statistically significant reduction in the PSA levels was observed at 2 years in C group (p<0.05), whereas any significant increase were not observed in group A (p>0.05). In group A, the repeatedly measured PSA levels were 2.67, 2.40, 2.41 and 2.42, respectively. In C group, these were 3.22, 2.09, 1.81 and 1.71 respectively. CONCLUSIONS: Our data showed that there was no clinically significant effect of long term treatment with alpha-blocker on the PSA levels. However, finasteride had significant effect on the serum PSA level during first two years of treatment.
Adrenergic Antagonists ; Diagnosis ; Finasteride* ; Follow-Up Studies* ; Humans ; Lower Urinary Tract Symptoms ; Male ; Oxidoreductases ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Retrospective Studies

Prostate, kidney, and bladder cancers are the three most prevalent urologic cancers in the Korean population. Throughout the last decade, there has been an upsurge in the incidence and prevalence of prostate and kidney cancers, along with a marked improvement in survival. A stage migration has been observed towards early detection of localized cancers, and accordingly, the landscape of urologic cancer treatment in Korea has been characterized by an exponential increase in the number of patients receiving surgery with curative intent. Herein, a substantial proportion of surgeries were performed using minimally-invasive methods, especially robot-assisted surgery. Current management strategies of urologic cancers in Korea are mostly based on evidences provided by international guidelines. There is prompt adoption and clinical application of novel systemic agents for advanced stage cancer, and surgical and oncological outcomes are comparable to those of Western reports. Multidisciplinary treatment options are available for various cancers at different stages. At the same time, treatment decisions are influenced by the availability of health-care resources, which is regulated by the National Health Insurance policy guidelines. Accumulating information on characteristics of urologic cancers in Korean patients demonstrates that Korean patients harbor more aggressive prostate cancer features compared to Western men. Due to the racial disparity in features of certain cancers, the optimal management strategy specific for the Korean population is yet to be validated. A comprehensive national cancer database may help to identify risk factors, select sequential strategies, and to assess survival outcome of Korean urologic cancer patients.
Epidemiology* ; Humans ; Incidence ; Kidney ; Kidney Neoplasms ; Korea* ; Male ; National Health Programs ; Prevalence ; Prostate ; Prostatic Neoplasms ; Risk Factors ; Urinary Bladder Neoplasms ; Urologic Neoplasms*

The aim of therapy for benign prostatic hyperplasia (BPH) is to improve quality of life by providing symptom relief and an increased maximum flow rate, as well as reduce disease progression and the development of new morbidities. There has been an enormous decline in the popularity of surgery and it is now apparent that medication is the most frequently used treatment for BPH. This has arguably therefore been the most major change in urological clinical practice in the last decade. Currently alpha(1)-adrenoceptor antagonists are the commonest medical therapy, and are thought to act by relaxing prostatic smooth muscle, the neural or so-called 'dynamic' component of BPO. 5alpha-reductase inhibitors are another option for BPH, which reduce prostatic mass and therefore the mechanical or 'static' component of benign prostatic obstruction (BPO). Another group of agents are the phytotherapeutic extracts, which act via various mechanisms, many as yet poorly defined. This review critically assesses existing publications relating to the medical management of BPH.
Disease Progression ; Muscle, Smooth ; Prostatic Hyperplasia* ; Quality of Life

The currently proposed factors inducing prostatic hyperplasia are the combined effect of androgen and estrogen and the reawakening of the embryonic growth potential of mature prostatic stroma. This experiment was designed to find out any histological or structural differences occurring after compensating sex hormones on the mature prostate and the implanted fetal urogenital sinus (UGS) tissue which possesses a differentiating potential under the same condition. The ventral lobe of the rat prostate with implanted fetal UGS showed 4.4 fold increase in weight compared to the non-implanted contralateral ventral lobe. After the castration, both ventral lobes showed marked atrophy, and no further progress in differentiation occurred in the implanted UGS. Dihydrotestosterone (DHT) compensation after castration revealed a significant increase in weight in the mature prostate but the ventral lobe with the implanted UGS showed relatively low recovery rate in weight than in non-castrated control group. The compensation of estradiol after the castration showed little difference in mature prostate compared to castrated control group, but the UGS implanted ventral lobe revealed a relative stromal hyperplasia. Unlike the single-hormone compensation, the mature prostate displayed the characteristic hyperplasia of epithelium of each acinar lumen, but the UGS dearly showed the formation of new acini with nodular pattern when compensated with both DHT and estradiol. The level of DHT showed a significant correlation with the height of the prostatic acinar cell which differentiated from the UGS, and an inverse correlation with the stroma/epithelium ratio of implanted group. The serum concentration of estradiol showed a significant correlation with the relative volume of juxta-prostatic tissues, such as the coagulating gland and the adjacent stroma. From the above results, it might be assumed that the estrogen may have an important role in the embryonic stroma-mediated initiation of nodular hyperplastic changes of microacini under the influence of DHT and the determination of histologic pattern after initiation might be controlled by the prostatic DHT concentration.
Acinar Cells ; Adult* ; Animals ; Atrophy ; Castration ; Compensation and Redress ; Dihydrotestosterone ; Epithelium ; Estradiol ; Estrogens ; Gonadal Steroid Hormones ; Humans ; Hyperplasia ; Mice* ; Prostate* ; Prostatic Hyperplasia ; Rats

We reviewed the medical records of 23 boys with surgically and pathologically proved monorchism. A striking laterality to the left side was identified. In 75 per cent of patients wolffian structures were present. These findings strongly suggest that in most instances of monorchism a testis had been present and had undergone subsequent in utero degeneration. Despite of various diagnostic technique for searching testes, we believe that surgical exploration continues to be the most reliable and more direct approach to the diagnosis and treatment of monorchism.
Diagnosis ; Humans ; Medical Records ; Strikes, Employee ; Testis*

During the microsurgery or during the postoperative period, the occurrence of the vascular spasm increases the failure rate of microvascular anastomosis,and in cases of trauma, the thrombogenic possibility is increased by the endothelial damage. The author thought that the vascular freezing of crushed vessels could improve the patency rate of microvascular anastomosis. Vascular freezing destroys most of the cells in the intima and media. There by causing degeneration of adrenergic fibers. Even though regeneration occurs after 2-3 weeks, regeneration in the smooth muscle layer is still incomplete. So vascular freezing has beneficial effects on relief of vasospasm. Fifteen Sprague-Dawley rats weighing approximately 300 g each were inflicted with crushing injury on the femoral arteries of the right side and the crushing injury with vascular freezing on the femoral arteries of the left side. The gross and histologic findings, as well as the patency rates, were observed at the postoperative 2nd, 10th, and 30th day,and the results were compared between the crushed and crush-freezing groups. The left side (crush-freezing group) showed less vasospasm and less thrombogenesis than the right side (crushed group). There were no significant differences in the patency rate between the crushed group and crush-freezing group. Vascular freezing is suggested to be effective on a potentially thrombogenic, endothelial damaged vessel as a prophylactic treatment method against vasospasm. Clinical application of vascular freezing awaits further experimentation.
Adrenergic Fibers ; Endothelium* ; Femoral Artery ; Freezing* ; Microsurgery ; Muscle, Smooth ; Postoperative Period ; Rats, Sprague-Dawley ; Regeneration ; Spasm

A development of percutaneous nephrostomy has laid the foundation for a major advance in the treatment of urolithiasis. The percutaneous, nephrolithotomy has already, become an accepted alternative to conventional surgery. With the use of a variety of instruments, calculi can be either removed intact or if too large, fragmented in situ and extracted. We have performed percutaneous extraction of renal and upper ureteral stones in 50 patients via Storz percutaneous universal nephroscope. An overall success rate of 74% including 60% in initial, 88% in subsequent period, an acceptable incidence of complication, a rapid convalescence, sooner return to work, minimal postoperative pain and a cost effectiveness were obtained. We conclude that percutaneous nephrolithotomy can be the primary choice of treatment in renal and upper ureteral stones.
Calculi ; Convalescence ; Cost-Benefit Analysis ; Humans ; Incidence ; Nephrostomy, Percutaneous* ; Pain, Postoperative ; Return to Work ; Ureter ; Urinary Calculi ; Urolithiasis