A clinical study was made on the 28 cases underwent prostatectomy during the 5 year-period from 1964 to 1968. The results are summarized as follows: 1. The patient underwent prostatectomy revealed increasing tendency in incidence, residual urine in average and being usually in the age range between 60 and 70 years. 2. The degree of prostatic enlargement was mostly grade 11 on rectal palpation and the removed prostate was 49. 3gm. in average weight. 3. Blood loss attributable to the operative manipulation was 1143 cc. in average. The patients underwent prostatectomy were discharged on the average 21.3 days postoperatively in which postoperative indwelling catheter was left in place for 15.3 days in average. 4. Postoperatively the convalescence was uneventful and the residual urine was disappeared or decreased markedly. 5. In the patients underwent prostatectomy via retropubic approach operative blood loss was mild and postoperative duration of indwelling catheterization was short as compared to that via the suprapubic approach. 6. No serious complication other than epididymitis developed in a few patients was observed postoperatively. 7. Suprapubic prostatectomy was found to be suitable for the patient with marked prostatic enlargement while the retropubic one yielded less tissue damage and somewhat rapid postoperative convalescence as compared to the former.
Catheters, Indwelling ; Convalescence ; Digital Rectal Examination ; Epididymitis ; Humans ; Incidence ; Male ; Prostate ; Prostatectomy*

Many kinds of operations have been devised to treat Kienböck's disease with variable results. But no one have mentioned about the advantage of early motion in distraction to prevent the fibro-osseous ankylosis and carpal collapse. Two cases with Kienböck's disease were treated by the complete excision of the lunate and replacement of it with pronator quadratus muscle pedicled rectangular bone graft. Once these procedures were accomplished, the distraction-motion devices were used to maintain the joint surfaces separated at predetermined distances while kinematically normal joint motion was gradually restored. Although the experience is limited to two cases, the final results seem to be very promising.
Ankylosis ; Arthroplasty ; Joints ; Transplants

Paralytic hand is the ultimate result of permsnent damage of the central nervous system, failure of the functional repair of peripheral nerve injuries and extensive muscular or tendinous defect resulting in the impairment of hand function. There are a lot of controversies in the side of treatment methods in the paralytic hand, and it is very difficult to formulate the most adequate surgical reconstruction for a given pstient. At Depsrtment of Orthopedic Surgery, Seoul National University Hospital, 66 cases oi paralytic hands in 62 patients have been treated surgically with tendon transfers for 7 years from Jan, 1980 to Dec, 1986. 49 case in 46 patients were followed up for more than one year, and surgical method and its results were anslysed. They consist of CNS lesion (17), peripheral nerve lesion(23) and musulotenidinous defect(9). The methods of surgical reconstruction were opponenesplasty(12), standard set extensor reconstruction(9), Green and Bsnks FCU transfer(11), intrinsic reconstruction(7), pronator rerouting(7), adductorplasty (5) and so on. The mean follow-up was 2.2 years, and in 38 cases good or excellent results were obtained.
Central Nervous System ; Follow-Up Studies ; Hand ; Humans ; Methods ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Seoul ; Tendon Transfer

PURPOSE: We evaluated the importance of redistribution and 24 hour reinjection images in Tl-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). MATERIALS AND METHODS: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection Tl-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or l (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assess-ment in stress-redistribution and stress-reinjection images. RESULTS: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. CONCLUSION: The 24 hour reinjection imaging is useful in the assessment of rnyocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.
Complement System Proteins ; Dipyridamole ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon

A new method of urinary diversion via Skinner`s modification of Koch continent ileal reservoir was tried. With this method continence with storage of urine under low pressure is well maintained so that no external applicances are necessary. Ileorenal reflux is also prevented with this nipple forming technique. From May l986 to September l986, 4 patients underwent urinary diversion that included creation of a modified Koch pouch by Skinner. Previous urinary diversion was by ureterocutaneous diversion in 1 patient. A total of 3 patients underwent radical cystectomies for bladder cancer In 1 patient, simultaneous urethrectomy was done because of carcinoma in situ in the urethra. There were no operative mortalities. All patients are continent and without reflux to the upper urinary tract. The volume capacity of pouch is more than 400ml. The pouch is emptied by self-catheterization every 4 to 6 hours during the day and once at night. Postoperative follow-up presently is short and it is impossible to check late complications. Although preliminary, this clinical trial suggests that the quality of life for patients can be improved markedly by the modified Koch continent ileal reservoir.
Carcinoma in Situ ; Colonic Pouches* ; Cystectomy ; Follow-Up Studies ; Humans ; Mortality ; Nipples ; Quality of Life ; Urethra ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urinary Tract

Hydroa vacciniforme is a very rare photosensitivity disorder. The primary skin lesion is a vesicle or bulla which then heals with vacciniform scarring. We report a case of hydroa vacciniforme recurred after 3 years period of quiescence in a 20 year-old man who had had history of the disease from the age of two. The duplication of the natural lesion, clinically and histologically, was successfully made by artificial UV-A irradiation on the patient's back.
Cicatrix ; Hydroa Vacciniforme* ; Photosensitivity Disorders ; Skin

A total of fifty three patients with posterior urethral strictures followed by pelvic bone fracture were managed by one-stage perineal repair at Pusan National University from Jan. 1985. to Jun 1992. End-to-end anastomosis was performed in all cases, but other procedures were added to accomplish tension-free anastomosis in 34 cases. These techniques, which included distal urethra mobilization, corporeal body separation and inferior pubectomy wore performed in a progressive manner as needed. Excellent results were achieved and success rate was 97.8 % of all cases. And we evaluate complications after such progressive maneuvers and the relationship between type of posterior urethral injury based on urethrography, the types of surgical procedure and the types of pelvic bone fractures. Additional procedure were attributed to severe initial type IV urethral injury, unstable pelvic bone fracture and complex urethral stricture. In spite of performing additional procedures, the incidence of impotence, restrictue and incontinence made no differences. Therefore, separation of corporeal bodies and inferior pubectomy are safe and efficient method to treat nearly almost cases of urethral strictures including complex urethral strictures.
Busan ; Erectile Dysfunction ; Humans ; Incidence ; Male ; Pelvic Bones ; Urethra ; Urethral Stricture*

Urine specimens were obtained from one hundred and thirty nine patients in-out-patient and in-patient service of B.N.U.H., Dept. of Urology, with the presumptive diagnosis of urinary tract infections or indwelling catheter. These specimens were processed by Triphenyltetrazolium Chloride test, quantitative test and identification of the organisms. The results were as follows: 1. Triphenyltetrazolium Chloride test was an easily performable and a fairmely accurate method for screening of urinary tract infections. 2. The urine specimens showed false negative reactions to triphenyltetrazoium Chloride in some cases with moderate (10(4) to 10(6) bacteria per milliliter) growth of bacteria or in the antibiotics used patients. 3. The incidence of urinary tract infections with gram negative bacilli are ninety-two percent. In their series, incidence of E. coli decreased and that of other gram negative bacilli increased such as Enterobacter, Proteus and Serratia, etc. This shift in the pathogen spectrum occurs mostly in the patients of complicated or lower urinary tract infections, in-patients, antibiotics used patients and the patients with indwelling catheter.
Anti-Bacterial Agents ; Bacteria ; Catheters, Indwelling ; Diagnosis ; Enterobacter ; False Negative Reactions ; Humans ; Incidence ; Mass Screening ; Proteus ; Serratia ; Urinary Tract Infections* ; Urinary Tract* ; Urology

True hermaphroditism is one of the rare congenital anomalies. Additional four cases of this anomaly are added to the 2 cases which were reported previously from the Dept. of Urology, Busan National University Hospital. Clinical review was performed about these 6 cases. The results were as follows; 1. The incidence of true hermaphroditism is 0.17% in 3,456 uro1ogicaladnrissions from Jan. 1964 to Mar. 1982, 1.6% in 380 admissions with congenital anomalies of the external genitalia and 25% in 24 admissions with hypospadias and cryptorchism during this period. 2. Hypospadias and cryptorchisrn are found in 6 cases, bifid scrotum 3 cases, and labioscrotal folds in 2 cases. Roentgenograms of retrograde urethrography were available in 4 cases and revealed blind vaginal pouch in 3 cases. Among these 3 cases, one had patent fallopian tube at the cephalad end of the pouch. The other one had well developed vagina and the uterus with patent fallopian tube. 3. The genital ducts were developed ipsilaterally in 9 gonads composed of pure testicular or ovarian tissues but developed to those of male pattern in 3 gonads containing the ovarian and testicular tissues. Among these 3 cases two cases did not have the vas deferens. 4. Of 6 gonads containing the testicular tissues, two were in the scrotum, 2 in inguinal and remained 2 were in the peritoneal cavity. Of gonads containing the ovarian tissues, seven were in the peritoneal cavity and one in the retroperitoneum. 5. Sex chromatin was positive in 3 cases, negative in 3 cases. 6. Of 5 cases who had been reared as male, two were assigned to female, one to male and remained 2 were not decided the sex. The other who had been reared as female was assigned to female. 7. The type of true hermaphroditism is lateral in 3 cases (Type I)and unilateral in 3 cases (Type IIIb 2 cases, Type IIIa I case)by the classification of Jones and Scott.
Busan ; Classification ; Cryptorchidism ; Fallopian Tubes ; Female ; Genitalia ; Gonads ; Humans ; Hypospadias ; Incidence ; Male ; Ovotesticular Disorders of Sex Development* ; Peritoneal Cavity ; Scrotum ; Sex Chromatin ; Urology ; Uterus ; Vagina ; Vas Deferens

PURPOSE: To evaluate the causative factors of the false positive CT findings of parametrial invasions of cervial cancer. MATERIALS AND METHODS: we analysed 17 parametria of 14 patients with the diseases staged over lib on CT, but confirmed to be under stage Ila on pathology. The CT findings were retrospectively reviewed, and compared with pathologic findings. RESULTS: The causes of false postive diagnosis of parametrial invasions on CT were prominent cardinal ligaments (n=12), vaginal fornix(n=3), and prominent uterine vessels(n=2). CONCLUSION: Familiarity with these CT finding may be helpful in avoiding false positive diagnosis of parametrial invasion in patients with uterine cervical carcinoma.
Diagnosis ; Humans ; Ligaments ; Pathology ; Recognition (Psychology) ; Retrospective Studies