No abstract available.
Urodynamics*

No abstract available.
Humans

A male child of 9 months with bilateral Wilms tumor was admitted to our hospital. His chief complaint was abdominal mass. Clinical examination and IVP, USG and CT-scan disclosed bilateral Wilms tumor. Right nephrectomy and left partial nephrectomy were performed. Anuria was experienced to 24 hours and so exploratory-laparotomy was done. Renal autotranplantation was performed because of the thrombosis of renal artery. But six days after operation he died.
Anuria ; Child ; Humans ; Male ; Nephrectomy ; Renal Artery ; Thrombosis ; Wilms Tumor*

OBJECTIVES: Phenylpropanolamine (PPA) had been used widely as cold remedies or appetite suppressants. However, products containing PPA were withdrawn in sequence in the US, Japan, and Korea due to the increased risk of hemorrhagic stroke. The purpose of this paper was to review safety issues related with the PPA use and hemorrhagic stroke in view of pharmacoepidemiology and pharmacovigilance. METHODS AND MATERIALS: Researches conducted for evaluating the association between the PPA use and hemorrhagic stroke in other countries were reviewed, which involved case reports, case series, case-control studies, and cohort studies. RESULTS: In terms of pharmacologic and clinical features, PPA may increase the risk of hemorrhagic stroke through increased blood pressure, heart rate, or vasculitis. The association between the PPA use and hemorrhagic stroke among young women was suggested by case reports from spontaneous adverse events reporting systems or medical journals. The cohort study, using the large prescription database in the US and published in 1984, failed to reveal the association in the population aged below 65. The case-control study conducted as the Yale Hemorrhagic Stroke Project, published in 2000, was the first study to find the association between the PPA as appetite suppressants and hemorrhagic stroke among women ages 18-49 years by well-designed analytic epidemiological research. It led to withdrawal of all products containing PPA in the US and many other countries since 2000. However, the association between PPA and cerebral hemorrhage could not be confirmed by the case-control study conducted in Mexico due to inappropriate recruitment of control group. CONCLUSIONS: During several years case reports have suggested that hemorrhagic stroke could be induced by PPA, and the Yale Hemorrhagic Stroke Project revealed the association by case-control study and provided a useful model for pharmacovigilance. Nevertheless, their finding could not be applied to other population such as elderly women and male population. And they could not provide any evidence on the association between PPA and stroke when PPA was used as cold remedy taken daily dose below 100mg.
Aged ; Appetite Depressants ; Blood Pressure ; Case-Control Studies ; Cerebral Hemorrhage ; Cohort Studies ; Female ; Heart Rate ; Humans ; Japan ; Korea ; Male ; Mexico ; Pharmacoepidemiology ; Pharmacovigilance ; Phenylpropanolamine* ; Prescriptions ; Stroke* ; Vasculitis

BACKGROUND: Epidurally administered clonidine represents an approach to control the pain after cesarean section that produces analgesia by an alpha 2-adrenergic mechanism and may provide postoperative analgesia without nausea, pruritus, and respiratory depression associated with systemic or intraspinal opioid administration. This study was undertaken to evaluate the analgesic effect according to the dose of appropriate bolus and the combination of epidural morphine and clonidine after cesarean section. METHOD: Forty five women, ASA physical status 1 or 2, scheduled for elective cesarean section were randomly assigned to receive epidural administration for postoperative pain control. Group A (n=15) received 1 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 150 g clonidine. Group B received 2 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 300 g clonidine. Group C received 3 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 450 g clonidine. Each combination of drug was injected at Bromage scale 1 after surgery. RESULTS: All groups showed relatively stable hemodynamic status. Analgesic effect was significantly better in Group B and C than Group A (p<0.05). Sedative effect was not a problem in all groups. The incidence of side effects in Group C was more than Group B, which than Group A, but almost cases did not require treatment. CONCLUSION: 2 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 300 g clonidine with excellent analgesic effect and less side effects is considered as adequate dose in postoperative pain control after cesarean section with epidural anesthesia.
Analgesia ; Anesthesia, Epidural* ; Cesarean Section* ; Clonidine* ; Female ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pregnancy ; Pruritus ; Respiratory Insufficiency

Urethral injury studied from Jan. 1976 to Jun. 1980 at Department of Urology, Busan National University Hospital was reviewed respectively with particular attention to etiology, diagnosis and operative procedure. During the period total number of patients with urethral injury was 104, of whom 67 were anterior urethral injury and the remaining 37 were posterior urethral injury. The following results were obtained. 1. The rate of the urethral injury to genitourinary tract was 49. 5 per cent. 2. In anterior urethral injury, the most common cause was industrial accident, the mode of injury was straddling. In posterior urethral injury, the most common case was traffic accident, the mode of injury was blunting. 3. According to the result of treatment in anterior urethral injury, Foley catheter indwelling was not effective in about half cases, but good results were by modified Badenoch`s pull-through urethroplasty just after injury or after long-term cystostomy. In posterior urethral injury, we had poor results with primary realignment just after trauma, but good results with classic Badenoch`s pull-through urethroplasty after long-term cystostomy.
Accidents, Occupational ; Accidents, Traffic ; Busan ; Catheters ; Cystostomy ; Diagnosis ; Humans ; Male* ; Surgical Procedures, Operative ; Urology

Small cell osteosarcoma is a rare form of osteosarcoma and the histological differential diagnosis from other small round cell tumors (SRCTs) is difficult. The immunohistochemical stain for MIC2 has been considered an useful diagnostic marker for Ewing's sarcoma and primitive neuroectodermal tumors but recently, other SRCTs such as malignant lymphoma and embryonal rhabdomyosarcoma also showed positive reaction. Therefore, the usefulness of MIC2 must still be proven. We experienced a case of small cell osteosarcoma of the mandible in a 25-year-old man. Histologically, the tumor consisted of small round cells that resembled those of Ewing's sarcoma. Immunohistochemically, the tumor cells expressed diffuse strong positive reaction for MIC2 gene products. However, the scanty foci of lacy osteoid material between the tumor cells seemed to be diagnostic of osteosarcoma. The histologic and immunohistochemical findings of this case suggest close relationship between small cell osteosarcoma and Ewing's sarcoma.
Adult ; Diagnosis, Differential ; Humans ; Lymphoma ; Mandible ; Neuroectodermal Tumors, Primitive ; Osteosarcoma* ; Rhabdomyosarcoma, Embryonal ; Sarcoma, Ewing*

The authors obtained the following results through comparative investigation between experiences from authors clinical study of ureterolithotomy by posterior vertical incision devised by Gil-Vernet and Yoon`s clinical study of ureterolithotomy by posterior vertical incision and his lumbar incision. 1. Operation time was average 62 min. and blood loss was average about 50cc. So operation time and blood loss were similar to Yoon`s result but more or less reduced as compared with lumbar incision. 2. Postoperative urine leakage and ambulation time were 1 day and 2 day that were more or less reduced as compared with Yoon`s result. 3. Ipsilateral lower abdominal wall protrusion was noted postoperatively. We think, this is from subcostal nerve injury. 4. Postoperatively sensation change on subcostal nerve, ilohypogastric nerve and ilioinguinal nerve innervation sites were noted in half of all, but disappeared in several weeks. Considering above results, while posterior vertical incision has merits such as minimal operative invasion and early postoperative ambulation time, but it often notes inevitable nerve damage. So, we think better results would be gained by careful attention to nerve and vascular distribution.
Abdominal Wall ; Sensation ; Walking

A group of the 59 patients (64 kidneys) of renal calculi, operated at our hospital in the past a half and four years from 1976 Jun. to 1980 May, was investigated statistically. 1. In the 64 operations there were 2 nephrectomies (3.1per cent), 12 pyelolithotomies (18.8 percent), 4 nephrolithotomies (6.3 per cent), 16 extended pyelolithotomies (25.0 per cent), 19 extended pyelolithotomies combined with local nephrolithotomies (29.7 per cent), 5 partial nephrectomies (7.8 per cent), and 6 lower pole pyelocalycotomies (9.4 per cent). From our experience the choice of surgery staghorn or multiple stone was indicated lower surgery is the treatment of choice most of the patients and nephrectomy was performed only in a small group. 2. In 62 conservative operations for renal calculi, residual calculi were observed in 6 kidneys (9.7 per cent). 3. In postoperative course, hematuria was discontinued within 3 days. Urine leakage also disappeared within 3 days in pyelolithotomy with closure of renal pelvis, but within 5 days in extended pyelolithotomy without closure of renal pelvis. In some cases, postoperative urinary tract infection was perpetuated by residual stone and preoperative infection.
Calculi ; Hematuria ; Humans ; Kidney ; Kidney Calculi* ; Kidney Pelvis ; Nephrectomy ; Urinary Tract Infections

Duret hemorrhage is characterized by an upper brainstem hemorrhage due to increased intracranial pressure by mass effect such as subdural hematoma or a brain tumor. The anteroposterior elongation and downward displacement of the upper brainstem by transtentorial herniation results in the compression and tearing of the paramedian perforating vessels that feed the upper brainstem tegmentum. The consequent hemorrhage that involves the upper brainstem renders recovery to be almost impossible. Following a tricuspid valve replacement surgery, a 56-year-old woman developed a left fronto-temporo-parietal nontraumatic subdural hematoma resulting in transtentorial herniation of the left mesial temporal lobe. A successful surgical evacuation of the hematoma was done with clinical improvement. Two days later, she was referred to neurology with an aggravated right side weakness, dysarthria, and a newly developed extraocular movement disturbance. A brain CT and MRI showed a pontine hemorrhage. We report a case of pontine hemorrhage, a Duret hemorrhage, after the surgical evacuation of nontraumatic subdural hematoma.
Brain ; Brain Neoplasms ; Brain Stem ; Dysarthria ; Female ; Hematoma ; Hematoma, Subdural* ; Hemorrhage* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Middle Aged ; Neurology ; Temporal Lobe ; Tricuspid Valve