A retrospective analysis was made to evaluate the value of early surgical exploration of acute scrotum in 19 children. Testicular torsion (9 cases ) was the most frequent cause followed by epididymitis(4), hematocele(2). appendix testis torsion(2), infected hydrocele(1) and benign cystic teratoma(1). The age distribution of testicular torsion showed a biphasic pattern, neonatal and pubertal and 3 out of 9 torsed testes showed transverse lie in standing position on physical examination. The pyuria was present only in l out of 4 cases with epididymitis and leukocytosis was found in 7 cases, 6 with testicular torsion and 1 with epididymitis. Preoperative ultrasonographic diagnoses were correct in 2 out of 4 cases, 3 with testiculer torsion and 1 with epididymitis. Testicular salvage was possible in 3 torsed testes if surgery was performed within 14 hours from the onset of the symptom. In summary. testicular torsion was the most frequent cause of acute scrotum in children and early surgical exploration was necessary to improve the salvage of torsed testes.
Age Distribution ; Appendix ; Child* ; Diagnosis ; Epididymitis ; Humans ; Leukocytosis ; Male ; Physical Examination ; Pyuria ; Retrospective Studies ; Scrotum* ; Spermatic Cord Torsion ; Testis

0.05). There was considerable difference in the upper and lower position of mandibular foramen between control and experimental group. It appeared that the distance of mandibular foramen from mandibular notch is 20.66mm (average) for the normal occlusion and 17.785mm(average)for the mandibular prognathism. So we can see the distance of mandibular foramen from mandibular notch for patients is more near 2.815mm (average) than normals. For the distance of mandibular foramen from the extension line of occlusal plane, it's 0.92mm (average) lower than occlusal plane for the normal and 0.5mm (average) upper for the patient. It's located 1.42mm (average) upper part of the patient.]]>
Dental Occlusion ; Hand Strength ; Humans ; Mandibular Nerve ; Prognathism

Background: To date, the clinical significance of visually equivocal amyloid positron emission tomography (PET) has not been well established. Objective: We studied the clinical significance of equivocal amyloid PET images from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Methods: Subjects with F-18 florbetapir PET scans at baseline who were followed up for 4 years were selected. Clinical characteristics, imaging biomarkers, cognitive function, and rate of conversion to AD were compared in subjects with visually equivocal findings. Results Of 249 subjects who completed the follow-up, 153 (61.4%), 20 (8.0%), and 129 (30.5%) were F-18 florbetapir-negative, -equivocal, and -positive, respectively. The mean standardized uptake value ratios (SUVR) of F-18 florbetapir PET were 0.75 ± 0.04, 0.85 ± 0.10, and 1.00 ± 0.09 for each group (p <0.001 between groups), and 15.0%, 70.0%, and 98.7% of patients were quantitatively above the positive threshold. The change in the SUVR of F-18 florbetapir PET was higher in the equivocal (6.09 ± 3.61%, p <0.001) and positive (3.13 ± 4.38%, p <0.001) groups than the negative group (0.88 ± 4.28%). Among the subjects with normal or subjective memory impairment and mild cognitive impairment, 5.3% with negative amyloid PET and 37.5% with positive amyloid PET converted to AD over the 4-year period. None of the equivocal amyloid PET subjects converted to AD during this period.

Visual internal urethrotomy may be a reasonable initial procedure of complete and incomplete urethral stricture before planning more extensive urethroplasty. However, it is essential to recognize its limitation because careless use can result in complications. So we have experienced 88 cases of complete and incomplete urethral stricture treated by visual internal urethrotomy. 1. In non-obliterated urethral stricture, satisfactory results were achieved in 57 of patients(78 %) after urethrotomy. Patients with more than 2cm long stricture and multiple strictures had the most unsatisfactory results ( required multiple urethrotomy). 2. In obliterated urethral stricture, 54 procedures of urethrotomy were carried out in 15 patients with complete urethral obstruction(average : 3.6times). When stricture was less than 1cm in length, good results were obtained in spite of several recurrences. However, when complete urethral stricture was more than 1cm in length, all patients failed due to recurred strictures. These results suggest that visual internal urethrotomy is a valuable initial method before urethroplasty, when stricture is less than 1cm in length in cases of complete urethral obstruction.
Constriction, Pathologic ; Humans ; Recurrence ; Urethral Obstruction ; Urethral Stricture*

Adenocarcinoma of the bladder is a rare tumor with incidence in the range between 0.6 and 2.0 % of all epithelial bladder neoplasms. Its prognosis is generally poor compared to transitional cell carcinoma of the bladder. During the past 10 years since 1979, we have experienced 8 cases (3.2%) of adenocarcinoma the bladder among 252 cases of epithelial bladder neoplasms. Six cases of these were primary adenocarcinoma and 2 cases were of urachal origin. Overall two year survival rate was 23% with only 1 case free of cancer up to 3 years. Histologically, the tumors were classified as colonic type (4 cases), clear cell type (1 case), and not otherwise specified type (3 cases), without signet ring cell and colloid type. It might as well be concluded that there is no significant correlation between histologic type and survival rate. However there seems to be a significant correlation between clinical stage and survival rate.
Adenocarcinoma* ; Carcinoma, Transitional Cell ; Colloids ; Colon ; Follow-Up Studies* ; Incidence ; Prognosis ; Survival Rate ; Urinary Bladder Neoplasms ; Urinary Bladder*

We treated 11 patients with advanced transitional cell carcinoma of upper urinary tract with adjuvant M-VAC chemotherapy and their median survival time was compared with 9 patients without M-VAC chemotherapy as e historical group. The total number of cycles per each patient ranged from 1 to 5 with a mean of 3.4. Of these patients, 8 patients could be evaluated for response and 4 patients were responded (2 complete and 2 incomplete. response rate 50%). The median duration of response was 26 months for complete responders and 4.5 months for incomplete responders. The median duration of survival for all chemotherapy group, complete responders, progression and historical control group were 22, 23+, 14 and 21 months. respectively. Median survival was 22 months in all 11 patients. 23+ months in clinical responders, 14 months in progression and 21 months in historical control group. Although overall survival was not prolonged significantly in chemotherapy than the historical control group, M-VAC was effective in small proportion of patients (CR: 2/8). The duration of survival of the patients with complete remission was prolonged significantly.
Carcinoma, Transitional Cell* ; Doxorubicin* ; Drug Therapy* ; Humans ; Urinary Tract* ; Vinblastine*

The primary objective in taking care of the spinal cord injury patients is preservation of renal function. We evaluated 28 cases with spinal cord injury, who underwent intravenous pyelography, voiding cystourethrography and urodynamic assessment to determine the effects of low bladder compliance, hyperreflexia and detrusor-sphincter dyssynergia on the upper tact during the past 5 years period. And also, an objective hostility score was introduced that would predict the fate of the upper tracts and help to determine the need of treatment. Urodynamic evaluation revealed that 17 or 28 cages (67 %) had detrusor hyperreflexia and 11 cases (33 %) had detrusor areflexia. Of the 28 cases. 12 cases (44 %) had low compliant bladder. Hydronephrosis was present in six of the 12 eases (41 %) that had low compliance. These results were in sharp contrast to the normal compliant bladder in which two of 16 cases (12 %) had hydronephrosis. No case with a hostility score of less than 5 went on to develop upper tract changes. In contrast, eight of 10 cases with scores of 6 or more went on to develop upper tract change. In conclusion, the patients with the hostility score of 6 or more were significantly at risk of developing upper tract damage. So, these patients should have adequate and frequent follow-up evaluation.
Ataxia ; Compliance ; Hostility ; Humans ; Hydronephrosis ; Reflex, Abnormal ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urodynamics ; Urography

OBJECTIVE: Our aim was to evaluate the accuracy of prenatal sonographic detection of fetal gastrointestinal(GI) anomalies and to present perinatal outcome of fetal GI anomalies, incidence of polyhydramnios, other malformations and chromosomal abnormalities associated with fetal GI anomalies. MATERIALS AND METHODS: Prenatal sonographic results were compared with GI anomalies found in 32 neonates during recent 8 years. 32 cases of fetal GI anomalies were divided into three groups based on the level of obstruction and complication; group 1: upper GI obstruction(4 esophageal, 5 duodenal and 8 ileojejunal atresia); group 2: lower GI obstruction(1 colonal, 9 anorectal atresia); group 3: GI obstruction with secondary complication(1 ascites, 2 meconium peritonitis, 2 meconium pseudocyst). RESULTS: The accurate prenatal sonographic detection rate of fetal GI anomalies was 70.6% in group 1 and 100% in group 3 and there was no detection in group 2. False positive diagnosis was made in 5 cases(2: esophageal atresia, 3:ileojejunal atresia), but none of them except one case of multiple cardiac anomalies confirmed by autopsy, was followed by termination of pregnancy. Polyhydramnios was significantly associated with group 1 and associated malformations with group 2. An abnormal karyotype existed in three out of 32(1 case of trisomy 18 in esophageal atresia, 2 cases of trisomy 21, each one in duodenal and anorectal atresia). Survival rate of group 1, 2, 3 were 76%, 25%, and 40% respectively. CONCLUSIONS: The upper GI anomalies were easily detected by prenatal sonographic examination and had a good prognosis. But, the lower GI anomalies were difficult to diagnose prenatally and had a poor prognosis. Therefore, further efforts to diagnose for lower GI anomalies should be performed.
Abnormal Karyotype ; Ascites ; Autopsy ; Chromosome Aberrations ; Colon ; Diagnosis ; Down Syndrome ; Esophageal Atresia ; Humans ; Incidence ; Infant, Newborn ; Meconium ; Peritonitis ; Polyhydramnios ; Pregnancy ; Prognosis ; Survival Rate ; Trisomy ; Ultrasonography*

PURPOSE: To evaluate the ultrasound (US) findings that can help differentiate lymphoid hyperplasia in the appendix from acute appendicitis. MATERIALS AND METHODS: A total of 1230 patients (below 20 years old) suspected of having appendicitis received an appendectomy between November, 1999, and March, 2008, with US findings in 27 patients with pathologically proven lymphoid hyperplasia of the appendix. Of 167 patients that received an appendectomy from January, 2007, to December, 2007, 52 patients with acute appendicitis were retrospectively reviewed as a control group. Retrospective review of US images was performed by two radiologists who were blinded to the pathologic results. The review was based on 12 ultrasonographic criteria derived from reports on the diagnostic findings of the appendicitis. RESULTS: Compared with acute appendicitis, lymphoid hyperplasia in appendix had a smaller diameter (7.14+/-1.22 mm vs 9.37+/-1.80 mm, p < 0.001) and less wall thickening (1.38+/-0.36 mm vs 1.74 +/- 0.56 mm, p =0.001). Periappendicular inflammation (p < 0.001), intraluminal air (p = 0.006), round shape in transverse scan (p = 0.002), increased blood flow on color Doppler US (p = 0.03) were also different. CONCLUSIONS: US is a useful modality to differentiate lymphoid hyperplasia in the appendix from acute appendicitis.
Appendectomy ; Appendicitis ; Appendix ; Child ; Humans ; Hyperplasia ; Inflammation ; Retrospective Studies

Purpose: This study investigated the impact of coronavirus disease 2019 (COVID-19) on body mass index (BMI) of children and adolescents. Methods: From May to July 2020, the obesity rate of children and adolescents was compared retrospectively to the corresponding rate in the same period in 2019. The change in height, weight, and BMI of the girls who received a gonadotropin releasing hormone agonist (GnRHa) for precocious puberty (n=53) and the controls (n=31) who visited a growth clinic for early breast budding but were not treated with GnRHa in the first half of 2020 were compared to the corresponding change in the first half of 2019 using a paired t-test. Results: The rate of overweight or obesity in new outpatients (n=113, 83 girls, 30 boys) who visited growth clinics from May to July 2019 was 25.3% for girls and 23.3% for boys. The corresponding rate for the same period in 2020 (n=201, 153 girls, 48 boys) was 31.4% for girls and 45.8% for boys. There was a significant increase in the rate of overweight or obesity. The BMI of the GnRHa treatment group increased significantly from May to July 2019 than during the same period in 2020 (P<0.01). There was no significant difference in BMI between those periods in the control group. Conclusion During the social distancing period, the incidence of obesity was higher in boys than in girls. The obesity rate in girls who visited the growth clinic for early breast budding during routine follow-ups did not increase.