Between May, 1987 and July, 1991, 27 renal staghorn calculi were treated with EDAP LT-01 extracorporeal shock wave lithotriptor as monotherapy. Of the staghorn calculi 18 were complete and 9 incomplete staghorn. Of the patients 5 had urinary tract infection before treatment. Stone size in longest diameter was up to 4cm in 37.0% of the cases, 4 to 9cm in 59.2% and longer than 9cm in 3.7%, including complete or partial staghorn stones. Complete response rate was 59.3%, including complete staghorn in 44.4 % and partial staghorn in 14.8%. In the complete response cases, the number of shocks used varied from storage 60 to storage 2770 at 5/sec frequency, 100% adjust power. Complete response rate was not related with hydronephrosis, size of stones and configuration or the stones, but it was related with chemical composition of the stone. In the cases of struvite stones, they needed fewer number of shocks than any other composition for complete response. Of the stones 25.9 % were treated after double-J stents were inserted. Over aI1 25.9% of the patients needed ancillary measures, including ureteroscopic removal in 11.1%, repeated ESWL for steinstrasse in 11.9% and litholapaxy in 3.7%. Of the cases 11 developed post treatment fever and they were treated with antibiotics without clinical problems, therefore urinary tract infection is no longer contraindication of ESWL. The ESWL monotherapy is one of the recommendable treatment method for staghorn calculi.
Anti-Bacterial Agents ; Calculi ; Fever ; Humans ; Hydronephrosis ; Kidney Calculi* ; Lithotripsy* ; Shock* ; Stents ; Urinary Tract Infections

No abstract available.
Anti-Bacterial Agents ; Orthopedics

No abstract available.
Splenomegaly*

BACKGROUND/AIMS: The aims of this study are to clarify the morphology of fundic gland polyp (FGP) and to compare the features of FGP between familial adenomatous polyposis-associated group and sporadic development group. METHODS: A total of 15 endo- scopic biopsy specimens of FGP from 13 patients were divided into three groups; Group A(3 cases; familial adenomatous polyposis family, multiple FGPs), Group B(3 cases; sporadic development, multiple FGPs) and Group C(7 cases; sporadic development, single FGP), and their endoseopic /microscopic features including mucin histochemistry and immunohistoc- hemistty(for PCNA) were compared. RESULTS: FGPs were confined to the gastric body and fundus in all 3 groups, and measured 2-8 mm. Their numbers varied even in Group A and Group B, The difference was observed in their median age: 26 years in Group A and 55 years in Group B, respectively, but there were no differences in endoscopic, histologic, mucin histochemical and immunohistochemical(for PCNA) features. Micro-scopically, all FGPs were composed of fundic glands and scattered microcysts with a spectrum of disordered glandular architecture which ranged from convoluted gland to Y-shaped gland, to stellateshaped gland, and to irregular tortuous glancl with dilated lumen. CONCLUSIONS: We assume that diversity af morphologic features of FGP may develop from progression of hyperplastic/hamartomatous fundic glandular proliferation which may end up with microcyst formation as an evolutional change. Familial adenomatous polyosis-associated FGPs were not endoscopically and histologically distingishable from sporadic deveoped FGPs.
Adenomatous Polyposis Coli* ; Biopsy ; Esophagus* ; Humans ; Intestines* ; Mucins ; Polyps* ; Stomach*

We aimed to determine normal reference ranges for prostate volume (PV) and annual PV change rate in a Korean nationwide screening population. Data from men who underwent a routine health check-up were collected from 13 university hospitals. The cohort comprised men aged > or =40 yr who had undergone 2 or more serial transrectal ultrasonographies. Men with initial PV>100 mL; serum PSA level>10 ng/mL; PV reduction>20% compared with initial PV, or who had history of prostate cancer or prostate surgery, were excluded. Linear regression and mixed effects regression analyses were used to predict mean PV and longitudinal change in PV over time. A total of 2,967 men formed the study cohort. Age, body mass index (BMI), and serum prostate-specific antigen (PSA) level were found to be significant predictors of PV. A predicted PV table, with a 95% confidence interval (CIs), was developed after adjusting for these 3 variables. Annual PV change rate was 0.51 mL/year (95% CI, 0.47-0.55). Annual PV change rate according to age was 0.68 mL/year, 0.84 mL/year, 1.09 mL/year, and 0.50 mL/year for subjects in their 40s, 50s, 60s, and > or =70 yr, respectively. Predicted annual PV change rate differed depending on age, BMI, serum PSA level and baseline PV. From a nationwide screening database, we established age-, PSA-, and BMI-specific reference ranges for PV and annual PV change rate in Korean men. Our newly established reference ranges for PV and annual PV change rate will be valuable in interpreting PV data in Korean men.
Adult ; Aged ; Aged, 80 and over ; Aging/*pathology ; Humans ; Male ; Mass Screening/*standards ; Middle Aged ; Organ Size ; Prostate/*anatomy & histology/ultrasonography ; Reference Values ; Reproducibility of Results ; Republic of Korea ; Sensitivity and Specificity ; Ultrasonography/*standards ; Urology/*standards

BACKGROUND: Stereotactic thalamotomy and pallidotomy for Parkinson's disease or essential tremor have been performed under local anesthesia. But some neurosurgeons have been reluctant to utilize this technique because of patient discomfort and neurological complications. So we used the propofol that provides excellent sedation and rapid and smooth recovery of mental abilities with minimal side effects. METHODS: After the patients were placed into the Leksell's stereotactic frame, anesthesia was induced by continuous infusion of propofol at the rate of 150 mcg/kg/min and then maintained at the rate of 50 mcg/kg/min. We investigated the hemodynamic changes, ABGA, total dose of propofol, time to loss of consciousness, recovery time from the end of infusion to eyes opening and side effects. RESULTS: The blood pressure decreased significantly at infusion start 15 min and 30 min (p<0.05) and heart rate decreased significantly at infusion start 30 min (p<0.05). The PaCO2 increased significantly at infusion start 15 min and 30 min (p<0.05). Total dose of propofol was 202.4+/-59.8 mg, time to loss of consciousness was 13.0+/-4.4 min, recovery time was 9.0+/-4.7 min and side effects were pain on infusion (2 cases) and postoperative nausea (1 case). CONCLUSIONS: Stereotactic thalamotomy and pallidotomy for Parkinson's disease or essential tremor were performed by infusion of propofol with minimal side effects and no neurological complications.
Anesthesia* ; Anesthesia, Local ; Blood Pressure ; Essential Tremor ; Heart Rate ; Hemodynamics ; Humans ; Movement Disorders* ; Pallidotomy ; Parkinson Disease ; Postoperative Nausea and Vomiting ; Propofol* ; Unconsciousness

This study aims to evaluate CT (Computed Tomography) characteristics through the estimation of HU (Hounsfield Unit) and the corresponding variations using coefficient of variation values for various materials as a function of physical factor. HU values for various materials with varying densities as a function of physical factor were measured using MDCT (Siemens SOMATOM Sensation 4, Germany). The results showed that the HU values were decreased and increased as a function of kVp and material density, respectively. Especially, the HU values for bone and iodine at 140 kVp were 32% and 42% smaller than those at 80 kVp, respectively. In case of iodine, the HU values also decreased and increased as a function of kVp and concentration, respectively. While the HU values were fixed as a function of mAs. The decreased ratio of HU values between 80 keV and 140 keV was different at various concentration and maximum difference was shown as 1.73 at 3% concentration. These results indicated that it may be possible to separate composition of materials, e.g. iodine and bone, using single source CT. The results showed that dual energy techniques using single source CT can be applied to material separation and expand CT imaging techniques to other practical applications.
Iodine ; Sensation

This study aims to evaluate CT (Computed Tomography) characteristics through the estimation of HU (Hounsfield Unit) and the corresponding variations using coefficient of variation values for various materials as a function of physical factor. HU values for various materials with varying densities as a function of physical factor were measured using MDCT (Siemens SOMATOM Sensation 4, Germany). The results showed that the HU values were decreased and increased as a function of kVp and material density, respectively. Especially, the HU values for bone and iodine at 140 kVp were 32% and 42% smaller than those at 80 kVp, respectively. In case of iodine, the HU values also decreased and increased as a function of kVp and concentration, respectively. While the HU values were fixed as a function of mAs. The decreased ratio of HU values between 80 keV and 140 keV was different at various concentration and maximum difference was shown as 1.73 at 3% concentration. These results indicated that it may be possible to separate composition of materials, e.g. iodine and bone, using single source CT. The results showed that dual energy techniques using single source CT can be applied to material separation and expand CT imaging techniques to other practical applications.
Iodine ; Sensation

Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson–Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.

A 23 months-old girl visited the hospital because of fever and left neck mass. She was diagnosed as acute suppurative thyroiditis with piriform sinus fistula. Thyroid sonography showed perithyroidal abscess formation and thyroid scan showed decreased uptake of Tc-99m pertechnate of both thyroid glands. Magnetic resonance imaging of neck showed abscess cavity extending to the swollen left thyroid gland. And there was tiny fistula between thyroid and piriform sinus in the barium esophagogram. Streptococcus gordonii was isolated on needle aspiration culture. We report a case of piriform sinus fistula of the neck complicated with suppurative thyroiditis. The fistula was treated with chemocauterization using trichloroacetic acid.
Abscess ; Barium ; Female ; Fever ; Fistula* ; Humans ; Magnetic Resonance Imaging ; Neck ; Needles ; Pyriform Sinus* ; Streptococcus gordonii ; Thyroid Gland ; Thyroiditis, Suppurative* ; Trichloroacetic Acid*