Dowling-Degos disease, or reticular pigmented anomaly of the flexures, is a rare genodermatosis characterized by an acquired reticular macular hyperpigmentation that initially affects the axillae and groin and later involves intergluteal and inframammary folds, the neck, trunk, and arms. We report a case of Dowling-Degos disease occurring in a 40-year-old woman who has typical hyperpigmentation on flexural areas without any family history and has vesicles on the lip and oral mucosae.
Adult ; Arm ; Axilla ; Female ; Groin ; Humans ; Hyperpigmentation ; Lip ; Mouth Mucosa ; Neck

Recently. the endopyelotomy has been used as a first choice of treatment in selected cases of ureteropelvic or ureteral strictures. 24 consecutive cages of endourologic-tomy procedure including 12 cases of endopyelotomy. 8 cases of endoureterotomy and 4 cases of endocalicotomy were performed from Nov. '89 to May '91. The causes of stricture were previous operation (7 cases), congenital (6 cases). tuberculosis (5 cases) and others. They were all followed more than 3 months. The overall success rete was 83.3%. The success means improvement of clinical symptoms and radiographic findings. The complications were upward migration of stent (1 case), granuloma (1 case) and re-stricture (2 cases). Especially in 1 cases of caliceal stricture the success rate was 100% with no complication. Our experience indicates that endourologic-tomy procedure has relatively good success rate, low morbidity, Low complication and a shorter recovery time. Especially endocalicotomy is one of the best method to treat caliceal stricture.
Constriction, Pathologic* ; Granuloma ; Neck* ; Stents ; Tuberculosis ; Ureter*

PURPOSE: Transrectal needle biopsy of the prostate is a definitive diagnostic procedure for prostate cancer. However, the sensitivity of a third biopsy is very low in patients with serum prostate-specific antigen(PSA) 4-10 ng/ml and negative repeat prostate biopsy. In addition, multiple prostate biopsies usually have low patient compliance due to the pain and complications associated with the procedure. The aim of this study was to evaluate the role of transurethral resection of the prostate(TURP) for the diagnosis of prostate cancer in patients with lower urinary tract symptoms and clinical suspicion but with negative repeat biopsy samples. MATERIALS AND METHODS: From January 2000 to December 2006, 51 patients less than 80 years old underwent TURP at our institution for lower urinary tract symptoms with a serum PSA 4-10ng/ml and negative repeat transrectal needle biopsy of the prostate. We examined their first serum PSA, serum PSA before the TURP, PSA density, as well as their age, prostate size and digital rectal exam findings. The probability for the detection of prostate cancer by TURP was investigated retrospectively. RESULTS: Prostate cancer was detected in seven patients(13.7%). The total Gleason score for the biopsy specimens was 5 in two patients, 6 in one patient and 7 in four patients. There were significant differences between the prostate cancer group and the benign prostate hypertrophy group with regard to the PSA density and prostate volume. However there were no significant differences between the first serum PSA and the serum PSA before TURP in the two groups. CONCLUSIONS: In case with a high suspicion for prostate cancer, the TURP helps in the diagnosis of prostate cancer in those patients with a negative repeat biopsy and a serum PSA 4-10ng/ml and improvement of their lower urinary tract symptoms.
Aged, 80 and over ; Biopsy ; Biopsy, Needle* ; Diagnosis* ; Humans ; Hypertrophy ; Lower Urinary Tract Symptoms* ; Needles* ; Neoplasm Grading ; Patient Compliance ; Prostate* ; Prostatic Neoplasms* ; Retrospective Studies ; Transurethral Resection of Prostate

PURPOSE: A suprapubic approach to the suburethral polypropylene (SPARC) procedure was reported as a new technique for urethral support in the treatment of stress urinary incontinence in women. The safety and efficacy of the SPARC procedure were evaluated in women with stress urinary incontinence. MATERIALS AND METHODS: 50 women (mean age 48.6) with stress urinary incontinence underwent the SPARC procedure under general anesthesia between October 2002 and May 2004. The preoperative evaluations included: the patients history, a physical examination, urinalysis, an urodynamic test and incontinence staging for the Stamey grade. 2 and 5 women had previously experienced failed anti-incontinence surgery and pelvic surgery, respectively. The mean follow-up period was 8.01 months, with all patients assessed for the procedural outcome, subjective satisfaction and complications. RESULTS: The mean follow-up period, hospital stay and operation time were 8.01 months (3-15), 3.7 days (2-6) and 23 minutes (18-45), respectively. The success rate was 94%. There were no significant perioperative and postoperative complications. 3 patients (6%) had bladder perforation during the operation that necessitated an indwelling Foley catheter (mean period 7.3 days). 3 patients (6%) each had postoperative cystitis and immediate voiding difficulty that necessitated an indwelling Foley catheter (mean period 3.0 days) and bladder training, but without cutting or releasing of the tapes. 7 patients (14%) had postoperative de novo urge symptoms. CONCLUSIONS: The SPARC procedure is a simple, safe and effective treatment for female stress urinary incontinence in terms of the short operation time and hospital day, and low complication and relatively high success rates. However, a longer follow-up will be necessary to determine its long term effect and efficacy.
Anesthesia, General ; Catheters ; Cystitis ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Physical Examination ; Polypropylenes ; Postoperative Complications ; Urinalysis ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics

OBJECTIVE: This study was designed to evaluate the effect of stretching on decreasing spasticity of ankle plantar flexor muscles by biomechanical assessments. METHOD: Twenty two ankle joints of nineteen patients with upper motor neuron lesion were included. The spasticity was assessed both clinically and biomechanically before and after stretching of ankle plantar flexor muscles by tilt table. For clinical assessment modified Ashworth scale (MAS) was used. For biomechanical assessment, ankle plantar flexor muscles were stretched isokinetically while EMG signals were recorded simultaneously and peak eccentric torque, stiffness index and stretch reflex threthold speed (SRTS) were measured. RESULTS: Two cases showed improvement in MAS after stretching but the others did not. SRTS of ankle plantar flexor was increased significantly while peak eccentric torque and stiffness index were unchanged. CONCLUSION: Passive stretching of ankle plantar flexor muscles decreased the stretch threshold, that is a neural component of spasticity but it did not decrease the mechanical component of spasticity.
Ankle Joint ; Ankle* ; Humans ; Motor Neurons ; Muscle Spasticity* ; Muscle Stretching Exercises* ; Muscles* ; Reflex, Stretch ; Torque

A 29 years old woman had suffered from posterior neck and right shoulder pain for one year. She was given a spinal manipulation that was by a non-licentiate at a non-hospital. Posterior neck and shoulder pains were worsened and headache was developed after the spinal manipulation. She was recommended to be kept on the manipulation. Although physical finding was non-specific, radiologic findings of CT and MRI revealed atlantoaxial subluxation. After cervical immobilization and anti-inflammatory drug medication for three months, she recovered and did return to her work. We expect that atlantoaxial subluxation after spinal manipulation is not rare even in healthy young person without underlying pathology and can progress to serious complications unless detailed examination and management are undertaken.
Adult ; Female ; Headache ; Humans ; Immobilization ; Magnetic Resonance Imaging ; Manipulation, Spinal* ; Neck ; Pathology ; Shoulder Pain

Reversible airway obstruction and wheezing are typical features of bronchial asthma, but these features may also be observed in other conditions. However, the inclusion of these conditions in the differential diagnosis of asthma-like symptoms in adults is often neglected, resulting in a correct diagnosis being made after months of unsuccessful treatment for asthma. We report two cases of an upper airway obstruction masquerading as asthma. In case one, adenoid cystic carcinoma was identified in the trachea of a patient showing asthma-like symptoms, positive response to allergic skin test and methacholine inhalation challenge. In the other case, aspirated foreign body was misdiagnosed and treated as asthma for more than one year. A high degree of suspicion and a thorough medical evaluation censisting of history, physical examination and pulmonary function test including shapes of spirogram are essential to the differential diagnosis of asthma-like symptoms
Adenoids* ; Adult ; Airway Obstruction* ; Asthma* ; Carcinoma, Adenoid Cystic* ; Diagnosis ; Diagnosis, Differential ; Foreign Bodies* ; Humans ; Inhalation ; Methacholine Chloride ; Physical Examination ; Respiratory Function Tests ; Respiratory Sounds ; Skin Tests ; Trachea

PURPOSE: High levels of prostatic zinc are associated with prostatic antimicrobial activity and are depressed in patients with chronic prostatitis. We investigated the inhibition of bacterial growth in the rat prostate with chronic prostatitis after an intraprostatic injection of zinc and compared the two different types of zinc delivery. MATERIALS AND MTHODS: Ninety male Wistar rats were used in the study. Experimental chronic bacterial prostatitis was induced by the instillation of a bacterial suspension (Escherichia coli 108/ml) into the prostatic urethra. The animals were followed-up for 4 weeks and then injected intraprostatically with either 0.2ml of a zinc liposome or a zinc solution (0.04M zinc sulfate). Animals were sacrificed 4, 6, and 8 weeks after the injection. The inhibition of inflammation and its consequences were analyzed both microbiologically and histologically. The prostatic zinc concentrations were measured by inductively coupled plasma atomic emission spectrometry. RESULTS: The average infection rates and mean Log10cfu/g of the zinc-treated groups were significantly lower than the controls. The histopathology showed resolving prostatitis in the zinc-treated groups compared with the controls. The prostatic zinc levels were higher in the zinc-treated groups than in the controls 4 and 6 weeks after the zinc injection (p<0.05). However, the zinc liposome and zinc solution groups were found to be effectively identical. CONCLUSIONS: An intraprostatic injection of zinc inhibited bacterial growth by increasing the zinc levels in the rat prostatitis model. These results suggest that a local application of zinc to the prostate presents a new treatment modality for chronic bacterial prostatitis at the point of its pathogenesis.
Animals ; Humans ; Inflammation ; Liposomes ; Male ; Models, Animal* ; Plasma ; Prostate ; Prostatitis* ; Rats* ; Rats, Wistar ; Spectrum Analysis ; Urethra ; Zinc*

PURPOSE: High levels of prostatic zinc are associated with prostatic antimicrobial activity and are depressed in patients with chronic prostatitis. We investigated the inhibition of bacterial growth in the rat prostate with chronic prostatitis after an intraprostatic injection of zinc and compared the two different types of zinc delivery. MATERIALS AND MTHODS: Ninety male Wistar rats were used in the study. Experimental chronic bacterial prostatitis was induced by the instillation of a bacterial suspension (Escherichia coli 108/ml) into the prostatic urethra. The animals were followed-up for 4 weeks and then injected intraprostatically with either 0.2ml of a zinc liposome or a zinc solution (0.04M zinc sulfate). Animals were sacrificed 4, 6, and 8 weeks after the injection. The inhibition of inflammation and its consequences were analyzed both microbiologically and histologically. The prostatic zinc concentrations were measured by inductively coupled plasma atomic emission spectrometry. RESULTS: The average infection rates and mean Log10cfu/g of the zinc-treated groups were significantly lower than the controls. The histopathology showed resolving prostatitis in the zinc-treated groups compared with the controls. The prostatic zinc levels were higher in the zinc-treated groups than in the controls 4 and 6 weeks after the zinc injection (p<0.05). However, the zinc liposome and zinc solution groups were found to be effectively identical. CONCLUSIONS: An intraprostatic injection of zinc inhibited bacterial growth by increasing the zinc levels in the rat prostatitis model. These results suggest that a local application of zinc to the prostate presents a new treatment modality for chronic bacterial prostatitis at the point of its pathogenesis.
Animals ; Humans ; Inflammation ; Liposomes ; Male ; Models, Animal* ; Plasma ; Prostate ; Prostatitis* ; Rats* ; Rats, Wistar ; Spectrum Analysis ; Urethra ; Zinc*

PURPOSE: Percutaneous aspiration with sclerotherapy is widely used as a treatment for simple symptomatic renal cysts because percutaneous aspiration with sclerotherapy is minimally invasive and cost-effective. Sclerotherapy is usually performed in combination with aspiration due to the high recurrence rate, 30-70%, for the simple aspiration. We conducted an analysis of percutaneous aspiration with repeated sclerotherapy, and we report the results of sclerotherapy after percutaneous aspiration of simple renal cysts and we also review the results of the other previous studies. MATERIALS AND METHODS: Between January 2001 and April 2004, the results of percutaneous aspiration with repeated sclerotherapy in 39 cases of simple renal cysts were evaluated. We evaluated the operation time, the hospital stay, the success rate, the complication rate and the follow-up period. All patients were available for follow-up over a period of 3 months by conducting ultrasound exams and computed tomography (CT) scans. RESULTS: Complete collapse, partial collapse and recurrence of the renal cysts occurred in 24/39 (61.5%), 13/39 (33.3%), and 2/39 (5.1%) cases, respectively. The mean operative time was 50.3 minutes and the mean hospital stay was 4.5 days. The cost of two sessions of sclerotherapy was about 240,000 won and that of three sessions of sclerotherapy was about 300,000 won. The size of the cyst was not related to the rate of collapse. Any complication related to percutaneous aspiration with repeated sclerotherapy were not noted. CONCLUSIONS: With regard for the success rate and cost-effectiveness, percutaneous aspiration with repeated sclerotherapy is considered a primary treatment for simple symptomatic renal cysts.
Drainage ; Follow-Up Studies ; Humans ; Length of Stay ; Operative Time ; Recurrence ; Sclerotherapy* ; Ultrasonography