Adenocarcinoma of the urinary bladder, including urachal carcinoma, is a rare tumor with incidence in the range between 0.5% and 2.2% of all epithelial bladder neoplasms. Ten cases of adenocarcinoma of the urinary bladder(eight cases of primary adenocarcinoma and two cases of urachal carcinoma)are presented. We described the computed tomography(CT)appearances of adenocarcinoma of the urinary bladder and tried to find out the characteristic CT findings of urachal carcinoma. CT scan were evaluated for the location of the tumors, presence of calcification in the tumor, and the tumor extension. Seven tumors were located at the dome of the bladder(70%0, two were at lateral walls, and one was at anterior wall. Seven were single mass and three were multicentric masses in the bladder. Fine punctate calcifications scattered within the tumors were detected in four cases(40%); three of the eight, primary adenocarcinoma, and one of the two, urachal carcinoma. Two urachal carcinomas were characterized by midline position and predominantly extravesical growth along the urachus. Gross extravesical extension with distant metastasis were presented in seven cases(70%) at the time of initial diagnosis. CT may be useful in evaluating the adenocarcinoma of the urinary bladder and differentiating urachal carcinoma from bladder cancer.
Adenocarcinoma* ; Diagnosis ; Incidence ; Neoplasm Metastasis ; Tomography, X-Ray Computed ; Urachus ; Urinary Bladder Neoplasms ; Urinary Bladder*

BACKGROUND: To evaluate depressure effect and safety of delapril, a new ACE inhibitor, in Korea. METHOD: Thirty three patients, aged 37-69, with mild to moderate essential hypertension were first observed for 2 weeks with placebo followed by administration of 15mg of delapril twice daily for 2 weeks, then doubled dosage to 30mg b.i.d. and combined with 25mg of dihydrochlorothiazide if optimal BP were not obtained at the end of 4th week, continued the same dose until the end of 10 week's trial period. RESULT: BP dropped 15/9mmHg inaverage at the end of 10th week rewarding 70% of cumulative effectiveness. Most frequent side reaction was dry cough, occurred in 9% of patients followed by chest tightness, headache, constipation and transient elevation of GPT. CONCLUSION: Delapril 15-30mg twice daily as monotheraphy or combined with diuretics is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Constipation ; Cough ; Diuretics ; Headache ; Humans ; Hydrochlorothiazide ; Hypertension* ; Korea ; Reward ; Thorax

In the diagnosis of acute spinal trauma, meticulous physical examination and history taking is the most important tool and auxilliary support support can be given by plain X-ray, CT or myelography, etc. But these cannot show the state of cord injury directly. On the contrary, MRI shows the cord directly as well as the soft and bony tissues. We analysed retrospectively 39 patients who suffered from acute spinal trauma at the level of cervical and thoracic spine and had their spine MRI taken. We verified the meaningful correlation between the signal change in the spinal cord on MRI and the degree of neurologic deficit and prognosis, using Frankel classification and trauma motor index at the time of admission and the final follow-up.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neurologic Manifestations ; Physical Examination ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spine

PURPOSE: To investigate the characteristics of patients with acute hemorrhagic central retinal vein occlusion. METHODS: We reviewed the medical records of 124 eyes of 122 patients who were diagnosed to have central retinal vein occlusion within one month after onset and followed for six months or longer. Eyes were divided into three groups - ischemic, hemorrhagic and nonischemic - and the visual prognosis and complications were compared among the three groups. RESULTS: The hemorrhagic group had a tendency to be a male and younger than the other groups. The mean initial and final visual acuity of the hemorrhagic group was logMAR 1.23 and 1.54, respectively, and showed significant decrease rate of visual acuity compared to that of ischemic group (p=0.022), logMAR 1.31 and 1.35, respectively. Iris neovascularization (INV) / angle neovascularization (ANV) occurred in 6 eyes (7.4%) of the ischemic group and in 3 eyes (12.5%) of the hemorrhagic group. The mean period form the initial examination to INV/ANV occurrence was 4.67 and 2.33 months, respectively. All eyes of the hemorrhagic group and 4 eyes (66.7%) of the ischemic group with INV/ANV progressed to neovascular glaucoma. CONCLUSIONS: The hemorrhagic group had a worse final visual acuity, a greater decreasing rate of visual acuity, and earlier occurrence of INV/ANV than ischemic group. Close follow-up and proper management are warranted in patients with acute hemorrhagic central retinal vein occlusion.
Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Iris ; Male ; Medical Records ; Prognosis ; Retinal Vein* ; Visual Acuity

Intravesical Alum irrigation is the safest and most effective method of treatment for intractable hematuria. Continuous vesical irrigation with 1 percent Alum solution was performed without anesthesia in 20 patients in whom massive bladder hemorrhage persisted despite of evacuation of clots and normal saline irrigation for at least 24 hours. Hematuria ceased in 18 patients and side effect was not observed. We have found this technique to be simple, efficient, nontoxic and less expensive than Previously reported methods.
Anesthesia ; Hematuria ; Hemorrhage* ; Humans ; Urinary Bladder*

PURPOSE: The purpose of this study was to evaluate the short- and long-term effectivensess of intracavitary urokinase with percutaneous catheter drainage in Ioculated thoracic empyemas. MATERIALS AND METHODS: 15 patients were identified as second stage of Ioculated thoracic empyema by estimating nature of pleural fluid, chest PA, lateral decubitus view and CT scan. Under the guidance of fluoroscopy or ultrasound, catheter was inserted percutaneously. Instillation of urokinase was started when amount of drained fluid became less than 30ml per day with 100,000U of urokinase mixed with 100ml of normal saline. Trial of urokinase was repeated until complete drainage of empyema was demonstrated on plain chest film obtained after 48 hours. RESULTS: Successful complete drainage was achieved in 14 of 15 patients. In long-term study, complete resorption was demonstrated in 11 of 12 patients. Average dosage of used urokinase was 330,000U and mean duration of catherter insertion was 35 days. CONCLUSION: lntracavitary urokinase with percutaneous catheter drainage is a safe and effective method to facilitate drainage of Ioculated empyema and to prevent recurrence.
Catheters ; Drainage ; Empyema ; Empyema, Pleural* ; Fluoroscopy ; Humans ; Recurrence ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

PURPOSE: The purpose of this study was to evaluate the short- and long-term effectivensess of intracavitary urokinase with percutaneous catheter drainage in Ioculated thoracic empyemas. MATERIALS AND METHODS: 15 patients were identified as second stage of Ioculated thoracic empyema by estimating nature of pleural fluid, chest PA, lateral decubitus view and CT scan. Under the guidance of fluoroscopy or ultrasound, catheter was inserted percutaneously. Instillation of urokinase was started when amount of drained fluid became less than 30ml per day with 100,000U of urokinase mixed with 100ml of normal saline. Trial of urokinase was repeated until complete drainage of empyema was demonstrated on plain chest film obtained after 48 hours. RESULTS: Successful complete drainage was achieved in 14 of 15 patients. In long-term study, complete resorption was demonstrated in 11 of 12 patients. Average dosage of used urokinase was 330,000U and mean duration of catherter insertion was 35 days. CONCLUSION: lntracavitary urokinase with percutaneous catheter drainage is a safe and effective method to facilitate drainage of Ioculated empyema and to prevent recurrence.
Catheters ; Drainage ; Empyema ; Empyema, Pleural* ; Fluoroscopy ; Humans ; Recurrence ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

Potassium citrate therapy caused a sustained increase in urinary pH and potassium, and restored urinary citrate to normal levels. No significant changes occurred in urinary uric acid, oxalate, sodium or phosphorus levels. Owing to these physiological changes, uric acid solubility increased, urinary saturation of calcium oxalate decreased and the propensity for spontaneous nucleation of calcium oxalate was reduced to normal. Therefore, the Physicochemical environment of urine following treatment become less conductive to the crystallization of calcium oxalate or uric acid. Twenty six patients with uric acid nephrolithiasis with or without calcium nephrolithiasis underwent treatment and long-term preventive management (mean of 20.8 months) with potassium citrate. Urinary pH increased from acid (5.0-5.5) to normal (6.5-7.0) during treatment. During the period of preventive management, stones were not developed.
Calcium ; Calcium Oxalate ; Citric Acid ; Crystallization ; Humans ; Hydrogen-Ion Concentration ; Nephrolithiasis ; Oxalic Acid ; Phosphorus ; Potassium Citrate* ; Potassium* ; Solubility ; Uric Acid ; Urinary Calculi*

BACKGROUND/AIMS: Paracentesis is an acceptable therapeutic modality for the symptomatic relief of dyspnea or abdominal fullness due to tense ascites in patients with cirrhosis. Whereas studies about the effects of paracentesis focused on the changes about hemodynamics, electrolytes and renal function in great detail, the effects of paracentesis on the changes about respiratory system have undergone limited investigations which are defined large-volume paracentesis. METHODS: We performed pulmonary function tests with arterial blood gas analysis just before and 24 hr after paracentesis. The paracentesis of average 2,300ml was carried out in ten liver cirrhosis patients with tense ascites who were free from underlying cardiopulmonary impairment. RESULTS: 1. The results of pulmonary function test just before paracentesis were as followings; FVC( functional vital capacity), FEV1(forced expiratory volume in 1 sec), FEF25 75(forced expiratory effort 25% 75%) and TLC(total lung capacity) were decreased as 78%, 79%, 62.3% and 89% of normal control value respectively, whereas RV(residual volume) was not decreased. DLCO(lung diffusion capacity of carbon monoxide)was decreased as 61.6%. 2. The results of pulmona function test 24 hr after paracentesis were as followings,' The symptomatic relief of dyspnea was achieved in all participated ten patients. Among lung volume parameters, FVC and VC were increased significantly(p=0.003, p=0.004). Whereas TLC was increased without statistical significance(p=0.228), and RV and FRC(functional residual capacity) showed no change. FEV1 was increased significantly(p=0.039), but FEF25 75 and the ratio of FEF1/FVC showed no change. DLCO was not increased. PaOy(partial pressure of oxygen in arterial blood) was impr'oved without statistical significance. CONCLUSIONS: These results suggest that the patients of liver cirrhosis with ascites have restrictive ventilatory impairment with additional obstructive ventilatory impairment. After paracentesis, the restrictive ventilatop impairment is improved by the relief of diaphragmatic motion limitation caused by ascites. Also, paracentesis of(not large volume, like 5000ml, but) relatively small volume, of 2000 3000ml can achieve objective improvement of dyspnea due to tense ascites.
Ascites ; Blood Gas Analysis ; Carbon ; Diffusion ; Dyspnea ; Electrolytes ; Fibrosis* ; Hemodynamics ; Humans ; Liver Cirrhosis ; Lung ; Oxygen ; Paracentesis* ; Respiratory Function Tests ; Respiratory System ; Transcutaneous Electric Nerve Stimulation

Gastrocelic fistula of malignant origin is a rare complication, usually due to gastric or colon cancer. Possible other etiologic factors resulting in gastrocolic fistula are peptic ulcer, trauma, carcinoid tumor, intestinal tuberculosis, Crohn's disease, lymphoma, intraabdominal abscess, diverticulitis and etc. At the present, earlier diagnosis and treatment of gastric and colon cancer may explain the low frequency of malignant gastrocolic fistula than the past but the review of Korean literatures revealed only two reports of gastrocolic fistula secondary to gastric cancer and another from benign gastric ulcer. Yet, there has been no report of fistula due to colon cancer. We experienced a case of colon cancer with postural dizziness, fecal eructation who was diagnosed as gastrocolic fistula by endoscopy, barium enema, UGI series and finally underwent operation. Therefore, we report this case with the review of literatures.
Abscess ; Barium ; Carcinoid Tumor ; Colon* ; Colonic Neoplasms* ; Crohn Disease ; Diagnosis ; Diverticulitis ; Dizziness ; Endoscopy ; Enema ; Eructation ; Fistula* ; Lymphoma ; Peptic Ulcer ; Stomach Neoplasms ; Stomach Ulcer ; Tuberculosis