Hypospadias can be repaired in the majority cases in 1-stage with a high success rate. We reviewed clinical experience of 50 patients who underwent primary hypospadias repair by 1 surgeon using 1-stage repairs except 3 cases in a 30-month period. The results were 1). The half of patients were younger than 5 years (48%). 2). A total of 34 cases (68.0%) had an associated ventral curvature. The dorsal tunica albuginea plication to correct intrinsic curvature was done in 21 cases (61.8%) and dividing the urethral plate in only 3 cases (8.8%). 3). Associated anomalies were cryptorchidism in 7, hydrocele in 3 and severe penoscrotal transposition in 8 cases. 4). 19 cases of anterior hypospadias were repaired by meatoplasty using Heineke-Mikulicz tissue rearrangement (9 cases), MAGPI (3 cases), pyramid procedure (4 cases), Mathieu urethroplasty (2 cases) and onlay island flap (1 case). Of the 31 cases of middle and posterior hypospadias onlay island flap repair was performed in 24 cases (77.4%). 5). The success rates in anterior, middle and posterior hypospadias were 94.7, 64.7 and 42.9%, respectively. The overall success rate was 70%. 6). The most commonly used procedure was onlay island flap urethroplasty. Only 14 of 25 cases (56.0%) were successful with this method but the last 8 cases were repaired with no complications. 7). The most common complications were urethrocutaneous fistula (11 cases) and meatal retraction (3 cases). The complications were managed by rotational advancement flap (11 cases), meatal based flap (2 cases) and urethral advancement (1 case) and the success rate was 73.3%. In conclusion, to achieve more satisfactory results the choice of operation depends on the configuration of either glans or meatus, presence or absence of chordee and status of ventral penile skin in anterior hypospadias. Although the 2-stage repair remains a safe and reliable alternatives for severe hypospadias 1-stage repair was more useful except severe hypospadias combined with penoscrotal transposition."
Cryptorchidism ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays ; Male ; Skin

The Page kidney is a recognized cause hypertension. Post-traumatic subcapsular hematoma is the most common clinical counterpart to the Page`s experimental model of parenchymal compression. We herein report a case of the Page kidney resulting from massive bilateral subcapsular hematoma
Hematoma* ; Hypertension* ; Kidney ; Models, Theoretical

PURPOSE: We used MRI to retrospectively analyze the brain of patients suffering from cerebral palsy. Our aim is to determine MRI's role in the assessment of brain damage, the relationship of gestational age. METHODS: A total of 66 patients(29 preform group and 37 term group), who visited Kang-Dong Sacred Heart Hospital from January, 1994 to July, 1998, were enrolled in this study. RESULTS: Among the 29 in the preform group, 13 patients showed MR images of hypoxic ischemic injury in which periventricular leukomalacid(PVL) and multifocal ischemic necrosis in 12(41.3%) and 1(3.4%) respectively. Neuronal migration disorders were 6(20.8%), other congenital malformations 5(17%) and normal MR images 5(17%) in this preform group. Among the 37 in the term group, 22 patients showed MR images of hypoxic ischemic injury in which selective neuronal necrosis were 11(29.7%), PVL 4(10.8%), focal and multifocal ischemic necrosis 4(10.8%) and status marmoratus 3(8.1%). Neuronal migration disorders were 4(10.8%), other congenital malformations 5(13.5%) and normal MR images 6(16.2%) in the term group. CONCLUSION: MRI provided useful information in a majority of children with cerebral palsy. Hypoxic ischemic injury was significantly different in preform and term groups. PVL was frequent in the preterm group and selective neuronal necrosis was statistically common in the term group.
Brain* ; Cerebral Palsy ; Child* ; Gestational Age ; Heart ; Humans ; Magnetic Resonance Imaging* ; Movement Disorders ; Necrosis ; Neuronal Migration Disorders ; Neurons ; Paralysis* ; Retrospective Studies

90 cases of spinal cord injured patients admitted to St. Mary`s Hospital, Catholic Medical College, during the period from January 1969 to December 1978 were analyzed. All of these patients had initial bladder management by a careful indwelling catheter. This method reduced the incidence of the vesico-ureteral reflux, but the incidence of bladder stone was increased in flaccid neurogenic bladder than spastic type. The final stage of neurogenic bladder was reached eventually, usually within the first 3 months after injury. 57 cases of the 90 patients remained catheter-free and 21 cases remained indwelling catheter. In the early part of this series transurethral resection was done as the primary operation and external sphincterectomy was done when this failed. Since this was not always successful the combined procedure, external sphincterotomy and transurethral resection was tried, In this series T.U.R. and/or external sphincterotomy was done in 8 cases and all the cases were successful.
Catheters, Indwelling ; Humans ; Incidence ; Muscle Spasticity ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux

90 cases of spinal cord injured patients admitted to St. Mary`s Hospital, Catholic Medical College, during the period from January 1969 to December 1978 were analyzed. All of these patients had initial bladder management by a careful indwelling catheter. This method reduced the incidence of the vesico-ureteral reflux, but the incidence of bladder stone was increased in flaccid neurogenic bladder than spastic type. The final stage of neurogenic bladder was reached eventually, usually within the first 3 months after injury. 57 cases of the 90 patients remained catheter-free and 21 cases remained indwelling catheter. In the early part of this series transurethral resection was done as the primary operation and external sphincterectomy was done when this failed. Since this was not always successful the combined procedure, external sphincterotomy and transurethral resection was tried, In this series T.U.R. and/or external sphincterotomy was done in 8 cases and all the cases were successful.
Catheters, Indwelling ; Humans ; Incidence ; Muscle Spasticity ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux

No abstract available.
Cystectomy* ; Quality of Life* ; Urinary Diversion*

Megameatus intact prepuce (MIP) is an unusual variant of hypospadias and comprised 3 percent of all hypospadias. Embryologically, maldevelopment of glandular epithelial infolding would appear to be the abnormal process responsible for MIP formation. We have performed the pyramid procedures in 3 patients seen with the MIP variant during 14 months and achieved good results. The pyramid procedure optimizes a safe and simple dissection of the megameatus-urethra, and allows for subsequent reduction and caliber of both with excellent functional and cosmetic results.
Female ; Humans ; Hypospadias ; Male

With the advent of checkpoint inhibitors, it has opened up opportunities for numerous cancer patients. However, as is the case with every treatment, complications need to be weighed. Gastrointestinal adverse effects, such as diarrhea and colitis are well-known complications for checkpoint inhibitors. In severe cases, colitis-induced colonic perforation may occur with an estimation of 1.0% to 1.5% in anti-CTLA-4 antibodies. However, only a handful of cases of such devastating complications have been reported in anti-PD-1 antibodies such as pembrolizumab and nivolumab. We here report a case of intestinal perforation in a patient treated with nivolumab.

With the advent of checkpoint inhibitors, it has opened up opportunities for numerous cancer patients. However, as is the case with every treatment, complications need to be weighed. Gastrointestinal adverse effects, such as diarrhea and colitis are well-known complications for checkpoint inhibitors. In severe cases, colitis-induced colonic perforation may occur with an estimation of 1.0% to 1.5% in anti-CTLA-4 antibodies. However, only a handful of cases of such devastating complications have been reported in anti-PD-1 antibodies such as pembrolizumab and nivolumab. We here report a case of intestinal perforation in a patient treated with nivolumab.

PURPOSE: There have been many different kinds of operations for obstructing left colon (distal to splenic flexure) cancer and rectal cancer because immediate resection and anastomosis was known to cause many complications. We performed this study to analyse operative cases and evaluate which procedure had the better result. METHODS: Thirty-six cases of left colon cancer and rectal cancer with complete obstruction were analysed from April 1990 to January 2001 and those cases were divided into two groups, the group of staged procedure and the group of primary resection. 28 cases were curative operations and 8 cases were palliative operations. RESULTS: The group of staged procedures had 17 cases of curative operations with 1st. stage-colostomy and 2nd. stage-cancer resection. And the group of primary resection had 11 cases of curative operations, 6 cases of Hartmann's procedures, 2 cases with intraoperative colonic lavage and resection and 3 cases with cancer resection, anastomosis and proximal colostomy. There were no differences in the distribution of age and cancer stage between two groups. In both groups, the sigmoid colon was the most prevalent obstruction site. The staged procedure group had higher operative mortality (25%) than the primary resection group (8%). And 5-year survival rate of the primary resection group was higher than that of the staged procedure group (45%: 33%), but there was no statistical significance. CONCLUSIONS: We think that the primary resection is the better surgical procedure because of shorter hospital stay and fewer operations in the treatment of obstructing left colon and rectal cancer.
Colon* ; Colon, Sigmoid ; Colonic Neoplasms ; Colostomy ; Length of Stay ; Mortality ; Rectal Neoplasms ; Rectum* ; Survival Rate ; Therapeutic Irrigation