BACKGROUND : A discussion of the chronologic trends of operative indications of breast masses for proper management of breast masses is desirable. METHODS : A retrospective analysis of 882 patients with breast masses who underwent operations at Kangnam General Hospital from January 1986 to December 1997 was done. All the lesions were classified according to for age, size of the mass, and the pathologic result. Concurrently, the distributions of the different masses were retrospectively analyzed for each one-year time period. RESULTS : The most prevalent age group was the third decade (28.6%) followed by the fourth decade (25.3%) and the fifth decade (24.4%). The most common lesion was fibroadenoma (38.7%), followed by mammary dysplasia (22.6%) and malignancy (18.3%). In fibroadenoma, the most common pathologic type was intracanalicular (34.9%), and the juvenile type occurred in significantly younger patients compared to other types (19.2 vs 29.2 years of age). In mammary dysplasia, the most common pathologic type was fibrous (74.4%), and the epithelial hyperplasia and adenosis types were occurred in older patients compared to the other types (39.1 and 41.0 vs 33.5 and 35.4 years of age). As the chronologically changing pattern of the pathologic types, the number of mammary dysplasia had a decreasing tendency and fibroadenoma had a relatively increasing one, and the reason may be the effect of fine-needle aspiration cytology. CONCLUSIONS : The result of this study shows that the distribution of the disease in terms of age and frequency is almost the same as that of other reported results. The trend of the disease types in terms of the time period shows that the operation rate for fibroadenomas is increasing while the rate for mammary dysplasia is decreasing. This tendency might come from the decreasing use of surgical biopsy for mammary dysplasia.
Biopsy* ; Biopsy, Fine-Needle ; Breast* ; Fibroadenoma ; Fibrocystic Breast Disease ; Hospitals, General ; Humans ; Hyperplasia ; Retrospective Studies

Congenital agenesis of the seminal vesicle is commonly associated with mullerian duct cysts and frequently combined with anomalies of the vas deferens or urinary tract. We report a case of a 29 year-old man with congenital agenesis of the seminal vesicle without any associated anomaly of the urogenital organs. He had infertility for 2 years and two semen analyses revealed azoospermia. There was no abnormal finding in physical examination of the testis, epididymis, or vas deferens. However, we could not locate the seminal vesicles in a transrectal ultrasound and computed tomography. We referred him to an infertility clinic for assisted reproductive technology.
Azoospermia ; Epididymis ; Humans ; Infertility ; Male ; Physical Examination ; Semen Analysis ; Seminal Vesicles ; Testis ; Urinary Tract ; Vas Deferens

Congenital agenesis of the seminal vesicle is commonly associated with mullerian duct cysts and frequently combined with anomalies of the vas deferens or urinary tract. We report a case of a 29 year-old man with congenital agenesis of the seminal vesicle without any associated anomaly of the urogenital organs. He had infertility for 2 years and two semen analyses revealed azoospermia. There was no abnormal finding in physical examination of the testis, epididymis, or vas deferens. However, we could not locate the seminal vesicles in a transrectal ultrasound and computed tomography. We referred him to an infertility clinic for assisted reproductive technology.
Azoospermia ; Epididymis ; Humans ; Infertility ; Male ; Physical Examination ; Semen Analysis ; Seminal Vesicles ; Testis ; Urinary Tract ; Vas Deferens

PURPOSE: To evaluate the effectiveness of a combination of enuresis alarm-desmopressin compared with a desmopressin-based combined pharmacotherapy as the first line in monosymptomatic nocturnal enuresis (MNE). MATERIALS AND METHODS: We evaluated 48 MNE children. Of these, 20 enuretic children were included in the alarm-desmopressin group (AD group) and 28 in the combination pharmacotherapy group (CP group). In the CP group, patients were given desmopressin based combination therapy with imipramine or oxybutynin for 6 months. In the AD group, patients were administered an enuresis alarm associated with an initial 3-month desmopressin combination. The response rates of each therapy were analyzed after 1, 3 and 6 months. After cessation of the 6 month treatment course, the initial and lasting cure rates were analyzed 1 and 6 month later. RESULTS: There was no differentiation in the baseline characteristics and drop-out rates between the two groups during treatment. The mean response rates in the AD and CP groups were 91.8 and 93.7%, respectively. The initial cure rate was higher in the AD (92.3%) than the CP group (52.4%) (p=0.024). The lasting cure rate was also higher in the AD (76.9%) than the CP group (33.3%) (p=0.032). Most of the relapses occurred within 2 month in the CP group and within 4 month in the AD group. CONCLUSIONS: In MNE, a combination of enuresis alarm-desmopressin showed a similar response rate, high initial and lasting cure rates, with a delayed relapse, compared with combination pharmacotherapy. Therefore, a combination of enuresis alarm-desmopressin can be considered a useful tool as the first line in MNE. (Korean J Urol 2005;46:19-24)
Behavior Therapy ; Child ; Deamino Arginine Vasopressin ; Drug Therapy ; Enuresis* ; Humans ; Imipramine ; Nocturnal Enuresis* ; Recurrence

Background: In some patients, coronavirus disease 2019 (COVID-19) is accompanied by loss of smell and taste, and this has been reportedly associated with exposure to air pollutants. This study investigated the relationship between the occurrence of chemosensory dysfunction in COVID-19 patients and air pollutant concentrations in Korea. Methods: Information on the clinical symptom of chemosensory dysfunction, the date of diagnosis, residential area, age, and sex of 60,194 confirmed COVID-19 cases reported to the Korea Disease Control and Prevention Agency from January 20 to December 31, 2020 was collected. In addition, the daily average concentration of air pollutants for a week in the patients’ residential area was collected from the Ministry of Environment based on the date of diagnosis of COVID-19. A binomial logistic regression model, using age and gender, standardized smoking rate, number of outpatient visits, 24-hour mean temperature and relative humidity at the regional level as covariates, was used to determine the effect of air pollution on chemosensory dysfunction. Results: Symptoms of chemosensory dysfunction were most frequent among patients in their 20s and 30s, and occurred more frequently in large cities. The logistic analysis showed that the concentration of particulate matter 10 (PM 10 ) and 2.5 (PM 2.5 ) up to 2 days before the diagnosis of COVID-19 and the concentration of sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), carbon monoxide (CO), and ozone (O 3) at least 7 days before the diagnosis of COVID-19 affected the development of chemosensory dysfunction. In the logistic regression model adjusted for age, sex, standardized smoking rate, number of outpatient visits, and daily average temperature and relative humidity, it was found that an increase in the interquartile range of PM 10 , PM 2.5 , SO 2 , NO 2 , and CO on the day of diagnosis increased the incidence of chemosensory dysfunction 1.10, 1.10, 1.17, 1.31, and 1.19-fold, respectively. In contrast, the O 3 concentration had a negative association with chemosensory dysfunction. Conclusion High concentrations of air pollutants such as PM 10 , PM 2.5 , SO 2 , NO 2 , and CO on the day of diagnosis increased the risk of developing chemosensory dysfunction from COVID-19 infection. This result underscores the need to actively prevent exposure to air pollution and prevent COVID-19 infection. In addition, policies that regulate activities and products that create high amounts of harmful environmental wastes may help in promoting better health for all during COVID-19 pandemic.

We report a case of torsion of a benign cyst arising from the parietal layer of the tunica vaginalis, which presented on an acute scrotum. Physical examination revealed a tender swelling of the left hemiscrotum. Surgical, we happened to find torsion of a cyst originating from the parietal layer of the tunica vaginalis. The pedicle of the cyst was twisted about 360 degrees.
Physical Examination ; Rabeprazole ; Scrotum*

PURPOSE: The homeobox (Hox) genes a and d controlling limb and genital development influence the digit ratio and the fetal production of testicular androgen, which may result in testicular descent in boys. To assess whether the digit ratio reflects disease status, we investigated the second and fourth finger lengths in children with cryptorchidism, in children with hydrocele as a disease control, and in healthy controls (boys and girls). MATERIALS AND METHODS: One hundred ninety-six children (46 with cryptorchidism, 50 with hydrocele, 50 healthy boys, and 50 healthy girls) who were 6 to 23 months of age were prospectively enrolled. Digit lengths were measured by 2 investigators, and the mean value was recorded. RESULTS: The second-to-fourth digit ratios (2D:4Ds) of the left hand in the cryptorchidism group, hydrocele group, healthy boys, and healthy girls were 0.958, 0.956, 0.950, and 0.956, respectively. The 2D:4D values of the right hand were 0.946, 0.945, 0.952, and 0.969, respectively. The right and left 2D:4D ratios were not significantly different among groups. The 2D:4D of both hands was not related to age, weight, or height. CONCLUSIONS: According to these results, the 2D:4D was not significantly different in boys with cryptorchidism than in boys with hydrocele or in healthy controls (boys and girls) and failed to reflect disease conditions in the infant period.
Anthropometry ; Case-Control Studies* ; Child ; Cryptorchidism* ; Extremities ; Female ; Fingers ; Genes, Homeobox ; Hand ; Humans ; Infant ; Male ; Prospective Studies ; Research Personnel

Most reports on serious MTX toxicity have focused on hepatic abnormalities, while other effects, including hematologic reactions, have not been emphasized. We experienced a case of pancytopenia secondary to MTX therapy in a patient with RA and renal insufficiency. A 67-year-old woman with a 12-year history of active seropositive RA that was a response to non-steroidal anti-inflammatory drugs, hydroxychloroquinine and intra-articular steroid injections, had been followed up and was diagnosed as early chronic renal failure in October, 1993. Recently, because of significant morning stiffness and polyarthralgia, the decision was made to institute MTX treatment. This was begun as a single oral dose of 5mg/week. After 2 doses, the patient was admitted to the hospital with general weakness. Laboratory tests showed a hemoglobin level of 7.9 g/dl, WBC count 1800/mm3 and platelet count of 64000/mm3. The serum creatinine level was 6.1 mEq/dl and the BUN level was 82 mEq/dl. Liver function test results were normal, but the serum albumin level was 2.7 g/dl. The patient subsequently developed fever and blood transfusions, granulocyte colony stimulating factor (G-CSF) and intravenous prophylactic antibiotic therapy were required. Her condition was improved. In summary, Low-dose MTX-related adverse hematologic side effects, including fatal pancytopenia, are rare but are a cause of increasing concern in patients with RA and renal insufficiency. Close monitoring of associated risk factors, particularly impaired renal function, should be mandatory for all patients who are receiving MTX therapy.
Aged ; Antirheumatic Agents/adverse effects* ; Antirheumatic Agents/administration & dosage ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/complications ; Case Report ; Female ; Human ; Kidney Failure, Chronic/complications ; Methotrexate/adverse effects* ; Methotrexate/administration & dosage ; Pancytopenia/chemically induced* ; Risk Factors

The diagnosis of pyomyositis in the pelvic region is difficult, as its incidence is relatively, with symptoms that mimic those of discogenic pain. Sciatica is a common presentation of a prolapsed lumbar disc. Less common causes, such as spinal stenosis, pelvic tumors or even primary nerve tumors can also cause these symptoms. Magnetic resonance imaging (MRI) is a useful diagnostic tool. Herein, the case of a patient with an acute pyogenic infection in the iliopsoas muscle, presenting with sciatica, is reported. This is a rare infective disease, which if promptly treated with intravenous antibiotics, can be completely resolved; otherwise, it can result in deep abscess formation, sepsis and death.
Abscess ; Anti-Bacterial Agents ; Diagnosis ; Humans ; Incidence ; Magnetic Resonance Imaging ; Pelvis ; Pyomyositis* ; Sciatica ; Sepsis ; Spinal Stenosis

BACKGROUND: Angiotensin-converting enzyme inhibitors(ACEi) do not decrease plasma angiotensin II levels in chronic use to the same extent as in acute use. this reincrease in angiotensin II level is explained either by a renin-mediated reactive rise in plasma angiotensin I or by non-ACE dependent angiotensin II generation. The aim of this study was to compare the additive effects of an ACEi and angiotensin II receptor antagonist(AT1a) in antiproteinuric effect, hyperkalemia, and hypotension. METHODS: 58 outpatients with chronic renal insufficiency were included and they were randomly classified into two groups : Group I(prescribed AT1a only), Group II(AT1a and ACEi combination therapy), and the changes of serum creatinine, the amount of proteinuria, the developement of hyperkalemia, and hypotension were evaluated. RESULTS: In group I, the amount of proteinuria decreased to 92.8% of initial amount at 1 month after the start of drugs. 2 of 28 patients(7.1%) developed hyperkalemia, and serum creatinine did not change (1.686+/-1.415mg/dL 1.821+/-1.301mg/dL, p=0.289). But in combination therapy group, serum creatinine level increased from baseline value of 1.466+/-0.619mg/dL to 1.800+/-0.881mg/dL(p=0.05), proteinuria did not change (101% of initial amount), and 7 of 30 patients(23.3%) developed hyperkalemia. CONCLUSION: Combination therapy seems to have no additive antiproteinuric effect, but serum creatinine and potassium levels should be closely monitered during the combination therapy.
Angiotensin I ; Angiotensin II* ; Angiotensins* ; Creatinine ; Humans ; Hyperkalemia ; Hypotension ; Outpatients ; Peptidyl-Dipeptidase A* ; Plasma ; Potassium ; Proteinuria ; Receptors, Angiotensin* ; Renal Insufficiency, Chronic