BACKGROUND: If the corrections of the cryptorchid testes are delayed, it may lead the patients to suffer loss of testes or fertility. So we purposed to analyze the present status of correction and the causes of delay and tried to emphasize the needs to educate and inform the ideal age for correction. METHODS: Total 363 cryptorchid patients who visited our hospital in 10 years from January 1987 to December 1996 were divided into 3 groups according to their ages at visit as under 2, 3 to 5 and over 6 years groups. We analyzed the operative findings of the 3 groups, compared the ratio of the over 6 group during the half ten years till 1991 to the same ratio after 1992 and also analyzed the causes of delay in 81 patients for whom the causes of delay could be identified in over 6 years group. RESULTS: The age distributions showed 88 patients(24.2%) of under 2 years group, 118 patients(32.5%) of 3 to 5 years group and 157 patients(43.3%) of over 6 years group. When we compare the former 5 years till 1991 to the latter 5 years after 1992, the number of the patients who underwent orchiopexy under the age of 2 were increased from 34 (19.1%) to 54(29.2%) and those over the age of 6 were decreased from 88(49.4%) to 69 (37.3%) but still in higher proportion. The intraoperative findings showed that the rate of atropic or smaller testes than normal size in over 6 years group(128 testes, 73.1%) were higher than those of under 2 years(10 testes, 9.8%) and 3 to 5 years group(28 testes, 20.2 %). The most common causes of delay in over 6 years group was recommendation by relatives or neighbors(36 patients, 48.1%) and the remainders were advices of doctors other than urologists(27 patients, 33.3%), poor economic status(8 patients, 9.9%) and unawareness of the anomaly(7 patients, 8.6%). CONCLUSIONS: To prevent the loss of testicular function or testis itself in patient with cryptorchidism, the early correction should be performed because the recommended age for the correction tends to be decreased. The public information for the recommended age should be provided and also educational programs for the primary physicians are supposed to be performed.
Age Distribution ; Cryptorchidism ; Fertility ; Humans ; Male ; Orchiopexy ; Testis

No abstract available.
Animals ; Hypokinesia* ; Immobilization* ; Muscle, Skeletal* ; Rats*

Hereditary fructose intolerance (HFI) is a carbohydrate metabolic disease of autosomal recessive inheritance. The basic deficit is deficiency of aldolase B, the enzyme catalyzing catabolism of fructose-1-phosphate, which is found only in intestinal mucosa, liver and kidney. Its main symptoms are abdominal pain, vomiting, hypoglycemia, and severe liver disease following the ingestion of fructose. Neurologic impairment is not typical in HFI, but it can occur in the acute phase of the disease. Neurologic impairment is related to the acute hepatic toxicity of fructose (hypoglycemia, abnormal coagulation, cardiovascular collapse). The 7 year-old German girl admitted because of generalized tonic clonic seizure. She had the first seizure at the age of 2, and was diagnosed as Lennox-Gastaut syndrome. Thereafter, frequent morning and midnight seizures were developed following indigestion of milk, sweety cake and cookies. Her family history was unknown because she was adopted from India at the 4 months of age. She showed developmental delay. After the ingestion of fructose, the patient experienced hypoglycemic episode within 60-90 minutes of the intake. Based on this finding, she was diagnosed as HFI. With fructose free diet, the patient became free of seizure even without the anticonvulsant, and improved in growth and development.
Abdominal Pain ; Child ; Diet ; Dyspepsia ; Eating ; Female ; Fructose ; Fructose Intolerance* ; Fructose-Bisphosphate Aldolase ; Growth and Development ; Humans ; Hypoglycemia ; India ; Intestinal Mucosa ; Kidney ; Liver ; Liver Diseases ; Metabolic Diseases ; Metabolism ; Milk ; Seizures ; Vomiting ; Wills

OBJECT: This cross-sectional study was performed in order to evaluate the prevalence of tardive dyskinesia among the hospitalized schizophrenic patients. METHODS: Four hundred nineteen hospitalized schizophrenic patients(male=263, female=156) were recruited for this study. They were treated with antipsychotics for more than 3 months. The prevalence of tardive dyskinesia was assessed by the Abnormal Involuntary Movement Scale. RESULTS: The prevalence of tardive dyskinesia was 35.6%(Male=36.9%, Female 33.3%). There were no significant differences in the prevalence of tardive dyskinesia among male and female schizophrenic patients. The prevalence of tardive dyskinesia among the patients over 30years old was much higher than those below 30years old. There were no significant correlations between the prevalence of tardive dyskinesia and the duration of hospitalization, the total amount of antipsychotics. The frequently involved parts of the body in the schizophrenic patients who have tardive dyskinesia were tongue, upper extremity, lips and perioral area, jaw, lower extremity, muscles of facial expression trunk, respectively. CONCLUSIONS: There was significant correlation between the age and the prevalence of tardive dyskinesia in the antipsychotic-treated schizophrenic patients.
Antipsychotic Agents ; Cross-Sectional Studies ; Dyskinesias ; Facial Expression ; Female ; Hospitalization ; Humans ; Jaw ; Lip ; Lower Extremity ; Male ; Movement Disorders* ; Muscles ; Prevalence* ; Schizophrenia ; Tongue ; Upper Extremity

A full understanding of the potential anatomical variations of the renal veins and its branches is imperative for donor nephrectomies. Preoperative renal angiography is the most important study to evaluate renal vascular anatomy. By this technique. the renal arteries are well visualized. but it is almost impossible to obtain the exact informations of the renal veins and its branches. To prevent extensive manipulation of the kidney by profuse bleeding. the exact information of the renal veins and its branches is very important. Based on intraoperative observation of 240 consecutive cases of donor nephrectomies. we observett. the common renal vein variants. Left renal veins usually had two branches; adrenal vein proximally and gonadal vein distally. Lumbar veins were identified in 112 cases(56.7%) Lumbar veins were connected to renal veins posteriorly near the draining site of gonadal veins. Therefore it is very important to dissect very carefully the posterior part of renal vein around the insertion of gonadal vein because of the existence of lumbar vein which might cause troublsome bleeding by accidental tearing. Especially when the cases of angulated renal veins were observed by renal angiography. the more attention will be required due to the strong possibility or the existence of lumbar vein.
Angiography ; Gonads ; Hemorrhage ; Humans ; Kidney ; Nephrectomy* ; Renal Artery ; Renal Veins ; Tissue Donors ; Veins

PURPOSE: In the diagnosis of pediatric urinary tract infection(UTI), the use of invasive methods, such as voiding cystourethrography(VCUG), is controversial. A retrospective study was carried out to evaluate the necessity for VCUG in assessing pediatric UTI. MATERIALS AND METHODS: Between April 2000 and March 2002, 70 children (60 boys, 10 girls) with symptomatic UTI were evaluated. All patients were evaluated with renal ultrasonography(RUS), 99mTc-DMSA renal scintigraphy(DMSA renal scan) and VCUG. The results of the VCUG were compared with RUS and similar comparisons made between the results of the VCUG and DMSA renal scans. Patients with both normal a RUS and DMSA renal scan were then evaluated for the frequency and grade of vesicoureteral reflux(VUR) on the VCUG. RESULTS: The mean age at the initial evaluation was 7.95 months, ranging from 1 to 52 months. RUS and DMSA scan abnormalities were found in 38(54.3%) and 26(37.1%) children, respectively. Of the 22 patients with VUR confirmed by VCUG, 11(50.0%) had an abnormal RUS, and 12 (54.5%) patients had abnormal DMSA renal scans. Of the 19 patients with both a normal RUS and DMSA scan, 4(21.2%, 6 kidney-ureter unit) were found to have VUR on VCUG. CONCLUSIONS: This study illustrated that a considerable number of patients may have significant VUR, despite normal renal ultrasonography and DMSA scans. Therefore, VCUG remains important in assessing pediatric UTI.
Child* ; Diagnosis ; Humans ; Retrospective Studies ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

No abstract available.

Multiple intracerebral space-occupying lesions (SOL) demonstrated by computed tomography (CT), magnetic resonance imaging (MRI), and radionuclide brain scanning or cerebral arteriography often present a diagnostic enigma. The differential diagnosis between brain abscess and brain tumor is occasionally difficult to determine on the basis of imaging studies and clinical judgement, especially in the case of brain SOL with mainly cystic or necrotic component. Elderly patients with a history suggestive of hidden malignancy and the above radiological features are usually presumptively diagnosed as having multiple cerebral metastases. We experienced a case of multiple brain abscess which was confirmed by diagnostic surgery, in a 67- year old male who showed clinical and radiological findings of mimicking cystic brain metastases with undetermined primary focus. Even with long-term therapy with antibiotics and supportive care, the patient suffered from massive ventriculitis and subsequently died.
Aged ; Angiography ; Anti-Bacterial Agents ; Brain Abscess* ; Brain Neoplasms ; Brain* ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis*

Mutation in the p53 suppressor gene is the most common genetic alteration found in human cancers including primary brain tumors. Ki-67 labeling index(LI) is known to be a marker of proliferating activity. The purpose of this study was to verify whether an immunohistochemical expression of p53 antibody and Ki-67 LI could be related to different clinicopathologic parameters including histologic grade, size, invasiveness and recurrence of the brain tumors. Materials were based on the 147 surgically resected brain tumors during the last two years. Of the 147 brain tumors, there were 35 astrocytic tumors, 35 meningiomas, 10 oligodendrogliomas, 7 craniopharyngiomas, 5 dysembryoplastic neuroepithelial tumors, 4 medulloblastomas, 5 ependymomas, 23 pituitary adenomas, 9 schwannomas, and 14 other brain tumors. The p53 expression and Ki-67 LI were higher in malignant brain tumors including astrocytic tumors, medulloblastoma, PNET and gliosarcoma. The p53 positivity was correlated with histologic grades and tumor recurrence. The brain tumors with a high Ki-67 LI(>6%) also showed a close relationship to a higher histologic grading, radiological invasiveness and recurrence. There was no evident correlation with the age and tumor size with p53 expression and Ki-67 LI. These results suggest that p53 overexpression and high proliferation potential of the tumor cells are associated with the higher histologic grade and aggressive clinical course in the central nervous system tumors.
Brain Neoplasms* ; Brain* ; Central Nervous System Neoplasms ; Craniopharyngioma ; Ependymoma ; Genes, Suppressor ; Gliosarcoma ; Humans ; Medulloblastoma ; Meningioma ; Neoplasms, Neuroepithelial ; Neurilemmoma ; Neuroectodermal Tumors, Primitive ; Oligodendroglioma ; Pituitary Neoplasms ; Recurrence

Oxygen supply is considered to one of the most important local factors influencing the contractility of smooth muscle. However, the effect of anoxia on the contractility is not uniform throughout the organs containing smooth muscle. This study was undertaken to evaluate the changes of the contractility of rat seminal vesicle to field stimulation, phenylephrine (Phe), acetylcholine (Ach), and KCI in anoxia. Seminal vesicle was rapidly removed from Sprague-Dawley rats which had been killed by cervical dislocation. Spiral segments were mounted in organ bath containing Tyrode's solution at 37'C and equilibrated with 95% O2 and 5% CO2 for 1 hr. Anoxia was produced by changing the gas mixture to 95% N2, 5% CO2. The effect of anoxia on the contractile responses to field stimulation, Phe, Ach, and KCI was determined at different times after the initiation of anoxia. The results of this study can be summarized as follows: 1. Anoxia induced a time-dependent decrease of the contractile responses to field stimulation (30 and 60 Hz). 2. Anoxia potentially inhibited the rhythmic contractions to Phe and Ach. However, the basal tension showed a transient relaxation followed by a contraction after 10 min. 3. In tonic contraction produced by KCI, anoxia caused a transient relaxation followed by a further contraction. However, this anoxic contraction was not inhibited by verapamil (0.1M). This study demonstrated that anoxia may cause poor contractile responses to field stimulation and increased basal tension to Phe, Ach, and KCI. But anoxic contraction by KCI was not inhibited by verapamil, which means that this anoxic contraction of rat seminal vesicle is not mediated by Ca++ influx.
Acetylcholine* ; Animals ; Anoxia* ; Baths ; Dislocations ; Muscle, Smooth ; Oxygen ; Phenylephrine* ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Seminal Vesicles* ; Verapamil