No abstract available.
Humans ; Prostate* ; Urinary Retention*

No abstract available.
Seoul*

A 41-year-old female was admitted to our hospital for self-audible wheezing sound and dyspnea. On past history, she has been suffered from chest discomfort, and treated recurrently by other hospitals. But, there was no symptomatic improvement. A stridor and mixed wheezing sound was auscultated on whole lung field. PFT revealed fixed type or variable intra- & extra-thoracic air way obstructive pattern. By bronchoscopy & bronchogram, we found web-like structure on the distal trachea. A bronchoplasty was performed and the post-operative PFT showed slight improvement & she had no more complaints.
Adult ; Bronchoscopy ; Dyspnea ; Female ; Hemoptysis* ; Humans ; Lung ; Respiratory Sounds ; Thorax ; Trachea

The provocation test of variant angina are known as ergonovine test, hyperventilation, acetylcholine, exercise and cold pressor test, but beta-blocker provocation test has not been reported as a case. So, this paper reports on the diagnosis of variant angina by beta-blocker provocation test and the case of subendocardial infarcion induced by this test. This study reports with literature and investigation about the following case : A 45-year-old man with a history of recurrent episode of typical angina on the early morning for the past 20 days. He was administrated beta-blocker given by oral route, and on the next morning there was chest pain as same degree as before, Holter EKG displayed ST segment elevation and ventricular tachycardia. It was confirmed focal spasm on coronary angiography, ST segment elevation on EKG, and newly developed hypokinesia on left ventriculogram and followed-up echocardiagraphy. When the chest pain is absent, EGK was normal. And we confirmed that elevation of cardiac enzyme was absent as a result of serial follow up study.
Acetylcholine ; Chest Pain ; Coronary Angiography ; Diagnosis ; Electrocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Hyperventilation ; Hypokinesia ; Infarction* ; Middle Aged ; Spasm ; Tachycardia, Ventricular

PURPOSE: Percutaneous Transhepatic Cholangioscopic Lithotomy (PTCS-L) has been reported as an effective and safe therapeutic method for complicated hepatobiliary stones, particularly in high risk patients. However, there were some limitations and technical difficulties encountered in PTCS-L. The purpose of this retrospective study was to assess the result of PTCS-L in patients with recurrent or residual hepatobiliary stones. METHODS: The medical records of 61 consecutive patients (Jan.1997~Jun.2002) treated with PTCS-L for biliary stone were reviewed. There were 29 patients with primary treatment, and 32 patients with adjuvant treatment for residual stones. PTCS-L was performed within 2 weeks following progressive exchange of PTCS catheter after PTBD. Lithotomy was combined with either electrohydraulic lithotripsy (EHL), Dormia basket, or saline irrigation under fluroscopic guide. If stone was free on one or two consecutive cholangiography after final session lithotomy, then PTCS catheter was removed, but in cases of biliary stricture, 20Fr. of PTCS catheter was placed for average 71 (ranged; 27~270) days. RESULTS: Locations of stones were intrahepatic duct (IHD) in 22 cases, common bile duct (CBD) in 22 cases, CBD & IHD in 11 cases, cystic duct stump & CBD in 3 cases, GB in 2 cases and GB & CBD in 1 case. Routes for PTCS-L were of Rt. hepatic approach (B5 or B6) in 15 cases, Lt. hepatic approach (B3) in 42 cases, both hepatic approach in 2 cases and percutaneous gallbladder drainage (PGBD) tract in 2 cases. Sessions of PTCS-L were one in 22 cases, two in 26 cases, three in 9 cases and four in 4 cases, and overall in 1.5 session. Causes of multiple session in 39 cases were biliary stricture in 13 cases (33%), impacted stones in 10 cases (26%), large stone (>2 cm) in 9 cases (23%) and anatomical variation of IHD including severe ductal angulation in 7 cases (18%), which necessitated routine combined use of EHL (total 44 cases) and sometimes fluroscopic lithotomy (3 cases). Complications encountered following PTCS-L were transient hemobilia in 11 cases, catheter dislodgement in 1 case and hepatic abscess in 1 case, but mortality was nil. During followed up of median 17 months (1~53 months), recurrence of stone occurred in 1 case and one among of 13 patients with biliary stricture underwent operation on recurred biliary stricture. CONCLUSION: PTCS-L is very useful alternative treatment to surgery for residual or recurrent stones and is highly indicated for those of high risk patients. However, Electrohydraulic lithotripsy (EHL) should be combined for those of patients with technical difficulties encountered in case of multiple large impacted stones particularly in the strictured and angulated intrahepatic ducts.
Catheters ; Cholangiography ; Common Bile Duct ; Constriction, Pathologic ; Cystic Duct ; Drainage ; Gallbladder ; Hemobilia ; Humans ; Lithotripsy ; Liver Abscess ; Medical Records ; Mortality ; Recurrence ; Retrospective Studies

BACKGROUND: It is well known that heavy alcohol consumption may result in various lesions on multiple organs and tissue, especially liver. The aim of this study was to measure prevalence of raised liver derived enzymes in healthy men and possible association with alcohol consumption, smoking and body mass index. METHODS: All subjects were 450 men who received Adult Health Examination at Seoul Hospital of Konkuk medical center from May, 1998 to October, 1998. We carried out telephone survey and analyzed 360 men, excluding men with HBs Ag(+), hepatic problems within 6 months, medication drug that could change serum activity of hepatic enzyme or joints, myscles, cardiac problem and non responder to telephone survey. We examined prevalence of raised liver enzymes and its possible association with alcohol consumption, smoking, and body mass index, applying logistic regression analysis. RESULTS: In 20.3% of study subjects, we found raised levels of lver derived enzymes. If the alcohol consumption was higher than 270 g/week, the odds ratio(OR) for raised liver enzymes, adjusted for body mass index and smoking, increased ; serum gamma glutamyltransferase(gamma GTP)(OR: 9.48), serum aspartate aminotransferase(AST)(OR: 13.09), and serum alanine aminotransferase(ALT)(OR: 7.40). Smoking was not associated with the risk of raised liver enzymes and obesity(body mass index 25 kg/m2) showed a positive association with two enzymes; gamma GTP(OR: 1.92) and ALT(OR: 2.08). CONCLUSION: If alcohol consumption was higher than 270 g/week, the risk of raised liver enzymes increased dramatically and gamma GTP, AST were shown more sensitive than ALT in alcoholic liver disease.
Adult ; Alanine ; Alcohol Drinking* ; Aspartic Acid ; Body Mass Index ; Guanosine Triphosphate ; Humans ; Joints ; Liver Diseases, Alcoholic ; Liver* ; Logistic Models ; Male ; Prevalence ; Seoul ; Smoke ; Smoking ; Telephone

A stercoral perforation of the colon is a rare phenomenon and is caused by severe prolonged constipation. Since the first reported case in 1894, approximately 80 additional cases have been reported. However, this rare condition seems to have been underestimated because of not only obscure diagnostic standards but also ignorance and failure to notice by surgeons. Due to its high mortality rate of about 35~40%, a stercoral ulcer perforation should be considered in any patient with chronic constipation who presents with peritonitis. We report a case of a 75-year-old female who was diagnosed as having a stercoral perforation of the sigmoid colon and review the clinical features, the diagnosis, and the treatment.
Aged ; Colon ; Colon, Sigmoid* ; Constipation ; Diagnosis ; Female ; Humans ; Mortality ; Peritonitis ; Ulcer

Priapism is usually classified into two types, high flow and low flow, by the intracavernosal blood gas analysis. These two types of priapism is categorized pathophysiologically and hemodynamically; therefore, different treatments were performed according to the type. We report a case with recurrent idiopathic priapism, which was diagnosed and managed as low flow priapism at first. But finally it changed to a high flow priapism confirmed by blood gas analysis and further duplex ultrasonic study. During treatment, it was very difficult to cure the ocmplicated infection because of the necrosis of the cavernosal tissue.
Blood Gas Analysis ; Necrosis ; Priapism* ; Ultrasonics ; Wound Infection

For the past two years, nephropexy using PCN was underwent in 9 cases of nephroptosis (8 patients) with variable degrees of flank pain. All were female and 6 on right, 1 on left and 1 on bilateral. All patients had a very mobile kidney and exact distance of movement measured on the film was greater than 6cm (6 to 15 cm). After this operation, 14-20 Fr. nephrostomy catheter was indwelled for about two weeks. All patients were followed at least 3 months(3 to 32, median 17 months). We followed the patients with symptom relief and IVP after 3 months. Nephropexy was regarded as success if she remained asymptomatic for more than 3 months. Five cases were successful and four cases felt recurrent flank pain within 1 month after the surgery. Among four cases of recurrence, one had repeated PCN and got successful result, another had open nephropexy and the others have been followed so far So overall success rate was 67% (6/9). In conclusion, nephropexy using PCN is less invasive, needs shorter period of admission and leaves ignorable scars postoperatively. Furthermore it can be repeated even in the case of failure or recurrence, which would make this new technique available as the first step for the surgical treatment of nephroptosis. And the success rate could be increased if the nephrostomy tract is dilated upto 30 Fr. and the PCN catheter is placed about 4 weeks.
Catheters ; Cicatrix ; Female ; Flank Pain ; Humans ; Kidney ; Nephrostomy, Percutaneous* ; Pregnenolone Carbonitrile ; Recurrence

Nalbuphine, a mixed agonist-antagonist type opioid, can precipitate abstinence syndrome in opioid-dependent patients especially in large doses. We can prevent this syndrome by avoiding the injection of agonist-antagonist type opioid to the patient who already has used opioid for a long time, and the method of relatively small dose increments in its use. We experienced a case of opioid withdrawal symptom in chronically morphine-administered patient via epidural catheter after using intramuscular nalbuphine for analgesia. The symptom was promptly relieved by intravascular morphine injection without any problems.
Analgesia ; Catheters ; Humans ; Morphine ; Nalbuphine* ; Substance Withdrawal Syndrome*