The prostate-specific antigen (PSA) has been considered a useful tumor marker in monitoring responses, disease progression and recurrence after therapy in patients with prostatic cancer. However. The effect of digital rectal examination on serum PSA determination has remained controversial. The author. therefore. investigated the influence of examination on seurm PSA values. Blood samples were taken before (T0) and 5 minutes (T1), 1 hour (T2), 24 hours (Ts) and I week (T4) after digital rectal examination and the concentration of serum PSA was measured using a Tandeme radioimmunometric assay in 49 persons including 7 patients with prostatic cancer. 27 patients with BPH and 15 controls free of prostatic disorder, The following results were obtained. 1. In normal control group. the mean (+/-SD) PSA values before and 5 minutes, 1 hour. 24 hours and l week after digital rectal examination were 1.51+/-1.12, 2.12+/-1.57. 2.53+/-1.62, 2.39+/-1.41 and 1.97+/-1.20 (ng/ml) respectively. Although serum PSA values measured at 5 minutes. 1 hour, 24 hours and 1 week after digital rectal examination were significantly elevated (p<0.05), most of post-examination PSA values remained within the normal range. 2. In benign prostatic hyperplasia. statistically significant differences between PSA values before and 1 hour and 24 hours after digital rectal examination were observed (p<0.05), while in prostatic cancer group. there were no significant differences between paired pre-examination and post-examination mean PSA values. 3. There were statistically significant differences between PSA values before and 5 minutes, 1 hour, 24 hours and 1 week after rectal examination in normal-value group (<4.0 ng/ml) and between PSA values before and 1 hour after rectal examination in high-value group (>4.0 ng /ml). These results suggest that the evaluation of the concentration or PSA level for prostatic cancer suspected should be done before or immediately after prostatic manipulation.
Digital Rectal Examination* ; Disease Progression ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Recurrence ; Reference Values

PURPOSE: The artificial erection is critical to chordee repair. We report the use of a natural erection induced by prostaglandin E(1)(PGE1) in the diagnosis and treatment of penile curvatu re as an alternative to artificial erection in children and adult patients. MATERIALS AND METHODS: Pharmacological erection was induced 14 children with a mean age of 5 years (range 1-10) and 8 adults with a mean age of 33 years (range 18-58) to diagnose and repair anomalies, such as simple penile curvature, chordee with or without hypospadias, webbed penis and Peyronie's disease. Alprostadil (1-16ng) as a agent for induce erection was used exclusively, but no agents were routinely given to reverse the erection was used exclusively, but no agents were routinely given to reverse the erections. The dose injected intracavernosally was dependent on the patient's age, penile size and response, and ranged from 0.5 to 10 micrograms. Time to and adequacy of erection, detumescence, changes in blood pressure and pulse rate were monitored. RESULTS: A dilatation of erectile tissue was achieved within 8 minutes and was judged adequate in 2 and excellent in 20. The mean duration of erection was 107 minutes, while a prolonged erection, for up to 2.5 hours, occured on 2 patients who were treated conservatively. Detumescence were occurred when the corpora were opened, but re-erected penis after closure of corpora in 7 cases who treated with Nesbit's corporeal plication or fibrous plaque excision and dermal graft. Although there were the impression of increased bleeding, there were no specific changes in blood pressure or pulse rate. CONCLUSIONS: Pharmacological erection in penile curvature is effective and reliable with no significant complications. Although PGE1 is expensive and induced slightly increased bleeding, pharmacological erection has the advantage of tumescence of the entire penis and consequently a constant and natural representation of chordee without corporeal or urethral injury. Therefore, the erection achieved by injecting PGE1 into the corpora cavemosa is a useful alternative to artificial erection in the diagnosis and treatment of penile anomalies.
Adult ; Alprostadil ; Blood Pressure ; Child ; Diagnosis ; Dilatation ; Female ; Heart Rate ; Hemorrhage ; Humans ; Hypospadias ; Male ; Penile Induration ; Penis ; Transplants

No abstract available.
Pancreas*

An isolated granulocytic sarcoma (chloroma) of the left ovary occured in the absence of leukemia in a 12-year-old woman. This lesion is defined as a localized tumor mass composed of immature cells of the granulocytic series. Granulocytic sarcomas can occur at extramedullary sites including ovary but, isolated myelosarcoma in the absence of usual manifestations of AML may be rare and has some difficulties in diagnosis. Contrary to findings in other series, granulocytic sarcoma arising in this nonleukemic patient did not progress to acute leukemia during two years she has been followed.
Child ; Diagnosis ; Female ; Humans ; Leukemia ; Ovary* ; Sarcoma, Myeloid*

A clinical analysis was done on forty-five patients with fracture of the femoral neck, who have been admitted and treated at our orthopedic department during the period of 6 years, from January 1975 to December 1980. The following results were obtained: Age over 60 comprised 60% of the patients. Male to female ratio revealed no significant difference, being 21 to 24. However, with advancing age, female was affected more frequently than male. The major cause of injuries were “fall or slip down” occuring in 33 patients (73.3%) and “hit by car” in 12 patients (26.7%). Of the 39 patients in whom Garden's calssification of fracture could be applied. Stage II was the most common type occuring in 29 patients (75%), followed by Stage N in 6(15.4%), and Stage 5 in 4 (10%). Of the total 45 cases, forty patients were reduced and fixed with multiple Knowles pins and two patients with Jewett nail. Three patients with neglected treatment of the fracture for over 1 to 4 months were treated with primary replacement arthroplasty of the femur in two and total hip replacement in one. Fractures were united within 3 months in 10 patients (23%), 4 to 6 months in 19 patients (45.2%), and non-union in 2 patients. Relationship between accuracy of reduction using Gardens alignment index and develepment of avascular necrosis was evaluated. Of the 27 patients with reduction in the range of 155 180 in both frontal and lateral views, 3 patients were developed avascular necrosis, and of the 9 patients with reduction of less than 155 in frontal view or greater than 180 in lateral view, 4 patients were developed avascular necrosis.
Agriculture ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip ; Clinical Study ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Humans ; Male ; Necrosis ; Orthopedics

No abstract available.
Priapism*

No abstract available.
Priapism*

The stiffness of the elbow joint is caused by trauma, infection, and ect. The conventional arthrop lasty and arthrodesis of this joint has been used but the indication is very limited because of unsati sfactory result. The Oganesyan external fixator, which was invented by Mstislav V. Volkov and Oganes V. Oganesyan in 1971, generally employes tne hinged-distraction apparatus to treat joint stiffness and flexion contracture. According to them, regeneration of both cartilage and underlying subchondral bony tissue is possible. These authors consider the main factor for regeneration of the cartilage af a destroyed joint surface to be early restitution of joint functions including unloaded motion and elimination of increased friction between the joint surfaces. From Jan. 1992 to Jan. 1994, We have experienced the 6 cases of stiff elbow who had been undergone biologic arthroplasty. The results were as follows; The gain of the average range of motion of the joint at final follow-up was 50.5°. The complications were mild pain in 2 cases, mild instability on exertion in 2 cases, recurrence of contracture in two cases and ulnar nerve irritation in one case. The complications affected no significant long term results except recurrence.
Arthrodesis ; Arthroplasty ; Cartilage ; Contracture ; Elbow Joint ; Elbow ; External Fixators ; Follow-Up Studies ; Friction ; Joints ; Range of Motion, Articular ; Recurrence ; Regeneration ; Ulnar Nerve

The differentiation between lung abscess and empyema can be difficult, but has important therapeuticconsequences. Thoracostomy tube drainage is essential therapy for an empyema, whereas prolonged antibiotic therapyand postural drainage often suffice for a lung abscess. Conventional radiographic findings are usually relied onto help make correct indfferentiation between empyema and lung abscess, but overlying lung disease or unfavorablelocation of lesion often results in ambiguous findings. Although ultrasound has proved useful in differentiatingempyema from lung abscess, CT is best accurate diagnostic method. Authors reviewed chest CT of 50 cases(41empyemas, 9 lung abscesses)which were diagnosed by suegery or clinical background during the period from May 1980to June 1985 at Dongsan Medical Center, Keimyung University. The results were as follows: 1) Age and sexdistribution a) Empyema: The incidence was most common in the 6th and 7th decades. Male to female ratio was 3:1.b) Lung abscess: The incidence was most common in the 5th, 6th and 7th decades. Male to female ratio was 2:1. 2)Wall characteristics(empyema 32 cases, lung abscess 9 cases): The 9 cases of 41 empyemas had not defined theirwalls. a) Empyema had at least a part of their wall that was thin (81%), uniform width(84%), and smooth on bothmargins (more than 96%). b) The wall of lung abscess was thick (89%), and irregular margins(100%). 3) Separationof uniformly thickened visceral pleura from parietal pleura("split pleura" sign) was seen only in 68% of allempyemas. 4) Adjacent lung compression was seen only in 88% of all empyemas. 5) Chest wall angle: In 78% of allempyemas had obtuse or mixed angles, wherease in 85% of all lung abscesses had acute angle. 6) Shape oflesion:Empyema had variant shapes from round to crescent, however all lung abscesses had round or ovoid shape. 7)Size of lesion: In 85% of all empyemas had medium(41%) or large (44%) size, but the lung abscess had onlysmall(33%) or medium (67%) size. 8) Air in lesion was seen in 41% empyemas and in 89% lung abscesses. 9) Adjacentlung consolidation showed in 34% empyemas and in all lung abscesses. 10) Free pleural fluid was seen in 12%empyemas and in 89% lung abscesses. 11)Septated lesions were seen in 32% empyemas and in 56% lung abscesses. 12)Multiple lesions were seen in 44% empyemas and in 55% lung abscesses. 13) Mediastinal shifting was seen in 49%enpyemas and in 44% lung abscesses, but which all lung abscesses were coexisted with empyemas. 14) Pleuralcalcification was seen only in 5 cases(12%) of all empyemas. 15) Location of leison: Most(93%) of empyemas werelocated in posterolateral portion of hemithorax, and most (78%) of lung abscesses involved in right lower lobe.
Clothing ; Drainage ; Drainage, Postural ; Empyema ; Female ; Humans ; Incidence ; Lung Abscess ; Lung Diseases ; Lung ; Male ; Methods ; Pleura ; Rabeprazole ; Thoracic Wall ; Thoracostomy ; Tomography, X-Ray Computed ; Ultrasonography

Twenty-six cases of fracture of the femur and tibia on the same leg in twenty-five patients were treated at the Dept. of Orthopedic Surgery, Kyungpook National University Hospital during the period of 1973 to 1979. Twenty-two patients were sustained by the motor vehicle accident. Open fractures of the femur and tibia were ten cases, and closed femur fracture and open tibia fracture were twelve cases. Concomitant Injuries were brain Injury in eight patients and hemorrhagic shock In seven patients. Eight patients were treated by internal fixation (Kuntschernall or Compression plate) on femur and by conservative treatment on tibia. Conservative treatment was done in eleven patients on both femur and tibia fracture. Five patients were amputated. Average healing time of fracture was: twenty-two weeks in femur and twenty-seven weeks in tibia. Functional end results were assessed and rated with satisfactory results In six patients and fair and poor in elght patients respectively.
Brain Injuries ; Clinical Study ; Femur ; Fractures, Open ; Gyeongsangbuk-do ; Humans ; Leg ; Motor Vehicles ; Orthopedics ; Shock, Hemorrhagic ; Tibia