Ectopic ureteroceles have a broad spectrum of presentation, anatomy and pathophysiology and the management is controversial. Herein, we report our experience of the management in 7 children with 8 ectopic ureteroceles associated with complete duplicated systems. Two functioning upper renal segments were able to be salvaged with ureteropyeIostomy and common sheath ureteral reimplantation. Four small ureteroceles not associated with reflux managed successfully with upper tract correction only(3 heminephrectomy and 1 ureteropyelostomy). Three children with ectopic ureteroceles associated with reflux and/or outlet obstruction underwent successful one stage total reconstruction which included heminephrectomy, ureterectomy, ureterocelectomy and lower pole ureter reimplantation. In summary, the management of ectopic ureterocele must be individualized taking into considerations the salvageability of renal segments, presence of reflux and/or outlet obstruction.
Child* ; Humans ; Replantation ; Ureter ; Ureterocele*

Laparoscopy was performed successfully at operation in 18 consecutive boys who had 19 nonpalpable testes Of the testes. 2 were in the inguinal region. 6 were in the just proximal to the internal inguinal ring. 2 were high intra-abominal position. and 9 were vanished testes (intracana1icular). In every case of vanished inguinal testis and intracanalicular testis. vas and gonadal vessels were observed laparoscopically to exit the internal inguinal ring. In these vanished testes. hernia or patent processus vaginalis was not observed and contralateral testes were located normally in the scrotum. OF 8 intraabdominal testes. 6 were detected laparoscopically. Laparoscopy provided localization or either testis or the course of spermatic vessels in all patients and these information facilitated accurate planning of operative repair.
Gonads ; Hernia ; Humans ; Inguinal Canal ; Laparoscopy* ; Scrotum ; Testis*

Between January 1987 and February 1990, records of 5Z patients with 60 impalpable testes who had surgery were reviewed retrospectively regarding localization and management of the testes. Seven out of 60 testes turned out to be palpable by careful examination under anesthesia. Ultrasonogram detected 8 testes (5 intracanalicular and 3 preperitoneal) out of 25 testes. Laparoscopy provided and in planning the appropriate surgical approach in all 8 testes. Of the 47 testes found at surgery 19 were intraabdominal, 14 intracanalicular, 12 in preperitoneal and 1 located in superficial inguinal area. Also 13 vanished testes were confirmed during surgery examining blind end of spermatic vessels and vasa. Two patients with intersex ( true hermaphroditism and hernia uteri inguinalis) were presented as unilateral impalpable testes. 42 testes were brought down surgically utilizing regular orchiopexy in 26 testes, transabdominal orchiopexy in 8 testes, Fowler-Stephens orchiopexy in 7 testes and staged orchiopexy in 1 testis were done with acceptable results. transabdominal approach is recommended in cases of suspecting intraabdominal testis or intersex.
Anesthesia ; Hernia ; Humans ; Laparoscopy ; Orchiopexy ; Ovotesticular Disorders of Sex Development ; Retrospective Studies ; Testis* ; Ultrasonography ; Uterus

Multicystic dysplastic kidney is the most frequent cause of abdominal mass in the neonate, but its presentation is variable depending on the size of cystic kidney, state of the opposite kidney and associated anomalies. multicystic dysplastic kidney also represents a spectrum of pathology from unilateral multicystic kidney through segmental and focal multicystic dysplasia to bilateral multicystic kidney. Herein we report 5 cases of MCK with different presentation and histology, a bilateral MCK associated with horseshoe kidney, a large MCK with uremia, a focal segmental MCK with contralateral UPJ obstruction, a small focal segmental MCK with contralateral megaureter and a small MCK detected by ultrasonogram for localization of impalpable testis.
Humans ; Infant, Newborn ; Kidney ; Kidney Diseases, Cystic ; Multicystic Dysplastic Kidney* ; Pathology ; Testis ; Ultrasonography ; Uremia

Caudal anesthesia has become increasingly widespread in pediatric surgery in recent years, especially for operation below the umbilicus. A prospective study was made to determine the efficacy of caudal anesthesia for pediatric urologic surgery. Seventy five patients who had analogous age and disease were entered in this study (caudal block with light general anesthesia in 47 patients and general anesthesia alone in 28 patients). The children who had caudal block were in psychologically ideal condition with reduced postoperative pain and less demand of analgesics during postoperative period. There were no toxic reactions of local anesthetics and technical faults in the caudate anesthesia. In conclusion, caudal anesthesia was notable for its simplicity, safety and effectiveness and was particularly useful in patients who have the propensity to develop bladder spasm.
Analgesics ; Anesthesia ; Anesthesia, Caudal* ; Anesthesia, General ; Anesthetics, Local ; Child ; Humans ; Pain, Postoperative ; Postoperative Period ; Prospective Studies ; Spasm ; Umbilicus ; Urinary Bladder ; Urology*

Urodynamic evaluation was undertaken in 46 patients who were admitted to neurologic department in the last year and diagnosed to have brain or spinal cord lesion. Computerized tomography (CT) and magnetic resonance imaging (MRI) were performed to localize the area of central nervous system(CNS) lesion. Damage to the basal ganglia and/or internal capsule(4 or the 6 patients) and cerebral cortex(3 of the 7 patients) showed frequent detrusor hyperreflexia, while thalamus and/or brain stem lesion seldom results in voiding dysfunction. Correlation of sphincter function with the area of brain injury was not conclusive. The mechanism of detrusor areflexia (5 of the 31 patients). Following recovery from brain injury and incompatibility between urodynamic findings and injury level of spinal cord lesion (3 of the 15 patients) should be studied with careful follow up to clarify this issue.
Basal Ganglia ; Brain ; Brain Injuries ; Brain Stem ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Reflex, Abnormal ; Spinal Cord ; Thalamus ; Urodynamics*

BACKGROUND AND OBJECTIVES: The purpose of this article was to investigate the difference of clinical manifestations in deep neck infections between pediatric patients and adult patients and to consider their respective treatment. SUBJECTS AND METHOD: The author reviewed the experience of 158 patients with deep neck infections from 1995 to 2004. Peritonsillar abscess, superficial infection, and infections related to external neck wound and head and neck tumors were excluded. Among 158 patients, 43 patients were children. To find out the characteristics of deep neck infection with pediatric patients, the author compared these patients with adult patients using student t-test and chi-square test. RESULTS: Compared with adult patients, pediatric patients with deep neck infections were found to have less dysphagia as a symptom, lower complication rate, fever higher than 38degrees C, and the white blood cell count of more than 15,000/mm3 (p<0.05). There were no significant differences in sex, duration of symptom, duration of hospital stay, involved spaces, numbers of involved spaces, etiology, and bacteriology between two groups (p>0.05). CONCLUSION: The author suggests that the prognosis of the pediatric patients with deep neck infections seems to be relatively good compared with adult patients and the severity of the disease should not be overestimated on the ground of high fever or white blood cell count.
Abscess ; Adult* ; Bacteriology ; Child ; Deglutition Disorders ; Fever ; Head ; Humans ; Length of Stay ; Leukocyte Count ; Neck* ; Peritonsillar Abscess ; Prognosis ; Wounds and Injuries

BACKGROUND AND OBJECTIVES: The effect of vocal abuse on school teachers' lives has not been sufficiently studied in Korea. Our goal was to investigate teachers' vocal characteristics and their functional, physical and emotional disorders due to vocal abuse, and the correlation between them. SUBJECTS AND METHOD: Voice samples of 142 school teachers who responded to the Voice Handicap Index (VHI) questionnaire were used for the acoustic analysis. The results were compared with the control group of 27 office workers of our hospital, who matched the experimental group with respect to age and sex. RESULTS: The subjective measure of VHI showed that the teacher handicap indices were significantly higher than those of the control group in functional, physical and emotional aspects: the corresponding median values were 8, 10, 4.5 and 2, 3, 1 for the two groups, respectively (p<0.05). There was no difference in jitter, shimmer and signal-to-noise ratio between the groups. A cross-correlation analysis revealed no significant correlation between VHI-scores and the results of acoustic analysis. CONCLUSION: The teachers recognize their voice problems as a serious physico-functional disorder. However, the acoustic analysis of the 2 second-voice samples could not detect any differences in voice quality between the two groups. There was no significant correlation between VHI scores and acoustic measures. It suggests that the acoustic measures of voice samples with a limited duration might have a restrictive value in presenting handicaps associated with voice abuse.
Acoustics ; Humans ; Korea ; Surveys and Questionnaires ; Signal-To-Noise Ratio ; Voice ; Voice Quality