PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.
Abdomen* ; Animals ; Cryptorchidism ; Humans ; Hypertrophy ; Inguinal Canal ; Leydig Cells ; Male ; Models, Animal ; Models, Theoretical ; Parturition ; Rats* ; Rats, Sprague-Dawley ; Scrotum ; Seminiferous Tubules ; Spermatogonia ; Testis*

Regular hemodialysis has been established as a way of treatment for end stage renal failure. In adults, hemodialysis 5 hours each time, three times weekly with one square meter hemodialyzer is now widely accepted as a standard, and there are many reports on long term follow up studies. Quite a large difference are present, however, in our community mainly originated from patient's poor compliance in frequent dialysis with short interdialysis interval. The author analyzed 200 cases of chronic renal failure who have received hemodialysis treatments during the 5 year period from July 1976 to June 1981 at the hemodialysis unit of the hanyang University Hospital and the following results are obtained; 1. Actual one year survival rate was much higher in thrice(87.1%) than one(35.1%) or twice(54.1%) weekly dialysis. 2. Long term(more than 6 months) complications were also more frequent in once(85.7%) or twice(70.2%) weekly treatments than in thrice(22.2%). The predominant complications were congestive heart failure, pericarditis, and infections. 3. Those who recieved three times weekly dialysis had better rehabilitation grades than the patients groups of twice or once weekly treatment. 4. Of peridialysis distressful symptoms, nausea, vomiting dizziness were less frequent in the group three times a week dialysis. In contrast, headache, hypotension, muscle cramps, and weakness were not significantly related with frequency of hemodialysis. 5. Those who voided a large amount of urine output had better survival and less frequent requirement of blood transfusions. 6. Main causes of death were due to patient poor compliance, hyperkalemia and cerebrovascular acidents. 7. Economic problems were the major cause of dialysis interruption.
Adult ; Blood Transfusion ; Cause of Death ; Compliance ; Dialysis ; Dizziness ; Follow-Up Studies ; Headache ; Heart Failure ; Humans ; Hyperkalemia ; Hypotension ; Kidney Failure, Chronic* ; Kidneys, Artificial ; Muscle Cramp ; Nausea ; Pericarditis ; Rehabilitation ; Renal Dialysis* ; Renal Insufficiency ; Survival Rate ; Vomiting

BACKGROUND: Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. METHODS: We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation. Functional scores and pain relief were assessed as outcomes. RESULTS: The mean follow-up period was 14.2 months. The mean Musculoskeletal Tumor Society functional score and Karnofsky performance status scale score were 27.7 and 75.6, respectively. Improvement of pain assessed using the visual analogue scale was 6.2 on average. Thirty-one patients (97%) experienced no pain after surgery. The mean ranges of forward flexion and abduction were 115° and 112.6°, respectively. All patients achieved stability and had no local recurrence without failure of fixation until the last follow-up. CONCLUSIONS: Proximal interlocking IM nailing with cement augmentation appears to be a reliable treatment option for pathological or impending fractures of the proximal humerus in selected patients with metastatic tumors, even with extensive bone destruction.
Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Fractures, Spontaneous* ; Humans ; Humerus* ; Karnofsky Performance Status ; Methods ; Neoplasm Metastasis ; Recurrence

In order to investigate the efficacy and safety of oral cilazapril, a new angiotensin converting enzyme inhibitor, on essential hypertension, a single daily dose of 2.5 to 5.0mg cilazapril was administered in 30 hypertensive patients with diastolic blood pressure in the range of 95??15mmHg while off all other anti-hypertensive agents for 10 weeks. Blood pressure and heart rate were measured every 2 weeks. The complete blood count with platelet count, blood chemistry by SMA-12 including lactic dehydrogenase and serum electrolytes, and urinalysis were performed at 4th and 10th week of therapy. The electrocardiography was performed at the beginning and the end of treatment period. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) The mean age was 49.2 years, and the ratio of male-to-female was 1 : 1.3. 2) Blood pressure started to fall significantly within 2 weeks of treatment with cliazpril 2.5mg(M+/-S.E., 15.4+/-17.4mmHg vs 138.5+/-23.3, 100.3+/-6.2 vs 89.4+/-6.6, p<0.05), and after 6 weeks of treatment with a mean dosage of 2.84mg. diastolic blood pressure of all subjects was maintained below 90mmHg throughout the rest of trial. 3) Pulse rate or body weight were not significantly changed during the entire treatment period(69.3+/-6.0/min vs 10th week : 69.0+/-7.7, 64.7+/-7.4kg vs 63.6+/-6.7, p>0.05). 4) There were no significant changes in blood chemistry including blood sugar, cholesterol and electrolytes, except mild changes of serum creativine and alkaline phosphatase values. 5) Hematologic findings, urinalysis and electrocardiographic findings remained unchanged. 6)Side effects were mostly mild in nature without potentially serious episodes(dry cough : 20%, indigestion, headache, dizziness, in order), but there was 1 cases in whom the dosage was redyced due to postural hypotension. From the above results, cilazapril with the dosage of 2.5 to 5.0mg was effectvie and well tolerated in essential hypertensive patients with diastolic blood pressure of 95 to 115mmHg, and cilazapril seems to be appropriate for monotherapy of mild to moderate hypertensive patients.
Alkaline Phosphatase ; Antihypertensive Agents ; Blood Cell Count ; Blood Glucose ; Blood Pressure ; Body Weight ; Chemistry ; Cholesterol ; Cilazapril* ; Cough ; Dizziness ; Dyspepsia ; Electrocardiography ; Electrolytes ; Headache ; Heart Rate ; Humans ; Hypertension ; Hypotension, Orthostatic ; Oxidoreductases ; Peptidyl-Dipeptidase A ; Platelet Count ; Urinalysis

The Mayer-Rokitansky-K ster-Hauser syndrome represents a spectrum of m llerian anomalies, including vaginal agenesis with or without renal anomalies, in genotypically and phenotypically normal female subjects with normal endocrine status. We experienced a case of this anomaly which combined with unilateral renal agenesis and pelvic cystic mass in child.
Child* ; Female ; Humans

No abstract available.

No abstract available.
Carcinoma, Transitional Cell* ; Tuberculosis, Renal* ; Ureter*

BACKGROUND: In the diagnosis of acute myocardial infarction, measurement of CK-MB is widely used as an enzyme test, but it needs special instruments, lacks specificity in the presence of concomitant skeletal muscle injuries, and has narrow diagnostic time window. Cardiac specific troponin T-a new marker for the diagnosis of myocardial injury-is now available. Besides the quantitative assay, rapid qualitative asay is also possible with the development of rapid assay Kit. We studied about the efficacy of the Troponin T rapid assay Kit in early doagnosis of actue myocardial infarction in the emergency room. METHODS: Total Ck, Ck-MB, LDH and serum troponin T activities were determined when the patients arrived at the emergency room and at the same time Troponin T rapid assay kit test was done. Final diagnosis was made through the serial measurement of CK, CK-MB and LDH. Diagnostic efficacy of each rest was evaluated. RESULTS: Overall diagnostic sensitivity and specificity of Troponin T rapid assay kit were 0.97 and 0.91. When evaluated only with the initial results, Troponin T rapid assay kit showed sensitivity 0.87, specificity 0.97, serum troponin T 0.75, 0.92, and Ck-Mb 0.81,0.95. In one patient who was finally diagnosed as a septic shock, Ck-MB was elevated but serum troponin T was not and Troponin T rapid assay kit test showed negative result. CONCLUSION: Troponin T rapid assay kit test seems to show nearly the same sensitivity and specificity in diagnosis of acute myocardial infarction compared to CK-MB. This test can be done simply and easily in a short time. Thus, with the use of this test, morbidity, mortality and economic loss due to misdiagnosis and delay of diagnosis of myocardial infarction might be reduced.
Diagnosis ; Diagnostic Errors ; Early Diagnosis* ; Emergency Service, Hospital ; Humans ; Mortality ; Muscle, Skeletal ; Myocardial Infarction* ; Sensitivity and Specificity ; Shock, Septic ; Troponin T* ; Troponin*

PURPOSE: Acute pyelonephritis in children may lead to permanent renal scarring with a risk of later hypertension and renal failure and so needs prompt diagnosis and appropriate treatment. The main aim of this study was to evaluate the value of 99mTc-dimercaptosuccinic acid(DMSA) renal scan in detecting renal involvement of acute urinary tract infection(UTI) and determining the sensitivity to find coexisting vesicoureteral reflux(VUR) in children. MATERIALS AND METHODS: A total of 192 children(97 males, 95 females) admitted with bacteriologically proven and symptomatic UTI between May 1994 and April 1997 were analysed. DMSA renal scan was performed in all cases. 70 children underwent VCUG. Findings of DMSA renal scan were analysed according to age, sex, previous history of UTI and VUR. RESULTS: 89 children(46%) were under the age of 1 year. There was a preponderance of UTI in boys under the age of 1 year(66.3%) and in girls over the age of 1 year(63.1%). Of the 192 children studied, 155 children(80.7%, 81 males, 74 females) had first episode and the remaining 37 children(19%, 16 males, 21 females) had previous history of symptomatic UTI. Abnormalities in DMSA renal scan were found in 67(43.2%) of 155 children with the first UTI and in 30(89%) of 37 children with recurrent UTI. Bilateral DMSA abnormalities were noted in 8(5.2%) of 155 children with the first UTI and in 11(29.7%) of 37 children with recurrent UTI. Of the 70 children who underwent VCUG, VUR was seen in 41(58.6%) children. Of the 41 children with VUR, 31(90.2%) children had abnormal DMSA images. VUR was demonstrated in 37(75.5%) of 49 children with abnormal DMSA images and especially in 100% of 14 children with bilateral abnormal DMSA images. CONCLUSIONS: A high proportion of abnormal DMSA images was found in children with recurrent UTI and children with VUR, especially high grade or bilateral reflux. DMSA renal scan is a sensitive method for evaluating the functional defect of involved kidney and predicting coexistent VUR according to its image appearance in patients with UTI.
Child* ; Cicatrix ; Diagnosis ; Female ; Humans ; Hypertension ; Kidney ; Male ; Pyelonephritis ; Renal Insufficiency ; Succimer ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

PURPOSE: Acute pyelonephritis in children may lead to permanent renal scarring with a risk of later hypertension and renal failure and so needs prompt diagnosis and appropriate treatment. The main aim of this study was to evaluate the value of 99mTc-dimercaptosuccinic acid(DMSA) renal scan in detecting renal involvement of acute urinary tract infection(UTI) and determining the sensitivity to find coexisting vesicoureteral reflux(VUR) in children. MATERIALS AND METHODS: A total of 192 children(97 males, 95 females) admitted with bacteriologically proven and symptomatic UTI between May 1994 and April 1997 were analysed. DMSA renal scan was performed in all cases. 70 children underwent VCUG. Findings of DMSA renal scan were analysed according to age, sex, previous history of UTI and VUR. RESULTS: 89 children(46%) were under the age of 1 year. There was a preponderance of UTI in boys under the age of 1 year(66.3%) and in girls over the age of 1 year(63.1%). Of the 192 children studied, 155 children(80.7%, 81 males, 74 females) had first episode and the remaining 37 children(19%, 16 males, 21 females) had previous history of symptomatic UTI. Abnormalities in DMSA renal scan were found in 67(43.2%) of 155 children with the first UTI and in 30(89%) of 37 children with recurrent UTI. Bilateral DMSA abnormalities were noted in 8(5.2%) of 155 children with the first UTI and in 11(29.7%) of 37 children with recurrent UTI. Of the 70 children who underwent VCUG, VUR was seen in 41(58.6%) children. Of the 41 children with VUR, 31(90.2%) children had abnormal DMSA images. VUR was demonstrated in 37(75.5%) of 49 children with abnormal DMSA images and especially in 100% of 14 children with bilateral abnormal DMSA images. CONCLUSIONS: A high proportion of abnormal DMSA images was found in children with recurrent UTI and children with VUR, especially high grade or bilateral reflux. DMSA renal scan is a sensitive method for evaluating the functional defect of involved kidney and predicting coexistent VUR according to its image appearance in patients with UTI.
Child* ; Cicatrix ; Diagnosis ; Female ; Humans ; Hypertension ; Kidney ; Male ; Pyelonephritis ; Renal Insufficiency ; Succimer ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux