No abstract available.
Korea* ; Maternal Death*

Herein, polyorchidism possessing of more than the usual number of testicles, which was found in two patients, is reported. Both patients had three testes, and one presented with painful swelling of the right scrotum caused by torsion of the testis and the other revealed a non-palpable testis in the right hemiscrotum. Both patients were managed surgically with orchiopexy and an orchiectomy, respectively, followed by the insertion of an artificial testis.
Humans ; Orchiectomy ; Orchiopexy ; Scrotum ; Testis ; Urogenital Abnormalities

BACKGROUND: Although the culture of urethral discharge using a cutton swab is regarded as one of the most sensitive and reliable diagnostic methods of gonorrhea, it may give pain or diagnostic methods of gonorrhea, it may give pain or discomfort to patients, and its detection rate may be influenced by the examiner's technical ability. OBJECTIVE: The purpose of this study was to compare the positive culture rates between ure4thral discharge and urinary sediment for the diagnosing of Neisseria gonorrheae. METHODS: We compared this technique with the culture of urethral discharge using the specimens from 357 male patients with gonococcal infection at VD clinic of Jungku Pvblic Health center in Seoul from Jan 1991 to Jun 1993. RESULTS: The culture of urinary sediment was positive in 339 of 357(94.95), whereas the culture of urethral discharge was positive in 346 of 357(96.95). However, these data have no statistical significance(P<0.05). The obe observed sensitivity and specificity of culture of urinary sediment comjpared to culture of urethral discharge were 97.75 and 90.9%, respectively. The predictive value of positive and negative test compared to the culture of urethral discharge were 99.7% and 55.65, respectively. As our data showed low negative predictive value, a negative culture result of urinary sediment does not always imply a negative culture result of urethral discharge. CONCLUSION: Therefore, at present, the previous method of the culture of urethral discharge is more highly recommended and further studies for this diagnostic and/or new method of gonorrhea based on larger group of patients is encouraged.
Gonorrhea ; Humans ; Male ; Neisseria gonorrhoeae* ; Neisseria* ; Sensitivity and Specificity ; Seoul

No abstract available.
Colon, Ascending* ; Leiomyosarcoma*

Glomus tumors are maturely organized proliferations of glomus cells and vascular channels. Such tumors are rare in the stomach, and only two cases have been reported in Korea. Because specific clinical or radiologic features are not associated with the glomus tumor, it can be recognized only by histologic characteristics. Although available data are inadequate for determining the histogenesis of this tumor, it may represent a hamartoma rather than a neoplastic disease. The treatment of choice is local resection. In frozen sections, it may be misidentified as a carcinoid tumor, leading to more extensive surgery than required for cure. We report a case of a glomus tumor of the stomach in a 30-year-old female patient who was operated on, and we present a review of the literature on this subject.
Adult ; Carcinoid Tumor ; Female ; Frozen Sections ; Glomus Tumor* ; Hamartoma ; Humans ; Korea ; Stomach*

Glomus tumors are maturely organized proliferations of glomus cells and vascular channels. Such tumors are rare in the stomach, and only two cases have been reported in Korea. Because specific clinical or radiologic features are not associated with the glomus tumor, it can be recognized only by histologic characteristics. Although available data are inadequate for determining the histogenesis of this tumor, it may represent a hamartoma rather than a neoplastic disease. The treatment of choice is local resection. In frozen sections, it may be misidentified as a carcinoid tumor, leading to more extensive surgery than required for cure. We report a case of a glomus tumor of the stomach in a 30-year-old female patient who was operated on, and we present a review of the literature on this subject.
Adult ; Carcinoid Tumor ; Female ; Frozen Sections ; Glomus Tumor* ; Hamartoma ; Humans ; Korea ; Stomach*

STUDY DESIGN: A retrospective review of the patients who have a fixation failure of instrumentalion for the spinal fusion in lumbar region. OBJECTIVES: To assess the incidence and different types of the mechanical failure of fixation and to evaluate their managements and their influences on the progression of a spinal fusion and to the clinical outcomes. SUMMARY OF LITERATURE REVIEW: Most of the spine surgeons have been experiencing the mechanical failures after instrumentations for a spinal fusion, eden though the incidence is decreasing with a modification of the implants. Reports on this problem are sporadic in conjunction with the other topics, rarely focusing on their management and their influences on the final outcomes. MATERIALS AND METHODS: 338 consecutive patients who had a lateral fusion in the lumbar region with an instrumentation of pedicle screws and rods, mostly with decompression, were reviewed to analyse the fixation failures of instrumentation after surgery. RESULTS: There were 26 patients (7.7%) who had the fixation failures of instrumentation, in terms of loosening around the pedicle screws in 18 patients (5.3%), the breakage of the pedicle screws in fide patients (1.5%), and the migration of a rod in three patients (0.9%). They were managed by prolonged use of brace and ergonomic back cares. Even with the fixation failures, 19 patients (73.1%) disclosed solid union uneventfully, but one patient had re-operation to obtain solid fusion. The final outcomes were satisfactory in 22 patients (84.6%), including four of six patients who had pseudoarthrosis. CONCLUSIONS: The fixation failure of instrumentation after a spinal fusion in lumbar region was not rare, but the progression of a spinal fusion usually quite well achieved and the final outcomes were not so bad, even with the implant failures and pseudoarthrosi s. Except for the persistently symptomatic pseudoarthrosis, only a prolonged use of brace and the ergonomic back cares are recommended for symptomatic patients.
Braces ; Decompression ; Humans ; Incidence ; Lumbosacral Region* ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion* ; Spine

STUDY DESIGN: A retrospective analysis of the patients who had cauda equina syndrome caused by a herniated lumbar disc. OBJECTIVES: To assess the clinical debates concerning the diagnosis, treatment, and results of treatment. SUMMARY OF LITERATURE REVIEW: This syndrome has been considered as an absolute indication of surgical treatment in the herniated lumbar disc and poor prognosis after surgery were reported. Although there are debates on the timing of surgery, early recognition early surgical treatment are recommended for a better results of treatment. MATERIALS AND METHODS: 23 consecutive patients having a cauda equina syndrome caused by herniated lumbar disc were reviewed retrospectively. They were 14 males and 9 females having ages of 41.6 in average. The incidence of this syndrome was 3.8% of the patients who had surgical treatment of herniated lumbar disc. RESULTS: All patients had bladder dysfunction in addition to the low back pain and radicular pain in the leg, but five patient did not recognize their urinary retention which were shaded by severe leg pain. A surgical treatment were performed for all patients at 6.8 days in average after onset of the bladder dysfunction. At follow-up of 3 years and 3 months in average after surgery, 20 patients(86.9%) had satisfactory resolution of the low back pain and leg pain, and all patients had complete recovery of motor weakness except one patients who had residual foot drop. Bladder function recovered satisfactorily in 18 patients (78.3%), but 4 patients had some difficulty of urination and one patient needed a sphinterotomy for urination. CONCLUSIONS: The cauda equine syndrome in herniated lumbar disc was often not recognized early and a poor result of treatment was not rare, particularly in the patients who had acute onset and severe bladder dysfunction. So, early diagnosis and active surgical treatment are recommended for a better results of treatment.
Cauda Equina* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Foot ; Humans ; Incidence ; Leg ; Low Back Pain ; Male ; Polyradiculopathy* ; Prognosis ; Retrospective Studies ; Urinary Bladder ; Urinary Retention ; Urination

A most common site for the isthmic spondylolisthesis is at fifth lumbar vertebra(L5) and far less at fourth(L4). The pathogenic lesion in the pars interarticularis is essentially the same in LA and L5 isthmic spondylolisthesis, but the clinical characteristics may differ each other according to their anatomical and biomechanical differences. A retrospective review of 24 patients of LA(study group) and 27 patients of L5(control group) isthmic spondylolisthesis was undertaken for their medical records and radiographs to compare the clinical characteristics in each groups. Included in each groups were all patients who were surgically treated during the same period and followed for more than two years after surgery. In the study group, 18 of 24 patients were females having an average age of 42.5 years(ranging 34-65), while in the control group, 17 of 27 patients were males having an average age of 38,1 years (ranging 13-59). The symptoms were severe leg pain in most of the study group, but in the control group, the leg pain and back pain were equally complained. The degrees of slip were similar in two groups, but a narrowing of dise space at slip segment was more prominent in study group. The lateral radiographs taken in flexion and extension revealed more changes of slip in study group (4.7mm in study group vs 2.8mm in control group in averages), and more angular motion at slip segment in study group unless the dise space is not severely narrowed. A spinal stenosis in CT findings was disclosed in almost all patients of study group and in 18 patients of control group. The sizes of L5 transeverse process were bigger than twice as those of L4 in 17(70.8%) patients including 9(37.5%) sacralizations of L5 in suty group, while in control group they were only 8(29.6%) patients with no sacralization. The heights of intercreastal line revealed no difference in two groups. The surgical procedures in study group were fusion only in two and decompression with fusion in 22(91.7%) patients and those in control group were fusion only in 11 and decompression with fusion in 16(59.3%) paticnts. The satisfactory results of treatment were in 21(87.5%) patients of study group and 25(92.6%) patients of control group without significant difference between two groups. In conclusion, the L4 spondylolytic spondylolisthesis compared to L5 lesion was more unstable and developed spinal stenosis more often. The surgical treatment and decompression procedure were also more needed in L4 lesions particularly in agend women.
Back Pain ; Decompression ; Female ; Humans ; Leg ; Male ; Medical Records ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis

No abstract available.
Carcinogenesis* ; Humans* ; Oncogenes*