No abstract available.
Fibromatosis, Aggressive*

No abstract available.
Anemia, Aplastic* ; Hepatitis*

No abstract available.
Neuroendocrine Cells* ; Prostate* ; Prostatic Hyperplasia*

The finding of extraluminal gas on plain abdominal radiogram is usually associated with a perforated viscus, and an emergency laparatomy is indicated. But we report herein an immature neonate with spontaneous pneumoperitoneum that was treated successfully with conservative management, although this infant she showed positive result in stool occult blood test. As this case shows, the finding of pneumoperitoneum is not of a surgical emergency, because there are many benign explanations for pneumoperitoneum. A through history taking and physical examination are most important in differentiating between surgical and nonsurgical pneumoperitonium.
Emergencies ; Humans ; Infant ; Infant, Newborn* ; Occult Blood ; Peritonitis ; Physical Examination ; Pneumoperitoneum*

Desmoid tumors are defined as aggressive overgrowth of fibrous sheets and musculoaponeurotic structures. Although desmoid tumors are generally known as a benign neoplasm, it's aggresive local invasiveness and frequent recurrence indicate it's position lying between the benign and malignancy. The association of desmoid tumor and familial adenomtous polyposis(FAP) was first made in 1923 by Nichols. In 1951, Gardner reported the familial occurrence of intestinal polyposis, osteomas, fibromas, and epidermal or sebaceous cyst. Desmoid tumors are common in patients with FAP and Occur in 3.5~29% of patients with FAP whereas the incidence in the gerenal population is 2~5/1,000,000 person years. Surgical resection of desmoids in patients with FAP has been controversial because unresectability and recurrence are more common than cure. Palliative and curative resections have a high morbidity. Surgery should be reserved for those patients with symptomatic mesenteric desmoids. If a small mesenteric desmoid is encountered incidentally and is easily resectable, it should be resected. If surgery has been less than satisfactory in the treatment of these patients, several different medical approaches can be combined with or without surgical resection with mixed result. Authors report a case of unresectable mesenteric desmoid tumor, developing after surgery of FAP and literatures were reviewed
Deception ; Epidermal Cyst ; Fibroma ; Fibromatosis, Aggressive* ; Humans ; Incidence ; Intestinal Polyposis ; Osteoma ; Recurrence

To develop an animal model of nephrolithiasis similar to the pattern of human renal stone disease, we adopted a protocol of administration of stone substrates along with induction of renal tubular injuries. Male Wister rats fed with 3% ammonium oxalate containing chows with or without additional 40 mg/kg/day of gentamicin for 8 days were compared with those fed with normal chows. On dissecting microscopic examination, rats receiving oxalate and gentamicin showed more crystals and plaques than rats receiving oxalate only, both in 15 days and 22 days after feeding, and most of the crystals were located at renal papilla. Average score of crystal abundance was 0.4, 1.15, respectively in rats receiving oxalate only and oxalate plus gentamicin after 15 days of feeding, and 0.9 and 1.55, respectively after 22 days. Little crystals were found in rats fed with normal chow with or without gentamicin. Urinary excretion of tubular epithelial brush border enzyme, gamma-glutamyl transpeptidase(GGT), was increased by gentamicin administration whereas creatinine clearance rate was not changed. Urinary excretion of oxalate was unchanged, but calcium and uric acid was markedly decreased in rats fed with oxalate and formed crystals, and citrate and magnesium excretion was also decreased. These results indicate that administration of oxalate along with inducing renal tubular damages by subcutaneous injection of gentamicin seems to form crystals and plaques in the kidney more rapidly and abundantly than feeding with oxalate alone.
Animals* ; Calcium ; Citric Acid ; Creatinine ; Gentamicins ; Humans ; Injections, Subcutaneous ; Kidney ; Magnesium ; Male ; Microvilli ; Models, Animal* ; Nephrolithiasis* ; Oxalic Acid ; Rats ; Uric Acid

BACKGROUND: Insulin induced hypoglycemia has been used to assess the adrenocortical function, but may be hazardous. The standard rapid ACTH stimulation test has been advocated as a substitute but is sometimes insensitive. In this study, low dose (1ug) rapid ACTH stimulation test was compared to insulin induced hypoglycemia and standard dose (250ug) rapid ACTH stimulation. METHODS: 27 patients (14 men and 13 women) with pituitary disease and definite adrenocortical dysfunction (14 patients were confirmed by insulin induced hypoglycemia) and 23 controls (pituitary control: 3 men and 7 women, confirmed by insulin induced hypoglycemia, normal control: 8 men and 5 women) were studied. All subjects underwent rapid ACTH stimulation test with 2 different level of stimulation (1 and 250ug). Serum cortisol levels were measured at 0, 30 and 60 min after each dose of ACTH injection. A normal response was defined as a peak cortisol value of 497nrnol/L (18ug/dL) or above, RESULTS: During rapid ACTH stimulation study in controls, the peak serum cortisol level was significantly lower (690+-25lnmol/L (25.0+-9.1ug/dL) vs. 933+-257nmol/L (33.8+-9.3ug/dL); p< 0.01) and the peak appeared earlier (30min. vs. 60min) after the administration of low dose ACTH than after standard dose. However, the serum cortisol level at 30min was not different. In patient group, each serum cortisol level at 30min and 60min had no difference between low and standard dose (p>0.1). None of these 27 patients showed normal response to low dose stimulation, but 2 of 27 did to standard dose. In controls, 19 of 23 showed normal response to low dose, and all of 23 did to standard dose (sensitivity 100% vs 92.5%, specificity 82.5% vs 100%). The results of low and high dose stimulation test agreed with those of insulin induced hypoglycemia (Kendalls g= 0.50 vs 0.92, p<0.01 vs 0.001). CONCLUSIONS: The results of a low dose (1ug) rapid ACTH stimulation test showed good correlation with those of the standard dose (250ug) rapid ACTH stimulation test and insulin induced hypoglycemia. Thus it may be used in screening for the diagnosis of adrenal insufficiency.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Diagnosis ; Female ; Humans ; Hydrocortisone ; Hypoglycemia ; Insulin ; Male ; Mass Screening ; Pituitary Diseases ; Sensitivity and Specificity

PURPOSE: We investigated the influence of age, rate of obesity, hepatic function and renal function on serum prostate-specific antigen in healthy men older than 50 years. MATERIALS AND METHODS: From January 1999 to December 2000, 2,296 healthy Korean men older than 50 years who visited Health Promotion Center at our hospital for a routine health checkup were entered into a prospective study. All men underwent detailed clinical examinations, including serum prostate-specific antigen (PSA) determination using Hybritech Tandem-R assay, anthropometric measurements, tests for liver disease, tests for renal function, and other constitutes. We determined the risk factors of the increase of serum PSA among these clinical parameters using univariate and multivariate logistic regression analyses. RESULTS: The univariate logistic regression analysis indicated that age, alanine aminotransferase (ALT), hemoglobin, potassium, albumin, high-density lipoprotein (HDL) were the risk factors of the increase of serum PSA. In the multivariate model used, age, ALT, alkaline phosphatase, albumin, HDL and cholesterol were an independent predictors of the increase of serum PSA, whereas hemoglobin and potassium lost their statistical significance. CONCLUSIONS: Our findings suggest that the health status as well as may influence on serum PSA level of healthy men older than 50 years. Additional work is needed to determine and validate the clinical significance of these findings.
Alanine Transaminase ; Alkaline Phosphatase ; Cholesterol ; Health Promotion ; Humans ; Lipoproteins ; Liver Diseases ; Logistic Models ; Male ; Obesity* ; Potassium ; Prospective Studies ; Prostate-Specific Antigen* ; Risk Factors

We report a case of spontaneous uretreral rupture cured by conservative management. The patient(65-year-old man) who had left flank pain for 6 days was presented to our hospital. He had no history of trauma and previous urologic problems. Diagnosis was made by IVP and abdominal CT scan, which showed extravasation from left upper ureter and accumulation of a large amount of contrast media in the retroperitoneal space. On ureteroscopy, partial obstruction of left lower ureter was found and the upper ureteral mucosa showed diffuse erythematous changes. The rupture site with erythematous edema and some necrotic tissues was identified in lateral wall near ureteropelvic junction. A guide wire was passed upward the rupture site under direct vision of ureteroscope and then 6 Fr. double J stent was successfully palced. The stent was removed 4 weeks after the placement. Followup IVP showed good urinary drainange without evidence of extravasation.
Contrast Media ; Diagnosis ; Edema ; Flank Pain ; Follow-Up Studies ; Mucous Membrane ; Retroperitoneal Space ; Rupture* ; Rupture, Spontaneous ; Stents ; Tomography, X-Ray Computed ; Ureter* ; Ureteroscopes ; Ureteroscopy

PURPOSE: To estimate the influences of pain and urinary symptoms on quality of life and determine the item that has the most predicting ability for quality of life in young men with chronic prostatitis-like symptoms. MATERIALS AND METHODS: Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index. of 28,841 men aged 20 years dwelling in the community, 16,321 men(a response rate 56.6%) completed self-administered questionnaires. A total of 1,057men who complained symptoms suggestive of chronic prostatitis were included in the study. The influences of pain and urinary symptoms on quality of life were determined by the logistic regression analysis. The receiver operating characteristic(ROC) curve was used to provide the predicting ability of each item quality of life. RESULTS: In multivariate analysis, pain and urinary symptoms were associated with an increased likelihood of impaired quality of life, and pain contributed more than urinary symptoms. Among items of pain and urinary symptoms, pain severity had the most predicting ability for impact, overall quality of life and quality of life impact domain. The areas under the ROC curves for impact, overall quality of life and quality of life impact domain were 71.3%, 69.3% and 67.0%, respectively. CONCLUSIONS: Urinary symptoms as well as pain may be associated with an increased likelihood of impaired quality of life in young men with chronic prostatitis-like symptoms. In addition, our findings suggest that pain severity is the most influencing factor for quality of life in this population.
Academies and Institutes ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Prostatitis ; Quality of Life* ; Surveys and Questionnaires ; ROC Curve