Varicocele is a abnormal dilation of entire venous circulation of testis. The etiology of varicocele subfertility is not clear, but at least contributory to its development is a valvular insufficiency at the internal spermatic-left renal vein confluence. The aims of phlebography of the spermatic vein are to confirm the venous anatomy of varicocele, to establish the selection of treatment approach, and to prove the cause of postoperatively persistent varicocele. The transfemoral phlebography of internal spermatic vein was performed in 26 cases. passive reflux from the left renal vein to internal spermatic vein was observed in all cases. Distal nutcracker phenomenon(DNP) was observed in 6 cases, proximal nutcracker phenomenon(PNP) in 4 cases and suspicious PNP in 2 cases. The treatment of the varicocele was performed by Palomo`s procedure in 22 cases and by stainless steel spring coil occlusion in 4 cases. The persistent varicocele was found in 3 cases of Palomo`s procedure and 1 cases of coil occlusion.
Infertility ; Phlebography* ; Renal Veins ; Stainless Steel ; Testis ; Varicocele* ; Veins

We made a clinical study on the effectiveness of local anesthesia in 22 cases of intrascrotal surgeries and 25 cases of varicocelectomies at the Department of Urology, C. A. F. G. H during the period from August 1983 to July 1984. The subjective reaction to pain was evaluated: the seven patients experienced slight pain, the four patients, moderate pain and the remaining thirty six patients, no pain. The operations were performed successfully without converting local anesthesia to general or spinal anesthesia by giving supplemental doses of anesthetic solution, demerol, or valium according to the degree of pain whenever the patients complained of pain. The average duration of anesthesia was 3.8 hours which was sufficient for intrascrotal surgeries and varicocelectomies. No specific complications developed during or after anesthesia except for nausea and vomiting in one case postoperatively. Most of the side effects of general or spinal anesthesia were avoided by adopting local anesthesia. It was not only beneficial to high-risk or elderly patients but ambulatory patients.
Aged ; Anesthesia ; Anesthesia, Local* ; Anesthesia, Spinal ; Diazepam ; Humans ; Meperidine ; Nausea ; Urology ; Vomiting

A clinical observation was performed on 13 cases of giant hydronephrosis in the Department of Urology, College of Medicine, Hanyang University from May 1972 to March 1981 The results are as follows; 1) In 13 cases of giant hydronephrosis 6 cases were male and 7 cases female, 2nd decade was most common. 2) Side of giant hydronephrosis; Rt. side: 4 cases, Lt. side: 9 cases. 3) The most common etiology of giant hydronephrosis was congenital UPJ stricture (53.8%). 4) The details of the symptoms as follows; 12 cases were flank mass, 5 fever and chillness, 4 frequency of urination, 3 hematuria, 2 abdominal distention and 1 oliguria. 5) Renal function test (B.U.N., creatinine) was normal except 1 case of solitary kidney with neurogenic bladder. 6) In 4 cases out of giant hydronephrosis were compensatory hydronephrotic change on contralateral kidney and 8 cases normal. 7) The operative procedures were as follows; 11 cases were nephrectomy, 1 case pyeloplasty and 1 case nephrostomy.
Constriction, Pathologic ; Female ; Fever ; Hematuria ; Humans ; Hydronephrosis* ; Kidney ; Male ; Nephrectomy ; Oliguria ; Surgical Procedures, Operative ; Urinary Bladder, Neurogenic ; Urination ; Urology

We have reported 50 cases of scrotal trauma during the period from Feb. l, l982 to Apr. 1. 1985. All of them were evaluated by careful physical examination and ultrasound. And then all suspicious cases of testicular rupture and severe scrotal swelling were explored surgically as soon as possible. The results were as follows: 1. Kick or blow was the most frequent cause of the injury (78%) and the next was gunshot injury (12%). 2. The incidence of testicular rupture in patients with scrotal trauma was 38%. 3. The rate of orchiectomy in the cases of early exploration was 16.7% and 61.5% in delay exploration. 4. Ultrasound examination was helpful in identifying rapidly those patients who needed surgical repair. Homogenous echoes were produced by normal testicular contents, whereas areas of disruption and hemorrhage appeared dense clusters of echoes. Accurate diagnostic rates of testicular rupture and scrotal hematoma by scrotal sonography were 9l.7% (11/l2) and 95% (19/20). 5. The complications including epididymitis, hydrocele scrotal abscess and testicular atrophy occurred 38.9% in conservative treatment, l6.7% in early exploration and 25% in delay exploration. 6. Early exploration for scrotal trauma decreased not only the change of the testicular loss but also complications.
Abscess ; Atrophy ; Epididymitis ; Hematoma ; Hemorrhage ; Humans ; Incidence ; Male ; Orchiectomy ; Physical Examination ; Rupture ; Ultrasonography

PURPOSE: Subacute necrotizing myelopathy(SNM) is a rare non-tumorous disease of spinal cord characterized by subacute clinical course of progressive neurological deterioration. We report MR findings of a patient with pathologically proved SNM. MATERIALS AND METHODS: 1 case of pathologically proved subacute necrotizing myelopathy. RESULTS: The patient was a 56-year-old man with progressive motor weakness and sensory loss of the lower extremities, and urinary and fecal incontinence for 11 months. Spine MRI revealed diffuse enlargement of the thoracic spinal cord from T2 to T7 level. Signal intensity of the expanded spinal cord was isointense relative to normal cord on T1 -weighted image and hyperintense on proton-density and T2-weighted images. On contrast enhanced T1-weighted image, there was diffuse homogeneous enhancement in the expanded cord lesion. CONCLUSION: MR demonstration of stable persistence of spinal cord lesion or atrophy over months or years with clinical findings of radual progressive neurologic deterioration may be helpful in the diagnosis of SN M(1 ).
Atrophy ; Diagnosis ; Fecal Incontinence ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Spinal Cord ; Spinal Cord Diseases* ; Spine

Retroperitoneal liposarcoma comprises 12 to 45 percent of all liposarcoma. It has been a therapeutic dilemma and a less prognosis because of its tendency to attain a tremendous size due to early silent growth and difficult wide en bloc excision in the retroperitoneum. Here in we report a case of retroperitoneal liposarcoma in 51 year old male patient with a brief review of the literatures.
Humans ; Liposarcoma* ; Male ; Middle Aged ; Prognosis

Esophageal carcinoma rarely metastasizes to the brain. Although some studies have mentioned esophageal cancer with solitary brain metastasis or with meningocerebral metastasis or with skull metastasis, multiple meningocerebral metastasis and extensive skull metastasis from squamous cell carcinoma of esophagus has not been reported in the literature. We encountered a case of an extensive osteolytic change of the skull and multiple meningocerebral metastases from esophageal carcinoma.
Brain ; Carcinoma, Squamous Cell* ; Epithelial Cells* ; Esophageal Neoplasms ; Esophagus* ; Neoplasm Metastasis* ; Skull*

Reiter`s disease can no longer be considerded a rare and relatively benign syndrome, defined by the clinical triad of urethritis, conjunctivitis and arthritis. In the etiology of Reiter`s disease, it can be regarded as a post-infectious syndrome after certain enteric disease or veneral infection and usually occurs in patients between 20 and 40 years old, with a male to female ratio of 10:1 in dysenteric cases and 50:1 in veneral cases. The diagnosis of Reiter`s disease should quite obious when the clinical manifestation of non specific urethritis, conjunctivitis, arthritis and mucocutaneous lesions. Recently, HLA-B27 antigen is strogly associated with Reiter`s syndrome and may be diagnosticlly useful when HLA-B27 is positive. There is no specific therapy for Reiter`s disease, but conservative treatement is aviable of acute stage oir recurrence of the disease. We have experienced a case of Reiter`s syndrome in 27 years old male and reproted with review of some literatures.
Adult ; Arthritis ; Conjunctivitis ; Diagnosis ; Female ; HLA-B27 Antigen ; Humans ; Male ; Recurrence ; Urethritis

Although most of pseudocysts as one of complications of pancreatitis occur primarily within the pancreas, the extrapancreatic locations of pseudocysts, especially in the liver, are rare events. With advanced technology of imaging studies including abdominal computed tomography, ultrasonography, and magnetic resonance imaging, their frequency seems to be increasing. We report here a case of left intrahepatic pancreatic pseudocyst following acute pancreatitis. Percutaneous puncture revealed a high level of amylase and lipase in the collection, confirming the diagnosis of intrahepatic pseudocyst. Symptomatic intrahepatic pseudocysts can be managed surgically, transcutaneously or endoscopically, and asymptomatic intrahepatic pseudocysts can be treated conservatively. We report this case with a review of literature.
Acute Disease ; Aged ; Humans ; Liver Diseases/*diagnosis/etiology/ultrasonography ; Magnetic Resonance Imaging ; Male ; Pancreatic Pseudocyst/*diagnosis/etiology/ultrasonography ; Pancreatitis, Alcoholic/complications/*diagnosis/ultrasonography ; Tomography, X-Ray Computed

L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the 7th RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.
Aged ; Disease Progression ; Female ; Humans ; Hypothyroidism ; Iodine ; Lymph Nodes ; Middle Aged ; Neck ; Neoplasm Metastasis ; Neoplasm, Residual ; Pleural Effusion ; Pleural Effusion, Malignant* ; Pleurodesis ; Quality of Life ; Recurrence ; Thyroglobulin ; Thyroid Gland* ; Thyroid Hormones ; Thyroid Neoplasms ; Thyrotropin ; Thyroxine