1.A Comparison of Surgical Morbidity and Postoperative Voiding Function in Infants and 1-2 year-old Children after Ureteral Reimplantation.
Korean Journal of Urology 2003;44(8):776-779
PURPOSE: The advisability of early ureteral reimplantation in infants is controversial, and to our knowledge no long-term results are available. Whether early ureteral reimplantation in infants increases surgical morbidity, compared to ureteral reimplantation after the age of 1 year, was investigated, and the long-term voiding function after ureteral reimplantation evaluated. MATERIALS AND METHODS: Between 1993 and 1999, 130 children underwent ureteral reimplantation at our institution. The diagnosis was a primary vesicoureteral reflux, obstructed megaureter and an ectopic ureter. Two groups of 64 children that underwent ureteral reimplantation were compared. Group 1 included children younger than 12 months at surgery and group 2 children those between 1 and 2 years. The long term results were evaluated with regard to surgical outcome, voiding function and urinary tract infection. An analysis of the voiding function included family interviews, uroflowmetry and post-void residual urine measurements. RESULTS: Complete long-term data were available for 47 boys and 17 girls. In Group 1, there were no complications in 50 renal units(96%), while two had postoperative reflux, and underwent macroplastique injection. In Group 2, there were no complications in 35 renal units(97.1%), while one patient had postoperative reflux, which resolved spontaneously. No significant difference was noted in the postoperative post-void residual urine volumes between the two groups. CONCLUSIONS: In our samples, early ureteral reimplantation resulted in a technical success rate of greater than 95% and low postoperative morbidity, with the exception of urinary tract infection. Our data show satisfactory bladder emptying and normal uroflowmetry. When indicated, ureteral reimplantation can be performed safely in young children, without fear of damaging bladder function.
Child*
;
Diagnosis
;
Female
;
Humans
;
Infant*
;
Replantation*
;
Ureter*
;
Urinary Bladder
;
Urinary Tract Infections
;
Vesico-Ureteral Reflux
2.The Effect of Ketoconazole in the Treatment of Candida albicans Keratitis in Rabbits.
Journal of the Korean Ophthalmological Society 1988;29(4):529-533
Candida albicans keratitis was established in rabbits by intrastromal injection of a suspension containing 1.2 X 10(4) spores. After a 48-hour incubation period, the animals were treated with oral ketoconazole(10mg/kg daily) alone and in combination with topical ketoconazole(2% solution ten times a day) for 2 weeks. Clinical scores were significantly lower in both treated groups than in the control group. But there was no significant difference between the two treated groups.
Animals
;
Candida albicans*
;
Candida*
;
Keratitis*
;
Ketoconazole*
;
Rabbits*
;
Spores
3.Study on the Constitutional Distributions of Disease Types and Symptoms by Shisho Constitution in Outpatients at the Center for Kampo Medicine, Keio University
Jong-Won KIM ; Kenji WATANABE ; Sung-Jun KIM ; Soo-Hyung JEON
Kampo Medicine 2014;65(4):251-267
Objectives : The purpose of this study is to know the shisho constitutional distribution of outpatients at the Center for Kampo Medicine, Keio University School of Medicine (the Keio Kampo Center, herein) and to find out if there are differences in the type of diseases and symptoms according to shisho constitution.
Methods : We collected data from 366 outpatients at the Keio Kampo Center. All did a SSCQ-P (shisho Constitution Questionnaire for Patients) to obtain a shisho constitution diagnosis. We then classified their shisho constitutions and surveyed disease and symptom prevalence according to same.
Results : 1 : Among the 366 outpatients, distribution rates for Taiyojin, Syoyojin, Taiinjin, and Syoinjin were 0.8%, 27.3%, 28.7%, and 43.2% respectively. 2 : And the prevalence of V. Mental and behavioral disorders, XI. Diseases of the digestive system, XV. Pregnancy, childbirth and the puerperium, and Feeling of coldness (under XVIII. Symptoms, signs and abnormal clinical and laboratory findings, NEC) items for Shoinjin were significantly higher than those for the other constitutions. (p < 0.05)
Conclusions : The distribution rate for shisho in 366 outpatients at the Keio Kampo Center was different from that in Korea, with the rate for shoinjin in these outpatients at the Center especially, being significantly higher than that for Koreans. There were also significant differences in the prevalence of some diseases and symptoms in shoinjin group.
4.Delay of Spontaneous Neutrophil Apoptosis by Vascular Endothelial Growth Factor.
Chang Won JEON ; Hae Young PARK ; Jong Young KWAK ; Hyung Ho KIM
Journal of the Korean Surgical Society 2005;69(4):328-334
PURPOSE: Vascular endothelial growth factor (VEGF) stimulates angiogenesis and vascular permeability. Tissue damage is related to angiogenesis, and induced by a delay in neutrophil apoptosis. This study was performed to investigate the effect of VEGF on the spontaneous neutrophil apoptosis via the activation of VEGFR-1 and phosphorylation of the p38-MAPK pathway. METHODS: Neutrophils were prepared from 10 healthy young donors, cultured for 20 h, and the apoptosis measured by the morphological changes and flow cytometry. The VEGF receptor expression and phosphorylation of mitogen activated protein kinase (MAPK) were measured using a Western blotting method. RESULTS: VEGF dose-dependently delayed the spontaneous neutrophil apoptosis, but this effect was blocked by pre-treatment of the cells with a VEGF receptor antagonist. VEGF increased the phosphorylated forms of the extracellular stress related kinase (Erk) and p38-MAPK. However, the VEGF-induced delay in apoptosis was not affected by the Erk inhibitor, PD98059 but was affected by the p38- MAPK inhibitor, SB203580. The VEGF receptor-1, but not the VEGF receptor-2, was detected in neutrophils, but its level was reduced in cultured neutrophils. CONCLUSION: VEGF delays neutrophil apoptosis through p38- MAPK activation.
Apoptosis*
;
Blotting, Western
;
Capillary Permeability
;
Flow Cytometry
;
Humans
;
Neutrophils*
;
Phosphorylation
;
Phosphotransferases
;
Protein Kinases
;
Receptors, Vascular Endothelial Growth Factor
;
Tissue Donors
;
Vascular Endothelial Growth Factor A*
;
Vascular Endothelial Growth Factor Receptor-1
5.The Significance of Simultaneous Transurethral Resection of Bladder Tumor and the Prostate in Patient who have Superficial Bladder Cancer with Bladder Outlet Obstruction.
Won Sik HAM ; Won Tae KIM ; Hyung Jin JEON ; Dong Hoon LEE ; Young Deuk CHOI
Korean Journal of Urology 2008;49(9):791-796
PURPOSE: We evaluated the clinical significance of simultaneous transurethral resection of bladder tumor(TURB) and the prostate(TURP) in patients who have superficial bladder cancer with bladder outlet obstruction. MATERIALS AND METHODS: Between April 1997 to April 2006, 213 patients with superficial bladder cancer were included in this study. The patients were treated with TURB only(n=107, Group I) or TURB with TURP (n=106, Group II). Bladder cancer recurrence was observed by performing cystoscopy and urine cytology. Uroflowmetry was performed three months after surgery. RESULTS: There were no significant differences in age, the tumor size or the number of tumors between groups I and II. There was no evidence of cancer implantation where TURP was applied. The recurrence rate of group II was significantly lower than that of group I(p=0.044), and the time to recurrence was longer for group II than for group I(p=0.026). There was no significant difference in the progression rate between the two groups(p=0.788). Three months after surgery, the mean residual urine volume was lower for group II(7.9ml) than that for group I(21.7ml). CONCLUSIONS: For superficial bladder cancer patients with bladder outlet obstruction, simultaneous TURB and TURP may help reduce the bladder cancer recurrence rate and delay the time to recurrence without the risk of cancer implantation at the site where TURP is applied.
Cystoscopy
;
Humans
;
Prostate
;
Recurrence
;
Transurethral Resection of Prostate
;
Urinary Bladder
;
Urinary Bladder Neck Obstruction
;
Urinary Bladder Neoplasms
6.Can Diffusion-Perfusion Mismatch on Brain MRI in Acute Ischemic Stroke Patients Predict Clinical Outcome?: Preliminary Study Focused on rCBV.
Hyung Won JEON ; Ji Hye KANG ; Su Yun LEE ; Yu Sil LEE ; Myong Jin KANG ; Jae Kwan CHA
Journal of the Korean Neurological Association 2008;26(4):295-300
BACKGROUND: Diffusion-perfusion mismatch (DPM) on MRI has been considered an ischemic penumbra. However, several reports have demonstrated limitation of DPM on MRI as a predictable marker of the ischemic penumbra. In this study, we investigated the relationship between DPM and the clinical progression in acute ischemic stroke patients. METHODS: We consecutively recruited fifty-seven patients showing acute ischemic stroke (within 24 hours) in the middle cerebral artery (MCA) territory. The clinical outcomes were determined by serial measurement of National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) during 30 days after their ischemic event. We also evaluated the relationship among the parameters of perfusion MRI and the clinical worsening in patients with DPM on initial MRI. RESULTS: Nineteen (33.3%) patients had DPM on MRI within 24 hours after stroke onset. Even though the frequency of clinical worsening for 30 days after stroke onset was higher in DPM group (26%) than in non-DPM group (11%), it did not reach statistical significance (p=0.143). However, extent of MCA stenosis (p<0.001) and time to peak (TTP) delay on MRI (p<0.001) were significantly greater in patients with DPM than in those without DPM. Among several parameters of the perfusion MRI, only relative cerebral blood volume (rCBV) was significantly related to the clinical worsening (62.9+/-24.7% vs 96.1+/-19.2%, p=0.007) in patients with DPM. CONCLUSIONS: This study shows that DPM on MRI does not always predict the clinical worsening in acute ischemic stroke. To overcome this problem, we should analyze rCBV map based DPM as well as TTP map based DPM.
Blood Volume
;
Brain
;
Constriction, Pathologic
;
Diffusion
;
Humans
;
Magnetic Resonance Imaging
;
Middle Cerebral Artery
;
Perfusion
;
Stroke
;
Thymine Nucleotides
7.Treatment of Periprosthetic Femoral Fractures with Cable Plate.
Hyung Sun AHN ; Ki Won LEE ; Chung Hwan KIM ; Jae Hun LEE ; Ju Sik JEON
Journal of the Korean Fracture Society 2006;19(1):78-82
PURPOSE: To evaluate the results of Cable plate fixation for the treatment of periprosthetic femoral fracture after hip arthroplasty. MATERIALS AND METHODS: We reviewed 10 cases of periprosthetic femoral fractures after hip arthroplasty between Nov. 2002 and May 2004. The mean follow up periods were 20 months. The fractures were classified according to Vancouver classification. Seven cases of type B1, one case of type B3 and two cases of type C were treated with open reduction and internal fixation with Cable plate. Evaluation of results was based on mean union time, postoperative complications and Harris hip score. RESULTS: The mean time for bony union was 4.8 months in type B1, 6 months in type B3 and 8 months in type C fracture. As for complications, there were refracture, metal breakage and nonunion. The postoperative mean Harris hip score was 91.5 points for type B1, 85 points for type B3 and 72.5 points for type C fracure. CONCLUSION: Cable plate can be useful for treatment of periprosthetic femoral fractures after hip arthroplasty, but the selection of treatment methods should be cautiously made according to the type of fracture and status of patients.
Arthroplasty
;
Classification
;
Femoral Fractures*
;
Femur
;
Follow-Up Studies
;
Hip
;
Humans
;
Postoperative Complications
8.Torsion of the Isolated Fallopian Tube in an Adolescence: A Case Report.
Yeon Hee KU ; Jin A KIM ; Chae Hyung LEE ; Kwang Bum BAE ; Hye Won JEON ; Gyu Ri HWANG
Korean Journal of Obstetrics and Gynecology 2006;49(5):1154-1157
Torsion of the fallopian tube is an uncommon cause for acute low abdominal pain in female that is difficult to diagnose. Because it has no pathognomonic clinical symptoms or laboratory findings, a high index of suspicion is important when there is history of pelvic pathologic conditions or surgery. The early diagnosis and surgical treatment of the disease are mandatory to preserve oviduct.
Abdominal Pain
;
Adolescent*
;
Animals
;
Early Diagnosis
;
Fallopian Tubes*
;
Female
;
Humans
;
Oviducts
9.The Natural Course in Children with Unilateral Multicystic Dysplastic Kidney.
Jung Min JOO ; Hyung Jin JEON ; Sang Won HAN
Korean Journal of Urology 2005;46(9):914-919
PURPOSE: Advances in modern ultrasonography combined with a dimercaptosuccinic acid (DMSA) renal scan have permitted the diagnosis of a multicystic dysplastic kidney (MCDK) with a high degree of certainty. Most multicystic dysplastic kidneys undergo spontaneous involution during follow-up, as demonstrated by serial ultrasonography. The purpose of this study was to contribute to a better understanding of the natural history of a MCDK, and suggest guidelines for follow-up of a MCDK. MATERIALS AND METHODS: Between November 1988 and May 2004, 142 children with a MCDK were diagnosed at our institute. A retrospective data analysis was carried out on 38 patients who were conservatively managed and followed for more than 6 months. Follow up ultrasonography examinations were performed every 6 months until patients were 5 years old, and annually thereafter. Patients were divided into simple and complex MCDK based on postnatal physical examination and renal ultrasonography. A simple MCDK was defined as unilateral renal dysplasia without genitourinary abnormalities. Complex MCDK included patients with unilateral renal dysplasia, but with other genitourinary abnormalities. RESULTS: The follow-up periods ranged from 6 to 76 months, with a median of 21.5 months. Partial and complete involution of the affected kidney was observed in 6 (15.8%) and 8 (21.1%) patients, respectively. There was no significant difference in the median involution time between the groups. The median time to involution in all patients was 36 months. CONCLUSIONS: Conservative management for a MCDK appears to be a safe option. Because of a complex MCDK has a high incidence of UTI, prophylactic antibiotics may be required. We recommend the long-term follow-up of a MCDK using ultrasonography monitoring.
Anti-Bacterial Agents
;
Child*
;
Child, Preschool
;
Diagnosis
;
Follow-Up Studies
;
Humans
;
Incidence
;
Kidney
;
Multicystic Dysplastic Kidney*
;
Natural History
;
Physical Examination
;
Retrospective Studies
;
Statistics as Topic
;
Succimer
;
Ultrasonography
;
Urogenital Abnormalities
10.The Impact of Voiding Dysfunction on Vesicoureteral Reflux and Renal Scars.
Young Jae IM ; Hyung Jin JEON ; Sang Won HAN
Korean Journal of Urology 2005;46(9):897-902
PURPOSE: To report the relationship between voiding dysfunction and reflux, renal scars and the common findings related to voiding dysfunction in patients with vesico-ureteral reflux (VUR). MATERIALS AND METHODS: Between March 2002 and February 2004, 56 children underwent a video-urodynamic study (video-UDS) for evaluation of VUR. The grade of VUR, various findings of voiding dysfunction and the maximal intravesical pressure (maxPves) were assessed during voiding, and severity of renal scars were assessed via video-UDS and DMSA scans, respectively. RESULTS: Voiding dysfunction was diagnosed in 30 patients (53.6%). The findings of voiding dysfunction were uninhibited contraction (14 patients), detrusor sphincter dyssynergia (15 patients) and bladder neck opening during the filling phase (17 patients). Urethrovaginal reflux and after contraction were noted in 6 and 8 patients, respectively. In the voiding dysfunction group, the mean VUR grade was 3.4, while this was 2.6 in 42 renal units of the normal voiding group (p=0.023). The mean maxPves values during voiding in the voiding dysfunction and normal voiding groups were 107.7 and 77cmH2O, respectively (p=0.002). On evaluation of the relationship between voiding dysfunction and the extent of renal scarring [no scar, single scar, multiple scars, reduced size], the existence of voiding dysfunction resulted in more severe forms of renal scarring (p=0.034). CONCLUSIONS: Voiding dysfunction can cause or aggravate VUR or urinary tract infection due to an increased intravesical pressure during voiding, which can ultimately cause permanent renal damage. Therefore, treatments, such as anticholinergic drugs or biofeedback, must be performed in patients with combined VUR and voiding dysfunction for a better treatment outcome.
Ataxia
;
Biofeedback, Psychology
;
Child
;
Cicatrix*
;
Humans
;
Neck
;
Succimer
;
Treatment Outcome
;
Urinary Bladder
;
Urinary Tract Infections
;
Urodynamics
;
Vesico-Ureteral Reflux*