We had been managed on 95 cases of distal ureteral stone with cystoscopic manipulation who were admitted to the Department of Urology, Han-iI Hospital during the period of 5 years from March 1st, 1981 to February 28th, 1986 using the Dormia stone dislodger and following results were obtained. 1. Among them, 41 cases were extracted immediately on primary application of the Dormia stone dislodgers and 7 cases were delivered by indwelling method and 13 cases were delivered spontaneously after ureteral meatotomy. 2. Over-all success rate was 67.4% but the subdivided success rate according to the size of stone decreased with increasing size of stone. 3. There were no major complication, but in one case basket was entrapped in the ureter.
Ureter* ; Urology

Cystinuria is an autosomal recessive inherited defect in renal tubular reabsorption of four amino acids, cystine, ornithine, lysine and arginine. Homozygotes were identified by the formation of urinary tract calculi composed of cystine and by gross hyperexcretion of above mentioned four amino acids. Urinary tract calculi composed primarily of cystine are rare in adults and children. These are usually pure and found exclusively in patients with cystinuria. Herein we report on a 4 and 3/12 years old male child with a right renal stone composed primarily of cystine which was confirmed by chemical analysis method postoperatively. After discharge he has been treated with D-penicillamine, large fluid intake and conversion of urine pH.
Adult ; Amino Acids ; Arginine ; Calculi ; Child* ; Cystine* ; Cystinuria ; Homozygote ; Humans ; Hydrogen-Ion Concentration ; Lysine ; Male ; Ornithine ; Penicillamine ; Urinary Tract

Major pelvic ganglia (MPG) neurons are classified into sympathetic and parasympathetic neurons according to the electrophysiological properties; membrane capacitance (Cm), expression of T-type Ca2+ channels, and the firing patterns during depolarization. In the present study, function and molecular expression of ATP-sensitive K+ (K(ATP)) channels was investigated in MPG neurons of male rats. Only in parasympathetic MPG neurons showing phasic firing patterns, hyperpolarizing changes were elicited by the application of diazoxide, an activator of K(ATP) channels. Glibenclamide (10microM), a K(ATP) channel blocker, completely abolished the diazoxide-induced hyperpolarization. Diazoxide increased inward currents at high K+ (90 mM) external solution, which was also blocked by glibenclamide. The metabolic inhibition by the treatment with mitochondrial respiratory chain inhibitors (rotenone and antimycin) hyperpolarized the resting membrane potential of parasympathetic neurons, which was not observed in sympathetic neurons. The hyperpolarizing response to metabolic inhibition was partially blocked by glibenclamide. RT-PCR analysis revealed that MPG neurons mainly expressed the K(ATP) channel subunits of Kir6.2 and SUR1. Our results suggest that MPG neurons have K(ATP) channels, mainly formed by Kir6.2 and SUR1, with phenotype-specificity, and that the conductance through this channel in parasympathetic neurons may contribute to the changes in excitability during hypoxia and/or metabolic inhibition.
Animals ; Anoxia ; Diazoxide ; Electron Transport ; Fires ; Ganglia ; Ganglion Cysts* ; Glyburide ; Humans ; Male* ; Membrane Potentials ; Membranes ; Neurons* ; Rats*

Permanent ischemic injury of the hand after radial artery cannulation is rare, but several cases of thromboembolism after the cannulation leading to amputation of affected limb or digits have been reported. A 48-yr-old man undergoing spine surgery showed normal modified Allen's test and had no preoperative vascular disease. We inserted 20-G radial artery catheter for the continuous monitoring of the blood flow and serial blood sampling. There was no specific event during the operation and the catheter was removed immediately after the operation. The signs and symptoms of the circulatory impairment of the radial artery developed four days after the operation and aggravated thereafter. Through the angiographic study, we found the total occlusion of the radial artery and some of its branches. After an emergent surgical exploration of the radial artery for removal of the thrombus and vein graft for the defect of the artery on the 8th postoperative day, the ischemic signs and symptoms disappeared and the radial pulse was restored.
Catheterization, Peripheral/*adverse effects ; Embolectomy ; Fingers/*blood supply/radiography ; Hand/*blood supply/radiography ; Human ; Male ; Middle Age ; Peripheral Vascular Diseases/etiology/*surgery ; Radial Artery/*abnormalities/surgery ; Thromboembolism/etiology/*surgery ; Treatment Outcome

PURPOSE: This study evaluated the preoperative and postoperative radiologic findings of patients with complete repairs after massive rotator cuff tears along with the incidence of re-tear and the clinical outcomes. MATERIALS AND METHODS: This study evaluated 33 cases who had open complete repairs for massive rotator cuff tears and these patients were followed up for more than 24 months. The clinical evaluation was performed according to the shoulder joint function test of the American Shoulder and Elbow Surgeons (ASES), and the degree of arthritis related to the massive rotator cuff tears was evaluated using the Hamada classification. RESULTS: The ASES scores improved from 37.6 preoperatively to 85.6 postoperatively. The mean preoperative acromio-humeral interval (AHI) score was 6.5 mm, which increased to 9.3 mm immediately after surgery, and there was a decreased to 6.5 mm noted at the last follow up. The lower radiology stages of arthritis according to the classification showed better preoperative and postoperative results. CONCLUSION: An open complete repair as the surgical treatment for a massive rotator cuff tear showed satisfactory results for pain relief and an improvement in the shoulder joint function though re-tear after surgery.
Arthritis ; Elbow ; Follow-Up Studies ; Humans ; Incidence ; Rotator Cuff ; Shoulder ; Shoulder Joint

Although bizarre parosteal osteochondromatous proliferation does not frequently occur, this calcified, osteal, chondromatous tumor has relatively high recurrence rates and presents clinical, radiological, histological features that can be classified with other lesions. And it is a benign disease that until now, there were no death or metastasis reports because of this tumor. This proliferation is hard to distinguish between other benign tumors and non-neoplastic lesions if it is occurred in small bone of hand or foot. We experienced bizarre parosteal osteochondromatous proliferation of middle phalanx of the little finger, and report this case and the review of relevant literature.
Fingers ; Foot ; Hand ; Neoplasm Metastasis ; Recurrence

PURPOSE: Glomus tumor has known as smaller than 1 cm, hard to palpate, therefore patients often suffer from chronic pain. Based on our experiences about glomus tumors, we would like to evaluate their distributions. MATERIALS AND METHODS: This study includes 24 cases that underwent surgery for clinically diagnosed glomus tumor from January, 2001 to May, 2009. Clinical symptoms were firstly evaluated and ultrasonography in 8 cases and Magnetic Resonance Imaging (MRI) in 5 cases were performed for more accurate diagnosis and localization. Complete resection with biopsy was done in all cases. RESULTS: According to pathologic findings, 20 out of 24 cases were reported as glomus tumor, and the other 4 cases were 2 fibrous tumor with chronic inflammation, 1 hemangioma, and 1 neuroma. Twenty glomus tumors at dorsal side under the nail were distributed to proximal radial in 11 cases, proximal ulnar in 6 cases, distal radial in 2 cases and distal ulnar in 1 case. Tumors were more frequently found at proximal in 17 cases(85%) and at radial side in 13 cases(65%). CONCLUSIONS: Glomus tumors tend to occur under nail of proximal and radial part. We think that accurate diagnosis and location of glomus tumors are needed to complete surgical resection.
Biopsy ; Chronic Pain ; Fingers ; Glomus Tumor ; Hemangioma ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Nails ; Neuroma

PURPOSE: To evaluate the amount and related factors of reduction loss in distal radius fracture after treatment by Kapandji technique. MATERIALS AND METHODS: From September 2004 to May 2006, 44 cases (43 patients) of distal radius fractures were treated by Kapandji technique. Fracture were classified with AO classification and volar tilt, radial inclination, and radial length were measured in preoperative, immediate, postoperative radiographs. Also the amount and related risk factors of reduction loss were analyzed. In addition, the radiological results at last follow up were evaluated using modified Lidstrom scoring system. RESULTS: There was significantly more reduction loss of volar tilt in the patients with AO type C comparing with other fracture types, but the patients who were treated using three k-wire fixations including intrafocal K-wires showed significantly more reduction loss of volar tilt also. Overall radiological results at last follow up showed that excellent was 50% in cases with dorsal comminution, but, the other cases 90%. In addition, excellent was 70% in type A cases, but, in type C 44%. CONCLUSION: Kapandji technique percutaneous pinning is the one of effective treatment options for distal radius fracture. But, type of fracture, total number of K-wires, and presence of dorsal cortical comminution showed the significant relation with postoperative reduction loss of volar tilt and overall radiological results at last follow up.
Classification ; Follow-Up Studies ; Humans ; Radius Fractures* ; Radius* ; Risk Factors

PURPOSE: To evaluate the incidence of avascular necrosis (AVN), prognostic reliability of the Hawkins sign, and clinical outcomes after operative treatment of fracture and dislocations of the talar neck. MATERIALS AND METHODS: We analysed 16 patients with fracture and dislocations of the talar neck which were treated by open reduction and internal fixation and followed up for more than 2 years. The postoperative radiographs were examined for Hawkins sign and avascular necrosis was confirmed by bone scan. The assessment of clinical results was based on the Hawkins scoring system. RESULTS: AVN was occurred in 2 of 16 cases (12.5%) only in type III. Hawkins sign was found 11 of 16 cases (68.8%), which included 8 cases in type II, 2 cases in type III and 1 case in type IV. The Hawkins sign was not observed in two cases with AVN. In contrast, only 2 of the 5 cases with a negative Hawkins sign developed AVN. According to Hawkins scoring system, 4 patients (25.0%) was in excellent, 7 patients (43.8%) in good, 4 patients (25.0%) in fair and 1 patient (6.3%) in poor. CONCLUSION: Incidence of AVN after operative treatment of fracture and dislocations of the talar neck was lower than that of previous reports. Hawkins sign had a high prognostic reliability, but absence of Hawkins' sign should not be considered a totally reliable indicator of development of avascular necrosis.
Dislocations ; Humans ; Incidence ; Neck ; Necrosis

PURPOSE: To evaluate the results of Acutrak-screw fixation without bone-graft for the treatment of stable scaphoid nonunion and to assess its prognostic factors. MATERIALS AND METHODS: Fifteen patients who underwent internal fixation using Acutrak-screw without bone graft for stable scaphoid nonunion were studied. Standard radiographs and CT were analyzed for degenerative changes (presence of cystic change and periscaphoid osteoarthritis), the nonunion site using fragment ratio and union. Clinically, patients age and the interval to surgery were evaluated. RESULTS: Mean follow-up duration was 31 months and 11 of 15 (73.3 percentages) cases healed at mean time of 12.8 weeks. Fragment ratio of nonunion site was 37.2 percentages in nonunion group and 54.2 percentages in union group (p=0.016). Presence of cystic change and periscaphoid osteoarthritis showed no singnificant statistical difference in both groups. Younger age lower than 20 years was closely related with bone union (p=0.001). But there were little correlation between bone union and interval to surgery. CONCLUSION: Internal fixation without bone graft showed 73.3 percentages of overall union rate in the treatment of stable scaphoid nonunion. And young patients who have distally located stable scaphoid nonunion can be successfully treated with internal fixation without bone graft.
Follow-Up Studies ; Humans ; Osteoarthritis ; Transplants