PURPOSE: Extracorporeal shock wave lithotripsy (SWL) has been established as the treatment of choice for the urinary stones. But, for the treatment of staghorn calculi, the efficacy of this therapeutic procedure is controversal. We intended to study the therapeutic results and the usefulness of ureteral stent between 2 types of lithotriptor, EDAP LT-01 and Storz Modulith SLX. MATERIALS AND METHODS: Sixty cases were diagnosed as staghorn calculi from February 1990 to December 1998. Among them, 31 patients were treated with EDAP LT-01 SWL (group A) and 29 patients with Storz Modulith SLX SWL (group B). We inserted a double-J stent in 45 patients that consisted of 24 patients from group A and 21 patients from group B. The number of treatment sessions, complications and success rates were compared regarding each SWL and volume of the stone. RESULTS: The success rates of each SWL were 70.9% in group A and 75.9% in group B. The success rates, according to staghorn morphology, were 71.4% and 85.7% in partial staghorn of group A and B. The average shock wave sessions were 12.0 and 7.4 in partial staghorn of group A and B. The success rates, according to staghorn volume, were 67.8% and 88.9% in less than 60cm3 of group A and B. The average shock wave sessions were 12.6 and 9.6 in less than 60cm3 of group A and B. The findings were statistically significant between the two groups in less than 60cm3 or partial staghorn. After SWL, incidence of steinstrasse was 12.5% and 33.3% in the double-J stent inserted patients of group A and B. CONCLUSIONS: SWL could be a method of primary treatment for staghorn calculi. Storz Modulith SLX SWL was more effective than EDAP LT-01 SWL for staghorn calculi of which the volume was less than 60cm3. Placement of ureteral stents would be effective in the treatment of staghorn calculi by EDAP LT-01 SWL and not in Storz Modulith SLX.
Calculi* ; Humans ; Incidence ; Lithotripsy ; Shock ; Stents ; Ureter ; Urinary Calculi

No abstract available.
Breast* ; Child* ; Humans

BACKGROUND: In previous our retrospective study, we concluded that administered fluid volume, duration of operation, operative procedures and anesthetic techniques were the major factors of postoperative urinary retention. However, the administered fluid volume, age, types and duration of the operation confined to hemorrhoidectomy was questioned as a precipitating factor. The high retention rate in spinal anesthesia is also questioned. METHODS: We investigated these possible precipitating factors of urinary retention in healthy patients (n=154) undergoing hemorrhoidectomy. The patients were randomly divided into three different anesthetic techniques: caudal (2% lidocaine 300 mg with 1 : 200,000 epinephrine), spinal (0.5% tetracaine 5 mg with epinephrine 0.1 mg or 5% lidocaine 40 mg) and general (enflurane, N2O, vecuronium). Urinary retentin was searched according to above factors following surgery. RESULTS: The overall urinary retention rate was 46.1%. The retention rate in patients with spinal anesthesia was higher than that in those with other anesthetic techniques (p<0.05). There was no significant difference between patients with lidocaine and tetracaine spinal anesthesia in urinary retention rate. The administered fluid volume in patients with urinary retention was significantly higher than that of patients without retention (p<0.05). Age, duration and types of hemorrhoidectomy did not significantly affect urinary retention rate. CONCLUSIONS: Restriction of fluid administration and avoidance of spinal anesthesia are necessary in reducing postoperative urinary retention following hemorrhoidectomy.
Anesthesia, Spinal ; Epinephrine ; Hemorrhoidectomy* ; Humans ; Lidocaine ; Precipitating Factors ; Retrospective Studies ; Surgical Procedures, Operative ; Tetracaine ; Urinary Retention*

No abstract available.
Prostatic Hyperplasia* ; Transurethral Resection of Prostate*

We report a case of generalized plane xanthoma which showed no-rmolipoproteinemia and was not associated with unerlying disorders or other type of xanthomas. A 48-year-old female has noticed well defined, slightly elevated, yellowish plaques which occurred on the periorbital areas, sides of the neck, scapular areas, anterior chest, buttocks and lower extremities for 3 years. Biopsy specimen taken from the neck showed perivascular accumulations of foam cells in the upper and mid dermis. Paper electrophoresis didn't, show elevation of any lipoprotein.
Biopsy ; Buttocks ; Dermis ; Electrophoresis, Paper ; Female ; Foam Cells ; Humans ; Lipoproteins ; Lower Extremity ; Middle Aged ; Neck ; Thorax ; Xanthomatosis*

No abstract available.
Fournier Gangrene*

Enteral nutrition (EN) formulas are foods that are used to improve the nutritional status of patients and these foods' safety and quality must be ensured. Therefore, EN formulas in other countries are managed differently from that of general foods. We investigated the direction of development of the relevant laws regulations and guidelines pertaining to EN formulas and we compared these laws regulations and guidelines from different countries, including Korea. The United States and Europe manage EN formulas as foods, but they are managed differently compared to general foods because of separate laws or programs pertaining to EN foods. In addition, the use of the formulas does not necessarily require a prescription, but when used by prescription, then medical insurance covers them. In Japan, there are two types of EN formulas, food and drug, and there are differences for their management and insurance coverage. In the case of Korea, EN formulas are classified as food and drug, and different management and insurance are applied in each case, which inhibits their systematic management and industrial development. Integration of a management system and establishment of a legal foundation is necessary for the systematic management and development of EN formula in Korea.
Enteral Nutrition ; Europe ; Humans ; Industrial Development ; Insurance ; Insurance Coverage ; Japan ; Jurisprudence ; Korea ; Nutritional Status ; Prescriptions ; Social Control, Formal ; United States

A histopathological study was performed on nevus sebaceus to observe its aging effect based on 75 cases of neuvs sebaceus those were collected during the past 10 years from three university hospitals in Seoul. The results are as follows: 1) Clinical findings The incidence was most frequent in the teenage group. The 75 cases consisted of 41 males and 34 females with a sex ratio of 1.2:1. Most of cases developed in the head and neck areas with 62.7% on the scalp and 29.3% on the face. 2) Histopathologic findings. The epidermal changes such as acanthosis(40%), papillomatosis(73%), hypergranulosis(44%) were most remarkable in the second decade and gradually decreased with aging. The apparent proliferation of sebaceous gland was observed in 73% and it was most prominent in the second decade. Apocrine glands were absent before the first decade but apparently increased after then. Proliferation of eccrine gland was not significant in all the age groups. Mild increase of immature hair follicles were noted in 49% of our cases with gradually decreasing tendency in the older age. The dermal inflammatory infiltrates were noted from the 2nd decade(28%) and thereafter gradually increased. Associated neoplasms were one apocrine adenoma, one sebaceous adenoma, two trichilemmomas and two arteriovenous hemangiomas. The majority of tumors occured in the third decade. Therefore, it is observed that neuvs sebaceous undergoes dynamic histopathologic changes according to the age of patient and later develop various secondary neoplastic changes. The pathogenesis of the nevus sebaceus is suggested to be closely related with developmental anomalies of primitive hair germ units in fetal stage.
Adolescent ; Male ; Female ; Humans ; Incidence

We reviewed MR angiograms to evaluate its efficacy for visualizing the renal arteries and detecting renovascular disease. 41 renal arteries in 19 patients were examined by MR angiography. 3-D time-of-flight technique was used as routine examination method for MR angiography and 2-D time-of-flight technique was added in some particular cases to visualize venous flow. Within two weeks after MR angiography was performed, 23 renal arteries in 10 patients were additionally examined by conventional angiography or intraarterial DSA. The success rates of vessel visualization on MR angiography in normal renal arteries were 100% in main 67.7% in segmental, and 11.8% in intrarenal arteries. As a result of comparative study in normal main renal arteries with MR angiograms and conventional angiograms, overall correspondence in the number and the shape was noted and the caliber discrepancy between two examination did not exceed 3.0 mm. one arteriovenous fistula with aneurysm, one stenotic artery and two occluded arteries were well evaluated One arteriovenous fistula with aneurysm, and two occluded arteries were well evaluated by MR angiography. However three stenotic lesions were misdiagnosed as occlusions on MR angiography. and the overall accuracy was 87%. We conclude that MR angiography has the potential to be a noninvasive and useful screening method for determining the number of renal arteries and for detection of abnormalities of main renal arteries.
Aneurysm ; Angiography* ; Arteries ; Arteriovenous Fistula ; Humans ; Mass Screening ; Methods ; Renal Artery*

No abstract available.
Adult* ; Humans ; Tibia*