PURPOSE: To report transient corneal edema after phacoemulsification as a predictive factor for the development of pseudophakic cystoid macular edema (PCME). METHODS: A total of 150 eyes from 150 patients (59 men and 91 women; mean age, 68.0 ± 10.15 years) were analyzed using spectral domain optical coherence tomography 1 week and 5 weeks after routine phacoemulsification cataract surgery. Transient corneal edema detected 1 week after surgery was analyzed to reveal any significant relationship with the development of PCME 5 weeks after surgery. RESULTS: Transient corneal edema developed in 17 (11.3%) of 150 eyes 1 week after surgery. A history of diabetes mellitus was significantly associated with development of transient corneal edema (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.41 to 11.54; p = 0.011). Both diabetes mellitus and transient corneal edema were significantly associated with PCME development 5 weeks after surgery (OR, 4.58; 95% CI, 1.56 to 13.43; p = 0.007; and OR, 6.71; CI, 2.05 to 21.95; p = 0.003, respectively). In the 8 eyes with both diabetes mellitus and transient corneal edema, 4 (50%) developed PCME 5 weeks after surgery. CONCLUSIONS: Transient corneal edema detected 1 week after routine cataract surgery is a predictive factor for development of PCME. Close postoperative observation and intervention is recommended in patients with transient corneal edema.
Adult ; Aged ; Aged, 80 and over ; Cornea/*pathology ; Corneal Edema/*diagnosis/etiology ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Glucosinolates ; Humans ; Macular Edema/diagnosis/*etiology ; Male ; Middle Aged ; *Phacoemulsification ; Pseudophakia/*complications/diagnosis ; Retrospective Studies ; Tomography, Optical Coherence

BACKGROUND/AIMS: The eradication rate of the first-line triple therapy (a proton pump inhibitor, clarithromycin, and amoxicillin) for Helicobacter pylori infection has gradually decreased in Korea. We evaluated whether clinical parameters, clarithromycin resistance, and CYP2C19 genotype can affect the eradication failure. METHODS: A total of 203 patients with H. pylori-positive chronic gastritis were consecutively enrolled. They received clarithromycin-based triple therapy for 7 days. A clarithromycin resistance test was performed by detection of A2142G and A2143G point mutations in H. pylori 23S rRNA. The CYP2C19 genotype was examined for polymorphism G681A of exon 5 and G636A of exon 4 by polymerase chain reaction with restriction fragment length polymorphism. Eradication was assessed by a ¹³C-urea breath test 4 weeks after treatment. RESULTS: Of 203 patients, 190 completed the study. The eradication rate was 64.0% according to intention-to-treat analysis and 68.4% by per-protocol analysis. CYP2C19 genotypes were identified as follows: 75 poor metabolizers, 75 intermediate metabolizers, and 40 rapid metabolizers. Nonetheless, this polymorphism was not significantly associated with eradication failure (p = 0.682). Clarithromycin resistance was detected in 33/190 patients (17.4%), and their eradication rate was zero. Clarithromycin resistance (odds ratio [OR], 19.13; 95% confidence interval [CI], 9.35 to 35.09) and female gender (OR, 1.73; 95% CI, 1.15 to 4.25) were significantly associated with eradication failure. The other clinical parameters such as age, cigarette smoking, alcohol intake, the body mass index, hypertension, and diabetes were not significantly associated with eradication. CONCLUSIONS Clarithromycin resistance and female gender are factors affecting H. pylori eradication failure in patients with chronic gastritis.

This study was designed to examine how such factors as hemodialysis parameters, body mass index, renin and aldosterone concentrations, sympathetic nervous activity, and parathyroid hormone concentrations are associated with the control of hypertension in hemodialysis patients. Hemodialysis patients (n=114) were grouped into four categories. Group 1 had normal BP without antihypertensive medication. Group 2 needed one antihypertensive drug, Group 3 needed combination of two or three categories of antihypertensive drugs without minoxidil. Group 4 needed more than three categories of antihypertensive drugs including minoxidil. Parathyroid hormone, beta2-microglobulin, renin and aldosterone, epinephrine, norepinephrine, and hemodialysis parameters were measured. The fractional clearance of urea as Kt/V urea was significantly lower in Group 3 and Group 4 than in Group 2 (p<0.01). Concentrations of parathyroid hormone were significantly higher in Group 4 than the other groups (p<0.01). Pre-hemodialysis norepinephrine concentrations were significantly higher in Group 4 than the other groups (p<0.05). Traditional factors associated with hypertension did not seem to be relevant to the degree of hypertension in hemodialysis patients in the present study. In conclusion, poor Kt/V urea, elevated parathyroid hormone concentrations, and elevated concentrations of plasma norepinephrine seemed to be the factors that might be associated with control of hypertension in hemodialysis patients.
Adult ; Aged ; Aldosterone/*blood ; Analysis of Variance ; Antihypertensive Agents/therapeutic use ; Blood Pressure/drug effects/*physiology ; Epinephrine/blood ; Female ; Humans ; Hypertension/blood/drug therapy/physiopathology ; Kidney Failure, Chronic/blood/physiopathology/therapy ; Male ; Middle Aged ; Norepinephrine/blood ; Parathyroid Hormone/*blood ; *Renal Dialysis ; Renin/*blood ; Sympathetic Nervous System/*physiology ; Urea/metabolism

The presence of accessory scrotum is a condition characterized by additional scrotal tissue with a normally developed scrotum. The condition is extremely rare and can be associated with a perineal lipoma. Herein, a case of accessory scrotum associated with a perineal lipoma is reported in a 4-day-old boy. He presented with a perineal mass and the diagnosis was confirmed by surgical excision and subsequent histological analysis. This is the first Korean report of an accessory scrotum associated with perineal lipoma. (Korean J Urol 2007;48:1096-1098)
Diagnosis ; Humans ; Lipoma* ; Male ; Perineum ; Scrotum*

There has been only 23 cases of neonatal adrenal hemorrhage presenting as an acute scrotum and unnecessary surgical exploration was performed in nine of these case(39%) due to suspected testicular torsion. We report here on a case of a 2-day-old boy with neonatal adrenal hemorrhage, and he presented with an acute scrotum; this child's condition was managed conservatively.
Adrenal Glands ; Hemorrhage* ; Humans ; Infant, Newborn ; Male ; Scrotum* ; Spermatic Cord Torsion

Diseases of the peripheral nervous system are the most prevalent in patients with end-stage renal disease (ESRD). Although increased blood levels of lead in ESRD have been reported, the role of lead remains to be elucidated. The purpose of this study was to determine the connection of blood lead concentration with peripheral nerve conduction velocity. One hundred ninety-eight healthy subjects (control group) and 68 patients with ESRD undergoing hemodialysis (ESRD group) were enrolled. Nerve conduction was measured within two hours after hemodialysis. Orthodromic sensory nerve action potentials and compound muscle action potentials were recorded on the median, ulnar, and radial nerves. Hemoglobin-corrected blood lead was significantly higher in ESRD patients than in controls (9.1+/-2.8 microgram/dL vs. 5.9+/-2.3 microgram/dL, p<0.001). 32.4% of 68 ESRD patients with diabetes mellitus were significantly related to poorer motor and sensory nerve conduction velocity (p<0.001). However, blood lead was not a significant predictor of the nerve conduction velocity (p>0.05). Our result suggested that even though the blood lead levels were high in ESRD, they were not associated with the decline of peripheral nerve function. Diabetes mellitus is a primary independent risk of neuropathy in ESRD patients.
Peripheral Nervous System Diseases/blood/etiology/physiopathology ; Peripheral Nerves/physiopathology ; Neural Conduction/*physiology ; Middle Aged ; Male ; Lead/*blood/metabolism ; Kidney Failure, Chronic/*blood/complications/*physiopathology ; Humans ; Female ; Diabetic Neuropathies/blood/physiopathology ; Case-Control Studies ; Bone and Bones/metabolism ; Body Burden ; Adult

PURPOSE: The aim of this study was to investigate the effect of tape-tension on outcome of tension-free vaginal tape(TVT) procedure and voiding function. MATERIALS AND METHODS: We included 62 women patients with stress urinary incontinence. The patients were randomized into two groups and underwent the TVT procedure according to the standard method with some modifications. In group I(n=28), the position of the tape was adjusted with no tension by placing Mayo scissors between the tape and urethra and in group II(n=34), the tape was placed in the same fashion except that create 5mm-long tape loop under urethra for more loosening the tape-tension than that of group I. The success rate of TVT, the rate of postoperative voiding dysfunction and pre- and postoperative quality of life(QOL), peak urinary flow rate(Qmax), post-void residual(PVR) were compared between the two groups. RESULTS: There were no significant differences in success rate and improvement of QOL between the groups. In group I, Qmax was significantly decreased and the PVR was significantly increased after TVT compared with group II. The voiding dysfunction after TVT occurred in 3(10.7%) and 1(2.9%) in group I, II respectively, and there was no significant difference. CONCLUSIONS: These data suggest that some loosening of the tape-tension in TVT procedure has no effect on the success of TVT and improvement of QOL. By some loosening of the tape-tension, postoperative voiding function could be improved and this finding would be helpful especially in patients with preoperative risk factor for voiding dysfunction after TVT.
Female ; Humans ; Risk Factors ; Suburethral Slings* ; Surgical Mesh ; Urethra ; Urinary Incontinence ; Urinary Incontinence, Stress

Torsion of the testicular appendix is a common cause of acute scrotum, and occurs during the prepubertal years. However, despite its high incidence, appendix torsion in undescended testis has rarely been reported. Herein, a rare case of torsion of the testicular appendix in an undescended testis is reported in a 9-year-old boy
Appendix* ; Child ; Cryptorchidism* ; Humans ; Incidence ; Male ; Scrotum ; Testis

PURPOSE: The aim of this study was to investigate the relationship between erectile dysfunction (ED) and metabolic syndrome (MS) in a population-based cohort study, the Hallym Aging Study (HAS). MATERIALS AND METHODS: Among the 1,520 participants in HAS, 278 men aged more than 50 years, who underwent detailed health evaluations, including health-related questionnaires, evaluation of their medical history and various lifestyle factors, as well as clinical measurements, were included in the study. ED and MS were assessed by using a 5-item version of the International Index of Erectile Function (IIEF-5) and the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), respectively, and the relationship between ED and MS was investigated. RESULTS: Of the 278 men, 120 (43.2%) had MS. Ninety percent of men with MS and 78.5% of men without MS had ED (p<0.05), and chi-square analysis revealed significant differences in the rate of MS between groups when stratified by ED severity (p<0.001). The multivariate logistic regression analysis, with control for age and comorbidities, showed that men with MS were 3 times as likely to have ED as were men without MS. Among the metabolic risk factors, only waist circumference (WC) was significantly associated with the presence and severity of ED (p<0.05). CONCLUSIONS: The presence of MS was an independent risk factor for ED, and WC was the most significant metabolic risk factor predicting the risk of ED. These results highlight the clinical importance of evaluating ED in patients with MS, especially in patients with abnormal WC.
Adult ; Aged ; Aging ; Cholesterol ; Cohort Studies ; Comorbidity ; Erectile Dysfunction ; Humans ; Life Style ; Logistic Models ; Male ; Risk Factors ; Waist Circumference

We report on a patient with 477 bladder calculi secondary to benign prostatic hyperplasia. To our knowledge this patient had one of the highest numbers of the bladder calculi reported.
Humans ; Prostatic Hyperplasia* ; Urinary Bladder Calculi* ; Urinary Bladder*