BACKGROUND: Benzoic acid contained in some food can hinder the biological monitoring of hippuric acid in urine, which is frequently used as an exposure index of toluene and xylene. METHOD: 20 male examinees who are not exposed to organic solvents in their jobs were given a bottle of drink containing benzoic acid(70 mg/dl) and took it. Urine samples were taken from every person just before, in 1.5 hrs after, and in 3 hrs after taking the drink. Hippuric acid in urine was analyzed with improved Ogata and Taguchi method and creatinine with Jaffe method. RESULT: Mean hippuric acid concentrations in urine just before, in 1.5 hrs after, and in 3 hrs after taking the drink were 0.59+/-0.21 g/g creatinine, 2.75+/-0.98 g/g creatinine, 1.04+/-0.58 g/g creatinine, respectively. And, each group had statistically significant differences (p<0.01). There were no statistically significant differences between two groups categorized by age, smoking, and drinking. CONCLUSION: From the results, we suggest that when hippuric acid concentration in urine is used as a exposure index of toluene, it should be surveyed whether the food containing benzoic acid was taken or not.
Benzoic Acid* ; Creatinine ; Drinking ; Environmental Monitoring ; Humans ; Male ; Smoke ; Smoking ; Solvents ; Toluene ; Xylenes

PURPOSE: Extracorporeal shock wave lithotripsy(ESWL) has been established as the first line procedure of urinary stone treatment. We studied retrospectively to evaluate the effectiveness of ESWL. MATERIALS AND METHODS: ESWL was performed in 750 cases with Modulith SL-20 electromagnetic lithotriptor from January, 1994 to June, 1997 in our Department of Urology. RESULTS: Most patients were distributed between the fourth and sixth decades 72.5%), and male to female ratio was 1.47:1. There were 750 cases of urinary stones: 172 cases of renal stone(23.0%), 529 cases of ureteral stone(70.4%), 14 cases of renal and ureteral stone(1.9%), 35 cases(4.7%) of bladder stone, and range of size was 5mm-60mm in diameter The success rate according to stone location was 76.2% In renal stone, 98.1% in ureter stone, 84.3% in renal and ureteral stone, and 71.4% In bladder stone. The success rate according to stone size measured on the KUB and sonography was 98.0% in 5-10mm, 82.0% in 11-20mm, 46.4% in 21-30mm and 40.0% over 31mm. The average number of sessions was 2.8 sessions. Of 59 cases of staghorn calculi, 16 were treated without preoperative silicone ureteral stenting, while 43 were treated with preoperative silicone ureteral stunting. The complications were gross hematuria(69.6%), flank pain(13.4%), nausea & vomiting(8.4%), fever(1.9%), steinstrasse(1.2%), perirenal hematoma(0.7%) and uremia(0.1%). The failure rate was 8.8%. The causes of failure were large stone(2.67%), difficulty in eliminating lower caliceal stones(1.33%), bladder stone(1.33%), impact stone(1.07%), caliceal diverticulum(0.93%), infundibular stenosis(0.67%), steinstrasse(0.53%), ureterocele(0.13%), and patient's desire for operation(0.13%). CONCLUSIONS: ESWL is considered to be a safe and non-invasive treatment method. ESWL therapy is less effective for stones larger than 2cm(43.4%), staghorn calculi(52.5%) or the presence of anatomical obstructions.
Calculi ; Female ; Humans ; Lithotripsy* ; Magnets ; Male ; Nausea ; Retrospective Studies ; Shock* ; Silicones ; Stents ; Ureter ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Calculi* ; Urology

In the published version of this article, an error in the sponsor's identity was discovered in the acknowledgment section.

Xanthogranulomatous pyelonephritis is an uncommon form of chronic pyelonephritis occurring usually in middle-aged women. This disease is characterized by destruction of the renal parenchyma which is then replaced by granulomatous tissue containing lipid-laden macrophages (foam cells). But this disease is hard to diagnose preoperatively since it resembles renal abscess, renal cell carcinoma, renal tuberculosis and so forth. Xanthogranulomatous pyelonephritis in children is rare. We report a case in a 30 month-old boy.
Abscess ; Carcinoma, Renal Cell ; Child* ; Child, Preschool ; Female ; Humans ; Macrophages ; Male ; Pyelonephritis ; Pyelonephritis, Xanthogranulomatous* ; Tuberculosis, Renal

The treatment of choice for Cushing's disease is surgical removal of tumor, the source of ACTH overproduction. In occasional patients in whom a surgical approach including total adrenalectomy is not feasible or surgical removal of tumor is not complete, medical treatment may be necessary because pituitary irradiation requires a long 1ag time to remission. Although ketoconazole, an imidazole derivative with inhibitory activity on adrenal steroidogenesis has been reported to be effective in the treatment of Cushing's disease, the limited effectiveness in lowering very high level of cortisol and occasional hepatotoxicity restrains its wide use. In this report, we describe a woman with Cushing's disease due to pituitary microadenoma. Transsphenoidal pituitary adenomeetomy followed by ketoconzole treatment had been unsuccessful in achieving remission of the disease, but combined treatment with ketoconazole and octreotide accomplished successful reduction in cortisol production.
Adrenalectomy ; Adrenocorticotropic Hormone ; Female ; Humans ; Hydrocortisone ; Ketoconazole* ; Octreotide* ; Pituitary Irradiation

OBJECTIVE: The objective of this study is to compare the effectiveness and safety in the labor induction between the high dose oxytocin method and the new low dose oxytocin method. STUDY DESIGN: Firstly, we selected 125 pregnant women hospitalized, having the indication of labor induction from March, 1995 to August, 1996. Of them, we selected 61 pregnant women tothem the high dose oxytocin method was used, as the control group, and in- creased the quantity of 2.5 mU/min every 20 minutes with the start dose of 2.5 mU/min to them. On the other hand, with the start dose of 1.25 mU/min, we increased the quantity of 1.25 mU/min every 20 minutes to the study group of low dose oxytocin method, 64 pregnant women. RESULTS: No statistical significance was found in the time from the effective uterine contraction to the delivery in the study group, in contrast to that of the control group to them the labor induction was conducted by using the high dose oxytocin. Maximum amount used to the high dose oxytocin was significantly more than that of the low dose oxytacin, but in the total given dose, there was no significant difference between two groups. Maxi- mum uterine contraction of the control group did not show any significant. difference from that of the study group, and there was also no significant difference in the frequency of generating the complications such as fetal distress. CONCLUSION: There was no difference in the labor.induction -to delivery time, and the complications of fetus, between the existing high dose oxytocin method and the new low dose oxytocin method. Therefore it is thought the low dose oxytocin method may reduce the possibility of a complieation compared with the high dose oxytocin method. However, it is considered this matter must be investigated further in the futrre.
Female ; Fetal Distress ; Fetus ; Hand ; Humans ; Oxytocin* ; Pregnant Women ; Uterine Contraction

BACKGROUND: The percutaneous pleural needle biopsy have been regarded as cornerstone in the diagnosis of lymphocyte dominant pleural effusions of which acid fast bacilli smear and cytologic exam was negative. However, the complications of percutaneous pleural needle biopsy is not rare arid its diagnostic efficacy is not always satisfactory. Recently, pleural fluid adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) are widely accepted as markers of tuberculous pleurisy arid malignant pleural effusion respectively. We designed this study to re-evaluate the role of percutaneous pleural needle biopsy in the diagnosis of lymphocyte dominant exudative pleural effusions whose APE smear, cytologic exam was negative. METHODS: Retrospective analysis of 73 cases of percutaneous pleural needle biopsy in case of lymphocyte dominant exudative pleural effusions whose AFB smear and cytoloic exam was negative from Jan 1994 to Feb 1996 was done. RESULT: In 35 cases, specific diagnosis was obtained(all cases were tuberculous pleurisy), arid in 3(1 cases specific diagnosis was not obtained in spite of getting adequate pleural tissues, and in the other 8 cases, percutaneous pleural biopsy failed to get pleural tissues. In 9 cases, complications were combined including pneuomothorax and hemothorax. All 49 cases of pleural effusions whose ADA value was higher than 40IU/L and satisfying other categories were finally diagnosed as tuberculous pleurisy, however, the pleural biopsy confirmed only 28 cases as tuberculous pleurisy. In 6 cases of pleural effusions of which CEA value is higher than l0ng/ml, the pleural biopsy made specific diagnosis n no case. Final diagnosis of above 6 cases consisted of 4 malignant of fusions, I malignancy associated effusion and I tuberculous pleurisy. CONCLUSION: In the diagnosis of 73 cases of lymphocyte dominant pleural effusions of which acid fast bacilli smear and cytologic exam was negative, percutaneous pleural biopsy diagnosed only in 35 cases. In the diagnosis of tuberculous pleurisy, the positive predictive value of higher ADA than 40 IU/L in lymphocyte dominant pleural effusion with negative AFB smear and negative cytologic exam was l00%. And the diagnostic efficacy of pleural biopsy was 57%. In cases of effusions with high CEA than 10ng/ml 83% and 0% respectively. Finally, we concluded that percutaneous pleural needle biopsy in the diagnosis of APE smear negative and cytologic exam negative lymphocyte dominant exudative pleural effusion was not obligatory especially in effusions with high ADA and low CEA value.
Adenosine Deaminase ; Biopsy ; Biopsy, Needle* ; Carcinoembryonic Antigen ; Diagnosis* ; Hemothorax ; Hominidae ; Humans ; Lymphocytes* ; Needles* ; Pleural Effusion* ; Pleural Effusion, Malignant ; Retrospective Studies ; Tuberculosis, Pleural

No abstract available.
Pubic Bone* ; Technetium Tc 99m Medronate*

We present a case of metameric arteriovenous malformation (AVM) in a neonate. The neonate appeared normal, except for a dimple and blue discoloration in the lower thoracic spine. Spinal ultrasonography revealed cutaneomeningiospinalangiomatosis in the thoracic spine. Spinal magnetic resonance imaging revealed a definite metameric AVM at the T10-T11 level and a cutaneous hemangioma at T11. The neonate was conclusively diagnosed with spinal metameric AVM at the T10-T11 level. The neonate was asymptomatic with no, abnormal physical or neurological complications, including urinary incontinence, fecal incontinence, or muscle weakness.
Arteriovenous Malformations* ; Fecal Incontinence ; Hemangioma ; Humans ; Infant ; Infant, Newborn* ; Magnetic Resonance Imaging ; Muscle Weakness ; Spinal Cord* ; Spine ; Ultrasonography ; Urinary Incontinence

PURPOSE: To report a case of secondary glaucoma and sclerokeratitis after cosmetic eye whitening by regional conjunctivectomy with Mitomycin C application. CASE SUMMARY: A 69 year-old man was referred to our clinic for a left ocular pain and ocular hypertension sustained for 3 months after cosmetic eye whitening by regional conjunctivectomy with Mitomycin C application for chronic conjunctival hyperemia. On first examination, the scleromalacia and large conjunctival epithelium defect in the nasal quadrant of the limbus area and diffuse sclerokeratitis were observed. Conjunctival and episcleral vessel deficit were seen except superior 30% portion in the left eye. The anterior chamber depth in the left eye was very shallow compared to the right eye and cell reaction in the left anterior chamber was detected. Intraocular pressure (IOP) in the left eye was 28 mmHg after Cosopt(R) and 15% mannitol 500 ml use. Glaucomatous cupping was detected. During follow-up, left IOP increased over 40 mmHg despite the maximal medical treatment and the progression of visual field defects was detected, so then left phacoemulsification, Ahmed valve implantation and amnion membrane transplantation were done. After surgery, the conjunctival epithelial defect and sclerokeratitis were improved much and IOP was regulated 20~30 mmHg without medication. Digital massage was done 2 times per day for decreasing IOP and wound remodeling after 1 month. At 3 month after surgery, the conjunctival epithelial defect recurred and scleromalacia was also progressed, so then we performed autoconjunctival flap and amnion membrane transplantation in left eye. The conjunctival epithelial defect were recovered completely, IOP was regulated 24~36 mmHg without medication, and 20~24 mmHg with Cosopt.(R) The compliance of patient is very poor, further management may be needed for IOP control. CONCLUSIONS: Cosmetic eye whitening by regional conjunctivectomy with Mitomycin C application can cause serious complications such as scleromalcia and secondary glaucoma. This case shows that particular care should be taken in order to minimize these complications.
Amnion ; Anterior Chamber ; Compliance ; Cosmetics ; Epithelium ; Eye ; Follow-Up Studies ; Glaucoma ; Glycosaminoglycans ; Humans ; Hyperemia ; Intraocular Pressure ; Mannitol ; Massage ; Membranes ; Mitomycin ; Ocular Hypertension ; Phacoemulsification ; Transplants ; Visual Fields