No abstract available.
Humans ; Male* ; Prostatic Hyperplasia*

Hypertrophic cardiomyopathy has been a well-known genetical transmitted disease entity with the advance of echocardiography. We have recently experienced a family with hypertrophic cardiomyopathy proved by noninvasive methods including chest x-ray,, electrocardiography and echocardiography. The propositus of this family was a 21 year-old solier who was admitted because of exertional dyspnea during military exercise. Both he and his sister had severely affected hearts with typical echocardiographic findings, asymmetrical septal hypertrophy(ASH) and systolic anterior motion of the anterior mitral leaflet(SAM). The clinical study is reported with the concerned literatures.
Cardiomyopathy, Hypertrophic* ; Dyspnea ; Echocardiography ; Electrocardiography ; Heart ; Humans ; Military Personnel ; Siblings ; Thorax ; Young Adult

Although cerebrospinal fluid leakage is suggested as one of the causes of spontaneous intracranial hypotension, on]y a few cases with direct evidence of cerebrospinal fluid leakage on radionuclide cisternography have been reported in the literature Indirect evidences of cerebrospinal fluid leakage such as early visualization of the soft tissue and bladder or delayed migration of radiotracer have been observed in most patients with spontaneous intracranial hypotension. We report a case of spontaneous intracranial hypotension in which cerebrospinal fluid leakage was directly demonstrated by early dynamic imaging of spine on radionuclide cisternography. We suggest that early dynamic imaging of spine is an important adjunctive procedure in detecting cerebrospinal fluid leakage in patients with spontaneous intracranial hypotension.
Cerebrospinal Fluid* ; Humans ; Intracranial Hypotension* ; Spine ; Urinary Bladder

PURPOSE: Caliceal diverticular calculi are mostly asymptomatic. In certain cases they may be associated with chronic or recurrent pain, recurrent urinary tract infections, progressive renal damage and hematur ia. The treatment of symptomatic caliceal diverticular calculi has evolved from open surgery to less invasive procedures, such as extracorporeal shock wave lithotripsy (SWL), percutaneous techniques, retrograde ureteroscopy and laparoscopy, but it remains controversial. Percutaneous techniques are frequently used to address the diverticular stone burden, to fulgurate the diverticular wall, to dilated the diverticular neck and improve drainage. For this reason, we reviewed 33 patients with caliceal diverticular calculi to determine whether they could be treated successfully by percutaneous nephrolithotomy (PCNL) as the initial treatment. MATERIALS AND METHODS: A total of 33 patients with caliceal diverticular calculi underwent PCNL between February 1990 and February 2000. The majority of diverticula were located at the upper pole. Access was gained via a direct target puncture. After sequential dilatation of the tract, stones were removed and the diverticular wall was fulgurated. The diverticular neck was dilated with the Amplatz dilator upto 24-30 Fr. and a 20 Fr. nephrostomy catheter was placed. RESULTS: PCNL was performed successfully in 30 patients (90.9%), but puncture was failed in 3. Mean operative time was 105 minutes and mean hospital stay was 4.5 days. All patients who were treated successfully with PCNL became stone-free without any complication. Mean follow-up was 20 months (ranged from 1 to 108 months). Of the 26 patients with symptoms preoperatively, 25 patients were rendered symptom-free (96.2%). Twenty-four patients were assessed with an intravenous urogram at 1 or 3 months and 6, 12 months and there was no stone recurrence. The diverticula were obliterated or had improved drainage in 95.8% (23/24) of assessable cases. CONCLUSIONS: We confirmed that PCNL is a safe, less invasive and effective procedure and should be considered an acceptable form of primary management of patients with caliceal diverticular stone.
Calculi ; Catheters ; Dilatation ; Diverticulum ; Drainage ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lithotripsy ; Neck ; Nephrostomy, Percutaneous ; Operative Time ; Punctures ; Recurrence ; Shock ; Ureteroscopy ; Urinary Tract Infections

Intra-uterine fracture of normal bone is extremely rare. It was reported few cases in the other contries, but it was very rare in Korea. It is difficult to distinguish it from birth fracture and the other fractures or deformities seen at birth. The authors experienced a case of intra-uterine fracture of the femur in the middle third of the shaft, with abundant callus formation in infant without serious injury to the mother.
Bony Callus ; Congenital Abnormalities ; Femur ; Humans ; Infant ; Korea ; Mothers ; Parturition

No abstract available.
Balloon Valvuloplasty* ; Pulmonary Valve Stenosis* ; Pulmonary Valve*

No abstract available.
Scimitar Syndrome*

OBJECTIVE: To evaluate the pregnancy outcome, designate the predicting factor of neonatal thrombocytopenia, and reevaluate the treatment scheme of idiopathic thrombocytopenic purpura (ITP) in pregnancy. METHODS: Medical records of 83 patients(98 deliveries) who were diagnosed as having ITP and delivered at the Department of Obstetrics and Gynecology, Yonsei University College of Medicine from January 1990 to May 1999 were reviewed. For statistical analysis Chi-square test and Fisher's exact test were used. RESULTS: Among various maternal characteristics, inability to raise platelet counts more than 100,000/mm3 by any means of treatment, categorized as ""poor response to treatment"", could be designated as the predicting factor of neonatal thrombocytopenia (p<0.05). Pregnant women treated with prednisolone had significantly greater chance of having preterm delivery (p<0.001). The occurrence of postpartum anemia requiring transfusion was higher in the group undertaking cesarean section (p<0.05). Although a control group was missing, the pregnancy outcome was poor in the category of pregnancy induced hypertension(PIH) and preterm labor being 17.3% and 33.7%, respectively. CONCLUSION: The ITP patient should be carefully monitored during the antenatal care visits because of the increased incidence in adverse pregnancy outcome such as PIH and preterm labor. Neonatal thrombocytopenia could be predicted in the presence of inability to raise platelet counts to more than 100,000/mm3 by any means of treatment. Cesarean section should not be performed routinely under the indication of ITP due to the accompanynig morbidity and low incidence of bleeding sequalae in the neonate. The accompanying complications of prednisolone treatment raises questions and warnings about its usage, therefore a prospective study is warranted to evaluate the effect and complications of prednisolone treatment.
Anemia ; Cesarean Section ; Female ; Gynecology ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn ; Medical Records ; Mortuary Practice ; Obstetric Labor, Premature ; Obstetrics ; Platelet Count ; Postpartum Period ; Prednisolone ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women ; Purpura, Thrombocytopenic, Idiopathic ; Thrombocytopenia* ; Thrombocytopenia, Neonatal Alloimmune

No abstract available.
Evoked Potentials, Motor*

PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*