Thirty nine cases (38 patient) of acetabular fracture and fracture-dislocation were treated in our hospital during the period 1973 to 1977. The short summary of the observation were as follows; 1. Among 39 cases (24 were male and 15 female), the most common cause of acetabular fracture and fracture-dislocation was traffic accident. 2. The acetabular fractures and fracture-dislocations were treated by conservative measures in 25 cases and by open reduction in 14 cases. The results were as follows; excellent in 12(30%), good in 19(48%), fair in 5 (15%) and poor in 3 cases (7%). 3. Among 3 cases of poor results, secondary traumatic arthritis and limitation of motion were observed in two cases and aseptic necrosis of the femoral head, in one case. 4. The result of conservative treatment was satisfactory if the stability of the hip joint and the congruity of the superior weight bearing dome of the acetabulum was well preserved.
Accidents, Traffic ; Acetabulum ; Arthritis ; Head ; Hip Joint ; Humans ; Male ; Necrosis ; Weight-Bearing

Intracavernous self-injection therapy is now being widely used to treat patients with erectile dysfunction. Many men with erectile dysfunction can achieve normal erection with this therapy, but about 50% of men using this therapy eventually discontinue treatment for reasons relating to penile pain, needle-phobia and side effects including corporeal scarring, penile hematoma and priapism. Therefore, the less invasive route of drug administration is highly recommended. We investigated the efficacy and safety of transurethral instillation of PGE1 solution for the treatment of erectile dysfunction in comparison with an intracavernous injection of PGE1. Forty seven normal males and nine neurogenic impotent patients due to spinal cord injury (SCI) were enrolled in this study and all subjects were evaluated with the penile duplex color doppler ultrasonography before and after the drug administration. Penile length and circumference were measured before and after the drug administration. The erectile response was recorded on a five-point erection assessment scale by Padma-Nathan. Of 12 normal males used transurethral instillation of PGE1 solution 5 (42%) were achieved erection allowing sexual intercourse (score 4 or 5). The mean peak systolic velocity at 30 minutes was 75.82+/-56.84cm/sec, 63.11 +/- 48.11cm/sec and end diastolic velocity at 30 minutes was 3.49+/-8.10cm/sec, 10.51 +/- 1.12cm/sec and resistance index was 0.96+/-0.15, 0.78+/-0.15 in normal males and SCI patients respectively. Mean length and circumference of penile shaft before and after transurethral instillation of PGE1 showed significant difference. Of 9 patients, 5 (55.5%) were achieved erection allowing sexual intercourse. With the transurethral instillation of PGE1 solution, urethral pain and burning sense were noticeable complication but systemic side effect was not noticed. In conclusion, transurethral PGE1 instillation can be satisfactorily used for the patients with erectile dysfunction of less prominent organic and neurogenic origin, although the effect of transurethral instillation of PGE1 is obviously less than that of intracavernosal injection.
Alprostadil* ; Burns ; Cicatrix ; Coitus ; Erectile Dysfunction ; Hematoma ; Humans ; Male* ; Priapism ; Spinal Cord Injuries ; Ultrasonography, Doppler, Color

Renal cell carcinoma is an uncommon tumor in children and only 3-5 percent of the renal cell carcinoma occur under age of twenty. Interestingly, some of the patients had a history of trauma occurring shortly before the onset of symptom calling attention to the tumor. In histology of renal cell carcinoma, clear cell type is most common and papillary type is 10-15 percent. The papillary type of renal cell carcinoma is characterized by better prognosis than non-papillary types. We report a case of papillary type of renal cell carcinoma which was detected incidentally after trauma in 13-year-old male patient.
Adolescent ; Carcinoma, Renal Cell* ; Child* ; Humans ; Male ; Prognosis

Palliative endourologic treatment was done in 94 cases for ureteral obstruction secondary to advanced malignancy The average survival was 4.2 months. The obstruction were caused by metastases or invasion of cancer in all patients. First we tried to insert a double J stent(STENT), when it failed percutaneous nephrostomy(PCN) was performed. Initially 16 patients were treated by STENT and 8 patients by PCN. The SIENT was changed 2.2 times on the average in all patients. 75% of the patients who had been treated by STENT experienced only one or two times of STENT changes before dying. Patency period of the STENT was 57.6 days on the average. The patency period was shorter in the patients who showed gross hematuria at the time of STENT insertion. Although survival was not so long, 60.6% patients were able to return to their homes. The endourologic management of the upper urinary tract obstruction will play a more important role and offer a better quality of life for end stage cancer patients.
Hematuria ; Humans ; Neoplasm Metastasis ; Pregnenolone Carbonitrile ; Quality of Life ; Stents ; Ureteral Obstruction ; Urinary Tract*

The number of spinal injuries are now increasing with the high speed of automobile and industrial development. It is a general trend to treat the spinal injuries more actively in recent years, Among 135 spinal injury patients who were admitted to this hospital from August 1,1972 to August 31,1978, twenty six cases of spine fractures and fracture-dislocations who was treated with surgical measures were evaluated and analysed. Short summary of the followings observed is as follows: 1. Out of 26 patients, there were 22 male and 4 female cases. The ratio between male and female was 5.5:1. The majority (16 cases, 62%) was found in the age group of 20 to 40 years. 55.4% of the cases was caused by traffic accident. 2. The most common site of the lesion was cervical spine (9 cases, 35%) and the most common mechanism of injury was flexion and rotation (10 cases, 38%). 3. Our surgical measures were mainly the early anatomical reduction and anterior and posterior spinal fusion followed by external immobilization. 4. Among 26 cases, 34% had complete paralysis and 31%, incomplete paralysis. Complete or partial recovery was observed in 22% of the completely paralysed cases and in 87% of the imcompletely paralysed cases. 5. The initial recovery of spinal cord injury was observed from 1 to 25 days postoperatively (average 15 days).
Accidents, Traffic ; Automobiles ; Clinical Study ; Female ; Humans ; Immobilization ; Industrial Development ; Male ; Paralysis ; Spinal Cord Injuries ; Spinal Fusion ; Spinal Injuries ; Spine

As experience increases, it became apparent that Colles' fracture is not so simple in nature and therefore not easy to treat as might be generally conceived. Only anatomical reduction and maintenance of the reduced position assures good function of the wrist without pain. It is not easy to accomplish even in simple displaced Colies' fracture and it is particularly so in cases of comminuted displaced fractures with involvement of the wrist joint. We believe, therefore, that each case should be evaluated carefully and treatment should be individuallized employing best method available including open reduction. We have treated fifty-two cases of the Colles' fractures from Sep.1974 to Mar. 1978. The average duration of the follow-up was 5.5 months. The brief summary of the observations made in regard to treatment and prognosis are as follows: 1. Among 52 cases, simple extra-articular fracture were 27 and comminuted intra-articular fracture 25 cases. The most common age group of the former was between 40 and 69 and the latter between 30 and 49. 2. The most common cause of the comminuted fracture was falling down from a height, and that of simple fracture was slipping down. 3. All simple fractures were treated with closed method. Several measures of treatment were tried for the comminuted fractures, e.g., closed reduction (10 cases), percutaneous pinning (2), pin and plaster after traction (4) and skeletal traction (7). 4. Better result was obtained with more secure reduction technique, such as, pin and plaster immobilization after traction or skeletal traction even when the comminution of the fracture was severe. 5. Prognosis of the treatment for comminuted intra-articular fracture are unpredictable. The open reduction was considered not particulary beneficial way of treatment.
Accidental Falls ; Clinical Study ; Colles' Fracture ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Immobilization ; Intra-Articular Fractures ; Methods ; Prognosis ; Traction ; Wrist ; Wrist Joint

No abstract available.
Spine*

A study was undertaken during the past 2 years of patients who visited the infertility clinic of this hospital. The patients included those with male infertility, scrotal mass, scrotal pain or impotence. These patients were studied by means of reviewing the clinical applications of 'Scrotogram' and the following results were obtained. A total of 122 cases underwent a 'Scrotogram' study and among them 80 cases were diagnosed as varicocele, which included 14 cases( 18%) of subclinical varicocele which are difficult to be diagnosed by initial physical examination. There was statistical significance in the varicocele index between the control group and the Grade I varicocele group(p<0.01) and between the control group and subclinical varicocele group(p<0.01), and between the Grade I and Grade II group.(p<0.01), and between the Grade II and Grade II group(p<0.05). Among 66 clinical varicocele patients, 63 cases(80% ) were diagnosed by varicocele index, and 54 cases(82% ) were diagnosed by static image. A combination of the above two methods allowed 61 cases(92%) to be diagnosed. Among 48 patients who underwent high ligation of internal spermatic vein, 25 patients were subject to postoperative follow-up 'Scrotogram', which revealed 12 cases with excellent results, 8 cases with good results, and 5 cases with poor results. The average varicocele index before and after surgery was 1.78 and 1.24 and there were statistical significance(p<0.01). There was statistical significance, in sperm count and motility between the control group and clinical varicocele group(p <0.01) and between the control group and subclinical varicocele group(p <0.01). However, there appeared no statistical significance in semen character between the clinical varicocele and subclinical varicocele group. Among the 13 patients who were subject to postoperative follow-up semen analysis 11 patient showed improved results, and there was marked improvement in sperm count(p<0.05). There was slight improvement in sperm motility and morphology but showed no statistical significance. At present, 2 patients were impreged. Among 110 patients with infertility and olieoasthenoteratozoospermia, 22 were initially diagnose as varicocele by physical examination only, and 7 patients were diagnosed as subclinical varicocele after a 'Scrotogram' was taken. In conclusion, the 'Scrotogram' is able to identify varicocele objectively, and also identify subclinical varicocele which is an important contributing factor to male infertility. Also, this method of study is able to assess the postoperative result of varicocele accurately.
Erectile Dysfunction ; Follow-Up Studies ; Humans ; Infertility ; Infertility, Male ; Ligation ; Male ; Physical Examination ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Varicocele ; Veins

Most of bladder tumors are transitional cell type and leiomyoma of the urinary bladder is a rare, benign mesothelial tumor. The clinical importance of leiomyomas is usually slight, but patients have shown symptoms that reflect the tumor's size and location within the bladder. Herein, we present a case of leiomyoma of the bladder in a 62-year-old woman. IVP, ultrasonography and CT suggested bladder mass and cystoscopic finding demonstrated intraluminal protruding mass near bladder neck with intact mucosa. The tumor was removed bytransurethral resection and diagnosis was confirmed by histologic examination.
Diagnosis ; Female ; Humans ; Leiomyoma* ; Middle Aged ; Mucous Membrane ; Neck ; Ultrasonography ; Urinary Bladder Neoplasms ; Urinary Bladder*

No abstract available.
Herpes Zoster* ; Infertility*