PURPOSE: We studied penile size of children who underwent hypospadias repair. Also we surveyed the degree of satisfaction with, as judged by patient's parents and urologist. MATERIALS AND METHODS: We measured the relaxed and erected penile size of children who underwent hypospadias repair and followed more than one year (28 cases of one stage repair and 20 cases of two stage repair). All of them had no complication. We used age adjusted ANOVA test for penile size, and Wilcoxon matched pairs signed rank test for comparison of satisfaction with penile appearance between one stage group and two stage group. RESULTS: Significant difference was noted between one stage group and two stage group for relaxed and erected penile length (p<0.05), but penile circumference was not (p>0.05). Two stage group showed statistically significant larger value than one stage group for glandular size, glandular shape, position of meatus, general appearance, and genital perception score as judged by patient's parents (p<0.05). And two stage group showed statistically larger value than one stage group for genital perception score judged by urologist (p<0.05). CONCLUSIONS: Our study demonstrated that two stage operation met with better penile size and satisfaction judged by patient's parents and urologist than one stage operation for middle and posterior penile hypospadias.
Child ; Female ; Humans ; Hypospadias* ; Male ; Parents

Inflammatory pseudotumor of urinary bladder is a rare benign entity that clinically and radiologically simulates a malignant tumor. This benign lesion can easily be mistaken for sarcoma, and only careful pathologic examination can provide a definite diagnosis. It is important to recognize this lesion as benign to avoid the potentially serious consequences of misdiagnosis. A 53-year-old man presented with a history of micturition pain and urinary frequency despite of symptomatic treatment with antibiotics for 2 weeks. Cystoscopic examination, ultrasonography and of revealed a well defined mass with central necrosis. The mass was located at the left lateral wall of the bladder, and it was 3x3 cm sized round shape. We suspected benign tumor by above diagnostic modalities and we confirmed inflammatory pseudotumor by frozen section of mass, followed by partial cystectomy was performed. Awareness of this unusual lesion is important to prevent unnecessary surgical procedure. We report a case of inflammatory pseudotumor of the urinary bladder and reviewed 21 cases of this disease including our case.
Anti-Bacterial Agents ; Cystectomy ; Diagnosis ; Diagnostic Errors ; Frozen Sections ; Granuloma, Plasma Cell* ; Humans ; Middle Aged ; Necrosis ; Sarcoma ; Ultrasonography ; Urinary Bladder* ; Urination

Recently, compensatory impotence has increased with the development of industry, the rise in vehicles, the sexual revolution, the secured legal and insurance services. Compensatory impotence is a medicolegal term for the male erectile dysfunction that requires a doctor's medical certificate and opinion are regarding legal responsibility, reparation or compensation rather than primary medical care of the diagnosis and treatment by the patient or his procurator. We studied 69 cases of compensatory impotence (mean age 38.1, range 24-58) at the Department of Urology, Pusan National University Hospital from January 1987 to December 1995. The marital status were married, separated, single and divorced in 37 (53.6%),14 (20.3%), 13 (18.8%) and 5 (7.3%) cases, respectively. Opinions as to cause of impotence were sought from medical documents of university hospital 34 (49.3%), legal documents required from the court 25 (36.2%) and industrial accident insurance documents 10 (14.5%). Trauma constituted 47 cases (68.1%) while 22 (31.9%) had no history of trauma. With trauma, spinal cord injury was the most common cause of impotence in 18 cases (38.3%), followed by urethral injury in 14 (29.8%), and penoscrotal injury, head trauma, pelvic bone fracture, electrical bum and bladder rupture in 5 (10.6%), 4 (8.5%), 3 (6.4%), 2 (4.3%), and 1 (2.1%), respectively. Organic impotence is predominant cause in trauma group and psychogenic is highest in nontrauma group. Of 34 cases who the impotence therapy was recommended, 14 (41.2%) were accepted. In conclusion, for the evaluation and management of the compensatory impotence with complex issue of legal, financial and social aspects, physician's objective mental attitude and the accurate medical survey with the legal comprehensions are primarily important. Additionally, common criteria for compensation should be established by the cooperative expertise of experts in the fields of medicine, law and insurance.
Accidents, Occupational ; Busan ; Compensation and Redress ; Craniocerebral Trauma ; Diagnosis ; Divorce ; Erectile Dysfunction* ; Humans ; Insurance ; Jurisprudence ; Male ; Marital Status ; Pelvic Bones ; Rupture ; Spinal Cord Injuries ; Urinary Bladder ; Urology

PURPOSE: Allelic loss on chromosome 18q is a hallmark of presence of a tummor represser gene. Recently, DPC4 (deleted in pancreatic carcinoma, locus 4), a candidate tumor suppressor gene, has been localized at 18q21. Inactivation of DPC4 gene was reported in pancreatic carcinomas, coloretal carcinomas, and prostatic carcinomas. The aim of the present study was to determine if it might be altered in stomach cancer. MATERIALS AND METHODS: We tested for DPC4 gene mutations and allelic status at 18q21 using a modified 'cold SSCP' method in 48 primary gastric carcinoma and correlated the findings with various clinicopathologic characteristics of the patients. RESULTS: The frequency of mutations in primary gastric cancer was 27.1% (13/48). Mutations of exon 1, 8, 10 were found in 2 (4.1%), 4 (8.2%) and 7 cases (14.6%), respectively. DNA sequencing of 13 cases with DPC4 mutations identified six cases (46.1%) with substitution, four cases with deletion (30.7%), and two cases (23.1%) with insertion. No significant difference was observed in the frequency of DPC4 mutations in terms of other various clinicopathologic characteristics. CONCLUSION: These findings suggest that DPC4 mutations may play a significant role in the establishment and progression of the primary gastric cancer.
Exons ; Genes, Tumor Suppressor ; Humans* ; Loss of Heterozygosity ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Stomach Neoplasms* ; Stomach*

The congenital patent urachus is the failure of complete urachal lumen closure and results in a free communication between the bladder and the umbilicus. Embriologically the urachus represents the vestigial remnant of the allantois which, in the fetus, communicates with the cloaca. The first patient is a 6-day-old female infant, and she was transferred due to urine leakage from the reddish hen egg sized protruding mass on the umbilicus. The fistulogram showed a long fistulous tract which communicates with bladder and umbilicus. A complete resection of the patent urachus was done. The second patient is a 1-day-old male infant, and he was transferred for operation of omphalocele from local clinic. Urine leakage was detected from the urachus at operative field, and so complete resection of the urachus was performed, and the one stage repair was performed for treatment of mild intestinal herniation. Postoperative courses of the two cases were uneventful.
Allantois ; Cloaca ; Female ; Fetus ; Hernia, Umbilical ; Humans ; Infant ; Male ; Ovum ; Umbilicus ; Urachus* ; Urinary Bladder

Voiding functions in patients with non-neoplastic and non-traumatic myelopathy take a variable course according to severity and duration of disease. Fifteen patients of non-neoplastic and non-traumatic myelopathy were investigated neurologically thoroughly. On M.R.I. findings, hyperintense lesion was notified in a half of them but the others were nonspecific. On Pressure-Flow-EMG studies there were 7 cases of detrusor hyperreflexia with DSD, 2 cases of detrusor hyporeflexia with nonrelaxing striated muscle, 1 cases of detrusor hyporeflexia with coordinated striated muscle and 3 cases of normal findings. The thorough examination including M.R.I. and urodynamic study will be needed in patient with non-neoplastic and non-traumatic myelopathy because future possibility of their serious complications such as deterioration of renal function or impotence.
Erectile Dysfunction ; Humans ; Male ; Muscle, Striated ; Reflex, Abnormal ; Spinal Cord Diseases* ; Urodynamics*

BACKGROUND AND OBJECTIVES: Stroke onset is known to vary by several factors. Although it has been known that stroke may develop most frequently in the morning, its association with the type of activity has quite rarely been described. METHODS: We prospectively investigated by interview the time of and the activity during or before the onset of stroke in patients with acute cerebral infarction from Aug. 1995 to Mar. 1996. The activities were subdivided into basal metabolic rate state, sedentary, light, moderate, and heavy movements based on the caloric expenditure. RESULTS: One hundred-twenty five patients were enrolled. The time of day when ischemic stroke most frequently occurred was from 8:00 AM to noon. The type of activity was significantly associated with stroke onset in that it developed most commonly during and just after sleep or resting. The relationship between the onset of stroke and such patterns of onset time and the activity was found only in the atherothrombotic infarction, but not in the other stroke types. CONCLUSION: We demonstrated that stroke has clear diurnal variation. Our observations also suggested that the activity may be significantly associated with stroke onset. These findings may be useful for better understanding of the pathogenesis and prevention of ischemic stroke.
Basal Metabolism ; Cerebral Infarction* ; Health Expenditures ; Humans ; Infarction ; Prospective Studies ; Stroke

Background: The purpose of this study was to investigate the anti-oral microbial activity and anti-inflammatory effects of rosmarinic acid (RA) in lipopolysaccharide (LPS)-stimulated MC3T3-E1 osteoblastic cells on a titanium (Ti) surface during osseointegration, and to confirm the possibility of using RA as a safe natural substance for the control of peri-implantitis (PI) in Ti-based dental implants. Methods: A disk diffusion test was conducted to confirm the antimicrobial activity of RA against oral microorganisms. In order to confirm the anti-inflammatory effects of RA, inflammatory conditions were induced with 100 ng/ml of LPS in MC3T3-E1 osteoblastic cells on the Ti surface treated with or without 14 mg/ml of RA. The production of nitric oxide (NO) and prostaglandin E2 (PGE2) in LPS-stimulated MC3T3-E1 osteoblastic cells on the Ti surface was confirmed using an NO assay kit and PGE2 enzyme-linked immunosorbent assay kit. Reverse transcription polymerase chain reaction and western blot analysis were performed to confirm the expression of interleukin (IL)-1β and tumor necrosis factor (TNF)-α in total RNA and protein. Results: RA showed weak antimicrobial effects against Streptococcus mutans and Escherichia coli, but no antimicrobial activity against the bacteria Aggregatibacter actinomycetemcomitans and the fungus Candida albicans. RA reduced the production of pro-inflammatory mediators, NO and PGE2, and proinflammatory cytokines, TNF-α and IL-1β, in LPS-stimulated MC3T3-E1 osteoblastic cells on the Ti surface at the protein and mRNA levels. Conclusion RA not only has anti-oral microbial activity, but also anti-inflammatory effects in LPS-stimulated MC3T3-E1 osteoblasts on the Ti surface, therefore, it can be used as a safe functional substance derived from plants for the prevention and control of PI for successful Ti-based implants.

Background: The purpose of this study was to investigate the effects of commercially available calamansi soju and other alcoholic beverages on the microhardness and erosion of resin restorations. Methods: In this study, we evaluated the effects of Calamansi soju, Chamisul fresh, Cass fresh, and Gancia Moscato D’asti on resin restorations. Jeju Samdasoo and Coca-Cola were used as negative and positive controls, respectively. Specimens to be immersed in the beverages were manufactured using composite resin according to the product instructions. In each group, the surface microhardness was measured using a surface microhardness instrument before and after immersion for 5, 15, 30, and 60 minutes. The pattern of change in the surface of the composite resin was observed under a scanning electron microscope (SEM). Paired t-tests, one-way ANOVA, and repeated measures ANOVA were performed to compare the surface microhardness of the specimens, and the Tukey test was used as a post hoc test. Results: The pH of all beverages except Jeju Samdasoo was ＜5.5, which is the critical pH that can induce erosion. The difference in surface microhardness of the composite resin before and after immersion for 60 minutes was significant in all groups. In particular, the largest change in surface microhardness was observed in the calamansi soju group. In the SEM analysis, loss of composite resin was observed in all groups except the Jeju Samdasoo group, and rough surfaces with pores of various sizes were observed. Conclusion In this study, all beverages except Jeju Samdasoo decreased the microhardness of the composite resin surface, and it was confirmed that calamansi soju had the greatest change.

BACKGROUND/AIMS: Serum HBV DNA levels are correlated with hepatic histologic activity in chronic HBV infection based on HBeAg. Liver injury may persist, even though HBV DNA are not detected by hybridization assay. This study was to investigate whether serum HBV DNA levels determined by more sensitive quantitative method are correlated with histologic activities in chronic HBV infections. METHODS: This study included 66 chronic HBV infected patients. HBV DNA level was quantified by Cobas Amplicor HBV Monitor(TM). RESULTS: Serum HBV DNA levels in HBeAg-positive patients were significantly higher than HBeAg-negative patients. In HBeAg-positive patients, serum HBV DNA levels showed a significant negative correlation with portal-periportal activity and fibrosis (r=-0.451, -0.446 respectively). AST levels were correlated with lobular, portal-periportal activity and fibrosis (r=0.432, 0.365, 0.301 respectively), whereas ALT levels were related to lobular activity (r=0.294). Elevated AST levels predicted lobular activity, portal-periportal activity, and fibrosis with moderate to severe degree (OR 1.733, 95% CI 1.083-2.775; OR 1.518, 95% 1.028-2.243, p=0.336; OR 17.897, 95% CI 1.517-211.208, p=0.022, respectively). CONCLUSIONS: In HBeAg-positive patients, serum HBV DNA level correlates inversely with histologic activity. On the other hands AST level correlates with histologic activity and the stage of moderate or severe degree.
Adolescent ; Adult ; Child ; Child, Preschool ; DNA, Viral/*blood ; Female ; Hepatitis B e Antigens/analysis ; Hepatitis B virus/genetics/*isolation & purification ; Hepatitis B, Chronic/pathology/*virology ; Humans ; Liver/*pathology ; Male ; Middle Aged