The pulsed dye laser, emitting at wavelengths of 504nm. for 1 micro sec. at a frequency of 10 Hz. transmitted via a 200 micron in-diameter silicon-coated fiber, was send for fragmentation of urinary stones. The mechanism of stone fragmentation by laser is 'shock wave' formation by laser light ( photoacoustic effect). From Nov. 1988 to Apr. 1990, we performed 89 procedures in 86 patients for the removal of stones (80 procedures in 77 ureteral stones, 3 procedures in bladder stones and 6 procedures in urethral stones). Of the calculi 80 were fragmented to spontaneously passable or easily extractable fragments. There was no significant complications attributable to laser lithotripsy. And there was no significant differences in the fragmentation of stones according to the component. So, we think that laser lithotripsy is a safe and effective modality in management of the urinary stones including renal and upper ureter stones with some exceptions if deflecting ureterorenoscope is available.
Calculi ; Humans ; Lasers, Dye* ; Lithotripsy, Laser ; Ureter ; Urinary Bladder Calculi ; Urinary Calculi*

Hepatoid carcinoma is a rare type of malignant tumor resembling hepatocellular carcinoma that arises in extrahepatic sites.(stomach, lung, ovary, pancreas, bladder and renal pelvis). Hepatoid carcinoma of the ovary is an extremely rare ovarian tumor, first described by Ishikura and Scully in 1987. Histologically it is important to differentiate this entity from other oxyphil tumors of the ovary as it requires aggressive treatment. We have experienced a case of hepatoid carcinoma of the ovary in 69-year-old postmenopausal woman, who has been treated with operation and adjuvant Taxol - cisplatin chemotherapy. We present this case with brief review of literatures.
Aged ; Carcinoma, Hepatocellular ; Cisplatin ; Drug Therapy ; Female ; Humans ; Lung ; Ovary ; Paclitaxel ; Pancreas ; Pregnancy* ; Primary Ovarian Insufficiency* ; Urinary Bladder

No abstract available.
Cryptococcosis*

No abstract available.
HL-60 Cells* ; Humans

BACKGROUND: Since dysthymia begins in late childhood or adolescence and has a chronic course, long-term pharmacotherapy may be required. New generation antidepressant, moclobemide, with more acceptable side effect profiles, is effective in the treatment of dysthymia. The main objective of this study was to determine whether they exhibit comparable efficacy and tolerability in dysthymia to amitriptyline. METHOD AND MATERIALS: The efficacy and tolerability of the moclobemide and amitriptyline, were compared in a eight-week single-centre double-blind study in patients(n=37) with dysthymia using he HAMD-17, the Clinical Global Impression Scale(CGI), the Montgomery-Asberg Depression Rating Scale(MADRS), Efficacy Index-Therapeutic Index(EITE), 4-point Index Side Effect Scale(4-PISES), and Efficacy Index-Side Effect Scale(EISE). RESULTS: A total of 37 patients entered the study, 19 were randomly assigned to the moclobemide group and 18 to be amitriptyline group. Demographic and illness characteristics were similar in both groups. There were no significant difference between two groups at the total 17-HDRS score, the HAMD-17% improvement, the total MADRS score, CGI response, and the EITE. In the comparison of EISE between two groups, the scores of the moclobemide group were relatively lower than the amitriptylinen group in full treatment. And the differences were significant(moclobemide group 1.39+/-0.61 ; amitriptyline group 2.00+/-0.85, p<.001). At the 4-PISE. There was no serious or treatment threatening side effects. And there was no specific difference in side effects between two groups. The moclobemide group reported higher EIR scores than the amitriptyline group at every follow up day, but the differences were not significant. And there was no significant differences in the scores of five HRQOL subcategories which is compared between two groups at every follow up days. CONCLUSIONS: In terms of 17-HDRS and MADRS, moclobemide and amitriptyline are equally effective at least in allevating dysthymic symptoms. But moclobemide tended to be less troubling and better tolerated than amitriptyline. Therefore, moclobemide treatment can be used as a safe, and higher satisfactory treatment strategy for the dysthymia.
Adolescent ; Amitriptyline* ; Depression ; Double-Blind Method ; Drug Therapy ; Dysthymic Disorder* ; Follow-Up Studies ; Humans ; Moclobemide*

Elevation of aspartate aminotransferase (AST), alanine aminotransferase(ALT),and bilirubin levels was noted incidentally in patients who received laparoscopic cholecystectomy(LC). This study was attempted to investigate the elevation of liver enzymes and bilirubin levels after LC and its clinical significance. Twenty patients who showed normal levels of preoperative liver function test were entered into this study, and blood was collected at 24hours, 72hours and 7days after operation for measurement of AST, ALT, alkaline phosphatase(ALP), and bilirubin levels. In AST, a mean 2.76-fold postoperative increase was observed in 18 patients(90%) and 12 patients(60%) showed an elevation rise above normal limits. In ALT, a mean 2.14-fold postoperative increase was observed in 16 patients(80%) and 10 patients(50%) showed an elevation rise above normal limits. A mean 1.42-fold and a mean 2.12-fold increase were observed in total and direct bilirubin level respectively and elevation above normal limits occured in 7 patients(35%) and 4 patients (20%) respectively. The patients with an elevation of AST, ALT and bilirubin levels did not show any related clinical problem, and the elevations were transitory and returned to normal value within several days without any specific treatment.. Although the exact causes of these elevations need further investigation, theys appear to have no obvious clinical significance.
Alanine ; Aspartate Aminotransferases ; Bilirubin* ; Cholecystectomy, Laparoscopic* ; Humans ; Liver Function Tests ; Liver* ; Reference Values

Tuberous sclerosis is a complex neurocutaneous disease in which facial angiofibroma, mental retardation, seizures, renal tumor and phakoma of the retina are particularly frequent, in which renal tumors are usually angiomyolipomas and they are usually small, bilateral and not combined with symptom. We report a case of bilateral renal angiomyolipomas in association with facial angiofibroma, which resulted in spontaneous rupture and massive retroperitoneal hemorrhage.
Angiofibroma ; Angiomyolipoma* ; Hemorrhage ; Intellectual Disability ; Kidney ; Retina ; Rupture, Spontaneous ; Seizures ; Tuberous Sclerosis*

PURPOSE: To evaluate the relationship between urethral hypermobility and Valsalva leak point pressure (VLPP), subjective symptom degree in women with stress urinary incontinence. MATERIALS AND METHODS: 229 patients who were diagnosed as stress urinary incontinence and had undergone all of standing cystourethrogaphy, urodynamic study including VLPP, and recording questionnaire of incontinence were included in this study. The subjective degree of stress urinary incontinence was graded to 3 grades by Stamey classification, and urethral mobility more than 2.0 cm on standing cystourethrography was determined as the urethral hypermobility. And patients were stratified 3 groups according to the VLPP of less than 60, 60 to 90 and greater than 90 cmH2O. Correlation between urethral hypermobility and VLPP, subjective symptom degree were evaluated. RESULTS: According to the VLPP of less than 60, 60 to 90 and greater than 90 cmH2O, urethral hypermobility was noted in 49.4%, 86.6%, 92.4%, respectively. The rate of urethral hypermobility increased according to VLPP does with statistical significance (p<0.05). And in subjective symptom grade I, II, III urethral hypermobility was noted in 75.0%, 79.7%, 61.0%, respectively. There was not significant correlation between urethral hypermobility and subjective symptom degree (p=0.15). CONCLUSION: Our results suggest that there is significant correlation between urethral hypermobility and VLPP. And in some of patients with stress urinary incontinence urethral hypermobility and intrinsic sphincter deficiency are coexist. However, we suggest that the preoperative evaluation for urethral hypermobility and intrinsic sphincter deficiency is needed to assess the surgical outcome more exactly in the patients with stress urinary incontinence.
Classification ; Female ; Humans ; Surveys and Questionnaires ; Urinary Incontinence ; Urodynamics

BACKGROUND: There are few recent studies on transfusion practice and blood use with regard to diagnoses of Korean recipients. We conducted a survey of blood component use in Yonsei University Medical Center in Seoul, Korea. METHODS: A survey was carried out on blood component transfusion from January 2000 to June 2000. Transfused components were listed by broad diagnostic categories formed from the principal diagnoses of the recipients according to the ICD-10. RESULTS: Of all investigated components (67,433 units), 18,623 units of RBCs (27.6%), 10,203 units of FFP (15.1%), 38,547 units of platelets (57.2%), and 60 units of whole blood (0.1%) were transfused. The transfusion rate in relation to sex was 1.7:1 and the majority of all blood units were transfused to patients aged <65 yrs (85.9%). The rate of blood component transfusion was the highest in the department of internal medicine (47,451 units, 70.4%). Of 18,623 RBCs units and 10,203 FFP units, 70.8% and 74.5% were transfused to patients in four diagnostic categories; neoplasms, digestive system diseases, circulatory system diseases, and leukemia or lymphoma. Of 38,547 platelets units, 87.8% were used in patients with neoplasms, leukemia or lymphoma, digestive system diseases and diseases of the blood and blood-forming organs. CONCLUSIONS: This survey provides information on the blood component usage in tertiary-care teaching hospital in Seoul, Korea. It demonstrates the concentration of today's blood utilization among a few diagnostic categories. This information is relevant for quality management of transfusion practice, cost analyses and for planning local and regional blood donation programs.
Academic Medical Centers ; Blood Component Transfusion ; Blood Donors ; Classification* ; Costs and Cost Analysis ; Diagnosis ; Digestive System Diseases ; Digestive System Neoplasms ; Hospitals, Teaching ; Humans ; Internal Medicine ; International Classification of Diseases ; Korea ; Leukemia ; Lymphoma ; Seoul

Although severe hemolytic diseases of the newborn triggered by anti-M are very rare, anti-M alloantibodies have been known to be associated with a cause of multipie intrauterine death. Serological and hematological investigations have been reported on a woman who experienced four multiple intrauterine deaths due to anti-M. The mothers blood type was of group A, NN and the husbands cells were of group B, MN. In the serological examination at 9th week's gestation of the fifth pregnancy, anti-M antibodies were identified in her serum. The antibodies comprised IgM saline agglutinin at a titer of 16 at 4 degrees C and IgG agglutinin reacted in an indirect antiglobulin technique at a titer of 4 at 37 degrees C. She underwent high-dose immunoglobulin infusion therapy on a monthly program from 3rd month gestation and a total of 6 times of intravenous immunoglobulin was given. The anti-M titer did not rise during the pregnancy. She delivered a live girl by cesarean section at the 37th week because of a failure of induction. The childs blood type was of group O, MN. The child was discharged and developed normally.
Antibodies ; Cesarean Section ; Child ; Female ; Humans ; Immunization, Passive* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Infant, Newborn ; Isoantibodies ; Mothers ; Pregnancy* ; Spouses