Extracorporeal shock wave lithotripsy(ESWL) is a newly accepted procedure for noninvasive treatment of urinary calculi. The clinical study was made in 109 patients(118 stones) with urinary stones who underwent ESWL. The results were as follows. 1. Among the 109 patients, 85 patients were male and 24 patients were female and age range of patients was from 18 years to 77 years with average 41.3 years. 2. In 118 stones, calyceal stones were 38 cases(32.2%), renal pelvis stones were 36 cases(30.5%), upper and lower ureter stones were 24 cases(20.3%) and 20 cases(17.0%), Staghorn calculi were 11 case(9.3%). 3. Stone free success rates depend on stone position and stone size. 4. Stones were completely fragmented in 95 cases(80,5%) and partially fragmented in 22 cases(18.6%). 5. Complications developed in 32 patients. There were colic pain in 26 cases, steinstrasse in 10 cases, fever in 6 cases, perirenal hematoma in 1 case and transient ileus in 1 case. 6. After ESWL, there were no significant changes in levels of alkaline phosphatase, amylase, GOT, GPT and creatinine except BUN. Levels of BUN were decreased significantly (p<0.05).
Alkaline Phosphatase ; Amylases ; Calculi ; Colic ; Creatinine ; Female ; Fever ; Hematoma ; Humans ; Ileus ; Kidney Pelvis ; Lithotripsy* ; Male ; Shock* ; Ureter ; Urinary Calculi*

Since 1984, 9 months regimen of chemotherapy have been adopted for the treatment of 22 patients (15 men and 7 women) suffering from genitourinary tuberculosis. Age range of patients was from 16 years to 68 years with average of 34.7 years. Urine culture for AFB were positive in 12 patients (54.6 %) and the other patients were diagnosed by radiologic, cystoscopic and histopathologic examinations In all 12 patients who had positive urine culture for AFB, urine has been sterilized within 3 months after treatment. The surgical managements with chemotherapy were performed in 9 patients. Toxic hepatitis due to drugs developed in 1 patient. The cost of chemotherapeutics spent in long term chemotherapy was 3 to 4 times higher than in short term chemotherapy. `There were no relapse bacteriologically during the follow up periods (3 to 22 months, average 10.4 months), but one patient has undergone ureteroneocystostomy due to UVJ stricture after completion of chemotherapy.
Constriction, Pathologic ; Drug Therapy* ; Drug-Induced Liver Injury ; Follow-Up Studies ; Humans ; Male ; Recurrence ; Tuberculosis*

A clinical observation was made on 92 patients of renal injury at the Department of Urology, Kyung Hee University during the period from January, 1980 to July, 1988. The results were as follows. 1. Among the 92 patients, 77 patients were male and 15 patients were female and most favorable age was 10 to 29 years for 41.3%. The most common injury was traffic accident for 39.1% and then fall down, assault, play and sport in order. 2. Associated injuries were seen in 34 patients, the most common injury was head injury. The most common clinical presentation was flank pain and tenderness for 92.4% and then hematuria, wound and bulging on flank, shock and abdominal pain in order. 3. Severity of renal injury was classified in 3 categories according to Scot's Classification. Among 92 patients, 50 patients were minor injury, major injury in 39 patients, pedicle injury in 3 patients. 4. Radiologic study was performed with excretory urography (86 cases), renal angiography (17 cases), RGP. (2 cases), abdominal sonography (7 cases) and abdominal C. T. was performed in recent years (12 cases). 5. All minor injuries were treated conservatively, pedicle injuries were nephrectomy, 21 patients of major injury were managed conservatively and 17 patients were managed operatively (14 cases: nephrectomy). 6. Among the 92 patients, complications were developed in 18 patients and then nephrectomy was performed in 5 patients.
Abdominal Pain ; Accidents, Traffic ; Angiography ; Classification ; Craniocerebral Trauma ; Female ; Flank Pain ; Hematuria ; Humans ; Male ; Nephrectomy ; Shock ; Sports ; Urography ; Urology ; Wounds and Injuries

We performed a retrospective review to evaluate the result of the management on primary vesicoureteral reflux in 36 children (59 refluxing ureters) during a 11-year period (1980 to 1990). Based upon the international classification, the vesicoureteral reflux was grade 1 in 6 cases (11.1 %). grade II in 14 (23.7 %), grade II in 13 (22.1 %), grade IV in 15 (25.4%) and grade V in 11 (18.6%) and designed to compare the risk or benefit of medical and surgical treatment as initial management for this. The group or primary medical management included with total 42 ureters and as the results of the management the reflux was completely disappeared in average 8.2 months at 22 ureters and 13 ureters were secondarily operated because of progressed reflux to recurrent urinary tract infection despite of appropriate medical treatment. The group of primary surgical management included with 3 ureters of grade III, 7 in grade IV, 7 of grade V, total 17 ureters and then 1 ureter of which was re-operated due to progressed reflux, but all reflux were cured. And we checked the 99m technetium-dimercapto-succinic acid renal scan to detect renal scars at pre-treatment in 33 ureters (22 patients) and post-treatment in 21 ureters (14 patients). As the results, the renal scars were detected in 17 ureters at pre-treatment patients. And during follow up, there were no changes of the renal scar at post-treatment in 18 ureters, but a new scar was developed in 3 ureters (grade II in I, grade IV in 2) even though having medical treatment. The radionuclide renal scan was highly sensitive to detect the scar, so should be performed.
Child* ; Cicatrix ; Classification ; Follow-Up Studies ; Humans ; Retrospective Studies ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

A new data management system for urologic patient was designed by composing revised discharge summary and a computer program. The revised .discharge summary consists of more detailed clinical records and maintenance of clinical records during the follow-up period post discharge. The computer program was written in FoxPro Version 2.0 and the urologic code system was developed by applying some modifications on the international classification of diseases. The present program takes major advantages in easy and errorless entry and retrieval of data. These include pull-down menus using simultaneous input and coding system without any needs of typing the required codes for problem, management, and diagnosis. Data search and case statistics can be easily obtained with any combinations of problem, management, and diagnosis. The authors consider the present system, in which the revised discharge summary and computer program were closely linked, is very useful in patient data management.
Clinical Coding ; Diagnosis ; Follow-Up Studies ; Humans ; International Classification of Diseases ; Urology*

Renal artery aneurysms, previously considered to be rare, have been diagnosed more frequently in recent years mainly due to extensive use of angiography. Most aneurysms are asymptomatic, found incidentally, and their presenting symptoms may include microscopic or gross hematuria, flank pain and renovascular hypertension. The diagnosis may be highly suggestive when rim like calcification is exist on KUB with symptoms, and renal angiography is needed to confirm diagnosis. The treatment may be conservative or operative according to size and site. Operative management may include nephrectomy, revascularization, and aneurysmectomy. We report a case of left renal artery aneurysm with incomplete ring-like calcification in a 52-year-old hypertensive woman. The selective renal angiography showed renal artery aneurysm arising from the bifurcation of left main renal artery Because of the risk of aneurysmal rupture through its weak portion with incomplete calcification and the possibility of the renovascular hypertension due to anastomotic stenosis after aneurysmectomy, we performed nephrectomy.
Aneurysm* ; Angiography ; Constriction, Pathologic ; Diagnosis ; Female ; Flank Pain ; Hematuria ; Humans ; Hypertension, Renovascular ; Kidney ; Middle Aged ; Nephrectomy ; Renal Artery* ; Rupture

No abstract available.
Collagen* ; Humans*

OBJECTIVES: The Mood Disorder Questionnaire (MDQ) has been validated as a diagnostic screening instrument for the detection of patients with bipolar disorder, but some patients with bipolar disorder obtain false negative screens. So we investigated demographic and clinical characteristics in false-negative MDQ in bipolar patients. METHODS: The participants were 60 DSM-IV bipolar outpatients in remission. All completed the Korean version of the Mood Disorder Questionnaire (K-MDQ) and the Korean version of the Beck Cognitive Insight Scale (K-BCIS) and were assessed by a trained clinician on the Young Mania Rating Scale, the Hamilton Depression Rating Scale and the Global Assessment of Functioning scale. The patients were categorized into two groups according to their K-MDQ score excluding further two questions (MDQ > or =7 : K-MDQ-positives and MDQ <7 : K-MDQ-negatives). Differences in demographic and clinical characteristics between these two groups were analyzed. RESULTS: There were no statistically significant differences between K-MDQ-positives and K-MDQ-negatives on the demographic and clinical variables, except on the K-BCIS where K-MDQ-negatives reported significantly lower scores on the K-BCIS composite index and self-reflectiveness subscale. CONCLUSION: These results suggest that lack of insight is a confounding factor in screening for bipolar disorder using the K-MDQ.
Bipolar Disorder ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening ; Mood Disorders ; Outpatients ; Surveys and Questionnaires

We had treated the 331 patients with lower ureter stone with EDAP-LT01 lithotriptor, Surveying 231 patients of them. whose retrospective study (or prospective) was possible, we have analyzed the factors that influenced on the treatment effect. So we got the following results. Most of stone size was ranged from 0.61 to 0.90 cm (38.6%). Stone clearance was achieved in 220 cases at 15 month and treatment failure was 11 cases (4.7%). Of the 220 patients, location of stone was more than 3.1 cm above ischial spine(IS) on KUB in 5 cases. Between 1.1-3.0 cm above it in 35 cases, +/-1. 0 cm of IS were 170 cases, and more than 1.1-3.0 cm below of it in 10 cases. There was no difference in the amount of total storage of shockwave in stone clearance according to location of stones, but high storage of shock wave required on cases of 3.1 cm above IS group. The 220 patients were grouped by in situ lower ureter stone at the time of the first visit to the hospital (158 cases), migration from upper stone (55 cases) and steinstrasse from upper tract stone (7 cases). The amount of shock wave consumption was 216.4, 301.2, 407.7 respectively, so initially lower ureter stone were treated with more effectiveness. Of the 220 cases, there were 184 cases of mild ureteral dilation, 34 cases of moderate ureteral dilation and 2 cases of severe ureteral dilation. The amount of shock wave consumption was 224, 295, 795 respectively. So treatment of these cases also showed significant difference (p=0.021). From these results, we concluded that effectiveness of ESWL against lower ureteral stone was related to the degree of ureteral dilatation, location of stone and situation of the stone migration within the ureter.
Dilatation ; Humans ; Retrospective Studies ; Shock ; Treatment Failure ; Ureter*

BACKGROUND: Community-acquired pneumonia (CAP) is more frequent in the elderly and results in higher morbidity and mortality. Korea is undergoing extraordinary demographic change. Elderly patients constitute an even-increasing proportion of the population but there have been few studies on the epidemiological investigation of the CAP in the elderly. The purpose of this study was to characterize the background, etiology, clinical course and outcome of CAP in elderly compared with younger patients. METHODS: During the study period (from 1st January to 31th December 1997), 214 patients with CAP were reviewed with regard to epidemiological, clinical, laboratory and microbiological data. 119 elderly patients (> or =65 years-old of age) were compared with 95 younger patients (<65 years-old of age). The both groups were compared with each others in terms of variables related to CAP. RESULTS: Comparison of epidemiological data between older and younger patients revealed a high prevalence of alcoholics (40% vs 56%), current smoker (33% vs 56%), malignancy (8% vs 24%) in the elderly. In terms of complication and clinical manifestation, shock (1% vs 6%), intubation (6% vs 20%), mechanical ventilation apply (5% vs 18%), respiratory failure (2% vs 12%), dyspnea (26% vs 56%), altered consciousness (0% vs 13%), extrapulmonary symptom (11% vs 18%) and bilateral infiltration (8% vs 20%) showed higher incidence in the elderly than in the younger patients. Causative organisms are identified in 47% (56/119) of elderly patients: those identified most frequently were S. pneumoniae (25%), K. pneumoniae (20%), S. aureus (16%), other Gram-negative bacilli (13%) and H. influenzae (11%). The overall mortality were significantly higher in the elderly patients (24%) than younger patients (5%). Two independent risk factors, those were related to the mortality of the elderly:higher APACHE II score (RR:3.43, 95% CI=1.43~7.21) and requirement of endotracheal tube (RR:4.73; 95% CI=1.72~16.5). CONCLUSION: CAP in the elderly shows more serious clinical and abnormal laboratory features than younger patients. In elderly, S. pneumoniae was the most common causative organism for CAP but other agents, particularly K. pneumoniae was isolated frequently. The severity of illness at initial presentation such as high APACHE II score and requirement of endotracheal tube were the major variables affecting the outcome.
Aged* ; Alcoholics ; APACHE ; Consciousness ; Dyspnea ; Humans ; Incidence ; Influenza, Human ; Intubation ; Korea ; Mortality ; Pneumonia* ; Prevalence ; Respiration, Artificial ; Respiratory Insufficiency ; Risk Factors ; Shock