Advances in gray scale ultrasonography have increased the usefulness of their modality in the clinical diagnostic method. Major improvements in the image resolution have greatly increased the diagnostic value of renal ultrasonography. The non-invasive and safe nature of ultrasound makes this technique ideal for accurate and quick evaluation. It has been well known facts that it is very difficult to obtain precise size, shape parenchymal thickness of the kidneys by conventional radiological techniques such as retrograde pyelography, antegrade percutaneous pyelography or arteriography and also the techniques are invasive to patients comparatively. Because of its simplicity, innocuousness and accurateness, diagnostic ultrasound is quite useful in the evaluation of functionally inactive kidney and should precede or be substitute for other aggressive technique. In those kidneys which remain unseen even after massive dose of dye, the ultrasound scan should be used before retrograde ureteral catheterization is undertaken. The author measured the size of kidney longitudinally, transversely and in thickness by ultrasonogram and compared with that of excretory urogram in 60 normal healthy persons and 32 cases of hydronephrosis. The results were obtained as follows: 1. The length of right kidney on ultrasonogram (11.4+/-0.55 cm) was smaller than on excretory urogram (12.2+/-0.45 cm) and the difference was 0.8 cm (t value: 2.21, p<0.02), and the length of left kidney on ultrasonogram (11.9+/-0.42 cm) was smaller than on excretory urogram (12.6+/-0.78 cm) and the difference was 0.7 cm (t value: 2.43. p<0.02). The width of right kidney on ultrasonogram (5.4+/-0.57 cm) was smaller than on excretory urogram (6.3+/-0.61 cm) and the difference was 0.9 cm (t value: 1.75, p<0.1) and the width of left kidney on ultrasonogram (5.6+/-0.58 cm) was smaller than on excretory urogram (6.3+/-0.49 cm) and the difference was 0.7 cm (t value: 1.82, p<0.1). The parenchymal depth of right kidney on ultrasonogram (2.2+/-0.48 cm) was larger than on excretory urogram (2.1+/-0.56 cm) and the difference was 0.1 cm (t value: 2.89, p<0.001), and the parenchymal depth of left kidney on ultrasonogram (2.1+/-0.54 cm) was alike on excretory urogram (2.1+/-0.57 cm) and there was no difference (t value: 2.31, p<0.05). 2. Among the 32 cases of hydronephrosis. 17 cases of hydronephrosis could be diagnosed by excretory urogram. In mild hydronephrosis, the length of kidney on ultrasonogram (12.2+/-0.56 cm) was smaller than on excretory urogram (12.8+/-0.46 cm) and the difference was 0.6 cm, the width of kidney on ultrasonogram (6.1+/-0.27 cm) was smaller than on excretory urogram (6.4+/-0.38 cm) and the difference was 0.3 cm, and the parenchymal depth of kidney on ultrasonogram (2.1+/-0.34 cm) was alike on excretory urogram (2.1+/-0.49 cm) and there no difference. In moderate hydronephrosis, the length of kidney on ultrasonogram(13.5+/-0.47 cm) was smaller than on excretory urogram(14.2+/-0.67 cm)and the difference was 0.7cm, the width of kidneys no ultrasonogram(7.2+/-0.58 cm) was smaller than on excretory urogram(7.8+/-0.73 cm) and the difference was 0.6cm, and the parenchymal depth of kidney on ultrasonogram(1.2+/-0.57 cm) was smaller than on excretory urogram(1.47+/-0.27 cm)and the difference was 0.2 cm. In severe hydronephrosis, the length of kidney on ultrasonogram(15.7+/-0.39 cm)was smaller than on excretory urogram(16.6+/-0.53 cm) and the difference was 0.9cm, the width of kidney on ultrasonogram(8.8+/-0.46 cm) was smaller than on excretory urogram(9.5+/-0.48 cm)and the difference was 0.7 cm, and the parenchymal depth of kidney on ultrasonogram was 0.7+/-0.27 cm but could not be measured on excretory urogram. 3. Among 32 cases of hydronephrosis,15 cases of hydronephrosis were non-visualized kidney on excretory urogram. On them, the renal sized and parenchymal depth were measured accurately by ultrasonography. By reviewing the above results, the ultrasonography of kidney is useful in measurement of kidney size and can be substitute for invasive uroradiological methods in evaluation of patients with hydronephrosis.
Adult* ; Angiography ; Humans ; Hydronephrosis* ; Kidney* ; Ultrasonography* ; Urinary Catheterization ; Urinary Catheters ; Urography

Cholesteatoma is a form of squamous metaplasia resulting in a collection of desquamated epithelium Cholesteatomas are commonly found in the ear, brain and less often in the intestinal tract, genitalia, skin and eye. They occur rarely in the urinary tract. Cholesteatoma of renal pelvis was first described by Rokitansky in 1861. Since then total 23 cases have been reported until now. The authors experienced the cholesteatoma of the renal pelvis incidentally in 11 years old male patient who had been chronically suffered from intermittent pair in the right upper quadrant, and report the case with review of the literatures.
Brain ; Child ; Cholesteatoma* ; Ear ; Epithelium ; Genitalia ; Humans ; Kidney Pelvis* ; Male ; Metaplasia ; Skin ; Urinary Tract

Recently the scrotal diseases have been tended toward increment and take a important share in urologic disease entities. The reasons of them are thought for early reconstruction of the scrotal disease, increase of the diseases that need catheter indwelling and inclination of the scrotal injury by accident. Also up-to-date mass vasectomy have been performed for family planning, the scrotal complications have been increased. So authors report a clinical observation was made on 171 cases with scrotal disease who had been admitted to Department of Urology. E.W.U.H., Seoul, Korea, during the period from Apr. 1, 1976 through Mar. 1, 1981. The results were as follows; 1. Among 1025 cases of in-patients for past 5 years, 171 cases belong to scrotal disease giving a rate of 16.7%. 2. The most common population was 1-10 years of age giving a rate of 31.5%. 3. The most common disease was hydrocele giving a rate of 29.2%. The cryptorchism was 21%, epididymitis 15.8%, vasectomy complication 9.9%, scrotal injury 5%, sterility 4.7% and others 14.3%. 4. Of 171 cases, operation was performed in 152 cases (88.9%). 5. Most common operation was hydrocelectomy (27%), orchiopexy (19.1%), epididymectomy (9.9%) and incision and drainage (7.3%) in order.
Catheters ; Cryptorchidism ; Drainage ; Epididymitis ; Family Planning Services ; Infertility ; Korea ; Male ; Orchiopexy ; Scrotum ; Seoul ; Urologic Diseases ; Urology ; Vasectomy

True hermaphroditism in which both ovarian and testicular tissues are present in same individual is a rare abnormality. Abnormal differentiation of external and internal genitalia is also observed. A total of 30O cases found in the literature by Niekerk, V.A. During exp1oratory surgery, testicular as well as ovarian tissues are found generally. Authors experienced one case of true hermaphroditism who had an ovotestis on the right gonad an ovary on the left with a karyotype of 46, XX and report this case with the review of literatures.
Disorders of Sex Development ; Female ; Genitalia ; Gonads ; Karyotype ; Ovary ; Ovotesticular Disorders of Sex Development*

BACKGROUND: Simian virus 40 (SV40), a polyomavirus, was discovered as a contaminant of a human polio vaccine in the 1960s. It is known that malignant mesothelioma (MM) is associated with SV40, and that the virus works as a cofactor to the carcinogenetic effects of asbestos. However, the reports about the correlation between SV40 and MM have not been consistent. The purpose of this study is to identify SV40 in MM tissue in Korea through detection of SV40 protein and DNA. METHODS: We analyzed 62 cases of available paraffin-blocks enrolled through the Korean Malignant Mesothelioma Surveillance System and performed immunohistochemistry for SV40 protein and real-time polymerase chain reaction (PCR) for SV40 DNA. RESULTS: Of 62 total cases, 40 had disease involving the pleura (64.5%), and 29 (46.8%) were found to be of the epithelioid subtype. Immunostaining demonstrated that all examined tissues were negative for SV40 protein. Sufficient DNA was extracted for real-time PCR analysis from 36 cases. Quantitative PCR of these samples showed no increase in SV40 transcript compared to the negative controls. CONCLUSIONS: SV40 is not associated with the development of MM in Korea.
Asbestos ; DNA ; Humans ; Immunohistochemistry ; Korea ; Mesothelioma ; Pleura ; Poliomyelitis ; Polymerase Chain Reaction ; Polyomavirus ; Real-Time Polymerase Chain Reaction ; Simian virus 40 ; Viruses

Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or die if reperfusion is not achieved in a timely manner. Intravenous tissue plasminogen activator (IV-TPA) administered within 4.5 hours after stroke onset was previously the only proven therapy, but IV-TPA alone does not sufficiently improve the outcome of patients with acute large artery occlusion. With the introduction of the advanced endovascular therapy that enables faster and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of adding endovascular recanalization therapy (ERT) to IV-TPA. Accordingly, to update the recommendations, we assembled members of a writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. The writing committee revised recommendations based on a review of the accumulated evidence, and a formal consensus was achieved by convening a panel of 34 experts from the participating academic societies. The current guideline provides evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization.
Arteries ; Cerebral Arteries ; Consensus ; Humans ; Neuroimaging ; Neurosurgeons ; Patient Selection ; Reperfusion ; Stroke* ; Tissue Plasminogen Activator ; Writing

Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or dead without timely reperfusion. Previously, intravenous tissue plasminogen activator (IV-TPA) within 4.5 hours after stroke onset was the only proven therapy, but IV-TPA alone does not sufficiently improve the outcome of patients with acute large artery occlusion. With the introduction of the advanced endovascular therapy, which enables more fast and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of endovascular recanalization therapy (ERT) when added to IV-TPA. Accordingly, to update the recommendations, we assembled members of the writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. Reviewing the evidences that have been accumulated, the writing members revised recommendations, for which formal consensus was achieved by convening a panel composed of 34 experts from the participating academic societies. The current guideline provides the evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization.
Arteries ; Cerebral Arteries ; Consensus ; Humans ; Neuroimaging ; Patient Selection ; Reperfusion ; Stroke* ; Tissue Plasminogen Activator ; Writing

Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or dead without timely reperfusion. Previously, intravenous tissue plasminogen activator (IV-TPA) within 4.5 hours after stroke onset was the only proven therapy, but IV-TPA alone does not sufficiently improve the outcome of patients with acute large artery occlusion. With the introduction of the advanced endovascular therapy, which enables more fast and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of endovascular recanalization therapy (ERT) when added to IV-TPA. Accordingly, to update the recommendations, we assembled members of the writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. Reviewing the evidences that have been accumulated, the writing members revised recommendations, for which formal consensus was achieved by convening a panel composed of 34 experts from the participating academic societies. The current guideline provides the evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization.
Arteries ; Cerebral Arteries ; Consensus ; Humans ; Neuroimaging ; Patient Selection ; Reperfusion ; Stroke* ; Tissue Plasminogen Activator ; Writing

Since the release of first Korean Clinical Practice Guideline of Stroke in 2009, many important new evidences have emerged in the field of thrombolytic therapy. Among the recent developments are the extended therapeutic time window of intravenous (IV) tissue plasminogen activator (tPA) up to 4.5 hours after onset, and the efforts for the wider application of IV thrombolysis to patients with minor stroke and elderly patients over 80 years old. Debates about the optimal dose of IV tPA according to the ethnic population is still ongoing. Further evidences for the efficacy of intra-arterial thrombolysis have also accumulated, including the application of various novel mechanical devices with promising results. Thus update of guideline became necessary and we revise the acute stroke management guideline, focusing on the thrombolytic therapy.
Aged ; Humans ; Stroke ; Thrombolytic Therapy ; Tissue Plasminogen Activator

Ischemic stroke and myocardial infarction share common risk factors and pathophysiologic mechanisms. Unrecognized coronary artery disease typically occurs in 20-30% of patients with ischemic stroke, and its presence helps to predict the outcome. Coronary artery disease is also an important cause of morbidity and mortality in patients with ischemic stroke. Therefore, applying a screening test for asymptomatic coronary artery disease may be considered in ischemic stroke patients who have a high cardiovascular risk profile. Coronary computed tomography (CT) angiography, myocardial perfusion imaging, or stress echocardiography can be used as a screening test. Coronary CT angiography is recommended in the absence of allergy to contrast media and renal insufficiency.
Angiography ; Contrast Media ; Coronary Artery Disease* ; Coronary Vessels* ; Echocardiography, Stress ; Humans ; Hypersensitivity ; Mass Screening* ; Mortality ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Renal Insufficiency ; Risk Factors ; Stroke*