The review of normal intravenous pyelography can give us important criteria of the diseases of the urinary system and the adjacent organs. Authors analyzed 200 cases of intravenous pyelography of normal Korean adults and measured the following points; the length of kidneys, the distance from midline to both poles, the slope degree of longitudinal axis, the ureteral length and width, the shortest distance from midline to abdominal ureters, the longest distance form midline to pelvic ureters, and configuration of urinary bladder. The results were obtained as follows; 1. The average length of kidneys in adult male was 12.53±0.78 cm on right, 12.83±0.82cm on left; in adult female, 12.08±0.72cm on right, 12.46±0.73cm on left. In the age distribution, the length gradually became shorter by getting old. In 20% of cases, right kidney was longer than left. 2. The average distance from both the renal poles to midline was longer in male compared to female. The distance from upper pole to the midline was longer in left side than right in male, but in the lower pole, there was no difference in both sexes. 3. The slope degree of the renal longitudinal axis was larger in male than in female, and lager in right kidney compared to left. 4. The length of ureter was longer on left, but there was no remarkable difference between both sexes. 5.The short set distance from midline to abdominal ureter, there was no remarkable difference between both sexes and also between right and left side. But concerning the longest distance from midline to pelvic ureter, it was longer in female; and especially in female, right side was shorter than left. 6. The longitudinal diameter of urinary bladder was longer in male, but horizontal diameter was longer in female.
Adult ; Age Distribution ; Female ; Humans ; Kidney ; Male ; Ureter ; Urinary Bladder ; Urinary Tract ; Urography

The azygos anterior cerebral artery, a rare anomaly in the circle of Willis in which only a single vessel supplies the medial aspects of both anterior cerebral hemispheres, is closely associated with saccular aneurysms. We present three cases of azygos anterior cerebral artery aneurysms among the 781 cerebral aneurysms surgically treated at our institution in an 11-year period. These three cases all involved elderly women who presented with subarachnoid hemorrhage. Conventional cerebral angiography and CT angiography revealed small saccular aneurysms at the distal ends of the azygos anterior cerebral arteries. These aneurysms were clipped successfully using a bifrontal interhemispheric approach. Hence, the pathogenesis of these particular aneurysms relating to hemodynamic change, associated anomalies, and surgical pitfalls is discussed with review of literature.
Aged ; Aneurysm* ; Angiography ; Anterior Cerebral Artery* ; Cerebral Angiography ; Cerebrum ; Circle of Willis ; Equipment and Supplies ; Female ; Hemodynamics ; Humans ; Intracranial Aneurysm ; Subarachnoid Hemorrhage

Alloimmune neonatal neutropenia (ANN) is due to maternal IgG neutrophil-specific antibodies that cross the placenta to sensitize fetal neutrophils and cause neutropenia in the neonate. Infection appears within a few days of life. Neutropenia worsens during the very first days of life and persists until 20-50 days in spite of the disappearance of detectable antibody in the infant's serum. We report a case of ANN in female neonate who was admitted on the 5th day of life due to poor oral intake. The diagnosis was made by indirect immunofluorescence with fluorescein-tagged antihuman globulin reagent. The patient was treated successfully with systematic intravenous antibiotics and highdose intravenous immunoglobulin (IVIG).
Anti-Bacterial Agents ; Antibodies ; Diagnosis ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin G ; Immunoglobulins ; Immunoglobulins, Intravenous ; Infant, Newborn ; Neutropenia* ; Neutrophils ; Placenta

Cardiac manifestations of hypereosinophilic syndrome rarely include left ventricular thrombosis leading to peripheral emboli. And the cases of thrombectomy in patients with left ventricular thrombus and hypereosinophilic syndrome are extremely rare. Recently we experienced a 58-years-old woman with hypereosinophilic syndrome, the history of thalamic infarction and a huge thrombi in left ventricle. We report this case with literatures.
Female ; Heart Ventricles ; Humans ; Hypereosinophilic Syndrome* ; Infarction ; Thrombectomy ; Thrombosis*

Between January, 1990, and December, 1994, 105 elderly patients(over the age of sixty) were referred to the Division of Nephrology at the Seoul National University Hospital as acute renal failure(ARF) (serum creatinine >1.7mg/dL, patients who had been diagnosed to have acute on chronic renal failure were excluded). To find out the characteristics of ARF in the elderly, we made a retrospective study of our data. Sufficient data for analysis were available in 101 of these. Among these patients, prerenal failure occured in 5% of the cases, ischemic ATN 34%, toxic ATN 11%, renovascular obstruction 5%, glomerular disease 5%, postrenal failure 15%. Dialysis was required in 31 patients(31%). Twenty four patients were treated by hemodialysis, it was carried out in 1 patient by the peritoneal route, and the other 6 patients were treated by CAVH. The most common indication was hypervolemia(77%). Twenty seven patients died during the period of acute renal failure. The most common cause of death was infection(15 patients), and the others were underlying diseases, pulmonary complications and cardiovascular complications. Oliguria, and chronic underlying disease were poor prognostic factors. There were significant differences between living and died group in APACHE II score(P<0.05). We conclude that ischemic ATN is a more common cause of ARF in the elderly than in the younger, and presence of oliguria and chronic underlying disease are poor prognostic factors.
Acute Kidney Injury* ; Aged* ; APACHE ; Cause of Death ; Creatinine ; Dialysis ; Hemofiltration ; Humans ; Kidney Failure, Chronic ; Lung Diseases ; Mortality ; Nephrology ; Oliguria ; Renal Dialysis ; Retrospective Studies ; Seoul

PURPOSE : To investigate the incidence and prevalence of C-shaped root canal using computed tomographic images of head and neck in Korean population. MATERIALS AND METHODS : Regardless of each examination purpose, randomly selected 268 examples which have serial axial computed tomographic images with 8 normal molars in maxilla and mandible were selected and investigated. Defined C-shaped root canal and we could get 82 proper image examples in view of this definition. These were detected and investigated of incidence and prevalence of C-shaped root canal. RESULTS : C-shaped root canals were found in 82 examples among 268 (30.6%) and 147 teeth. They were only found on molar area, and the highest incidence was 37.41% of left mandibular second molars, and the lowest was 2.04% of right maxillary second molars. On prevalence of tooth position, mandibular second molar was the highest, 65% of C-shaped root canal teeth and maxillary second molar was 6% the lowest. CONCLUSION : 31% of randomly selected CT images no considering check-up reason have C-shaped root canals. The C-shaped root canals of mandibular second molar are found most frequently and they are also detectable on maxilla. On Korean population, C-shaped root canals are one of conditions that have to concern with dental treatment for it appears at a high prevalence relatively.
Dental Pulp Cavity ; Head ; Incidence ; Mandible ; Maxilla ; Molar ; Neck ; Prevalence ; Tooth

BACKGROUND AND OBJECTIVES: The aims of this study were 1) to assess the development of open-set speech perception in prelingually deaf children who had multichannel cochlear implants implanted and 2) to document the outcomes according to age at implantation and the device type. SUBJECTS AND METHOD: The subjects for this study were 23 prelingually deaf children who received a Nucleus 22 or Nucleus 24 multichannel cochlear implants and who had been followed-up for a period of 1-4 years at Dong-A University Hospital. They had no other disabilities. Open-set speech perception was evaluated pre-operatively, postoperatively for 6 months and then on a yearly basis using the following assessment materials: Phonetically Balanced Kindergarten monosyllabic word lists, bisyllabic word lists, and Glendonald Auditory Screening Procedure(GASP) sentence subtest. Paired t-tests were performed to assess improvement in the mean scores at each interval for all children. T-tests were used to examine differences in the mean scores between two groups divided by age at implantation and the device type. RESULTS: Open-set speech perception for all subjects was improved to mean 84% for monosyllabic phonemes and 89% and 88% for bisyllabic phonemes and everyday sentences respectively at 4 years postimplantation. Open-set speech perception ability was better for children who received implantation before 5 years of age than those who did it after 5 years of age at 3 years interval and 4 years interval. The performance was also better for children who received Nucleus 24M than those who received Nucleus 22 at all intervals. CONCLUSION: The prelingually deaf children in our study showed significant open-set speech perception abilities at the time of the last postoperative evaluation. Rapid improvement was noted in open-set speech perception for the children who had Nucleus 24M implanted before 5 years of age. In order to maximize the effects of access to auditory stimuli provided by the cochlear implant on the development of open-set speech perception, a structured postoperative schedule of programming and rehabilitation is recommended in addition to the optimal educational environment.
Appointments and Schedules ; Child* ; Cochlear Implants* ; Deafness ; Humans ; Mass Screening ; Rehabilitation ; Speech Perception

Mineralocorticoids influences on acid-base homeostasis by the regulation of urine acidification. But its mechanism of acion is not well known in human. This study compared the acid-base status and the indices of urine acidification before and after mineralocorticoid administration in human, and analyzed the effect of mineralocorticoids on human acid-base homeostasis. We administered 9a-fludrocortisone in 6 chronic renal failure patients and 6 normal controls 0.5mg daily for 7 days. The results were as following: 1) After administration of 9a-fludrocortisone in patients group, serum aldosterone level changed from 120.2+/-71.0pg/mL to 44.8+/-32.2pg/mL(mean+/-SD, p< 0.05). Serum HCO- level was not changed. Urine ammonium excretion was incresed from 24.6+/-12.3 mmol/day to 43.7+/-19.0 (p<0.05), but there were no change in urine pH and urine anion gap, Serum potassium level decreased from 5.5+/-0.7mBq/L to 4.1+/-0.5mEq/L (p<0.05), and TTKG increased from 3.9 to 8.9(p<0.05). 2) After administration of 9a-fludrocortisone in control group, serum aldosterone level changed from 99.7+/-44.5pg/mL to 25.1+/-3 mL(p<0.05). Serum HCO- level was not changed. Urine ammonium excretion was incresed from 44.3+/-21.6mmoVday to 76.3+/-19.6(p<0.05), but there were no change in urine pH and urine anion gap. Serum potassium level decreased from 4.8+/-0.5mEq/L to 3.9+/-0.2mHq/L(p< 0.05), but there was no change in TTKG. 3) No patient or control showed any discomfort after 9-fludrocortisone administration, and there was no elevation in diastolic blood pressure, increase in body weight, electrolyte abnormality. In summary, after 9alpha-fludrocortisane administration, urinary ammonium excretion increased in both patients and control group, and this phenomenon occured with correction of hyperkalemia without urine pH change. This result implies urinary ammonium excretion increase by mineralocorticoid. In human increase in renal distal acidification by mineralocorticoid is due to increase in renal ammoniagenesis rather than stimulation on proton excretion.
Acid-Base Equilibrium ; Aldosterone ; Ammonium Compounds* ; Blood Pressure ; Body Weight ; Homeostasis ; Humans ; Hydrogen-Ion Concentration ; Hyperkalemia ; Kidney Failure, Chronic ; Mineralocorticoids ; Potassium* ; Protons

OBJECTIVE: The aim of this study was to analyze the treatment results and prognostic factors in patients with massive cerebral infarction who underwent decompressive craniectomy. METHODS: From January 2000 to December 2005, we performed decompressive craniectomy in 24 patients with massive cerebral infarction. We retrospectively reviewed the medical records, radiological findings, initial clinical assessment using the Glasgow Coma Scale, serial computerized tomography (CT) with measurement of midline and septum pellucidum shift, and cerebral infarction territories. Patients were evaluated based on the following factors : the pre- and post-operative midline shifting on CT scan, infarction area or its dominancy, consciousness level, pupillary light reflex and Glasgow Outcome Scale. RESULTS: All 24 patients (11 men, 13 women; mean age, 63 years; right middle cerebral artery (MCA) territory, 17 patients; left MCA territory, 7 patients) were treated with large decompressive craniectomy and duroplasty. The average time interval between the onset of symptoms and surgical decompression was 2.5 days. The mean Glasgow Coma Scale was 12.4 on admission and 8.3 preoperatively. Of the 24 surgically treated patients, the good outcome group (Group 2 : GOS 4-5) comprised 9 cases and the poor outcome group (Group1 : GOS 1-3) comprised 15 cases. CONCLUSION: We consider decompressive craniectomy for large hemispheric infarction as a life-saving procedure. Good preoperative GCS, late clinical deterioration, small size of the infarction area, absence of anisocoria, and preoperative midline shift less than 11mm were considered to be positive predictors of good outcome. Careful patient selection based on the above-mentioned factors and early operation may improve the functional outcome of surgical management for large hemispheric infarction.
Anisocoria ; Brain Edema ; Cerebral Infarction* ; Consciousness ; Decompression, Surgical ; Decompressive Craniectomy ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Infarction ; Intracranial Pressure ; Male ; Medical Records ; Middle Cerebral Artery ; Patient Selection ; Reflex ; Retrospective Studies ; Septum Pellucidum ; Tomography, X-Ray Computed

BACKGROUND: The purpose of this study was to determine the associations of the potential risk factors including reproductive history and lifestyle factors with bone mineral density at postmenopause. METHODS: The bone mineral density of the lumbar spine and proximal femur were measured by dual energy X-ray absorptiometry (DEXA), and physical and anthropometric data were obtained in 187 healthy postmenopausal women aged 45 to 73. Informations about risk factors were assessed by questionairres including medicosurgical and family history, reproductive history and lifestyle factors (dietary calcium intake, past use of oral contraceptives, consumption of alcohol and caffeine, smoking habits and exercise pattern). RESULTS: 1) Each prevalence of osteopenia and osteoporosis was 43.9% and 16.6% in postmenopausal women. 2) In simple correlation analysis between each risk factor and bone mineral density, factors associated with higher level in body mineral density (BMD) were body mass index (BMI)(p<0.01) and reproductive periods (p<0.05) in lumar spine and femur neck, and exerecise strength in femur neck (p<0.05). On the other hand, more aging and longer postmnopausal periods, lower BMD in lumbar spine and femur (p<0.01) and later menarche, lower BMD in lumbar spine (p<0.01) and femur neck (p<0.05) and higher frequencies of parity were influenced on lower BMD in lumbar spine and femur wards (p<0.01) and femur neck (p<0.05). But the other factors had no relation to BMD. 3) There was no significant difference in BMD according to the amount of diet calcium intake, gravity, lactation, the past use of oral contraceptives, the family history of osteoporosis, smoking habits and intake of caffeine and alcohol. 4) No reproductive history and other risk factors were significantly associated with BMD after the influences of age, postmenopausal periods and BMI were adjusted in multiple regression analysis. CONCLUSION: These results show there are no consistent effects on bone mineral density, after adjusting for age and BMI, of reproductive history and any other risk factors in postmenopausal women.
Absorptiometry, Photon ; Aging ; Body Mass Index ; Bone Density* ; Bone Diseases, Metabolic ; Caffeine ; Calcium ; Contraceptives, Oral ; Diet ; Female ; Femur ; Femur Neck ; Gravitation ; Hand ; Humans ; Lactation ; Life Style ; Menarche ; Osteoporosis ; Parity ; Postmenopause* ; Prevalence ; Reproduction ; Reproductive History ; Risk Factors* ; Smoke ; Smoking ; Spine