PURPOSE: The artificial erection is critical to chordee repair. We report the use of a natural erection induced by prostaglandin E(1)(PGE1) in the diagnosis and treatment of penile curvatu re as an alternative to artificial erection in children and adult patients. MATERIALS AND METHODS: Pharmacological erection was induced 14 children with a mean age of 5 years (range 1-10) and 8 adults with a mean age of 33 years (range 18-58) to diagnose and repair anomalies, such as simple penile curvature, chordee with or without hypospadias, webbed penis and Peyronie's disease. Alprostadil (1-16ng) as a agent for induce erection was used exclusively, but no agents were routinely given to reverse the erection was used exclusively, but no agents were routinely given to reverse the erections. The dose injected intracavernosally was dependent on the patient's age, penile size and response, and ranged from 0.5 to 10 micrograms. Time to and adequacy of erection, detumescence, changes in blood pressure and pulse rate were monitored. RESULTS: A dilatation of erectile tissue was achieved within 8 minutes and was judged adequate in 2 and excellent in 20. The mean duration of erection was 107 minutes, while a prolonged erection, for up to 2.5 hours, occured on 2 patients who were treated conservatively. Detumescence were occurred when the corpora were opened, but re-erected penis after closure of corpora in 7 cases who treated with Nesbit's corporeal plication or fibrous plaque excision and dermal graft. Although there were the impression of increased bleeding, there were no specific changes in blood pressure or pulse rate. CONCLUSIONS: Pharmacological erection in penile curvature is effective and reliable with no significant complications. Although PGE1 is expensive and induced slightly increased bleeding, pharmacological erection has the advantage of tumescence of the entire penis and consequently a constant and natural representation of chordee without corporeal or urethral injury. Therefore, the erection achieved by injecting PGE1 into the corpora cavemosa is a useful alternative to artificial erection in the diagnosis and treatment of penile anomalies.
Adult ; Alprostadil ; Blood Pressure ; Child ; Diagnosis ; Dilatation ; Female ; Heart Rate ; Hemorrhage ; Humans ; Hypospadias ; Male ; Penile Induration ; Penis ; Transplants

The authors have studied on the effect of digital pressure on eyeball under the surface anesthesia instead of other reducing agents of intraocular pressure and retrobulbar anesthesia in order to lower the intraocular pressure as a preoperative procedure of cataract extraction in 26 eyeballs of 24 patients and following results were obtained: 1. The authors had intraocular pressure lowered till averaging 10.8 mmHg (average 13.5 ~ 8.0 mmHg) of original pressure by ocular massage. 2. Massage on eyeball was thought to be a satisfactory preoperative procedure to perform cataract extractIon. 3. In operative complications, loss of vitreous and rupture of capsule were noticed 11.5% and 60% respectively. and it was thought to be caused by technical failure in surgeons. In view of this fact we could not find that the loss of vitreous was caused by intraocular pressure below 13.5 mmHg.
Anesthesia ; Cataract Extraction* ; Cataract* ; Humans ; Intraocular Pressure ; Massage* ; Preoperative Care ; Reducing Agents ; Rupture

The early ultrastructural changes of basement membrane thickening and degeneration of the pericyte were noted in retinal capillaries in diabetic patients. However no early ultrastructural changes were reported in diabetic iris capillary. The authors studied the ultrastructural features of basement membrane of iris capillaries which were obtained during cataract surgery in five diabetic patients and compared with those obtained in five nondiabetic patients. The endothelium basal lamina, pericyte basal lamina and membrane-like pericyte matrix in didabetic iris capillaries were thicker than those in nondiabetic Iris capillaries. The thickening of pericyte basal lamina is more prominant than the endothelium basal lamina in diabetes. The duration of diabetes had no relationship to endothelium basal lamina but, showed statistically significant relationship to thickness of pericyte bascal lamina and pericyte matrix.
Basement Membrane* ; Capillaries* ; Cataract ; Endothelium ; Humans ; Iris* ; Pericytes ; Retinaldehyde

Leiomyoma is rare. Most of patients present with urinary tract infection, hematuria, dyspareunia, or complaint of mass. A case of leiomyoma on urethrovaginal septum in a 36 years old female was presented. The presenting symptom was a protruding mass at the anterior vaginal wall The mass was removed surgically and confirmed as a leiomyoma pathologically.
Adult ; Dyspareunia ; Female ; Hematuria ; Humans ; Leiomyoma* ; Urinary Tract Infections

Pigmented fungiform papillae of the tongue is a rare disorder in Korea. It is characterized clinically by pigmentation confined to the fungiform papillae and histopathologically by the presence of melanophages in the upper dermis. We report a case of pigmented fungiform papillae of the tongue in a 21-year-old woman who had brown to violaceous dots on the fungiform papillae and pigmented patches on the right lateral dorsum of the tongue. Histological findings showed increased melanophages in the upper dermis.
Dermis ; Female ; Humans ; Korea ; Pigmentation ; Tongue* ; Young Adult

BACKGROUND: To evaluate the changing pattern of liver abscess treatment, we did a retrospective analysis of 80 patients with liver abscess, treated surgically and medically at the Department of Surgery and Internal Medicine, Wonkwang University Hospital from January 1985 to December, 1995. RESULTS: Among 80cases of liver abscess, 59 cases(76%) were pyogenic abscess and 21 cases(24%) were amebic abscess. The liver abscess was more commonly located in the right lobe. In the 59cases of pyogenic liver abscess, etiologic factors were biliary stones with cholangitis(19 cases), cholecystitis(6 cases), hepatobiliary cancer(4 cases), diabetes mellitus(3 cases). All 21 cases of amebic abscess were treated with percutaneous catheter drainage and metronidazole administration; 20 cases were treated successfully and 1 case died of sepsis. Among the 59 cases of pyogenic liver abscess, 38 cases were treated with percutaneous catheter drainage; 30 cases were successful, but 8 cases were not. Operations were performed in 21 cases because of underlying intraabdominal conditions requiring surgical correction( 19cases) and panperitonitis due to rupture of liver abscess(2cases). CONCLUSION: In the treatment of amebic abscss, percutaneous catheter drainage and metanidazole adminstration should be considered first. Percutaneous catheter drainage and antibiotic treatment tend to increase more than surgical treatment in the pyogenic liver abscess therapy. The liver abscess is no more surgical indication, unless it is associated with underlying intraabdominal conditions requiring surgical correction and panperitonitis due to rupture of liver abscess.
Abscess ; Amebiasis ; Catheters ; Drainage ; Humans ; Internal Medicine ; Liver Abscess* ; Liver Abscess, Amebic ; Liver Abscess, Pyogenic ; Liver* ; Metronidazole ; Retrospective Studies ; Rupture ; Sepsis

No abstract available.
Bacteria, Anaerobic*

No abstract available.
Bacteria, Anaerobic*

BACKGROUND/AIMS: The nature of gallbladder polyp is obscure before operation, and surgical indication is still controversial. The aim of this study is to suggest the therapeutic guideline for patients with the gallbladder polyps in the laparoscopic era. METHODS: Among 49 patients who received cholecystectomy because of gallbladder polyp from January 1, 1992 to December 31, 2000 in Department of Surgery, Seoul Municipal Boramae Hospital, we studied 42 histopathologically confirmed gallbladder polyp patients retrospectively. These patients were divided into two groups as true polyp(adenoma, carcinoma) and pseudopolyp(cholesterol, inflammatory, hyperplastic), and clinical characteristics were compared between the groups. RESULTS: The mean age was 48.19+/-11.09 years and male to female ratio was 17:25 in all patients. Of 42 patients, 32 pseudopolyps(76.2%) and 10 true polyps(23.8%) were confirmed by pathologic examination. Of 32 pseudopolyps, cholesterol polyps(29cases, 90.6%) were most common type. 4 carcinomas and 6 adenomas were included in 10 true polyps. Of 6 adenomas, coexistence with dysplasia was present in two cases. 1 case of carcinoma was present as arising from underlying tubular adenoma. Compared with pseudopolyp, true polyp showed significant larger size in diameter than psedopolyp(p=0.014). Despite of these statistical difference, 44% of pseudopolyps was more than 10mm in maximum diameter. 2 cases of true polyp(20%) was less than 10mm. However all of the other clinical features such as, the patients's age, sex, symptom, presence of gallstones, and number of polypoid lesion were not significantly different between the groups. All 4 carcinoma patients received laparoscopic cholecystectomy are disease free state with mean 68.5 months follow-up period. CONCLUSION: Although true polyps showed statistically significant larger than pseudopolyps in maximum diameter, there was no clear cut point dividing the two groups. All of the other clinical characteristics could not differentiated true polyps from pseudopolyps. Because of the low morbidity of laparoscopic procedure, premalignant potential of gallbladder adenoma and the adenoma-carcinoma sequence are unquestionable, an aggressive surgical intervention should be proposed in the era of laparoscopic surgery.
Adenoma ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholesterol ; Female ; Follow-Up Studies ; Gallbladder* ; Gallstones ; Humans ; Laparoscopy ; Male ; Polyps* ; Retrospective Studies ; Seoul

BACKGROUND: As many as several weeks of incubation may be necessary for the recovery of mycobacteria when conventional culture media are used. Previous studies evaluating Mycobacteria Growth Indicator Tube (MGIT) as a rapid for the growth and detection of mycobacteria from clinical specimens have been reported. We compared MGIT with Ogawa media for the recovery of mycobacteria from clinical specimens. METHODS: Ninety nine clinical specimens received in the laboratory of Wonju Christian Hospital from June to September 199 were used for this study. The specimens from nonsterile body sites were digested, decontaminated, and concentrated, for culture and Ziehl-Neelsen stain, and specimen were inoculated onto MGIT tube and 3% Ogawa egg medium, and cultured for 8 weeks. RESULTS: Of the 38 specimens culture-positive for mycobacteria, 3 grew isolates in MGIT medium only, 8 grew isolates in Ogawa media only, and 27 grew isolates in both media. Mean (median, range) times to detection of mycobacteria were 13.7 (5.5, 2-48) days with MGIT and 19.6 (18, 13-37) days with Ogawa (P>0.05). The number recovered with MGIT plus Ogawa media was 24 (63.2%) within 14 days of receipt of specimen, and 31 (81.6%) within 21 days. The contamination rates were 31 % for MGIT and 1 % for Ogawa media. CONCLUSIONS: MGIT appears useful to quickly detect and identify mycobacteria from clinical specimens. However, because the number of culture-positive specimen in MGIT was not greater than those recovered with Ogawa media, MGIT should be used in combination with solid media to reduce turnaround times and increase the isolation rate.
Culture Media ; Gangwon-do ; Mycobacterium ; Ovum