A clinical observation was done in 72 patients with renal cell carcinoma admitted to Department of Urology, St. Mary's Hospital, Catholic University Medical College from Jan. 1980 to Jun. 1988 retrospectively. There were 52 men and 20 women, giving a ratio of 2.6 to 1, with the highest incidence in the sixth to seventh decades (66%). The most common symptom and sign were hematuria, flank pain and palpable mass in orders, but classic symptom triad of renal cell carcinoma was present in only 11% of the patients. Symptoms secondary to metastasis were only initial presentations in more than half of the patients with stage IV disease, initially 11% (12 pts.) of all the patients with renal cell carcinoma. CT scan showed a high diagnostic accuracy (78%) as compared to pathologic examination. So recently angiography is not done routinely. In one patient, tumor was not detected by CT scan, but by ultrasonography and angiography. Liver scan is not indicated unless there are 2 or more abnormal values among liver function test including alkaline phosphatase, GOT and GPT. Bone metastasis is not correlated with the elevation of alkaline phosphatase and bone scan is indicated only when bone pain and/or gait disturbance are present. Radical nephrectomy is the choice of treatment and adjunctive therapy including. irradiation, chemotherapy, hormone therapy and immunotherapy were not effective. The majority of distant metastasis (86%) occurred within the first 2 years following nephrectomy and metastatic sites were lung, lymph nodes, liver and bone in orders. Of the 72 patients, it was possible for 36 patients to follow up more than 3 years. Patients with stage 1 disease showed 90%. (9/10) 3 year survival and there were no significant differences in 3 year survival between stage II (50%) and stage III (44%) disease. No patients with stage IV disease survived more than 3 years.
Alkaline Phosphatase ; Angiography ; Carcinoma, Renal Cell* ; Drug Therapy ; Female ; Flank Pain ; Follow-Up Studies ; Gait ; Hematuria ; Humans ; Immunotherapy ; Incidence ; Liver ; Liver Function Tests ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography ; Urology

urothelial tumors of the upper urinary tract are relatively uncommon, mostly malignant. 25 patients with urothelial tumor of upper urinary tract seen at St. Mary`s hospital from Jan. 1975 to Dec. 1986 are reviewed retrospectively. The average age was 57.3 years, approximately half of them being more than 60 years old. Gross Hematuria was the most prevalent sign and cytologic examination of the urine has proved not to be diagnostic. The most common findings of excretory urography and retrograde urography were non- visualization of the kidney and filling defect. CT can help to evaluate the extent of disease by determining the invasion or metastasis to surrounding tissues or retroperitoneal node. All 25 patients were surgically explored, 23 patients underwent nephroureterectomy and 6 of them was also done lymphadenectomy, distal ureterectomy with ureteral reimplantation was done in 1 patient and simple nephrectomy was done under the misdiagnosis of renal tuberculosis in 1 patient. There were close relations between histological grade and pathologic grade. Of the 25 patients, stage A and grade II were the most common, each of them were 11 and 16 cases. The over-all 2 year survival rate of 13 patients followed up was seventy percent.
Diagnostic Errors ; Hematuria ; Humans ; Kidney ; Lymph Node Excision ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Replantation ; Retrospective Studies ; Survival Rate ; Tuberculosis, Renal ; Ureter ; Urinary Tract* ; Urography

Pyogenic osteomyelitis is at times tragic disease from which severe deformity and disability may result. The incidence and mortality rate of pyogenic osteomyelitis have decreased strikingly since penicillin became available for general use in the treatment of pyogenic osteomyelitis in 1944 and had a dramatic effect. Recently, since the use of new antlblotics, the effect of treatment has been expected in Pyogenic osteomyelitis. But causative organisms of pyogenic osteomyelitis was gradually increasing in resistance to antibiotics. There is also a trend of gradual increase of pyogenic osteomyelltis due to Gram negative bacilli. The author has been analysed 134 patients on whom followup was observed for a minimum of six months at the Department of Orthopedic Surgery of Hanyang University from May, 1972 to December, 1978. The results were as follows: 1. The incidence of pyogenic osteomyelitis is a trend of gradual increase with 14.2% in 1973, 15.7% in 1975 and 26.9% in 1978. 2. Sex ratio was 2.6: 1 (Male: Female): Age distribution showed the group between 5 and 15 years old was 20 patients(62.5%) in acute osteomyeIitis, and the group between 15 and 30 years oId was 52 Patients (51%) In chronic osteomyelitis. 3. The order of involved bones is femur(41%), tibia(27.8%) and humerus(10.4%). 4. Erythrocyte sedimentation rate was remarkably increased in 92.8% of male and 86.5% of female. 5. The causative organism was mostly staphylococcus aureus(84%) in acute osteomyelitis, and Staphylococcus aureus(44.8%), mixed organisms(20.9%) and Gram negative, bacilli(8.3%) in chronic osteomyelitis. Especially, mixed cases with Staphylococcus aureus and Gram negative bacilli contain 55% of mixed organisms. 6. Penicillin was most resistant (79.7%) to Staphylococcus aureus. Cloxacillin was most susceptable (91.3%) to Staphylococcus aureus. 7. The treatment of acute osteomyelitis showed arrest(72.7%) in case of massive antibiotics by early finding of clinical symptom, but if clinical symptoms were not improved within 48 hours with the use of antibiotics, early decompression was done and was arrested(84.6%) in acute osteomyelitis. Closed continuous irrigatlon with saucerization was done and was arrested(85.7%) in chronic osteomyelitis.
Age Distribution ; Anti-Bacterial Agents ; Blood Sedimentation ; Clinical Study ; Cloxacillin ; Congenital Abnormalities ; Decompression ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mortality ; Orthopedics ; Osteomyelitis ; Penicillins ; Sex Ratio ; Staphylococcus ; Staphylococcus aureus

Sacral agenesis is a rare condition. This syndrome was first described by Hohl in 1852 and is usually associated with other anomalies such as vertebral deformities, deformed hypoplastic legs, urologic and gastrointestinal problems. We have experienced two cases of this deformity; one with partial sacral agenesis, and the other with partial lumbar agenesis and complete absence of sacrum.
Congenital Abnormalities ; Leg ; Sacrum

No abstract available.

Thirty consecutive patient seen in a pediatric out patient and emergency department, in whom the diagnosis of intussusception was considered, had an ultrasound examination of the abdomen before the barium enema. The peak age was 5~12 month (range 4~34 month). Intussusception was detected by ultrasonography in all 25 cases proved by barium enema (sensitivity 100%). Normal findings on ultrasonography correlated with a negative barium enema results in 5 of 5 cases (negative predictive value=100%). No intussusception was missed by ultrasonography. To determine which patient would most benefit from ultrasonography, we divided patients into either a high risk group (100% intussusception) or a low risk group (37.5% intussusception) on the basis of clinical symptoms. We conclude that ultrasonography can be used as a rapid sensitive screening procedure in the diagnosis or exclusion of childhood intussusception. Probability of surgical reduction was associated with size of of total thickness and external rim thickness.
Abdomen ; Barium ; Child* ; Diagnosis* ; Emergency Service, Hospital ; Enema ; Humans ; Infant* ; Intussusception* ; Mass Screening ; Ultrasonography*

Little is known about platelet dynamics and the effect of antiplatelet therapy in Kawasaki disease (KD). This study sought to define platelet activation dynamics in KD patients by assaying platelet-derived microparticles (PDMPs). We measured plasma PDMPs levels in 46 patients with KD using an enzyme-linked immunosorbent assay (ELISA). Blood samples were collected before, at 2–5 days, and 9–15 days after intravenous immunoglobulin (IVIG) infusion, 2 months and 4–5 months after the onset of KD. We measured PDMP levels in 23 febrile and 10 afebrile control patients. In the acute phase of KD patients, PDMP levels increased significantly after IVIG treatment (12.04 ± 5.58 nmol before IVIG infusion vs. 19.81 ± 13.21 nmol at 2–5 days after IVIG infusion, P = 0.006). PDMP levels were negatively correlated with age and positively correlated with procalcitonin levels in the acute phase of KD. No significant difference was found in PDMP levels between KD patients with and without coronary artery lesion (CAL). Elevated PDMP levels after IVIG therapy significantly decreased below the pre-IVIG level in subacute phase (19.81 ± 13.21 nmol at 2–5 days after IVIG infusion vs. 8.33 ± 2.02 nmol at 9–15 days after IVIG infusion, P < 0.001), and PDMP levels stayed below the pre-IVIG level in the convalescent phase, during which antiplatelet therapy was given. However, PDMP levels rebounded after discontinuing aspirin in 17 patients. In conclusion, enhanced platelet activation was noted before treatment of KD and peaked immediately after IVIG treatment. Recurrent rising of PDMP levels was observed after discontinuing aspirin, although there were no significant differences between the PDMP levels at 2 months after the onset of KD and those at 4–5 months after the onset of the disease.
Aspirin ; Blood Platelets ; Coronary Vessels ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome* ; Plasma ; Platelet Activation

PURPOSE: It is generally accepted that the air pollution can cause acute respiratory diseases. This study was undertaken to investigate the relationship between the increase in the level of air pollutants and hospital visits for pediatric respiratory diseases in Incheon city. METHODS: We retrospectively reviewed the medical records of pediatric patients who visited the outpatient department(OPD) of Inha University Hospital for respiratory diseases(such as bronchial asthma, pneumonia, bronchitis, bronchiolitis and URI) from January 1 to December 31 1997. We converted the data into an average per day that included meteorologic data of air pollution(such as O3, CO, SO2, NO2, and PM10) and weather data(such as atmospheric temperature, relative humidity) in three different places in Incheon city. We used a Poisson distribution, selecting a lowess statistics model. We also used the S-PLUS statistics program. RESULTS: Ozone(O3), CO, and SO2 were all found to have significant associations with the OPD visits for pediatric respiratory diseases. After meteorologic variables(such as CO, SO2, NO2, PM10, atmospheric temperature, and relative humidity) controlled, we determined the relative risk between the increase in the OPD visits for respiratory diseases and every 0.01 ppm increase in O3. The relative risk was 1.16 and the 95% confidence intervals were 1.12-1.20. CONCLUSION: There was a significant relationship between the incidence of pediatric respiratory diseases and the increase in the level of air pollutants, especially O3, CO, and SO2 in Incheon city. Further studies on the effects of continuous daily exposure to low or ambient levels of air pollutants are needed.
Air Pollutants ; Air Pollution* ; Asthma ; Bronchiolitis ; Bronchitis ; Humans ; Incheon* ; Incidence ; Medical Records ; Outpatients ; Pneumonia ; Retrospective Studies ; Weather

OBJECTIVE: To compare the therapeutic effects between stellate ganglion block and steroid therapy in post-stroke complex regional pain syndrome. METHOD: In this controlled study, thirty-eight patients with post-stroke complex regional pain syndrome were randomly divided into two groups. One group received a total of five repeated stellate ganglion block every three days and the other group received an oral corticosteroid therapy. Therapeutic effects were assessed before treatment, after fifteen days and thirty days in the each group and evaluated via volume of the involved hand, circumference of the middle finger, shoulder and hand pain score. RESULTS: In both groups, hand edema and circumference of middle finger were decreased after fifteen days and thirty days of treatment. However, the stellate ganglion block group showed more significant improvement in mean change of hand edema and circumference compared to the steroid therapy group. The hand and shoulder pain were also decreased significantly after fifteen days in both groups. In stellate ganglion block group, patients' pain kept decreased even after thirty days had passed since the treatment. However, in the other group who got the steroid therapy, there was no further decrease from the fifteenth day after the therapy. CONCLUSION: Although both treatment were effective in relieving symptoms of post-stroke complex regional pain syndrome, the stellate ganglion block was more effective. However, further controlled study is required.
Edema ; Fingers ; Hand ; Humans ; Shoulder ; Shoulder Pain ; Stellate Ganglion*

OBJECTIVE: To evaluate that lower back pain would influence postural control ability. METHOD: Thirty-eight adults (18 men, 20 women) participated and were divided into two groups; the study (patients with lower back pain) group and the control (healthy adults) group. Postural control ability of participants was evaluated through the Balance Master(R) system. A total of seven measurements were analyzed to determine the difference between the study and control group. RESULTS: Patients with lower back pain demonstrated weight bearing patterns on the non-tender side, wider area of sway (degrees) under conditions (unilateral stance on firm surface with eye closed) in modified clinical test sensory interaction on balance (p<0.05). Wider area of turn sway (degrees) and long turn time (sec) during step/quick turn were demonstrated in patients with lower back pain (p<0.05). CONCLUSION: The results showed that patients with lower back pain was reduced in the postural control ability. Further studies about the effect of back exercise on postural control ability of patients with lower back pain should be carried out.
Adult ; Humans ; Low Back Pain* ; Male ; Weight-Bearing