No abstract available.
Humans ; Infant* ; Infant, Newborn* ; Radial Artery*

The most common adverse effect of intravenous heparin is hemorrhage. Of the these, retroperitoneal hemorrhage and femoral neuropathy secondary to heparin anticoagulation has reported in 1966 for the first time by DeBolt and Jordan. We experienced a case of spontaneous retroperitoneal hemorrhage due to iliopsoas muscle hematoma in patient with myocardial infarction receiving intravenous heparin for a 3 days in therapeutic doses. The pathophysiology of iliopsoas muscle hematoma has not yet been cleared. But because of the possibility of large amount in volume, retroperitoneal hemorrhage has been known as a serious adverse effect that leads to the hypovolemic shock and death. In this article, we described the clinical manifestation, the importance of the early diagnosis and diagnostic clues and associated factors of the retroperitoneal hemorrhage in patient receiving intravenous heparin.
Early Diagnosis ; Femoral Neuropathy ; Hematoma* ; Hemorrhage* ; Heparin* ; Humans ; Jordan ; Myocardial Infarction* ; Shock

The clinician is posed a serious clinical dilemma when confronted with absence of testis during surgical management of impalpable testis. Herein we performed a comparative clinical study of palpable and impalpable undescended testis in 135 patients, 150 undescended testes during the period from January, 1979 to June, 1984. The results were as follows: 1. Among the 150 undescended testes, 47 cases(31.3%), were impalpable undescended testes on physical examination. 2. In 135 patients of undescended testis, number of patients below 2 year-old(considered as optimal age of orchiopexy) were 15(11.1%) patients and below 10 year-old were 75(55.6%) patients. There was no marked difference of age distribution in patients of palpable and impalpable undescended testis. 3. Associated anomalies were found in 16 (11.9%) patients of total 135 patients, and twice more commonly found in the patients of impalpable undescended testis than palpable undescended testis. 4. As surgical location of undescended testis, abdominal type and absence of testis were more common in impalpable undescended testis (10.6% and 8.7% of cases) than palpable undescended testis (1% and 0% of cases).
Age Distribution ; Child ; Cryptorchidism* ; Humans ; Male ; Physical Examination ; Testis

Among many causes of calcium containing urinary stones, the hypercalciuria associated with normocalcemia is the most common one. Absorptive hypercalciuria and renal hypercalciuria constitute two major forms of idiopathic hypercalciuria. According to Coe et al., a renal leak of calcium and secondary hyperparathyroidism are present in renal hypercalciuria but not in absorptive hypercalciuria. It has been suggested that fasting urinary cAMP may provide a measure of parathyroid function. So determination of fasting urinary calcium and cAMP may be useful in the differentiation of the two major forms of idiopathic hypercalciuria. We performed the study to evaluate the significance of urinary calcium and cAMP in the determinating the types of hypercalciuria. Calcium metabolism studies and urinary cAMP determination were done in 28 in-patients with urinary stones under usual diet and fasting state. The results were as followings: 1. Among 28 patients, 15 patients had renal hypercalciuria, 6 had absorptive hypercalciuria and 7 had normocalciuria. 2. On usual diet, 24-hour urine cAMP level was 3.815+/-0.560 nmol/mg creatinine in renal hypercalciuria, 3.508+/-1.253 nmol/mg creatinine in absorptive hypercalciuria and 3.202+/-0.980 nmol/mg creatinine in normocalciuric patients. 3. On fasting state, 2-hour urine cAMP level was 4.611+/-2.591 nmol/mg creatinine in renal hypercalciuria, 4.304+/-3.173 nmol/mg creatinine in absorptive hypercalciuria and 2.400+/-1.080 nmol/mg creatinine in normocalciuric patients. 4. urinary cAMP on usual diet and fasting condition did not differ significantly among 15 renal and 6 absorptive hypercalciuric patients. (t-value; 0.82 and 0.22, respectively, p>0.1)
Calcium ; Creatinine ; Diet ; Fasting ; Humans ; Hypercalciuria ; Hyperparathyroidism, Secondary ; Metabolism ; Urinary Calculi*

BACKGROUND: The purpose of this study was to determine the accuracy and the reliability in diagnosing breast cancer. METHODS: This clinical study was performed on 132 patients with palpable breast masses who had been diagnosed with excisional biopsy from August 1997 to July 1998 at the Department of Surgery, Seoul Adventist Hospital. Among the 132 patients, the mammographs were taken for 65 patients, ultrasonographs for 83 patients, and fine needle aspiration biopsies (FNAB) for 72 patients. The results of the three diagnostic procedures were compared with the postexcisional histologic diagnosis. RESULTS: 1) Mammography discovered breast cancer with an accuracy of 70.8%, a false positive fraction of 6.8%, a false negative fraction of 76.2%, a sensitivity of 23.8%, a specificity of 93.2%, and a positive predictive value of 62.5%. 2) Ultrasonography detected breast cancer with an accuracy of 74.7%, a false positive fraction of 6.9%, a false negative fraction of 68.0%, a sensitivity of 32.0%, a specificity of 93.1%, and a positive predictive value of 66.7%. 3) Among the 72 aspirates, 7 (9.7%) aspirates had a technically unsatisfactory aspiration cytology. 4) Of the 65 technically satisfactory cytologies, the diagnosis was malignant in 16 cases, suspicious for malignancy in 6 cases, and benign in 43 cases. 5) Aspiration cytology detected breast cancer with an accuracy of 90.8%, a false positive fraction of 4.9%, a false negative fraction of 16.7%, a sensitivity of 83.3%, a specificity of 95.1%, and a positive predictive value of 90.9%. CONCLUSIONS: The fine needle aspiration biopsy was more reliable than either mammography or ultrasonography. Also, as an initial diagnostic method, fine needle aspiration biopsy had a high degree of accuracy in diagnozing palpable breast masses.
Biopsy* ; Biopsy, Fine-Needle* ; Breast Neoplasms* ; Breast* ; Diagnosis* ; Humans ; Mammography* ; Sensitivity and Specificity ; Seoul ; Ultrasonography ; Ultrasonography, Mammary*

Complication of transurethral prostatic resection is hemorrhage, water intoxication, urethral stricture, perforation of bladder neck and surgical capsule, urinary incontinence . and infection. Hemorrhage is the most usual complication of TURP. Measurement of blood loss during TURP is very difficult because of dilution of blood with irrigating fluid and is very important to management of patient during and after surgery because its objectives are elderly patient. We studied the blood loss during TURP in 41 patients from Jan., 1984 to June, 1985, but 6patients were excluded because blood transfusion was performed during TURP by recognition of massive blood loss. Blood loss was measured in 35 cases by spectrophotometer used benzidine-heme color reaction. Following results were obtained. 1. Blood loss during TURP per time was 329+/-241 ml (Mean+/-S.D.) 2. Resection time was 71+21 min (Mean+/-S.D.) and blood loss per minute was 4.61 ml. Correlation coefficient between resection time and blood loss was +0.12 and was not significant. 3. Resected prostatic chip weight was 17.6+/-7.3 gm(Mean+/-S.D.) and blood loss per gram was 18.7 ml. Correlation coefficient between resected weight and lood loss was +0.29 and was significant weakly. 4. Irrigation fluid was used 22.2+8.l L (Mean+/-S.D.) and blood loss per liter was 14.8ml. Correlation coefficient between irrigation fluid and blood loss was +0.32 and was significant weakly.
Aged ; Blood Transfusion ; Hemorrhage ; Humans ; Neck ; Transurethral Resection of Prostate* ; Urethral Stricture ; Urinary Bladder ; Urinary Incontinence ; Water Intoxication

An eighty year old woman was admitted at our hospital diagnosed as a cervical transverse myelitis at a previous hospital. She had a sudden weakness of right upper extremity and left lower extremity 2 months after admission. She received magnetic resonance imaging of brain and spinal cord and cerebrospinal fluid examination and was diagnosed as a recurrent transverse myelitis and midbrain infarction. After a steroid treatment, the weakness of extremities was improved.
Brain ; Cerebrospinal Fluid ; Extremities ; Female ; Humans ; Infarction ; Lower Extremity ; Magnetic Resonance Imaging ; Mesencephalon ; Myelitis, Transverse* ; Recurrence ; Spinal Cord ; Upper Extremity

An eighty year old woman was admitted at our hospital diagnosed as a cervical transverse myelitis at a previous hospital. She had a sudden weakness of right upper extremity and left lower extremity 2 months after admission. She received magnetic resonance imaging of brain and spinal cord and cerebrospinal fluid examination and was diagnosed as a recurrent transverse myelitis and midbrain infarction. After a steroid treatment, the weakness of extremities was improved.
Brain ; Cerebrospinal Fluid ; Extremities ; Female ; Humans ; Infarction ; Lower Extremity ; Magnetic Resonance Imaging ; Mesencephalon ; Myelitis, Transverse* ; Recurrence ; Spinal Cord ; Upper Extremity

The authors studied the diagnostic usefulness of the Topographic analysis of EEG, using Topography ststem 700 (San-ei), in evaluation of supratentorial focal cerebral lesions of 27 patients with various etiology, comparing with visual anslysis of EEG. Focal cerebral lesions, which were proven with brain C-T, were 11 cases of cerebral infarction, 6 of intracranial hematoma, 6 of cerebral gliolysis and 4 of others. The topography system displays the spatial distribution of activity in the classic delta, theta, alpha and beta frequency and computed mapping of EEG displays equipotential maps of square of roots of power spectra over each frequency band. For visual analysis of slow waves and background activity changes, Mayo classification system of EEG abnormality was used and for visual evaluation of topographic display, above system was also applied with some modification in order to compare with the data of visual analysis of conventional EEG. The results of the study were as follows; 1. While visual analysis of conventional anlysis of EEGs showed abnormality only in 13 cases (48.1%) of 27, topographic analysis showed abnormality in 22 cases (81.5%). Topographic analysis was more sensitive than than visual analysis of the EEG and topographic analysis was thought to be more sensitive in assessment of local slow waves as well as minor changes, especially slight asymmetry, of background EEG activity. 2. Topographic analysis showed higher concor dance rate (55.6%) to the brain C-T finding in lateralization of supratentorial focal cerbral lesion than that (44.4%) of visual analysis of the conventional EEG.
Bisoprolol ; Brain ; Cerebral Infarction ; Classification ; Electroencephalography* ; Hematoma ; Humans

A total of 28 consecutive patients underwent total cystectomy and urinary diversion from May, l978 to April, l986. The range of patient age was from 46 years old to 84 years old. The sex of patients was 24 in male and 4 in female. Histopathological diagnosis of specimen was transitional cell carcinoma in 25 cases, squamous cell carcinoma in 2 cases and carcinosarcoma in a case. Accuracy rate of clinical staging by pelvic CT scanning was low as 44%, clinical overstaging was 44% and clinical understaging was l2%. Early complication after cystectomy was occurred in l4 cases as wound infection, paralytic ileus, parastomal dermatitis, etc. Late complication was occurred in 8 cases as acute pyelonephritis, stomal stenosis, renal function deterioration and adhesive ileus. Mean follow up period of survival patients was 35.2 months with a range from 4 months to 96 months. Deaths during follow up were 8 patients and the average survival period was 20.6 months.
Adhesives ; Aged, 80 and over ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Carcinosarcoma ; Constriction, Pathologic ; Cystectomy* ; Dermatitis ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Male ; Middle Aged ; Pyelonephritis ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion ; Wound Infection