No abstract available.
Adenocarcinoma* ; Estrogens*

No abstract available.
Upper Extremity Deep Vein Thrombosis

Urinary tract calculi composed primarily of cystine are rare in adults and children. These are usually pure and found exclusively in patients with cystinuria. Cystinuria is an inherited defect in renal tubular reabsorption of four amino acids, cystine, ornithine, lysine, and arginine. Herein we report on a 2 and 1/12 years old male child with a right renal stone and multiple bladder stones composed primarily of cystine which were confirmed by X-ray diffraction method post-operatively.
Adult ; Amino Acids ; Arginine ; Calculi ; Child ; Cystine* ; Cystinuria ; Humans ; Lysine ; Male ; Ornithine ; Urinary Bladder Calculi ; Urinary Tract ; X-Ray Diffraction

Duplication of the renal pelvis and ureter is the most common congenital anomaly of the upper urinary tract. The three most important abnormalities associated with duplicated kidney are vesicoureteral reflux, ectopic ureter and ureterocele. Herein we present three cases of unilateral, complete duplicated ureter in children associated with ectopic ureteral orifice, vesicoureteral reflux and ectopic ureterocele, respectively, with review of related literatures. They have suffered from urinary incontinence with normal voiding since birth, recurrent urinary tract infection and protruding mass from the urethral meatus on straining respectively. Two cases of them were treated with partial nephrectomy and ureterectomy, the third was performed partial nephrectomy, ureterectomy and ureterocelectomy.
Child* ; Humans ; Kidney ; Kidney Pelvis ; Nephrectomy ; Parturition ; Ureter* ; Ureterocele ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: All procedures for the removal of retained intrahepatic stones were performed on inpatient basis. We evaluated the advantage of the procedures performed on inpatient basis compared with outpatient basis in terms of the success rate, causes of failure and the complication. MATERIALS AND METHODS: Percutaneous removal of retained intrahepatic stones was performed in 58 patients through a T-tube tract on inpatient basis from April 1990 to December 4992. Stones were exclusively intrahepatic in 28 patients, whereas 30 patients had combined stones in common bile duct. Preshaped catheters, baskets, and balloon catheters were used to remove the stones and dilate the strictures of the ducts. Extracorporeal shock wave lithotripsy and choledochoscopy with electrohydraulic lithotripsy were used to crush the impacted stones. RESULTS: The stones were completely removed in 34 (58.6%) of 58 patients and most of the stones were removed in 17 patients (29.3%). The overall success rate was 87.9%. The complications (cholangitis in 13% and pancreatitis in 0.8% per session) were found and successfully managed by appropriate care. CONCLUSION: Better success rate could be achieved by more aggressive appraoch on inpatient basis when compared with previous reports on outpatient basis. We suggest that the procedures should be performed on inpatient basis especially in a case with severe strictures or impacted stones.
Catheters ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Inpatients ; Lithotripsy ; Outpatients ; Pancreatitis ; Shock

Since Brown first described the eosinophilic cystitis in 1959, 42 cases has been reported in the literature. In Korea, only 1 case was reported from the National Medical Center a couple of years ago. Eosinophilic cystitis is characterized histologically by infiltration of eosinophils into the mucosa, submucosa and muscularis of the bladder and cystoscopically by elevated erythematous mucosal lesions. These lesions have been mistakenly diagnosed as bladder tumors prior to biopsy. Clinically, it presents with dramatic and recurrent episodes of dysuria and hematuria. It can occur in two different clinical setups. The first is seen in women and children and is often associated with allergic disorders and eosinophilia. The second presents in older man and is usually associated with bladder injury related to other conditions of bladder and prostate. We herein add two cases of eosinophilic cystitis, review etiologic theories and outline management.
Biopsy ; Child ; Cystitis* ; Dysuria ; Eosinophilia ; Eosinophils* ; Female ; Hematuria ; Humans ; Korea ; Mucous Membrane ; Prostate ; Urinary Bladder ; Urinary Bladder Neoplasms

A total of 6043 surgical cases were performed at S.D.A. Hospital from 1973 to 1979. These were analyzed statistically according to yearly numbers and emergency states, age, sex, anesthetic methods, anesthetic technique, duration of anesthesia, anesthetic agents and mortality. These were all inpatients operated under general anesthesia, and the results are as follows. Results. 1) Yearly numbers and emergency numbers were steadily increasing. 2) Sex ratio was 65%: 35% 2887 male cases(47.7%) and 5156 female cases(52.23%). 3) More than half of the age group was adult(21 to 60 years) 4) Halothane, nitrous oxide and neuromuscular blocker were used with increasing tendency. 5) The anesthetic technique was, in more than 90% of cases, was circle absorption system. 6) General surgery cases were 40% of the total of all departments. 7) In 66.95% of anesthesias the duration was 1 to 3 hours. 8) General anesthesia group was 98.63%. 9) Deathe occurred in 6 cases our of a total of 6043 cases.
Absorption ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Emergencies ; Female ; Halothane ; Humans ; Inpatients ; Male ; Mortality ; Neuromuscular Blockade ; Nitrous Oxide ; Sex Ratio

OBJECTIVES: The percutaneous vertebroplasty provides a good result in the treatment of osteoporotic vertebral compression fractures. But, the epidural leakage of polymethylmetacrylate(PMMA) after vertebroplasty may decrease the therapeutic effects because of the compression of thecal sac and/or nerve roots. The authors carried out a prospective study to evaluate the causative factors of epidural leakage of PMMA and to assess the influence on the outcome. METHODS: This study involved 347 vertebral levels of compression fractures in 159 patients. Among these, the epidural leakages were identified in 92 vertebral levels(26.5%) in 64 patients(40.3%) on post-operative CT scan. RESULTS: The incidence of epidural leakage of PMMA was significantly higher in the level above T7(p=0.001). The large amount of the injected PMMA and the use of an injector also increased the incidence(p=0.03 and p=0.045, respectively). The position of the needle tip in the vertebral body and the pattern of venous drainage did not influence. The immediate post-operative visual analogue scale(VAS) scores and facial scales(FS) were higher in the patients with epidural leakage(p=0.009). But there were no significant differences between the two groups after three months of operation(p=0.541). Conclusions: The incidence of epidural leakage of PMMA after percutaneous vertebroplasty appears to have relationship with the amount of PMMA and the levels injected. The epidural leakage of PMMA reduced the immediate therapeutic effects of vertebroplasty, but did not influence the late outcome. However, the epidural leakage should be avoided because of its potential neurological complications.
Drainage ; Fractures, Compression* ; Humans ; Incidence ; Needles ; Osteoporosis ; Polymethyl Methacrylate* ; Prospective Studies ; Tomography, X-Ray Computed ; Vertebroplasty*

The purpose of this study is to review the validity of quantitative indices on the Evaluation of Korean Medical Schools in 1996. The data required for the indices were obtained from the 1996's edition of the Directory of Korea Medical Education and compared to the results of the evaluation. Among the quantitative indices of the evaluation the number of professors and assistants of basic medical science was the most valuable index to differentiate the better group from lesser groups of medical schools in Korea.
Education, Medical ; Korea ; Schools, Medical*

Intractable pain from advanced carcinoma of the upper abdomen is difficult to manage. On method used to control pain associated with these malignancies is to block off the splanchnic nerve. In 1919 kappis described a technique by which the splanchnic nerve of the upper abdomen could be anesthetized, using a percutaneous injection. This method has been used for the relief of upper abdominal pain due to hepatoma and cancer of the pancreas, stomach, gall bladder, bile duct, and colon. During the period from November 1968 to January 1986, this method was used in 208 cases of malignancy at Severance Hospital and clinically evaluated. Patients were retroactively grouped according to the stage of development of technique used. Twelve patients who received the treatment in the period from November 1968 to March 1977 were designated as group 1, 26 patients from April 1977 to April 1979 as group 2, and 170 from May 1979 to January 1986 as group 3. The results are as follows: 1) The number of patients receiving splanchnic nerve block has been increasing since 1977. 2) A total of 208 patients, including 133 males and 75 females, ranging in age from 18 to 84 and averaging 51. 3) The causes of pain were stomach cancer 90, pancreatic cancer 69, and miscelianeous cancer 49 cases respectively. 4) There were 57.7% who had had surgery, and 3.7% of whom had had chemotherapy before the splanchnic nerve block was done. 5) These blocks were carried out with the patient in the prone position as described by Dr. Moore. Fro group 2 and 3 C-arm image intensifier was used. In group 1, a 22 gauze 10cm long needle was inserted at the lower border of the 12th rib on each side about 7cm from the midline. The average distance from the middle was 6.60+/-0.61cm on the left side and 6.60+/-0.83cm on the right side in group 2, and 5.46+/-0.76 on the left side and 5.49+/-0.69cm on the right side in group 3. The average depth to which the needle was inserted was 8.60+/-0.52cm on the left side and 8.74+/-0.60cm on the right side in group 2, and 8.96+/-0.63cm on the left side and 9.18+/-0.57cm on the right side in group 3. 6) The points of the inserted needles were positioned in the upper quarter anteriorly. 51.8% on the left side and 54.4% on the right side of the L1 vertebra by lateral roentgenogram in group 3. The inserted needle points were located in the upper and anterolateral part, of the L1 vertebra 68.5% on the left side and 60.6% on the right side, on the anteroposterior rentgenogram in group 3. The needle tip was not advanced beyond the anterior margin of the vertebral body. 7) In some case of group 3, contrast media was injected before the block was done. It shows the spread upward along the anterior margin of the vertebral body. 8) The concentration and the average amount of drug used in each group was as follows: In group 1, 39.17+/-6.69ml of 0.5% -1% lidocaine or 0.25% bupivacaine were injected for the test block and one to three days after the test block 40.00+/-4.26ml of 50% alcohol was injected for the semipermanent block. In group 2, 13.75+/-4.48ml of 1% lidocaine were used as the test block and followed by 46.17+/-4.37ml of 50% alcohol was injected as the semipermanent block. In group 3, 15.63+/-1.19ml of 1% lidocaine for test block followed by 15.62+/-1.20ml of pure alcohol and 16.05+/-2.58ml of 50% alcohol for semipermanent block were injected. 9) The result of the test block was satisfactory in all cases. However the semipermanet block was 83.3 percent of the patients in group 1 who received relief from pain for at least 2 weeks after the block, 73.1% in group 2, and 91.8% in group 3. In these unsuccessful cases, 2 cases in group 1 were controlled by narotics but 7 cases in group 2 and 14 cases in group 3 received the same splanchnic nerve block 1 or 2 times again within 2 weeks. But in some cases it was 3 to 5 months before the 2nd block and in 1 cases even 7 years. 10) The most common complications of splanchnic nerve block were hypotensino(25.5%) occasional flushing of the face, nausea, vomiting, and chest discomfort. 11) For the patients in group 3, the supplemental block most commonly used was a continuous epidural block; it was used as a diagnostic block and to afford relief from pain before the splanchnic nervel block was done. 12) The interval between the receiving of the alcohol block and discharge was from 5 to 8 days in 61 cases(31.1%) and from 1 to 2 days in 48 cases(24.5%). From the above results, it can be concluded that the splanchnic nerver block done in the prone position with pure and 50% alcohol immediately after an effective test block with 1% lidocaine under C-arm fluoroscopic control is satisfactory and reliable. How to minimize the repeat block is still a problem to be solved.
Abdomen ; Abdominal Pain ; Bile Ducts ; Bupivacaine ; Carcinoma, Hepatocellular ; Colon ; Contrast Media ; Drug Therapy ; Female ; Flushing ; Humans ; Lidocaine ; Male ; Nausea ; Needles ; Pain, Intractable ; Pancreatic Neoplasms ; Prone Position ; Ribs ; Spine ; Splanchnic Nerves* ; Stomach ; Stomach Neoplasms ; Thorax ; Urinary Bladder ; Vomiting