The records of fifty two cases of the ileal conduit at the Seoul National University Hospital during a 6-year period from January 1, 1975 to December 31, 1980 were reviewed. 1. There were 42 males and 10 females (ratio of 4.2:1) ranged in age from 5 to 74 years with peak incidence in the 6th decade. 2. The most common indication of this procedure was bladder tumor and other indications were neurogenic bladder, bilateral ureteral stricture, genitourinary tuberculosis, actinomycosis, urethral stricture. urethral cancer and colon cancer. 3. Seventy seven percent of patients with abnormal renal function preoperatively improved postoperatively. 4. Operative mortality was 3.8%. Early complication included wound infection and disruption, sepsis, obstruction and urine leakage in ileoureteral junction, pneumonia, fecal leakage from ileoileal junction, postoperative acute renal failure, bleeding from ileal loop, and urethral bleeding. Late complication included intestinal obstruction, parastromal dermatitis, acute pyelonephritis, ureteral obstruction and incisional hernia. 5. Thirty three of 43 patients developed bacteriuria, 30.3% of the patients showed mixed infection and major causative organisms were Pseudomonas, Enterobacter, E. coli and Serratia.
Actinomycosis ; Acute Kidney Injury ; Bacteriuria ; Coinfection ; Colonic Neoplasms ; Constriction, Pathologic ; Dermatitis ; Enterobacter ; Female ; Hemorrhage ; Hernia ; Humans ; Incidence ; Intestinal Obstruction ; Male ; Mortality ; Pneumonia ; Pseudomonas ; Pyelonephritis ; Seoul ; Sepsis ; Serratia ; Tuberculosis ; Ureter ; Ureteral Obstruction ; Urethral Neoplasms ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Bladder, Neurogenic ; Urinary Diversion* ; Wound Infection

This is to report a clinical observation on 81 cases of genito-urinary tract injuries treated at the urology service. Capital Army Hospital, during the period from January, 1960 to July, 1963. Of 81 Cases which stood for 0.82% of all genito-urinary out patients, 58 cases (or 71.6%) occurred in the urethra, the most common site of involvement, and 6 cases (or 7.2%) showed multiple injuries. Age ranged between 21 and 10 years with the highest incidence of 58.4% in the ages between 21-25 years. In lateralyzation of injury while the kidney showed nosignificant difference the ureter was more frequently involved in the left than in the right with a ratio of 4:1. Traffic accident was listed as high as 56.9% to be most frequent cause of injury and contusion, fall, gun-shot and explosion were listed less frequently. Of associated major injuries, pelvic fracture was seen in 20 cases (33.9%) and all the urethral injuries were accompanied with injuries to gastro-intestinal tract. Of all cases herein reported, 62.3% of cases were treated surgically and the remaining 37.7%. non-surgically. Surgical intervention was necessary in 33.3% of kidney injury, 100% of ureteral injury, 67.8% of urethral injuries and 40% of genital injuries. Average hospitalization required 20.2 days for renal injury and 67.2 days for urethral injury.
Accidents, Traffic ; Contusions ; Explosions ; Hospitalization ; Hospitals, Military ; Humans ; Incidence ; Kidney ; Multiple Trauma ; Outpatients ; Ureter ; Urethra ; Urology

Clinical and statistical observation was made on outpatient inpatients and operations in Urology Department of the Capital Army Hospital during the period from Jan., 1962 to Dec. 1963 and the results (1) Clinical statistics on outpatients. 1) Total outpatient were 2213 cases, 2179 males and U females, and the male to female ratio was 64.1:1. 2) The number of outpatient increased in winter and decreased in summer. 3) According to age distribution, the majority of the patients (96.2%) where between 21 and 40 years of age. 4) The most common diseases were urethritis (35.7%) showing annual increase, while redundant prepuce, urolithiasis, injury of genito-urinary tract, nonspecific epididymitis and hydrocele, showing annual decrease. 5) Renal tuberculosis showed annual decrease and tuberculous epididymitis, annual increase. (II) Clinical statistics on inpatients. 1) The inpatients during 2 years were 241 cases which comprised10.9% of total outpatients. The male inpatients stood for 11% of total outpatient and the female inpatients, 5.9%. 2) The most common disease were renal tuberculosis, hydrocele, non-specific epididymitis, stones of kidney and ureter, tuberculous epididymitis, urethral rupture and scrotal hematoma. (III) Clinical statistics on operations. The number of total operations were 640 during 2 years. Circumcision comprised 34.0% of total operations, vasectomy, 30.6% Nephrectomy, 6.1% ; epididymectomy, 6.1%, hydrocelectomy, 4.1% and plastic surgery of urethra, 2.3%. One case of Bricker's operation was performed.
Age Distribution ; Circumcision, Male ; Epididymitis ; Female ; Hematoma ; Hospitals, Military* ; Humans ; Inpatients* ; Kidney ; Korea* ; Male ; Nephrectomy ; Outpatients* ; Rupture ; Seoul* ; Surgery, Plastic ; Tuberculosis, Renal ; Ureter ; Urethra ; Urethritis ; Urolithiasis ; Urology* ; Vasectomy

There were 122 infertile males who received testicular biopsy in our department during the period from 1978 to 1980. Among them, 20 patients were diagnosed to have Sertoli cell only syndrome by pathologic finding. A cumulative clinical investigation was undertaken in 20 patients with Sertoli cell only syndrome using history taking, orchidometer, semen analysis, and plasma hormonal assay (FSH. LH, & Testosterone). We found the interesting relationship between the size of the testis and plasma hormonal levels. 1. In pathologic finding, Sertoli cell only syndrome was 16%, spermatic arrest 16%, hypospermatogenesis 15%, peritubular fibrosis 15%, and normal testis accompanying obstruction of efferent duct 22%. 2. The size of the testis was average 12ml, and plasma FSH was increased to average 27.43 IU/L, plasma LH was also increased to average 25.9 IU/L, but plasma testosterone was within normal ranges (average 5.58 ng/ml).
Biopsy ; Fibrosis ; Humans ; Male ; Oligospermia ; Plasma* ; Reference Values ; Semen Analysis ; Sertoli Cell-Only Syndrome* ; Testis* ; Testosterone

No abstract available.
Erythromycin* ; Gastric Emptying* ; Gastroparesis*

PURPOSE: To determine the clinical utility of coronary CT angiography (CCTA) with low-dose chest CT in the evaluation of patients with atypical chest pain. MATERIALS AND METHODS: Ninety-six patients (mean age 60.2 years; age range, 41-68 years; 70 males) were referred for CCTA with low-dose chest CT (16-slice MDCT, Siemens) for an evaluation of atypical chest pain. When significant stenoses (lumen diameter reduction > 50%) were detected on CCTA, invasive coronary angiography (CA) was performed as the standard of reference. In all patients, medical chart review or telephone contact with patients was used to evaluate the contribution of CCTA with low-dose chest CT to the final clinical diagnosis, at least 6 months after performing CCTA. RESULTS: Among 96 patients, seven patients (7%) had significant stenoses as detected on CCTA, whereas two patients (2%) had significant stenoses and five patients had insignificant stenoses or no stenosis, as detected on conventional catheter angiography. In 18 (19%) of the 89 patients without significant stenosis detected on CCTA, this protocol provided additional information that suggested or confirmed an alternate clinical diagnosis. CONCLUSION: In patients with atypical chest pain, CCTA with low-dose chest CT could help to exclude ischemic heart disease and could provide important ancillary information for the final diagnosis.
Angiography ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Myocardial Ischemia ; Telephone ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: The optimal treatment for mitral regurgitation from leaflet prolapse or multiple leaflet pathology is not yet established. Recently, new chordae formation(NC) with olytetra-fluoroethylene(PTFE) has become increasingly popular. The aims of the current study was to see the effects of new chordae formation on mitral alvuloplasty. MATERIAL AND METHOD: From January 1994 to december 1999 322 patients receiving itral valvuloplasty were divided into two groups in which 144 patients(Group I) received NC and 178 patients(group II) received mitral valvuloplasty without NC. Echocardiograms were performed in the immediate postoperative period, at 6 months and 1 year after surgery and annually thereafter. RESULT: Mitral valvuloplasty was performed for mitral regurgitation in 95%(322/ 337) of the patients and the mean followup period was 27+/-20.6 months of which follow-up was complete for 95.4%(306/ 322). The degree of mitral regurgitation in both groups I and II improved from 3.8+/-0.4 to 1.3+/-0.9 and 3.6+/-0.3 to 1.1+/-0.7, respectively. There was also no significant difference in the mean mitral area or transvavular pressure gradient across the mitral valve. The overall early and late mortality rates were 0.9%(3) and 1.2%(4), also showing no significant difference between the two groups. The late survival rate(97.8+/-1.6 vs 97.7+/-1.6%), freedom from structural degeneration 93.7+/-3.6 vs 90.7+/-3.4%) freedom from reoperation(99.3+/-0.7 vs 96.6+/-1.8%), freedom from thromboembolism, freedom infective endocarditis, and valve related complications showed no significant difference between the two groups. CONCLUSION: Mitral valvuloplasty with NC not only resulted in an increase in the volume of mitral reconstruction(r=0.98, p<0.01) but enhanced urability and stability comparable to currently established methods. Mitral valvuloplasty with NC was especially effective in the treatment of pan valvular pathology, commissural lesions and multiple leaflet pathology which would otherwise have been difficult to treat with current methods.
Endocarditis ; Follow-Up Studies ; Freedom ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Mitral Valve* ; Mortality ; Pathology ; Postoperative Period ; Prolapse ; Thromboembolism

BACKGROUND: Coronary artery bypass grafting(CABG) has been established as an effective treatment modality in improving the symptoms of ischemic heart disease as well as in preventing sudden death. Since the relatively wide use of arterial grafting in the 80's, an improvement in long term patency rates compared with saphenous vein grafting has been suggested. We have been using multiple arterial grafts since 1998, and we attempted to compare our early results with those of saphenous vein grafting. MATERIAL AND METHOD: Out of the 355 patients that received CABG at our center between June,1998 and May,1999, 153 patients that used cardioplegia were reviewed. 76 had received single arterial graft(Group I) and 77 had received more than 2 arterial grafts(Group II). Preoperative clinical data, ecohocardiography, and angiographic studies were analyzed retrospectively. RESULT: Preoperatively, there were statistically significant differences between Group I and Group II with respect to age and smoking history. There was one early postoperative mortality in each group. The number of anastomoses constructed per patient showed a statistical difference. There were no other differences in operative and postoperative results. CONCLUSION: Even in our learning period, there was no difference in our early results between arterial grafting and saphenous vein grafting. These early results suggest that arterial grafting may afford patients as improving in late survival. Futhermore, these results suggest that complete arterial revasularization may serve to prolong life expectancy.
Coronary Artery Bypass* ; Coronary Vessels* ; Death, Sudden ; Heart Arrest, Induced ; Humans ; Learning ; Life Expectancy ; Mortality ; Myocardial Ischemia ; Retrospective Studies ; Saphenous Vein ; Smoke ; Smoking ; Transplants*

The objective of this study was to develop a pre-clinical large animal model for the in vivo hemodynamic testing of prosthetic valves in the aortic position without the need for cardiopulmonary bypass. Ten male pigs were used. A composite valved conduit was constructed in the operating room by implanting a prosthetic valve between two separate pieces of vascular conduits, which bypassed the ascending aorta to the descending aorta. Prior to applying a side-biting clamp to the ascending aorta for proximal grafting to the aortic anastomosis, an aorta to femoral artery shunt was placed just proximally to this clamp. The heart rate, cardiac output, Vmax, transvalvular pressure gradient, effective orifice area and incremental dobutamine stress response were assessed. A dose dependant increase with dobutamine was seen in terms of cardiac output, Vmax, and the peak transvalvular pressure gradient both in the native and in the prosthetic valve. However, the increment was much steeper in the prosthetic valve. No significant differences in cardiac output were noted between the native and the prosthetic valves. The described pre-clinical porcine model was found suitable for site-specific in-vivo hemodynamic assessment of aortic valvular prosthesis without cardiopulmonary bypass.
Adrenergic beta-Agonists/pharmacology ; Animals ; Aorta/pathology ; Aortic Valve/*pathology ; Disease Models, Animal ; Dobutamine/pharmacology ; Dose-Response Relationship, Drug ; Heart Rate ; *Heart Valve Prosthesis ; Male ; Pressure ; *Prosthesis Implantation ; Support, Non-U.S. Gov't ; Swine ; Thoracic Arteries/pathology

PURPOSE: The purpose of this study was to evaluate the early results of total hip arthroplasty (THA) performed using large diameter femoral head against with highly cross-linked polyethylene as a bearing surface in patients less than sixty years of age. MATERIALS AND METHODS: Seventy patients were enrolled and retrospectively reviewed. The mean age of patients at index surgery was 49 years and the mean follow-up period was 61 months. Clinical follow-up involved implementing the Harris hip score (HHS) and a radiographic evaluation that included linear radiolucency, osteolysis, and loosening. An annual wear rate was performed at 6 weeks; at 3, 6, and 12 months; and on a yearly basis thereafter. RESULTS: The average HHS at last follow-up was 94 (range: 82-98). Radiographically, no osteolysis in the pelvis or proximal femur was observed in any patient. No acetabular cup or femoral stem failed due to aseptic loosening. No eccentric wear was observed on any liner, and no liner fracture occurred. However, one patient experienced hip dislocation. The average femoral head penetration rate during the first postoperative year was 0.077+/-0.026 mm/year, and the average steady-state wear rate was 0.033+/-0.023 mm/year. CONCLUSION: THA with a large diameter femoral head of highly cross-linked polyethylene in patients younger than 60 years of age was found to produce results comparable to previous in vitro laboratory hip simulation studies. In particular, patient satisfaction was high due to no limitation in range of motion or hip posture during the early post-operative period. Longer-term follow-up is required to demonstrate the clinical benefits of this new material more comprehensively.
Arthroplasty ; Femur ; Follow-Up Studies ; Head ; Hip ; Hip Dislocation ; Humans ; Osteolysis ; Patient Satisfaction ; Pelvis ; Polyethylene ; Posture ; Range of Motion, Articular ; Retrospective Studies ; Tacrine ; Ursidae