To evaluate the cost-effectiveness of excretory urography, results were reviewed in 60 patients with chronic epididymitis. In 37 patients(of total 60 cases) who have neither scrotal fistula nor hematuria (microscopic or gross) nor positive urine AFB staining, there was no tuberculous finding in excretory urography. And findings consistent with renal tuberculosis were found in 11 cases (73% ) of 15 patients with scrotal fistula, in 9 cases (75%) of 12 patients with hematuria and in 4 cases (80%) of 5 patients with positive urine AFB staining. Therefore, routine use excretory urography in chronic epididymitis is revealing neither scrotal fistula nor hematuria nor positive AFB in urine is not always necessary for detection of renal tuberculosis in terms of cost effectiveness.
Cost-Benefit Analysis ; Epididymitis* ; Fistula ; Hematuria ; Humans ; Male ; Tuberculosis, Renal ; Urography*

The effects of intraperitoneal injection and intravesical instillation of viable Bacillus Calmette-Guerin(BCG) as an inhibitor in the development of experimental bladder tumors, were examined in rats administered with N-butyl-N-(4-hydroxybutyl) nitrosamine(BBN). A single intraperitoneal injection of BCG at the initiation of BBN administration inhibited significantly the occurrence of transitional cell carcinoma of the urinary bladder, while the same intraperitoneal BCG 2 weeks prior to the administration of BBN did not significantly suppress the carcinogenesis. A series of additional intravesical BCG instillation of different doses and durations to the initial intraperitoneal BCG did not potentiate significantly the antitumor effect by BCG, however, there was a considerable reduction of tumor incidence. The above results suggest that viable BCG immunotherapy alter favorably the course of the experimental bladder cancer in rats, and the routes, intervals and doses of BCG would critically effect the anti-tumor activity, accordingly.
Administration, Intravesical ; Animals ; Bacillus* ; Carcinogenesis* ; Carcinoma, Transitional Cell ; Immunotherapy ; Incidence ; Injections, Intraperitoneal ; Mycobacterium bovis ; Rats* ; Urinary Bladder Neoplasms ; Urinary Bladder*

A study of urodynamics including simultaneous cystometry/rectal pressure/electromyography and simultaneous urethral profilometry/ electromyography on neurogenic bladder was performed in the Department of Urology, Seoul National University Hospital during the period March, 1980 through July, 1980 and the following results were obtained; 1. Of 13 cases, 2 cases were hyperreflexis and 11cases were areflexia on cystometry. On cystometry and urethral electromyography, detrusor sphincter dyssynergia was observed in 1 case of hyperreflexia and 2 cases of areflexia. In 1 case of detrusor sphincter dyssynergia having areflexia voiding cystourethrography was performed under the fluoroscopy in standing position and the site of dyssynergia could be detected. On cystometry and rectal pressure monitoring, the true detrusor pressure could be obtained through electronic subtraction (total bladder pressure minus rectal pressure.) . 2. Of 13 cases, maximum urethral closure pressure was below the normal value in 6 cases of areflexia but functional urethral length was normal in all cases on urethroprofilometry. On urethroprofilometry and urethral electromyography, it was found that the difference of the distribution existed in the urethral sphincter between the both sexes.
Ataxia ; Electromyography ; Fluoroscopy ; Reference Values ; Reflex, Abnormal ; Seoul ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urodynamics* ; Urology

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta whitch originates just distal to the level of the origins of the coronary arteries, and whitch includes a wide spectrum of pathologic changes. A 27 years-old-female was admitted because of further evaluation of known some heart disease. Clinical diagnosis of supravalvular aortic stenosis was made by echocardiography and angiography. We presented a case of supravalvular aortic stenosis with a review of literature.
Angiography ; Aorta ; Aortic Stenosis, Supravalvular* ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Echocardiography ; Heart Diseases

Hypothalamic-pituitary-gonadal function in male hepatic insufficiency was clinically in vestigated using cases of chronic hepatitis of viral origin, liver cirrhosis and non-hepatic control, with particular attention on incidencies of esophageal varix, spider angioma, palmar erythema and ascitic accumulation along with measurement of plasma levels of testosterone, estradiol, luteinizing hormone and follicle stimulating hormone. The following results were obtained : 1. Significant decreases of plasma testosterone and significant increase of estradiol were observed in cases of liver cirrhosis. The value of luteinizing hormone increased with significance. 2. Incidencies of esophageal varix, ascites, spider angioma and palmar erythema were higher in liver cirrhosis than in chronic hepatitis. 3. Decrease in testosterone level and increase of estradiol level were observed more prominently while there were higher grade of esophageal varix or presence of both spider angioma and palmar erythema throughout.
Ascites ; Erythema ; Esophageal and Gastric Varices ; Estradiol ; Follicle Stimulating Hormone ; Gonads ; Hemangioma ; Hepatic Insufficiency ; Hepatitis, Chronic ; Humans ; Hypothalamus ; Liver Cirrhosis ; Liver Failure* ; Luteinizing Hormone ; Male ; Plasma ; Spiders ; Testosterone

BACKGROUNDING/AIMS: Although several papers provided evidence of a survival advantage for preoperative transcatheter arterial chemoembolization(TAE), recent studies have revealed that patients with resectable tumors have not been benefited from this adjuvant therapy. This study has been done for investigating the effect of the preoperative TAE with resectable hepatocellular carcinoma(HCC) which were diagnosed and treated by surgery and surgery with TAE by analysis and comparison with patient's survival rate between two different methods of treatment. METHODS: We retrospectively reviewed the medical records of 39 patients who underwent the hepatic resection for hepatocellular carcinoma at Chonnam National University Hospital between 1986 and 1997. Median follow-up period was 28 months. Survival rates were estimated by Kaplan-Meier method and difference was detected by Log-rank test using SPSS program.. RESULTS: Male patients were 28 and female were 11 and their mean age was 54.4 years. The patients treated by operation alone were 17 and by preoperative TAE with operation were 22. A reduction of tumor size was achived in 13 of the 22 patients(59.1%) who underwent preoperative TAE. The cumulative survival rate of 1 year, 2 year, 3 year were 90%, 84%, 70% in patients treated by operation alone, 86%, 75%, 52% in patients treated by preoperative TAE and operation respectively. And the relative risk of death for TAE with operation and operation alone was 0.974. The postoperative mean liver function test of the patients who underwent preoperative TAE was higher than those who did not. CONCLUSIONS: The advantage of preoperative TAE with resectable HCC still remains disputable. However, preoperative TAE has the advantage of reducing tumor size and make it easy to operate and decrease the resection field. But the liver function after TAE may deteriorate in some of the patients with liver dysfunction. In conclusion, preoperative TAE must not be performed for resectable HCC as a routine procedure because the overall survival rate was similar between the two groups.
Carcinoma, Hepatocellular* ; Female ; Follow-Up Studies ; Humans ; Jeollanam-do ; Liver ; Liver Diseases ; Liver Function Tests ; Male ; Medical Records ; Prognosis* ; Retrospective Studies ; Survival Rate

Recently, Prosthetic replacement of hip was recognized as a reliable technique for the treatment of avascular necrosis of femoral head in adult. There were many reports about post-operative evaluation of functional difference between hemiarthroplasty and total hip arthroplasty and which revealed that the revision rate for the total hip arthroplasty was less compared with the femoral endoprosthesis. Also, controversy was existed between the porous coating system and bone cement fixation. In order to evaluate the functional difference among each prosthetic replacement, authors reviewed the result of 10 cases of cementless unipolar endoprosthesis (abbreviated as UE), 10 cases of cementless bipolar endoprosthesis (abbreviated as BE), and 25 cases of cementless total hip replacement arthroplasy (abbreviated as THRA), performed at Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital, during the period from September, 1985 to August, 1988. The following results were obtained: 1. The incidence was higher in 6th decade in UE, THRA groups, 4th decade in BE group. 2. The average follow up of UE, BE, and THRA groups were 30.7, 15.2, and 16.9 months, respectively. 3. By radiological classification of Marcus et al., the average stages of UE, BE, and THRA were 4.9, 4.0, and 5.3respectively. 4. According to Harris hip rating system, post-op. Harris scores were increased as much as 33.1, 37.2, and 43.4 in UE, BE, and THRA groups respectivelycompared with pre-op. score. 5. In this study, the last follow up results of hip function in BE, and THRA groups were better than that evaluated at 6 months after surgery in most cases. 6. External rotation, which was one of needed motion in cross leg sitting position, was significantly influenced by the degree of excision of joint capsule, the type of replacement prosthesis, the regimen of post-op. starting exercise, and a history of previous surgical treatment. 7. Because serious complications were not developed at recent follow up, the UE, BE, and THRA groups showed insignificant difference in functional difference in prosthetic replacement.
Adult ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip ; Classification ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Joint Capsule ; Leg ; Necrosis ; Prostheses and Implants

Fabry's disease, angiokeratoma corporis diffusum, is a rare X-linked inborn error of glycosphingolipid metabolism due to the lack of the lysosomal enzyme, alpha-galactosidase A, resulting in a progressive intracellular deposition of neutral glycosphingolipids in various tissues, including the dorsal root ganglia, autonomic nervous system, vascular endothelial, and smooth muscle cells. Clinical manifestations of Fabry's disease result predominantly from the progressive deposition of globotriaocylceramide in the nervous system or vascular endothelium, and are characterized by acro-paresthesia, angiokeratoma, corneal opacity, TIA or stroke, ischemic heart disease, and renal failure. We report a case of a 19-year-old man presenting with a 12-year history of severe distal pain, acroparesthesia, short stature, and delayed puberty. An enzymatic assay disclosed substantially diminished alpha-galactosidase A activity and an electron microscopy of the peripheral nerve showed lipid inclusions which were composed of concentrically laminated, ovoid osmiophilic bodies in the perineural fibroblast and endothelial cells. These findings are typical of Fabry's disease and additional genetic study revealed deletion mutation(TTAG) at the 6th exon of the alpha-galactosidase A gene, which is a novel mutation that had never been reported in literatures. Symptomatic treatment with carbamazepine and clonazepam was tried with a good response.
alpha-Galactosidase ; Angiokeratoma ; Autonomic Nervous System ; Carbamazepine ; Clonazepam ; Corneal Opacity ; Endothelial Cells ; Endothelium, Vascular ; Enzyme Assays ; Exons* ; Fabry Disease* ; Fibroblasts ; Ganglia, Spinal ; Humans ; Metabolism ; Microscopy, Electron ; Myocardial Ischemia ; Myocytes, Smooth Muscle ; Nervous System ; Neutral Glycosphingolipids ; Peripheral Nerves ; Puberty, Delayed ; Renal Insufficiency ; Stroke ; Young Adult

No abstract available.
Fabry Disease* ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory*

Laparoscopic examination was performed successfully on 28 patients with 30 nonpalpable testes, ranging from 20 to 173 months of age. The procedure was done immediately before exploration under same general anesthesia and successful in determining the location of testes in all cases. These informations were clinically beneficial for selective the subsequent operative approach. Attempt of orchiopexy in 9 testes, orchiectomy in 4 cases due to too short spermatic cord and removal or atrophic testis-like tissue with cord structure in 17 cases were undergone and resected tissues were confirmed by histopathological examination. The results revealed 13 anorchia, 2 rate testis and 2 smell remnant of testicular tissue, which were not far from each laparoscopic findings. we could have avoided surgical procedure in 13 cases which had closed internal inguinal ring and no visible testicular tissue and application of some endourologic procedure such as coagulation or resection could be carefully considered in those cases. There was no complication from the procedure and it added insignificant increase in operative time.
Anesthesia, General ; Cryptorchidism ; Humans ; Inguinal Canal ; Laparoscopy ; Male ; Operative Time ; Orchiectomy ; Orchiopexy ; Smell ; Spermatic Cord ; Testis*