No abstract available.
Drainage* ; Humans ; Jaundice, Obstructive*

No abstract available.

No abstract available.
Toes*

Proper management of childhood and adolescent varicocele remains still controversial. In general, all methods for varicocele ablation for adults are available and include open surgical ligation, laparoscopic ligation, or percutaneous ablation. We evaluated the usefulness of percutaneous embolization of internal spermatic vein in boys with varicocele. Between February 1988 to May 1996, 48 boys of 53 varicoceles underwent percut aneous embolization. In 49 cases, the embolization were technically possible and in the other 4 cases, we could not access the internal spermatic vein because of vasospasm and venous abnormality. The results were successful in 40 cases (81.6%) and failed in 9 cases (18.4%), including 4 (8.2%) of persistent and 5 (10.2%) of recurred cases. There were no major complications except 3 cases of extravasation of contrast material. Percutaneous embolization may be recommended as a primary treatment for childhood and adolescent varicocele.
Adolescent* ; Adult ; Humans ; Ligation ; Varicocele* ; Veins*

Two cases of renal infarctions were presented with review of literature.
Infarction*

Lateral pharyngeal space is one of potential fascial planes of head and neck, that may become involved by various pathological processes, such as infection, inflammation and neoplasm. The calcified stylohyoid ligament with styloid process is also located in this space, so this space is more acquainted with Eagle's syndrome in oral and maxillofacial field. During the mandibular transbuccal fixation procedures of 29-year old female patient who had right condylar neck and left parasymphysis fracture, we had lost one 10.0 mm miniscrew. After confirming the location of the lost miniscrew from different angled plain skull radiographies, we tried to find it in the lateral pharyngeal space via transtonsillar approach at the time of plate removal operation. This case report is aimed to share our valuable experience of the effective approach way to the lateral pharyngeal space, which has many advantages, such as short operative time, minimal bleeding, fast post-operative recovery, and less morbidity. The related literature is also reviewed.
Adult ; Female ; Foreign Bodies* ; Head ; Hemorrhage ; Humans ; Inflammation ; Ligaments ; Neck ; Operative Time ; Pathologic Processes ; Skull

Exercise-induced ischemic ST responses were analyzed in 36 patients who presented with chest pain and had exercise test and the results were compared with their coronary angiographic findings. Among 36 exercise test positives, the incidences of one-, two- and three vessel disease, and left main disease were 25%(9 cases), 30%(11 cases), 25%(9 cases) and 9%(3 cases), respectively. The incidence of multivessel disease(i.e., two-to three vessel disease or left main disease) in patients with ST depression > or =2.0mm was 72% and that in those with ST depression of 1.0-1.9mm was 45%. In patients with downsloping ST depression, the incidence of multivessel disease was significantly higher than that of one vessel disease(86% vs 14%, p<0.001). But both incidences of one vessel disease and multivessel disease were similar in patients with flat and slowly upsloping ST depression. More than two thirds of patients with ischemic ST depression appearing in the first 6 minutes of exercise or those lasting past 7 minutes in recovery were associated with multivessel disease. It is concluded that attention to depth, type, appearance time and duration of ST depression during exercise test is particularly helpful in detecting patients with advanced coronary disease.
Chest Pain ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Depression ; Electrocardiography* ; Exercise Test ; Humans ; Incidence

OBJECTIVES: Developments in endoscopic technique and equipments have improved duct clearance rate in patients with extrahepatic bile duct(EHBD) stone. In this study, we reviewed our experience in extracting EHBD stones with standard and more advanced technique and equipments such as mechanical lithotripsy and extra corporeal shock wave lithotripsy. Aims of this study were to determine the overall success rate of endoscopic ex tracting for EHBD stone, to identify risk factors for failed duct clearance at initial and final therapeutic ERCP. METHODS: We retrospectively reviewed 214 consec utive patients who underwent Endoscopic Retrograde Cholangiopancreatography(ERCP) for EHBD stone over 45 months period. Factors evaluated for failed duct clearance included stone size, stone number, stone shape, concomitant stone of gallbladder and intrahepatic duct, presence of distal bile duct stricture, periampullary diverticula(PAD), Billroth-II gastrojejunostomy, and sepsis at admission. RESULTS: The overall success rate of endoscopic treatment for EHBD stone was 93.5% (200/214). The causes of failed duct clearance were failed endoscopic sphincterotomy in 5/214 (2.3%), technical failure of extracting stone in 5/214(2.3%), and aggravation of acute cholecystitis between therapeutic endoscopic sessions in 4/214(1.9%). Risk factors for failed duct clearance with endoscopic extraction of EHBD stone were size and shape of the stone, concomitant stone of gallbladder and intra hepatic duct, and stricture of distal common bile duct. The duct clearance rate with initial therapeutic ERCP was 56.5%(121/200). Risk factors for failed duct clearance with initial therapeutic ERCP were size, shape and number of stone, and sepsis at admission. The com plications of endoscopic treatment for EHBD stone were major bleeding in 5/200 (2.5%), pancreatitis in 18/200 (9.0%), but there was no perforation. CONCLUSION: Eventhough risk for failure of endo scopic treatment for EHBD stone were giant or piston shaped stone, concomitant stone of gallbladder and intra hepatic duct, and stricture of distal common bile duct, we conclude that endoscopic treatment for EHBD stone is safe and effective treatment modality, and choice of treatment.
Bile ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis, Acute ; Common Bile Duct ; Constriction, Pathologic ; Gallbladder ; Gastric Bypass ; Hemorrhage ; Hepatic Duct, Common ; Humans ; Lithotripsy ; Pancreatitis ; Retrospective Studies ; Risk Factors ; Sepsis ; Shock ; Sphincterotomy, Endoscopic

PURPOSE: This study was performed to investigate whether the free to total PSA ratio(F/T PSA ratio) offers a better discriminant for the detection of patient with prostatic cancer(CaP) and those with benign prostatic hyperplasia(BPH) than serum total PSA alone. MATERIALS AND METHODS: From September 1996 to February 1999, free and total PSA levels were measured on frozen sera samples of 154 men with BPH and 46 with CaP using immunoradiometric assay. RESULTS: In all subjects, the mean total PSA was significantly higher in CaP group(72.59+/-66.58ng/ml) than BPH group(3.12+/-4.10ng/ml). The mean PSAD was significantly higher in CaP group(1.64+/-1.86) than BPH group(0.08+/-0.01). The mean F/T PSA ratio was significantly lower in CaP group(0.19+/-0.07) than BPH group(0.30+/-0.13). Among 41 subjects whose total PSA were between 4-20ng/ml, the mean PSAD was significantly higher in CaP group(0.37+/-0.16) than BPH group(0.17+/-0.07), but the mean F/T PSA ratio was not significantly different between CaP(0.19+/-0.10) and BPH group(0.25+/-0.13). By comparing the sensitivity and specificity of total PSA alone, PSAD and F/T PSA ratio on receiver operating characteristic(ROC) curve in all subjects and subjects with total PSA between 4-20ng/ml, F/T PSA ratio had no superiority than total PSA alone and PSAD for. discrimination between CaP and BPH. CONCLUSIONS: We suggest that the F/T PSA ratio is not superior to total PSA alone and PSAD in the detection of prostatic cancer, and further evaluation of the usefulness of F/T PSA ratio should be required.
Discrimination (Psychology) ; Humans ; Immunoradiometric Assay ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms* ; Sensitivity and Specificity

OBJECTIVE: Depending on genetic or environmental effects over adolescent development, typical behavioral responses come out in adolescence. Also, alteration of nitric oxide (NO) levels in the brain has been associated with modifications of stress related behavior. Present study was designed to investigate the possible influence of chronic stress from restraint on the generation of depression in adolescent mice, and also to evaluate whether NO has modulatory roles in the behavioral and biological reactions. METHODS: ICR mice exposed to stressful restraint, 2 h per day, was treated with NG-nitro L-arginine methyl ester (L-NAME) (10 mg/kg), a non-selective NO synthase (NOS) inhibitor. To evaluate depression-like behavior in the mice, forced swim test and open field test were performed after the last restraint. To investigate stress-induced changes in the expression level of glial cell-derived neurotrophic factor (GDNF), free-floating immunohistochemistry was performed. RESULTS: The results showed that stressed group has longer immobility time and less crossing number in forced swimming and open field test, and that these stress responses were significantly prevented by L-NAME. Furthermore, decreased GDNF expression in the hippocampus by stress was prevented to that of controls within the L-NAME treated group. CONCLUSION: The results suggest that stress and NO signaling could be involved in generation of depression in adolescence. It also suggested that GDNF might contribute to prevent stress-related behaviors.
Adolescent ; Adolescent Development ; Animals ; Arginine ; Brain ; Depression ; Glial Cell Line-Derived Neurotrophic Factor ; Hippocampus ; Humans ; Immunohistochemistry ; Mice ; Mice, Inbred ICR ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Swimming