No abstract available.
Pregnancy*

We measured the concentration of serum PSA to define statistical upper limits for PSA in relation to age in 228 men without clinical evidence of prostatic cancer. We defined the cancer-free group as men with a PSA less than or equal to 2.5ng/ml(ELSA-PSA' monoclonal immunoradiometric assay) and nonsuspicious digital rectal examination and those with an abnormality in either parameter underwent transrectal ultrasound and pathologically excluded prostatic cancer from the group by transrectal prostatic biopsy or transurethral resection. A total 252 men between 40 and 79 years of age entered the protocol, of whom 228 men satisfied our cancer-free criteria. There was a significant correlation between natural logarithm transformed PSA(In PSA) and age by linear regression analysis(r=0.32, p=0.02) and age-specific upper limits of PSA=mean+2SD) were 2.62ng/ml in the 40 to 49-year group, 3.45ng/ml in the 50 to 59-year group, 5.09ng/ml in 60 to 69- year group and 7.07ng/ml in the 70 to 79-year group.
Biopsy ; Digital Rectal Examination ; Humans ; Linear Models ; Male ; Prostatic Neoplasms ; Ultrasonography

Congenital vaginal atresia is rare and occurs as a result of aplasia of the mullerian ducts This is a source of great embarrassment and distress to patients and their close relatives. These patients are usually treated with chronic dilatation of the shallow vaginal introitus (Frank Technique) or by skin graft vaginoplasty (McIndoe procedure). Neither of these procedures is entirely satisfactory, as both may lead to neovaginal stenosis, inadequate length or poor lubrication. The use of an isolated segment of intestine for vaginoplasty generally circumvents these problems. A 31-year-old unmarried woman had suffered from vaginal narrowing and stenosis after skin graft vaginoplasties. We treated her with vaginoplasty using an isolated ileal segment.
Adult ; Constriction, Pathologic ; Dilatation ; Female ; Humans ; Ileum* ; Intestines ; Lubrication ; Mullerian Ducts ; Single Person ; Skin ; Transplants

Simple cysts of the testis are rare benign lesions of uncertain etiology. A 3-month-old male infant presented with painful enlargement of the left testicle and was suspected for testicular torsion. On scrotal exploration, the diagnosis of intratesticular simple cyst was made intraoperatively and the patient treated with orchiectomy.
Diagnosis ; Humans ; Infant ; Male ; Orchiectomy ; Spermatic Cord Torsion ; Testis

A study was carried out to demonstrate that Colonlyte(polyethylene glycol electrolyte lavage solution; PEG-ELS), a colonic lavage solution presently used for gut cleansing in preparation for colonic procedures, can be an effective agent in the preoperative bowel preparation for urologic surgery. Eighteen patients received 1-day preparation with 4,000ml of Colonlyte. Patient tolerance evaluated by a questionnaire showed overall comfortness in 77.8% of the patients. There was no electrolyte changes between pre- and post-preparation. Bowel cleansing was adequate(""good"" to ""excellent"" cleansing) in 89 % of the patients. Gas passage was identified 3 days and 9 hours postoperatively(mean) after termination of general anesthesia. One patient (5.6%) developed postoperative superficial wound infection but there was no serious complications such as intra-abdominal abscess, anastomotic disruption, or sepsis. Colonlyte is a safe, effective, and economic method of preoperative bowel preparation in urologic surgery.
Abdominal Abscess ; Anesthesia, General ; Colon ; Humans ; Surveys and Questionnaires ; Sepsis ; Therapeutic Irrigation ; Wound Infection

BACKGROUND: The purpose of this study was to determine cut-off point of appendicular skeletal muscle mass (ASM) adjusted body mass index (BMI) for sarcopenia in the Korean women and evaluate the prevalence of sarcopenia in postmenopausal women. METHODS: This study was based on the data obtained from 2008 to 2011 Korean National Health and Nutrition Examination Survey (KNHANES) IV and V. A whole body dual energy X-ray absorptiometry (DXA) scan and measurement of BMI were performed on individuals of ≥10 years old. Five thousand, two hundred and fifteen women older than 50 years were included in the study. ASM was obtained by adding the muscle masses of the four limbs. To determine the young reference group, mean and standard deviation of ASM and ASM/BMI by ages was measured. We calculated the prevalence rate of sarcopenia by each age group according to the cut-off point based on ASM and ASM/BMI. RESULTS: In determining the cut-off values related ASM/BMI, using the value that is two standard deviations below mean values for young reference group (20's and 30's) thus recommends 0.50 m² in women. The overall prevalence among women older than 50 years was 15.6%. Among women older than 65 years prevalence of sarcopenia was 22.9%. CONCLUSIONS: The prevalence of sarcopenia among Korean women obtained in this study is within the proper range of value to research about sarcopenia. Furthermore, using 0.50 m² as the cut-off value can help compare various studies about sarcopenia in Korea.
Absorptiometry, Photon ; Body Mass Index* ; Extremities ; Female ; Humans ; Korea ; Muscle, Skeletal ; Nutrition Surveys ; Postmenopause ; Prevalence* ; Republic of Korea ; Sarcopenia*

Purpose: The incidence and characteristics of ipsilateral adrenal involvement in patients with renal cell carcinoma (RCC) were assessed to determine whether a routine ipsilateral adrenalectomy is still required during radical nephrectomy.Materials and Methods: Between October 1994 and June 2003, the records of 543 patients with RCC, who underwent radical nephrectomy, were retrospectively reviewed. Patients were divided into two subgroups: 325 patients that had undergone a radical nephrectomy with ipsilateral adrenalectomy, and 218 with adrenal-sparing. The medical records, pathologic specimens, preoperative and postoperative computerized tomography (CT) finding were reviewed. The influence of an adrenalectomy on the disease- specific survival rate was also analyzed by the Kaplan-Meier method. Results: There were no significant differences between the ipsilateral adrenalectomy and adrenal-sparing groups in terms of age, sex, location and T and M stages. There were no significant differences in the disease-specific survival rates between the two groups (p=0.092). Of the 325 patients with ipsilateral adrenalectomy, 12 (3.7%) had adrenal involvement, all of which were diagnosed as cT3 or greater, with 9 detected with preoperative CT. Preoperative CT had 75% sensitive, a 33% positive predictive value, 94.2% specificity and a 99% negative predictive value for adrenal involvement by RCC. Among patients without adrenal involvement, there were no significant differences in the disease-specific survival rates between patients with an ipsilateral adrenalectomy and adrenal-sparing. Conclusions: A routine ipsilateral adrenalectomy during a radical nephrectomy does not improve the survival rate. A routine ipsilateral adrenalectomy may not be needed, particularly when no ipsilateral adrenal involvement is found to exist on the preoperative CT.
Adrenalectomy* ; Carcinoma, Renal Cell* ; Humans ; Incidence ; Medical Records ; Nephrectomy* ; Retrospective Studies ; Sensitivity and Specificity ; Survival Rate

A new data management system for urologic patient was designed by composing revised discharge summary and a computer program. The revised .discharge summary consists of more detailed clinical records and maintenance of clinical records during the follow-up period post discharge. The computer program was written in FoxPro Version 2.0 and the urologic code system was developed by applying some modifications on the international classification of diseases. The present program takes major advantages in easy and errorless entry and retrieval of data. These include pull-down menus using simultaneous input and coding system without any needs of typing the required codes for problem, management, and diagnosis. Data search and case statistics can be easily obtained with any combinations of problem, management, and diagnosis. The authors consider the present system, in which the revised discharge summary and computer program were closely linked, is very useful in patient data management.
Clinical Coding ; Diagnosis ; Follow-Up Studies ; Humans ; International Classification of Diseases ; Urology*

There are three compartments of the forearm by fascia: volar, dorsal and lateral. Compartment syndrome of the forearm, which commonly develops in the volar deep compartment, can be induced by various causes. We experienced a case of acute dorsal compartment syndrome of the forearm in a patient with rhabdomyolysis. Because of severe pain and progressive palsy of the posterior interosseous nerve, fasciotomy and release of posterior interosseous nerve were performed. Acute compartment syndrome localized at the dorsal compartment of the forearm is very rare, and compartment syndrome of the forearm in a patient with rhabdomyolysis has not been reported previously. We report the case with review of literatures.
Compartment Syndromes* ; Fascia ; Forearm* ; Humans ; Paralysis ; Rhabdomyolysis*

PURPOSE: The aim of this study is to evaluate treatment outcomes and mortality risks associated with hemodynamic instability caused by severe pelvic fracture in a regional trauma center. METHODS: The medical charts of 44 patients with hemodynamic instability due to pelvic fractures who were admitted to a regional trauma center from January 2014 to May 2017 were analyzed retrospectively. RESULTS: The mean age was 61.8 years, and the mean injury severity score was 39.1. Twenty-six patients (59.1%) were transferred from other hospitals, and the median time from injury to emergency room arrival was 115.5 minutes. Preperitoneal pelvic packing, pelvic angiography, and external pelvic fixation were performed in 38 patients (86.4%) for hemostasis. The mortality rate was 52.3%, and 15 patients (34.1%) died from hemorrhage. Logistic regression analysis showed that initial low systolic blood pressure and packed red blood cell (PRBC) requirement were independent risk factors associated with mortality. PRBC requirement for four hours and application of emergent hemostatic procedures were independent factors associated with hemorrhage-induced mortality. CONCLUSION: Emergency procedures for hemostasis should be performed immediately for patients with hemodynamic instability due to pelvic fracture, and they should be transferred to a regional trauma center as soon as possible.
Angiography ; Blood Pressure ; Emergencies ; Emergency Service, Hospital ; Erythrocytes ; Hemodynamics* ; Hemorrhage ; Hemostasis ; Humans ; Injury Severity Score ; Logistic Models ; Mortality* ; Pelvis ; Retrospective Studies ; Risk Factors* ; Shock ; Trauma Centers*