Two cases of spontaneous kidney rupture with literatural review was presented at first in Korea. 1) 56 years male patient and 25 years male patient admitted to our department of Urology through Emergency Room after onset of 2 and 1 day. after treatment at local clinic. 2) Chief complaints were one side flank pain which was followed by total gross hematuria. 3) Preoperative diagnoses were kidney rupture due to necrotic pelvic tumor in 56 years male and hypernephroma in 25 years male patient. 4) Operation was procedured at 8 days and 4 days after admission respectively. 5) The operative procedure were nephrectomy in both cases. 6) The pathological diagnoses were pelvis rupture due to renal stone and parenchymal rupture due to renal infarction in each case.
Carcinoma, Renal Cell ; Diagnosis ; Emergency Service, Hospital ; Flank Pain ; Hematuria ; Humans ; Infarction ; Kidney* ; Korea ; Male ; Nephrectomy ; Pelvis ; Rupture ; Rupture, Spontaneous* ; Surgical Procedures, Operative ; Urology

Paragonimiasis is a parasitic disease found in carnivorous animals which is caused by trematodes of the genus Paragonimus. Human infestation occurs by ingestion of raw or not incompletely cooked freshwater crab or crayfish with the metacercaria. Recently, the prevalence of human paragonimiasis has decreased markedly, however, about one hundred clinical cases have been diagnosed annually by antibody test in Korea. The symptoms, such as chronic cough, hemoptysis, and radiological findings are often confused with those of tuberculosis. Therefore, differential diagnosis between tuberculosis and paragonimiasis is important in Korea which has a high prevalence of tuberculosis. Recently, we experienced a case of pulmonary paragonimiasis in a 13yearold girl with hemoptysis and chest pain. Chest roentgenogram with subsequent tomography demonstrating multiple cavitary lesions and linear tubular densities. Strong positive was noted in intradermal skin test for Paragonimus westermani as well as in IgG antibody detection using ELISA method. Diagnosis was confirmed by stool with multiple P. westermani ova, which was treated with a two day course of praziquantel.
Animals ; Astacoidea ; Chest Pain ; Cough ; Diagnosis ; Diagnosis, Differential ; Eating ; Enzyme-Linked Immunosorbent Assay ; Female ; Fresh Water ; Hemoptysis ; Humans ; Immunoglobulin G ; Korea ; Ovum ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Parasitic Diseases ; Praziquantel ; Prevalence ; Skin Tests ; Thorax ; Tuberculosis

Electroretinograms (ERGs) were measured in 65 patients with diabetes and 10 control subjects. The single flash ERGs were recorded as a function of the stimulus intensity. A Naka-Rushton-type function was fit to b-wave amplitudes, measured as a function of stimulus intensity, to evaluate changes in ERG amplitude and sensitivity. We also measured the temporal aspects of the ERG b-waves. The ERG sensitivity tended to decrease as the retinopathy progressed. An average sensitivity loss in eyes with diabetic retinopathy was statistically significant. However, the eyes of diabetic patients without visible retinopathy did not show significant ERG sensitivity loss. There was less variability in temporal compared with amplitude measurements of ERG components, and significantly prolonged b-wave implicit times were found in all stages of retinopathy and in eyes of diabetic patients without retinopathy.
Adolescent ; Adult ; Aged ; Diabetic Retinopathy/*physiopathology ; Electroretinography ; Humans ; Middle Aged ; Retina/physiology ; Sensitivity and Specificity ; Sensory Thresholds/physiology

PURPOSE: Reconstruction of the soft tissue defect exposing Achilles tendon is a formidable challenge because of the paucity of soft tissue and relatively poor blood supply. This article describes the reconstruction of soft tissue defect exposing Achilles tendon using gracilis muscle free flap and split-thickness skin graft. METHODS: From 2000 to 2005, four patients with soft tissue defect exposing Achilles tendon and infection were operated using gracilis muscle free flap and split-thickness skin graft. The defect size ranged from 3.5 to 5cm wide and 6.5 to 8cm long. The mean postoperative follow-up was twenty months. RESULTS: All the flaps were survived without necrosis and infection. We obtained the satisfactory results with good functional and aesthetical outcomes. All cases showed good results with the characteristics of a relatively thin flap without additional debulking procedure. CONCLUSION: Gracilis muscle free flap with split thickness skin graft could be a good option for reconstruction of soft tissue defect of posterior ankle, exposing Achilles tendon with minimal morbidity of the donor site.
Achilles Tendon* ; Ankle ; Follow-Up Studies ; Free Tissue Flaps* ; Humans ; Necrosis ; Skin* ; Tissue Donors ; Transplants*

Transrectal ultrasound (TRUS)-guided biopsy of the prostate is a common outpatient procedure for diagnosing prostatic cancer. It is a relatively noninvasive, safe, and effective method, as the majority of post-biopsy complications are mild and self-limiting. Fatal complications including infection or massive hemorrhage are rare, but can be life threatening. We herein present an autopsy case of fatal rectal bleeding after prostate biopsy and an analysis of similar cases.
Autopsy ; Biopsy ; Hemorrhage ; Humans ; Outpatients ; Prostate ; Prostatic Neoplasms

Carcinoma of the gallbladder is relatively rare malignancy usually found in an elderly, predominantly female population. Histologically, adenocarcinoma predominate, with only 10% to 15% being of other varieties(small cell carcinoma and others). Small cell carcinoma of the gallbladder is a rare lesion and predominantly a disease of older women with clinical history of stones. These tumors show an aggressive clinical course and death usually occurs with in a few months of the diagnosis. The diagnosis of small cell carcinoma should be based on cell morphology, histologic pattern and immunohistochemical study. Correct diagnosis is important not only because these tumors give rise to endocrine syndromes, but also because the chemotherapeutic approach to small cell carcinoma differs from that for adenocarcinoma.
Adenocarcinoma ; Aged ; Carcinoma, Small Cell* ; Diagnosis ; Female ; Gallbladder* ; Humans

PURPOSE: Allevyn(R)(Smith & Nephew, England) is a type of polyurethane foam material with good wound discharge absorption. Acticoat(R)(Smith & Nephew, England) is a silver coated dressing material which is effective in infected wound. The purpose of this study is to compare the effects of dry gauze, Acticoat(R) and Allevyn(R) on infected full-thickness wound healing in rat. METHODS: One hundred and twenty rats were divided into 3 groups: group I(dressing with dry gauze, n=40), group II(dressing with Allevyn(R), n=40), group III(dressing with Acticoat(R), n=40). A 15x15mm square full-thickness wound was made on the dorsum and left open for 24 hours. The size of wound defects were measured each dressing changes. The histological evaluation was performed on the 3rd day, 7th day, 14th day, 21th day. RESULTS: After the wound was left open for 24 hours, typical findings of bacterial infection was observed. After the 7th day, group III showed larger area of epithelialization, smaller defect size compared to those of two other groups. Complete replacement by fibrotic scar tissue was observed in group III with no signs of inflammation on the 14th day. By day 21, the average defect size in group III was decreased from initial 100% to 3.63%. while in group I and II, it was decreased to 62.66% and 53.62%, respectively. CONCLUSION: Acticoat(R) is an effective tool in the treatment of infected wound.
Absorption ; Animals ; Bacterial Infections ; Bandages ; Cicatrix ; Inflammation ; Polyurethanes ; Rats* ; Silver ; Skin* ; Wound Healing ; Wounds and Injuries*

An epidemiological study was performed to know the infection status of E. hortense among the human residents and fish intermediate hosts in Chongsong-gun, Kyongsangbuk-do. Out of 263 people examined, 59(22.4 per cent) were positive for the eggs of E. hortense. Total 152 fresh water tishes (9 species) were examined, and Odontobutis obscura interrupta, Misgurnus angullicaudatus and Squalidus coreanus were found to harbour the metacercariae of E. hortense. Juvenile or adult E. hortense were expelled from 35 out of 54 cases treated with praziquantel. The number of worms per individual ranged from l to 649, with the average burden of 51. The eosinophil count of infected persons ranged 1-24 per cent (6 per cent in average). The number of eggs per day per worm (EPDPW) in human host was estimated about 1,478. The results showed that Chongsong-gun is an endemic area of E. hortense.
parasitology-helminth-tematoda ; Echinostoma hortense ; Hippeutis cantori ; epidemiology

OBJECTIVE: This study was undertaken to compare the diagnostic performances of magnetic resonance imaging (MRI), MR myelography (MRM) and myelography in young soldiers with a herniated lumbar disc (HLD). METHODS: Sixty-five male soldiers with HLD comprised the study cohort. A visual analogue scale for low back pain (VAS-LBP), VAS for leg radiating pain (VAS-LP), and Oswestry disability index (ODI) were applied. Lumbar MR, MRM, and myelographic findings were checked and evaluated by four independent radiologists, respectively. Each radiologist was asked to score (1 to 5) the degree of disc protrusion and nerve root compression using modified grading systems devised by the North American Spine Society and Pfirrmann and the physical examination rules for conscription in the Republic of Korea. Correlated coefficients between clinical and radiological factors were calculated. Interpretational reproducibility between MRI and myelography by four bases were calculated and compared. RESULTS: Mean patient age was 20.5 +/- 1.1. Mean VAS-LBP and VAS-LP were 6.7 +/- 1.6 and 7.4 +/- 1.7, respectively. Mean ODI was 48.0 +/- 16.2%. Mean MRI, MRM, and myelography scores were 3.3 +/- 0.9, 3.5 +/- 1.0, and 3.9 +/- 1.1, respectively. All scores of diagnostic performances were significantly correlated (p < 0.05). However, none of these scores reflected the severity of patients' symptoms. There was no statistical difference of interpretational reproducibility between MRI and myelography. CONCLUSION: Although MRI and myelography are based on different principles, they produce similar interpretational reproducibility in young soldiers with a HLD. However, these modalities do not reflect the severity of symptoms.
Cohort Studies ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Male ; Military Personnel ; Myelography ; Physical Examination ; Radiculopathy ; Republic of Korea ; Spine

OBJECTIVES: Human epidermal growth factor receptor-2 (HER2) and 3 (HER3) belong to the epidermal growth factor receptor (EGFR) family of transmembrane receptor tyrosine kinases. In this study, we assessed HER2/HER3 expression levels in specimens of epithelial ovarian cancer and determined their correlation with clinical features of ovarian cancer. METHODS: Tissue microarrays (TMAs) were prepared from paraffin blocks of 105 ovarian tumour samples. HER2, HER3, PI3K, Akt, p-Akt, mTOR, p-mTOR, S6, and p-S6 expression levels were investigated using immunohistochemistry (IHC). HER2 and HER3 amplifications were determined using in situ hybridization (ISH). The correlation between HER2/3 expression and disease outcome of the patients including surgical outcome, progression-free survival (PFS) and overall survival (OS) was analysed. RESULTS: HER2 positivity was 3.8% by IHC and 5.7% by ISH, whereas that of HER3 was 12.4% and 8.6%, respectively. HER2 status by either IHC or ISH was not related to PFS (p=0.128, 0.168, respectively) and OS (p=0.245, 0.164, respectively). However, the HER3 status determined using fluorescence ISH was associated with poor PFS (p=0.035 on log rank test), which was a significant risk factor even after adjusting other possible risk factors in multivariate analysis (hazard ratio=2.377 [1.18–7.49], p=0.021). Expressions of Akt, p-mTOR, and S6 were also related with poor progression (p=0.008, 0.049, 0.014, respectively). CONCLUSION: HER3 is possibly an independent marker for poor prognosis in individuals with ovarian cancer, as the HER3 signalling pathway is distinct from that of HER2. The possibility of targeted therapy for patients with HER3 alteration in ovarian cancer should be evaluated.
Disease-Free Survival ; Epidermal Growth Factor ; Fluorescence ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Multivariate Analysis ; Ovarian Neoplasms ; Paraffin ; Phosphotransferases ; Prognosis ; Receptor, Epidermal Growth Factor ; Risk Factors ; Tyrosine