Recently, continent internal urinary diversion has begun to achieve worldwide popularity. Herein, we report an experience with a 5 year-old female patient who had total urinary incontinence due to left ectopic ureter and vesicourethrovaginal fistula. The ileocecal ureterosigmoidostomy was performed as a staged procedure. The ileocecal segment including a part of ascending colon was isolated, an intussusception through the ileocecal valve was performed as the antireflux mechanism, and the ureters were spatulated and anastomosed side to side. The combined ureters then were sewn end to end to the ileum and the cecum was brought out on the skin as a stoma. Eleven months after first operation, the cecal stoma was taken down and discarded, and the remaining cecum containing the antireflux intussusception was anastomosed end to side to the lower sigmoid, internalizing the urinary diversion. After operation, she has gained perfect urinary control with no evidence of reflux, urinary tract infection and electrolyte imbalance for the 5 years follow up period. In conclusion, ileocecal ureterosigmoidostomy is a reasonable alternative to conventional ureterosigmoidostomy that may reduce the risk of development of cancer.
Cecum ; Child, Preschool ; Colon, Ascending ; Colon, Sigmoid ; Female ; Fistula ; Follow-Up Studies ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Skin ; Ureter ; Urinary Diversion ; Urinary Incontinence ; Urinary Tract Infections

We reviewed medical records of 32 children with vesicoureteral reflux who underwent ureteral reimplantation by Cohen technique. Between January 1990 and December 1993, 21 patients were managed with ureteral catheters and suprapubic tubes during the initial postoperative period (group A), whereas between January 1994 and June 1995, 11 consecutive patients were managed with "catheterless" technique employing none of these devices (group B). The mean age was 39.7 months, the male to female ratio was 24:8 and the mean follow-up period was 13.1 months. The mean length of hospital stay was 10.2 days for group A and 7.2 days for group B (p=0.001). The mean day of pain medication was 8.9 days for group A and 6.0 days for group B (p=0.011) The mean number of pain medication was 35.6 times for group A and 24.0 times for group B (p> 0.05). This represents a 32.6% decrease in the mean number of pain medication for group B, despite of the statistical insignificance. There was neither complication nor failure for group B. In conclusion, we believe that the catheter-free ureteral reimplantation provides a safe and reliable alternative which may results in less morbidity than traditional methods in children.
Catheters ; Child* ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Medical Records ; Postoperative Period ; Replantation* ; Ureter* ; Urinary Catheters ; Vesico-Ureteral Reflux

The incidence of impalpable testis is approximately 20 percent of undescended testis population and some may possess vascular pedicle shortening that prohibits scrotal placement in one stage orchiopexy. From July 1987 through April 1988, 12 patients with 17 impalpable testicles were explored by lower midline incision and the following results were obtained : 1. We could identify and prove the location of testis and/or anorchia without postoperative complication : 10 intraabdominal testes (59%), 3 intracanalicular (18%), 4 anorchia (23%). 2. Among 10 intraabdominal testes 5 testes were brought down by transabdominal orchiopexy, 3 testes by Fowler-Stephens method, and 1 testis by staged orchiopexy and remaining testis were removed. 3. Among 3 intracanalicular testes 2 testes were brought down by transabdominal orchiopexy and one testis was removed. 4. Follow up testicular examination of fixed testes revealed no testicular atrophy in all transabdominal orchiopexed testes and no testicular atrophy in 1 of 3 testes which were performed by Fowler-Stephens method.
Atrophy ; Cryptorchidism ; Follow-Up Studies ; Humans ; Incidence ; Male ; Orchiopexy ; Postoperative Complications ; Testis*

463 female patients visited our hospital due to lower urinary tract symptoms during the period from March 1st, 1980 to February 28th, 1981. Among them, 127 female patients whose urinalysis was normal were performed endoscopic examination and studied clinically, based on endoscopic findings. The results are summerized as follows. 1) The endoscopic findings were classified into 5 groups. Group I: Almost normal urethral mucosa, bladder neck and vesical mucosa, 11 cases. Group II: Gray-whitish velvety trigone with almost normal urethra and bladder neck, 16 cases. Group III: Mild granular hyperemia of the urethra, bladder neck and trigone 31 cases. Group IV: Mild bullous hyperemia of the urethra, bladder neck and trigone with a few pseudopolyps, 43 cases. Group V: Marked granular hyperemia of the urethra with many pseudopolyps and bullous hyperemia of bladder neck and trigone, 26 cases. 2) The most common age group was in 4th decade (33.8%). Group I and group II were younger than group IV and group V. 3) Common symptoms were frequency (78.0%), tenesmus (68.5%), painful urination (26.8%), urgency (20.5%), suprapubic discomfort (33.1%) and lumbago (18.9%). There were no significant differences among 5 groups. 4) 47 cases had the history of urethritis-cystitis and it was outstanding in group IV and group V. 5) Trabeculation (52.8%) was the most common change in bladder on cystoscopic examination. Meatal stenosis which was found in 44 cases (34.6%) was the most common associated disease. Endoscopic examination was necessary to establish the correct diagnosis and determine the therapeutic choice such as conservative, surgical and psychological treatment in female urethral syndrome.
Constriction, Pathologic ; Diagnosis ; Endoscopy ; Female* ; Humans ; Hyperemia ; Low Back Pain ; Lower Urinary Tract Symptoms* ; Mucous Membrane ; Neck ; Urethra ; Urinalysis ; Urinary Bladder ; Urination

It is well recognized that dilation of upper urinary tract can occur in the absence of either reflux or mechanical obstruction. The demonstration of the cause of upper urinary tract dilation may critically alter the management of a patient. So several diagnostic methods were designed to demonstrate it, but their clinical application were not satisfactory due to inaccuracy, invasiveness and technical difficulty. Diuresis renography has recently been introduced as a method of evaluating upper urinary tract dilation found on intravenous urography. It is a simple, rapid, non invasive test which has enable to define the cause. 23 cases which have equivocal upper urinary tract dilation on intravenous urography were examined by diuresis renography in the Department of Urology, Kyung Hee University Hospital, during the period from October 1980 to March 1982 and three differential categories were obtained as follows. 1. Normal type (9 cases): Both standard and diuresis renograms were normal. 2. Obstructive type (3 cases): Initial renogram was obstructive and remained so during diuresis. 3 cases in this category were confirmed by operation and follow-up intravenous urography. 3. Atonic type (11 cases): Initial renogram tracing was obstructive but rapid isotope elimination occurred after diuresis.
Diuresis* ; Follow-Up Studies ; Humans ; Radioisotope Renography* ; Urinary Tract* ; Urography ; Urology

Soft Contact Lenses(SCL) are used widely instead of glasses among young female, especially university students, for cosmetic purpose. Usually Shirmer test has been used to evaluate the tear production state however more objective method is the tear film break up time. Authors evaluated the effect of soft contact lenses on BUT. We selected 40 femalse wearing on Hyper-Thin soft contact lenses, and One Soflens(Baush and Lomb) as soft contact lens wearing group and 30 females without no evidence of systemic disease or ocular disease affecting on tear production as normal control group. And authors studied mean value of BUT at each group, difference of BUT between 2 groups and finally evaluated the BUT change accord ing to duration of wearing. The results were as follows. 1. The mean value of tear film break up time(BUT) was 8.64 +/- 3.91 seconds and 11.12 +/- 4.94 seconds in soft contact lens wearing group and normal control group respectively. 2. There was a statistically significant difference of BUT between each group(P<0.05). 3. There was statistically significant difference of BUT between more than 4 years of soft contact lens wearing group and less than 3 years of wearing gorup(P<0.05).
Contact Lenses, Hydrophilic* ; Eyeglasses ; Female ; Glass ; Humans ; Tears*

A retrospective analysis was made to evaluate the value of early surgical exploration of acute scrotum in 19 children. Testicular torsion (9 cases ) was the most frequent cause followed by epididymitis(4), hematocele(2). appendix testis torsion(2), infected hydrocele(1) and benign cystic teratoma(1). The age distribution of testicular torsion showed a biphasic pattern, neonatal and pubertal and 3 out of 9 torsed testes showed transverse lie in standing position on physical examination. The pyuria was present only in l out of 4 cases with epididymitis and leukocytosis was found in 7 cases, 6 with testicular torsion and 1 with epididymitis. Preoperative ultrasonographic diagnoses were correct in 2 out of 4 cases, 3 with testiculer torsion and 1 with epididymitis. Testicular salvage was possible in 3 torsed testes if surgery was performed within 14 hours from the onset of the symptom. In summary. testicular torsion was the most frequent cause of acute scrotum in children and early surgical exploration was necessary to improve the salvage of torsed testes.
Age Distribution ; Appendix ; Child* ; Diagnosis ; Epididymitis ; Humans ; Leukocytosis ; Male ; Physical Examination ; Pyuria ; Retrospective Studies ; Scrotum* ; Spermatic Cord Torsion ; Testis

Background:Eutropin is a recombinant human growth hormone preparation and has been used in patients with growth hormone deficiency. Short stature is a characteristic feature of Turner syndrome, which is caused by sexual chromosomal anomalies. Growth hormone therapy would increase growth velocity and increase the ultimate final height in patients with Turner syndrome. The purpose of this study was to evaluate the clinical effects and safety in patients with Turner syndrome with Eutropin treatment. Subjects and METHODS:60 patients with Turner syndrome,who were diagnosed by chromosome study,were treated with Eutropin 1IU/kg/week for 12 months and followed up every 3 month. The height and weight were evaluate at 0, 3, 6, 9, 12 months. A complete blood count, ESR, urinary analysis and chemistry studies were done every 3 month. IGF- I , T4, TSH & anti-GH antibody were measured at 6 months and 12 months. Chest X-ray was checked at 0, 6 ,12 months. RESULTS:60 patients were enrolled but 10 patients were lost or treated irregularly and excluded in the study of growth effect. but included all cases in safety analysis. At the onset of Eutropin therapy,their mean age was 10.8+/-2.9 years old(range 4.2- 14.9yr)and the height was 121.1+/-13.7cm(-3.1+/-0.9 SDS) and yearly growth velociy was 3.4+/-1.5cm. Their weight was 30.5+/-10.6kg and bone age 9.1+/-3.0 yrs. After Eutropin treatment, mean height was increased to 123.2+/-13.5cm at 3 months, 125.2+/-13.1cm at 6 months, 127.5+/-12.4cm at 9 months, 128.3+/-12.8cm at 12 months. Height velocity were increased to 8.3+/-3.1cm at 3 months, 8.1+/-2.6cm at 6 months, 7.6+/-1.9cm at 9 months and 7.1+/-1.9cm at 12 months(P<0.001). Height SDS at 0, 3, 6, 9, 12 months were -3.1+/-0.9, -2.9+/-1.0, -2.7+/-0.9, -2.7+/-0.9 respectively(P>0.001).Their bone age were 9.1+/-3.0yr, 9.6+/-2.9yr, 10.2+/-2.7yr before and 6 & 12 months after treatment respectively. HA/BA were 0.84+/-0.15, 0.87+/-0.13, 0.88+/-0.12 at before and 6 & 12 months after treatment respectively(P<0.05). Growth velocity of 4-8 yrs group was most prominent compared to other groups. Serum IGF- I concentration was increased from 167.4+/-85.8ng/ml to 368.4+/-158.1ng/ml at 6 months and 423.2+/-181.0ng/ml at 12 month(P<0.001) after treatment. No significant changes were observed in thyroid function, CBC, ESR, Blood chemistry and urinalysis. Anti-hGH antibody were positive in 2 patients, but these didnot attenualte the growth velocity. CONCLUSION: Treatment with Eutropin increased significantly height velocity in patients with Turner syndrome. No specific adverse events were observed during Eutropin therapy.
Blood Cell Count ; Chemistry ; Growth Hormone ; Human Growth Hormone ; Humans* ; Thorax ; Thyroid Gland ; Turner Syndrome* ; Urinalysis

BACKGROUND: Scuba diving has become increasingly popular in Korea. Medical problems are common with dives, especially decompression sickness(DCS). This study was performed to obtain an useful information of hyperbaric oxygen therapy in DCS in Korea. METHOD: We reviewed the 62 cases of Korean divers, who were diagnosed as DCS and received recompression therapy according to U.S. Navy Standard Recompression Treatment Table at Ocean and Underwater Medical Research and Training Center of ROK Navy, for 6 years from Jan. 1993 to Nov. 1998. RESULT: 1) the mean no-decompression limit excess time between type I DCS group(72.7 min.) and type II DCS group(92.8min.) showed significant difference. 2) The rate of symptoms appeared on surfacing and within 10min. after surfacing of type I and type II DCS were 41.4%and 72.7% respectively. 3) The cure late of type I and type II were 75.9%and 42.4% respectively. In type II DCS group, the cure rate of the group within 12 hour-delayed recompression treatment and the group above 12 hour-delayed treatment were 64.3%and time 26.3% respectively, and in type I DCS group, 100% and 66.7% respectively. CONCLUSION: These findings suggest that the education of safety, the strict observance of the standard decompression table, and the avoidance of excessive repeated diving are important for reducing the risk of diving related disease. And to offer proper management of DCS, there should be more multiplace hyperbaric oxygen chambers, the suitable transport system, and the specialist of diving medicine or hyperbaric medicine in Korea.
Decompression Sickness* ; Decompression* ; Diving ; Education ; Hyperbaric Oxygenation* ; Korea ; Oxygen ; Specialization

The purpose of this study was to evaluate the abrasion resistance of surface penetrating sealant which was applied on a composite resin restoration and to provide proper time to reapply sealant on composite resin surface. Two hundred rectangular specimens, sized 8 x 3 x 2 mm, were made of Micronew (Bisco, Inc., Schaumburg, IL, U.S.A) and divided into two groups; F group (n = 10) was finished with coarse and medium grit of Sof-Lex discs and BisCoverwas applied B group (n = 190) after finishing with discs. B group was again subdivided into nineteen subgroups. From B-1 group to B-18 group were subjected to toothbrush abrasion test using a distilled water-dentifrice slurry and toothbrush heads. B-IM group was not subjected to toothbrush abrasion test. Average surface roughness (Ra) of each group was calculated using a surface roughness tester (Surfcorder MSE-1700: Kosaka Laboratory Ltd., Tokyo, Japan). A representative specimen of each group was examined by FE-SEM (S-4700: Hitachi High Technologies Co., Tokyo, Japan). The data were analysed using cluster analysis, paired t-test, and repeated measure ANOVA. The results of this study were as follows; 1. Ra of F group was 0.898 +/- 0.145 microm and B-IM group was 0.289 +/- 0.142 microm. Ra became higher from B-1 group (0.299 +/- 0.48 microm) to B-18 group (0.642 +/- 0.313 microm). 2. Final cluster center of Ra was 0.361 microm in cluster 1 (B-IM ~ B-7), 0.511 microm in cluster 2 (B-8 ~ B-14) and 0.624 microm in cluster 3 (B-15 ~ B-18). There were significant difference among Ra of three clusters. 3. Ra of B-IM group was decreased 210.72% than Ra of F group. Ra of B-8 group and B-15 group was increased 35.49% and 51.35% respectively than Ra of B-IM group. 4. On FE-SEM, B-IM group showed the smoothest resin surface. B-8 group and B-15 group showed vertically shallow scratches, and wide and irregular vertical scratches on composite resin surface respectively. Within a limitation of this study, finished resin surface will be again smooth and glazy if BisCover would be reapplied within 8 to 14 months after applying to resin surface.
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