PURPOSE: We performed a retrospective study to determine the comparative characteristics of vesicoureteral reflux (VUR) between the infants less than 1 year and children more than 1 year old and whether early treatment in infantile VUR may be of benefit to preserve the renal function and to prevent the new renal scar. MATERIALS AND METHODS: All of 62 cases (infant group 19 and children group 43) with primary VUR were managed as the ureteral reimplantation from January 1991 to December 1996. RESULTS: The average age of patients was 7.1 months in infant group and 6.0 years in children group. The sex ratio of male to female showed no difference between infant and children group (1.7:1 Vs 1.5:1). The average follow up periods were 20.5 and 23.7 months in infant and children groups, respectively. The high grade reflux and renal scarring in infant group were significantly more frequent than those in children group (P<0.05), but the prevalence of urinary tract infection in children group was significantly higher than that in infant group (P<0.05). There was no significant difference in the rates of bilaterality and in the sex ratio between infant and children group. The success rate of operation was 100 percent in both groups. CONCLUSION: We suggest that the early surgical treatment in infants with bilateral and higher grade VUR may be of benefit to the preservation of renal function and the decrease of renal parenchymal change.
Child* ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Infant* ; Male ; Prevalence ; Replantation ; Retrospective Studies ; Sex Ratio ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

BACKGROUND: While the effect of the flashlamp pumped dye laser in the treatment of telangiectasia and other vascular disease has been reported by many authors, there have been a few reports on the therapeutic effect of the copper vapor laser(CVL) on telangiectasia and other vascular lesions. OBJECTIVE: Our purpose was to assess the clinical results in Korean patients who had cutaneous vascular disorders that were treated with the CVL at 578 nm. METHODS: A total of 23 patients with vascular lesions such as telangiectasia were involved. The effect of the laser treatment was evaluated 3 months after the last treatment. RESULTS: Of the 15 patients with telangiectasia, 12 patients showed good or excellent responses. 2 out of 3 patients with strawberry hemangioma showed good results. As for the other lesions, 2 out of the remaining patients 5 showed excellent results. CONCLUSION: The CVL has a beneficial effect and is a good alternative treatment modality for vascular lesions.
Copper* ; Hemangioma, Cavernous ; Humans ; Lasers, Dye ; Lasers, Gas* ; Telangiectasis ; Vascular Diseases

Color Doppler ultrasound imaging( DCI), non-invasive technique, provides the informations of vascular distributions and hemodynamic status, which is helpful to make the differential diagnosis between renal cell carcinoma and benign lesions. We evaluated tumor vascularity, peak systolic velocity, end diastolic velocity, and resistive index(RI) using DCI in 11 cases of renal cell carcinoma and 2 cases of benign lesions. Hypervascularity within the tumor was seen in all patients with renal cell carcinoma. Peak systolic velocity was higher than 3kHz(average 5. 5kHz) in 9 cases. End diastolic velocity was higher than 1kHz(average 2.2kHz) in 9 cases. RI was lower than 0.7(average 0.59) in 9 cases. Arteriovenous shunt was seen in 7 cases. In 4 cases with intermediate mass on CT and USG,' DCI was helpful to make the diagnosis preoperatively. In 2 cases of renal cell carcinoma, DCI was beneficial to evaluate the presence and the extent of tumor thrombi. Whether the hemodynamic parameters could be a prognostic factor needs more cases to be defined.
Carcinoma, Renal Cell* ; Diagnosis ; Diagnosis, Differential ; Hemodynamics ; Humans ; Ultrasonography*

No abstract available.
Busan* ; Child* ; Humans ; Mass Screening* ; Urinary Tract*

No abstract available.
Busan* ; Child* ; Humans ; Mass Screening* ; Urinary Tract*

PURPOSE: There has been various reports on the inverse association between coffee consumption and serum gamma-glutamyltransferase(GGT) activity in the general population of Western countries. However, this association is uncertain in the communities in which coffee consumption is less popular. So we tried to identify this association in men of rural area in Korea. METHODS: We examined the association between coffee consumption and serum GGT activity in cross-sectional study involving 379 male population health examinees aged 40 years and older from rural areas in Kyungnam prefecture in Korea. Those who perceived their health status as poor were excluded. Possible confounding effects of age, body mass index, alcohol consumption and cigarette smoking were controlled by multiple regression analysis and analysis of covariance. RESULTS: In multiple regression analysis, serum GGT activity was positively associated with alcohol intake, body mass index(P<0.001) and was negatively associated with coffee consumption(P=0.022), whereas no significant association was observed in cigarette smoking(P=0.094). Adjusted serum GGT activity level at the coffee consumption level of 0, one and two or more cups a day was 37.6 U/l, 35.9 U/l and 26.8 U/l respectively(Ptrend=0.008). CONCLUSION: Decreased serum GGT activity appears to be associated with coffee consumption in men of rural area, and further studies on the interrelationships among coffee consumption, alcohol intake and obesity will be necessary.
Alcohol Drinking ; Body Mass Index ; Coffee* ; Cross-Sectional Studies ; gamma-Glutamyltransferase* ; Gyeongsangnam-do ; Humans ; Korea ; Male ; Obesity ; Smoking ; Tobacco Products

To evaluate the clinical correlation between the penile size and benign prostatic hyperplasia (BPH) we measured the penile circumference(PC) and length(PL) as the flaccid state in 416 male cases more than 50 old years. PC was measured on the penile groove and PL from upper margin of symphysis pubis to the tip of penile glans. We compared PC and PL with prostatic volume, IPSS symptom score, uroflow and BPH defined by Garraway (1993)(BPH-G). All cases were classified as group I(below 9.0cm : 231 cases), II(above 9.0cm : 185 cases) in PC and A(below 8.0cm . 206 cases), B(above 8.0cm 210 cases) in PL. The ranges of PC and PL value were 6.0- 13.0cm(ave. 9.2) and 5.0-13.0cm(ave. 8.2), respectively. PC and PL values according to presence and absence of BPH-G were 9.3+/-0.8cm, 8.4+/-2.6cm and 8.6+/-1.5cm, 7.6+/-2.6cm, respectively (P<0.05), and PC values in prostatic volume below 30gm and more than 30gm, 8.8+/-l.0cm, 9.5+/-0.7cm, respectively (p<0.05). Among BPH associated factors, only prostatic volume has a correlation with penile size according to regression analysis(<0.05). Prevalence of BPH in group I, II and A, B was 10.4%, 27.09& and 0.49&, 31.4%, respectively(p<0.05). As higher PL or PC, as higher prevalence of BPH. We suggest that prominently large penile size, especially PC may be a possible sign of BPH.
Humans ; Male ; Prevalence ; Prostatic Hyperplasia*

The complications and the patients' attitude after transrectal systematic sextant biopsy of the prostate were evaluated by the questionnaire retrospectively. One hundred and sixty one of 211 men over 50 years old responded to the questionnaire. Transrectal sextant biopsy of the prostate under the finger guidance was performed by two doctors using Biopty Gun. The first 85 men (group A) received glycerin enema and oral administration of norfloxacin 30 minutes before the biopsy and norfloxacin was administered once again two to three hours after the biopsy. The other 126 men (group B) received the same procedures but the enema was performed using mixture of glycerin & betadine solution and the norfloxacin was administered 30 minutes before and for 3 days after the biopsy. Benign prostatic hyperplasia was diagnosed pathologically in 190 cases(90.1%) and prostate cancer in 8 cases(3.8%). No complication was less found in group A(23.4%) than in group B(40.5%)(P<0.05). Reported complications were perineal tenderness (group A: 42.9%,group B: 31.0%), hematuria (group A: 32.5%, group B: 34.5%), hemospermia (group A: 29.99%, group B: 19.0%), rectal bleeding (group A: 11.7%, group B: 11.9%), fever (group A: 15.69%, group B: 6.0%) and scrotal tenderness (group A: 2.6%, group B: 3.6%). In group A sepsis was developed in one case. Perineal tenderness lasted for 6.7 days in group A 5.1 days in group B. Hematuria was observed for 9.7 days in group A, 7.5 days in group B. Hemospermia was seen for 28.1 days in group A, 13.7 days in group B. Average duration of complications was shorter in group B (P<0.05). The better they understand the procedure of the biopsy, the less pain and the more satisfaction they experience. the rate of failure in obtaining tissue cores was 6.2%. If the doctor experiences more than about 120 cores of the tissue, the learning curve of success rate to obtain the proper specimens arrives to its plateau. In conclusion, the incidence of complications may be decreased by using appropriate pretreatment, especially adequate amount of antibiotics. Patient education is one of the most important steps to reduce the complications of this invasive technique.
Administration, Oral ; Anti-Bacterial Agents ; Biopsy* ; Enema ; Fever ; Fingers* ; Glycerol ; Hematuria ; Hemorrhage ; Hemospermia ; Humans ; Incidence ; Learning Curve ; Male ; Middle Aged ; Norfloxacin ; Patient Education as Topic ; Povidone-Iodine ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Surveys and Questionnaires ; Retrospective Studies ; Sepsis

PURPOSE: HIF-1alpha(Hypoxia inducible factor-1alpha) and VEGF(vascular endothelial growth factor) have been reported to be involved in tumor growth and metastasis but little data concerning their role in transitional bladder cancer is available and few studies have yet evaluated their prognostic values. The aim of the present study was to assess HIF-1alpha and VEGF expression and to evaluate the relationship between HIF-1alpha/ VEGF and histopathologic characteristics in bladder tumors. MATERIALS AND METHODS: HIF-1alpha and VEGF immunohistochemical stainings were performed on formalin-fixed, paraffin-embedded archival tissues from 27 transitional bladder cancer tissues and from 4 normal bladder tissues as a control group. Interpretation of immunohistochemical staining was performed semi-quantitatively by one pathologist. RESULTS: Expressions of HIF-1alpha and VEGF tended to be higher in the patient group than in the control group. HIF-1alpha expression was correlated with VEGF expression. HIF-1alpha and VEGF tended to be positively correlated with pathologic stage and grade of transitional bladder cancer. CONCLUSIONS: HIF-1alpha and VEGF expression might be independent predictors of outcome, as well as stage and grade of transitional bladder cancer. This study suggests that HIF-1alpha and VEGF may be potential prognostic factors in bladder cancer.
Angiogenesis Inducing Agents ; Anoxia* ; Humans* ; Neoplasm Metastasis ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vascular Endothelial Growth Factor A*

OBJECTIVE: Patients with poor grade aneurysm usually present with increased intracranial pressure(ICP), even those without an intracranial clot. Based on this fact, the present study investigated a significance of intracranial pressure monitoring in those patients. PATIENTS AND METHODS:A total of 60 patients with Hunt and Hess Grade IV(50 patients) or V(10 patients) were treated for aneurysmal subarachnoid hemorrhage(SAH) during a 3-year-period, and intraparenchymal ICP was measured in the majority, immediately after arrival to the emergency room. Early surgery including intraoperative ventriculostomy was undertaken within 3 days after SAH. An ultraearly surgery was performed without preceding angiogram or ICP monitoring in patients with large sylvian hematomas, highly suggestive of middle cerebral artery aneurysm. Outcomes were assessed by the Glasgow Outcome Scale(GOS) at 6 months. RESULTS: In overall, favorable outcome(GOS scores 1-2) was seen in 27(54.0%) of admission Grade IV and 1(10.0%) of admission Grade V patients. Of the 38 surgical patients with preoperative ICP monitorings, 25 patients (80.6%) exhibiting ICP values of less than 40mmHg showed favorable outcome, however, no patients with ICP values above 40mmHg recovered(Fisher's exact test, p=0.0001). CONCLUSION: It is concluded that a preoperative ICP above 40mmHg before ventriculostomy indicate significant vital brain destruction as intractable intracranial hypertension, and Grade IV patients at admission with an ICP below 40mmHg can be of benefit from early surgical intervention while Grade V patients still remains unfavorable.
Aneurysm* ; Brain ; Emergency Service, Hospital ; Hematoma ; Humans ; Intracranial Aneurysm ; Intracranial Hypertension ; Intracranial Pressure* ; Ventriculostomy