From April 1988 to July 1991. 203 cases of urinary stones, including 183 ureteral, 15 bladder and 5 urethral stones were managed by Candela MDL-1 Laser Lithotriptor under the ureteroscope. The success rates according to location were 68%(17,25) in upper ureter. 78.4%(29/37) in mid ureter, 93.4% (113/121) in lower ureter and 100%(20/20) in bladder and urethra. and the mean success rate was 88.2%t 179,203). The success rates according to stone size were 98.2% (54/55) in below 0.5cm. 87.6%(92,lO5) in 0.6-1.0cm, 75%(24/32) in 1.1-2.0cm and 81.8(9/11) in above 2. 1cm. The total cases of failure were 24. and the causes of failure were approach failure or poor visualization end upward migration. 9 cases of failure were managed by retried laser lithotripsy. 4 by ureterolithotomy and 5 cases were resolved in spontaneous passing. But 8 cases were lost in follow-up. The end mean success rate was 94.1%(191/203). 27 cases of gross hematuria and 34 of colic pain, which persisted more than 48 hours after operation. were managed conservatively. Also. in 5 cases of ureteral injuries. 2 cases were managed by surgical intervention and 3 by internal ureteral stent. Therefore. laser lithotripsy is a safe, effective and cost-effective single treatment modality in lower urinary tract stones. And if it is possible to maintain good visual field and to prevent upward migration. we will get the higher success rate in mid and upper ureteral stones.
Colic ; Follow-Up Studies ; Hematuria ; Lithotripsy, Laser* ; Stents ; Ureter ; Ureteroscopes ; Urethra ; Urinary Bladder ; Urinary Calculi* ; Visual Fields

A 32 year-old male was admitted to our hospital complaining of nausea, vomiting, fever and abdominal pain. Physical examination revealed lower abdominal mass associated with severe peritoneal irritation sign. The right testis was not palpated. Though the tumor might be the abdominal cryptorchid testis tumor. the other surgical abdominal conditions of non-urologic origin couldn't be rouled out. So, we performed emergent exploration. The mass had been ruptured and adhered to sigmoid colon. Histological examination revealed mixed germ cell tumor, composed of yolk sac tumor and classic seminoma. We performed systemic chemotherapy with bleomycin. etoposide and cisplatin under diagnosis of mixed germ cell tumor of stage III B-5.
Abdominal Pain ; Adult ; Bleomycin ; Cisplatin ; Colon, Sigmoid ; Diagnosis ; Drug Therapy ; Endodermal Sinus Tumor ; Etoposide ; Fever ; Humans ; Male ; Nausea ; Neoplasms, Germ Cell and Embryonal ; Physical Examination ; Rupture, Spontaneous* ; Seminoma ; Testis* ; Vomiting

Leiomyoma of the bladder is a rare. benign mesothelial tumor. Genitourinary leiomyoma may arise in any anatomic structure containing smooth muscle. A case of severely calcified leiomyoma or bladder is presented. Excretory urogram and computed tomogram suggested a bladder mass with calcification. The cystoscopic findings demonstrated intra-luminal protruding bladder mass with intact mucosa which suggested mesothelial calcified bladder tumor.
Leiomyoma* ; Mucous Membrane ; Muscle, Smooth ; Urinary Bladder Neoplasms ; Urinary Bladder*

OBJECTIVE: To evaluate effects of caregiver's education program on their satisfaction, as well as patient functional recovery, performed in addition to daily conventional rehabilitation treatment. METHODS: Three hundred eleven subjects diagnosed with first-onset stroke and transferred to the Department of Physical Medicine and Rehabilitation of Inha University Hospital were surveyed. In 2015, caregivers attended an education program for acute and subacute stroke patients. Patients who received an additional rehabilitation therapy were assigned to the experimental group (n=81), whereas the control group (n=100) consisted of transfer cases in 2014 with only conventional treatment. The experimental group was classified by severity using the Korean version of the National Institutes of Health Stroke Scale (K-NIHSS), which was administered to all 181 subjects, in addition to, the Korean version of the Mini Mental Status Examination (K-MMSE), a Modified Barthel Index (K-MBI), and the Berg Balance Scale (K-BBS). Caregiver satisfaction and burden before and after education programs were assessed using the Canadian Occupational Performance Measure (COPM), as well as family burden and caregiver burnout scales. RESULTS: No significant intergroup difference was observed between initial K-NIHSS, K-MMSE, K-BBS, K-MBI scores, and times from admission to transfer. Those with moderate or severe strokes under the experimental condition showed a more significant improvement than the control group as determined by the K-NIHSS and K-BBS, as well as tendential K-MMSE and K-MBI score increases. Satisfaction was significantly greater for family members and formal caregivers of patients with strokes of moderate severity in the experimental group. CONCLUSION: The caregiver's education program for stroke subjects had a positive outcome on patients' functional improvement and caregiver satisfaction. The authors believe that the additional rehabilitation therapy with the education program aids patients to achieve functional improvements for an optimal return to social life.
Caregivers ; Education* ; Humans ; Physical and Rehabilitation Medicine ; Rehabilitation* ; Stroke* ; Treatment Outcome ; Weights and Measures

Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a CO2 laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with CO2 laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.
Airway Obstruction ; Body Weight ; Cyanosis ; Failure to Thrive ; Gastroesophageal Reflux ; Hoarseness ; Humans ; Infant ; Infant, Newborn ; Laryngomalacia ; Laryngoscopy ; Lasers, Gas ; Male ; Recurrence ; Respiratory Sounds ; Thorax ; Tongue

A congenital portosystemic shunt is a very rare portosystemic vascular anomaly which leads to jaundice, hypoglycemia, hyperammonemia, liver cirrhosis, hepatic coma, and pulmonary hypertension. Anatomically, portosystemic shunts are divided into intra- and extra- hepatic shunts. Congenital intrahepatic portosystemic shunts are rare anomalies, and the early diagnosis is important to prevent hepatic encephalopathy and hypoglycemia. We report a case of an infant with symptoms of heart failure due to a congenital intrahepatic portosystemic shunt and a ventricular septal defect (VSD), which were treated successfully with four coil embolizations and open heart surgery for the VSD.
Early Diagnosis ; Heart ; Heart Failure ; Heart Septal Defects, Ventricular ; Hepatic Encephalopathy ; Humans ; Hyperammonemia ; Hypertension, Pulmonary ; Hypoglycemia ; Infant ; Jaundice ; Liver Cirrhosis ; Parturition ; Portasystemic Shunt, Surgical ; Thoracic Surgery

The aim of our study was to investigate the differential effects of dexamethasone (DXM) and hydrocortisone (HCS) on somatic growth and postnatal lung development in a rat model of bronchopulmonary dysplasia (BPD). A rat model of BPD was induced by administering intra-amniotic lipopolysaccharide (LPS) and postnatal hyperoxia. The rats were treated with a 6-day (D1-D6) tapering course of DXM (starting dose 0.5 mg/kg/day), HCS (starting dose 2 mg/kg/day), or an equivalent volume of normal saline. DXM treatment in a rat model of BPD induced by LPS and hyperoxia was also associated with a more profound weight loss compared to control and LPS + O2 groups not exposed to corticosteroid, whereas HCS treatment affected body weight only slightly. Examination of lung morphology showed worse mean cord length in both LPS + O2 + DXM and LPS + O2 + HCS groups as compared to the LPS + O2 alone group, and the LPS + O2 + DXM group had thicker alveolar walls than the LPS + O2 group at day 14. The HCS treatment was not significantly associated with aberrant alveolar wall thickening and retarded somatic growth. The use of postnatal DXM or HCS in a rat model of BPD induced by intra-amniotic LPS and postnatal hyperoxia appeared detrimental to lung growth, but there was less effect in the case of HCS. These findings suggest that effect of HCS on somatic growth and pulmonary outcome may be better tolerated in neonates for preventing and/or treating BPD.
Amnion/drug effects ; Animals ; Animals, Newborn ; Anti-Inflammatory Agents/*pharmacology ; Dexamethasone/*pharmacology ; Disease Models, Animal ; Female ; Hydrocortisone/*pharmacology ; *Hyperoxia ; Lipopolysaccharides/toxicity ; Lung Diseases/*pathology ; Oxygen/metabolism ; Pulmonary Alveoli/*drug effects/growth & development/pathology ; Rats ; Rats, Sprague-Dawley

Hydroxyapatite(HA) has been extensively used as bone graft materials and tooth implant surface coating materials because of its biocompatibility and osteoconductive properties. However, as HA is intrinsically poor in mechanical properties, zirconia(ZrO2) was incorporated with HA as reinforcing phases for improvement of mechanical properties. The purpose of this study was to investigate the biological activities of HA-coated zirconia through the cell proliferation test, measurements of alkaline phosphatase activity, and histologic examination. Four kinds of tested blocks were prepared according to the pore size (300-500micrometer/500-700micrometer) and the porosity (70%/90%). Cell proliferation and alkaline phosphatase activity was measured at 1, 7, 14 days. The number of cells proliferate after 7, 14 days were significantly increased in all groups when compared with that of the first day, but there was no significant difference between the 4 groups at each time period. At the 7 day, alkaline phosphatase activities of cells cultured in 4 groups were higher than that of the first day, but there was no significant difference between the 4 groups at each time period. The human gingival fibroblast and MG 63 cell was used to evaluate the cell cytotoxicity using MTT test. The materials tested in the current study turned out to be non-cytotoxic. In histologic examination(SEM), at 1 day there were many cells attached on the surfaces of all kinds of tested blocks. The number of cells were increased over time. At the 14 day, there were more cells proliferated than 1 day and some of the pores of blocks were partially filled with the proliferated cells. The in vitro response of osteoblast-like cells to the HA-coated zirconia showed comparable effect on transformation comparable to hydroxyapatite.
Alkaline Phosphatase ; Bone Regeneration ; Cell Proliferation ; Durapatite ; Fibroblasts ; Humans ; Porosity ; Tooth ; Transplants

OBJECTIVE: To follow up the long-term functioning in a community through assessing personal background and status based on the International Classification of Functioning, Disability and Health (ICF) after a stroke, by using a Korean version of World Health Organization Disability Assessment Scale II (K-WHODAS II). METHODS: We surveyed 146 patients diagnosed at the first-onset of acute stroke and discharged after Inha University Hospital, and 101 patients answered the K-WHODAS II survey. We analyzed the relationship of six functioning domains of K-WHODAS II with K-MMSE (Korean version of Mini-Mental State Examination) and K-MBI (Korean version of Modified Barthel Index) at admission and discharge, and personal background. All subjects were divided into five groups, according to the disease durations, to assess the functional changes and the differences of K-MMSE and K-MBI at the admission and discharge. RESULTS: K-MBI and K-MMSE at admission and discharge showed no significant differences in all five groups, respectively (p>0.05), reflecting no baseline disparity for long-term follow-up. All subjects showed positive gains of K-MBI and K-MMSE at discharge (p<0.05). The six functioning domains and total scores of K-WHODAS II had decreasing trends until 3 years after the stroke onset, but rose thereafter. Higher scores of K-MBI and K-MMSE, younger age, women, working status, higher educational level, and living with a partner were correlated with lower scores of K-WHODAS II (p<0.05). CONCLUSION: The long-term functioning after stroke was affected not only by cognitive and motor status in hospital, but also by certain kinds of personal background. K-WHODAS II may be used to monitor functioning status in a community and to assess personal backgrounds in subjects with chronic stroke.
Female ; Follow-Up Studies ; Humans ; International Classification of Functioning, Disability and Health ; Korea* ; Stroke* ; Women, Working ; World Health Organization

PURPOSE: The survival rate of infants weighing less than 1,000 g at birth(extremely low birth weight infants, ELBWI) has increased due to recent advances in perinatal and neonatal intensive care. The purpose of this study was to evaluate the survival rates of ELBWI born at Seoul National University Hospital during the last six years. METHODS: A total of 99 infants were divided into three groups(period I : 2000 to 2001, period II: 2002 to 2003, period III: 2004 to 2005) based on date of birth. We compared the survival rate of ELBWI over the three periods, using CRIB II score for adjustment for clinical severity. RESULTS: Overall survival rate of ELBWI was 74.7 percent. The survival rate of ELBWI increased over the three periods(period I: 60.7 percent, period II : 73.3 percent, period III: 85.3 percent). The threshold of viability(defined as survival of at least 50 percent of infants) was 25 weeks of gestation and 600 g at birth. The birth weight-specific survival rates increased considerably over the three periods for infants < 750 g at birth(period I: 10 percent, period II: 46.2 percent, period III: 70.6 percent). The survival rates of ELBWI over the three periods increased much remarkably after adjustment for clinical severity by CRIB II score. CONCLUSION: In our institution, survival rates of ELBWI during the last six years continued to improve, particularly for infants weighing < 750 g at birth. This increase in survival rates was not associated with the clinical severity of ELBWI.
Humans ; Infant Equipment ; Infant* ; Infant, Extremely Low Birth Weight ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Parturition ; Pregnancy ; Seoul ; Survival Rate*