No abstract available.
Immunoglobulin G* ; Inflammation*

PURPOSE: We prospectively determined the value of a non-enhanced spiral CT (NESCT) in the diagnosis of suspected urolithiasis by a comparison with excretory urography (EU). MATERIALS AND METHODS: After giving informed consents, 114 and 103 patients, with suspected urolithiasis, underwent either NESCT or EU, respectively. All the NESCT and EU films were assessed by 2 urologists and 1 radiologist with no knowledge of the clinical histories. The sensitivity, specificity, positive and negative predictive value, diagnostic accuracy and other valuable diagnostics in each group were compared. RESULTS: The sensitivity, specificity and accuracy of NESCT in diagnosing urinary calculi were 96.8, 95.2 and 96.5%, and for EU, were 75.3, 90.9 and 78.6%, respectively. The examinations were performed with an average of less than 5 minutes for the NESCT versus 113+/-31 minutes for the EU, and the times taken to a definitive diagnosis in the two groups were 2.4+/-0.3 and 59+/-5.2 hours, respectively. In the EU group, 24 patients (23.3%) had revisited and 11 (10.6%) were admitted for pain control, prior to the imaging evaluation, only 2 patients (1.7%) revisited, and none were admitted in the NESCT group. In our institution, the cost of a NESCT was more expensive than that of an EU (140,000 vs. 35,790 Won), however the cost-effectiveness is enhanced by the accuracy of NESCT, which lead to fewer ancillary studies. CONCLUSIONS: NESCT is accurate, reliable and safe, and has many advantages over EU, and therefore could be recommended as a first diagnostic modality for the evaluation of patients with suspected urolithiasis.
Diagnosis* ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Urinary Calculi ; Urography ; Urolithiasis*

Hallux valgus has been defined as a static subluxation of the first metatarsophalangeal joint with lateral deviation of the proximal phalanx on the first metatarsal head from the longitudinal axis of the first metatarsal with medial deviation of the first metatarsal. And first-second metatarsal angle is increased as well as bursal hypertrophy over the medial eminence of the first metatarsal head. Many procedures have been reported for the treatment of the hallux valgus ranging from resection arthroplasty to distal first metatarsal or basal first metatarsal osteotomy. Of these, Johnson and Corless have required sufficiently good results in the modifying Mitchell osteotomy into Chevron osteotomy. The Chevron procedure is an osteotomy involving the distal portion of the first metatarsal, lateral displacement of the metatarsal head with exostosectomy, and tightening of the medial capsular structures. Authors studied 17 cases in 10 patients with the hallux valgus deformity treated by Chevron osteotomy at the Department of Orthopedic Surgery, Capital Armed Forced General Hospital from September 1987 to September 1989. The results were as follows; 1. Seven patients (12 cases) were male and three patients (5 cases) were female. All patients had bilateral hallux valgus deformity. 2. The average first-second intermetatarsal angle was 11 degrees and average valgus angle was 32 degrees, preoperatively. They were corrected to 9 degrees and 14 degrees respectively. 3. The metatarsalgia of the great toe was subsided in all cases and they were satisfied with the result of their operations in respect to cosmetically and functionally. Avascular necrosis of capital fragment, nonunion, and dorsal angulation were not developed in any case. But, one case had marginal skin necrosis, presumably due to excessive compressive dressing. 4. Chevron osteotomy is a technically easy procedure and it can be obtained early bone healing with less complication.
Arm ; Arthroplasty ; Bandages ; Congenital Abnormalities ; Female ; Hallux Valgus ; Hallux ; Head ; Hospitals, General ; Humans ; Hypertrophy ; Male ; Median Eminence ; Metatarsal Bones ; Metatarsalgia ; Metatarsophalangeal Joint ; Necrosis ; Orthopedics ; Osteotomy ; Skin ; Toes

PURPOSE: The incidence of renal tuberculosis has decreased considerably in recent years, but the disease still threatens public health. Childhood genitourinary tuberculosis (GUTB) has been very rare. The aim of the study was to analyze the clinical aspects and characteristics of childhood GUTB. MATERIALS AND METHODS: A total of 145 cases of GUTB were diagnosed. We analyzed retrospectively the clinical manifestations of eight patients with GUTB younger than 15 years of age. RESULTS: The age of the patients, six boys and two girls, ranged from 5 to 14 years. Follow up period ranged from 12 to 145 months. Presenting features were diverse and included gross hematuria in five cases. Rarer presenting features included one case of epididymorchitis. All had had BCG vaccination at around 1 month old. Conclusive diagnosis was made on the basis of isolation of mycobacterium tuberculosis in five patients, whereas three patients were given a therapeutic trial based on clinical manifestations. The most common site of involvement was the kidney (7 cases). Temporary urinary diversional procedures were performed in two patients for relieving ureteral obstruction. Excisional surgery was needed in three patients, whereas one underwent ureteroneocystostomy for ureteric stricture. Response to antitubercular drug therapy was gratifying. No relapse was observed during follow-up period. CONCLUSIONS: Childhood GUTB is rare, but may become serious. The importance of early diagnosis is emphasized, and aggressive treatment is needed in advanced childhood tuberculosis for preservation of renal function.
Child* ; Constriction, Pathologic ; Diagnosis ; Drug Therapy ; Early Diagnosis ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Incidence ; Infant, Newborn ; Kidney ; Mycobacterium bovis ; Mycobacterium tuberculosis ; Public Health ; Recurrence ; Retrospective Studies ; Tuberculosis* ; Tuberculosis, Renal ; Ureter ; Ureteral Obstruction ; Urinary Diversion ; Vaccination

PURPOSE: Testicular microlithiasis (TM) is an uncommon benign condition characterized by calcium deposits in the lumen of the seminiferous tubules. It may be associated with testicular malignancies and infertility. MATERIALS AND METHODS: We performed a retrospective review of clinical charts and scrotal ultrasound findings of 18 patients who were found to have TM. Scrotal ultrasound scans were performed using 5- to 10-mHz high-resolution transducers. The indication for ultrasonography was an abnormal scrotal examination. RESULTS: The mean age at presentation was 39.9 years (range 14 to 70 years). Most (15; 83.3%) of the patients had bilateral TM. There were no differences in the sonographic patterns and appearance according to patient age. A third of the patients (7; 38.9%) had benign epididymal lesions. Two with bilateral TM had unilateral testicular malignancy. A varicocele was identified in two men, who demonstrated normal semen parameters. A 16-year-old boy showed no interval sonographic changes at 1-year follow-up. CONCLUSIONS: Testicular microlithiasis usually affects both testes. The association between TM and progres sion of cancer is unclear.
Adolescent ; Calcium ; Follow-Up Studies ; Humans ; Infertility ; Male ; Retrospective Studies ; Semen ; Seminiferous Tubules ; Testis ; Transducers ; Ultrasonography ; Varicocele

PURPOSE: This study was conducted to investigate the characteristics of drug induced anaphylaxis and anaphylactic shock in patients who were admitted to the emergency department. METHODS: We retrospectively collected the data on patients with drug induced anaphylaxis and who were admitted to the emergency department from January 2001 to June 2009. The study group was divided into the non-shock and shock groups according to whether the systolic blood pressure more than 90 mmHg. The initial demographic data, the causes of drug-induced anaphylaxis, the clinical manifestations, the treatment and the prognosis were reviewed for 72 patients. RESULTS: The mean age of the study subjects was 47.9+/-14.2 years old and there were 40 male patients and 32 female patients. There were 26 patients in the non-shock group and 46 in the shock group. The mean age was older in the shock group than in the non-shock group (51.5+/-15.1 vs 42.5+/-10.6, p-0.002). A history of drug allergy was more common in the shock group, but no difference was found for the comorbid chronic diseases between the two groups. Radio-contrast media was the most common cause, followed non-steroidal anti inflammatory drugs and antibiotics, but there is no difference in the causes between the two groups. The symptoms of cyanosis, syncope, sweating and dizziness were more frequently manifested in the shock group. The administration of intravenous fluid and injection of subcutaneous epinephrine at the emergency department were more frequent in the shock group than in the non-shock group. CONCLUSION: For the patients who were admitted to the emergency department with drug induced anaphylaxis, the mean age was older and the symptoms of cyanosis, syncope, sweating, dizziness were more frequent in the anaphylactic shock patients than in the non-shock group. More treatments were given at the emergency department to the anaphylactic shock patients.
Anaphylaxis ; Anti-Bacterial Agents ; Blood Pressure ; Chronic Disease ; Cyanosis ; Dizziness ; Drug Hypersensitivity ; Emergencies ; Epinephrine ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies ; Shock ; Sweat ; Sweating ; Syncope

Iliac vein compression syndrome is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein thrombosis, severe leg edema and ulceration. We experienced a 55-year-old male patient with recurrent left leg ulcer for 15 years. Skin grafting had been done three times, but none of them healed the patient. Femoral venography showed a complete occlusion of the left common iliac vein. Palma-Dale bypass grafting procedure(crossover saphenous vein bypass grafting) and arteriovenous fistula formation was done. The leg ulcer healed two months after the operation.
Arteriovenous Fistula ; Edema ; Humans ; Iliac Artery ; Iliac Vein* ; Leg Ulcer* ; Leg* ; Male ; May-Thurner Syndrome* ; Middle Aged ; Phlebography ; Saphenous Vein ; Skin Transplantation ; Transplants ; Ulcer ; Venous Thrombosis

A prospective randomised trial was performed to assess the diagnostic accuracy according to the time interval and the efficacy of endoscopic injection of hypertonic saline-epinephrine(HS- E)solution, consisting of 3.5% sodium chloride with 0.0045% epinephrine, for actively bleeding peptic ulcers, exposed vessel or blood clot on ulcer bed, or Mallory-Weiss tear. Over 24 month, emergency endoscopy in 180 patients admitted for upper gastrointestinal hemorrhage identified 51 patients with nonvariceal hemorrhage. The causes of bleeding were; gastric ulcer in 32; duodenal ulcer in 13; gastric cancer in 4; Mallory-Weiss tear in 2. With this method, the hemostatic effect was permanent in 40 cases(84.3%), temporary in 9 cases(11.8%), and failed in 2 cases(3.9%). By applying this method, the rate of emergency operation for patients with bleeding from the upper gastrointestinal tract was significantly reduced from 20.0% (8/40)to 3.9%(2/51)(p<0.05). Emergency endoscopy in acute UGI bleeding increases the accuracy of detection of actual bleeding sites(p<0.05), but if the endoscopic procedure was performed within 48 hours, the hemostatic rate was not affected(p<0.05). We concluded that hypertonic saline-epinephrine injection method could provide a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal upper gastrointestinal bleeding.
Duodenal Ulcer ; Emergencies ; Endoscopy ; Epinephrine* ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans ; Mallory-Weiss Syndrome ; Peptic Ulcer ; Prospective Studies ; Sodium Chloride ; Stomach Neoplasms ; Stomach Ulcer ; Ulcer ; Upper Gastrointestinal Tract*

Currently, endoscopic injection sclerotherapy(EIS) is the most widely used method for treating and eradicating acutely bleeding esophageal varices in repeated sessions, but may be associated with some undesirable local and systemic complications. (continue...)
Esophageal and Gastric Varices* ; Esophagus ; Hemorrhage ; Hemostasis ; Ligation* ; Sclerotherapy* ; Varicose Veins

No abstract available.
Transplantation* ; Tuberculosis*