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*

No abstract available.
Immunoglobulin G* ; Inflammation*

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: 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: 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: This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury. METHODS: Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed. RESULTS: The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred. CONCLUSION: There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.
Abbreviated Injury Scale ; Abdominal Injuries ; Accidents, Traffic ; Blood Pressure ; Demography ; Emergencies ; Erythrocytes ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Injury Severity Score ; Intensive Care Units ; Liver ; Male ; Medical Records ; Pelvic Bones ; Retrospective Studies ; Shock

No abstract available.
Transplantation* ; Tuberculosis*

No abstract available.
Transplantation* ; Tuberculosis*

Cancer is the most frequent cause of death in both developing and developed countries, including Korea. The aim of this study was to present survival rates of Korean cancer patients. Survival analysis was carried out with data collected under the Korea Central Cancer Registry Program, which included all cancer patients diagnosed from January 1, 1997 to December 31, 1997. We have analyzed the effects of age at diagnosis and sex on cancer survival from the cancer registry data of 64,240 Korean patients diagnosed of cancer in 1997. The overall survival rate of all Korean cancer patients (both men and women) was 67% at 1 yr and 57% at 2 yr. The 1- and 2-yr survival rates for all cancers in men were 58% and 47%, respectively, while those in women were 77% and 69%, respectively. Men had a lower survival rate than women in most malignancies. The pancreatic cancer was shown the lowest 1-yr survival rate.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Korea ; Male ; Middle Aged ; Neoplasms/*mortality ; Survival Analysis ; Survival Rate

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*