No abstract available.
Hepatitis, Chronic* ; Interferon-alpha* ; Killer Cells, Natural* ; Prednisolone*

Wilms' tumor is malignant renal tumor, originated from undifferentiated mesonephric blastema. Adult Wilms' tumor, unlike that of childhood, is a rare disease and a total of l67 cases have been reported in the world medical literature until 1980. Diagnosis of adut Wilms` tumor is very difficult preoperatively and the pathologic hallmark is the presence of abortive or embryonal glomerulotubular structure with an immature spindle cell stroma. The therapeutic guidelines and surgical principles that govern childhood Wilms' tumor should be applied to adult Wilms' tumor. We reported a case of Wilms' tumor developed in 34 year-old male patient complaining of right flank pain with gross hematuria for 2 months.
Adult* ; Diagnosis ; Flank Pain ; Hematuria ; Humans ; Male ; Rare Diseases ; Wilms Tumor*

Primary sclerosing cholangitis, a chronic cholestatic liver disease, is uncommon and is characterized byinflammation and fibrosis of the bile ducts. It frequently occurs in association with ulcerative colitis. Wedescribe two cases of primary sclerosing cholangitis in patients with ulcerative colitis.
Bile Ducts ; Cholangitis ; Cholangitis, Sclerosing* ; Colitis, Ulcerative* ; Fibrosis ; Humans ; Liver Diseases ; Ulcer*

Epidural neuroplasty is a treatment modality for back pain and/or radiating pain caused by mechanical compression or neural inflammation of intra-spinal neural structures. Since epidural neuroplasty was first introduced as a treatment for pain caused by epidural adhesion such as failed back surgery syndrome (FBSS), it has been performed as a treatment for many kinds of pain of spinal origin including acute/chronic herniation of intervertebral disc, radiculopathy, spinal stenosis, FBSS, epidural adhesion, vertebral compression fracture, vertebral metastasis, resistant multilevel degenerative arthritis, epidural scar pain by infection or meningitis, and whiplash injury. Epidural neuroplasty is a catheterization technique used to treat back pain and/or radiating pain by injecting therapeutic drugs into lesions of epidural space shown as a filling defect in epidurogram. Usually, normal saline, local anesthetics, and steroid are used as therapeutic drugs. The exact mechanisms of action of the procedure are unknown but include 2 postulated mechanisms of action for pain relief. i.e., mechanical adhesiolysis by volume effect and chemical adhesiolysis by injected drugs. Relative large volumes of normal saline injection resolve adhesions and wash out accumulated pain substances; local anesthetics are used for stabilization and analgesia of flaring neural structures and for pain management for procedure related pain; and steroid is used for the treatment of inflammation of neural and peri-neural structures. The resolution of filling defect can be verified by post-procedure epidurogram. The key point of epidural neuroplasty for good results, is the exact localization of the epidural catheter into the epidural lesion.
Analgesia ; Anesthetics, Local ; Back Pain ; Catheterization ; Catheters ; Cicatrix ; Epidural Space ; Failed Back Surgery Syndrome ; Fractures, Compression ; Inflammation ; Intervertebral Disc ; Intervertebral Disc Displacement ; Meningitis ; Neoplasm Metastasis ; Osteoarthritis ; Pain Management ; Radiculopathy ; Spinal Stenosis ; Whiplash Injuries

A clinical evaluation was made on 19 patients with urethral stricture following urethral catheterization in 155 urethral stricture patients during 12 years from January. 1979 to December. 1990. The following results were obtained. I. In 155 cases of urethral stricture, iatrogenic urethral stricture was 24 cases (15.4%) of which the most common cause was urethral catheterization(19 cases) and followed by instrumentation (2 cases). 2. In 19 cases of urethral stricture following urethral catheterization. the most common site was the anterior urethra (bulbous 10 cases. pendulous 7 cases) and multiple strictures showed 5 of 17 anterior urethral strictures. 3. In 19 cases, 16 cases (84.2%) occurred in patients who have kept the urethral catheter within seven days and 18 cases (94.7%) were inserted and cared the urethral catheter by non-urologist. 4. Treatment was performed internal urethrotomy in 16, dilatation in 2 and catheter indwelling during 1 week in 1. 5. In 24 cases of iatrogenic urethral stricture. mean number of dilation to recurrent strictures after primary procedure had required O.5 time. From our results. we suggest that education for the careful insertion and method of care for the urethral catheter to non-urologist is least likely to induce urethral stricture formation.
Catheters ; Constriction, Pathologic ; Dilatation ; Education ; Humans ; Urethra ; Urethral Stricture* ; Urinary Catheterization* ; Urinary Catheters*

Vasectomy is one of the most common forms of male contraception throughout the world. However, more vasectomy reversals are sought each year because of the increasing number of second marriages and other causes. Before recommending vasectomy, urologists may wish to resolve in their own mind the conflict between reports that maintain the testis is harmed by vasectomy and those that slate is not. We studied a group of patients undergoing vasectomy reversal to determine whether histopathologic change on light and electron microscopy would be detected. Only one testis specimen from post-vasectomy patients showed an abnormality correlated with spermatogenesis and five cases showed mild focal interstitial fibrosis without abnormality of spermatogenesis on light and electron microscopy. We found that vasectomy has some influence to the spermatogenesis and pathologic change.
Contraception ; Fibrosis ; Humans* ; Marriage ; Microscopy, Electron ; Spermatogenesis ; Testis* ; Vasectomy* ; Vasovasostomy

A clinical observation was made on 64 cases of the bladder rupture who were admitted to our hospital during the period from June, 1979 to February, 1991. The results are as following ; 1. Of 355 cases of the genitourinary tract injury, the bladder rupture were 64 cases (18.0%), which were composed of 40 cases (62.5%) of bladder rupture without pelvic bone fracture and 24 cases (37.5%) of bladder rupture with pelvic bone fracture. The bladder rupture without pelvic bone fracture were composed of 35 cases (87.5%) with intraperitoneal bladder rupture and 5 cases (12.5%) with extraperitoneal bladder rupture, the bladder rupture with pelvic bone fracture were composed of 13 cases (12.5%) with intra and extraperitoneal bladder rupture. 2. In 24 patients with pelvic bone fracture, the most common site of bladder ruptures were found on the lateral wall in 12 cases (50%), and followed by the dome in 9 cases (37.5%), multiple areas in 3 cases (12.5%). In 40 patients without pelvic bone fracture, the most common site of bladder ruptures were found on the dome in 33 cases (82.5%), and followed by the multiple areas in 4 cases (10%), lateral wall in 3 cases (7.5%). 3. The average size of the bladder rupture was 6.5cm in cases without pelvic bone fracture, 6. 8cm in cases with pelvic bone fracture, especially comminuted pelvic ring fracture had most severed bladder rupture (average; 8.3cm). 4. Of 24 pelvic bone fractures, pubic rami fractures were most common (41.6%), and followed by comminuted pelvic ring fracture (25%), anterior and posterior pelvic ring fractures (12.5%), acetabulum and isolated fractures (8.3%), symphyseal separation fractures (4.1%) in order of frequency. 5. 5 cases (20%) of pelvic bone fractures were associated with posterior urethral injury, especially 60% in The pubic rami fracture. There was no significant relation between the type of pelvic fracture and the type of bladder rupture, but the fractures involving pubic arch were more often associated with posterior urethral injury.
Acetabulum ; Humans ; Pelvic Bones* ; Rupture* ; Urinary Bladder*

BACKGROUND: Two results have been conflict regarding the pH of gastric contents in obese and lean surgical patients. Obese patients have been considered to have lower pH of gastric contents than lean surgical patients since the study by Vaughan, whereas Harter reported no significant difference in the pH's of obese and lean surgical patients. The author wanted to investigate whether gastric content pH differs or not between obese and lean surgical patients aged from 20 to 60 years. METHODS: Forty patients scheduled for elective abdominal hysterectomy under general endotracheal anesthesia were studied. Group I (n = 20) was composed of lean patients whose body mass indices (BMIs) were between 20 and 25, whereas Group II (n = 20) was composed of obese patients whose BMIs were above 30. Every patient was fasted between 8 and 14 hours preoperatively. Within 10 minutes of endotracheal intubation, gastric contents were withdrawn with a 20 cc syringe connected to a 16F nasogastric tube placed in the stomach. pH and the incidences of pH <2.5, and pH <1.8 were compared. RESULTS: No significant difference in pH (P = 0.199) or in the incidences of pH less than 2.5 (P = 0.23) or 1.8 (P = 0.52) were observed between obese and lean patients. CONCLUSIONS: Obese and lean patients have similar fasting gastric pH's, as long as the obesity is not too severe (BMI under 40).
Anesthesia ; Fasting ; Humans ; Hydrogen-Ion Concentration* ; Hysterectomy ; Incidence ; Intubation, Intratracheal ; Obesity ; Stomach ; Syringes

The 46, XX male or sex-reversal syndrome is a rare entity, which may be reported first by de la Chapelle and associates in 1964, an additional 135 cases have been recognized, yet only 20 percent of these patients have been diagnosed during childhood. The 46, XX male may be associated with hypogonadism and infertility in adult, and occasionally, sexual ambiguity in the neonate. At least 10% of patients have had hypospadia or ambiguous external genitalia. The 46, XX male was diagnosed with cytogenic study, H-Y antigen, hormonal study testicular biopsy, radiologic study. Here, we report a case of 19 month-old child XX-male with hypospadia and chordee.
46, XX Testicular Disorders of Sex Development* ; Adult ; Biopsy ; Child ; Female ; Genitalia ; H-Y Antigen ; Humans ; Hypogonadism ; Hypospadias ; Infant ; Infant, Newborn ; Infertility ; Male

A total of 17 children with 24 renoureteral units underwent 58 treatment with EDAP LT-01 extracorporeal shock wave lithotripsy for urinary tract stones between January 4, 1989 and January 30, 1993. The patients were followed for over two months. The results were obtained as follows ; 1. The distribution of sex was 9(53%) in male and 8(47%) in female. The average patient age was 7 years with a range of 6 months to 16 years. 2. The location of stones were kidney in l8 cases( 75.0%) ; calyx in 10 (41.7% ) and renal pelvis in 8(33.3% ) and ureter in 6(25.0%) ; upper ureter in 2(8.3%) and lower ureter in 4( 16.7%). There were multiple renal stone in 4 and bilateral renal stone in 2. The average stone length was 9mm with a range of 3 to 10mm. 3. Of the 13 patients whose age was less than 10 years, 11(84.6%) required intravenous Ketamine anesthesia. Two patients whose age was more than 10 years and two patients less than 10 years were treated without any type of anesthesia. 4. The average numbers of treatment were 2.1 session and the average storage required was 19.4 in one session The average treatment time was 39.7 minutes. 5. The total average success rate was 87.5% 6. All of the patients were not the pre- and post- ESWL additional manipulation. ESWL complications did not require admission and surgical management. Therefore, we conclude that EDAP LT-01 is an effective and easy procedure for treatment of urinary stones in children.
Anesthesia ; Child* ; Female ; Humans ; Ketamine ; Kidney ; Kidney Pelvis ; Lithotripsy* ; Male ; Shock* ; Ureter ; Urinary Calculi