Statistical observation was made on 117 cases of congenital anomalies of the genitourinary tract in Korean children who had been admitted to Department of Urology, St. Mary's Hospital from January 1. 1965 to December 31.1972. Statistical observation was included age and sex distribution, clinical manifestation, annual and organ distribution, associated diseases with anomalies and the kinds of operation methods. The results were as follows; 1. 174 cases (11%) were pediatric patients among the total number of patients admitted to Vrologic department during observation. 2. 117 cases (7.3%) of pediatric patients among the total number of patients admitted to the Urologic department during observation had congenital anomalies of the genitourinary tact. 3. The ratio of congenital anomaly to acquired disease in pediatients was approximately 2: l. 4. The congenital anomaly of the genitourinary tract affected both male and female patients (ratio of 15.9 : 1) with a peak incidence in the four to ten age range. 5. The most vulnerable organs of the geni1ourinary tract anomaly were genitalia and urethra. 6. In the genitourinary tract diseases congenital anomaly, injury, tumor and tuberculosis were the most common diseases. 7. 13 cases (33. 3%) of the urinary tract anomaly were accompanied with pyelonephritis, hydronephrosis and ureterovesical reflux.
Child* ; Female ; Genitalia ; Humans ; Hydronephrosis ; Incidence ; Male ; Pyelonephritis ; Sex Distribution ; Tuberculosis ; Urethra ; Urinary Tract ; Urology

Clinical observation was made on 37 cases (41 ureter) who had beet performed antireflux procedure at Department of Urology from October 1, 1968 to July 31. 1973. Clinical observation was included age and sex distribution, indication for operation. operation site, method of operation, additional procedure, duration of indwelling ureteral splint catheter and complication. The results were as follows; 1. Antireflux procedure was performed for ureteral stricture, bladder tumor. kidney transplantation. megaloureter and ureterovesical reflux. 2. 38 ureters were performed with the method of Politano-Leadbetter procedure and 3 ureters with Paquia procedure. 3. Majority cases were required additional procedure suck as partial cystectomy, kidney translantation. ureteral tailoring. psoas hitch, nephrostomy and ileocystoplasty. 4. Mean duration of indwelling ureteral splint catheter was 3 days on antireflux procedure and 10 days on antireflux procedure with ureteral tailoring or ileocystoplasty. 5. Complication bad beet observed in 9 cases, which included acute pyelonephritis, ureterovesical reflux, sepsis, uremia, urine leakage and vesicocutaneous fistula.
Beta vulgaris ; Catheters ; Constriction, Pathologic ; Cystectomy ; Fistula ; Kidney ; Kidney Transplantation ; Pyelonephritis ; Sepsis ; Sex Distribution ; Splints ; Uremia ; Ureter ; Urinary Bladder Neoplasms ; Urology

Massage is generally accepted as a safe and a widely used modality for various conditions, such as pain, lymphedema, and facial palsy. However, several complications, some with devastating results, have been reported. We introduce a case of a 43-year-old man who suffered from tetraplegia after a neck massage. Imaging studies revealed compressive myelopathy at the C6 level, ossification of the posterior longitudinal ligament (OPLL), and a herniated nucleus pulposus (HNP) at the C5-6 level. After 3 years of rehabilitation, his motor power improved, and he is able to walk and drive with adaptation. OPLL is a well-known predisposing factor for myelopathy in minor trauma, and it increases the risk of HNP, when it is associated with the degenerative disc. Our case emphasizes the need for additional caution in applying manipulation, including massage, in patients with OPLL; patients who are relatively young (i.e., in the fifth decade of life) are not immune to minor trauma.
Adult ; Facial Paralysis ; Humans ; Longitudinal Ligaments ; Lymphedema ; Massage ; Neck ; Ossification of Posterior Longitudinal Ligament ; Quadriplegia ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Diseases ; Spinal Cord Injuries

BACKGROUND AND AIMS: FibroScan(R) is a new medical device that noninvasively measures liver stiffness. The aim of this study was to assess the accuracy of the liver stiffness measurement by FibroScan(R) for making the diagnosis of liver fibrosis in patients with chronic viral hepatitis. METHODS: We studied 103 patients with chronic viral hepatitis B or C and they underwent FibroScan(R) and liver biopsy between October 2005 and August 2006. Liver fibrosis was staged on a 0-4 scale according to the Korean Society of Pathologists Scoring System. The diagnostic accuracy was assessed by analysis of the receiver operator characteristics (ROC). RESULTS: The liver stiffness was 3.5-57.1 kPa (mean: 11.8, SD: 8.9). The mean value of liver stiffness in each fibrosis stage group (F1, F2, F3 and F4) was 5.8+/-1.8 kPa, 11.3+/-6.8 kPa, 11.8+/-6.0 kPa and 23.4+/-16.5 kPa, respectively. Liver stiffness measured by FibroScan(R) showed reliable correlation with the liver fibrosis stage as confirmed by liver biopsy (r=0.56, p<0.001). The AUROC (95% CI) of > or = F2, > or = F3 and F4 was 0.93 (0.86-0.99), 0.72 (0.62-0.82) and 0.80 (0.67-0.92), respectively. The sensitivity and specificity of 7.5 kPa, which was the cutoff value for > or = F2, was 84% and 90%, respectively. CONCLUSIONS: FibroScan(R) is a reliable method for the diagnosis of significant fibrosis (> or =F2) and cirrhosis in patients with chronic liver disease. The liver stiffness measurement by FibroScan(R) showed good diagnostic performance for significant fibrosis.
Adult ; Aged ; Disease Progression ; Female ; Hepatitis B, Chronic/complications/*ultrasonography ; Hepatitis C, Chronic/complications/*ultrasonography ; Humans ; Liver/*ultrasonography ; Liver Cirrhosis/etiology/*ultrasonography ; Male ; Middle Aged ; Predictive Value of Tests ; ROC Curve ; Sensitivity and Specificity

BACKGROUND/AIMS: Transient elastography is a new noninvasive tool for measuring liver stiffness that accurately predicts significant fibrosis and cirrhosis. However, several studies have indicated that liver stiffness can be significantly influenced by major changes in aminotransferase in patients with chronic viral hepatitis. The aim of this study was to determine the factors influencing liver stiffness in patients with chronic liver disease. METHODS: We studied 158 patients with chronic liver disease who underwent transient elastography and liver biopsy sampling. Histologic findings on fibrosis and necroinflammatory activity in the biopsy specimens were evaluated according to the Korean Society of Pathologists Scoring System. Routine biochemical tests were performed according to standard methods. RESULTS: Liver stiffness was strongly correlated with liver fibrosis stage (Spearman coefficient=0.636, P<0.001), lobular activity (Spearman coefficient=0.359, P<0.001), and portoperiportal activity grade (Spearman coefficient=0.448, P<0.001). Liver stiffness was significantly associated with serum levels of total bilirubin (P=0.025), direct bilirubin (P=0.049), gamma-glutamyl transpeptidase (P=0.014), platelet count (P=0.004), albumin (P<0.001), and international normalized ratio (P<0.001). Multivariate analysis showed that fibrosis stage (B 3.50, P=0.009) and lobular activity grade (B 3.25, P=0.047) were independently associated with liver stiffness. CONCLUSIONS: Liver stiffness as measured by transient elastography is associated with the grade of necroinflammatory activity and the stage of fibrosis, irrespective of serum ALT levels.
Adult ; Aged ; Bilirubin/blood ; Biopsy ; Chronic Disease ; Elasticity ; *Elasticity Imaging Techniques ; Female ; Hepatitis B, Chronic/*complications ; Hepatitis C, Chronic/*complications ; Humans ; International Normalized Ratio ; Liver Cirrhosis/etiology/pathology/*ultrasonography ; Male ; Middle Aged ; Platelet Count ; Risk Factors ; Severity of Illness Index ; gamma-Glutamyltransferase/blood

BACKGROUND: High-dose chemotherapy is increasingly employed in many refractory malignant diseases. This therapy has been reported to increase response rate and survival benefits but it is also associated with higher treatment-related morbidity and mortality. We evaluated clinical characteristics and course of the pulmonary toxicity following high-dose chemotherapy with peripheral blood stem cell transplantation. METHODS: Ninety-seven patients who had received high-dose chemotherapy with peripheral blood stem cell transplantation were evaluated. Five patients who developed lung lesions which were not related to infection nor primary malignant disease underwent transbronchial lung biopsy. The patients' clinical characteristics, treatments, and prognosis were reviewed retrospectively. RESULTS: Five patients(5.1%) developed idiopathic pneumonia syndrome. The high dose chemotherapy regimens employed were cyclophosphamide, BCNU, and cisplatin in 3 cases, one case of BCNU, etoposide, Ara-C, cyclophosphamide combination, and a regimen consisting of BCNU, etoposide, Ara-C, and melphalan. The total dose of BCNU used was 300-400 mg/m2 and that of cyclophosphsmide was 6,000 mg/m2. All of 5 patients received radiation therapy before this treatment. After an average duration of 14 weeks (4-26 weeks) of high-dose chemotherapy, patients developed cough, dyspnea and fever. The chest X-rays showed bilateral diffuse infiltration in 3 cases and the focal infiltration in the other 2 cases. All the patients received corticosteroid therapy as a treatment for the lung lesions. Two of them progressed to acute respiratory distress syndrome and died. Three patients recovered without residual lung lesion but one of them died of dilated cardiomyopathy. CONCLUSION: High-dose chemotherapy with peripheral blood stem cell transplantation especially which containing BCNU regimen may develop idiopathic pneumonia syndrome related to pulmonary toxicity and corticosteroid therapy may be beneficial in some cases.
Biopsy ; Cardiomyopathy, Dilated ; Carmustine ; Cisplatin ; Cough ; Cyclophosphamide ; Cytarabine ; Drug Therapy* ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Etoposide ; Fever ; Humans ; Lung ; Melphalan ; Mortality ; Peripheral Blood Stem Cell Transplantation* ; Pneumonia ; Prognosis ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Thorax