The phenomenon of Myotonia consist in a failure of voluntary muscles to relax immediately when voluntary innervation ceases. The stiffness is accentuated by cold and relieved by exercise, while generalized muscle weakness and atrophy (or not commonly hypertrophy of muscle) is common. Myotonia is a feature of four principal clinical syndromes which have been classified myotonia congenita (Thomsens disease), myotonia atrophica (Steinerts disease), paramyotonia and myotonia and myotonia acquisita by Walton et al. We report here a forty six years old male of myotonia atrophica (Dystrophia myotonia, Steinerts disease) who presents bilateral cataracts, frontal baldness, gonadal atrophy, facial myopathy, sterno-cleidomastoid muscle atrophy and a progressive generalized myopathy of peripheral distribution in the limbs.
Alopecia ; Atrophy ; Cataract ; Extremities ; Gonads ; Humans ; Hypertrophy ; Male ; Muscle Weakness ; Muscle, Skeletal ; Muscular Atrophy ; Muscular Diseases ; Myotonia Congenita ; Myotonia ; Myotonic Dystrophy

No abstract available.
Female ; Ovary* ; Teratoma*

Bornstein and plate (1911) and Bassoe (1913), followed by many European and American, described the radiographic appearance of avascular necrosis of the bone in compressed air worker. Divers bone lesions was described for the first time by Grutzmacher in 1941. There is not any report of information on the caisson disease and divers bone lesions in this country. Inview of these considerations, during the period from March to June 1981, 124 traditional civilian divers and 132 Naval divers, were observed in eight Korean coastal cities (In-cheon, Sam-chun-po, Sin-hae, Pu-san, Ul-san, Ku-ryung-po, joo-moon-jin and Sok-cho). For each divers, a record was made of his medical history, diving experiences and frequencies of bends attacks. The clinical examination included blood pressure, body weight, a chest radiograph and routine checks of the shoulders, hips and knees, but an X-ray examination extended to the spines, ankles, elbows when symptoms existed. The results were as follow: l. Out of 256 divers, 113 (44.2%) had bone lesions, seventy-five traditional divers (60.5%) had bone lesions out of 125 divers, but naval divers, only thirty eight (28.8%) of 132 had such lesions. 2. Divers bone lesion incidence is increased with diving experience especially over 10 years. 3. The most frequent bone lesions occured in the upper end of the humerus, the upper end of the femur, the lower end of the femur and proximal tibia. 4. The most frequent divers bone lesions in X-ray was dense areas (Bl). 5. There was a high incidence (93.1%) in man with a history of the bends and significantly relate between the sites of the bends and those of the lesions. 6. Divers bone lesions incidence was increased with the length of diving experiences, diving depth, diving time, ages and with bends experiences.
Ankle ; Blood Pressure ; Body Weight ; Compressed Air ; Decompression Sickness ; Diving ; Elbow ; Femur ; Hip ; Humerus ; Incidence ; Knee ; Korea ; Necrosis ; Radiography, Thoracic ; Shoulder ; Spine ; Tibia

A cases is reported of congenital atlanto-occipital fusion in a 12-years-old girl. The lesion was treated by occipito-cervical arthrodesis by iliac bone grafting with wiring. The congenital atlanto-occipital fusion has not progressed in this 2 years of observation. This is presented with a review of literature.
Arthrodesis ; Bone Transplantation ; Female ; Humans

Actinomycosis, in which the principal causative agent in man is known to Actinomyces israelii, is a chronic, suppurative diseases characterized by extensive fibrosis, multiple abscesses, and formation of sinus tracts that drain suppurative exudates. On the basis of the anatomical sites involved; it can be subclassified into the cervicofacial form, which is the most common form, pulmonary form and abdominal form. Kidneys are rarely affected. Clinically, radiologically, and at operation it is difficult to differentiate the renal actinomycosis from renal tuberculosis and renal carcinoma. The prognosis is excellent after nephrectomy followed by appropriate antibiotic therapy. We presented a case of renal actinomycosis with a brief review of the literatures.
Male ; Humans

Recently, the priapism is mostly seen after intracavernous injection of vasoactive drugs for the diagnosis and therapy of erectile dysfunction. Prompt relief of the priapism is essential to prevent ischemia and fibrosis of the corpora with resultant impotence. Of 2992 patients who have used intracavernous injection of vasoactive agents for diagnostic and therapeutic purposes of erectile dysfunction (August 1986-June 1995), 133 men (4.4%) experienced priapism persisting for more than 4 hours. Mean patient age was 45.6 (23-70) years. The etiology of impotence was psychogenic in 60.2%, unclear in 16.5%, vasculogenic in 10.6%, diabetogenic in 8.3%. The vasoactive agents used for the intracavernous injection were: 1) papaverine, 2) dimix; a mixture of papaverine (27. 3mg/ml) and phentolamine (0.9mg/ml), 3) trimix; a mixture of papaverine (18.8mg/ml), phentolamine (0.5mg/ml) and PGE1 (6.3mg/ml). The incidence of priapism was 3.8% in papaverine, 7. 7% in dimix and 0.7% in trimix. The average doses of papaverine, dimix and trimix to have developed the priapism were 30.3+/-9.8mg, 0.4+/-0.3ml and 0.15+/-0.1ml, respectively. Average duration of the priapism was 8.6 (4-59) hours. Priapism usually developed during diagnostic workup (63.2%) and initial dose determination phase of treatment (32.3%). The priapism resolved spontaneously in 44.4%. The priapism was treated by aspiration alone in 17.3% and irrigation with 0.1% epinephrine solution in 37.6%. One patient required cavernosaphenous shunt operation. The potency became worse after resolution of the priapism in 5 among 34 patients of follow-up. The etiology of impotence in these 5 men was vasculogenic (1/3), psychogenic (2/22) and unclear (2/4). In conclusion, trimix is the best drug among the 3 regimens for the intracavernous self-injection in terms of lowest incidence of drug-induced priapism. Vasculogenic impotence patient seems to have a greater risk of worse potency after resolution of the priapism.
Alprostadil ; Diagnosis ; Epinephrine ; Erectile Dysfunction ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Impotence, Vasculogenic ; Incidence ; Ischemia ; Male ; Papaverine ; Phentolamine ; Priapism*

We review 66 patients with lower caliceal stones treated with extracorporeal shock wave lithotipsy. One of the major problems involved with extracorporeal shock wave lithotripsy is the high rate of residual stone fragments in the lower calices. We observed the influence of the presence of lower caliceal dilatation, hydronephrosis, and the size of alone on the passage of stone. Thirty-nine of the 66 patients with a lower caliceal stone and no stone fragments. The success rate was only 59 per cent. The stone was completely fragmented in 59 of 66 (89%) patients. Thirty-nine of 59 patients who had completely fragmented stones. had no residual fragments. The patients who had no lower caliceal dilatation and a relativgly small size stone (less than 1.5 x 1.0 cm). such as in group 4. had a high success rate of 70%. The patients with a large stone or the presence of caliceal dilatation. were expected to low success rate, therefore there was a need for repeated treatment with extracorporeal shock wave lithotripsy and combined treatment with percutaneous nephrostomy.
Dilatation ; Humans ; Hydronephrosis ; Lithotripsy* ; Nephrostomy, Percutaneous ; Shock*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

There has been remarkable progress in the treatment of erectile dysfunction during last decade. We have analyzed 2,000 patients with erectile dysfunction who had been treated with a variety of treatment modalities during last 10 years to identify the annual changes in the proportion of the respective treatment modality. The most remarkable change was seen in the proportion of patients treated by vasoactive pharmacotherapy The proportion was 12.0% on 1984, which was gradually increased in time, and reached to 82.1% on 1994. Another remarkable change was found in the proportion of patients treated by surgery, especially vascular surgery : The proportion of patients treated by penile prosthesis implantation on 1985 and vein ligation on 1986 was 64.0% and 14.3%, respectively ; whereas, it was decreased to 1.8 % and 0% on 1994, respectively. In conclusion, we could find remarkable change of trend in the primary treatment modality for erectile dysfunction from invasive and costly surgical treatment to less invasive and cheap vasoactive pharmacotherapy. Nowadays, intracavernous self-injection of vasoactive agents plays a primary role in the treatment of impotence. Penile prosthesis implantation remains as the last treatment modality for erectile dysfunction. However, vascular surgery is rarely being performed nowadays because of its poor long-term outcome.
Drug Therapy ; Erectile Dysfunction* ; Humans ; Ligation ; Male ; Penile Implantation ; Veins