We report herein a case of tuberculosis cutis orificialis in a 50-year-old man. He suffered from well demarcated, 2x5cm sized, slightly tender, pus discharging, perianal ulcer with bluish edges for 3 months. The biopsy specimen from the ulcer revealed tuberculoid structure with Langhans giant cells in the deep dermis and a few acid-fast bacilli. AFB cultures from the sputum, pus, and tissue were successful. Intradermal test with PPD showed positive result. Chest roentgenographic findings disclosed advanced pulmonary tuberculosis. Almost complete healing of the perianal ulcers occurred following 2 months of therapy using antituberculosis drugs.
Biopsy ; Dermis ; Giant Cells, Langhans ; Humans ; Intradermal Tests ; Middle Aged ; Sputum ; Suppuration ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

We report herein a 53-year-old male patient with a large condyloma acuminaturn of 16 months duration on his penis. Clinically, an approximat;ely 3.5 X 2.0 Cm sized, asyrnptomatic, verrucous-surfaced, papilloma was present on his prepuce and glans. Elistological examination disclosed hyperkeratosis, marked acanthosis, papillomatosis, vacuolated upper malphigian cells, dilated capillaries, and mononuclear infiltrntes in the upper dermis. Trial of DNCB immunotherapy showed a dramatic effect on tumor regression.
Capillaries ; Dermis ; Dinitrochlorobenzene* ; Humans ; Immunotherapy ; Male ; Middle Aged ; Papilloma ; Penis

PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.
Abdomen* ; Animals ; Cryptorchidism ; Humans ; Hypertrophy ; Inguinal Canal ; Leydig Cells ; Male ; Models, Animal ; Models, Theoretical ; Parturition ; Rats* ; Rats, Sprague-Dawley ; Scrotum ; Seminiferous Tubules ; Spermatogonia ; Testis*

Nutcracker syndrome is a rare disease caused by the compression of the renal vein between the aorta and superior mesenteric artery. It is known to cause of venous hypertension, peripelvic and periureteral varicosities. Clinical manifestations include varicocele, hematuria, and flank or abdominal pain. Surgical correction is needed in nutcracker syndrome cases with severe or recurrent hematuria and abdominal or flank pain. Reanastomosis of the renal vein at 5cm below the original insertion site at the inferior vena cava is the one of the most common corrective methods and the transabdominal approach is usually employed. This disease usually appears in healthy young people and in order to decrease postoperative complications such as intestinal obstruction and bowel adhesion by avoiding unnecessary intraperitoneal manipulation, the authors used the extraperitoneal approach through a flank incision. We report because, in selected cases, we consider that this extraperitoneal approach is one of the alternative methods for the usual transperitoneal approach.
Abdominal Pain ; Aorta ; Flank Pain ; Hematuria ; Hypertension ; Intestinal Obstruction ; Mesenteric Artery, Superior ; Postoperative Complications ; Rare Diseases ; Renal Veins ; Varicocele ; Vena Cava, Inferior

Because of the frequent misdiagnosis of the carpal injury, the orthopedic surgeon must know the mechanism of injury and exact radiological interpretation. We had encountered 114 cases of carpal injury, in which carpal fracture, carpal dislocation and instability were analysed by radiological examination. The following results were obtained: 1. In 75 carpal bone fractures, the most common fracture was scaphoid fracture (64 cases), the next com- mon one was triangular fracture (4 cases). 2. Among the 64 scaphoid fractures, the waist portion was the most frequent site (45 cases) and the least was tubercle fracture (2 cases). 3. Of the carpal bone fractures, the fresh fracture was 48 cases (64%) and old one was 27 cases (36%), these showed sclerosis, cystic change, and degenerative change in radiological examination. 4. In 14 carpal dislocations, perilunar dislocation was 2.5 times move common than lunate dislocation, and the trans-scaphoid perilunar dislocation was the most common dislocation. 5. Carpal instability was 25 cases. These were dorsiflexion instability, navicular rotary subluxation, and pal- mar-flexion instability. The most common instability was dorsiflexion instability.
Carpal Bones ; Classification ; Diagnostic Errors ; Dislocations ; Incidence ; Orthopedics ; Sclerosis ; Wrist

INTRODUCTION AND OBJECTIVES: A kidney in the growing state and the possibility of spontaneous improvement are characteristics of the pediatric ureteropelvic junction obstruction (UPJO) that make the treatment of this disease difficult. We have tried to determine the histopathologic changes of the kidneys with UPJO relating to age, differential renal function and urinary tract infection (UTI). METHODS: The total number of patients was 38 (40 kidneys). The age at the operation time was under 3 months in 9 cases (9 kidneys), 3 to 12 months in 10 cases (10 kidneys), and 1 to 18 years in 20 cases (21 kidneys). Needle biopsies from 3 different sites at the lower pole of the kidney were taken. The tissue was blindly observed for the presence of irreversible change (arteriolar thickening, glomerulosclerosis, interstitial fibrosis and periglomerular fibrosis) and reversible change (inflammatory cell infiltration) by light microscopy. Each pathological finding was graded as I, II or III, and each grade was given a numerical value. Statistical analysis was done with ANOVA. RESULTS: Although the kidneys from patients under 3 months tended to show better histopathologic findings, there was no statistically significant difference in all 5 pathologic findings regardless of patient age. 5 cases (5 kidneys) with previous percutaneous nephrostomy (PCN) were not included in any group for analysis due to possible histologic changes of the renal parenchyma. Inflammatory cell infiltration, arteriolar thickening, glomerulosclerosis and periglomerular fibrosis were statistically significant in patients with previous or present UTI (14 kidneys) compared to the patients without UTI (26 kidneys). The patients with a mean differential renal function less than 30% (7 kidneys) as measured by DTPA or DMSA renal scan showed statistically significant changes in all of the 5 histopathologic findings compared to the patients with differential renal function greater than 30% (27 kidneys). 4 cases with bilateral UPJO (6 kidneys) were excluded from comparing the differential renal function. 5 kidneys with previous PCN had statistically significant degree of glomerulosclerosis compared to others. CONCLUSIONS: Although we did not determine whether pediatric UPJO affects renal growth, it is probable that statistically significant irreversible histopathologic changes do not occur according to age. Considering histopathologic findings only, differential renal function and UTI Should be key factors in deciding the management of pediatric UPJO. In addition, PCN seems to induce more severe histopathologic changes of the kidney.
Biopsy, Needle ; Fibrosis ; Humans ; Kidney* ; Microscopy ; Nephrostomy, Percutaneous ; Pentetic Acid ; Pregnenolone Carbonitrile ; Succimer ; Urinary Tract Infections

By definition, PSAD is the serum PSA concentration divided volume of the gland, as determined from transrectal ultrasonography. If prostatic volume were the sole determinant of the serum PSA concentration, there would be no correlation between PSAD and age. We examined the relationships between serum PSA concentration, rostatic volume and age. Entry included 318 men over 40 years who have no clinical evidence of prostate cancer. The mean age of this study population was 65.2(range 40-89). The mean PSA was 3.94ng/ml and the mean prostate volume 36.4cc(range 11-120). 85 men(26.7 %) had volumes >20cc and levels >4ng/ml. When all entry included, the serum PSA concentration correlates directly with age (r=0.2, p<0.01). Based on linear regression analysis, the serum PSA concentration would increase approximately 2.7% per year. The prostatic volume correlates directly with age(r=0.3, p<0.01). Based on linear regression analysis, the prostatic volume would increase approximately 2.2% per year. Correlation between the prostatic volume and PSA was also significant(r=0.1, p<0.01). Based on linear regression analysis, an increase in prostatic volume of 1mL will, on the average, produce a corresponding increase of 3.2% in PSA. There was an increasing tendency of PSAD with age but statistically insignificant. The mean PSAD was 0.11 but 47men of 59 had >0.15 in levels 4-10ng/ml. In conclusion, the application of PSAD in clinical field should be taken into consideration seriously and interpretation of PSA should be include the corresponding variables such as age and prostate volume. The PSA velocity or age specific reference range for PSA can aid in the application of PSA.
Aging* ; Humans ; Linear Models ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Reference Values ; Ultrasonography

Malignant mesenchymoma is a rare soft tissue neoplasm showing two or more separate and distinct types of malignant mesenchymal differentiation in addition to an undifferentiated sarcomatous component. Occasional cases of malignant mesenchymoma have been reported in the spermatic cord and paratesticular area. However, documented reports have been seldom found in Korea. We report a case in which there was evidence of lipo-, rhabdomyo-, osteosarcomatous differentiation in the same neoplasm with brief review of the literatures.
Korea ; Liposarcoma ; Mesenchymoma* ; Osteosarcoma ; Rhabdomyosarcoma ; Soft Tissue Neoplasms ; Spermatic Cord

PURPOSE: Patients with neurogenic bladder ultimately undergo morphometric and functional changes of their bladder and urethra. As a result, voiding symptoms such as frequency, nocturia, urgency and incontinence appear Propiverine hydrochloride(BUP-4) is a benzylic acid derivative with musculotropic antispamodic activity and moderate anticholinergic effect. We evaluated the clinical and urodynamic effects of BUP-4 for patients with neurogenic urinary frequency and incontinence MATERIALS AND METHODS: Twenty six patients with neurogenic bladder suffering from urinary frequency and incontinence(including 5 placebo) were given 20mg of BUP-4 orally a day and its clinical and urodynamic effect were evaluated. RESULTS: In the group treated with BUP-4 for four weeks, 57.9% in 19 patients with frequency, 53.3% in 15 nocturia, 50.0% in 14 weak stream, 55.6% in 9 intermittency, 50.0% in 10 dribbling, 64.3% in 14 urgency, 55.6% in 9 hesitancy, 73.7% in 19 incontinence showed improvement of their symptom. Urodynamic study performed after treatment with BUP-4 for 4 weeks or more revealed greater than 10% increase in bladder capacity compared to pretreatment study in 11 patients out of 21(52.4%) and their maximum bladder capacity increased significantly from 181.7+/-101.3 to 249.4+/- 184.7mL(p=0.012). Maximum detrusor pressure decreased from 52.5+/-35.6 to 50.9+/- 26.8cmH2O(p=0.010). Changes in compliance and volume on the first urge sense were statistically insignificant. In placebo group, no significant symptomatic and urodynamic improvement were reported. Side effects of the drug had appeared in 7 patients(33.3%) out of 21 after 4 weeks of treatment -5 cases of dry mouth and 2 cases of nausea - but they were not severe enough to stop the treatment. CONCLUSIONS: The use of BUP-4 in patients with neurogenic bladder results in improvement of symptoms and urodynamic profile(bladder capacity and maximum detrusor pressure). Thus, BUP-4 could be used as one of the first line drugs in the treatment of patients with neurogenic bladder.
Compliance ; Humans ; Mouth ; Nausea ; Nocturia ; Rivers ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urodynamics*

Neonatal diabetes mellitus (NDM) is defined as hyperglycemia that presents clinical symptoms within the first month of life and requires insulin therapy to maintain euglycemia. The diabetic condition may be transient, permanent, or transient with recurrence later in life. NDM is a rare clinical disorder. Three cases of NDM have been reported in Korea so far. We experienced two cases of NDM in twin brothers who were born with small for gestational ages. Their HLA typings were DR9 and DR14, and insulin autoantibody, islet cell antibody, GAD-reactive autoantibody, and insulin receptor antibody were not found. The genetic analysis with polymorphic DNA markers for chromosome 6 indicated paternal uniparental isodisomy.
Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Gestational Age ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Insulin ; Islets of Langerhans ; Korea ; Receptor, Insulin ; Recurrence ; Siblings* ; Twins* ; Uniparental Disomy