No abstract available.
Esophagus* ; Leiomyoma*

Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

INTRODUCTION: Premature ejaculation is the most prevalent form of male sexual dysfunction, but its cause has not been well established. Recently some studies indicated that penile sensitivity is decreased in men with premature ejaculation. MATERIALS AND METHODS: To clarify the association between penile sensitivity and premature ejaculation, we evaluated penile sensitivity in 18 patients with premature ejaculation without erectile dysfunction and neurologic deficit, and 15 normal potent male volunteers by SMV-5 digital vibrometer (Teknologue, Tokyo, Japan), which has higher precision and reproducibility than analogue type biothesiometers. Vibration thresholds were recorded at the glans penis, penile shaft, and frenulum of the penis in flaccid and erectile state induced by PGE1 10 ug. We also recorded those at ulnar process and medial maleolus of the tibia. RESULTS: There was no difference in vibration threshold at the ulnar process and the medial maleolus of the tibia between the two groups (p>0.05). And we found no difference in penile sensitivity at the glans penis, penile shaft, frenulum of the penis between the two groups, in both erectile and flaccid states (p>0.05). Penile sensitivity was decreased in erectile state compared to flaccid state, but it is not statistically significant (p>0.05). CONCLUSION: Based on our results, penile hypersensitivity measured by SMV-5 vibrometer does not appear to be a major factor contributing to premature ejaculation. And further study aimed at other somatic or cognitive factors awaits implementation.
Alprostadil ; Erectile Dysfunction ; Humans ; Hypersensitivity ; Male ; Neurologic Manifestations ; Penis ; Premature Ejaculation* ; Tibia ; Vibration ; Volunteers

A study was done to evaluate the diagnostic value of ultrasonography on acute scrotum patients. During the last three years, 25 patients were managed at Cheju Medical Center, eight of them were testicular torsion patients including one cryptorchid testicular torsion. one torsion of appendix testis, 11 acute epididymitis and 5 testicular rupture due to blunt scrotal trauma. Ultrasonography revealed enlarged testis and epididymis in all of the 8 testicular torsion patients and 7 of them showed inhomogeneously decreased echogenecity of the testis and epididymis. All acute epididymitis patients showed enlargement of the epididymis, and inhomogeneously decreased echogenecity was found in 8 of them. But testicular echogenecity was normal in all of the acute epididymitis patients and enlargement of the testis was found in two. All of the 5 testicular rupture patients showed irregular hypoechoic portions in the testicle and distorted testicular morphology, and linear fracture lines of the testis were found in two. We could suggest that scrotal ultrasonography is useful for the early differential diagnosis of the acute scrotum, especially when scrotal radioisotope scan is not available.
Appendix ; Diagnosis, Differential ; Epididymis ; Epididymitis ; Humans ; Jeju-do ; Male ; Rupture ; Scrotum* ; Spermatic Cord Torsion ; Testis ; Ultrasonography*

A study was done to evaluate the diagnostic value of ultrasonography on acute scrotum patients. During the last three years, 25 patients were managed at Cheju Medical Center, eight of them were testicular torsion patients including one cryptorchid testicular torsion. one torsion of appendix testis, 11 acute epididymitis and 5 testicular rupture due to blunt scrotal trauma. Ultrasonography revealed enlarged testis and epididymis in all of the 8 testicular torsion patients and 7 of them showed inhomogeneously decreased echogenecity of the testis and epididymis. All acute epididymitis patients showed enlargement of the epididymis, and inhomogeneously decreased echogenecity was found in 8 of them. But testicular echogenecity was normal in all of the acute epididymitis patients and enlargement of the testis was found in two. All of the 5 testicular rupture patients showed irregular hypoechoic portions in the testicle and distorted testicular morphology, and linear fracture lines of the testis were found in two. We could suggest that scrotal ultrasonography is useful for the early differential diagnosis of the acute scrotum, especially when scrotal radioisotope scan is not available.
Appendix ; Diagnosis, Differential ; Epididymis ; Epididymitis ; Humans ; Jeju-do ; Male ; Rupture ; Scrotum* ; Spermatic Cord Torsion ; Testis ; Ultrasonography*

No abstract available.
Cardiopulmonary Bypass* ; Emergencies* ; Heart* ; Hemorrhage* ; Thoracic Surgery*

No abstract available.
Hypothermia* ; Vena Cava, Inferior*

No abstract available.
Biopsy* ; Child* ; Humans

PURPOSE: The factors for predicting persistent urge symptom and urge incontinence following a tension-free vaginal tape (TVT) procedure were investigated in patients with mixed urinary incontinence. MATERIALS AND METHODS: Two hundred and seventy-four women, with a mean age of 55 years, ranging from 28 to 80, with female urinary incontinence (stress urinary incontinence; 201, mixed urinary incontinence; 73) were the subjects of this study. After a TVT procedure, the patients were followed up at 1, 6 and 12 months and every 1 year thereafter. Cure of incontinence after the procedure was defined as the absence of a subjective complaint of leakage and the absence of objective leakage on stress testing, with all other cases considered as failures. RESULTS: There was no significant difference in the cure rates for stress urinary incontinence in patients with stress and mixed urinary incontinence. However, of 73 patients with mixed urinary incontinence, 20 (27.4%) ans 12 (16.4%) had persistent urgency and continued urge incontinence, respectively. In a multivariate analysis, a low maximal urethral closure pressure (MUCP) was found to be associated with an increased likelihood of persistent urgency (odds ratio, 0.94; 95% confidence interval, 0.38-0.99; p=0.029) and the persistent urge incontinence (odds ratio, 0.94; 95% confidence interval, 0.88-0.99; p=0.030) after a TVT procedure in patients with mixed urinary incontinence. CONCLUSIONS: Our findings suggest that a low MUCP may be associated with the persistent urgency and urge incontinence after a TVT procedure in patients with mixed urinary incontinence.
Exercise Test ; Female ; Humans ; Multivariate Analysis ; Suburethral Slings* ; Surgical Mesh ; Urinary Incontinence* ; Urinary Incontinence, Urge*

PURPOSE: To report the outcome of laparoscopic pyelo- and ureterolithotomies with the aid of flexible nephroscopy. MATERIALS AND METHODS: A retrospective analysis was performed in 71 patients with complex renal stones or large and impacted proximal ureteral stones. Patients underwent laparoscopic pyelo- or ureterolithotomies with or without the removal of small residual stones by use of flexible nephroscopy between July 2005 and July 2010. Operative success was defined as no residual stones in the intravenous pyelogram at 12 weeks postoperatively. Perioperative results and surgical outcomes were analyzed. RESULTS: The patients' mean age was 54.7+/-13.7 years, and 53 males (74.6%) and 18 females (25.4%) were included. The mean maximal stone size was 19.4+/-9.4 mm. A total of 47 cases were complex renal stones and 24 cases were impacted ureteral stones. Mean operative time was 139.0+/-63.7 minutes. Stones were completely removed in 61 cases (85.9%), and no further ancillary treatment was needed for clinically insignificant residual fragments in 7 cases (9.9%). For complex renal stones, the complete stone-free rate and clinically significant stone-free rate were 80.9% and 93.6%, respectively. Multivariate analysis showed that the use of flexible nephroscopy for complex renal stones can reduce the risk of residual stones. A major complication occurred in one case, in which open conversion was performed. CONCLUSIONS: Laparoscopic stone surgery is a safe and minimally invasive procedure with a high success rate, especially with the aid of flexible nephroscopy, and is not associated with procedure-specific complications.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney Calculi/pathology/radiography/*surgery ; Laparoscopy/methods ; Male ; Middle Aged ; Nephrostomy, Percutaneous/*methods ; Retrospective Studies ; Treatment Outcome ; Ureteral Calculi/pathology/radiography/*surgery ; Young Adult