We evaluate the effects of a calcium antagonist(nifedipine) and a xanthine oxidase inhibitor (allopurinol), drugs having a protective effect against shock wave induced renal dysfunction, on acute changes of renal function after piezoelectric ESWL. A total of 40 patients with renal stones undergoing piezoelectric ESWL with LT02 lithotriptor was randomly assigned to 4 groups. Group 1 received no medication and the others received nifedipine(group 2), allopurinol(group 3), and nifedipine plus allopurinol(group 4), respectively. NAG, LDH, 7-GTP, D2M, and microalbumin were measured in the 24-hour urine before and after ESWL. Baseline levels of these parameters were not statistically different between the control group and the others. After ESWL, NAG and microalbumin were significantly increased in group l(p<0.01). In groups 2 and 4, all of the parameters after ESWL were not significantly different from the Values before ESWL. Although the level of NAG after ESWL was significantly higher(p<0.01) than that of the pre-ESWL in group 3, the change of NAG was milder in group 3 comparing to group 1. The range of increase of NAG in groups 2 and 4 were significantly low(<0.01) compared to group 1, and the range of increase of microalbumin in groups 2, 3, 4 were significantly low compared to group l(group 2, 4; p<0.01, group 3; p<0.05). Our results indicate that nifedipine and/or allopurinol can prevent or decrease acute changes of renal function after ESWL using LT02 piezoelectric lithotriptor and especially nifedipine seems to be more efficient than allopurinol.
Allopurinol* ; Calcium ; Humans ; Lithotripsy* ; Nifedipine* ; Shock* ; Urinary Calculi ; Xanthine Oxidase

We evaluate the effects of a calcium antagonist(nifedipine) and a xanthine oxidase inhibitor (allopurinol), drugs having a protective effect against shock wave induced renal dysfunction, on acute changes of renal function after piezoelectric ESWL. A total of 40 patients with renal stones undergoing piezoelectric ESWL with LT02 lithotriptor was randomly assigned to 4 groups. Group 1 received no medication and the others received nifedipine(group 2), allopurinol(group 3), and nifedipine plus allopurinol(group 4), respectively. NAG, LDH, 7-GTP, D2M, and microalbumin were measured in the 24-hour urine before and after ESWL. Baseline levels of these parameters were not statistically different between the control group and the others. After ESWL, NAG and microalbumin were significantly increased in group l(p<0.01). In groups 2 and 4, all of the parameters after ESWL were not significantly different from the Values before ESWL. Although the level of NAG after ESWL was significantly higher(p<0.01) than that of the pre-ESWL in group 3, the change of NAG was milder in group 3 comparing to group 1. The range of increase of NAG in groups 2 and 4 were significantly low(<0.01) compared to group 1, and the range of increase of microalbumin in groups 2, 3, 4 were significantly low compared to group l(group 2, 4; p<0.01, group 3; p<0.05). Our results indicate that nifedipine and/or allopurinol can prevent or decrease acute changes of renal function after ESWL using LT02 piezoelectric lithotriptor and especially nifedipine seems to be more efficient than allopurinol.
Allopurinol* ; Calcium ; Humans ; Lithotripsy* ; Nifedipine* ; Shock* ; Urinary Calculi ; Xanthine Oxidase

We report a rare case of primary glomerular disease with both features of IgA nephropathy and membranous glomerulonephritis in a 27 year-old woman with nephrotic syndrome. Histologically, glomeruli showed slight mesangial expansion, proliferation of mesangial cells, and short subepithelial spikes on capillary wall. Direct immunofluorescence demonstrated granular IgG and C3 deposits along the capillary walls, and IgA with C3 deposits in mesangium. Granular subepithelial and rnesangial deposits were observed by electron microscopy. The patient showed complete remission after 6 months therapy with steroid and ACE inhibitor.
Adult ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerulonephritis, IGA* ; Glomerulonephritis, Membranous* ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Mesangial Cells ; Microscopy, Electron ; Nephrotic Syndrome

No abstract available.
Bone Plates* ; Tibia*

No abstract available.
Knee*

No abstract available.

No abstract available.
Femur* ; Tibia*

Cerebral embolic infarction is the most common neurologic complication of cardiac myxoma (CM). Development of cerebral aneurysms in CM is very rare. We present a 64-year-old woman with acute cerebral infarction and multiple cerebral aneurysms complicated by CM. The aneurysms were multiple, fusiform-shaped, and located in distal branch of major cerebral arteries. The serum interleukin (IL)-6 was highly elevated, which was normalized after surgical resection of CM. There was no regression of aneurysms on follow-up neuroimaging. Multiple cerebral aneurysms in CM are rare condition. Highly elevated serum IL-6 may be associated with increased risk of cerebral aneurysmal formation.
Aneurysm ; Cerebral Arteries ; Cerebral Infarction ; Female ; Follow-Up Studies ; Humans ; Infarction ; Interleukin-6 ; Interleukins ; Intracranial Aneurysm ; Middle Aged ; Myxoma ; Neuroimaging

PURPOSE: We evaluated the preoperative clinical factors that affect the surgical outcome of posterior urethral anastomosis (PUA) with a gracilis muscle flap (GMF) to determine which factors predict benefit from the use of the GMF. MATERIALS AND METHODS: This was a retrospective analysis of 49 patients who underwent a delayed PUA with a GMF. A successful clinical outcome was defined as achieving a peak urinary flow rate greater than 15 mL/s at 3 and 12 months postoperatively without evidence of stricture recurrence on a retrograde urethrogram or cystourethroscopy at 3 months postoperatively. Multiple clinical factors were evaluated by use of univariate and multivariate analyses. RESULTS: The outcome of 21 of 49 patients (42.9%) was deemed successful. The mean age of the 49 patients was 37.2+/-13.5 years and the mean follow-up duration was 43.4+/-28.0 months. The length of the urethral defect was significantly shorter in patients with a successful outcome than in patients with an unsuccessful outcome (p=0.010). The outcome differed significantly depending on whether the patients had a previously successful urethroplasty (p=0.036) or whether they had suffered a pelvic bone injury (p=0.012). Multivariate logistic regression analyses revealed that a previous urethroplasty was the only preoperative clinical factor that significantly affected the surgical outcome in PUA with a GMF (odds ratio, 0.218; 95% confidence interval, 0.050 to 0.947; p=0.042). CONCLUSIONS: A history of previous urethroplasty is a preoperative clinical factor that significantly affects the surgical outcome in PUA with a GMF; the procedure is more likely to be successful in patients who have not previously undergone urethroplasty.
Anastomosis, Surgical ; Constriction, Pathologic ; Follow-Up Studies ; Glia Maturation Factor ; Humans ; Logistic Models ; Muscles ; Pelvic Bones ; Recurrence ; Retrospective Studies ; Surgical Flaps ; Urethral Stricture

PURPOSE: The aim of this study was to evaluate the usefulness of FDG-PET/CT as follow up imaging tool in patients with endometrial cancer after therapy. Material and Methods: One hundred one patients with endometrial cancer who underwent FDG PET/CT after the treatment of this disease were included in this study population (25-79 yr old, Mean age 50.6 yr old) and all these patients also performed various laboratory and imaging studies such as serum tumor marker, CT or MRI. The lesions having increased focal FDG uptake were classified into benign, equivocal, and malignant one according to their pattern and activity. Tumor recurrence was confirmed by histopathological results and other clinical and imaging data. RESULTS: Among the 19 patients with 30 malignant or equivocal hot uptakes, 11 of 14 patients supposed to be malignant finding in PET/CT were proved to be tumor recurrence, while one of 5 patients with equivocal lesions were recurred malignancy. Two false negative cases were turned out to be peritoneal carcinomatosis. Estimated sensitivity, specificity and accuracy of PET/CT for diagnosis of recurrence in endometrial carcinoma after treatment were 86 %, 92 % and 91%, respectively. Positive and negative predictive values in the same issue were 63% and 98%, respectively. CONCLUSION: FDG-PET/CT is useful for regular work up of endometrial carcinoma after the treatment because of its high negative predictive value as well as high sensitivity and specificity.
Carcinoma ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Recurrence ; Sensitivity and Specificity