No abstract available.
Calcium* ; Diet* ; Hypercalciuria* ; Osteocalcin*

PURPOSE: Sexual differences in the incidence and crystalline composition of urinary stones in humans are well-known, but it is unclear why men have a higher incidence of calcium oxalate stones than women. We investigated the effects of male sex hormones on stone formation using an ethylene glycol (EG) - induced urolithiasis model in rats. MATERIALS AND METHODS: Adult male Sprague-Dawley rats were divided into 4 groups, each containing 10 rats. One group of rats was left untreated and served as control. The other 3 groups were fed a 1% ethylene glycol (EG) lithogenic diet for 4 weeks. Among these, one group was non-castrated, one group was castrated and one group was non-castrated and given finasteride orally. Serum testosterone, creatinine, electrolytes, 24-hour urine levels of oxalate and citrate, and creatinine clearance were measured. The crystal deposits were examined by light and polarizing microscopes. RESULTS: Testosterone promoted calcium oxalate stone formation in EG - treated rats. Finasteride administration significantly decreased urinary oxalate excretion and calcium oxalate deposition, compared with controls. Urinary citrate was significantly decreased in EG-treated rats, but was not influenced by castration or administration of finasteride. There were no significant differences in serum concentrations of creatinine, sodium, or potassium among the control and experimental groups. CONCLUSIONS: Our data suggest that testosterone promotes calcium oxalate stone formation, and that dihydrotestosterone may be partially responsible for the exaggerated hyperoxaluria in EG-treated rats. Additionally, male sex hormones have a lesser influence on urinary citrate than oxalate.
Adult ; Animals ; Calcium Oxalate* ; Calcium* ; Castration ; Citric Acid ; Creatinine ; Crystallins ; Diet ; Dihydrotestosterone ; Electrolytes ; Ethylene Glycol ; Female ; Finasteride ; Gonadal Steroid Hormones* ; Humans ; Hyperoxaluria ; Incidence ; Male* ; Nephrolithiasis* ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Sodium ; Testosterone ; Urinary Calculi ; Urolithiasis

Cutaneous larva migrans(CLM) is a ubiquitous self-limiting skin eruption which has intensely pruritic, serpiginous, raised, sharply demarcated, red lesions. It is most frequently caused by larvae of dog and cat hookworms. We report two typical cases of cutaneous larva migrans that appeared as pruritic exanthems in two people after they had travelled in Southeast Asia. It is suggested one should consider cutaneous larva migrans in the differential diagnoses of erythematous pruritic lesions.
Ancylostomatoidea ; Animals ; Asia, Southeastern ; Cats ; Diagnosis, Differential ; Dogs ; Exanthema ; Larva ; Larva Migrans* ; Skin

The experience of a replacement surgery of ankylosed elbow joint by the Shiers chrome-cobalt hinge prosthesis is introduced with a brief review of literatures.
Arthroplasty ; Elbow Joint ; Elbow ; Prostheses and Implants

The pelvis is a ring structure with strong ligamentous support. This support includes the symphysis pubis, the anterior and posterior sacroiliac ligaments, and the strong sacrospinous and sacrotuberous ligaments. Since the pelvis is a ring, disruption of any protion of the ring is always associated with disruption in another portion of the ring. Massive pelvic disruption is an important and often life threathening injury. It is usually due to a motor vehicle accident, a fall from a height, industrial injury, and so on. The authors reviewed 28 cases of unstable pelvic fracture treated at the orthopaedic department of Catholic Medical Center during the period from January 1975 to December 1980, and the injury was classified according to the Pennal and Tiles method, and analyzed the clinical data as to the cause of mechanical violence, type of fracture and treatment, post-traumatic pelvic instabilities, and the results. The persistant post-traumatic pelvic instability was assessed by physical examination, and Chamberlain and Trostlers stress Roentgen view of the pelvis. The clinical results obtained were as follows: 1. The incidence of the unstable pelvic fracture was 17.7% (28) of all pelvic fractures (158). The incidence of injury in male was approximately 5 times more frequent than female, and most of the patients were in the 3rd to 5th decade of their life. The causes of injury were road accident (54%), coal mine accident and fall from a height in orders. 2. The four-rami fracture with posterior disruption due to the lateral compression injury was the most common type of unstable pelvic fractures. 3. In conservatively treated patients, the pelvic instability persisted in 37.5% (6 in 16 cases) of the cases and all of them necessitated the joint stabilizing operation. Twelve cases were treated operatively. Among them, performed operations include wiring of symphysis pubis in 2 and sacroiliac joint fusion in 4 within 4 weeks after injury. But for the other 6 cases in which pelvic instability persisted in spite of the sufficient conservative treatment, sacroiliac joint fusion or sacroiliac joint fusion together with a symphyseal plate fixation were done. 4. Satisfactory results was obtained in 62.51% (10 in 16 cases) of nonoperated cases, and 91.7% (11 in 12 cases) of operated group. Authors consider that the most important step in the management of traumatic pelvic instability are; firstly the early recognition of the correlation of the fracture-fragments; the fracture mechanism, and the possible presence or the post-traumatic pelvic instability, and secondly finalizing the therapeutic plan. Early surgical stabilization of the duration of the treatment and the residual disability.
Clinical Study ; Coal ; Female ; Humans ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Motor Vehicles ; Pelvis ; Physical Examination ; Pubic Bone ; Sacroiliac Joint ; Violence

BACKGROUND: Vitiligo is an acquired disorder with destruction of melanocytes and is clinically characterized by depigmented patches of skin. The pathogenesis of vitiligo is still unclear, but melanocyte self destruction, neurohumoral factors, autoimmunity and inherent cellular defects have all been proposed as possible etiological factors. OBJECTIVE: The purpose of this study was to find out the differences in expression of HLA antigens among subtypes of vitiligo according to classification, onset and family history and then to disclose the pathogenesis of vitiligo in view of genetic and autoimmunological aspects. METHODS: We investigated HLA-A, B, C, DR in subgroups of 87 vitiligo patients according to type, onset, and family history. Results : 1. There were no HLA antigens with significantly increased frequency in vitiligo patients compared to the control group. 2. There was a significant increase in frequency of HLA-DRl2 in patients of non-segmental vitiligo with a family history ; an increase in frequency of HLA Cw2 in patients without a family history ; and a significant increase in frequency of HLA-DRl2 in all patients of non-segmental vitiligo compared to the control group.(p(c)<0.05). 3. The frequency of HLA-B63 was significantly increased in all patients of segmental vitiligo compared to the control group(p(c)<0.05), but there were no HLA antigens with significantly increased frequency in patients of subgroups of segmental vitiligo divided by the presence or absence of a family history of vitiligo. 4. The frequency of HLA-B54 was significantly increased in all vitiligo patients with a family history(p(c)0.05) but there were no HLA antigens with significantly increased frequency in all vitiligo patients without a family history. 5. There were no HLA antigens with significantly increased frequency in vitiligo patients subgrouped by age of onset (less or over 16 years) of disease. Conclusion : From the above results, we can assume that non-segmental vitiligo may have autoimmune mechanisms in the pathogenesis, as there was a significant increase in HLA-DRl2 in patients with non-segmental vitiligo.
Age of Onset ; Autoimmunity ; Classification ; HLA Antigens* ; HLA-A Antigens ; Humans ; Melanocytes ; Skin ; Vitiligo*

Paraffin-embedded surgical specimens from 27 human astrocytic tumors(7 astrocytomas, 10 anaplastic astrocytomas and 10 glioblastomas) were analyzed immunohistochemically for the presence of p53 protein and proliferation markers of proliferating cell nuclear antigen(PCNA), Ki-67 and agyrophilic nucleolar organizer regions (AgNORs). Approximately 33% of total cases were p53-protein positive. The p53-protein positive nuclei were revealed in 5 cases(50%) of glioblastomas, 4 cases(40%) of anaplastic astocytomas. None of the astrocytomas including 2 pilocytic tumors was p53-protein positive. There were no differences between histological types and p53-protein expression(p=0.0593), however, the more malignant histological features appear to be reflected by a greater incidence of p53 accumulation. In comparative evaluation of p53-protein expression and proliferation indices of PCNA, Ki-67 and AgNORs statistical analysis revealed significant correlation between p53 protein expression and Ki-67 labeling indices only(p=0.0177). p53-protein positive astrocytic tumors showed higher Ki-67 labeling index(10.8+/-6.9%) compared to p53-protein negative tumors(5.3+/-4.3%). In conclusion the malignant histological feature of astrocytic tumors may be associated with p53-protein expression, and among proliferation indices Ki-67 labeling index is correlated with p53-protein expression.
Astrocytoma ; Glioblastoma ; Humans ; Incidence ; Nucleolus Organizer Region ; Proliferating Cell Nuclear Antigen

PURPOSE: Extracorporeal shock wave lithotripsy(SWL) is considered to be a safe and efficient treatment for urinary stones, but controversies still remain for the treatment of stones in caliceal diverticula, because the anatomical factor of the stone formation persists, even when the stone itself has been resolved. For this reason, we reviewed 37 patients with calyceal diverticular stone to determine whether they could be treated successfully by SWL as the initial treatment. MATERIALS AND METHODS: A total of 37 patients with caliceal diverticular calculi underwent SWL with EDAP-LT01, LT02 and LT02-Plus between February 1990 and June 1998. Among the 37 patients, 26 were asymptomatic and 11 were symptomatic. RESULTS: The location of the diverticulum was right upper calyx in 12 kidneys, right middle calyx in 5, right lower calyx in 7, left upper calyx in 7, left middle calyx in 4 and left lower calyx in 2. The average stone size was 1.1cm, with a range of 0.2 to 2.5cm. A stone-free state was initially achieved in 17(45.9%) patients for 1 to 26 months (mean 5.1 months). The average number of treatments was 3.5. Additionally, a success rate of 68.8% can be achieved in the patients with radiographical patency of diverticular neck. Extended follow-up in 17 patients for 8 to 100 months (mean 47.1 months) after SWL revealed recurrent stones in only 1(5.9%). Of the 11 patients with flank pain or urinary tract infection before SWL, 8(72.7%) were relieved or markedly improved in 1 to 2 months(mean 1.3 months) after average session of 2.1. Side effects of SWL developed in 10(27%); Colic in 8(21.6%), mild fever in 1(2.7%), and severe gross hematuria in 1(2.7%). CONCLUSIONS: We confirmed that SWL is a safe and effective method and should be considered an acceptable form of primary management for patients with calyceal diverticular stone.
Calculi ; Colic ; Diverticulum ; Fever ; Flank Pain ; Follow-Up Studies ; Hematuria ; Humans ; Kidney ; Lithotripsy* ; Neck ; Shock* ; Urinary Calculi ; Urinary Tract Infections

BACKGROUND: With the recent development in arterial reconstructive procedure such as percutaneous transluminal coronary angioplasty or atherectomy, the incidence of vascular complications involving femoral artery is increasing due to greater use of larger percutaneous instruments(including arterial sheath) and periprocedural anticoagulant therapy. Femoral pseudoaneurysm requires rapid diagnosis and management to prevent limb ischemia, worsening of the arterial injury or repair of the arterial defect. Recently, accurate diagnosis of these injuries can be made nonivasively with duplex sonography and Doppler color flow imaging, and nonsurgical treatment may be possible by using external compression guided by ultrasound even in patients requiring prolonged anticoagulant therapy. METHOD: Three patients, one undergoing coronary angiography and two undergoing percutaneous transluminal coronary angioplasty, developed expansile groin masses at the vascular access sites diagnosed as femoral artery pseudoaneurysm s by Doppler ultrasound. All patients were hypertensives, taking aspirin and two patients who underwent PTCA received intravenous heparin after procedure. After diagnosis of femoral pseudoaneurysm, all patients underwent mechanical(C-clamp) external compression guided by ultrasound for 3 hours. RESULT: Follow up color flow scans were obtained after 24 hours and in one patients, blood flow in the tract was eliminated but persistent blood flow was observed in two patients who underwent PTCA. Before closure of pseudoaneurysm, one patient needed another 6 hours of ultrasound guided compression and the other needed more 12 hours. All patients were discharged without complication or recurrence of pseudoaneurysm. CONCLUSION: These cases suggest that nonsurgical closure of femoral pseudoaneurysms is feasible even in patients requiring prolonged antiplatelet and anticoagulant therapy.
Aneurysm, False* ; Angioplasty, Balloon, Coronary ; Aspirin ; Atherectomy ; Cardiac Catheterization* ; Cardiac Catheters* ; Coronary Angiography ; Diagnosis ; Extremities ; Femoral Artery ; Follow-Up Studies ; Groin ; Heparin ; Humans ; Incidence ; Ischemia ; Recurrence ; Ultrasonography

PURPOSE: The aim of this study was to determine whether patients with recurrent stone formations have significant metabolic risk factors compared to patients with first-time stone formations. MATERIALS AND METHODS: 456 patients who participated in the stone metabolic study at Chung-Ang University Hospital between January 1, 2001 and June 30, 2002 were selected as subjects. 347 patients (211 males, 136 females) with first-time stone formations and 109 patients (77 males, 32 females) with recurrent stone formations were selected. The blood test and 24-hour urine test were categorized and grouped according to: 1) gender; 2) age brackets of 40 and under, 40-49, and 60 and over; 3) and gender-based age bracket distribution. RESULTS: Hypocitraturia was the most common metabolic abnormality in both males and females and in all age groups. Hypocitraturia, in particular, was shown to have more significant associations (p<0.05) in female patients in their 40s and 50s with recurrent stone formations (75%) compared to female patients of the same age range with first-time stone formations (38.6%). In addition, a small urine volume was found to have similar significant associations with these subject groups (p<0.05) with respect to patients with first-time stone formations and recurrent stone formations. Female Patients (especially those in their 40s and 50s) with recurrent stone formations (242.1+/-158.5) were found to have a higher probability (p<0.05) of hypocitraturia than patients with first-time stone formation (419.9+/-242.3). CONCLUSIONS: In women with recurrent stone formation, hypocitraturia and low urine volume are the risk factors that differentiate them from patients with first-time stone formation. The correction of hypocitraturia & low urine volume may significantly reduce the patients' chances for recurrent stone formation.
Female ; Hematologic Tests ; Humans ; Male ; Recurrence ; Risk Factors* ; Urolithiasis