Pyuria, pain and hematuria are the predominant symptoms in urologic diseases. Among them hematuria is the most important complaint referable to the urinary tract in both children and adults Accordingly, hematuria should never be ignored, and no matter how trivial the bleeding a complete urologic investigation into itscause is mandatory. A statistical survey was made on hematuria of the in-patientsin the Department of Urology at ST. Mary's Hospital, during the two years from August 1966 to July 1968 and the following results were obtained. 1. During that period. out of 437 cases who were hospitalized, 246 cases(179 males and 67 females) had hematuria, giving a rate of 5t percent (gross: 24 percent, micro-hematuria: 30 percent) 2. More than 70 percent of all the cases of hematuria processed were found to be calculus, tumor and tuberculosis of the genitourinary tract. 3. Most frequent incidences of hematuria 'were shown to be trauma in children, while calculus, tuberculosis and tumor in young and middle aged group, and tumor in old aged group as well. 4. Among 141 cases of micro-hematuria, grade I showed 78 cases(55 percent) 5. The location of bleeding in 1O5 cases of gross hematuria was in the kidney by 40 percent, bladder, ureter and urethra in that order of frequency.
Adult ; Calculi ; Child ; Hematuria* ; Hemorrhage ; Humans ; Incidence ; Kidney ; Male ; Middle Aged ; Pyuria ; Tuberculosis ; Ureter ; Urethra ; Urinary Bladder ; Urinary Tract ; Urolithiasis ; Urologic Diseases* ; Urology

Intrauterine fetal fracture is rare and hardly ever is a diagnosis made before the baby is born. A 32-years-old, woman at 37(+6) weeks gestation was admitted in labor. The patient had no history of abdominal trauma and disease. The length of fetal femur was shorter than average in antenatal care. Fetus was delivered by Cesarean delivery. He was diagnosed intrauterine femur fracture by radiologic evaluation. We therefore are reporting the prenatal diagnosis of an intrauterine fetal fracture of the femur in this case.
Diagnosis ; Female ; Femur* ; Fetus ; Humans ; Pregnancy ; Prenatal Diagnosis*

PURPOSE: The positive rates of allergy skin test of pollens are relatively higher in children in Suwon compared to other areas in Korea. To evaluate the significance of tree pollen as a causative allergen, we undertook this study. METHODS: In 252 children with asthma, scratch tests were done with 72 extracts, including 9 tree pollen. Antigen specific serum IgE antibodies were measured by radioimmunoassay. In 2 children, birch-bronchial challenges were performed. RESULTS: By allergic skin tests, 231 of 252 children showed positive skin reactions to more than 1 antigen, and 102 (44.2%) showed positive reactions to tree pollen extracts. Twenty-five (24.5%) were house dust mites non-sensitive, tree pollen sensitive children. The skin test positivity to individual antigens are as follows : D. pteronyssinus (72.7%), D. farinae (68.4%), hazel (53%), willow (53%), birch (19.9%), oak (19.5%), beech (17.3%), alder (10.4%), ash (8.7%) and elm (7.4%). The degree of skin reaction to tree pollen was relatively weaker than those of house dust mites. The positive concordance rates between skin tests and specific IgE reactions to D. pteronyssinus, D. farinae and tree pollens were 94.4%, 77.3% and 64.1%, respectively. Seven out of 25 mite non-sensitive children had seasonal pollinosis and 2 children experienced early asthmatic responses due to birch-bronchial challenge tests. CONCLUSION: Up to 44.2% of children with respiratory allergy showed positive reactions to tree pollen extracts and 24.5% of them were house dust mites non-sensitive cases. Therefore, tree pollen should be investigated as a causative allergen, regardless of a patient's age.
Alnus ; Antibodies ; Asthma ; Betula ; Child* ; Fagus ; Gyeonggi-do ; Humans ; Hypersensitivity ; Immunoglobulin E ; Korea ; Mites ; Pollen* ; Pyroglyphidae ; Radioimmunoassay ; Rhinitis ; Rhinitis, Allergic, Seasonal* ; Salix ; Seasons ; Skin ; Skin Tests

OBJECTIVE: To evaluate the clinicopathological characteristics and DNA flow cytometry in uterine sarcoma. METHODS: A retrospective review of twenty six patients diagnosed and treated for a uterine sarcoma in Korea university hospital from 1990 to 2000 has been performed. DNA flow cytometry was performed in eighteen patients on paraffin-embedded archival tissue from uterine sarcoma. RESULTS: Of the twenty six patients 10 cases (38.4%) were leiomyosarcoma, 7 cases (26.9%) were endometrial stromal sarcoma and 9 cases (34.6%) were malignant mixed mullerian tumor. Median survival time was 36.0 months, and 3-year survival rate were 30.8%, 55.5%, and 16.6%, respectively. Main symptoms were vaginal bleeding and abdominal distension. Using the FIGO surgical staging criteria, we found the following distribution; 7 cases (26.9%) stage I, 4 cases (15.3%) stage II, 9 cases (34.6%) stage III and 6 cases (23%) stage IV. Mean survival time were 74.7, 28.5, 27.9, and 16.6 month, respectively. Stage I and II patients had superior survival rate than Stage III and IV (p=0.0008). Fifty percent of tumors were aneuploid and in aneuploid tumors S-phase fraction rate was increased significantly (P=0.023). Patients with mitotic rate under 10 in 10 HPF had superior survival rate compaired with over 10 in 10 HPF (p=0.024). CONCLUSION: Stage and mitotic rate were suggested as most important prognostic factor in uterine sarcoma.
Aneuploidy ; DNA* ; Flow Cytometry* ; Humans ; Korea ; Leiomyosarcoma ; Retrospective Studies ; Sarcoma* ; Sarcoma, Endometrial Stromal ; Survival Rate ; Uterine Hemorrhage

A 29-year-old man was admitted to hospital with fever, myalgia, and sore throat. Initial laboratory findings were compatible with acute hepatitis; he was positive for the serologic marker for acute hepatitis A. On the 3rd day of admission, in spite of normalization of body temperature and a reduction in serum liver enzyme levels, serum levels of creatinine phosphokinase had increased up to 16,949 U/L. The patient recovered with supportive therapy and was discharged on the 12th day. We report a case of acute hepatitis A complicated by rhabdomyolysis during hospitalization.
Acute Disease ; Adult ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Creatine Kinase/blood ; Hepatitis A/complications/*diagnosis ; Hospitalization ; Humans ; Male ; Rhabdomyolysis/*diagnosis/etiology

OBJECTIVE: To assess the effect of dominant and non-dominant vision in controlling posture in quiet stance. METHOD: Twenty-five healthy elderly subjects aged over 60 years old and twenty-five young subjects aged under 30 years old were assessed by computerized dynamic posturography. Postural stability was measured in two conditions; dominant eye open and non-dominant eye open. We used the sensory organization test (SOT) for evaluating sensory impairment. A SOT assessed the subject's ability to use and integrate somatosensory input, vision, and vestibular cues effectively to maintain balance. The SOT was conducted 3 times, and the average value of the 3 trials was used for data analysis. Equilibrium scores reflected the subject's anteroposterior sway. The highest possible score was 100, which indicated that the subject did not sway at all, and a score of 0 indicated a fall from the footplate. Determination of ocular dominance was performed by a hole-in-the card test. RESULTS: For the twenty-five young subjects in this study, equilibrium score in two conditions did not differ. However, for elderly subjects over 60 years, the equilibrium score in dominant vision was higher than in nondominant vision (p<0.05). CONCLUSION: In young subjects, there were no significant differences in postural control between dominant vision and non-dominant vision. However, in elderly subjects, postural control in non-dominant vision was significantly impaired. Therefore, the evaluation of a dominant eye should be considered in rehabilitation programs for elderly people.
Aged ; Cues ; Dominance, Ocular ; Eye ; Humans ; Posture ; Statistics as Topic ; Vision, Ocular

BACKGROUND: Vitamin D has pleiotropic effects important for the proper functioning of multiple organ systems. We investigated whether serum 25-hydroxyvitamin D [25(OH)D] levels influenced hospitalization-free survival in patients with chronic kidney disease (CKD). METHODS: In this prospective study, serum levels of 25(OH)D were measured in 210 patients with CKD in the winter of 2009. Data regarding hospitalizations were collected over the subsequent 3 years. RESULTS: Vitamin D deficiency, as defined by a serum 25(OH)D level below 15 ng/mL, was observed in 76.7% of the patients. The mean 25(OH)D serum level was 13.6 ± 7.8 ng/mL in predialysis patients (n = 62) and 11.3 ± 6.7 ng/mL in dialysis patients (n = 148). During the follow-up, 107 patients (28 predialysis and 79 dialysis) were hospitalized because of infectious (33.6%) or cardiovascular diseases (23.4%). Predialysis and dialysis groups were divided into 2 subgroups based on the median 25(OH)D serum level. Kaplan-Meier analysis revealed that the risk of hospitalization was significantly lower in both predialysis and dialysis patients with above-median serum 25(OH)D levels (log-rank test; P = 0.043 and 0.002, respectively). Multivariate Cox proportional hazards models also demonstrated that the risk of hospitalization was significantly lower for patients with higher serum 25(OH)D levels in both the predialysis (hazard ratio, 0.963; 95% confidence interval, 0.93-0.99) and dialysis groups (hazard ratio, 0.955; 95% confidence interval, 0.91-0.99). CONCLUSION: A lower serum 25(OH)D level predicted poorer hospitalization-free survival in both predialysis and dialysis CKD patients.
Cardiovascular Diseases ; Dialysis* ; Follow-Up Studies ; Hospitalization ; Humans ; Kaplan-Meier Estimate ; Proportional Hazards Models ; Prospective Studies* ; Renal Insufficiency, Chronic* ; Vitamin D ; Vitamin D Deficiency

BACKGROUND: Gallstone is one of the most common cause of acute abdominal pain and is increasingly managed by laparoscopic cholecystectomy. Silent gallstones are usually managed expectantly and are considered for surgery only if the characteristic biliary pain occurs. If predictors of stone-related complications such as acute cholecystitis, pancreatitis, and cholangitis can be identified, patients at high risk can be selectively referred for treatment regardless of symptoms development, while those at lower risk may be safely observed. The purpose of this study was to find out the predictors of stone-related complication or biliary pain in patients with gallbladder stones. METHODS: We collected clinical data retrospectively on patients who were diagnosed with gallstone at Asan Medical Center. Total gallstone number was classified into 1, 2~4, over 5. Diameter of the gallstones were subdivided into 20 mm. Statistical analysis was performed using SAS program (Ver 6.11). RESULTS: 918 patients (432 men and 486 women) were included in the analysis. The mean age was 54.3 years; that of men was 55 years and women was 53.8 years. Stone-related complications developed in 201 patients of acute cholecystitis, 78 patients of acute gallstone pancreatitis and 80 patients of acute cholangitis. Biliary pain was occurred in 568 patients. 658 patients were experienced cholecystectomy (158 patients open cholecystectomy and 500 patiens LLC). 377 patients were experiened ERCP, and 289 persons of that were experienced EST. Acute gallstone pancreatitis and acute cholangitis were significantly more frequent in older age and patients experiencing biliary pain. Their gallstone size was significantly smaller and the number was significantly more numerous in the univariate analysis. But, in the multiple logistic regression analysis, only age and the smallest stone size were independent risk factors. Patients who experiencing biliary pain were older and had significantly smaller and multiple gallstones in the univariate analysis. However in the multiple logistic regression analysis only age and stone number were independent variables. Acute cholecystitis was significantly more frequent in the old age group and patients with biliary pain. CONCLUSION: In the multiple logistic regression analysis, old age and small gallstones were predictors of acute gallstone pancreatitis and acute cholangitis. Old age and multiple gallstones were associated with biliary pain. Old age and biliary pain were predictors of acute cholecystitis, but the gallstone size and number were not associated in this study. We suggest that a well-designed prospective study is necessary in the future.
Abdominal Pain ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Chungcheongnam-do ; Female ; Gallbladder ; Gallstones* ; Humans ; Logistic Models ; Male ; Pancreatitis ; Retrospective Studies ; Risk Factors

BACKGROUND: This study was performed to evaluate the effects of pre-emptive subdiaphragmatic instillation of lidocaine before pneumoperitoneum on postoperative pain following a laparoscopic cholecystectomy (LC) and also to evaluate it's effect on the changes of blood pressure during an operation. METHODS: Thirty-three relatively healthy patients for an LC were allocated into the two groups. after the induction of general anesthesia with sodium thiopental, vecuronium, nitrous oxide and enflurane (1-2 vol%), 0.2% lidocaine 200 ml was subdiaphragmatically instilled 10 min before pneumoperitoneum in the lidocaine group (n = 15), and normal saline in the control group (n = 18). The changes of the systolic and mean arterial pressure (SAP and MAP), postoperative pain score, and the number of analgesics used during the postoperative 24 h were compared between two groups. RESULTS: The pain scores at postoperative 1, 3, 6, 12, 18 and 24 h and the number of analgesics used were significantly low in the lidocaine group compared to the control group (P<0.01). The elevations of SAP and MAP during pneumoperitoneum were significantly attenuated in the lidocaine group (P<0.01). CONCLUSIONS: This data suggests that subdiaphragmatic instillation of lidocaine before pneumoperitoneum is effective in the control of postoperative pain following an LC and also effective to attenuate the elevation of blood pressure during pneumoperitoneum. However, further study is needed to evaluate the safety of these methods before recommendation of routine use.
Analgesics ; Anesthesia, General ; Arterial Pressure ; Blood Pressure* ; Cholecystectomy, Laparoscopic* ; Enflurane ; Humans ; Lidocaine* ; Nitrous Oxide ; Pain, Postoperative* ; Pneumoperitoneum* ; Sodium ; Thiopental ; Vecuronium Bromide

PURPOSE: This study aimed at evaluating the pattern of changes in estrogen receptor (ER), progesterone receptor (PR) and the HER2 expression in primary and recurrent breast cancer. METHODS: In the study, we analyzed the changes of the ER and PR and the HER2 immunohistochemical expression to identify the patterns of changes and the predictive factors for the changes in 153 patients with primary and recurrent breast cancer between 1991 and 2005. RESULTS: There was a significant decrease in the positive rate of ER (50.3% to 38.6%, p<0.001), PR (43.8% to 26.8%, p=0.0095) and the HER2 (40.3% to 36.3%, p<0.001) expression in the primary breast cancers and recurrent breast cancers. The rate of triple negativity (ER/PR/HER2: all negative) was increased from 25.8% to 43.5% (p<0.001). Among 44 (28.6%) patients with changes in ER and ER status changed from positive to negative in 31 patients (20.3%) and negative to positive in 13 patients (8.3%) (p=0.007). For 58 patients (37.9%) who showed a change of the PR, the PR status changed from positive to negative in 42 patients (27.5%) and vice versa in 16 patients (10.4%) (p=0.0006). Twenty one patients (16.9%) changed from HER2 positive to HER2 negative and vice versa in 9 patients (7.3%) (p=0.029) among the 30 patients (24.2%) with changes in the HER2 expression. A multivariate analysis indicated that hormonal therapy was a significant factor that had an influence on the ER (odds ratio, 4.4) and PR (odds ratio, 2.6) changes. There were no significant differences in the survival rates according to the changes of the ER and PR, and the HER2 expression. CONCLUSION: The more common changes from positive to negative among the ER, PR, and HER2 indicated poor tumor biology of recurrent tumor. Therefore, the assessment of the ER, PR, and HER2 statuses is important for effectively treating recurrent breast cancer and especially those who have a previous history of hormonal therapy although survival benefit was not observed in this study.
Biology ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Multivariate Analysis ; Receptors, Progesterone ; Recurrence ; Survival Rate