No abstract available.
Humans ; Quality of Life*

A 10-year-old boy presented with dribbling on urination, intermittent left flank pain and pyuria since birth. With voiding cystourelhrography this case was diagnosed as congenital anterior urethral valve which was confirmed by panendoscopic study. He was underwent electrocoagulation of the valve and left nephrectomy. And so he was discharged with good urinary stream on the 23 rd postoperative day.
Child ; Electrocoagulation ; Flank Pain ; Humans ; Male ; Nephrectomy ; Parturition ; Pyuria ; Rivers ; Urination

PURPOSE: Kawasaki disease(KD) may be linked to primary infection by certain common viruses. KD concurrent with Epstein-Barr virus(EBV) suggests the possibility of an etiologic agent related to the KD rather than to the EBV infection itself, but, the influence on coronary complication is unclear. To establish whether infection with EBV contributed to the outcome of coronary artery lesions in patients with KD is the purpose of this study. METHODS: Retrospective studies were performed on 96 cases(age 2.48+/-1.94 years) of KD evaluated with serologic studies of EBV(EBV EA IgM, EBV EA IgG, EBNA IgG) at admission. We evaluated the clinical features and coronary outcome between a control group with KD and an EBV associated group with KD. RESULTS: On serologic studies of EBV, 62 patients(64.6%) with one more than positive results were in the EBV associated group with KD, in 30 patients with recent EBV infection, and in 32 patients with previous EBV infection. There were no significant differences between the control group and the EBV associated group in age, sex, and other clinical findings. Eighten patients (18.7%) had abnormal baseline echocardiogram, 13 patients(21.0%) among them were in the EBV associated group and 5 patients(14.7%) were in the control group; there was no significant difference between the two groups. Significantly 11 of 13 patients(84.6%) with coronary lesions had positive result of EBNA IgG, suggesting previous infection. There were no significant differences in retreatment and recurrence incidence. After retreatment, in 3 of 6 cases with the EBV associated group, and in no cases with the control group, cardiac complications were observed. CONCLUSION: Previous or chronic EBV infection may influence the occurrence of coronary lesion in patients with KD, even though patients with cardiac complication improved later.
Coronary Vessels* ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Recurrence ; Retreatment ; Retrospective Studies

We have experienced an unusual case of hemorrhagic infarct in the right testis at the age of 59 years. The spermatic cord showed normal appearance and no torsion was noted. Orchiectomy was performed as frozen section revealed hemorrhagic infarction of the testis. Herein, hemorrhagic infarction of testis, a rare clinical entity, was reported with review of literatures.
Frozen Sections ; Infarction ; Orchiectomy ; Spermatic Cord ; Testis*

OBJECTIVE: To investigate the characteristics of cognitive deficits in patients with post-stroke dysphagia, and to analyze the relationships between cognitive dysfunction and severity of dysphagia in supratentorial stroke. METHODS: A total of 55 patients with first-ever supratentorial lesion stroke were enrolled retrospectively, within 3 months of onset. We rated dysphagia from 0 (normal) to 4 (severe) using the dysphagia severity scale (DSS) through clinical examinations and videofluoroscopic swallowing studies (VFSS). The subjects were classified either as non-dysphagic (scale 0) or dysphagic (scale 1 to 4). We compared general characteristics, stroke severity and the functional scores of the two groups. We then performed comprehensive cognitive function tests and investigated the differences in cognitive performance between the two groups, and analyzed the correlation between cognitive test scores, DSS, and parameters of oral and pharyngeal phase. RESULTS: Fugl-Meyer motor assessment, the Berg Balance Scale, and the Korean version of the Modified Barthel Index showed significant differences between the two groups. Cognitive test scores for the dysphagia group were significantly lower than the non-dysphagia group. Significant correlations were shown between dysphagia severity and certain cognitive subtest scores: visual span backward (p=0.039), trail making tests A (p=0.042) and B (p=0.002), and Raven progressive matrices (p=0.002). The presence of dysphagia was also significantly correlated with cognitive subtests, in particular for visual attention and executive attention (odds ratio [OR]=1.009; 95% confidence interval [CI], 1.002–1.016; p=0.017). Parameters of premature loss were also significantly correlated with the same subtests (OR=1.009; 95% CI, 1.002–1.016; p=0.017). CONCLUSION: Our results suggest that cognitive function is associated with the presence and severity of post-stroke dysphagia. Above all, visual attention and executive functions may have meaningful influence on the oral phase of swallowing in stroke patients with supratentorial lesions.
Cognition Disorders ; Cognition* ; Crows ; Deglutition ; Deglutition Disorders* ; Executive Function ; Humans ; Retrospective Studies ; Stroke* ; Trail Making Test

The purpose of this study was to investigate the stress distribution in the periodontal tissue and the displacement of teeth when active torque was applied to the maxillary incisors by three-dimensional finite element analysis. A three-dimensional finite element model consisted of the maxillary teeth and surrounding periodontal membrane, .022 x .028 Roth prescription bracket and stainless steel, NiTi and TMA rectangular ideal arch wires which were modeled by hexahedron elements. Applied active torques were 2, 5 and 10 degrees. The findings of this study showed that the reaction force acting on the bracket was the extrusion force on the mesial side of the incisors and canine and the intrusion force on the distal side of the incisors and canine. The amount of force and moment was greatest at the lateral incisor. When active anterior labial crown torque was applied, labial crown and distal tipping and intrusion of the incisors took place, and lingual crown distal tipping and extrusion of the canine occured. An excessive force was concentrated on the lateral incisor, when the stainless steel wire was used. NiTi or TMA wire is desirable for torque control.
Crowns ; Finite Element Analysis* ; Incisor* ; Membranes ; Prescriptions ; Stainless Steel ; Tooth ; Torque*

OBJECTIVE: To develop and standardize the Limb and Oral Apraxia Test (LOAT) for Korean patients and investigate its reliability, validity, and clinical usefulness for patients with stroke. METHODS: We developed the LOAT according to a cognitive neuropsychological model of limb and oral praxis. The test included meaningless, intransitive, transitive, and oral praxis composed of 72 items (56 items on limb praxis and 16 items on oral praxis; maximum score 216). We standardized the LOAT in a nationwide sample of 324 healthy adults. Intra-rater and inter-rater reliability and concurrent validity tests were performed in patients with stroke. We prospectively applied the LOAT in 80 patients and analyzed the incidence of apraxia. We also compared the clinical characteristics between the apraxia and non-apraxia groups. RESULTS: The internal consistency was high (Cronbach’s alpha=0.952). The inter-rater and intra-rater reliability and concurrent validity were also high (r=0.924–0.992, 0.961–0.999, and 0.830, respectively; p<0.001). The mean total, limb, and oral scores were not significantly different according to age and education (p>0.05). Among the 80 patients with stroke, 19 (23.8%) had limb apraxia and 21 (26.3%) had oral apraxia. Left hemispheric lesions and aphasia were significantly more frequently observed in the limb/oral apraxia group than in the non-apraxia group (p<0.001). CONCLUSION: The LOAT is a newly developed comprehensive test for limb and oral apraxia for Korean patients with stroke. It has high internal consistency, reliability, and validity and is a useful apraxia test for patients with stroke.
Adult ; Aphasia ; Apraxias ; Dominance, Cerebral ; Education ; Extremities ; Humans ; Incidence ; Prospective Studies ; Psychometrics ; Reproducibility of Results ; Stroke

BACKGROUND: As surgical complications tend to occur more frequently in the beginning stages of a surgeon's career, knowledge of perioperative complications is important to perform a safe procedure, especially if the surgeon is a novice. We sought to identify and describe perioperative complications and their management in connection with minimally invasive transforaminal lumbar interbody fusion (TLIF). METHODS: We performed a retrospective chart review of our first 124 patients who underwent minimally invasive TLIF. The primary outcome measure was adverse events during the perioperative period, including neurovascular injury, implant-related complications, and wound infection. Pseudarthroses and adjacent segment pathologies were not included in this review. Adverse events that were not specifically related to spinal surgery and did not affect recovery were also excluded. RESULTS: Perioperative complications occurred in 9% of patients (11/124); including three cases of temporary postoperative neuralgia, two deep wound infections, two pedicle screw misplacements, two cage migrations, one dural tear, and one grafted bone extrusion. No neurologic deficits were reported. Eight complications occurred in the first one-third of the series and only 3 complications occurred in the last two-thirds of the series. Additional surgeries were performed in 6% of patients (7/124); including four reoperations (two for cage migrations, one for a misplaced screw, and one for an extruded graft bone fragment) and three hardware removals (one for a misplaced screw and two for infected cages). CONCLUSIONS: We found perioperative complications occurred more often in the early period of a surgeon's experience with minimally invasive TLIF. Implant-related complications were common and successfully managed by additional surgeries in this series. We suggest greater caution should be exercised to avoid the potential complications, especially when surgeon is a novice to this procedure.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; *Learning Curve ; Lumbar Vertebrae/*surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/adverse effects/methods ; Retrospective Studies ; Spinal Diseases/*surgery ; Spinal Fusion/*adverse effects/methods ; Young Adult

OBJECTIVE: To determine clinical and radiological factors that predict the successful outcome of percutaneous disc decompression (PDD) in patients with lumbar herniated nucleus pulposus (HNP). METHODS: We retrospectively reviewed the clinical and radiological features of patients who underwent lumbar PDD from April 2009 to March 2013. Sixty-nine patients with lumbar HNP were studied. Clinical outcome was assessed by the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Multivariate logistic regression analysis was performed to assess relationship among clinical and radiological factors and the successful outcome of the PDD. RESULTS: The VAS and the ODI decreased significantly at 1 year follow-up (p<0.01). One year after PDD, the reduction of the VAS (DeltaVAS) was significantly greater in the patients with pain for <6 months (p=0.03) and subarticular HNP (p=0.015). The reduction of the ODI (DeltaODI) was significantly greater in the patients with high intensity zone (p=0.04). Multivariate logistic regression analysis revealed the following 5 factors that were associated with the successful outcome after PDD: pain duration for <6 months (odds ratio [OR]=14.036; p=0.006), positive straight leg raising test (OR=8.425, p=0.014), the extruded HNP (OR=0.106, p=0.04), the sequestrated HNP (OR=0.037, p=0.026), and the subarticular HNP (OR=10.876, p=0.012). CONCLUSION: PDD provided significant improvement of pain and disability of patients. The results of the analysis indicated that the duration of pain <6 months, positive straight leg raising test, the subarticular HNP, and the protruded HNP were predicting factors associated with the successful response of PDD in patients with lumbar HNP.
Decompression* ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Leg ; Logistic Models ; Radiculopathy ; Regression Analysis ; Retrospective Studies ; Treatment Outcome

Primary urethral carcinoma accounts for less than 1% of the malignancies in males and adenocarcinoma accounts for 5% of all urethral carcinomas. A 36-year-old man with a history suggestive of urethral stricture was scheduled to undergo retrograde urethrography and visual urethrotomy. On urethroscopic examination, an abnormal polypoid mass was found in the proximal bulbous urethra, so transurethral resection biopsy was added to the urethrotomy. Histopathologic examination demonstrated urethral adenocarcinoma with no invasion to the corpus spongiosum and cavernosa on the magnetic resonance imaging. There was no evidence of metastasis and the search for the primary focus of adenocarcinoma revealed that the tumor originated from the urethra. The patient underwent segmental urethral resection and there has been no recurrence for 1-year follow-up.
Adenocarcinoma* ; Adult ; Biopsy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Recurrence ; Urethra ; Urethral Stricture