A case of 26 years old male having horseshoe kidney associated with giant hydronephrosis due to aberrant vessel was presented with a brief review of the literatures. The patient was managed by division of isthmus and nephrectomy with good result.
Adult ; Humans ; Hydronephrosis* ; Kidney* ; Male ; Nephrectomy

A clinical and statistical study was made on 61 Patients with renal tuberculosis who were admitted to the urological department. Taegu Armed Forces General Hospital during the period from January, 1971 to May, 1975. The results were summarized as follows: 1. The incidence of the renal tuberculosis was 17.1% of all in-patients. 2. Nine cases (14.8%) were affected in both sides, 23 cases (37.7%) in the right and 29 cases (47.5%) in the left side. S. The initial symptoms were mostly those of vesical symptoms. 4. In 39.3% of the cases, past history or present illness of tuberculosis was noted, of which 21.3% had pulmonary tuberculosis and 9.8% pleurisy. 5. The frequent coexisting other genitourinary tract tuberculosis were bladder Tb(37.7%) epididymal Tb(36.2%) and prostatic Tb(19.7%). 6. By acid-fast stain of urine, tubercle bacilli were demonstrated in 50.8% of cases. 7. According to the result of urinary findings during chemotherapy (P. A. S. INAH. and SM), tubercle bacilli were not detected after chemotherapy for 3 months in the cases of minimal and moderate advanced lesion. Pyuria and hematuria disappeared after chemotherapy for 3 months in the cases of minimal and for 6 months in cases of moderate advanced lesion. tubercle bacilli were not detected in most cases and leukocyte and erythrocyte counts were decreased only in a half cases after chemotherapy for 6 months. 8. Tubercle bacilli were not detected after nephrectomy and pyuria and hematuria disappeared within 3 months after operation in most cases.
Arm ; Daegu ; Drug Therapy ; Erythrocyte Count ; Hematuria ; Hospitals, General ; Humans ; Incidence ; Leukocytes ; Nephrectomy ; Pleurisy ; Pyuria ; Statistics as Topic* ; Tuberculosis ; Tuberculosis, Pulmonary ; Tuberculosis, Renal* ; Urinary Bladder

An experiment was made to detect the presence of Trichomonas vaginalis in 120 patients with lower urinary tract infection and 480 male soldiers without any noticeable symptoms. Microscopic examination and cultivation of sediment of centrifuged specimen of urine and of prostatic secretion obtained by prostatic massage was performed. Clinical observation was performed. Clinical observation was also made on 26 cases of Trichomoniasis in the lower urinary tract of males. The results were summarized as follows: 1. T. vaginalis was demonstrated in 7.5% of the lower urinary tract infected group (Group A) and 3.33% of control group (Group B). 2. Motile trichomonads were found in 57.1% through microscopic examination and additionally 42.9% by cultivation. 3. The sites of infection were urethra in 68%, prostate in 40% and bladder and epididymis in 4%. 4. The frequent subjective symptoms were itching sensation in the urethra (16%), perineal discomfort (12%), dysuria (12%) and urethral discharge (8%). 5. Higher level than the normal limit of leukocyte count through microscopic examination was observed in 48% in urine and 24% in prostatic secretion of the patients with Trichomoniasis. 6. Other pathologic bacteriae were demonstrated in 40% in urine and 20% in prostatic secretion by Gram stain. The most frequently mixed bacteriae were Gram positive cocci. 7. Nitrimedazine 250mg was administered orally twice a day for 7 days in 10 cases of Trichomoniasis in the urethra without mixed bacterial infection. The result was effective in 9 cases.
Bacteria ; Bacterial Infections ; Dysuria ; Epididymis ; Gram-Positive Cocci ; Humans ; Leukocyte Count ; Male* ; Massage ; Military Personnel ; Prostate ; Pruritus ; Sensation ; Trichomonas vaginalis ; Urethra ; Urinary Bladder ; Urinary Tract Infections ; Urinary Tract*

Primary teratomas of the bladder are exceedingly rare, only several cases have been reported in the literature. A case of primary teratoma of the bladder in a 31 years old woman is presented and reported with a brief review of the literature. The patient was managed by segmental resection of the bladder with good results.
Adult ; Female ; Humans ; Teratoma* ; Urinary Bladder*

BACKGROUND/AIMS: Recent guidelines strongly recommend that the interval of surveillance colonoscopy be determined according to the risk stratification obtained at index colonoscopy. However, because of the differences in perception of the classification of colorectal intraepithelial neoplasia between Asian and Western countries, there is some confusion about surveillance colonoscopy. The aim of the present study was to evaluate the clinicopathological characteristics and the interval of surveillance colonoscopy between patients with high-grade dysplasia/carcinoma in situ and those with intramucosal carcinoma. METHODS: From January 2003 to June 2010, 727 patients were included from 8 tertiary centers. Four hundred fifteen patients (57.1%) had high-grade dysplasia/carcinoma in situ (group A), and 312 (43.9%) had intramucosal carcinoma (group B). Clinicopathological data were reviewed retrospectively. RESULTS: Group A had a significantly more frequent family history of colorectal cancer (3.1% vs. 0.6%, P<0.001), smaller polyp size (12 mm vs. 15 mm, P=0.001), and more proximal location (31.1% vs. 21.8%, P=0.005) than did group B. Among 727 patients, surveillance colonoscopy was performed within 6 months in 55.8% of patients and within 12 months in 77.8%. Group B had a significantly shorter interval of surveillance colonoscopy than did group A (P<0.001). There was no difference in detection of advanced neoplasia at surveillance colonoscopy between the 2 groups (6.6% vs. 5.4%, P=0.638). CONCLUSIONS: The recommended interval of surveillance colonoscopy is not followed in Korea. More education about post-polypectomy surveillance guidelines is required.
Asian Continental Ancestry Group ; Carcinoma in Situ ; Colonic Polyps ; Colonoscopy* ; Colorectal Neoplasms ; Humans ; Korea* ; Polyps

BACKGROUND/AIMS: The therapeutic strategy between endoscopic piecemeal mucosal resection (EPMR) and endoscopic submucosal dissection (ESD) for large laterally spreading tumors (LSTs) has not been clearly defined. The aim of this study was to compare the clinical outcomes between EPMR and ESD in patients with large LST. METHODS: From July 2006 to September 2010, 106 patients who underwent endoscopic resection for large (>20 mm) LSTs were included in our retrospective analysis. RESULTS: Baseline characteristics of the patients and tumors were not different between two groups except for location (EPMR-right colon, ESD-rectum). The en bloc resection rate and complete resection rate were significantly higher in the ESD group than those in the EPMR group (EPMR vs. ESD, 53.5% vs. 88.6, P<0.01, 45.1% vs. 71.4%, P=0.01, respectively). However, total procedure time was significantly shorter in the EPMR group (21.3 min vs. 44.4 min, P<0.01). Furthermore, the rates of complication including perforation and bleeding were significantly lower in the EPMR group than those in the ESD group (perforation, 1.4% vs. 11.4%, P=0.02; bleeding, 4.2% vs. 17.1%, P=0.03, respectively). During 19.9 months of follow-up, no significant difference was observed in terms of recurrence (1.5% vs. 3.2%). Non-granular, pseudo-depressed type (LST-PD) showed a significantly higher presence of adenocarcinoma and deeper submucosal invasion than other types of LSTs. CONCLUSIONS: The therapeutic strategy for choosing between EPMR and ESD for large LST lesions should be determined based on the macroscopic findings of their subtype. En bloc resection with ESD should be applied to LST-PDs due to their higher rate of submucosal invasion.
Adenocarcinoma ; Colon ; Follow-Up Studies ; Hemorrhage ; Humans ; Recurrence ; Retrospective Studies

BACKGROUND: Coronary artery bypass grafting(CABG) has been established as an effective treatment modality in improving the symptoms of ischemic heart disease as well as in preventing sudden death. Since the relatively wide use of arterial grafting in the 80's, an improvement in long term patency rates compared with saphenous vein grafting has been suggested. We have been using multiple arterial grafts since 1998, and we attempted to compare our early results with those of saphenous vein grafting. MATERIAL AND METHOD: Out of the 355 patients that received CABG at our center between June,1998 and May,1999, 153 patients that used cardioplegia were reviewed. 76 had received single arterial graft(Group I) and 77 had received more than 2 arterial grafts(Group II). Preoperative clinical data, ecohocardiography, and angiographic studies were analyzed retrospectively. RESULT: Preoperatively, there were statistically significant differences between Group I and Group II with respect to age and smoking history. There was one early postoperative mortality in each group. The number of anastomoses constructed per patient showed a statistical difference. There were no other differences in operative and postoperative results. CONCLUSION: Even in our learning period, there was no difference in our early results between arterial grafting and saphenous vein grafting. These early results suggest that arterial grafting may afford patients as improving in late survival. Futhermore, these results suggest that complete arterial revasularization may serve to prolong life expectancy.
Coronary Artery Bypass* ; Coronary Vessels* ; Death, Sudden ; Heart Arrest, Induced ; Humans ; Learning ; Life Expectancy ; Mortality ; Myocardial Ischemia ; Retrospective Studies ; Saphenous Vein ; Smoke ; Smoking ; Transplants*

OBJECTIVE: End-tidal partial pressure of carbon dioxide(PETCO2) is often used as an estimate of arterial partial pressure of carbon dioxide(PaCO2), with the understanding that PaCO2 usually exceeds PETCO2. During craniotomies, because hyperventilation is used to therapeutically lower intracranial pressure, the difference between arterial and end-tidal partial pressure of carbon dioxide(P(a-ET)CO2) has therapeutic implications. To determine how much information concerning neurosurgical operation and clinical outcome is provided by the PETCO2, PaCO2 and P(a-ET)CO2 during surgery, we evaluated 81 patients who had neurosurgical operation. METHODS: There were 51 males and 30 females with a mean age of 50.3 years(range 7-85 years). After the induction of general anesthesia, body temperature was maintained in a normothermia, endtidal CO2 was maintained 28-34mmHg and the systolic blood pressure was kept 90-120mmHg. ETCO2, PaCO2 and regional cortical blood flow(rCoBF) were checked at the time of dura closure. Neurologic outcome was evaluated at 8 hours after operation to rule out other factors which may influence on the patient's long-term outcome. Data were collected and compared by student's t-test or chi-square analysis. RESULTS: The PaCO2 was 34.6+/-5.2mmHg(range, 24.9-54.8), PETCO2 was 29.9+/-4.1mmHg(range, 20.0-45.0) and P(a-ET)CO2 was 4.7+/-3.5mmHg(range, -1.1-18.6). The correlation between the PaCO2 and PETCO2 was statistically significant(PETCO2=13.3-0.57xPaCO2). But there was no correlation of rCoBF with PaCO2 and ETCO2. P(a-ET)CO2 values less than 8mmHg were correlated well with good neurologic outcome compared with higher P(a-ET)CO2 patients. PaCO2, rCoBF, mean arterial blood pressure, arterial pH and initial Glasgow coma scale showed statistically significant correlation with neurologic outcome(p<0.05). CONCLUSION: Based on our study, P(a-ET)CO2 value could be used as a good prognostic factor during the neurosurgical operation and anesthesiologist should be tried to decrease this value. And in patients who has a intact brain autoregulation, rCoBF was not influenced by PaCO2 and ETCO2, entirely.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Body Temperature ; Brain ; Carbon Dioxide* ; Carbon* ; Craniotomy ; Female ; Glasgow Coma Scale ; Homeostasis ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation ; Intracranial Pressure ; Male ; Partial Pressure*

Actinomycosis is an indolent, slowly progressive infection caused by anaerobic bacteria, primarily of the genus Actinomyces, that colonize the mouth, colon, and vagina. A vital step in the development of actinomycosis is disruption of the mucosal barrier. Actinomycosis occurs most frequently at a cervicofacial, abdominal, and pelvic region. Thoracic actinomycosis usually follows an indolent progressive course with involvement of the pulmonary parenchyma and/or the pleural space. Rarely, pulmonary nodules or endobronchial lesions can occur. We report a case of a 62-year-old woman of chronic cough with sputum and pulmonary mass with consolidation at the right lower lobe on chest radiography. Fiberoptic bronchoscopic findings revealed a polypoid tumor like mass completely obstructing RLL lobar bronchus and a hard bony material embedded there. Histologic examination of the biopsy specimens demonstrated acute and chronic inflammation with calcified material and a sulfur granule, which led to the diagnosis of endobronchial actinomycosis. The patient responded to several bronchoscopic procedures and intravenous penicillin G.
Actinomyces ; Actinomycosis* ; Bacteria, Anaerobic ; Biopsy ; Bronchi ; Bronchoscopy ; Colon ; Cough ; Diagnosis ; Female ; Foreign Bodies* ; Humans ; Inflammation ; Middle Aged ; Mouth ; Pelvis ; Penicillin G ; Radiography ; Sputum ; Sulfur ; Thorax ; Vagina

Actinomycosis is an indolent, slowly progressive infection caused by anaerobic bacteria, primarily of the genus Actinomyces, that colonize the mouth, colon, and vagina. A vital step in the development of actinomycosis is disruption of the mucosal barrier. Actinomycosis occurs most frequently at a cervicofacial, abdominal, and pelvic region. Thoracic actinomycosis usually follows an indolent progressive course with involvement of the pulmonary parenchyma and/or the pleural space. Rarely, pulmonary nodules or endobronchial lesions can occur. We report a case of a 62-year-old woman of chronic cough with sputum and pulmonary mass with consolidation at the right lower lobe on chest radiography. Fiberoptic bronchoscopic findings revealed a polypoid tumor like mass completely obstructing RLL lobar bronchus and a hard bony material embedded there. Histologic examination of the biopsy specimens demonstrated acute and chronic inflammation with calcified material and a sulfur granule, which led to the diagnosis of endobronchial actinomycosis. The patient responded to several bronchoscopic procedures and intravenous penicillin G.
Actinomyces ; Actinomycosis* ; Bacteria, Anaerobic ; Biopsy ; Bronchi ; Bronchoscopy ; Colon ; Cough ; Diagnosis ; Female ; Foreign Bodies* ; Humans ; Inflammation ; Middle Aged ; Mouth ; Pelvis ; Penicillin G ; Radiography ; Sputum ; Sulfur ; Thorax ; Vagina