The ultrasonographic features in 26 cases of blunt testicular trauma were reviewed. Ultrasonography diagnosed correctly in 11 surgically proven cases of testicular rupture. There were three false-positive cases, two with a large scrotal hematocele and one with epididymis rupture. there were no false-negative cases. The sensitivity and specificity of ultrasonographic diagnosis were 100% and 80% respectively. The positive and negative predictive values were 78. 6% and 100% respectively. Therefore, the negative diagnosis by ultrasonography can warrant conservative therapy.
Diagnosis ; Epididymis ; Hematocele ; Male ; Rupture ; Sensitivity and Specificity ; Ultrasonography*

We designed this study to investigate the effects of adenosine on penile erection in Sprague- Dawley rats, in vivo. This was performed by simultaneous monitoring intracavernosal pressure( ICP) and systemic blood pressure with UROCOMPACT 6000 plus( WIEST, Germany) after intracavernosal injection of adenosine, papaverine and adenosine plus papaverine. Increment of maximal ICP was observed in the adenosine treated-group (0.015 to 0.15mg, n=30) in dose dependent manner, i.e., 15.8+/-0.95cmH2O with 0.015mg adenosine to 44.6+/-2.72cmH2O with 0.15mg adenosine, in mean ICP(n=l0, P<0.05). A similar finding was observed in the papaverine treated-group (0.015 to 0.15mg, n =30) in dose dependent manner. i.e., 28.1+/-2.88cmH2O with 0.015mg papaverine to 62.3+/-4.93cmH2O with 0.15mg papaverine, in mean ICP (n=10, P<0.05). The additive effect of adenosine plus papaverine treated-group( 0.015 + 0.015 to 0.15 +0.l5mg, n=30) was to enhance the results obtained by adenosine or papaverine alone in dose dependent manner. i.e., 50.7+/-1.71cmH2O with 0.015mg + 0.015mg papaverine to 79.5+/-5.63cmH2O with 0.15mg adenosine + 0.15mg papaverine. in mean ICP(n= 10, P<0.05). These results suggest that adenosine plays an important role on penile erection in rats. Adenosine may be useful for the future management of impotence, although the clinical effect remains to be investigated.
Adenosine* ; Animals ; Blood Pressure ; Erectile Dysfunction ; Male ; Papaverine ; Penile Erection* ; Rats*

Suprapubic cystostomy by trocar is a simple, safe and useful method for urinary diversion in acute urinary retention. But rarely, severe complications occur during or after suprapubic cystostomy such as bowel perforation, through and through perforation of the bladder, rectal injury and severe hematuria. We studied the complications of suprapubic cystostomy retrospectively and compared 19 patients who performed ultrasonographic examination with 30 patients without ultrasonographic examination. The complications in 30 patients without preliminary ultrasonographic examination were initial failure in 4 cases (13.3%), extravesical Foley indwelling in 2 cases (6.7%), puncture site closed to the pubic bone in 2 cases (6.7%), spontaneous bladder rupture in 1 case (3.3%) and bowel injury in 1 case (3.3%). But, the complication in 19 patients with preliminary ultrasonographic examination was only 1 retried case (5.3%) because of extravesical Foley indwelling. As above results, the brief preliminary ultrasonographic examination of the bladder is a very useful method with minimal risk during suprapubic cystostomy by trocar.
Cystostomy* ; Hematuria ; Humans ; Pubic Bone ; Punctures ; Retrospective Studies ; Rupture ; Surgical Instruments* ; Ultrasonography ; Urinary Bladder ; Urinary Diversion ; Urinary Retention

No abstract available.
Adult* ; Esophageal Atresia* ; Fistula* ; Humans

Priapism is a well recognized complication of some oral medications. Those most commonly cited are: antipsychotic drugs, especially the phenolhiazine: trazodone and chlorpromazine :and the antihyperlensive drugs hydralazine, guanethidine and prazocin. We report a case or priapism associated with the use of chlorpromazine who experienced 2 episodes or priapism and never experience priapism after cessation of the drug.
Antipsychotic Agents ; Chlorpromazine* ; Guanethidine ; Hydralazine ; Priapism* ; Trazodone

BACKGROUND: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. METHODS: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6-mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. RESULTS: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. CONCLUSIONS: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.
Biomechanical Phenomena ; Cadaver* ; Dislocations ; Ligaments* ; Muscles ; Scapula ; Shoulder

Nutcracker syndrome is a rare disease caused by the compression of the renal vein between the aorta and superior mesenteric artery. It is known to cause of venous hypertension, peripelvic and periureteral varicosities. Clinical manifestations include varicocele, hematuria, and flank or abdominal pain. Surgical correction is needed in nutcracker syndrome cases with severe or recurrent hematuria and abdominal or flank pain. Reanastomosis of the renal vein at 5cm below the original insertion site at the inferior vena cava is the one of the most common corrective methods and the transabdominal approach is usually employed. This disease usually appears in healthy young people and in order to decrease postoperative complications such as intestinal obstruction and bowel adhesion by avoiding unnecessary intraperitoneal manipulation, the authors used the extraperitoneal approach through a flank incision. We report because, in selected cases, we consider that this extraperitoneal approach is one of the alternative methods for the usual transperitoneal approach.
Abdominal Pain ; Aorta ; Flank Pain ; Hematuria ; Hypertension ; Intestinal Obstruction ; Mesenteric Artery, Superior ; Postoperative Complications ; Rare Diseases ; Renal Veins ; Varicocele ; Vena Cava, Inferior

Use of ESWL has made many changes in the treatment of urinary trat stones. However, the treatment of the stone below the iliac crest was not possible owing to the arrangement of the apparatus and the location of the stone within the bony pelvis. For solving the problem, we selected 5 patients having mid ureteral stone. They were placed in prone position and administered shockwave from 500 times to 2600 times. The result was 3 patients had no residual stone and 2 patients showed decreased size of stones in follow-up examinations. All the patients showed no specific complication. The ESWL is able to disintegrate mid ureteral stone by using the change of patient`s position and avoiding the shield of bone around the stone.
Follow-Up Studies ; Humans ; Pelvis ; Prone Position ; Ureter*

In 1974, bipolar hip prosthesis was developed by Giliberty and Bateman to reduce the problems of unipolar prosthesis, including acetabular wear and acetabular protrusion, but the indications for it are still controversial. From July, 1988, to February, 1991, at Pusan maryknoll hospital, 37 hips in 33 patients of femoral neck fracture (25 hips) and avascular necrosis (12 hips) with relatively normal acetabular articular cartilage were treated with bipolar hip prosthetic replacement. The thirty-seven cases were reviewed for more than 3 years(range, 3 years to 4 years 8 months: average, 3 years 10 months), and assessed in terms of acetabular migration and function. The authors compared the datas of the femoral neck fracture with those of the avascular necrosis of femoral head. There was no statistical difference between two groups in function. But the acetabular migration of bipolar hip prosthesis used in femoral neck fracture was lesser than that of avascular necrosis of femoral head, and the serial acetabular migration disclosed gradual decrease. The authors concluded that the results of bipolar endoprosthesis used in femoral neck fracture was superior than those of avascular necrosis of femoral head with relatively normal acetabular articular cartilage.
Acetabulum ; Busan ; Cartilage, Articular ; Femoral Neck Fractures ; Femur Neck ; Head ; Hip ; Hip Prosthesis ; Humans ; Necrosis ; Prostheses and Implants

Hemangiomas of the skin are common, but intrascrotal hemangioma is a rare Complications include hemorrhage, ulceration, skin infection, thromboses and phlebitis. We report a case of intrascrotal hemangioma with spontaneous bleeding.
Hemangioma* ; Hemorrhage* ; Phlebitis ; Scrotum ; Skin ; Thrombosis ; Ulcer