From the stand point of understanding the pathophysiology of abnormalities in sexual development, disorders can be categorized as resulting from derangements in any of the 3 principal processes involved in sexual differentiation, namely, disorders of genetic sex, disorders of gonadal sex, and disorders of phenotypic sex. During the last 5 years we have found 60 cases of disorders of sexual differentiation and tried to classify the cases according to the schematization of the above. The cases were reviewed with the observation on karyotype, external or internal or internal genitalia, in some, hormonal balance, utilizing various methods of operative examination The disorders of genetic sex consist of 3 cases of true hermaphroditism, 7 cases of Klinefelter`s syndrome, 9 cases of Turner`s syndrome, 1 case of sex reversal syndrome (XX male) l case of mixed gonadal dysgenesis, and l case of dysgenetic male pseudohermaphroditism. The disorders of gonadal sex consist of 6 cases of pure gonadal dysgenesis. The disorders of phenotypic sex consist of 11 cases of adrenogenital syndrome, 7 cases of male pseudohermaphroJitism, and 2 case of congenital absence of vagina. The remained 12 cases which were suspected as disorders of sexual differentiation were not able to be differentiated according to the inadequacy of diagnostic studies.
46, XY Disorders of Sex Development ; Adrenogenital Syndrome ; Genitalia ; Gonadal Dysgenesis ; Gonadal Dysgenesis, Mixed ; Gonads ; Humans ; Karyotype ; Male ; Ovotesticular Disorders of Sex Development ; Sex Differentiation* ; Sexual Development ; Vagina

In the field of urological surgery, the use of bowel has been established as methods of urinary diversion or reconstruction of urinary tract since ileal conduit was settled by Bricker in 1950. Urinary diversion or reconstruction with use of bowel segment is usually performed for the purposes of life saving and social adaptation of patients by removal of tumor itself and by preservation of renal function and normal urination. A favorable prognosis can be expected by urinary diversion utilizing a intestinal segment after removal of bladder and its surrounding tissues for the therapy of bladder carcinoma. In Korea, where tuberculosis is prevailing, interests of many urologists are centered on the preservation of bladder capacity for the treatment of contracted bladder complicating tuberculosis of urinary tract. But until recently, only a few experimental or clinical studies on urinary diversion and reconstructs on with use of the intestinal segment were reported in this country. A clinical observation was made on I7 cases of urinary diversion or reconstruction with use of the intestinal segment, which were performed on the patients admitted to the Department of Urology, Severance Hospital in 1977. The results are as follows: 1. The age distribution of patients was from 4th, to 6th. decades. 2. Among the patients, 13 cases were male and 4 cases were female bladder tumor were male. 3. The patients were consisted of 11 cases of bladder tumor, 5 cases of tuberculous contracted bladder and 1 case of a large vesicovaginal fistula 4. In operations, ileal conduit for 11 cases of bladder tumor, ileocystoplasty for 5 cases of tuberculous contracted bladder and ureterosigmoidostomy for 1 case of a large vesicovaginal fistula were performed. Acccmpanyingileal conduit, total cystectomy was performed in 10 cases end ligation of biateral hypogastric arteries only in the rest.5. In bladder tumor, comparing with pathological staging, the number of clinical understating and overstaging were 5 and 2 cases respectively. The pathological stages were not significantly correlated with the grades. 6. After ileocystoplasty for tuberculous contracted bladder, the intervals of urination was prolonged to 2 hours or more and improvement of incontinence was noted in all cases. 7. The blood levels of urea nitrogen and creatinine returned to normal except 1 case complicated with infection of urinary tract after operation. 8. The mean volumes of transfused blood during operation were 1,026ml for ileal conduit with total cystectomy, and 664ml for ileocystoplasty. The mean operation time was 5 hours and 56 minutes for ileal conduit with total cystectomy and 5 hours and 12 minutes for ileocystoplasty 10. The average postoperative duration were 18 days in ileal conduit with total cystectomy and 17 days in ileocystoplasty. 11. The postoperative complications included 5 cases of wound infection, 5 cases of urinary tract infection, 3 cases of paralytic ileus or mechanical ileus and 2 cases of urine leak.
Age Distribution ; Arteries ; Creatinine ; Cystectomy ; Female ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Intestines* ; Korea ; Ligation ; Male ; Nitrogen ; Postoperative Complications ; Prognosis ; Tuberculosis ; Urea ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion* ; Urinary Tract Infections ; Urinary Tract* ; Urination ; Urology ; Vesicovaginal Fistula ; Wound Infection

Calcaneus is very important in weight bearing and maintaining the normal contour of the foot. Many diseases can cause the cyst-like destructive changes of the calcaneus. In most cases, histological confirmation and bacteriological examination are necessary for the final diagnosis. In recent years, four cases of the cyst-like destructive lesions of the calcaneus were treated and had satisfactory results. They were confirmed with biopsy and bacterial culture as followings; acute osteomyelitis, chronic osteomyelitis, tuberculous osteomyelitis and simple bone cyst. Operations on the osteomyelitis were curettage with or without sequestrectomy and the simple bone cyst the curettage and bone graft. After operations, proper antibiotics and plaster immobilization followed routinely.
Anti-Bacterial Agents ; Biopsy ; Bone Cysts ; Calcaneus ; Curettage ; Diagnosis ; Foot ; Immobilization ; Osteomyelitis ; Transplants ; Weight-Bearing

A fairly common cause of painful hips in children is the condition variousiy called transient synovitis, phantom hip, toxic synovitis, or transitory synovitis. Infection, trauma, or allergic conditions can be causes of them. The main symptom is most frequently pain of sudden onset in the region of the hip joint with a limp on the affected side. Limitation of motion, especially of abduction, internal rotation and extension seems to confirm the clinical diagnosis. The disease is of interest, not because it is a disabling condition, but because of the difficulty in differentiating it from more serious diseases of the hip, such as tuberculosis, osteomyelitis, or Legg-Perthe's disease. Fifty seven cases of the transient synovitis of the hips were treated and reported on their clinical states and results as follows; 1. The diagnostic criterias were pain, limping, limitation of motion, W.B.C. count, erythrocyte sedimentation rate and radiological findings. 2. The treatment was conservative including bed rest, skin traction on the affected leg, non weight-bearing, antibiotics and sedatives. 3. 78.9% of the patients had improved symptoms and signs within three weeks of treatment. 4. Seven hips subsequently developed rheumatoid arthritis (3 cases), slipped upper femoral epiphysis (1 case), pyogenic arthritis (1 case), osteoarthritis (1 case) and snapping hip (1 case).
Anti-Bacterial Agents ; Arthritis ; Arthritis, Rheumatoid ; Bed Rest ; Child ; Diagnosis ; Epiphyses ; Erythrocyte Count ; Hip Joint ; Hip ; Humans ; Hypnotics and Sedatives ; Leg ; Osteoarthritis ; Osteomyelitis ; Skin ; Synovitis ; Traction ; Tuberculosis ; Weight-Bearing

PURPOSE: The efficacy of intranasal corticosteroids for the treatment of allergic rhinitis has been reported. But the efficacy of intranasal corticosteroids has not been compared between perennial nonallergic rhinitis (PNAR) and perennial allergic rhinitis (PAR). METHODS: Twenty-three patients with PNAR and 19 patients with PAR were enrolled in this study. Every patient received fluticasone propionate (FP) 200 g (100 g, bid) daily for 4weeks. Control group (n=16) was received only anti-histamine (hydroxyzine 0.6 mg/kg/dose) intermittently. Efficacy of FP was evaluated by the mean change in nasal congestion, rhinorrhea, nasal itching, sneezing and total nasal symptom score (a sum of patient ratings of nasal congestion, rhinorrhea, nasal itching, and sneezing). RESULTS: Both groups (PNAR and PAR) showed similar improvement of nasal symptom with FP 200 g compared with control. (P< 0.05) In the total population, both groups showed significant improvements from baseline in TNSS compared with control during each week of treatment. (P< 0.05) In PNAR and PAR, nasal congestion was significantly improved more than in control. (P< 0.01, P< 0.01) Rhinorrhea and itching in PAR were improved more than in control. (P=0.02, P=0.03) In sneezing, all three groups showed no differences. (P=1.00, P=0.31, P= 0.29) CONCLUSION: Intranasal FP is an effective treatment for perennial nonallergic rhinitis as same as perennial allergic rhinitis.
Adrenal Cortex Hormones ; Diethylpropion ; Estrogens, Conjugated (USP) ; Humans ; Pruritus ; Rhinitis* ; Sneezing ; Fluticasone

Pulmonary embolism is a rare complication after percutaneous vertebroplasty for compression fracture. Embolization is related to cement leakage outside the treated vertebral body into the adjacent venous system. We report on a case of pulmonary embolism with bone cement in the right pulmonary artery in a 75-year-old female who had undergone percutaneous vertebroplasty 2 months before. Her simple X-ray of the spine captured polymethyl metacrylate leakage from the vertebral body, which indicated the pathophysiology of this event.
Aged ; Asymptomatic Diseases ; Bone Cements ; Female ; Fractures, Compression ; Humans ; Pulmonary Artery ; Pulmonary Embolism* ; Spine ; Vertebroplasty*

No abstract available.
Apolipoproteins* ; Genotype* ; Humans ; Myocardial Infarction*

PURPOSE: To analyze the causes and the clinical results of treatment for the nonunion of femur shaft fractures that occurred after interlocking intramedullary nail fixation. MATERIALS AND METHODS: We reviewed 19 cases of aseptic nonunion of femur shaft fracture in 174 patients after interlocking IM nailing from March 1999 to February 2004 and followed up for more than one year. First we investigated the factors causing nonunion. For operative options, two methods about exchange nailing and exchange nailing with bone graft were performed. Finally clinical results were analyzed with bone union rate by treatment methods and compared with the nonunion factors statistically. RESULTS: According to the causes and types of nonunion, we performed larger IM nail change in 10 cases and IM nail change with bone graft in 9 cases. Bone union was achieved in all cases. Average bone union period were 18.5 weeks in exchange group and 16.1 weeks in exchange with bone graft group. There are significant difference between treatment methods statistically (p<0.05). Compared with the nonunion factors, initial open fracture and smoking groups showed late union rate statistically. CONCLUSION: Based on our analysis, IM nail change is a useful method for nonunion after initial IM nailing in femoral shaft fracture, and additional bone graft that according to the radiologic pattern and stability, especially the fracture gap is also a useful option for nonunion treatment.
Femur ; Fracture Fixation, Intramedullary* ; Fractures, Open ; Humans ; Methods ; Smoke ; Smoking ; Transplants

PURPOSE: The role of the amniotic membrane with or without radiation was investigated with regard to preventing adhesion after flexor tenorrhaphy of chicken. MATERIALS AND METHODS: Nine chicken were divided into three groups. The second flexor tendon of the chicken was operated on. In group A, the flexor tendon was excised and one half and the tendon was repaired. In group B, the repaired tendon was covered with an amniotic membrane. In group C, the repaired tendon was covered with a lyophilised and 25 kGy irradiated amniotic membrane. The gross and histology findings on the level of inflammation and fibrosis of the repaired tendon were evaluated at 3, 6 and 9 weeks after surgery. RESULTS: Group C had the least inflammatory cell infiltration and fibroblast proliferation at any time. CONCLUSION: The use of radiated amniotic membrane was effective in preventing inflammation and adhesion after flexor tenorrhaphy in chickens.
Amnion* ; Chickens* ; Fibroblasts ; Fibrosis ; Inflammation ; Tendons ; Tissue Adhesions*

Purpose: This study examined the clinical and radiological outcomes of TFNA (Trochanteric Fixation Nail-Advanced) and PFNA-II (Proximal Femoral Nail Antirotation-II) used in the treatment of unstable intertrochanteric femur fractures. The association between lateral screw sliding and lateral trochanteric pain was analyzed. Materials and Methods: The study included 116 patients diagnosed with unstable intertrochanteric femur fractures who underwent intramedullary nailing surgery at the author’s hospital. The patients were divided into two groups: 72 who received PFNA-II and 44 who received TFNA. Ten patients with positive greater trochanter tenderness and 106 patients with negative tenderness were assessed for the factors associated with lateral trochanteric pain. The radiological outcomes included an evaluation of fracture union, screw position, tipapex distance, proximal femoral nail protrusion, and lateral sliding length of the helical blade. The clinical outcomes were assessed using the Harris Hip Score, visual analogue scale (VAS) score, greater trochanter tenderness, and pre- and postoperative ambulation ability. Results: Thirty-three patients (45.8%) of the PFNA-II group and 18 (40.9%) of the TFNA group had lateral sliding of the helical blade, with no significant difference between the two groups (p=0.604). The VAS score was significantly higher in the TFNA group (3.77±1.71) than the PFNA-II group (3.10±1.57, p=0.032). Furthermore, the prevalence of a positive greater trochanter tenderness was significantly higher in the TFNA group (seven patients) than in the PFNA-II group (3 patients, p=0.04). Eight patients had lateral sliding in the positive greater trochanter tenderness group, whereas 43 had lateral sliding in the negative greater trochanter tenderness group (p=0.030). The lateral sliding length was 8.87±5.22 and 2.68±4.47 in the positive and negative groups, respectively (p<0.001). Conclusion The PFNA-II and TFNA groups showed favorable clinical and radiological outcomes, suggesting that both devices are suitable for treating unstable intertrochanteric femur fractures. A comparison of the two devices showed that TFNA induces more lateral trochanteric pain than PFNA-II, and the presence and extent of lateral sliding were associated with lateral trochanteric pain.