BACKGROUND: The infection rate of intestinal parasites has been abruptly decreased during a couple of decades, but the report that Clonorchis sinensis has been decreased in infection rate was not shown. Because Clonorchis sinensis could induce the serious complications such as cholecystitis, cholelithiasis, cholangiocarcinoma, authors thought that clonorchiasis requird early diagnosis, treatment and prevention. Therefore the authors surveyed the infection pattern of Clonorchis sinensis for inhabitants who lived in Miryang city, well-known as endemic area for a long time, located at lower basin of Nakdong river. METHODS: The 661 subjects that received workers health examination in Miryang Youngnam General Hospital from September to November, 1996, were surveyed by using questionnaire, skin test and stool egg examination. This questionnaire contained history, duration, frequency of raw freshwater fish ingestion, history and treatment of clonorchiasis, history of other hepatic disease. The authors performed laboratory examination to 54 stool egg positive subjects. RESULTS: Among 661 subjects, the stool egg positive subjects were 54 and showed 8.2% in infection rate. In male(8.9%), stool egg positive rate was higher than female(4.9%). As age increased, stool egg positive rate also increased. Compared to the age group less than 30, stool egg positive rate was higher among age group 30 or over, particularly, in age group 50 or over, stool egg positive rate showed highest infection rate, 31.6%. And stool egg positive rate was increased according to increase of period, frequency of raw freshwater fish ingestion. Subjects with history of clonorchiasis and administrating Praziquantel had higher infection rate than the other subjects without the history. CONCLUSIONS: In this survey, the authors thought that high risk factors of clonorchiasis were male, age of 30 or over(particularly age of 50 or over), more than 10 years in raw freshwater fish ingestion period, more than twice per month in raw freshwater fish ingestion frequency. Then people having these risk factors must be performed various examinations for clonorchiasis, although they had not clinical symptoms, signs and abnormal laboratory findings.
Cholangiocarcinoma ; Cholecystitis ; Cholelithiasis ; Clonorchiasis ; Clonorchis sinensis* ; Early Diagnosis ; Eating ; Fresh Water ; Gyeongsangnam-do ; Hospitals, General ; Humans ; Male ; Ovum ; Parasites ; Praziquantel ; Risk Factors ; Rivers* ; Skin Tests ; Surveys and Questionnaires

PURPOSE: Medical treatment of Peyronie's disease with tamoxifen has been initially proposed as acting upon the early phase of the disease. As recent reports show no significant benefit of tamoxifen, we review the long term results of tamoxifen treatment of Peyronie's disease. MATERIALS AND METHODS: Time to progression during tamoxifen treatment of patients showing acute disease and chronic disease was compared. The acute phase was identified by pain during erection. Progression was defined as enlargement of plaque size or appearance of calcification. RESULTS: The average treatment duration was 15.9+/-13.8 months (range: 3 to 48 months). The median time to progression was 7 months for acute patients and 20 months for chronic patients. Eighty percent of patients in the acute phase showed relief of pain; however, overall progression was 72.1% (78.0% for acute, 66.7% for chronic). Patient history, comorbidities, serum testosterone or initial plaque characteristics, and severity of curvature were not predictive of disease progression. CONCLUSIONS: Tamoxifen showed no significant benefit in slowing the progression of Peyronie's disease in the acute phase over the chronic phase. Peyronie's disease continued to progress, though at a dampened rate for patient's in the chronic phase.
Acute Disease ; Chronic Disease ; Comorbidity ; Humans ; Male ; Penile Induration ; Tamoxifen ; Testosterone

STUDY OBJECTIVE: determine the level of medical care required for mass gatherings and describe the types of medical problems encountered in a religious mass gathered ceremony. DESIGN: Standard charts and a four-tiered triage system(minor, moderate, urgent, and emergent) were developed before the event. The triage system was applied to each chart retrospectively by a single emergency physician. SETTING: Medical staff(10 physicians,13 nurses,1 pharmacist, and 54 first-aid attendants) were based in 8 advanced life support (ALS) clinics. INTERVENTIONS: First-aid attendants referred patients to the clinics, where nurses conducted initial assessments and referred patients to physicians at the venue. Three ambulances were stationed at the venues. RESULT: 22 trauma patients were developed and 183 medical complaints were encountered. Only 7 urgent medical problems were encountered.
Ambulances ; Emergencies* ; Humans ; Pharmacists ; Retrospective Studies ; Triage

Glans penis augmentation (GPA) has received little attention from experts despite the existence of a subset of patients who may be dissatisfied with a small glans or poor tumescence of the glans during erection. Recently, GPA using an injectable filler or implantation of a graft or filler has been developed. Despite a demanding injection technique and inevitable uneven undulation of the glandular surface, GPA using injectable hyaluronic acid (HA) gel is a novel and useful therapy and an effective and safe procedure for soft tissue enhancement. For long-term presence of implants, timed supplementation can be used similar to that for fascial plasty. In complications such as mucosal necrosis of the glans penis, most cases occur from the use of non-HA gel or an unpurified form and misunderstanding of the management protocol for immediate side effects. Currently, GPA using injectable HA gel is not recommended in the International Society for Sexual Medicine guideline due to possible sensory loss. In a 5-year long-term follow-up of GPA by subcutaneous injection of HA gel, the residual volume of implants decreased by 15% of the maximal glandular circumference, but was still effective for alleviating the hypersensitivity of the glans penis in premature ejaculation patients. For efficacy in premature ejaculation, selection of appropriate candidates is the most important factor for success. GPA does not harm erectile function and is less invasive and irreversible compared to dorsal neurectomy. To refine the procedure, more interest and well-designed studies are required for the establishment of the procedure.
Follow-Up Studies ; Humans ; Hyaluronic Acid* ; Hypersensitivity ; Injections, Subcutaneous ; Male ; Necrosis ; Penis* ; Plastics ; Premature Ejaculation ; Residual Volume ; Transplants

After nephrectomy for non-malignant disease, primary tumors of the ureteric stump are extremely rare and present a significant diagnostic problem, and only few cases have been reported in the literature. The very rare adenocarcinoma of the ureter is typically papillary and is associated with urinary tract infection and stones. In adenocarcinoma, because it is often difficult to determine whether the tumor is primary or secondary due to the generalized instability of the urothelium, and its histogenesis and biologic behavior remain uncertain partially due to the rarity of this neoplasm, a diagnostic differentiation pathologically from other tumors is required. We herein describe a case of 68 year old man who had a primary well-differentiated papillary mucigenic. adenocarcinoma of the ureteric stump after nephrectomy for renal stones.
Adenocarcinoma ; Adenocarcinoma, Papillary* ; Aged ; Humans ; Nephrectomy ; Ureter* ; Urinary Tract Infections ; Urothelium

OBJECTIVE: To investigate the injury mechanism in patients who had peroneal neuropathy after a tibio-fibular fracture and the correlation between tibio-fibular fracture location and the severity of the peroneal neuropathy by using electrodiagnosis. METHOD: Thirty-four patients with peroneal neuropathy after a tibio-fibular fracture were recruited for this study. Their medical records, radiologic and electrodiagnostic findings were investigated retrospectively. They were divided into 2 groups according to the existence of a fibular head fracture. The group of patients without the fibular head fracture was further classified according to the criteria of Orthopedic Trauma Association (OTA) classification. The differences between the two groups in the severity of the neuropathy and electrodiagnostic findings were evaluated. RESULTS: Nine cases (26.5%) had tibio-fibular fractures with a coexisting fibular-head fracture and 25 cases (73.5%) had tibio-fibular fractures without fractures in the fibular-head area. There was no statistical significance in the correlation between the existence of the fibular head fracture and the severity of the electrodiagnostic findings. Neither was there any statistically significant relationship between the site of the tibio-fibular fracture and the severity of the peroneal neuropathy (p>0.05). CONCLUSION: This study showed there were numerous cases with common peroneal neuropathy after tibiofibular fracture without a coexisting fibular-head fracture, which shows the importance of indirect nerve injury mechanisms as well as that of direct nerve injury as a cause of peroneal neuropathy. In addition, this study showed that there was no statistically significant correlation between the site of tibio-fibular fracture and the severity of peroneal neuropathy.
Head ; Humans ; Medical Records ; Orthopedics ; Peroneal Neuropathies ; Retrospective Studies ; Tibial Fractures

PURPOSE: Previous studies concerning the ischemic priapism revealed that hypoxia alter the erectile and contractile responses of penis. But the effects of accompaning acidosis on the trabecular smooth muscle contractility have not been fully evaluated or understood yet. We performed this study to elucidate the role of acidosis on the trabecular smooth muscle contractility like in ischemic priapism. MATERIALS AND METHODS: Under the general anesthesia, 55 mature male cats were conditioned to systemic metabolic acidosis by hypoventilation with animal ventilator. The changes of intracavernous pressure to erectics(acetylcholine, L-arginine, PGE1), erectolytics(epinephrine, TXA2), K+-channel-related drugs (pinacidil, 4-aminopyridine, TEA, glibenclamide) and calcium ionophore were monitored at Set 1 (PO2>60mmHg, pH>7.25), Set 2(PO2 <30mmHg,7.25>pH>7.0), Set 3(PO2<30mmHg, pH<7.0), and Set 4(PO2>60mmHg, pH<7.0) in vivo. RESULTS: At Set 1 and Set 2, the acetylcholine or PGE1-induced relaxations were suppressed by epinephrine, TXA2 or ionomycin(n=9, p<0.01). The contractility was in order of epinephrine, TXA2 and ionomycin. Cavernous relaxations to acetylcholine or PGE1 were reduced by acidosis(n=8, p<0.01). TXA2 or ionomycin did not produced contraction even with higher concentration but epinephrine maintained contractility with higher concentration at acidosis (n=7, p<0.05). Acidosis-induced relaxation was not prevented by 4-aminopyridine, TEA, or glibenclamide(n=6, p<0.05). Pinacidil did not induced relaxation at acidosis(n=6, p<0.01). CONCLUSIONS: Acidosis impairs the contractile response of cavernous smooth muscle to submaximal stimulation with erectolytics. It may be the results of the interference by(H+) with the intra and extracellular mechanisms that regulate the homeostasis of(Ca2+). Conclusively, acidosis is another limiting factor of trabecular smooth muscle contractility like in ischemic priapism.
4-Aminopyridine ; Acetylcholine ; Acidosis* ; Alprostadil ; Anesthesia, General ; Animals ; Anoxia ; Arginine ; Calcium ; Cats ; Epinephrine ; Homeostasis ; Humans ; Hypoventilation ; Ionomycin ; Male ; Muscle, Smooth* ; Penis ; Pinacidil ; Priapism ; Relaxation ; Tea ; Ventilators, Mechanical

Acute mountain sickness is an illness caused by climbing to a high altitude without prior acclimatization. Neurological consequences, like parkinsonism following acute mountain sickness without lesion of brain MRI have been reported rarely. A healthy 56-year-old man presented with dysarthria and gait disturbance. Neurological examination revealed tremor of hands, limb rigidity, and bradykinesia. The symptoms developed approximately 30 days following a 3,500 m climb of the Annapurna in the Himalayas. Brain MRI did not reveal any abnormalities including globus pallidus. The parkinsonism symptoms persisted for about 3 months before a complete recovered was made. We suggest that parkinsonism can develop after climbing to a high altitude but that the symptoms can be transient if a brain MRI detects no abnormalities.

Takayasu's arteritis is a chronic inflammatory disease of unknown etiology involving the thoracic and abdominal aorta and its major branches. In some cases other vessel such as renal arteries, coronary arteries, and even pulmonary arteries may be involved. Total aortography is very important, because the clinical features are determined by the extent and severity of the specific artery involved in the occlusive phase of the disease. We report a case of Takayasu's arteritis type IV in a 38 year man with pulmonary arterial involvement and pulmo-nary hypertension.
Aorta, Abdominal ; Aortography ; Arteries ; Arteritis* ; Coronary Vessels ; Hypertension ; Hypertension, Pulmonary* ; Pulmonary Artery ; Renal Artery ; Takayasu Arteritis*

BACKGROUND: Endotracheal intubation is a common procedure in anesthesia, which can usually be accomplished easily. However, if the attempt is unexpectedly difficult the patient may be seriously at risk. If we can anticipate difficult intubation by assessing the airways in advance, anesthesiologists can plan the safest and most effective way of managing tracheal intubation. The purpose of this study is to evaluate a correlation between airway assessment factors and laryngoscopic grades for predicting difficult intubation. METHODS: The data were collected from a total of 427(male 189) patients older than 16 years of age undergoing non-emergency surgery. Seven airway assessment factors, measured at three levels of severity, were evaluated. Airway assessment factors include inter incisor gap, Samsoon and Young classification, thyromental distance, head and neck movement, body weight, history of difficult intubation and buck teeth. RESULTS: There was a significant correlation between total airway score and laryngoscopic grade. The incidence of difficult intubations was 9 out of 427 patients. Samsoon and Young classification, thyromental distance, head and neck movement, history of difficult intubation were significantly independent airway factors for predicting difficult intubations. Increase of total airway score represents the risk of difficult intubations. CONCLUSION: We suggest that total airway score could be used as a valuable predictor for assessing difficult intubations.
Anesthesia ; Body Weight ; Classification ; Head ; Humans ; Incidence ; Incisor ; Intubation* ; Intubation, Intratracheal ; Neck ; Tooth