No abstract available.
Calcium* ; Diet* ; Hypercalciuria* ; Osteocalcin*

PURPOSE: Sexual differences in the incidence and crystalline composition of urinary stones in humans are well-known, but it is unclear why men have a higher incidence of calcium oxalate stones than women. We investigated the effects of male sex hormones on stone formation using an ethylene glycol (EG) - induced urolithiasis model in rats. MATERIALS AND METHODS: Adult male Sprague-Dawley rats were divided into 4 groups, each containing 10 rats. One group of rats was left untreated and served as control. The other 3 groups were fed a 1% ethylene glycol (EG) lithogenic diet for 4 weeks. Among these, one group was non-castrated, one group was castrated and one group was non-castrated and given finasteride orally. Serum testosterone, creatinine, electrolytes, 24-hour urine levels of oxalate and citrate, and creatinine clearance were measured. The crystal deposits were examined by light and polarizing microscopes. RESULTS: Testosterone promoted calcium oxalate stone formation in EG - treated rats. Finasteride administration significantly decreased urinary oxalate excretion and calcium oxalate deposition, compared with controls. Urinary citrate was significantly decreased in EG-treated rats, but was not influenced by castration or administration of finasteride. There were no significant differences in serum concentrations of creatinine, sodium, or potassium among the control and experimental groups. CONCLUSIONS: Our data suggest that testosterone promotes calcium oxalate stone formation, and that dihydrotestosterone may be partially responsible for the exaggerated hyperoxaluria in EG-treated rats. Additionally, male sex hormones have a lesser influence on urinary citrate than oxalate.
Adult ; Animals ; Calcium Oxalate* ; Calcium* ; Castration ; Citric Acid ; Creatinine ; Crystallins ; Diet ; Dihydrotestosterone ; Electrolytes ; Ethylene Glycol ; Female ; Finasteride ; Gonadal Steroid Hormones* ; Humans ; Hyperoxaluria ; Incidence ; Male* ; Nephrolithiasis* ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Sodium ; Testosterone ; Urinary Calculi ; Urolithiasis

No abstract available.

Background: Bupivacaine was introduced to be a long-acting spinal anesthetic agent. It has been argued about whether the addition of epinephrine prolongs the bupivacaine action or not. The aim of this present investigation was to find out the effect of additional epinephrine on spinal anesthesia with bupivacaine. Methods: 47 patients undergoing an operation on lower extremity were randomly allocated to 2 groups. All patients were anesthetized by subarachnoid block with 0.5% bupivacaine in 8% glucose, which was mixed with 0.2 ml of normal saline in group non-E (n=24) and 0.2 ml of 1:1,000 epinephrine in group E (n=23). We evaluated blood pressure and heart rate, the sensory and motor blockade and voiding time after spinal anesthesia. Results: The systolic blood pressure (SBP) at 8 and 10 min after anesthesia were lower in group non-E than in group E (p<0.05). The trend of decreasing diastolic blood pressure was similar in both groups. The heart rate(HR) at 2 min after anesthesia was lower in group non-E than in group E (p<0.05). The sensory block in T10 was produced faster in group non-E (7 min) than in group E (11 min)(p<0.05). And the maximal sensory block level and its reaching time was T7 and 14 min in group non-E, and T8 and 17 min in group E (p=0.12, p=0.11). Two segment regression time was 124 min in group non-E, and 184 min in group E (p=011). The onset time of motor block to Bromage scale 3 was 12 min in group non-E and 16 min in group E (p=0.06). The recovery time from complete motor block to Bromage scale 1 after maximal motor block was 263 min in group non-E, and 278 min in group E. The time at which patients voided after anesthesia was 469 min in group non-E, and 466 min in group E. Three patients urinated by using a urinary catheter in each group. Conclusions: The addition of epinephrine to bupivacaine for spinal anesthesia can slow the decrease in SBP and increase the HR at early stage of anesthesia, and slow the sensory block.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine* ; Epinephrine* ; Glucose ; Heart ; Heart Rate ; Humans ; Lower Extremity ; Urinary Catheters

STUDY DESIGN: A retrospective study. OBJECTIVES: To assess the relationship between surgical outcomes and preoperative MRI findings, a retrospective review was conducted on the surgical outcomes depending on the preoperative MRI findings including type of herniation and Modic changes. SUMMARY OF LITERATURE REVIEW: In most reports, the patients that have large disc herniation were expected to have improved surgical outcomes. However, there have been controversies regarding the outcomes and Modic changes. MATERIALS AND METHODS: The retrospective review was conducted in 82 patients who underwent a discectomy for single level lumbar disc herniation. The average follow-up period was 34.2 months. Among their preoperative baseline MRI measurements, the stage of disc herniation, degree of nerve root compression, degree of dural sac compression, and Modic change of vertebral endplate were evaluated for the subsequent comparison between the preoperative and postoperative changes and ODI score. RESULTS: Patients with extrusion or sequestration type showed significant improvements compared to the patients with protrusion type disc herniation. By degree of nerve root compression, patients with root compression showed significant improvements compared to the patients who had contact type. The degree of dural sac compression revealed no correlation with changes in the ODI score. 23 of the 82 patients, the preoperative MRI showed a Modic change. Compared to the group who did not show such a Modic change, they turned out to be unrelated to the preoperative and postoperative changes in the ODI score. CONCLUSIONS: Patients who had extrusion or sequestration type disc herniation showed a better clinical improvement than protrusion type. Patients with compression type root lesion showed better clinical improvement than contact type root lesion. No correlation was noted regarding the outcomes of the surgical treatment and degree of dural sac compression or Modic changes.
Diskectomy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

BACKGROUND: In the Republic of Korea, there had been no reports about indigenous malaria cases since 1984 until a vivax malaria case was detected in 1993. Thereafter fram 1993 to 1996, 486 malaria cases were reported. Most of the patients were soldiers in the northern militarized zone. However, since 1997, several patients with malaria were detected in Kang Hwa where there had previously been no report of malaria cases. It is our intent to report the 16 cases diagrnosed in Kang Hwa Community Hospital from January 1, 1997 to August 10, 1998. METHODS: Medical records of the malaria cases from January 1, 1997, to August 10, 1998 in Kang Hwa Community Haspital were reviewed. All of the patients had no histories of traveling abroad, drug abuse or blood transfusion. They were all civilians. Laboratory studies including blood cell count, routine chemistry and platelet-associated IgG(PAIgG) and abdominal sanography were taken. RESULTS: All of the patients were diagnosed with malaria by blood smears. Common symptams were fever(100%), headache(94%), rigors(81%), myaJgia(56%), nausea or vomiting(44%), alternate day fever (25%), left flank pain(19%), diarrhea(13%), and abdominal pain(13%). Splenomegaly was detected in 92% of cases by sonography. Laboratory findings included leukopenia(37.5%), anemia(37.5%) and thrombocytopenia(81.3%). Platelet-associated IgG was elevated in 1 of 5 thrombocytopenic patients who had had the laboratory study performed. All recovered withaut complications. CONCLUSIONS: Cases of indigenous malaria have been progressively increasing in the Republic of Korea. Fortunately, patients responded well to treatment, but continued interest will be required in the future.
Blood Cell Count ; Blood Transfusion ; Chemistry ; Fever ; Hospitals, Community ; Humans ; Immunoglobulin G ; Malaria ; Malaria, Vivax ; Medical Records ; Military Personnel ; Nausea ; Republic of Korea ; Splenomegaly ; Substance-Related Disorders ; Thrombocytopenia

PURPOSE: Citrate is a well recognized inhibitor of the formation of urinary calcium stones, and hypocitraturia plays an important role in the recurrent calcium urolithiasis. We evaluated the biochemical effects of dietary natural fruit juice in calcium stone formers with hypocitraturia in an attempt to decrease or eliminate the need for pharmacological therapy. MATERIALS AND METHODS: This prospective study included 26 women and 34 men (mean age 42.5 years) with documented calcium urolithiasis. Among 60 patients, hypocitraturia(<320mg/24-hour urine) was detected in 40. Forty patients with hypocitraturia were divided into each 20 patient groups, one for orange juice and the other for grape juice. Twenty patients without hypocitraturia were also divided into each 10 patient groups for the controls. Each bottle of orange and grape juice measures 180ml in volume, which contains citrate of 1.22gm and 0.65gm, respectively. All 60 patients consumed juices at regular intervals, 4 bottles a day for 14 days. Blood and 24-hour urine sample were obtained for biochemical analysis after 7 and 14 days of juice therapy and compared to the baseline values of pre-juice therapy. RESULTS: The administration of natural fruit juice, either orange or grape, did not result in any significant change in serum biochemical study in all 60 patients(p>0.05). But, levels of urinary citrate were significantly increased in 29(97%) patients in orange juice group(n=30) and were normalized in 19(95%) patients with hypocitraturia. In grape juice group(n=30), levels of urinary citrate were significantly increased in 28(93%) patients and were normalized in 18(90%) patients with hypocitraturia. But, in hypocitraturic patients taking orange juice, urinary oxalate increased in 12(60%) patients. The natural juice therapy was well tolerated. Some G-I trouble occured(11%) but did not require cessation of therapy. Cirtate supplementation with natural fruit juice increased urinary citrate more than 1.5-2 times, but increased urinary oxalate value in orange juice group with hypocitraturia. CONCLUSIONS: Natural fruit juices, orange and grape, are well tolerated dietary source of citrate, and may be useful as adjunctive treatment for patients with hypocitraturic calcium urolithiasis.
Calcium* ; Citric Acid ; Citrus sinensis ; Female ; Fruit* ; Humans ; Male ; Prospective Studies ; Urolithiasis* ; Vitis

EDAP-LT01 ESWL underwent 71 treatments in 20 patients with urinary stone of solitary kidney between February 25, 1987 and August 18, 1988. 1. The sex ratio was about 2:1, 13(65.0%) in male and 7(35.0%) in female patients. The average patient age was 50 years with a range of 23 to 65 years. The previous nephrectomy was owing to urinary tract stone in 19(95.0% ) and transitional cell carcinoma of renal pelvis in 1 (5.0%). 2. The duration of hospitalization was required from 2 to 7 days and the average post-ESWL stay was 1.5 days. 3. The treated stone locations were kidney in 18(90.0% ) ;calyx in 12(60.0% ) and renal pelvis in 6(30.0%) and ureter in 2(10.0%) ;upper ureter in 1(5.0% ) and lower ureter in 1(5.0%) There were multiple renal stones in 4(20.0% ).The average stone size was 1.6cm with a range of 0.7 to 4.1cm. 4. The average numbers of treatrnent were 2.7 sessions and the average treatment time was 30.2 minutes with a range of 17 to 42 minutes. The average storage was required 180 in one session. Of the patients, 4(20.0% ) were complained severe pain but treatment interruption or anesthesia were not required. 5. The success rate among 11 patients who completed ESWL treatment were 100.0% in 0.7-1.0cm, 60.0% in 1.0-2.0cm, 100.0% in 2.0-3.0cm and 77.8% in calyceal stones, 100.0% in renal pelvis stones. 100.0% in lower ureteral stones. Thus, the total average success rate was 81.8 %. 6. The method of pre-ESWL additional manipulation was used a upper ureteral stone 'push-up' in 1(5.0%). The post-ESWL additional measures were made in 4(20.0 % ) ;'push-up' & double -J stenting in 1(5.0% ) and double-J stenting in 3(15.0% ). The causes of failed ESWL were impacted stone in 1 and 'push-up' failure in 1. 7. None of the patients had significant changes in renal function by shock waves. ESWL complications were not required admission and medical management. Therefore, we confirmed that EDAP-LTOI piezoelectric ESWL is not influenced on renal function and is a safe, effective method for treatment of urinary stones in patients with a solitary kidney.
Anesthesia ; Carcinoma, Transitional Cell ; Female ; Hospitalization ; Humans ; Kidney Pelvis ; Kidney* ; Lithotripsy* ; Male ; Nephrectomy ; Sex Ratio ; Shock* ; Stents ; Ureter ; Urinary Calculi*

No abstract available.
Baroreflex* ; Cyclosporine* ; Rabbits*

From February 1987 to December 1990, 654 patients with renal stones completed the multiple ESWL monotherapies using the EDAP-LT01 piezoelectric lithotriptor. The location of stones was calyx in 452 patients. pelvis in 1O8. calyx and pelvis in 94 and the stone size ranged from 0.6 to 4.8cm (mean 1.9cm). The number of treatment sessions was 2 to 19 sessions (mean 4.7) with 72.2% of re-treatment rate. In accordance with increment of stone size, number of treatment increased but success rate decreased; 2.8 sessions. 96.2% for 0.6-<1 cm. 4.4, 93.2% for 1-<2 cm, 5.5. 87.7% for 2-<3 cm. 6.3, 65.5% for 3-<4 cm and 6.4, 58.8% for stones larger than 4 cm. Supposing 654 patients had been completed by 5 sessions only. 67.9% of success rate would have been expected. But. 88.4% (578,654) of success rate was obtained by multiple treatment up to 19 sessions, adding 20.5%. Auxiliary ureteral manipulations were required in 88 (13.5%) patients and there were no significant complications. Therefore. multiple ESWL monotherapy is considered to be a efficient. safe procedure as the first applicable method for treatment of larger renal stones and to extend the indications of ESWL for renal stone.
Humans ; Pelvis ; Ureter