A diagnostic accuracy was evaluated in total of 65 patients with acute painful scrotal swelling who underwent ultasonography and/or radionuclide scrotal imaging as an initial diagnostic modality. An accuracy with radionuclide scrotal imaging was 77.8% (7/9) in patients with testicular torsion. 92.0% (23,25) in those with epididymoorchitis. Ultasonography showed the diagnostic accuracy of 100% (15,15) in patients with epididymoorchitis. 66.7% (2/3) in those with testicular torsion and 87.5% (14,16) in those with scrotal trauma. One patient with the torsion of appendix testis was not diagnosed by radionuclide scrotal imaging preoperatively. Two of 8 patients (25%) with testis rupture were misdiagnosed by ultrasonography. Scrotal ultrasonography and nuclear medicine scan are useful adjuncts in diagnosis of torsion of appendix testis and testicular abscess. A possibility of misleading for diagnosis should not be overlooked. Scrotal exploration is mandatory in patients whose clinical pictures are not correlated with radiographic findings.
Abscess ; Acute Pain ; Appendix ; Diagnosis* ; Humans ; Nuclear Medicine ; Rupture ; Spermatic Cord Torsion ; Testis ; Ultrasonography*

Transurethral microwave thermotherapy(TUMT) is a new treatment modality for benign prostatic hyperplasia(BPH). Among those BPH patients who are treated by TUMT, 32 patients who are followed up appropriately are selected to analyze the effectiveness of TUMT. Patients were treated one time, for 1 hour. without sedation on an outpatient basis. All patients tolerated the treatment well without secondary effect Toxicity was mild. consisting of bladder spasm, urinary retention, dysuria, hematuria and urethral pain. Significant increase in urine flow rate(from 6.71 ml/sec to 11.2 ml/sec), decrease in post-void residual urine volume (from 82.2 ml to 28.6 ml) and decrease in frequency of nocturia (from 3.1 to 1.7) were observed. TUMT represents a safe and promising out-patient approach to treatment of BPH, particularly for patients who are not candidates for conventional surgical approaches because of medical or personal reasons.
Dysuria ; Hematuria ; Humans ; Microwaves* ; Nocturia ; Outpatients ; Prostatic Hyperplasia* ; Spasm ; Urinary Bladder ; Urinary Retention

Torsades de pointes is characterized by paroxysms of ventricular tachycardia at rates typically greater than 200 beats/min in which QRS morphology shows alternating polarity in an undulating pattern so that the complexes appear to be twisting about the beseline;this arrhythmia is virtually always associated with prolongation of the QT interval. Its importance lies not in its unusual structure but in the potentially fatal outcome if conventional treatment is administred. Torsades de pointes was diagnosed in 4 patients;the first with hypokalemia, the second with congenital QT prolongation syndrome, the third with amiodarone, the fourth with organophosphorous and hypokalemia. Treatment of these patients consisted of potassium supply, isoproterenol, lidocaine, phenobarbital, tenormin, phenytoin, cardioversion, atropine. Three patients improved successfully, but one patient died, as a direct result of the ensuing ventricular fibrillation and cardiac arrest on one hour after admission.
Amiodarone ; Arrhythmias, Cardiac ; Atenolol ; Atropine ; Electric Countershock ; Fatal Outcome ; Heart Arrest ; Humans ; Hypokalemia ; Isoproterenol ; Lidocaine ; Phenobarbital ; Phenytoin ; Potassium ; Tachycardia, Ventricular ; Torsades de Pointes* ; Ventricular Fibrillation

To evaluate the antihypertensive effects of serotonin antagonist, ketanserin, a daily dosage of 10~40mg (18.9+/-6.8 mean+/-SE) was administered to 22 patients with essential hypertension and aged 55??1 years (64+/-7.7 mean+/-SE) for 12 weeks. After 12 weeks of ketanserin treatment mean blood pressure decreased from 177.9+/-11.9 to 15.7+/-15.3mmHg in systole and from 104.2+/-7.4 to 88.4+/-7.9mmHg in diastole (P<0.001). There was no significant change in heart rates with ketanserin treatment. The antihypertensive treatment with ketanserin was effective in 18 patients(81.8%) and ineffective in 4 patients (18.2%). Adverse reactions such as drowsiness (8.7%), edama (4.3%) and weakness (4.3%) were noted, but all were mild and transient. This results suggest that ketanserin is an effective and safe antihypersive agent in the treatment of essential hyperension.
Aging* ; Blood Pressure ; Diastole ; Heart Rate ; Humans ; Hypertension* ; Ketanserin* ; Serotonin ; Sleep Stages ; Systole

Sebaceous trichofolliculoma, which is a variant of trichofolliculoma, is a rare disease that clinically show a centrally depressed lesion usually singly on the nose, and histologically a centrally located cavity, lined by squamous epithelium, with numerous sebaceous lobules connected to them. We describe a case of sebaceous trichofolliculoma in a 27-year-old woman who had several brown papules on the nose. We think that this is the first report of sebaceous trichofolliculloma in Korean literature.
Adult ; Epithelium ; Female ; Humans ; Nose ; Rare Diseases

PURPOSE: To investigate the change in intraocular pressure (IOP) of normal healthy eyes at different positions while performing sit-ups. METHODS: Twenty normal healthy eyes of 20 subjects were studied. IOP was measured while in the 'sitting upright', 'supine', and 'head-down' position to determine postural effect on IOP when executing a sit-up. Measurements were taken after the performance of a sit-up and during the performance of a sit-up, in both the head up and head down positions to test the effect of the exercise on the IOP. In addition, the IOP after an 'isometric exercise with Valsalva's maneuver in the supine or head-down position' was measured to determine the actual IOP during a sit-up. RESULTS: The postural change from sitting upright to tilting the head in a downward position caused the IOP to increase. After the performance of a sit-up, the IOP decreased in both the upright and supine positions, though IOP increased in the head-down position. After the isometric exercise with Valsalva's maneuver, IOP increased significantly regardless of position. CONCLUSIONS: IOP increased significantly during sit-ups, but decreased afterward. Future studies should be performed to evaluate the long-term effects of IOP change during and after sit-ups with respect to the prognosis of glaucoma.
Exercise ; Eye ; Glaucoma ; Head ; Intraocular Pressure ; Posture ; Prognosis ; Supine Position ; Valsalva Maneuver

Merkel cell carcinoma is a rapidly growing malignant neuroendocrine tumor with a high rate of recurrence and metastasis for which wide excision is recommended. About 10 cases of spontaneous regression have been reported in the world. We report a case of Merkel cell carcinoma which showed spontaneous regression. The patient was a 68-year-old woman with a two-month history of a rapidly enlarging dusky red tumor on her right cheek. Microscopically, the tumor cells were uniform with round to oval shaped nucleus and scanty cytoplasm, and showed trabecular arrangement. Ultrastructually, dense core neurosecretory granules 100 to 200nm in diameter were found in the cytoplasm of tumor cells. As far as we know, this is the first case of the spontaneous regression of the tumor in the country.
Aged ; Carcinoma, Merkel Cell* ; Cheek ; Cytoplasm ; Female ; Humans ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Recurrence

BACKGROUND: Gastric cancer remains the main cause of cancer-related death in Korea. Accurate preoperative staging of gastric cancer is essential to predict prognosis and to plan optimal treatment. Although there are many reports dealing with the diagnostic values of conventional methods, controversies are still present especially in the field of preoperative staging. In this study, we evaluated the accuracy of gastroscopy and upper gastrointestinal series(UGI) for diagnosis of gastric cancer, and determined the usefulness of ultrasonography and computed tomography for preoperative staging. METHODS: One hundred twenty-three patients, who underwent operation from Aug. 1991 to Mar. 1995 under the diagnosis of gastric cancer were analyzed. We excluded 15 patients because their postoperative definitive stagings were undetemined. RESULTS: 1) Among 123 patients, the proportion of early gastric cancer was 26.0%(32/123) and that of the advanced gastric cancer was 74.0%(91/123). 2) The sensitivity of endoscopic diagnosis of gastric cancer was 96.7%(119/123), and the accuracy to determine the depth of invasion was 82.9% (102/123). 3) The sensitivity of UGI study for gastric cancer was 89.9%(98/109), and the accuracy to determine the depth of invasion was 61.5%(61/109). 4) The sensitivity of abdominal ultrasonography to detect the tumor was 11.3%(8/71), the accuracy to determine the T stage was 29.2%(28/96), and the sensitivity and specificity to detect lymph node metastasis was 13.6%(8/59), 100%(37/37), respectively. 5) The sensitivity of abdominal CT to detect the tumor was 74.3%(26/35), the accuracy to determine the T stage was 32.5%(13/40), and the sensitivity and specificity to detect lymph node metastasis were 34.5%(9/29), 72.7%(8/11), respectively. 6) The accuracy of preoperative staging was 45.5%(56/123). The 49.6%(62/123) of gastric cancer was downstaged, whereas only 4.1%(5/123) was overstaged. CONCLUSION: Our results show that high accuracy for diagnosis of gastrie cancer with the gastroscopy and UGI. However preoperative staging with ultrasonography and computed tomograpy was often underestimated, which could be concluded that the usefulness of the radiologic methods was limited.
Diagnosis* ; Gastroscopy ; Humans ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive Pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. 99mTc-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared 99mTc-DTPA radioaerosol inhalation scan with 99mTc-MAA perfusion scan in predicting postoperative lung function. METHOD: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneumonectomy FEV1=Preop FEV1x% of total function of lung to remain RESULTS: 1) The inhalation scan showed good correlations between measured and predicted FEV1, FVC and FEF25-75%. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted FEV1, FVC and FEF25-75%. (correlation coefficiency; 0.86, 0.72, 0.97 respectively). 3) Among three parameters, FEV1 showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. CONCLUSION: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function although the former showed a better correlation in FVC.
Humans ; Inhalation* ; Lung ; Lung Neoplasms ; Perfusion* ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Respiratory Insufficiency ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: Otitis media, with effusion has been known to require long term medical treatment. When medical treatment fails, myringotomy with or without ventilation tube insertion needs to be performed, but the duration of middle ear ventilation with myringotomy is very limited. The insertion of ventilation tubes may also cause some complications, and may require general anesthesia when performing at a young age. The purpose of this report is to see if myringotomy using CO laser can be used as an effective tool in the treatment of otitis media with effusion. MATERIALS AND METHODS: We retrospectively studied 66 ears of patients who went through myringotomy using CO laser between March, 1998 and May, 1999. We analyzed myringotomy size, patency time, recurrence and cost effectiveness. RESULTS: The average size of myringotorny was 2.1 mm in diameter. It remained patent for as long as 1.9 weeks in average. All myringotomy sites were healed without persistent perforations. Average recurrence rate and time were 27% and 3.2months, respectively. The medical treatment is expensive and needs more frequent follow-ups, but laser treatment is cheaper and requires less frequent follow-ups. CONCLUSIONS: CO laser myringotomy is a safe and cost effective procedure which can be done easily at the office in most of the cases.
Anesthesia, General ; Cost-Benefit Analysis ; Ear ; Follow-Up Studies ; Humans ; Middle Ear Ventilation ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Recurrence ; Retrospective Studies ; Ventilation