Uterine choriocarcinoma metastatic to kidney and brain is rare. We experienced a 55-year-old woman with complaints of right flank pain and gross hematuria. On admission urine HCG was positive and serum HCG was elevated to 42,250 mIU/ml. Intravenous pyelography revealed delayed visualization of the right kidney. Ultrasonography and computed tomography of the abdomen showed the irregular, multiloculated, mixed density lesion in the posterolateral parenchyme and a subcapsular hematoma of the right kidney. Three days after admission, the patient suffered a seizure. Computed tomography of brain revealed the mass which was the same density as the right kidney in the midbrain and medial occipital lobe of cerebrum. Cerebrospinal HCG was also elevated Under the impression or choriocarcinoma metastatic to kidney and brain, chemotheraphy (EMA- CO : etoposide, methotrexate, actinomycin D, cyclophosphamide and oncovin) was started.
Abdomen ; Brain* ; Cerebrum ; Choriocarcinoma* ; Cyclophosphamide ; Dactinomycin ; Etoposide ; Female ; Flank Pain ; Hematoma ; Hematuria ; Humans ; Kidney* ; Mesencephalon ; Methotrexate ; Middle Aged ; Occipital Lobe ; Pregnancy ; Seizures ; Ultrasonography ; Urography

Tissue welding is a potentially expectable surgical application in the field of medical laser technology. We investigated to establish the technology of laser welding and its efficacy with auxiliary stent and solder in the anastomosis of urological tubular organs including ureter and urethra of rabbits and vas of human using CO2, laser(Shaplan 1100 System). The objects consist of four groups including control group of the conventional microsuture anastomosis and three experimental groups that included group I of laser welding only, group II of laser welding with stent and group III of laser welding with solder. The overall success rate in control group was 90.7 % and in experimental groups were lower with 58.3% and 73.3% in group I and II , respectively, but higher with 95.5% group III. According to each tubular organ in experimental groups, the overall success rates in ureter, urethra and vas were 83.3%, 75.0% and 76.9% respectively, so that the thinner in the wall thickness of tubular organ revealed the higher success rate. Also, time of procedures was significantly shorter in laser groups than control group. Histological findings of laser welding showed the only localized adventitial reactions with intact subserosal layer. In conclusion, laser welding in the urological tubular organ anastomosis with auxiliary solder is not only a more simple and fast technique but also has higher success rate than conventional microsuture anastomosis.
Humans ; Rabbits ; Stents ; Ureter ; Urethra ; Welding*

Congenital urethral stricture are uncommon in boys and occurs at the junction of the endodermal primary urethra and ectodermal secondary urethra. This structure is thought to be related embryonically to failure of complete dissolution of urogenital membrane at the junction of the urogenital sinus and genital fold. Endoscopically, this lesion is recognized as a ring-form stenosis just distal to the external urethral sphincter. Congenital urethral stricture is an important cause of recurrent urinary tract infections, enuresis, failure in thrive or hematuria in pediatric urological practice. The most effective treatment of this lesion is optic internal urethrotomy under direct vision. We report two cases of 6 and 12-year-old boys hospitalized with complaints of high fever, dysuria, urgency and frequency. Six-year-old boy has grade III VUR and 12-year-old boy has grade IV VUR with Hutch diverticulum. We managed with visual internal urethrotomy only in 6-year-old boy but visual internal urethrotomy and bilateral ureteroneocystostomy in 12-year-old boy.
Child ; Constriction, Pathologic ; Diverticulum ; Dysuria ; Ectoderm ; Endoderm ; Enuresis ; Fever ; Hematuria ; Humans ; Male ; Membranes ; Urethra ; Urethral Stricture* ; Urinary Tract Infections* ; Urinary Tract*

Urinary tract obstruction is one of the most common abnormalities of the excretory system in children. It is well known that renal function is progressively deteriorated by urinary tract obstruction and partially recovered by relief of the obstruction. But the reports about the changes of the renal function in contralateral healthy kidney after relief of unilateral obstruction are rare. Thus, we investigated pre- and post-operative changes of renal function not only on the obstructed kidneys but also on the contralateral normal kidneys in twenty-two children(12 were younger than 2 years old) with unilateral hydronephrosis due to ureteropelvic junction obstruction, using 99m-Tc-DMSA renal uptake rate. A marked increase in 99m-Tc-DMSA renal uptake rate was observed in twelve cases(54.5 % ) after pyeloplasty on the obstructed kidney. Among them eight children were younger than 2 years old. In 7 children younger than 2 years old, a preoperative 99m-Tc-DMSA renal uptake rate in contralateral normal kidney was markedly decreased. Among them, marked increase in postoperative 99m-Tc-DMSA renal uptake rate was observed in 5 cases(71.4%). In other words, in 5 children younger than 2 years old, a remarkable increase of 99m-Tc-DMSA renal uptake rate after reconstructive operation was recognized not only on obstructed kidney but also on the contralateral normal kidney. These tendency could not be observed in those older than 3 years old. These results suggest that, in the young children, the obstructed kidney inhibits the contralateral normal and compensatory renal growth, and that the relief of obstruction eliminates this inhibition and causes the renal growth spur in a normal kidney. In summary, we proposed that it is essential to correct unilateral ureteropelvic junction obstruction before two years of age if an improvement of renal function not only on the obstructed kidney but also on the normal kidney is to be expected.
Child* ; Child, Preschool ; Humans ; Hydronephrosis ; Kidney ; Urinary Tract

Spontaneous rupture of kidney is a rare condition which usually presents as an acute abdomen requiring prompt diagnostic evaluation and proper therapy. We experienced a 27-year-old pregnant woman hospitalized with complaint of right flank pain. Ultrasonography and DIP (shield lower abdomen) revealed multiple sandy renal stones and right caliectasis with extravasation of contrast media through renal fornices into perirenal space. We present a case of spontaneous rupture of kidney associated with multiple renal stones during pregnancy, successfully managed with temporary insertion of ureteral catheter.
Abdomen, Acute ; Adult ; Extravasation of Diagnostic and Therapeutic Materials ; Female ; Flank Pain ; Humans ; Kidney* ; Pregnancy* ; Pregnant Women ; Rupture, Spontaneous* ; Ultrasonography ; Urinary Catheters

PURPOSE: To develop new on-line statistical program for the Korean Society for Radiation Oncology (KOSRO) to collect and extract medical data in radiation oncology more efficiently. MATERIALS AND METHODS: The statistical program is a web-based program. The directory was placed in a sub-folder of the homepage of KOSRO and its web address is http://www.kosro.or.kr/asda. The operating systems server is Linux and the webserver is the Apache HTTP server. For database (DB) server, MySQL is adopted and dedicated scripting language is the PHP. Each ID and password are controlled independently and all screen pages for data input or analysis are made to be friendly to users. Scroll-down menu is actively used for the convenience of user and the consistence of data analysis. RESULTS: Year of data is one of top categories and main topics include human resource, equipment, clinical statistics, specialized treatment and research achievement. Each topic or category has several subcategorized topics. Real-time on-line report of analysis is produced immediately after entering each data and the administrator is able to monitor status of data input of each hospital. Backup of data as spread sheets can be accessed by the administrator and be used for academic works by any members of the KOSRO. CONCLUSION: The new on-line statistical program was developed to collect data from nationwide departments of radiation oncology. Intuitive screen and consistent input structure are expected to promote entering data of member hospitals and annual statistics should be a cornerstone of advance in radiation oncology.
Administrative Personnel ; APACHE ; Humans ; Radiation Oncology* ; Statistics as Topic

PURPOSE: To develop new on-line statistical program for the Korean Society for Radiation Oncology (KOSRO) to collect and extract medical data in radiation oncology more efficiently. MATERIALS AND METHODS: The statistical program is a web-based program. The directory was placed in a sub-folder of the homepage of KOSRO and its web address is http://www.kosro.or.kr/asda. The operating systems server is Linux and the webserver is the Apache HTTP server. For database (DB) server, MySQL is adopted and dedicated scripting language is the PHP. Each ID and password are controlled independently and all screen pages for data input or analysis are made to be friendly to users. Scroll-down menu is actively used for the convenience of user and the consistence of data analysis. RESULTS: Year of data is one of top categories and main topics include human resource, equipment, clinical statistics, specialized treatment and research achievement. Each topic or category has several subcategorized topics. Real-time on-line report of analysis is produced immediately after entering each data and the administrator is able to monitor status of data input of each hospital. Backup of data as spread sheets can be accessed by the administrator and be used for academic works by any members of the KOSRO. CONCLUSION: The new on-line statistical program was developed to collect data from nationwide departments of radiation oncology. Intuitive screen and consistent input structure are expected to promote entering data of member hospitals and annual statistics should be a cornerstone of advance in radiation oncology.
Administrative Personnel ; APACHE ; Humans ; Radiation Oncology* ; Statistics as Topic

BACKGROUND: Sedation with propofol during esophagogastroduodenoscopy (EGD) has been increased. However, the use of propofol during EGD may have significant side effects such as hypoxemia and hypotension. We studied the dose of propofol for adequate sedation without side effects during EGD. METHODS: From June to August 2003, 46 healthy persons who visited St. Carollo hospital health management center for diagnostic EGD were enrolled for this study. Twenty four persons (Group A) were given a initial loading dose of propofol 60 mg (in person below 60 kg by body weight) and 80 mg (in person above 60 kg by body weight). Twenty two persons (Group B) were given a initial loading dose of propofol 80 mg and 100 mg at the same way. Additional dose of propofol which was injected once a minute until adequate sedation by 20 mg and maintenance dose during EGD were compared between two groups. Respiration rate, pulse rate, blood pressure, arterial oxygen saturation and ejection fraction of left ventricle were monitored. RESULTS: There were no significant differences between two groups in monitored parameters. Persons in group B were given significantly lower additional dose (p<0.001) and maintenance dose (p<0.05) of propofol. However total amount of propofol during EGD was not significantly different between two groups. CONCLUSION: In relatively young (under 60 years of age) and healthy persons without significant medical problem, 80 mg and 100 mg of propofol (in person below 60 kg and above 60 kg by body weight) as initial loading dose of propofol during EGD are more clinically relevant than 60 mg and 80 mg of propofol (in person below 60 kg and above 60 kg by body weight).
Anoxia ; Arterial Pressure ; Endoscopy, Digestive System ; Endoscopy, Gastrointestinal* ; Heart Rate ; Heart Ventricles ; Humans ; Hypotension ; Oxygen ; Propofol* ; Respiratory Rate

We report a case of mucinous adenocarcinoma in the ascending colon. A 55-year-old woman was admitted to Asan Medical Center due to right lower quadrant abdominal pain. On physical examination, an approximately 5X5 cm sized tender mass was palpated in the right lower quadrant. Colonoscopy revealed a fungating mass covered with gelatinous, yellow-whitish mucoid material in the ascending colon. Abdominal computed tomography showed irregular wall thickening from ileocecal valve to mid ascending colon with pericolic fat thickening. She underwent right hemicolectomy and surgical specimen revealed well differentiated tubulopapillary adenocarcinoma with mucinous background consistent with mucinous adenocarcinoma.
Abdominal Pain ; Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Chungcheongnam-do ; Colon, Ascending ; Colonic Neoplasms ; Colonoscopy ; Female ; Gelatin ; Humans ; Ileocecal Valve ; Middle Aged ; Mucins* ; Physical Examination

Background: Despite a plethora of research on the topic, there is still no solid evidence that pharmacological treatment actually reduces the risk of suicide in patients with mental illness.In this study, we aimed to assess the effect of psychotropic medications on suicidal ideation in patients with major depressive disorder (MDD) and bipolar disorder (BPD) in two age groups: less than 25 years and 25 years and older. Methods: We analyzed 312 patients with mood disorders with current suicidal thoughts or recent suicide attempts. We followed the participants from baseline for 6 months and assessed changes in suicidal ideation with Columbia-Suicide Severity Rating Scale (C-SSRS).The effect of psychotropic drug administration on suicidal ideation over time was analyzed using a linear mixed model. Results: In patients aged 25 years and older with mood disorders, suicidal ideation was more severe when using psychotropic drugs than when not using them. However, suicidal ideation decreased rapidly over time. The time-dependent reduction in suicidal ideation was accelerated when using antidepressants and sedatives/hypnotics in adult MDD, and when using mood stabilizers in adult BPD. However, this effect was not observed in participants aged less than 25 years. Conclusion Adequate psychotropic medication may reduce suicidal ideation in patients with mood disorders aged 25 years and older. Additional research on psychotropic drugs is needed to effectively reduce the risk of suicide among children and adolescents with mood disorders.