Advances in laser technology have resulted in the creation of a new field of medical therapy. By virtue of the hyperdermic effects that can occur when intense energy of laser light is absorbed and transformed into heat, some lasers can be used to destroy tissue by vaporization or coagulation. The technology to allow extensive use in urology has only been recently perfected with the development of flexible light guides adaptable to standard urologic instruments. The Nd_YAG lasers can be attached to these urologic instruments and transmit through the water or the urine, so it has been prevailed in urologic disease, especially bladder tumor. We used the Nd_YAG lasers for the treatment of 25 patients with bladder tumor that admitted to the department of urology, Ewha Womans University Hospital during the period from October, l984 to July, 1986. The Nd_YAG lasers could be attached to the standard urologic instruments easily, so its use was very convenient and almost all portion of bladder wall could be irradiated. Intraoperative and postoperative bleeding was absent and indwelling of catheter wasn`t needed. During operation the obturator nerve reflex didn`t occur and the Jepth of coagulation could be controlled, so the risk of vesical perforation was almost nil. One year recurrence rate and progression rate to invasive tumor of 21 superficial bladder tumor patients was 28.6% and 4.8%, local recurrence didn`t occur in all patients. The main disadvantage of lasers was the incapability to get the pathologic specimen for staging and grading of tumor. Although laser therapy alone cannot obtain tissue specimen, it has various advantages and concomitant use with TUR increases the effectiveness of tumor therapy. So the lasers will act as an important role in the treatment of bladder tumor.
Catheters ; Female ; Hemorrhage ; Hot Temperature ; Humans ; Laser Therapy ; Lasers, Solid-State* ; Obturator Nerve ; Recurrence ; Reflex ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urologic Diseases ; Urology ; Virtues ; Volatilization ; Water

No abstract available.
Bowen's Disease ; Foot

Acute scrotum is any pathologic condition of the scrotum or intrascrotal contents that requires emergency medical or surgical management. Management of each disease entity is different, but the differential diagnosis is very difficult. So many testes had been lost due to delay of the adequate surgery and unnecessary explorations had been taken under the misdiagnosis. Clinical observations were carried out on 59 patients with acute scrotum admitted to the department of urology, Ewha Womans University Hospital during 10 years from April, 1976 to March, 1986. There were 36 patients with acute epididymitis, 6 spermatic cord torsion and 17 scrotal trauma, the mean age was 32.6 year old in acute epididymitis, 12.8 spermatic cord torsion and 23.5 scrotal trauma. Symptoms and signs showed no significant difference from each disease entity, but Prehn`s sign was somewhat useful to differentiate each one. In half patients with spermatic cord torsion that had arrived to the hospital within 24 hours from onset of symptom, the testes could be saved. Testicular scan with 99mTc-perte- chnetate was performed in 14 patients and the diagnostic accuracy was 93%, 21 patients with acute epididymitis had urinary tract infection and spermatic cord torsion occurred in 2 patients with cryptorchidism.
Cryptorchidism ; Diagnosis, Differential ; Diagnostic Errors ; Emergencies ; Epididymitis ; Female ; Humans ; Male ; Scrotum* ; Spermatic Cord Torsion ; Testis ; Urinary Tract Infections ; Urology

Sporotrichosis is a chronic infection that follows accidental implantation of the fungus Sporothrix schenckii into the skin. The infection begins with skin trauma under conditions when conidia may be present. A 48-year-old woman presented with a 5-year history of an 8X 12 cm sized, centrally depressed, erythematous plaque on the left wrist. She had been treated with antifungal agents at an other hospital for about 6 months but there was no improvement. The histopathological findings showed an infiltration of mononuclear cells and tuberculoid structures on the whole dermis and subcutis. According to the histopathological findings and clinical manifestations, she was diagnosed as having lupus vulgaris. There was much improvement of the lesion after antituberculous therapy. However, 2 months later she developed asymptomatic multiple erythematous papules around the lesion of lupus vulgaris and along the lymphatic drainage of the left arm. The histopathological findings of the newly developed lesion showed a granulomatous reaction and an infiltrate of acute and chronic inflammatory cells. Moist and creamy colonies were changed into brown-to-black ones with a leathery appearance with age. This appearance and clinical manifestations confirmed the diagnosis of lymphocutaneous sporotrichosis. This clinical appearance reflects that the sporotrichosis developed on the ulcerative lesion or biopsy site of lupus vulgaris.
Antifungal Agents ; Arm ; Biopsy ; Dermis ; Diagnosis ; Drainage ; Female ; Fungi ; Humans ; Lupus Vulgaris* ; Middle Aged ; Skin ; Spores, Fungal ; Sporothrix ; Sporotrichosis* ; Ulcer ; Wrist

Sclerema neonatorum is an uncommon and fatal disease which encountered in premature & debilitated newborn infants. Recently we experienced a case of sclerema neonatorum in premature infant with congenital heart disease which was confirmed by autopsy. We present a case with a brief review of literatures.
Autopsy ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Infant, Premature ; Sclerema Neonatorum*

A case of pycnodysostosis in 12 years old girl was presented with a brief review ofliterature. This patient was admitted to our pediatric dept. of N.P.H. with chief complaints of loss of appetite and respiratory difficulty. She was characterized by a peculiar face with anterior bossing, exophthalmos, opened anterior fontanel and coronal suture and dwarfism. So bone series was performed and showed character of pycnodysostosis such as opened anterior fontanel and coronal suture, receding mandibular angle, inoreased bone density with narrowing bone marrow and acrcosteolytica on distal phalanx. But she died on the 25 th hospital day due to chronic renal failure.
Appetite ; Bone Density ; Bone Marrow ; Child ; Cranial Fontanelles ; Dwarfism ; Exophthalmos ; Female ; Humans ; Kidney Failure, Chronic ; Pycnodysostosis* ; Sutures

No abstract available.
Uterine Prolapse*

PURPOSE: To evaluate the usefulness of magnetic resonance imaging (MRI) for assessing fracture types and soft tissue injuries associated with tibial plateau fractures. MATERIALS AND METHODS: MRI was performed in 38 patients with tibial plateau fractures, each of which was classified according to the Schatzker system. We evaluated MR images and assessed the prevalence of each fracture type and accompanying soft tissue injuries. We also assessed whether ligamentous injury correlated with the extent of articular depression, splitting, and comminution. In 24 patients, diagnosis was based on MRI and operative or arthroscopic findings, and in 14 patients, on MRI alone. RESULTS: The totals of fracture types I, II, III, IV, V and VI were 4 (11 %), 15 (39 %), 6 (16 %), 4 (11 %), 4 (11%), and 5 cases (13 %), respectively. In 30 cases (79 %), there were associated ligamentous or meniscal injuries. Medial collateral ligaments and lateral menisci were injured in 17 (45 %) and 14 cases (37 %), respectively. Type II and IV fracture patterns were associated with soft tissue injuries in 14 of 15 cases (93 %) and 4 of 4 cases(100 %), respectively. As the extent of articular depression increased and the extent of bony comminution decreased, there was an increased prevalence of accompanying ligamentous injuries. CONCLUSION: In tibial plateau fractures, MR imaging is a useful diagnostic modality for the evaluation of both fracture type and accompanying ligamentous or meniscal injuries.
Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Soft Tissue Injuries*

Simultaneous occurrence of remote intracerebral hemorrhage (ICH) and intracranial aneurysmal subarachnoid hemorrhage is very rare. We report on a case of concurrent hypertensive ICH at the left thalamus and rupture of an intracranial aneurysm at the bifurcation of the single A2 segment of the anterior cerebral artery in a 64-year-old woman, which was clipped previously, with review of the literature. To our knowledge, this is the first case report demonstrating bleeding of previously clipped aneurysm with simultaneous hypertensive ICH. Hypertensive crisis following ICH seems to have provoked rupture of the residual aneurysm.
Aneurysm ; Anterior Cerebral Artery ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhage, Hypertensive ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage ; Thalamus

Congenital ureteral valves are transeverse folds of redundant mucosa which contains smooth muscle fibers and are very rare disease. We observed one case of congenital ureteral valve in 2-year old boy with hydronephrosis, which was treated by segmental resection and tubeless end-to-end anastomosis of ureter. Herein we reported a case of congenital ureteral valve with a review of the literatures.
Child, Preschool ; Humans ; Hydronephrosis ; Male ; Mucous Membrane ; Muscle, Smooth ; Rare Diseases ; Ureter*