No abstract available.
Ankle Fractures* ; Ankle*

A 25 year old patient who had low back pain and sciatica was diagnosed as having a lumbar intraspinal extradural synovial cyst adjacent to a facet joint between the third and fourth lumbar vertebrae. The extradural defects defined with positive contrast myelography and postmyelographic computed tomographic scanning were posterolateral to the dural sac. Biopsy revealed the findings compatible with synovial cyst. Treatment consisted of laminectomy and surgical excision of the cyst.
Biopsy ; Humans ; Laminectomy ; Low Back Pain ; Lumbar Vertebrae ; Myelography ; Sciatica ; Synovial Cyst ; Zygapophyseal Joint

The formation of cysts in the parameatal area has been reported as rare. A parameatal urethral cyst is a congenital anomaly and has been reported even more rarely in adults. In this study, we present two cases of parameatal urethral cyst and aim to investigate their causes and treatment methods. The extent of cyst spread was assessed using a urethroscope prior to cyst excision, and the excision range was determined accordingly. Complete excision of the cyst was performed as the treatment for parameatal urethral cyst. Both patients were adults who presented with urinary symptoms related to the cyst, necessitating the excision of the congenital parameatal urethral cyst.

PURPOSE: The aim of this study was to evaluate the efficacy of a terpene mixture compared with alpha-blocker in patients with chronic pelvic pain syndrome (CPPS). MATERIALS AND METHODS: Patients diagnosed with CPPS were included in this study. The patients were randomly placed into three groups. Group 1 was treated with levofloxacin alone (36 patients), group 2 was treated with levofloxacin and alfuzosin (33 patients), and group 3 was treated with levofloxacin and terpene mixture (34 patients) for 8 weeks. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was evaluated in patients in each group at the beginning of the study and after 8 weeks of treatment. RESULTS: Pain domain, urinary domain, quality of life domain, and total score on the NIH-CPSI were not significantly different at the initial visit. After treatment with each medication, improvements on the pain domain and total score of the NIH-CPSI were better in group 3 than in group 1 or group 2 (p<0.05). Improvement on the urinary domain of the NIH-CPSI was better in group 2 than in group 1 or group 3 (p=0.014). Changes in the quality of life domain of the NIH-CPSI were not significant among the three groups. CONCLUSIONS: This study suggests that the terpene mixture and alpha-blockers may have significant benefit for symptomatic relief, especially in the pain and urinary domains, respectively.
Adrenergic alpha-Antagonists ; Humans ; National Institutes of Health (U.S.) ; Ofloxacin ; Pelvic Pain ; Prospective Studies ; Prostatitis ; Quality of Life ; Quinazolines ; Terpenes

No abstract available.
Catheters*

PURPOSE: A 5-alpha-reductase inhibitor(5 alpha RI) can induce apoptosis and decrease the prostatic volume in patients with benign prostatic hyperplasia (BPH). In this study we assessed the expression of survivin and bcl-2 in the epithelium of BPH patients treated with finasteride. MATERIALS AND METHODS: Group 1 consisted of 39 patients who underwent transurethral resection of the prostate(TURP) without medication and Group 2 consisted of 31 patients who underwent TURP and were treated with finasteride for more than three months. The mean age of both groups of patients was 73.03+/-7.02 years and 74.71+/-5.99 years, respectively. Immunohistochemical staining for survivin, bcl-2 and ki-67 was performed in prostatic tissues. The percentage of cells that expressed survivin and bcl-2 were classified into four categories based on the staining intensity. The expression of ki-67 in nuclei using 10 random cells per specimen was obtained. The relationship between 5alphaRI and the expression of survivin, bcl-2 and ki-67 was analyzed. RESULTS: The total mean prostate volume of group 1 patients and group 2 patients was 45.51ml and 37.23ml, respectively (p<0.001) and the mean serum total prostate-specific antigen(PSA) level of group 1 patients and group 2 patients was 5.09ng/ml and 3.75ng/ml, respectively(p=0.105). Decreased expression of survivin and bcl-2 in specimens from group 2 patients was observed as compared to the level of expression in group 1 patients(p<0.001, p=0.001). Expression of ki-67 determined in samples from both groups was not significantly different(p=0.345). CONCLUSIONS: We suggest that finasteride may induce apoptosis of prostatic epithelial cells in BPH patients by reducing the expression of survivin and bcl-2. These findings may indicate a reduction of prostatic volume.

PURPOSE: The aim of this study was to evaluate the effect of periurethral prostatic calculi on lower urinary tract symptoms(LUTS) at the initial visit and after treatment with an alpha-blocker in benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 223 male patients with LUTS were studied. Group 1 consisted of 81 patients with periurethral prostatic calculi within 5 mm from the prostatic urethra of the transitional zone, as determined by transrectal ultrasound. Group 2 consisted of 142 patients without periurethral prostatic calculi within 5 mm from the prostatic urethra. The International Prostate Symptom Score(IPSS), maximal urinary flow rate (Qmax) and post voided residual urine(PVR) were measured in patients of both groups at the beginning of the study and at eight weeks after the treatment with 4 mg doxazosin gastrointestinal therapeutic system (GITS). RESULTS: Voiding, storage and the total IPSS for Group 1 patients were higher than for Group 2 patients(p>0.05). Quality of life(QoL), Qmax, and PVR were not significantly different at the initial visit. After treatment with 4 mg doxazosin GITS, an improvement of voiding, storage and the total IPSS for Group 2 patients was seen as compared to Group 1 patients (p<0.05). The mean improvement of QoL was 0.44+/-0.73 for group 1 patients and 1.13+/-0.82 for group 2 patients(p<0.001). The mean change of Qmax was 1.02+/-1.40 ml/sec for Group 1 patients and 1.52+/-1.84ml/sec for Group 2 patients(p=0.035). Changes of PVR were not significant between the two groups. CONCLUSIONS:This study suggests that the periurethral prostatic calculi may aggravate lower urinary tract symptoms and decrease the effect of alpha- blockers.
Male ; Humans

PURPOSE: We investigated the effect of the level of spinal cord injury and urinary catheterization on sexual function and activity in male patients with upper motor neuron (UMN) injury. MATERIALS AND METHODS: We reviewed patient's chart, radiologic and urodynamic study. We interviewed patient's sexual activity according to educational status, economic and marriage state, occupation, duration of spinal cord injury and pattern of voiding. A total of 114 male patients with neurogenic bladder due to UMN injury were included in the study. Group 1 consisted of 33 patients who underwent a clean intermittent catheterization (CIC) regimen and group 2 consisted of 81 patients with a suprapubic catheter, condom catheter, or Foley catheter. A detailed sexual behavior was taken for all patients to complete a questionnaire including the 5-item version of the International Index of Erectile Function (IIEF-5). RESULTS: Satisfaction with intercourse (p=0.037) and total score (p=0.032) on the IIEF-5 were significantly higher in group 1 than in group 2. The other items on the IIEF-5 did not differ significantly between the groups. When the subjects were stratified according to level of spinal cord injury, 8 patients (18.6%) with cervical cord injury had no sexual activity, whereas 24 patients (33.8%) with non-cervical-cord injury did (p=0.048). Patients with no sexual activity were 12.1% (4/33) of the patients in the CIC group and 34.6% (28/81) of the patients who underwent other regimens (p=0.016). CONCLUSIONS: Our results demonstrate that level of spinal cord injury and urinary catheterization may influence the sexual activity of male patients with UMN injury. Our results suggest that the CIC regimen had a positive effect on the sexual activity of these patients.
Catheters ; Condoms ; Educational Status ; Erectile Dysfunction ; Humans ; Intermittent Urethral Catheterization ; Male ; Marriage ; Motor Neurons ; Occupations ; Sexual Behavior ; Spinal Cord ; Spinal Cord Injuries ; Urinary Bladder, Neurogenic ; Urinary Catheterization ; Urinary Catheters ; Urodynamics

Cervicomedullary junction arteriovenous malformation(AVM) is extremely rare. The authors present a case of a cervicomedullary junction AVM in a 31-year-old woman presenting with recurrent intraventricular hemorrhage(IVH). Magnetic resonance imaging revealed the AVM(of a size of approximately 2X2.5X4cm) extending from a lower medulla to C2-3 level. Vertebral angiography demonstrated a tightly coiled vascular mass with multiple feeders (radiculomedullary arteries) and irregular-shaped aneurysm at distal part of feeder originating at right C-1 level. The patient underwent superselective embolization of upper nidus and the aneurysm. The pertinent literature is reviewed, and diagnostic and therapeutic implications are discussed.
Adult ; Aneurysm ; Angiography ; Arteriovenous Malformations ; Female ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging

Cholesterol granuloma of frontal bone is a rare disease which usually occurs at the lateral part of the supraorbital ridge. This expanding lesion grows slowly and extends into the orbit and anterior cranial fossa. The most common symptom is proptosis. This granuloma is composed of a granulomatous reaction surrounding cholesterol crystals. Surgical treatment involves aspiration of contents and stripping or curettage of the lining which is highly successful. We experienced a case of cholesterol granuloma of frontal bone with huge intracranial extension, which was cured by surgical removal. The clinical features, radiologic, and pathologic finding were discussed and the pertinent literatures were reviewed.
Cholesterol* ; Cranial Fossa, Anterior ; Curettage ; Exophthalmos ; Frontal Bone* ; Granuloma* ; Orbit ; Rare Diseases