Cystoscopy is important in staging of cervix cancer. However, there have been controversies about its routine use, interpretation of the result and necessity of biopsy during cystoscopy. Herein we analysed 1,049 cases. Among 1,049, 53 abnormalities (5.1 %) were found.; 22 grossly visible tumor invasion (2.1 %), 30 bullous edema (2.9 %), 1 transitional cell carcinoma (0.1 %). Transurethral biopsy was done on 14 cases with gross tumor invasion and 13 (92.9 %) showed microscopic bladder mucosa invasion, all of which were in from stage II b to IV. Bullous edema was analyzed by biopsy results, operative findings and computed tomography scan in 25 cases.; 13 bladder muscle invasion (52 %), 2 bladder mucosa invasion (8%), 5 normal bladder wall (20 %), 5 nonspecific inflammation (20 %). However, cystoscopic biopsy was unreliable in evaluation of bullous edema. Biopsy confirmed bladder mucosa invasion were found in 15 of 1,049 (1.4 %).; stage 0 to II a 0. stage II b 2.4%, III 11.3%, IV 15%. We conclude that cystoscopy is useful only in stage more than II b, bullous edema means bladder wall invasion in majority of cases and should be evaluated by noninvasive computed tomography and that biopsy should be reserved only in suspicious cases.
Biopsy ; Carcinoma, Transitional Cell ; Cervix Uteri* ; Cystoscopy* ; Edema ; Female ; Inflammation ; Mucous Membrane ; Urinary Bladder ; Uterine Cervical Neoplasms*

The study was conducted to measure the stature, span, body weight, standing trunk flexion and trunk extension of 989 healthy Korean school girls from age 11 to 14 and to determine the correlation coefficients among those items. The results obtained were as follows : 1. The average statures by age were 140.68cm at 11, 147.45cm at 12, 150.14cm at 13 and 154.76cm at 14 years of age, and the stature growth per year was 4.64cm. 2. The average spans by age were 137.60cm at 11, 145.52cm at 12, 149.33cm at 13 and 153.76cm at 14 years of age, and the span growth per year was 5.39cm. 3. The stature was always longer than span, but the difference between the two items decreased with the increase of age. 4. The average body weights by age were 33.89kg at 11, 38.84kg at 12,42.21kg at 13 and 47.62kg at 14 years of age, and the increase of body weight per year was 4.58kg. 5. Remarkable growth occurred in stature and spanfrom age 11 to 12, but in body weight from age 13 to 14. 6. The average standing trunk flexions by age were 5.14cm at 11, 7.50cm at 12, 11.44cm at 13, and 12.02cm at 14 years of age. 7. The average trunk extensions by age were 40.84cm at 11, 44.40cm at 12,47.68cm at 13 and 48.53cm at 14 years of age. 8. In flexibility (standing trunk flexion and trunk extension) the annual increase was the smalled from 13 to 14 years of age. This is probably because the increase in body weight becomes hindrance to flexibility 9. the correlation coefficients between stature and span showed very high values ranging from 0.93 to 0.82. The coefficients between stature and both weight as well as between body weight and span recorded high values in all age groups. But the values decreased with age. 10. the correlation coefficients between flexibilities and physical measurements showed very low values. 11. The correlation coefficients between flexion and extension were very low(0.15) at 11 and low(ranging from 0.25 to 0.37) after 12 years of age 12. The regression equations among all of the items in each age group are given in a table for reference.
Body Weight ; Female* ; Humans ; Pliability*

No abstract available.
Animals ; Cerebral Cortex* ; Imipramine* ; Rats* ; Receptors, Adrenergic*

STUDY DESIGN: Surgically treated thirty-five Denis type B thoracolumbar and lumbar burst fractures were assessed to compare the differences of fracture patterns by the level of fracture. OBJECTIVE: To know the major surgical indications according to the level of fracture. SUMMARY OF BACKGROUND DATA: General operative indications of thoracolumbar and lumbar burst fractures were collapse of anterior body height more than 40-50%, kyphotic deformity more than 30 degrees, canal encroachment more than 50% and neurologic deficit. But we could not apply the same surgical indications to the whole thoraco]embar and lumbar burst fractures because their fracture patterns are different. METHODS: We compared the collapse of anterior body height, collapse of posterior body height, Cobb angle, wedge angle, canal encroachment and incidence of posterior injury according to the level of fracture. RESULTS: The higher the level of fracture, the more the collapse of anterior body height, Cobb angle, wedge angle and incidence of posterior injury But the lower the level of fracture, the more the canal encroachment. CONCLUSIONS: These results mean that the primary surgical indications for thoracolumbar junction are collapse of anterior body height, possibility of posterior injury and increased kyphosis, while for the lower lumbar fractures, amount of canal encroachment is an important factor to make decision for surgery.
Body Height ; Congenital Abnormalities ; Incidence ; Kyphosis ; Neurologic Manifestations

Female urethral syndrome is one of the most common urologic disease in middle age women, but much remains to be known about its etiology and management. For the purpose of identifying underlying voiding dysfunction of this disease, urodynamic studies were done on 28 patients with female urethral syndrome seen in Urologic Department of Seoul National University hospital during the past 14 months from January 1983 to February 1984. Results were as follows: 1. Twenty cases showed normal urodynamic findings, and no significant findings were found in urethral pressure profile studies. 2. Three cases showed functional bladder outlet obstruction due to failure of urethral sphincter relaxation during voiding, two of which were treated by diazepam, and one of which by diazepam and phenoxybenzamine, and all three cases showed improvement of symptoms and maximum roflow rate. 3. Six cases showed detrusor instability, and three were sensory detrusor instability, other three were idiopathic detrusor hyperreflexia. 4. We conclude that routine whole urodynamic study is unnecessary in evaluation of female urethral syndrome, but uroflowmetry can be used as a simple screening study. when uroflowmetry curve shows interrupted pattern, maximum uroflow rate is less than 15 cc/sec., and urethral calibration and castopandoscopy reveals no anatomical bladder outlet obstruction, combined cystometry-urethral sphincter electromyography is necessary to rule out functional obstruction due to failure of relaxation of urethral sphincter during voiding. A new flow chart for the management of female urethral syndrome is presented.
Calibration ; Diazepam ; Electromyography ; Female* ; Humans ; Mass Screening ; Middle Aged ; Phenoxybenzamine ; Reflex, Abnormal ; Relaxation ; Seoul ; Urethra ; Urinary Bladder Neck Obstruction ; Urodynamics* ; Urologic Diseases

It is essential to know whether there is metastasis to bone and liver in bladder tumor management. However, there have been controversies about value of bone and liver scan. Herein we reviewed 65 cases with bladder tumor in which bone scan and/or liver scan were done. Bone scan was done in 64 cases at diagnosis, and 15 showed abnormal hot spots, among which 8(13%) were true metastasis. So specificity of bone scan was 53% . Of 12 patients with bone metastasis 7 (58%) showed elevated serum alkaline phosphatase, and 2 (17%) complained bone pain. Bone metastasis was found only in patients with invasive tumor, 5 of 29(17%) at diagnosis, 3 of 29(10%) during follow up. Liver scan was done in 19 patients at diagnosis and 1 during follow up, of which 3 showed space occupying lesion, but only 2 of 3 were true metastasis. 2 cases with liver metastasis were found only in patients with invasive tumor and abnormal liver function. We can conclude that bone scan should be done in all patients with invasive bladder tumor and its result should be confirmed by bone survey, but liver scan should be done selectively in patients with invasive bladder tumor and abnormal liver function.
Alkaline Phosphatase ; Diagnosis ; Follow-Up Studies ; Humans ; Liver* ; Neoplasm Metastasis ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder*

OBJECTIVES: Hypokalemia is one of the most common electrolyte disorders encountered in clinical medicine. It is important electrolyte disorder because it is account for neuromuscular, cardiovascular and renal disturbance. But there are few studies to evaluate the incidence and cause of hypokalemia in emergency patients. Present study was performed to evaluate the incidence and cause of hypokalemia and coincidental changes of other electrolyte and chemical parameters of blood and urine. METHODS: Hypokalemia was defined as a serum potassium concentration less than 3.5mEq/L. A total 80 medical patient without renal failure were prospectively studied for 62 days. Electrolytes and chemical parameters of the blood and urine were determined at emergency room. RESULTS: 1) Of medical inpatients through emergency room, hypokalemia was detected in high frequency(32%) and mild degree(mean; 3.1+/-0.1mEq/L). 2) The most common cause of hypokalemia was diuretics(23%), other causes were vomiting, SIADH, diarrhea, alkalemia, and unidentified cause(each; 15.4%). 3) Compared to the normokalemic group, the hypokalemic group showed significant decrease in urinary anion gap(P=0.003). 4) There was no significant difference of spot urine potassium concentrations between renal and extrarenal origin of hypokalemia. CONCLUSION: The hypokalemia in emergency patients was detected in high frequency and mild degree. Urine anion gap was significantly decreased in hypokalemic group than normokalemic group. Spot urine potassium concentration was less effective in differentiation of renal and extrarenal origin of hypokalemia.
Acid-Base Equilibrium ; Clinical Medicine ; Diarrhea ; Electrolytes ; Emergencies* ; Emergency Service, Hospital ; Humans ; Hypokalemia* ; Inappropriate ADH Syndrome ; Incidence ; Inpatients ; Potassium ; Prospective Studies ; Renal Insufficiency ; Vomiting

Elevation of aspartate aminotransferase (AST), alanine aminotransferase(ALT),and bilirubin levels was noted incidentally in patients who received laparoscopic cholecystectomy(LC). This study was attempted to investigate the elevation of liver enzymes and bilirubin levels after LC and its clinical significance. Twenty patients who showed normal levels of preoperative liver function test were entered into this study, and blood was collected at 24hours, 72hours and 7days after operation for measurement of AST, ALT, alkaline phosphatase(ALP), and bilirubin levels. In AST, a mean 2.76-fold postoperative increase was observed in 18 patients(90%) and 12 patients(60%) showed an elevation rise above normal limits. In ALT, a mean 2.14-fold postoperative increase was observed in 16 patients(80%) and 10 patients(50%) showed an elevation rise above normal limits. A mean 1.42-fold and a mean 2.12-fold increase were observed in total and direct bilirubin level respectively and elevation above normal limits occured in 7 patients(35%) and 4 patients (20%) respectively. The patients with an elevation of AST, ALT and bilirubin levels did not show any related clinical problem, and the elevations were transitory and returned to normal value within several days without any specific treatment.. Although the exact causes of these elevations need further investigation, theys appear to have no obvious clinical significance.
Alanine ; Aspartate Aminotransferases ; Bilirubin* ; Cholecystectomy, Laparoscopic* ; Humans ; Liver Function Tests ; Liver* ; Reference Values

The T-antigen(Thomsen-Friedenreich antigen, T-Ag) has been found in malignant cells but in most normal cells, in which the T-Ag is cryptic but can be unmasked with neuraminidase. The significance of T-Ag expression in urinary bladder cancer by staining paraffin sections with a T-specific lectin(Peanut agglutinin, PNA) immunoperoxidase technic was investigated. Sixty-five cases of transitional cell carcinoma were divided into three grades as I, II and III by the degree of cellular differentiation and four groups as A : superficial tumors without recurrence, B ; superficial tumors with recurrence but without up-staging, C :superficial tumors with recurrence and up-staging and D ; initially invasive tumors accordingly. Over all T-Ag positive rate in transitional cell carcinomas was 37% and 5 normal and 5 inflammatory vesical mucosas were negative for T-Ag. In 95% of transitional cell carcinomas initially negative for T-Ag, cryptic T-Ag became positive after neuraminidase treatment. The control subjects initially all negative for T-Ag became positive for cryptic T-Ag after neuraminidase treatment. The T-Ag positive rates of group A, B, C and D were 25%, 30%. 50% and 58%, respectively and those of grade I, II and III were 28%, 37% and 47%, respectively. The positive rate of T-Ag was correlated with the grade but not with the recurrence or invasiveness. Also, T-Ag expression was not correlated with ABO(H) blood group. These conflicting data suggest that further extensive study will be necessary whether immunohistochemical detection of T-Ag in tissue sections could be of prognostic value in patients with transitional cell carcinoma.
Antigens, Viral, Tumor* ; Carcinoma, Transitional Cell* ; Humans ; Immunoenzyme Techniques ; Mucous Membrane ; Neuraminidase ; Paraffin ; Recurrence ; Urinary Bladder Neoplasms ; Urinary Bladder*

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta whitch originates just distal to the level of the origins of the coronary arteries, and whitch includes a wide spectrum of pathologic changes. A 27 years-old-female was admitted because of further evaluation of known some heart disease. Clinical diagnosis of supravalvular aortic stenosis was made by echocardiography and angiography. We presented a case of supravalvular aortic stenosis with a review of literature.
Angiography ; Aorta ; Aortic Stenosis, Supravalvular* ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Echocardiography ; Heart Diseases