In an effort to characterize the trend of renal injury of recent years, we reviewed the charts and x-ray films of 50 patients with renal trauma which occurred in the last 6 years. They were 42 males and 8 females with a mean age of 26.4 years (range: 5 to 66) and most of them are younger generation. The main causes of injury were related to falling down in 21 cases (42%) and traffic accident in 17 cases (34%), followed by stab injury in 7 cases and assault in 5 cases. The severity of renal injury was classified using the renal injury scale which was published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A.A.S.T.) in 1989. According to radiologic and operative findings, they were classified as follows; Grade I, 4 cases; Grade II, 7 cases; Grade III, 12 cases; Grade IV, 23 cases; and Grade V, 4 cases. Of the 50 patients, 39 had gross hematuria and remaining 11 patients had microscopic hematuria. There was no correlation between the degree of hematuria and the severity of renal injury (p=0.098). The major combined other organ injuries were hemoperitoneum in 12 cases, fracture of extremities in 8 cases, liver laceration in 5 cases, hemopneumothorax in 4 cases and intestinal perforation in 2 cases. Surgical treatment was performed in 27 cases (54%) and the remaining 23 cases (46%) which were renal laceration of various degrees without intraperitoneal injuries were managed conservatively.
Accidents, Traffic ; Extremities ; Female ; Hematuria ; Hemoperitoneum ; Hemopneumothorax ; Humans ; Intestinal Perforation ; Kidney ; Lacerations ; Liver ; Male ; X-Ray Film

No abstract available.
Dislocations* ; Tendons*

One hundred and two patients with benign prostatic hyperplasia were treated by transurethral radio-frequency thermotherapy (TURT) device (Thermex-II, Direx, Israel) with 47.5 degrees C in single session for 2 hours and 30 minutes from November 1992 to October 1993. Among them, 83 patients, who were followed up for more than 3 months were included in this study. Twenty-seven (32.5%) patients had a history of acute retention. Pretreated values of the mean Madsen-Iversen symptom score, maximum urine flow rate, postvoiding residual urine volume, prostate volume and prostate specific antigen (PSA) were 15.4, 6.5 ml/sec, 61.3ml, 43.2ml and 0.77 ng/ml respectively. Madsen-Iversen symptom score, maximum urine flow rate were measured at 2 weeks, 1, 3 and 6 months after TURT. The residual urine volume, prostate volume and PSA level were measured at 3 and 6 months after TURT. During the follow up, the symptom score started to decrease significantly at 1 month (9.9, p< 0.01) after TURT, and gradually decreased up to 6.9 at 3 months. The maximum flow rate showed initial significant improvement at 2 weeks (8.1 ml/sec., p< 0.01), but no significant interval change was observed thereafter. The residual volume decreased significantly at 3 months (41.3 ml, p< 0.01) and no decrement was noted until 6 months. Neither the prostate volume nor PSA value changed significantly at 3 or 6 months after TURT. The improvement, which was defined as a change of 50% or more in at least one of subjective or objective symptoms showed in 63.9% (53/83) at 3 months and 57.1% (32/56) at 6 months. Both subjective and objective improvements at 3 and 6 months after treatment showed in 24.1% and 19.6%, respectively.
Aged ; Follow-Up Studies ; Human ; *Hyperthermia, Induced/methods ; Male ; Middle Age ; Prognosis ; Prostatic Hyperplasia/*therapy ; Radio Waves/therapeutic use

The vitrectomy and silicone oil injection has been used occasionally for the advertent retinal detachment, but the silicone oil placement within the vitreous cavity may cause the complications in such as band keratopathy, emulsification of silicone oil, iritis and glaucoma, etc. Especially, in the phakic eyes, the silicone oil may enter the anterior chamber in the form of a suspension of fine globules resembling an inverted hypopyon and it is called the hyperoleon. The authors observed a case of hyperoleon 4 months after surgery, reporting it with the review of literatures.
Anterior Chamber ; Glaucoma ; Iritis ; Retinal Detachment ; Silicone Oils ; Vitrectomy

No abstract available.
Cisplatin* ; Drug Therapy* ; Humans ; Ifosfamide* ; Paclitaxel*

Six patients with macular hole and retinal detachment and no visible vitreoretinal connection examined by slitlamp and 3-mirror contact lens were treated by two methods. In two patients with relatively localized retinal detachment in central fundus, 0.7ml or more of pure SF6 gas was injected into vitreous cavity by 27 gauge needle after paracentesis was done because of keeping the large space of gas injection as preventmg the increase of lOP. In the remained 4 patients, 1.2ml or more of pure SF6 gas was injected into vitreous cavity after the subretinal fluid was released externally, and then paracentesis was done because of preventing the increase of lOP. After operation, all patients were placed in prone position for 6 hours or more in a day. In 5 of 6 patients, the retina remained attached duing more than 6 months. Even if 2 with posterior staphyloma in 6 patients were treated with two or more operations, 1 patient was failed. Although visual improvement at 6 months after operation was limited due to macular degeneration, the visual acuity were above 0.05 in 3 patients. This operation is simple and safe and not damaged en macula. This procedure is good surgical method in patients with retinal detachment wirh macular hole but without other breaks or visible vitreous adhesion or posterior staphyloma.
Drainage* ; Humans ; Macular Degeneration ; Needles ; Paracentesis* ; Prone Position ; Retina ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Subretinal Fluid* ; Visual Acuity

Six patients with macular hole and retinal detachment and no visible vitreoretinal connection examined by slitlamp and 3-mirror contact lens were treated by two methods. In two patients with relatively localized retinal detachment in central fundus, 0.7ml or more of pure SF6 gas was injected into vitreous cavity by 27 gauge needle after paracentesis was done because of keeping the large space of gas injection as preventmg the increase of lOP. In the remained 4 patients, 1.2ml or more of pure SF6 gas was injected into vitreous cavity after the subretinal fluid was released externally, and then paracentesis was done because of preventing the increase of lOP. After operation, all patients were placed in prone position for 6 hours or more in a day. In 5 of 6 patients, the retina remained attached duing more than 6 months. Even if 2 with posterior staphyloma in 6 patients were treated with two or more operations, 1 patient was failed. Although visual improvement at 6 months after operation was limited due to macular degeneration, the visual acuity were above 0.05 in 3 patients. This operation is simple and safe and not damaged en macula. This procedure is good surgical method in patients with retinal detachment wirh macular hole but without other breaks or visible vitreous adhesion or posterior staphyloma.
Drainage* ; Humans ; Macular Degeneration ; Needles ; Paracentesis* ; Prone Position ; Retina ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Subretinal Fluid* ; Visual Acuity

Until now, we do not have specific Korean data on the age related prostatic volume and voiding symptoms associated with prostatic volume among randomized aged population. Due to this problem, we studied the correlations on the age, prostatic volume and voiding symptom among random sampled 255 people over the age 60 from the 11 Myun in Chinyang Gun, Kyungsangnam-do from the July 12th to July 26th, 1993. The mean age of the examined people was 71.5 years. 244 people answered on questionaire for voiding symptom scoring and 224 people agreed on the transrectal ultrasonic measurement of the prostatic volume. The prolate spheroid method and elliptical method were used for the measurement of the prostatic volume with the major transverse diameter, major anteroposterior diameter and cephalocaudal diameter of each prostates as Terris. The volume of the prostate ranged from 6.2cc to 54.5cc ( Prolate spheroid method ) and 4.7cc to 44.1cc(Elliptical method ). The prostate volumes measured by the elliptical method were smaller than that measured by prolate spheroid method in each age group. The average prostatic volume measured by the elliptical volume and prolate spheroid method were 17.7/22.5cc(E/P) in age 61 to 65 group(n=17), 19.9/22.8cc in age 66 to 70 group(n= 88), 21.6/ 26.0cc in age 71 to 75 group(n=71), 24.4/27.7cc in age 76 to 80 group(n=34) and 18.1/23.7cc in age over 80 group(n =14) and the pattern of the changes in the prostatic volume related with aging was significant(p <0.05 ). The voiding symptom scores were measured and divided according to the prostate volume into 3 groups, below 20cc, 20.1 to 30 and over 30cc groups. The voiding symptom scores ranged from 0 to 35 and the mean symptom scores were 10.9, 11.7 and 14.1 in each group and these changes were not statistically significant(p>0.05).
Aging ; Humans ; Phosmet ; Prostate ; Ultrasonics

PURPOSE: Since a significant number of patients with locally invasive bladder tumor(T3a/T3b) subsequently develop distant metastases, there have been lots of controversies in deciding treatment modalities. In the past decade, progress has been made in the development of effective chemotherapy for the treatment of advanced transitional cell carcinoma of the urothelium. Thus, we reviewed the effectiveness of the M-VAC(methotrexate, vinblastine, adriamycin, and cisplatin) chemotherapy for locally invasive transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS: We reviewed 36 patients who were diagnosed as T3a/T3b TCC and treated with aggressive transurethral resection of the bladder tumor(TURBt) and M-VAC chemotherapy Remission was defined in case of complete disappearance of the tumor or downstaging, and progression was defined in case of persistent disease or upstaging. RESULTS: Mean age of the patients was 60.4 years old(33 males; 3 females), and mean follow up was 12.2 +/- 8.9 months. Response rate considering loss of follow up according to the Kaplan-Meyer's method, was 79, 49, 44, 37% at 6, 12, 18, 24th month, respectively. Disease progressions were found in 19 patients during follow up, and the mean duration to progression was 9.2 +/- 5.0(1-19)months. 79% of the patients with disease progression showed progression within 12 months. Lymph node metastases or distant metastases were confirmed in 68% of progressed patients. CONCLUSIONS: M-VAC chemotherapy after aggressive TURBt is limited, but erective treatment modality, and it is also useful in deciding the prognosis of cancer with its responsiveness.
Carcinoma, Transitional Cell* ; Disease Progression ; Doxorubicin* ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urothelium ; Vinblastine*

Epidermal cysts slowly growing, intradermal or subcutaneous tumors that usually cease growing after having reached 1 to 5 cm in diameter. We report a case of giant epidermal cyst on the scapular region with the appearance of well delineated huge mass measured 19×17×14cm in size. Its clinical and surgical management are illustrated.
Epidermal Cyst