OBJECTIVE: To compare two testing protocols for evaluating range of motion (ROM) changes in the preloaded cadaveric spines implanted with a mobile core type Charite(TM) lumbar artificial disc. METHODS: Using five human cadaveric lumbosacral spines (L2-S2), baseline ROMs were measured with a bending moment of 8 Nm for all motion modes (flexion/extension, lateral bending, and axial rotation) in intact spine. The ROM was tracked using a video-based motion-capturing system. After the Charite(TM) disc was implanted at the L4-L5 level, the measurement was repeated using two different methods : 1) loading up to 8 Nm with the compressive follower preload as in testing the intact spine (Load control protocol), 2) loading in displacement control until the total ROM of L2-S2 matches that when the intact spine was loaded under load control (Hybrid protocol). The comparison between the data of each protocol was performed. RESULTS: The ROMs of the L4-L5 arthroplasty level were increased in all test modalities (p < 0.05 in bending and rotation) under both load and hybrid protocols. At the adjacent segments, the ROMs were increased in all modes except flexion under load control protocol. Under hybrid protocol, the adjacent segments demonstrated decreased ROMs in all modalities except extension at the inferior segment. Statistical significance between load and hybrid protocols was observed during bending and rotation at the operative and adjacent levels (p < 0.05). CONCLUSION: In hybrid protocol, the Charite(TM) disc provided a relatively better restoration of ROM, than in the load control protocol, reproducing clinical observations in terms of motion following surgery.
Arthroplasty ; Cadaver ; Chimera ; Displacement (Psychology) ; Humans ; Range of Motion, Articular ; Spine ; Track and Field

Endometriosis represents extrauterine nonneoplastic endometrial tissue. It is most commonly diagnosed in women of childbearing age, with a peak age of 40 to 44 years. The incidence of genitourinary involvement ranges from 1% to 2%. Ureteral endometriosis is a rare entity, and its diagnosis requires a high index of suspicion. We report a case of ureteral endometriosis in a 44-year-old multiparous woman with a brief review of literature.
Adult ; Diagnosis ; Endometriosis* ; Female ; Humans ; Hydronephrosis ; Incidence ; Ureter*

The occurrence of bladder tumors in the first 2 decades of life are rare neoplasias. Transitional cell tumors of the bladder are extremely a rare clinical disease entity. Here, a case of a papillary urothelial tumor in a 5-year-old girl is reported, with a brief review of the literature. Histologically, the tumor was a solitary and papillary urothelial tumor of low malignant potential (by WHO and the ISUP).
Child ; Child, Preschool* ; Female* ; Humans ; Urinary Bladder Neoplasms ; Urinary Bladder*

A case of a 37 year-old man of congenital diabetes insipidus is reported. He complained of polydipsia, which began from his youth, drinking about 10 L of water every day. He didn't look ill or mentally retarded. In his family, his only brother has shown similar symptoms and his older sister had no symptom. On radiologic study, both kidneys showed severe hydronephrosis and the bladder was markedly distended. Water deprivation test was performed. The result was consistent with diabetes insipidus and the urine osmolality didn't respond to antidiuretic hormone injection, and he was diagnosed as nephrogenic diabetes insipidus. We began to treat him with thiazide and amiloride. The amount of water he's been drinking daily has decreased to 3-4 L per day. We discuss this case with a brief review of literature.
Adolescent ; Adult ; Amiloride ; Diabetes Insipidus ; Diabetes Insipidus, Nephrogenic* ; Drinking ; Humans ; Hydronephrosis ; Kidney ; Mentally Disabled Persons ; Osmolar Concentration ; Polydipsia ; Siblings ; Urinary Bladder ; Water ; Water Deprivation

No abstract available.
Child* ; Deamino Arginine Vasopressin* ; Humans ; Imipramine*

Since penile prosthesis were introduced clinically, higf operation success rates and good patient satisfaction ratings have been reported. Nevertheless, the complication rates have been reported to range from 4% to 7% penile prosthesis (AMS-CXM) and widespread condylomata on the genitaile. Physical examination revealed that the right prosthesis cylinder had perforated the distal medial side of the corpus cavernosum and almost perforated the distal urethra, and the left cylinder had perforated the distal midline septum and was overhanging the right cylinder. Additionally, condylomata acuminata infected the whole penile skin and lower pubic area. The patient underwent multiple treatments for condyloma, including podophyllin, electrocoagulation, and coagulation using a laser, for 6 months and a "windsock" operation using Gore-Tex in both corpora cavernosa with a penoscrotal skin incision for his prosthetic probiem. There have been no complications at 9 months'follow-up.
Condylomata Acuminata ; Electrocoagulation ; Erectile Dysfunction* ; Genitalia* ; Humans ; Male ; Patient Satisfaction ; Penile Prosthesis ; Physical Examination ; Podophyllin ; Polytetrafluoroethylene ; Prostheses and Implants ; Skin ; Urethra

BACKGROUND: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that this is a refractory disease which may cause a deleterious effect on patients' quality of life (QOL). OBJECTIVE: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the changes of QOL after treatment. METHODS: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after systemic antifungal treatment. Responses to the questionnaire were scored by f-point scale (0~4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptom and functional impact, patients' views concerning treatment, and relationship with doctor. RESULTS: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients' QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS: from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients' view concerning treatment(AS: from 1.34 to 1.02) 4. The degree of patients' satisfaction at the therapeutic effect was very high - 62.4% (immediately after. treatment) and 65.8% (9 months after initiation of treatment) of patients answered excellent or good. CONCLUSION: This study confirms that toenail onychomycosis has significant Impact on the overall QOL of patients. Also the effect of antifungal therapy on patients' QOL were satisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis.
Female ; Humans ; Korea* ; Male ; Nails* ; Onychomycosis* ; Quality of Life* ; Social Change ; Surveys and Questionnaires

Xanthogranulomatous pyelonephritis is an uncommon form of chronic pyelonephritis occurring usually in middle-aged women. This disease is characterized by destruction of the renal parenchyma which is then replaced by granulomatous tissue containing lipid-laden macrophages (foam cells). But this disease is hard to diagnose preoperatively since it resembles renal abscess, renal cell carcinoma, renal tuberculosis and so forth. Xanthogranulomatous pyelonephritis in children is rare. We report a case in a 30 month-old boy.
Abscess ; Carcinoma, Renal Cell ; Child* ; Child, Preschool ; Female ; Humans ; Macrophages ; Male ; Pyelonephritis ; Pyelonephritis, Xanthogranulomatous* ; Tuberculosis, Renal

OBJECTIVES: Arteriovenous fistula (AVF) is Achilles hill of patients receiving maintenance hemodialysis, but thrombosis of AVF is a frequently encountered problem in maintenance hemodialysis patients. AVF thrombosis or occlusion is known to be associated with old age, underlying diabetes mellitus, increased fibrinogen and factor VIII, short AVF maturation time, low dialyzer blood flow, etc. Recently, several reports suggested that high titer of IgG anticardiolipin antibody (IgG-ACA) is associated with single or repeated clotting of AVF and elevated Lp(a) level is associated with vascular access occlusion in patients under maintenance hemodialysis. This study is to investigate the relationship between AVF thrombosis and the presence of elevated titiers of LP(a) and IgG-ACA. METHODS: This study included 20 patients with end stage renal disease under hemodialysis via AVF. Ten subjects have had one or more episodes of AVF obstruction (group A). Another 10 subjects without episodes of AVF obstruction (group B) were selected matching with age, sex, underlying disease, duration of hemodialysis, blood glucose level and lipid profile of subjects in group A. The IgG, IgM anticardiolipin antibody titers with indirect ELISA method and LP(a) level with turbidimetric assay were measured and analysed. RESULTS: Four subjects in group A showed positive IgG-ACA titer what of all subjects in group B were negative titer (p=0.03). Only one subject in group A and two subjects in group B showed positive IgM-ACA titer (p>0.05). The median value of Lp(a) was 32.75 (mg/dl), 43.1 (mg/dl) in group A and group B respectively and was not significantly different each other (p>0.05). CONCLUSIONS: In end stage renal patients receiving hemodialysis, positive IgG-ACA titier seems to be an independent risk factor of AVF thrombosis.
Antibodies, Anticardiolipin* ; Arteriovenous Fistula* ; Blood Glucose ; Diabetes Mellitus ; Enzyme-Linked Immunosorbent Assay ; Factor VIII ; Fibrinogen ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Kidney Failure, Chronic ; Lipoprotein(a)* ; Renal Dialysis* ; Risk Factors ; Thrombosis*

No abstract available.
Early Diagnosis* ; Osteogenesis* ; Ultrasonography*