A Case of Combined Facial and Vestibulocochlear Nerve Paralysis in Brainstem Infarction / 대한이비인후과학회지

Isolated cranial nerve palsy without long tract signs such as contralateral hemiparesis, hemihypoesthesia and ataxia is often reported as brainstem infarction. But most of them are accompanied by oculomotor or abducens nerve palsy. Isolated cranial nerve palsy involving the facial nerve and vestibulocochlear nerve is very rare in brainstem infarction. We report, with a review of literature, a case of right caudal pontine infarct on the dorsolateral portion of the middle cerebellar peduncle with isolated 7th and 8th cranial nerve palsies.

The Effect of Contralateral Acoustic Stimulation on the Latency of Distortion Product Otoacoustic Emissions / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The auditory efferent system -Medial olivocochlear bundle (MOCB)-controls the sensitivity and frequency selectivity of the cochlea and maintains the cochlea for optimal acoustic signaling. Contralateral acoustic sound stimulates the MOCB and has inhibitory effects on the sound evoked amplitude response of the cochlea. There are only a few reports on the latency response of contralateral acoustic stimulation (CAS) on distortion product otoacoustic emission (DPOAE), and it has no consistent conclusion. The purpose of this study was to evaluate whether changing the latency of DPOAE by CAS could be a stable method for monitoring the function of MOCB. SUBJECTS AND METHOD: The change in the latencies of DPOAE after CAS were monitored in 24 normal hearing ears with f2 sweep paradigm. The CAS level was divided into two groups, one was under 65 dB SPL and other was over 65 dB SPL. RESULTS: As f2 frequency changed from 1 kHz to 2 kHz, the latency of DPOAE was shortened from 11.82 +/- 1.87 ms to 7.29 +/- 0.86 ms in low stimulation level (50 dB SPL) and from 10.70 +/- 2.65 ms to 6.16 +/- 1.59 ms in high stimulation level (75 dB SPL) There were no significant shortening on the latency of DPOAE after CAS in low stimulation level group. But in higher stimulation level group (75 dB SPL), DPOAE latency changed from 10.70 +/- 2.65 ms to 10.12 +/- 1.95 ms (CAS level: 35 dB SL) and to 9.76 +/- 2.97 ms (CAS level: 50 dB SL) in 1 kHz, from 6.16 +/- 1.59 ms to 5.96 +/- 1.49 ms (CAS level: 35 dB SL) and to 5.83 +/- 1.28 ms (CAS level: 50 dB SL) in 2 kHz. CONCLUSION: Changes in the latency of DPOAE after CAS is not a stable monitoring tool for the function of MOCB.

Two Cases of the Landau-Kleffner Syndrome / 대한이비인후과학회지

Landau-Kleffner syndrome, or acquired epileptiform aphasia, is an epilepsy syndrome with variable disruption of acquired language and epileptiform discharges on electroencephalograph (EEG). Auditory agnosia can deteriorate into total unresponsiveness and impaired expressive communication. In spite of the presence of this condition, the pure tone audiometry, otoacoustic emission and brainstem evoked auditory potential could be normal. Therefore, in the above hearing tests which are the mainstream methods for pediatric hearing evaluation, otolaryngologists should have suspicion for the presence of this syndrome, although it is rare.

Auditory Effects of Microperfused Lidocaine on Guinea Pig Cochlea / 대한이비인후과학회지

OBJECTIVES: Lidocaine is one of the therapeutic trials to treat tinnitus. However, the exact mechanism of the effect of lidocaine remains unclear. The aim of this study was to elucidate the action site of lidocaine in the cochlea by measuring compound action potential (CAP) and transient evoked otoacoustic emission (TEOAE) amplitude in guinea pigs. METHOD: Artificial perilymph was perfused into the scala tympani of the guinea pig cochlea in the control group, and lidocaine diluted with artificial perilymph was perfused into the scala tympani of the experimental groups. Electrocochleogram (ECoG) and TEOAE were measured in each groups both before and after lidocaine perfusion. RESULTS: Artificial perilymph perfused to the scala tympani of the guinea pig cochleae did not affect either the CAP threshold or the TEOAE response. But, lidocaine perfused into the scala tympani of the guinea pig cochleae produced a dose-dependent increase in CAP threshold, but did not affect TEOAE response. CONCLUSION: This study revealed that lidocaine perfused into the scala tympani of the guinea pig cochlea affects the CAPthreshold but not the TEOAE amplitude and reproducibility. It means that the locally perfused lidocaine affects the cochlear nerve greater than the outer hair cells.

Clinical Outcome of Prenatal Hydronephrosis / 대한비뇨기과학회지

PURPOSE: The popular use of prenatal ultrasonography has lead to an increase in the diagnosis of hydronephrosis in fetuses. However, there is little data available, in Korea, on the natural progress of prenatal hydronephrosis. Therefore, to help in the management of patients, the follow-up data on fetuses, with antenatally diagnosed hydronephrosis, were analyzed. MATERIALS AND METHODS: Fifty-five (71 renal units) of 102 patients (118 renal units), with antenatally diagnosed hydronephrosis, were available for followed up from the 27th to the 36th fetal week. The follow-up postnatal ultrasonographs were retrospectively reviewed to try and determine the etiology, natural progress, prognosis and treatment of prenatal hydronephrosis. Diuretic 99mTc-DTPA renal and 99mTc-DMSA renal scans, intravenous pyelography and voiding cystourethrography were performed in the unimproved cases. RESULTS: The etiologies of prenatal hydronephrosis were ureteropelvic junction obstruction, VACTERL syndrome, vesicoureteral reflux, duplicated ureter, ureterovesical junction obstruction and polycystic kidney. During the follow-up period, 38 renal units, with prenatal hydronephrosis, improved spontaneously, but 18 units were aggravated. Operations were performed in 13 units. CONCLUSIONS: Many of the fetal hydronephrosis, diagnosed antenatally, disappeared postnatally. It is suggested that fetal, or neonatal, hydronephrosis does not necessarily imply the presence of obstructive uropathy or significant functional abnormality. The fetal antenatally diagnosed hydronephrosis, with clinical symptoms of pyuria, hematuria or a palpable abdominal mass, were often aggravated to a significant uropathy, which required a follow up evaluation and treatment.

A Case of Bilateral Testicular Teratoma Found in Infant / 영남의대학술지

Testicular teratoma is characterized that has more than one germ cell layer in various stages of maturation and differentiation. The incidence of mature teratoma varies from 2 to 9% of all germinal testicular tumor. Only 3 cases of bilateral teratoma have been reported in the literature to date. The teratoma can occurs at all ages but is most common between the age of 15-35 year. It is relatively infrequently seen in childhood and infancy. In these age group, teratoma tends to be a benign. Recently, we experienced one case of bilateral testicular teratoma in 4 month-old infancy. We report a case of bilateral testicular teratoma found infancy with review of related literatures.

The Effect of Testicular Torsion on the Histologic Findings and Apoptosis of the Contralateral Testis at Various Ages in Rats / 대한비뇨기과학회지

PURPOSE: Unilateral testicular torsion, while harming the ipsilateral testis, may also affect the contralateral testis. A reduction in testicular blood flow, immune reactions and biochemical changes have been reported to affect spermatogenesis. However, physiologic fertility, spermatogenesis, the production of sex hormones and the testicualr blood flow might vary according to age. Therefore, an experimental study was conducted to investigate the effects of testicular torsion on the contralateral testis at various ages in rats. MATERIALS AND METHODS: Sprague-Dawley rats, 2, 5 and 8 weeks old were divided into 4 experimental subgroups in the torsion only, detorsion (torsion followed by detorsion at 1 hour), orchiectomy (torsion followed by an orchiectomy at 24 hours) and a control group. Six weeks later, the changes in the testicular weight, the mean tubular diameter, spermatogenesis and apoptosis of the contralateral testicle were determined. RESULTS: The changes in the testicular weight, mean tubular diameter and spermatogenesis were similar in the 2 weeks group regardless of the experimental methods (p>0.05). In the 5 weeks group, the tubular diameter had decreased significantly in the orchiectomy and torsion only group (p< 0.05), and incomplete spermatogenesis was observed in the torsion only group. In the 8 weeks group, the testicular weight and tubular diameter was significantly lower in the orchiectomy and torsion only group (p< 0.05), but spermatogenesis was relatively well preserved. The apoptotic cell index was significantly higher in the orchiectomy and torsion only group at 5 and 8 weeks group (p< 0.05). CONCLUSIONS: Unilateral testicular torsion causes histological changes and incomplete spermatogenesis in the contralateral testicle. These results suggest that the effect of a unilateral testicualr torsion was predominant in untreated and pubertal rats, but is rarely observed in infantile rats.

The Effect of Testicular Torsion on the Histologic Findings and Apoptosis of the Contralateral Testis at Various Ages in Rats / 대한비뇨기과학회지

PURPOSE: Unilateral testicular torsion, while harming the ipsilateral testis, may also affect the contralateral testis. A reduction in testicular blood flow, immune reactions and biochemical changes have been reported to affect spermatogenesis. However, physiologic fertility, spermatogenesis, the production of sex hormones and the testicualr blood flow might vary according to age. Therefore, an experimental study was conducted to investigate the effects of testicular torsion on the contralateral testis at various ages in rats. MATERIALS AND METHODS: Sprague-Dawley rats, 2, 5 and 8 weeks old were divided into 4 experimental subgroups in the torsion only, detorsion (torsion followed by detorsion at 1 hour), orchiectomy (torsion followed by an orchiectomy at 24 hours) and a control group. Six weeks later, the changes in the testicular weight, the mean tubular diameter, spermatogenesis and apoptosis of the contralateral testicle were determined. RESULTS: The changes in the testicular weight, mean tubular diameter and spermatogenesis were similar in the 2 weeks group regardless of the experimental methods (p>0.05). In the 5 weeks group, the tubular diameter had decreased significantly in the orchiectomy and torsion only group (p< 0.05), and incomplete spermatogenesis was observed in the torsion only group. In the 8 weeks group, the testicular weight and tubular diameter was significantly lower in the orchiectomy and torsion only group (p< 0.05), but spermatogenesis was relatively well preserved. The apoptotic cell index was significantly higher in the orchiectomy and torsion only group at 5 and 8 weeks group (p< 0.05). CONCLUSIONS: Unilateral testicular torsion causes histological changes and incomplete spermatogenesis in the contralateral testicle. These results suggest that the effect of a unilateral testicualr torsion was predominant in untreated and pubertal rats, but is rarely observed in infantile rats.

A Case of Infected Huge Lymphangioma in Pelvic cavity / 영남의대학술지

Lymphangioma is a benign tumor resulted from abnormal communication between large dermal lymphatic channels and central lymphatic system. The tumor is encountered more often in the neck and axilla and less often in mediastinum, omentum, retroperitoneum, and scrotum. It rarely developed at urogenital system, and there has been no previous description of lymphangioma involving the bladder wall in Korea. We report a case of 35-year-old female with infected huge lymphagioma arising from pelvic cavity and involving bladder wall.

A Case of Infected Huge Lymphangioma in Pelvic cavity / 영남의대학술지

Lymphangioma is a benign tumor resulted from abnormal communication between large dermal lymphatic channels and central lymphatic system. The tumor is encountered more often in the neck and axilla and less often in mediastinum, omentum, retroperitoneum, and scrotum. It rarely developed at urogenital system, and there has been no previous description of lymphangioma involving the bladder wall in Korea. We report a case of 35-year-old female with infected huge lymphagioma arising from pelvic cavity and involving bladder wall.

Role of Inducible Nitric Oxide Synthase as a Mediator of Renal Ischemia/Reperfusion Injury in the Rat / 대한비뇨기과학회지

PURPOSE: This study was undertaken to elucidate if nitric oxide (NO), produced by inducible nitric oxide synthase (iNOS) following renal ischemia/reperfusion (I/R), contributes to renal injury in rats, and if selective inhibition of iNOS prevents tissue injury following I/R. MATERIALS AND METHODS: Sprague-Dawley rats (male, 200-250gm, n=80) were divided into 4 groups. The groups were pretreated with L-arginine (L-ARG group), N-nitro-L- arginine methyl ester (L-NAME group), aminoguanidine (AG group) or normal saline (control group) before I/R. The renal blood flow was measured using laser Doppler at the left renal pedicle just before clamping the pedicle and at 15, 30, and 45 min after reperfusion. The HandE stain of nephrectomized tissues following I/R was performed for histological scoring of tubular damage and medullary vascular congestion. The expression of iNOS, using reverse transcription-polymerase chain reaction (RT-PCR), in the AG and control groups was determined in the kidney tissues following I/R. RESULTS: The recovery rate of the renal blood flow after I/R was significantly higher in the AG group compared to the controls. From light microscopy, the control group showed attenuated tubular lining epithelial cells, especially in the proximal tubules. However, Glomeruli and individual tubular cells showed no pathological changes. Mild congestion was noted in the medullary area. The L-NAME group showed marked tubular necrosis and medullary congestion. This tubular necrotic injury was compromised in the L-ARG group, but it was almost normal in the AG group. The medullary congestion was still severe in the L-ARG group, but was minimally present in the AG group. RT-PCR of the iNOS in the rat renal tissue revealed an iNOS band at 200bp. No significant difference in the density of the iNOS band was observed between the two groups. CONCLUSIONS: These results suggest that the NO, produced by iNOS following I/R, leads to renal tubular necrosis and medullary congestion, and selective inhibition of the iNOS may prevent renal tissue damage following I/R injury.

A Case of Congenital Fibroepithelial Polyp of the Ureter in a Child / 대한비뇨기과학회지

The fibroepithelial polyp of the ureter is a rare, benign tumor. Its pathogenesis is unclear, but most investigators agree that it arises from elements of mesodermal origin within the ureteral wall. Symptoms include hematuria and intermittent flank pain secondary to partial ureteral obstruction. Correct radiologic assessment is crucial to direct surgical management. We report a case of a fibroepithelial polyp of the ureter in a child in whom correct preoperative diagnosis was made by correlating the results of excretory urography, sonography, CT and urine cytology.

The Effects of Externally Administered Insulin-like Growth Factor-I on Glomerulosclerosis during Compensatory Renal Hypertrophy in Rats / 대한비뇨기과학회지

PURPOSE: Among renotropic agents, a growth hormone (GH) independent insulin-like growth factor-I (IGF-I) improves renal function without inducing glomerulosclerosis and its potential for treating renaldisease is increasing. With this in mind, this study was designed to find out the effects of externallyadministered IGF-I toward preventing glomerulosclerosis after renal volume loss in rats. MATERIALS AND METHODS: Sprague-Dawley rats (110-130gm) were divided into four groups in accordance with 3/4 nephrectomyand/or IGF-I administration. The 3/4 nephrectomy was performed at 30 days after birth, and recombinanthuman IGF-I was administered for 60 days after 3/4 nephrectomy. The change of body weight and wet weight of the remnant kidney were determined. The glomerular planar area and percentage of glomerulosclerosiswere measured. RESULTS: The body weight andthe wet weight of remnant kidney were significantly increased after administration of IGF-I in the3/4 nephrectomy group. The glomerular planar area was significantly increased after administration of IGF-I in the 3/4 nephrectomy group, and significant increase in glomerular planar area was observed in the 3/4 nephrectomy group regardless of IGF-I administration. And the percentage of glomerulosclerosis was significantly decreased. CONCLUSIONS: Thus it is concluded that this study proved that the externally administered IGF-I prevents lomerulosclerosis after severe renal volume loss in rats. It may have a potential to become a useful medical agent for suppressing glomerular sclerotic change and facilitating renal function in chronic renal failure patients.

The Incidence of Contralateral Vesicoureteral Reflux after Endoscopic or Open Surgical Correction of Primary Unilateral Vesicoureteral Reflux in Children / 대한신장학회잡지

The incidence of contralateral reflux after unilateral reimplantation in children with primary unilateral vesicoureteral reflux(VUR) is reported to be 0.8-32%. We evaluated the characteristics of contralateral reflux after endoscopic or open surgical correction of primary unilateral VUR in children. 30 children who underwent unilateral reimplantation by Paquin (25pts) and submucosal Macroplastique injection(5pts) were evaluated. The association between postoperative contralateral reflux and age, sex, ipsilateral implant side, postoperative urinary tract infection, and surgical method were evaluated. There were 18 male and 12 female patients. Initial reflux was observed in the right in 18 and 12 in left. The initial reflux grades were II, III, IV, and V in 2, 11, 14, and 3 patients, respectively. Postoperative urinary tract infection was observed in 4 patients of whom 1 had contralateral reflux. In conclusion, there was no single factor that could predict the development of contralateral reflux after unilateral correction of unilateral primary VUR. Furthermore, the fact that contralateral reflux occurred even after submucosal Macroplastique injection suggests that the method of surgery is not related to the subsequent development of contralateral reflux.

Effect of Insulin-like Growth Factor-I on Renal Function During Compensatory Renal Hypertrophy in Neonatal Rates / 대한비뇨기과학회지

No abstract available.

Does Every Patient with Ureteropelvic Junction Obstruction Need Voiding Cystourethrography? / 대한비뇨기과학회지

No abstract available.

Does Every Patient with Ureteropelvic Junction Obstruction Need Voiding Cystourethrography? / 대한비뇨기과학회지

No abstract available.

Structural Evidence Against Hormonal Theraphy in Cryptorchid Testis-Abnormal Gubernacular Attachment / 대한비뇨기과학회지

No abstract available.

Two Cases of Anterior Urethral Valve / 대한비뇨기과학회지

No abstract available.

Comparison OF Northgate SD-3 and Modulith SLX Lithotriptors: Treatment Results with 2,000 Renal and Ureteral Stones / 영남의대학술지

Some reports have shown a decreased effectiveness of extracorporeal shock wave lithotripsy(ESWL) with newer lithotriptors. We compared the treatment results of ESWL with a second generation Northgate SD-3 and a third generation Modulith SLX device. A total of 2,000 patients underwent ESWL treatments for single urinary calculus between September, 1988 and July, 1998. The 1,241 patients were treated with Northgate SD-3 between September, 1988 and December, 1995. The 759 patients were treated with Modulith SLX between January, 1996 and July 1998. The treatment results were compared using the chi-square test to determine statistical significance. The overall success rate, success rate according to the location and size, the mean number of sessions, complication rate and retreatment rate were obtained, according to lithotriptor. The overall success rate was 90.6% with Northgate SD-3 and 89.1% with Modulith SLX. With Northgate SD-3 and modulith SLX. the success rate according to the location was 91.0%(579/636), 88.1%(236/268) in the kidney, 93.2%(517/555), 89.9%(258/287) in upper ureter; 83.3%(10/12) and 94.4%(167/177) in middle and lower ureter; 47.4%(18/38) and 55.6%(15/27) in staghorn stone, respectively, The success rate According to the size of stone with Northgate SD-3 and Modulith SLX for stone with the size under 10mm was 96.1% (612/637) and 93.1%(470/505); from 11mm to 20mm was 87.3%(421/482) and 86.4%(165/191); from 21mm to 30mm, 77.5%(62/80) and 67.5%(23/34); and for stone larger then 31mm was 69%(29/42) and 62.1%(18/29), respectively, Mean number of sessions for successful fragmentation was 1.21 and 1.69, respectively, with Northgate SD-3 and Modulith SLX. Retreatment rate was 16.7% and 17.5%, respectively. The complications after treatment were severe pain(6.2% with Northgate SD-3 vs. 2.0% with Modulith SLX), steinstrasse(3.4% vs. 1.9%), fever(1.2% vs. 0.5%) and perirenal hematoma(0.2% vs. 0%) in order of frequency. There was no significant difference in the effectiveness between of Northgate SD-3 and Modulith SLX. However, a statistically significant difference was observed between the two lithotriptors. We concluded that ESWL with Modulith SLX is more safe compared to Northgate SD-3.