Added Value of Coronal Reformations for Duty Radiologists and for Referring Physicians or Surgeons in the CT Diagnosis of Acute Appendicitis

OBJECTIVE: To assess the added value of coronal reformation for radiologists and for referring physicians or surgeons in the CT diagnosis of acute appendicitis. MATERIALS AND METHODS: Contrast-enhanced CT was performed using 16-detector-row scanners in 110 patients, 46 of whom had appendicitis. Transverse (5-mm thickness, 4-mm increment), coronal (5-mm thickness, 4-mm increment), and combined transverse and coronal sections were interpreted by four radiologists, two surgeons and two emergency physicians. The area under the receiver operating characteristic curve (Az value), sensitivity, specificity (McNemar test), diagnostic confidence and appendiceal visualization (Wilcoxon signed rank test) were compared. RESULTS: For radiologists, the additional coronal sections tended to increase the Az value (0.972 vs. 0.986, p = 0.076) and pooled sensitivity (92% [95% CI: 88, 96] vs. 96% [93, 99]), and enhanced appendiceal visualization in true-positive cases (p = 0.031). For non-radiologists, no such enhancement was observed, and the confidence for excluding acute appendicitis declined (p = 0.013). Coronal sections alone were inferior to transverse sections for diagnostic confidence as well as appendiceal visualization for each reader group studied (p < 0.05). CONCLUSION: The added value of coronal reformation is more apparent for radiologists compared to referring physicians or surgeons in the CT diagnosis of acute appendicitis.

Healing Effects of Demineralized Freeze-Dried Bone Allograft and Deproteinized Bovine Bone Mineral on Periodontal Fenestration Defect in Rats / 대한치주과학회지

The present study was performed to compare effects of demineralized freeze-dried bone allograft(DFDBA) with deproteinized bovine bone mineral(DBBM) on periodontal fenestration defect in rats. Twelve adult male rats weighing 500 to 540 grams were used in this study. Periodontal fenestration defects were surgically created with tapered fissure bur(small ef, Cyrillic 1mm) at the left side of buccal surface of the mandible. The defect size was from anterior border of the first molar to anterior of the ascending ramus mesiodistally and from just below the alveolar crest to apically 1.5-2mm area apicocoronally with 2mm in depth. Rats were divided into control group, test group I and II. Four defects were assigned to the test group I grafted with DBBM and other 4 defects were assigned to the test group II grafted with DFDBA. The rest of defects were the negative control group. At 10 days and 35 days after surgery, 12 rats were sacrificed through intracardiac perfusion and specimens were obtained prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows : 1. In the control group, new bone, osteoid, dense connective tissue were observed in the defects at 10 days. new bone formation was not found but loose connective tissue was formed in the defect and fibrous encapsulation of graft materials was shown in two test groups at 10 days. 2. In all groups, new bone formation was shown in the defect at 35 days. And in the control group, bone formation increased at 35 days than at 10 days. 3. In the test group I and II at 35 days, graft materials were combined with new bone and joined host bone. There was very close contact between new bone, graft materials, and host bone with no gaps. 4. In the test group I and II, new bone formation was similar to that in the control group but not exeeded. In conclusion, in the test group I new bone formation was similar to that in the test group II at 35 days, but there was infiltration of inflammatory cells at 10 days. DFDBA and DBBM were considered as the biocompatible graft materials and effective in the regeneration of new bone.

Two Cases of Traumatic Dislocation of Testis / 대한비뇨기과학회지

Traumatic dislocation of the testis is an unusual disorder and is characterized by an ectopically displaced testis as the result of closed injury. We report on 2 patients inguinal dislocation of the testis that was treated by orchiopexy, with brief of literatures.

Nonoperative Management of Extraperitoneal Bladder Rupture / 대한비뇨기과학회지

During last two year and seven month, We have seen 38 patients bladder rupture due to 34 blunt trauma, 2 penetrating injuries and 2 iatrogenic causes. There were 13(34.2%) intraperitoneal and 25(65.8%) extraperitoneal injuries. Nonoperative( catheter ) management was used in 21 patients with extraperitoneal rupture of the bladder with extravasation of dye found by retrograde cystogram and successfully treated by urethral catheter drainage only. We excluded 4 patients coexisting urethral rupture and significant intraabdominal injury. Complication occurred in 8 of the 2l patients but all were treated spontaneously during catheter drainage. It seemed obvious that nonoperative management will give a satisfactory result and would not be necessarily benefit from an operation to closing the bladder.

A case of adrenal myelolipoma / 대한비뇨기과학회지

No abstract is available.

Effectiveness of ultrasound in traumatized scrotum / 대한비뇨기과학회지

The decision between continued medical therapy and surgical exploration in patients with traumatized scrotum is difficult. We evaluated scrotal ultrasound as a non-invasive aid in such problematic cases. During s 42 months period. 17 patients were hospitalized for treatment of traumatized scrotum. All of them underwent careful physical examination and scrotal ultrasound. The results were as follows.; 1. In the appropriate clinical setting. ultrasound provides objective information supporting the need for surgical intervention in patients with traumatized scrotum and prevents unnecessary operation. 2. The results of treatment in 12 cases of 13 cases who underwent conservative treatment were good. 3. Scrotal ultrasound is necessary as soon as possible in traumatized scrotum and testicular salvage rates are improved markedly when early surgical correction of a ruptured tunica albuginea is performed. 4. Ultrasound is noninvasive and effective single diagnostic method in scrotal injury.

Management of iatrogenic ureteral injury / 대한비뇨기과학회지

We treated 19 patients with ureteral injuries during the recent 7 years. Gynecologic operations were the most common antecedent surgical procedures(89%). The diagnosis of ureteral injuries was made immediately in 3 patients and was delayed 3 to 78 days in 16 patients. All of the 3 injuries recognized during an operation were repaired at the time of injury. Of the 16 patients with injuries recognized in the postoperative period, 1 patient was managed with percutaneous nephrostomy. 14 patients received corrective surgery successfully, but the corrective surgery in remaining patient was railed and ultimately resulted in a nephrectomy because of avascular necrosis of ureter during operation. Therefore, it is better to do corrective surgery primarily in patients with ureteral injuries recognized postoperatively in order to decrease percutaneous nephrostomy associated morbidity and hospital admission period.

Two cases of perineal testis / 대한비뇨기과학회지

Perineal testicular ectopia is unusually observed but it is easily recognized by the presence of testis in the perineum and treated by surgery. We are submitting two cases of perineal testis with review of literatures.

A Case of Wilms' Tumor in Adult / 대한비뇨기과학회지

Wilms' tumor is the most common malignancy of the genitourinary tract in children and accounts for about 20% of all childhood solid tumors. In the adult population, the true incidence of this entity is difficult to ascertain, but it seems to be rare. The therapeutic guidelines that govern childhood Wilms' tumor should be applied to adult Wilms' tumor and multimodal therapy should be the hallmark of management.

Clinical Observation for Complications of Transurethral Resection in the Treatrnent of Benign Prostatic Hyperplasia / 대한비뇨기과학회지

A clinical observation for operative, postoperative complications were made from 61 case of TURP from June 1985 to April 1989. The following results were obtained. 1. Mean operative time was 81.5 minutes and mean weight of resected prostatic tissue was 13. 6gm. Therefore, it had taken average 6.97 minutes to resect 1gm of prostatic tissue. 2. Perioperative blood replacement was performed in only 16 cases except one case of death and the mean amount was 0.66 pint (210ml). The remaining 45 cases (73.8 %) were not necessary to transfuse blood. 3. Postoperative serum sodium concentration was decreased in 38 of 60 cases and not changed in 8 cases and increased in 14 cases. These changes in serum sodium concentration showed no significant correlation with operative, amount of irrigating fluid. 4. Nineteen of 61 cases of TURP showed several types of non-fatal complications and one case of these expired and the rest of people showed' no complication. 5. The most common complication was transient urinary incontinence (11.4%), the remainders were in order of urethral stricture (6.6%), late bleeding (4.9%), re-TURP due to inadequate resection (3.3%), death (severe bleeding) (1.6%).

Clinical Effect of Prazosin Hydrochloride in Patient with Benign Prostatic Hypertrophy / 대한비뇨기과학회지

The clinical effect of prazosin, an alpha-1-receptor blocking agent, was studied in 31 patients with benign prostatic hypertrophy. The daily dose of 1.5-6 mg of prazosin was given for 2 weeks to 3 months. The efficacy was assessed by using uroflowmetry calculated from maximum flow rate, average flow rate and residual urine volume. The result revealed significant improvement of day time frequency, night time frequency (p<0.05) and maximum and average flow rate (p<0.05). It was suspected that prazosin was the valuable alpha-1-receptor blocker for benign prostatic hypertrophy and worth while to initiate medical treatment before undergoing any surgical intervention or when surgery is contraindicated.

A Case of Paratesticular Rhabdomyosarcoma / 대한비뇨기과학회지

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood, representing 4 to 8% of all malignant tumors in children below 15 years old, but rhabdomyosarcoma of the paratesticular region is rare. The paratesticular rhabdomyosarcoma is a highly malignant lesion with early invasion and metastasis, which has retroperitoneal metastases in about half of the patients at time of diagnosis. However, the survival rates have been improved greatly by using multimodal therapy. We are submitting a case of paratesticular rhabdomyosarcoma with retroperitoneal lymph node metastasis with review of literatures.

Clinical Observation on Injury of Genitourinary Tract in Childhood / 대한비뇨기과학회지

Clinical observation was made on the injuries of genitourinary tract of in patient under 15 year in the department of urology, Hart Yang University Hospital during the period from May, 1972 to April, 1983. The results were as follows: 1. Of 3140 cases hospitalized, 30 cases were injury of genitourinary tract in children giving ratio of 0.96%. 2. The favorable age was from 7 to 9years for 40%. The sex ratio, male to female, was 4:1.3. Traffic. accident was the most frequent cause of injury (53.3%) and the ,next was fall-down (43.3%), especially 8 cases of fall-down were from playing. 4. The kidney was involved most frequently in 35.1% (8 cases were fight side) and urethra was next in 32.4%,external genitalia 21,6% bladder in 10.8%. 5. The fracture was the most frequent associated injury (71.4%) and it's sites of fracture were pelvis, femur, ribs, and etc. 6. Treatment of the renal injury was performed as conservative treatment frequently (66.7%) and 5 cases were undergone nephrectomy. Posterior urethra was involved more commonly and. preferable treatment was primary realignment with interlocking sound.

Clinical Observation on Injury of Genitourinary Tract in Childhood / 대한비뇨기과학회지

Clinical observation was made on the injuries of genitourinary tract of in patient under 15 year in the department of urology, Hart Yang University Hospital during the period from May, 1972 to April, 1983. The results were as follows: 1. Of 3140 cases hospitalized, 30 cases were injury of genitourinary tract in children giving ratio of 0.96%. 2. The favorable age was from 7 to 9years for 40%. The sex ratio, male to female, was 4:1.3. Traffic. accident was the most frequent cause of injury (53.3%) and the ,next was fall-down (43.3%), especially 8 cases of fall-down were from playing. 4. The kidney was involved most frequently in 35.1% (8 cases were fight side) and urethra was next in 32.4%,external genitalia 21,6% bladder in 10.8%. 5. The fracture was the most frequent associated injury (71.4%) and it's sites of fracture were pelvis, femur, ribs, and etc. 6. Treatment of the renal injury was performed as conservative treatment frequently (66.7%) and 5 cases were undergone nephrectomy. Posterior urethra was involved more commonly and. preferable treatment was primary realignment with interlocking sound.