Calcified Thyroid Nodules: Review of the Significance of Peripheral Calcifications

Thyroid calcification may occur in both benign and malignant thyroid disease, but previous literature reports have indicated that calcification is more common in malignant lesions than it is in benign ones. Various patterns of calcification are seen, including microcalcification, coarse dense macrocalcification, and peripheral calcification. Microcalcification and coarse dense macrocalcification are two of the most specific features of thyroid malignancy. However, to date, the clinical significance of peripheral calcification remains unclear and therefore controversial. In this pictorial review, we describe the ultrasonographic features of calcified thyroid nodules and seek to delineate the spectrum and determine the clinical significance of peripheral calcification by correlating it with pathologic results. A broad spectrum of benign to malignant tumors is associated with peripheral calcification. Peripheral calcification in a thyroid nodule should be considered to indicate an indeterminate lesion, and ultrasonography-guided FNAB or core biopsy should be performed in order to exclude malignancy.

Concurrent Emphysematous Cholecystitis and Emphysematous Pancreatitis: A Case Report

Emphysematous infections of the abdomen and pelvis are potentially life-threatening conditions which require aggressive medical and surgical management. Therefore, early radiographic detection is important in the management of these conditions. Concurrent emphysematous infections involving different organs have been rarely reported, and primarily occur in immunocompromised patients. Here, we report a rare case of concurrent emphysematous cholecystitis and emphysematous pancreatitis in a 97 year old male patient.

Assessment of Subpleural Opacities on High-Resolution CT

PURPOSE: The purpose of this study was to assess the value of HRCT for determining the cause of subpleural opacities. MATERIALS AND METHODS: We evaluated 49 cases of subpleural opacities on HRCT scan, among with the patients with subpleural opacities seen on the conventional chest radiographs. Two "blinded" reviewers retrospectively analyzed the CT scans by working in consensus. RESULTS: The patients consisted of COP (n=14), NSIP (n=13), UIP (n =10), fibrosis associated with connective tissue disease or drug toxicity (n=4), CEP (n=4), Churg-Strauss syndrome (n=2), DIP (n=1) and AIP (n=1). The predominant findings were consolidation (57%) with a peribronchovascular distribution (57%) in the COP patients, GGO (69%) and the associated focal reticular densities (61%) in the NSIP patients, and reticular or reticulonodular densities with a paucity of GGO in the UIP patients (100%). For the diagnosis of COP, NSIP and UIP, the use of HRCT demonstrated a high sensitivity (86%, 85% and 90%, respectively), specificity (97%, 86% and 95%) and accuracy (94%, 86% and 94%). CONCLUSION: Although an overlap of CT findings is seen for diseases showing subpleural opacities, consolidation with a subpleural and peribronchovascular distribution is highly suggestive for COP, subpleural GGO is highly suggestive of NSIP, subpleural reticular or reticulonodular densities with a paucity of GGO is highly suggestive of UIP, and subpleural consolidation accompanied by reticular densities is suggestive of fibrosis.

Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization.

The Short Stature in Children with Hypertrophy of Adenoid and Tonsil or Allergic Rhinitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There is little data to indicate that hypertrophy of adenoid and tonsil may cause short stature. However, there is no data relating short stature to allergic rhinitis in the Korean population. The aim of this study was to investigate the effect of hypertrophy of adenoid and tonsil and allergic rhinitis on children with short stature. SUBJECTS AND METHOD: One hundred and ninety-one children were included in the disease group, which consisted of three groups, allergic rhinitis only (n=83), hypertrophy of adenoid and tonsil only (n=67), and combintorial of allergic rhinitis and hypertrophy of adenoid and tonsil (n=41). There were 174 pediatric patients in the control group. Growth hormone levels, thyroid function and both wrist X-rays were checked on the children with short stature in order to exclude other chief medical problems causing short stature. For the purpose of evaluating the relationship between short stature and clinical factors, allergy parameters, eosinophil partition rate and total IgE levels were checked in the allergic rhinitis group, and the size of the adenoid and tonsil were checked in the adenoid and tonsil hypertrophy group. The relationship between the incidence of short stature and above clinical factors was evaluated. RESULTS: The incidence of short stature was significantly higher in each disease group than in the control. However, there was no statistically significant differences between each disease group. The above clinical factors were not associated with short stature. CONCLUSION: Hypertrophy in adenoid and tonsil and allergic rhinitis might be an independent cause of short stature.

A comparison of Modified One Layer Vasovasostomy with Optical Loupe and Microscope / 대한불임학회지

OBJECTIVE: The objective of this study was to compare results of the macroscopic one-layer vasovasostomy with those of microscopic one-layer vasovasostomy and to analyze the change of semen parameters according to the interval of vasal obstruction. METHOD AND MATERIALS: Between March 1987 and December 1997, we performed 121 vasovasostomies using modified one-layer technique with loupe magnification (macroscopic vasovasostomy) or microscope. Among the 68 could be followed post-operatively, 37 patients were treated by macroscopic technique with loupe, and 31 patients by microscopic technique. We compared rates of anatomical patency (sperm count above than 10x106/ml) and pregnancy of macroscopic vasovasotomy with those of microscopic vasovasostomy. Patency and pregnancy fates according to vasal obstructive interval were also examined. RESULTS: The patency rates of macroscopic and microscopic technique were 86.5% and 87.1%, and pregnancy rates of macroscopic and microscopic technique were 64.9% and 67.7%. There was no statistical significance between these two methods (p>0.05). The pregnancy rates and sperm motility were decreased if more than 10 years had elapsed following vasectomy(p<0.05). CONCLUSION: We found little difference in success rates resulting from macroscopic and microscopic vasovasostomy and the former had the advantage of reduced cost and a lower operator skill level. in post-operative semen analysis, the sperm motility was the most probable factor associated with vasal obstructive interval.

Are Chronic Prostatitis and Urethritis Related? / 대한남성과학회지

PURPOSE: It is the general conception that chronic prostatitis is initiated by urethritis. However, in the actual clinical situations, many male patients without histories of urethritis. To evaluate the possible relationship, a review of patients with chronic prostatitis was carried out. MATERIALS AND METHODS: Three hundred consecutive patients with prostatitis were reviewed retrospectively concerning the duration of prostatits, any history of urethritis, and the history of intercourse, including that with a high-risk partner(e.g., prostitute). RESULT: A history of urethritis was found in 216 of the patients(72%),but 30 patients(10%) denied both high-risk sexual intercourse and urethritis. In 54 patients (18%), there was no history of urethritis but a recognized sexual encounter with a high-risk partner. CONCLUSIONS: Having urethritis may not be an important factor in chronic prostatitis. This information could be most comforting to those who are afflicted with chronic prostatitis and concerned about the nature of their disease. Chronic prostatitis can be explained simply as an inflammation of prostate, not a dreadful end result of sexually transmitted disease.

Are Chronic Prostatitis and Urethritis Related? / 대한남성과학회지

PURPOSE: It is the general conception that chronic prostatitis is initiated by urethritis. However, in the actual clinical situations, many male patients without histories of urethritis. To evaluate the possible relationship, a review of patients with chronic prostatitis was carried out. MATERIALS AND METHODS: Three hundred consecutive patients with prostatitis were reviewed retrospectively concerning the duration of prostatits, any history of urethritis, and the history of intercourse, including that with a high-risk partner(e.g., prostitute). RESULT: A history of urethritis was found in 216 of the patients(72%),but 30 patients(10%) denied both high-risk sexual intercourse and urethritis. In 54 patients (18%), there was no history of urethritis but a recognized sexual encounter with a high-risk partner. CONCLUSIONS: Having urethritis may not be an important factor in chronic prostatitis. This information could be most comforting to those who are afflicted with chronic prostatitis and concerned about the nature of their disease. Chronic prostatitis can be explained simply as an inflammation of prostate, not a dreadful end result of sexually transmitted disease.

PSA and Prostatitis in Men under 45 Years Old / 대한비뇨기과학회지

PURPOSE: We evaluated the effect of prostatitis on prostatic-specific antigen(PSA) in 79 patients aged under 45 years old complained symptoms of prostatism. MATERIALS AND METHOD: The patients were divided into 2 groups: 61 patients who were diagnosed with prostatitis(group P) and 18 patients with prostatodynia and a history of prostatitis(group PD). As a control(group N) the PSA data obtained in the serial screening program of primary health clinic of 3,992 men under 45 years old were used. PSA was measured by Enzyme Immuno-Assay (AxSYM kit, Abbott Co.) and Tandem-R techniques. Prostate size was measured by the ellipsoidal method using the transrectal ultrasonogram (SonoAce 5000, Medison, Korea). RESULTS: Mean age was 37 years old for both control and patients(Group p,36; Group PD, 39; Group N, 37). Average serum PSA level(ng/ml) was 2.00(Group p, 1.99; Group PD, 2.05; Group N, 0.97). When PSA level was correlated with different age groups (20's; 30's; 40-45), PSA levels were 1.04, 0.96, and 0.96ng/m1 for group N and 1.77, 2.00, and 2.17ng/m1 for groups P & PD, which was significantly higher than group N(p<0.05). The numbers of patients with PSA above 4.0ng/ml were more frequently seen in group P & PD than N(group P & PD 11%, group N 0.88%). The average prostatic volume was 20.9cc (Group p,20.2; Group PD,23.3). The prostatic volume was significantly larger in Group PO but no significant correlations were noted between PSA and PSAD and between PSA and EPS WBC count. There were 19 patients in the first decade,30 in the second decade and 40 between 41-45 years and the average PSA levels were 1.77, 2.00, and 2.17ng/m1, respectively. Average prostate volumes were 18.6, 19.9, and 23.4cc, and the average PSAD 0.10, 0.10, 0.09, respectively; no significant correlation was seen in any of the measurements between the three age groups. Conclusions: These findings indicate that serum PSA level can be elevated in prostatitis and careful consideration be made when PSA is used as a tumor marker.

The Significance on the Retrograde Pericatheter Urethrography in the Timing of the Removal of Indwelling Uretbral Catheter / 대한비뇨기과학회지

Whether indwelling urethral catheter should be removed after urethroplasty or visual internal urethrotomy in patients with posterior urethral injured is still controversial. From May 1990 to February 1995, 28 patients with posterior urethral injury underwent retrograde pericatheter urethrography for the purpose of the evaluation of urethral continuity in the timing of the removal of indwelling urethral catheter. The indwelling catheter was removed in 24 patients whose urethra did not have any extravasation, and 4 patients had detectable extravasation. We conclude that retrograde pericatheter urethrogram is the most useful radiologically diagnostic method to evaluate in the timing of the removal of indwelling urethral catheter and to obtain the objective parameter of urethral patency in posterior urethral injured patients, postoperatively.

Penoplasty Using Liposuction in the Treatment of Concealed Penis / 대한비뇨기과학회지

In obese children, the phallus may be camouflaged by excessive deposition of fat at prepubic area. Recently, concealed penis has begun to receive the more attention about possibility of its urologic correction. Between February 1993 and February l994, we treated 5 patients with concealed penis. All patients were prepuberty, their phalli are palpated normal in size and no specific abnormal findings were detected in preoperative evaluation including physical examination, laboratory examinations (CBC, platelet, PT, PTT, liver function test, urinalysis, hormonal assay, chromosomal study). 2 of 5 patients were circumcised and 1 of 5 patient had a history of penoplasty without liposuction. The phallus length were measured 0cm to 0.5cm (mean 0.2cm) preoperatively, 3.5cm to 4.5cm (mean 4.0cm) postoperatively and 3.5cm to 4.2cm (mean 3.9cm) at 3 months after operation. In conclusion, we suggest that penoplasty using liposuction produces a good functional and cosmetic results.

A Case of Fibroma of Tunica Vaginalis / 대한비뇨기과학회지

Benign tumors within the scrotum are rare. The clinical recognition and correct identification are important from a standpoint of treatment and prognosis, as compared with the malignant testicular tumors. This benign tumor is also called fibrous pseudotumor of the testis. It is difficult to distinguish fibromas of the tunica vaginalis from tumors arising within the scrotum. The majority of the tumors of the testicular tunics are benign and therefore the prognosis is more favorable than those of the testes. Clinically, it is difficult to distinguish the fibroma of tunics from a malignant tumor of the testis. Final diagnosis is usually made after surgical exploration. A case of tunica vaginalis in 71-year-old male is presented with a brief review of literatures.