The Clinical Evaluation of Calcium Phosphate Cement Compared with Polymethylmethacrylate for Kyphoplasty

OBJECTIVE: We investigated the clinical outcome of kyphoplasty using calcium phosphate (CaP) for vertebral augmentation compared with polymethylmethacrylate (PMMA). We conducted a retrospective study to determine whether patients with osteoporotic vertebral fracture who underwent CaP kyphoplasty had improved outcome in the correction of vertebral body and relief of pain compared with those who underwent PMMA treatment. METHODS: From January 2005 to December 2006, 117 consecutive patients with osteoporotic compression fracture were treated at our institute. Among them, 23 patients have treated to kyphoplasty using PMMA or CaP. We reviewed the clinical data and imaging studies retrospectively as sources for analysis. RESULTS: The 23 patients included in the study. A mean ages of CaP and PMMA group were 70+/-9.5 and 67+/-9.5 years respectively. Preoperative compression ratios (CR) were 0.71+/-0.12 and 0.74+/-0.15 on both groups. Postoperative CR, however, showed the difference between two groups. The differences of preoperative and postoperative Cobb`s angle were 10.04 and 2.18 on CaP and PMMA group respectively and the mean injected volume of cement were 3.85+/-1.73 and 4.4+/-1.23 ml. CONCLUSION: The amount of injected volume of bone cement in kyphoplasty has no difference on both groups. But, follow-up compression ratio and Cobb`s angle are larger in CaP group than PMMA group. However, pain and functional recovery is not different on both group. As a result, CaP can not sufficiently support the strength of vertebral body, but be used to control the acute pain.

Spinal Cord Tumors of the Thoracolumbar Junction Requiring Surgery: A Retrospective Review of Clinical Features and Surgical Outcome

PURPOSE: A retrospective review of medical records and imaging studies. To investigate characteristic clinical features and surgical outcomes of spinal cord tumors (SCTs) of the thoracolumbar junction (TLJ). The spinal cord transitions to the cauda equina in the TLJ. The TLJ contains the upper and lower motor neurons of the spinal cord and cauda equina. As a result, the clinical features of lesions in the TLJ vary, and these anatomical characteristics may affect surgical outcome. MATERIALS AND METHODS: Pathological diagnosis, clinical features, neurological signs, and surgical outcomes were investigated in 76 patients surgically treated at our institute for SCTs arising from T11 to L2. The patients were divided into epiconus (T11-12, n=18) and conus groups (L1-2, n=58). RESULTS: Patients in the epiconus group had hyperactive deep tendon reflexes (DTRs), while those in the conus group had hypoactive DTRs (p < 0.05). Nine patients were misdiagnosed with intervertebral disc diseases (IVDs) before correct diagnoses were made. It was impossible to definitively determine the exact cause of symptoms in four patients who had both SCTs and IVDs. CONCLUSION: Among SCTs of the TLJ, the epiconus group displayed upper motor neuron syndrome and the conus group displayed lower motor neuron syndrome. SCTs of the TLJ were frequently misdiagnosed as IVDs due to symptomatic similarities. SCTs of the TLJ should be included in differential diagnosis of back and leg pain, and it is highly recommended that routine lumbar magnetic resonance imaging include the TLJ.

The Analysis of Preference for Three PDE-5 Inhibitors / 대한남성과학회지

PURPOSE: To evaluate the preference factors for the treatment of erectile dysfunction (ED) with three different kinds of PDE-5 inhibitors. MATERIALS AND METHODS: This prospective, open-label study recruited 140 patients from 5 medical centers and urological clinics in the Daegu and Gyeongbuk area of South Korea. All patients underwent sildenafil, tadalafil, and vardenafil therapy with at least four attempts at sexual intercourse for each medication. There was a 1-week drug washout period following each medication period. Patients were asked to state their preference among the three medications. RESULTS: The mean age of the 140 patients was 50.9 years. Most patients had mild-to-moderate ED(57 patients, 40.7%) and moderate ED(47 patients, 33.6%), the remaining patients had mild(23 patients, 16.4%) or severe ED (13 patients, 9.3%). Of 140 evaluated patients, 58(41.3%) patients preferred treatment with tadalafil, compared with 39(28.1%) with sildenafil and 37(26.6%) with vardenafil. When grouped by age, tadalafil was most preferred by men in their 30s and 40s(42.9%, 57.5%), sildenafil was preferred by those in their 50s(48.3%), and vardenafil was preferred by those in their 60s(51.6%). The reasons for specific preferences were prolonged erectile function (68.0%) and good erectile function(66.0%) for tadalafil, good erectile function (88.2%) for the sildenafil, and good rigidity of the erect penis(59.4%) for vardenafil. CONCLUSIONS: Tadalafil was most preferred among the phosphodiesterase inhibitors, but the preference rates varied for men of different ages. All the medications were well tolerated.

The Analysis of Preference for Three PDE-5 Inhibitors / 대한남성과학회지

PURPOSE: To evaluate the preference factors for the treatment of erectile dysfunction (ED) with three different kinds of PDE-5 inhibitors. MATERIALS AND METHODS: This prospective, open-label study recruited 140 patients from 5 medical centers and urological clinics in the Daegu and Gyeongbuk area of South Korea. All patients underwent sildenafil, tadalafil, and vardenafil therapy with at least four attempts at sexual intercourse for each medication. There was a 1-week drug washout period following each medication period. Patients were asked to state their preference among the three medications. RESULTS: The mean age of the 140 patients was 50.9 years. Most patients had mild-to-moderate ED(57 patients, 40.7%) and moderate ED(47 patients, 33.6%), the remaining patients had mild(23 patients, 16.4%) or severe ED (13 patients, 9.3%). Of 140 evaluated patients, 58(41.3%) patients preferred treatment with tadalafil, compared with 39(28.1%) with sildenafil and 37(26.6%) with vardenafil. When grouped by age, tadalafil was most preferred by men in their 30s and 40s(42.9%, 57.5%), sildenafil was preferred by those in their 50s(48.3%), and vardenafil was preferred by those in their 60s(51.6%). The reasons for specific preferences were prolonged erectile function (68.0%) and good erectile function(66.0%) for tadalafil, good erectile function (88.2%) for the sildenafil, and good rigidity of the erect penis(59.4%) for vardenafil. CONCLUSIONS: Tadalafil was most preferred among the phosphodiesterase inhibitors, but the preference rates varied for men of different ages. All the medications were well tolerated.

Effects of Intravesical Heparin Treatment on the Permeability of Bladder Mucosa in Allergic Cystitis in Rat / 대한비뇨기과학회지

PURPOSE: The relative impermeability of the bladder mucosa is due to the glycosaminoglycan layer covering the urothelium and the tight junction of the urothelium. Recently, one of the most popular theories of interstitial cystitis is the penetration of urinary irritants into the suburothelial tissue due to an increased permeability of the urothelium. This study was performed to evaluate the effect of the intravesical heparin treatment on the permeability of bladder mucosa in allergic cystitis. MATERIALS AND METHODS: Rats were sensitized by intraperitoneal injection of ovalbumin(10mg/m1/kg) given on days 1, 3 and 5. The experiments were performed 4 weeks afrer the last injection. Controls were run simultaneously with the sensitized animals. Sensitized rats were challenged with intravesical ovalbumin(10mg/m1, 1ml) and control rats received 1 ml saline Intravesically. Sensitized-antigen challenged group was divided into two subgroups; rats treated with intravesical hepanin(5mg/ml in 0.9% NaCl) or those treated with 1 ml saline intravesically Immediately following the intravesical heparin(or saline) treatment, 1ml of 14C-urea was placed into the bladder for two hours. We examined the peripheral blood concentration of 14C-urea at periods up to 120 minutes. RESULTS: There was no 14C-urea present in the blood in control group. There was a progressive increase in the blood level of 14C-urea with time in the sensitized-antigen challenge group. Compared with intravesical saline treatment group, there was less progressive increase in the blood level of 14C-urea with time in the intravesical heparin treatment group. W8 also measured radioactivity of 14C-urea in the bladder tissues and found significantly lower level of 14C-urea in the bladder tissues from intravesical heparin treatment group than intravesical saline treatment group. CONCLUSIONS: This study indicates that immunologically induced cystitis increases bladder mucosal permeability in rats and intravesical heparin treatment decrease the permeability significantly.

A Case of Leiomyomatosis peritonealis disseminata / 대한부인종양콜포스코피학회잡지

Leiomyomatosis peritonealis disseminata is a rare non-neoplastic proliferation of histologically benign smooth muscle that occurs in the alxlominal cavity of during the reproductive years of life, often giving rise to false choical imprwsion of d.isseminated carcinomatosis grossly, In 1952 Wilson & Peale described a condition which they called "multiple peritoneal leiomyomas". Taubert et al(1965) clearly delinated the features of the lesion and named it leiomyomatosis peritonealis disseminata(LPD). We report a case of leiomyomatosis peritonealis disseminata with a brief review of literatures.

Bladder Augmentation and Continent Diversion Using the Mainz Pouch (Mixed Augmentation Ileum and Cecum) / 대한비뇨기과학회지

The Mainz pouch offers a low pressure reservoir of adequate capacity, antirefluxing ureteral implantation and continent reservoir for bladder augmentation and continent diversion. Reconstruction of a urinary reservoir using a Mainz pouch was performed on 2 patients in 1987. The Mainz pouch was used for bladder augmentation in one patient and for continent urinary diversion in other one. The operative technique and clinical results are described.

Evaluation of 3 Cases of Renal Injuries with Dynamic Computed Tomography / 대한비뇨기과학회지

Dynamic computed tomography was performed in 3 patients thought to have renal trauma. Computed tomography, particularly if complemented by dynamic recording has proved to be most sensitive procedure and to offer most comprehensive diagnostic assessment for the majority of renal injuries. Ability of this dynamic computed tomography to guide assessment of viability of injured renal parenchyma is of great importance when determing the need for surgical intervention. The information provided by the dynamic computed tomogram rivals and duplicated that generated by arteriogram, but the advantage of dynamic computed tomography is less invasive procedure.

Surgical Repair of Hypospadias / 대한비뇨기과학회지

A clinical evaluation was made with particular attention to the technique of surgical repair on 61 patients with hypospadias who had been admitted to the Department of Urology, Kyungpook National University Hospital during 10 years periods from January, 1976 to June, 1986. The results were as follows: 1. The patients were between 1 to 29 years. Only 15 patients (24.6 %) were found in the age group under 6 years and 10(16.3%) in the age group over 20. 2. The most common type of hypospadias was penoscrotal in 33 patients (54.l%) and associated anomalies were found in 16 (26%) in which the most common one was cryptochism in 9. 3. 61 patients underwent hypospadias repair in which one stage repairs were used 13 and two stage repairs on 48. In two stage repairs, chordectomies were performed on 35 patients and second stage urethroplasties on 35. 35 patients underwent chordectomy in which Byars technique were used on 32 and Nesbit technique on 3. In the 32 patients who underwent chordectomy using Byars technique, 29 (9l%) were successful, while 3 others had skin necrosis or incomplete chordee repair. 35 patients underwent second stage urethroplasty in which Byars technique were used on 30 and other techniques on 5. In the 30 patients who underwent second stage urethroplasty using Byars technique, 20 (67%) were successful, which 8 having fistulas and 2 urethral stricture. 13 patients underwent one stage repair in which Duckett techniques were used on 4, MAGPI techniques on 3 Devine-Horton techniques on 2 and other techniques on 4. In the 13 patients performed one stage repair, 9 were successful, while 4 had fistulas or skin necrosis. 4. Of 83 surgical procedures performed with chordectomy, second stage urethroplasty or one stage repair, complication was encountered in l7 (20.6%). Of which the most frequent one was fistula. Of the 10 observed fistulas, 5 responsed nicely to one additional repair, while 3 required more additional repair and 2 had been lost in follow-up.

Replacement Lipomatosis of the Kidney: A Case Report / 대한비뇨기과학회지

Replacement lipomatosis of the kidney is a rare disease. It is characterized by fatty replacement of destroyed or atrophic renal parenchyma which associated with inflammatory or noninflammatory renal disease. Herein we reported a case of replacement lipomatosis of the kidney with renal tuberculosis and calculus.

Unusual Wilms' Tumor Extending Into the Bladder: A Case Report / 대한비뇨기과학회지

A case of unusual Wilms` tumor growing into the collecting system without invading into the parenchyma of the kidney is reported. The tumor filled completely the renal pelvis and ureter, and extended into the bladder but there was no invasion in the mucosa of renal pelvis, ureter or bladder.