Successful Removal of Common Bile Duct Stone Using Endoscopic Papillary Balloon Dilation (EPBD), in A 28-month-old Child with Down's Syndrome / 대한소화기내시경학회지

Although cholelithiasis is an uncommon condition in infants, a recent study documented the increasing detection of this disorder. This increase may be explained by the wide use and improvement in abdominal ultrasound. Choledocholithiasis with cholestatic jaundice in infants usually requires therapeutic intervention, even though the incidence of spontaneous resolution has been reported to be higher in infants than adults. Choledocholithiasis in children has traditionally been managed surgically with open common duct exploration. Recently, endoscopic stone removal was accepted as a standard therapy in pediatric choledocholithiasis. We report a case of the successful removal of common bile duct stone using endoscopic papillary balloon dilation (EPBD), in a 28-month-old infant with Down's syndrome.

Consideration of Surface Dose and Depth of Maximum Dose Using Various Detectors for High Energy X-rays / 대한방사선종양학회지

PURPOSE: It is difficult to exactly determine the surface dose and the dose distribution in buildup region of high energy X-rays by using the conventional ion chamber. The aim of this study is to evaluate the accuracy of widely used dosimetry systems to measure the surface dose and the depth of maximum dose (dmax). MATERIALS AND METHODS: We measured the percent depth dose (PDD) from the surface to the dmax in either a water phantom or in a solid water phantom using TLD-100 chips, thimble type ion chamber, diode detector, diamond detector and Markus parallel plate ion chamber for 6 MV and 15 MV X-rays, 10 10 cm2, at SSD=100 cm. We analysed the surface dose and the dmax. In order to verify the accuracy of the TLD data, we executed the Monte Carlo simulation for 6 MV X-ray beams. RESULTS: The surface doses in 6 MV and 15 MV X-rays were 29.31% and 23.36% for Markus parallel plate ion chamber, 37.17% and 24.01% for TLD, 34.87% and 24.06% for diamond detector, 38.13% and 27.8% for diode detector, and 47.92% and 36.01% for thimble type ion chamber, respectively. In Monte Carlo simulation for 6 MV X-rays, the surface dose was 36.22%, which is similar to the 37.17% of the TLD measurement data. The dmax in 6 MV and 15 MV X-rays was 14~16 mm and 27~29 mm, respectively. There was no significant difference in the dmax among the detectors. CONCLUSION: There was a remarkable difference in the surface dose among the detectors. The Markus parallel plate chamber showed the most accurate result. The surface dose of the thimble ion chamber was 10% higher than that of other detectors. We suggest that the correction should be made when the surface dose of the thimble ion chamber is used for the treatment planning for the superficial tumors. All the detectors used in our study showed no difference in the dmax.

Results of Stereotactic Radiosurgery with Linear Accelerator for Intracranial Arteriovenous Malformation / 대한치료방사선과학회지

PURPOSE: Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM). We present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. MATERIALS AND METHODS: From January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a single fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. RESULTS: Angiography was available in 13 patients with a follow-up period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. CONCLUSION: We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.

A Case of Interstitial Cell Tumor of Testis In Adult / 대한비뇨기과학회지

Interstitial cell tumor of testis is relatively rare, comprising only 0.8 to 1.4 percent of all testicular tumors. A 67-year-old man was admitted to our hospital with rapid growing testicular mass. He had the experience of hydrocele and many times of aspiration since childhood. On physical examination, the testicular mass (left) was hard, adult fist sized and associated with transparent cystic fluid. Under the impression of testicular tumor, orchiectomy was performed. We report this case with review of literature.

Semen Culture Findings in 53 cases suspected of Chronic Prostatitis / 대한비뇨기과학회지

Although the chronic prostatitis is the most common infectious disease in the urinary tract in male, it is confusing us to diagnose and treat thoroughly. It is usually diagnosed by careful history, urinalysis, rectal palpation, and wet smear of prostatic secretions. But sometimes these findings are not identical to the true conditions of patients. 53 patients suspected of chronic prostatitis were studied by cultures of prostatic secretion and semen. And they compared to each other. The results were as follows: 1. Semen cultures, in 10 cases of the control group, showed positive findings in two cases. One was staphylococcus epidermis and the other was Gram(+) bacillococcus, but their colony counts were less than 100. 2. The positive findings on prostatic secretion culture were 37 cases (69. 8%) and on semen culture were 28 cases(52. 9%) 3. The etiologic organisms of chronic prostatitis by semen and prostatic secretion cultures revealed staphylococcus epidermis, staphylococcus aureus, streptococcus, Gram(-) diplococcus and Gram(+) bacillococcus in order of frequency. 4. Pathologic findings on prostatic biopsy according to different etiologic organisms revealed nothing remarkable except nonspecific chronic inflammation in each group. 5. Although there is no evidence the semen culture is superior to the prostatic secretion culture for diagnosis of the chronic prostatitis, it is more useful in the patient who may have an acute exacervation of chronic prostatitis, the patient whose prostatic juice can't be obtained by massage, and the patient who can't endure pain because of rectal pathology such as anal fissure or severe hemorrhoids.

A Study for the Radiologic Diagnosis of the Seminal Vesicles / 대한비뇨기과학회지

Since the first description on the vasoseminal vesiculography by Belfield(1913). Young and Waters (1920) had succeeded in getting the seminal vesiculograms by the routes of the ejaculatory ducts. Despite of the useful value of the seminal vesiculograms in the diagnosis of seminal vesiculopathies. it had not been used popularly due to difficulties on procedure. For evaluation of normal values of the seminal vesiculograms in Korean. 30 patients were selected. 20 patients of infertility and 10 patients of volunteers who received vasectomy. in Busan Armed Forces General Hospital from 1973 to 1975. The seminal vesiculograms had been taken by the vasectomy wounds in all cases. The results of analysis for normal seminal vesiculograms. in 15 cases, abnormal in 12 cases, and failed due to vas deference obstruction in 3 cases were as follows: 1. The length of main channel, in normal group, was 3.4+/-0.50cm, in right side. 3.3+/-0.12cm. in left side. and right side was 0.1cm longer than left. But in abnormal group it was 0.3 cm. shorter than normal group. 2. The width of lumen. in normal group. was 1.5+/-0.30cm. in right side. 1.3+/-0.34cm. in left side. and right side was 0.2cm. wider than left side. But in abnormal group it was 0.1cm. wider than normal group. 3. The angle between two long axes. in normal group, was 115+/-11. But in abnormal group it was 16 larger than normal group. 4. The ejaculatory duct, in normal group, runs directly downward to the verumontanum from the joined point of the seminal vesicle duct and the ampulla of vas. But in abnormal group it was obstructed or spastic in its contour.