Reconstruction of contracted bladder with a segment of small or large bowel has got a wide acceptance in the urological field today The use of a sigmoid colon segment isolated from the fecal stream appears to be most feasible for replacing or enlarging the bladder because the sigmoid colon with its proximity to the bladder would be the most logical donor organ. It might even be assumed so from a functional point of view. From January. 1961 to December 1962. in the Department of General Surgery. National Medical Center there has been performed 30 sigmoidocystoplasties for contracted bladder. The purpose of this paper is to present comparative clinical features of the reconstructed bladder and post-operative complications following closed loop and cup form sigmoidocystoplasty. Material: Of 30 cases of contracted bladder, 28 were contracted T. B bladder and 2 were non-specific cystitis. All 30 cases had previously undergone nephrectomy due either to non-functioning kidney, or extensive destruction. Seventeen cases were males and 13 cases were females. Agewas ranging from 12 to 67 years Two different techniques of sigmoidocystoplasty have been employed, namely closed loop (13 cases) and cup-form (17) sigmoiducyetoplasty, therefore, it has been possible to make a comparative study between two techniques. Clinical result and Conclusion: 1) Bladder reconstruction by means of an isolated sigmoid segment resulted in producing an efficaciously functioning artificial bladder as a urinary reservoir. No mortality 2) One case which was a complete failure was a case of contracted T. B. bladder with urinary incontinence, therefore, it should be emphasized that urinary incontinence is an absolute contraindication for sigmoidocystoplasty. 3)Bladder reconstructi with cup-form sigmoidocystoplasty was superior to closed loop sigmoidocystoplasty because of; A) Shape, position and Prevention of residual urine formation of the reconstructed bladder. B) Tidal volume as closed as total bladder volume. C) Very similar cystometry curve to the normal. D) Reduction of post-operative complication. 4) Production of mucus urine causes troublesome discomfort to the patient after bladder reconstruction, therefore, it would be ideal if we can prevent mucous urine. 5) Although the serum chloride has some tendency to increase after sigmoidocyetoplagty, however, no hyperchloremic acidosis was produced if the kidney function was normal. 6) All hyperchloremic acidosis cases in this series had irreversible hydronephrosis of the remaining kidney. This might give the impression that severe hydronephrosis is a contra-indication to sigmoidocystoplasty. However, as a contracted bladder gives not only miserable urinary symptoms but also shortens the life by progressive destruction of be kidney, the indication for reconstruction of a contracted bladder, even in the presence of severe hydronephrosis, should be discussed. A non-absorbable reconstructed bladder should be most ideal artificial bladder.
Acidosis ; Colon, Sigmoid ; Cystitis ; Female ; Humans ; Hydronephrosis ; Kidney ; Logic ; Male ; Mortality ; Mucus ; Nephrectomy ; Rivers ; Tidal Volume ; Tissue Donors ; Urinary Bladder* ; Urinary Incontinence

Retrocaval ureter is a relatively rare anomaly where ureteric obstruction may occur as a result of ureter passes behind the inferior vena cava (IVC), hence, compressing it between the IVC and the vertebrae. We report 2 cases of retrocaval ureter with different presentations. One patient was managed surgically with minimally invasive approach and the other was managed conservatively.
Retrocaval Ureter

OBJECTIVES: This study was conducted to develop a Korean version of the Participatory Action Oriented Training (PAOT) program and training materials for improvement of agricultural working environments. METHODS: The PAOT manual and checklist were developed on the basis of the original English version of the training materials, a questionnaire survey of agricultural health and safety professionals, and a brainstorming conference. Good example pictures were collected through visits to agricultural workers' houses, and an easily understandable picture was drawn by an animation specialist. A PAOT action manual and five types of action checklists were developed for use in different agricultural environments. Each action checklist contained six categories and 38 items of agricultural health and safety principles; the six categories were material storage and handling, work stations and tools, machine safety, physical environment, working schedule and organization, and basic health and safety management. Incorporating these training materials, a one-day Korean PAOT program was developed. RESULTS: Among 307 candidate agricultural workers from four rural Korean villages, 94 workers (59 males, 35 females) participated in a PAOT from July 2007 to Oct 2008. The PAOT program was successful and the mean self-estimated satisfaction score of the participants was greater than 90%. CONCLUSIONS: A Korean PAOT program and training materials were successfully developed and applied to Korean agricultural workers. Although more studies are needed, it is expected that PAOT will greatly contribute to the improvement of agricultural working conditions and health and safety through the use of agricultural workers' self initiatives.
Appointments and Schedules ; Checklist ; Farmers ; Handling (Psychology) ; Humans ; Korea ; Male ; Safety Management ; Specialization ; Surveys and Questionnaires

BACKGROUND: Blepharospasm and apraxia of lid opening (ALO) are nonparalytic causes of involuntary eyelid closure (IEC). Recently Aramideh (1994) divided the IEC into 5 groups by electromyography (EMG) study, and reported that each group had different responses to Botulinum A toxin treatment. Objective : We looked whether clinical observation can match the EMG, and possibly predict the response to Botulinum A toxiu treatment. Method : Based on EMG study of Aramideh (1994), clinically observable characteristics of each group were defined. One of the authors reviewed the videotapes of IEC and applied the above criteria to make the clinical diagnosis. Other author blinded to the clinical information performed 2 channel EMG of levator palpebrae superioris (LP) and orbicularis oculi (00) muscles, and made the EMG diagnosis. Clinical and EMG diagnoses were matched. Results : Twenty five patients (5 men and 20 women) were included in the study. Clinically, 16 were diagnosed as group I (blepharospasm), 1 as group 111(combined blepharospasm and LP motor impersistence), 7 as group tV(combined blepharospasm and involuntary LP inhibition), and 1 as group V(involuntary LP inhibition). There were no patient in group ll (combined dystonic activities of LP and 00). On EMG study, 14 were diagnosed as group 1, 2 as group ll, 1 as group 111, 7 as group IV, and 1 as group V The mismatch between the two diagnoseis occurred between group I and tV in 4 patients, group I and ll in 2, and group I and 111 in 2. Conclusions : Clinical observations are generally correct in predicting EMG diagnosis. Holvever groups with mixed features(ll, 111, and Iv) are difficult to diagnose by clinical observation only. Usefulness of clinical and EMG diagnosis on predicting Botulinum A toxin response will need to be evaluated. Key Words : Involuntary eyelid closure, Blepharospasm, Apraxia of lid opening, Electromyography.
Apraxias ; Blepharospasm ; Botulinum Toxins, Type A ; Diagnosis* ; Electromyography ; Eyelids* ; Humans ; Male ; Muscles ; Videotape Recording

Circulating tumor cells (CTCs) are a valuable biomarker for the diagnosis, prognosis, and therapeutic management of gastrointestinal (GI) cancers. A major challenge in GI cancer treatment is the high rate of metastasis, which significantly contributes to cancer-related mortality. CTCs are crucial in the metastatic cascade, serving as indicators of tumor progression. Therefore, the detection and molecular characterization of CTCs have prognostic potential for identifying early-stage GI cancers and assessing metastatic probability, enabling timely treatment. Moreover, CTC analysis offers a minimally invasive method for real-time monitoring of tumors.Clinicians can adjust therapeutic strategies accordingly by tracking changes in CTC count and molecular profile. Despite this promising application, no standardized protocol for CTC isolation in GI tract cancers has been established, which poses a barrier to routine clinical use. This review explores the current CTC detection methodologies, their clinical relevance in GI cancer management, and the potential integration of CTC analysis into personalized medicine. We also discuss the challenges and future directions in CTC research, focusing on clinical validation and the development of standardized procedures to fully realize the utility of CTC count for improving patient care.

PURPOSE: Recently, Geneticin (G418) were known to exert neuroprotective effects in the hypoxic-ischemic (H-I) brain injury, but the mechanism is still unclear. The roles of fibroblast growth factor (FGF) and FGF receptor (FGFR) ware not well known in the H-I brain injury. We investigated the neuroprotective effects of systemically administrated Geneticin through the regulation of FGFR following the H-I brain injury METHODS: The cortical neuron cell culture of Spague-Dawley (SD) rat embryo brain (E18) was done in a hypoxic incubator. The cultured cells were divided three groups: a normoxia group, a hypoxia group, and an Geneticin-treated group. After verifying the desired amount of cellular injury in the hypoxia group, the Geneticin-treated group (after an H-I insult) was further divided into two groups. This produced four final groups: normoxia, hypoxia, and Geneticin-treated groups before H-I insult and a Geneticin-treated group after HI insult. The expression of FGFR-2 and FGFR-3 mRNA was measured using Northern blotting. RESULTS: The expression of FGFR-2 and FGFR-3 mRNA was notably increased in the hypoxic group compared to the normoxic group. In both Geneticin-treated groups before and after a hypoxic insult, the expression of FGFR-2 and FGFR-3 mRNA was decreased. CONCLUSION: It suggests that FGFR has an important role in hypoxic brain injury. Geneticin appears to exert a protective effect through down regulation of the expression of FGFR mRNA. However, more experiments are needed in order to demonstrate the usefulness of Geneticin as a preventative and rescue treatment for H-I brain injuries of neonatal brain.
Animals ; Anoxia ; Blotting, Northern ; Brain ; Brain Injuries ; Cell Culture Techniques* ; Cells, Cultured ; Down-Regulation ; Embryonic Structures ; Fibroblast Growth Factors* ; Fibroblasts* ; Incubators ; Neurons* ; Neuroprotective Agents ; Rats ; Receptors, Fibroblast Growth Factor* ; RNA, Messenger

To evaluate the result of diathermic capsulotomy for phacoemulsification in hypermature intumescent cataracts, we retrospectively studied 34 patients(35 eyes) who were operated from January 1995 to February 1997. Central corneal endothelia cell counts were taken preoperatively and 2 months postoperatively by non-contact specular microscopy and endothelial cell loss(%) was calculated. The anterior capsular radial tear occurred in 24 eyes(68%), posterior capsular rupture occurred in 1 eye(2.9%) and the percentage of postoperative endothelial cell loss was 6.45(+/-7.27)%. The high rate of anterior capsular radialtear was due to altered mechanical integrity of the diathermic capsulotomy edge. But the thermal effect on the corneal endothelium was minute. Based on these findings, the diathermic capsulotomy for phacoemulsification in hypermature intumescent cataracts is very useful technique.
Cataract* ; Cell Count ; Endothelial Cells ; Endothelium, Corneal ; Microscopy ; Phacoemulsification* ; Retrospective Studies ; Rupture

Several different viscoelastic substances are widely used in many ophthalmologic fields. In our study, the efficacy and safety of the different kinds of viscoelastics -Healon(R), Provisc(R), Viscorenal(R), Hyal-2000(R), Viscoat(R) and Biolon(R)-was evaluated in undergoing phacoemulsification and posterior intraocular lens implantation, corneal transplantation and ocular trauma surgery. We evaluated and the facility of the injection the foreign materials during injection of viscoelastics through the microscopy. We measured the changes of intraocular pressure at the postoperative 1 day and corneal endothelial cell count at the postoperative 2 month. The mean endothelial cell loss after phacoemulsification and posterior intraocular lens implantation was 13.71% at postoperative 1 day and there was no significantly different among groups. The incidence of the foreign materials including air bubles in viscoelastics in the operating microscope was Provisc(R), Hyal 2000 Viscorneal(R), Biolon(R), Healon(R) in order. The mean incidence of the intraocular pressure above 25 mmHg after cataract surgery at postoperative 1 day was 3.94%and was Hyal 2000(R), Biolon(R), Viscorneal(R), Healon(R), Provisc(R) in order. The incidence of the additional use of the antiglaucoma drugs in keratoplasty patients was 76%in Healon(R) group, 26.7%in Viscoat(R) group, 69.2%in Provisc(R) group respectively. From the results of this report, we conclude that it is desirable to use the proper viscoelastics according to the chemical and physical properties in special situations, but there is no significant difference in the same viscoelastic substance.
Cataract ; Corneal Transplantation ; Endothelial Cells ; Humans ; Incidence ; Intraocular Pressure ; Lens Implantation, Intraocular ; Microscopy ; Phacoemulsification ; Viscoelastic Substances

The data obtained from present experiments demonstrated that among several inhalation anesthetics, ether was the most irritable, resulting in marked irregularity of respiratory movement, and halothane depressed respiratory rate more than the other. The pulse rate and blood pressure were decreased marked1y in ether and the halothane anesthesia. the rate of beat of the isolated atria was not greately altered after anesthesia with ether or trichlore-thylene, while it was reduced after chloroform or halothane inhalation. The response of isolated atria to exogeneous norepinephrine was most prominent in the atria isolated from halothane anesthetized rabbits. Myocardial catecholamine contents were reduced uniformly after anesthesia with each anesthetics and most significantly with the halothane inhalation. From the above results, it may be concluded that the increasing cardiac activity with general inhalation anesthetics is closely related to the quantitative changes of the endogenous myocardial catecholamine contents.
Anesthesia, Inhalation/adverse effects ; Anesthetics/*toxicity ; Animals ; Catecholamines/*metabolism ; Heart/*drug effects ; Myocardium/*metabolism ; Norepinephrine/*pharmacology ; Rabbits

Results of vitrectomy as treatment of full thickness(stage 3,4) macular hole were reported large variability and difference n anatomical and funtional success rate. So many surgeons fely difficulty in expectation of postoperative results before operation on stage 3,4. To use decision of proper operation time & effective treatment and expect the postoperative results before operation, after anatomical & functional factor affecting postoperative results & prognosis were arranged, relationship of these data after vitrectomy were evaluated. Pars plana vitrectomy in 25 patients(25 eyes) with stage 3(8 eyes) and stage 4(17 eyes) macular hole was performed. Functional success was seen in 7 eye(28%) and Anatomical success was seen in 12 eyes(48%). Preoperative factors such an stage of macular hole, preoperative visual acuity, size or macular hole, and sex were not found any association with postoperative functional & anatomical success rate. the group that had completely attached hole after vitrectomy and small preoperative cuff size(<1.0mm) were showed improvement of visual acuity compared with the other group. But these results were statistically not significant. And patients (5 eyes) with additional removal of ILM with PVD or memb peeling were showed good anatomical success rate(80%), but no difference of postoperative visual acuity compared with the other group. Although preoperative fluid cuff size and around hole and completely closure of hole after surgery were statistically not significant, highly correlated with postoperative visual acuity compared with the other factor. But long-term follow-up & recruitment of additional cases are required to consider as one of the significant factor on deciding operation time & expecting postoperative result.
Follow-Up Studies ; Humans ; Prognosis* ; Retinal Perforations* ; Visual Acuity ; Vitrectomy*