The microsurgical free vascularized latissimus dorsi myocutaneous flap was successfully applied in the correction of long-term flexion contracture of the left knee due to scalding burn on the paralyzed leg from poliomyelitis. The patient was a 21 year old male, who suffered from 70° of flexion contracture of the left knee due to scalding burn at the age of 7 years. He has had flaccid paralysis of both legs since the age of 2 years. and not been able to ambulate with bilateral crutches and long leg braces. However after posterior capsulotomy, and successful microsurgical free vascularized latissimus dorsi myocutaneous flap, his left knee could be fully extended and fitted into bilateral long leg braces. So he was able to walk with bilateral crutches and discharged from the hospital on the day of 5th week after admission. Therefore microsurgical free vascularized latissimus dorsi myocutaneous flap is recommended for large soft. tissue defects such as those arising from posterior capsulotomy of knee joint used in the correction of flexion contracture from scalding burn scar upon the paralyzed legs from poliomyelitis.
Braces ; Burns ; Cicatrix ; Contracture ; Crutches ; Humans ; Knee Joint ; Knee ; Leg ; Male ; Myocutaneous Flap ; Paralysis ; Poliomyelitis ; Posterior Capsulotomy ; Superficial Back Muscles

No abstract available.
Laparoscopy* ; Ureter*

Fracture of the posterior lumbar ring apophysis or vertebral cartilaginous end plate is unusual, having previously been described only in adolescent males. In this report, we present 3 such cases involving 2 adolescent males and 1 adolescent female. All patients had a bony ridge or fragment projecting into the spinal canal, usually from the lower border of L4 vertebral body; a defect in the posteroinferior aspect of the vertebral body. Preoperative myelogram and computerized tomogram including plain X-ray appear to be helpful in demonstrating bone within the canal and preoperative diagnosis can facilitate selection of the appropriate surgical approach. The radiographic findings, including the myelogram and computerized tomographic appearance are detailed and the previous literatures are reviewed.
Adolescent ; Diagnosis ; Female ; Humans ; Male ; Spinal Canal

A total of 43 spinal cord injury patients with erectile dysfunction was placed on intracavernous injection of papaverine alone for one year. Thirty nine patients were able to obtain an erection adequate for penetration and 41 achieved transient functional penile erections after injection of papaverine. Of the 39 responders 20 patients practice self injection as a method to restore erectile function. Three episodes of priapism occurred in 3 patients and all patients were treated with aspiration of corpora. Two patients developedlocalized Intracorporeal induration and 5 suffered ecchymosis on injection site. We believe that intracavernous papaverine injection is a useful method for erectile impotence in men with spinal cord injury.
Ecchymosis ; Erectile Dysfunction* ; Humans ; Male ; Papaverine* ; Priapism ; Spinal Cord Injuries* ; Spinal Cord*

Lymphoma of the prostate is exceedingly rare. Much more common than primary lymphoma of the prostate id secondary involvement of malignant lymphomas originating at other sites. A variety of treatments have bee n used, including prostatectomy, radiotherapy or combinations of chemotherapy and radiotherapy. Generally, the prognosis is very poor, and there is currently no consensus regarding treatment. We report on a patient with T-cell lymphoma who presented with symptoms of bladder neck obstruction. The patient has been asymptomatic and under complete remission after completion of doxorubicin-based chemotherapy for 2 cycles.
Bees ; Consensus ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Lymphoma ; Lymphoma, T-Cell* ; Prognosis ; Prostate* ; Prostatectomy ; Radiotherapy ; T-Lymphocytes* ; Urinary Bladder Neck Obstruction

No abstract available.
Cesarean Section* ; Female ; Pregnancy

Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

No abstract available.
Urodynamics*

PURPOSE: Neuroendocrine (NE) cells of the prostate are considered to be involved in the pathogenesis of benign prostate hyperplasia (BPH). By a comparative analysis of NE cell density in BPH tissue of men who were either exposed to or not exposed to 5alpha-reductase inhibitor, we investigated the relationship between NE cells and BPH, and the effect of androgen deprivation on NE cells. MATERIALS AND METHODS: Prostate tissue specimens, obtained from 30 men by transurethral resection of the prostate or radical cystoprostatectomy, were used. Of the 30 patients, 10 had a prostate smaller than 25 ml (normal control), the other 20 had a prostate larger than 40ml, 10 of who had taken 5alpha-reductase inhibitor (finasteride) for 3 months before surgery (androgen blockade group), and 10 who had not (BPH group). The distribution of NE cells in the prostate was examined using the anti-chromogranin A (CgA) antibody, and the density of the CgA-positive cells was compared by an optical dissector method. Immunoblotting was performed using the neuron specific enolase (NSE) antibody. A Mann-Whitney U test was used in a statistical analysis. RESULTS: Most of the CgA-positive NE cells were localized between the acinar epithelial cells. The mean numbers of CgA-positive NE cells per acinus in the normal controls and the BPH groups were 1.67+/-0.78 and 4.45+/-2.54, respectively, and the difference was statistically significant (p<0.05). However, the mean number of CgA-positive NE cells in the androgen blockade group, was 4.93+/-2.17, which was similar to the BPH group. In a NSE immunoblotting study, a distinct band was observed in the BPH and androgen blockade groups, but the density of the band was higher in the androgen blockade group. CONCLUSIONS: Our results suggest that NE cells may be involved in the hyperplastic process of BPH. Inhibition of dihydrotestosterone, caused by the oral administration of the 5alpha-reductase inhibitor, failed to induce any significant change in the NE cells, probably due to the incomplete androgen blockade.
Administration, Oral ; Cell Count ; Dihydrotestosterone* ; Epithelial Cells ; Humans ; Hyperplasia ; Immunoblotting ; Male ; Neuroendocrine Cells* ; Phosphopyruvate Hydratase ; Prostate ; Prostatic Hyperplasia*

Trichophyton tonsurans is a major causative agent of tinea capitis in the United States, Canada, Mezico and other Latin American countries, but the infection of T.tonsurans has not been reported in Korea. We report a case of tinea capitis caused by T. tonsurans in a 15-year-old student wrestler. He had a 3*3cm sized non-inflammatory alopecia with black dots on the right occipital area of the scalp. The diagnosis was established by a hght microscopic examination of the affected hairs and by mycological studies from cultures. To our knowledge, this is the first case in which T. tonsurans has been isolated in Korea, It is likely that the student acquired the infection through contact with a foreign wrestler during interaational games and practice. We should be concerned about the potential of spread of this infection in our country.
Adolescent ; Alopecia ; Canada ; Diagnosis ; Hair ; Humans ; Korea ; Scalp ; Tinea Capitis ; Tinea* ; Trichophyton* ; United States