PURPOSE: In contracted bladder of various etiologies, if many of conservative managements fail, a surgical treatment seems to be the only therapeutic approach. We tried to evaluate the long term results of aug mentation cystoplasty including the postoperative complication and the degree of satisfaction in patients. MATERIALS AND METHODS: From 1989 to 1988, augmentation cystoplasties had been performed in 11 patients with contracted bladder of various etiologies. We reviewed the patients' medical records including the result of urodynamic examinations, retrospectively. Postoperative follow-up periods were 9 to 114months (mean:61months). Patients were interviewed by telephone. RESULTS: Urinary frequency, nocturia, dysuria and suprapubic pain were improved in all patients, but dysuria persisted in one patient with tuberculous cystitis. Clean intermittent catheterization (CIC) was done in there of 11 patients due to large volume of residual urine. The volume of residual urine was 200-300ml in one with hyperreflexic neurogenic bladder, and 100-200ml in two with interstitial cystitis. Self voiding was possible in 8 patients with residual urine volume less than 90ml. Almost all patients were very satisfied symptomatically in the telephone survey. There were no significant complications which required surgical revision. CONCLUSIONS: It is concluded that augmentation cystoplasty could be an excellent method of treatment for selective patients with contracted bladder, who have not improved symtomatically by medication or conservative management.
Cystitis ; Cystitis, Interstitial ; Dysuria ; Follow-Up Studies ; Humans ; Intermittent Urethral Catheterization ; Medical Records ; Nocturia ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Telephone ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urodynamics

PURPOSE: The purpose of this study was to compare the fracture strength of the zirconia monolithic all-ceramic crowns according to the thickness (0.5mm, 0.8mm, 1.1mm) and metal-ceramic crowns (1.0mm, 1.5mm). MATERIAL AND METHOD: Twelve crowns for each of 3 zirconia crown groups were fabricated using CAD/CAM system (Kavo, Germany) and twelve crowns for each of 2 metal-ceramic crown groups were made by the conventional method. All crowns were luted to the metal dies using resin cement. Half of the specimens were exposed to thermocycling (5-55degrees C, 1 Hz) and cyclic loading (300,000 cycles, 50N). Subsequently, all crowns were mounted on the testing jig in a universal testing machine. The load was directed at the center of crown with perpendicular to the long axis of each specimen until catastrophic failure occurred. Analysis of variance and Tukey multiple comparison test (P<.05) were used for statistical analysis of all groups, and paired t-test (P<.05) was followed for statistical comparison between each groups'fracture load before and after cyclic loading. RESULTS: 1. The fracture strength of the zirconia monolithic crowns and the metal-ceramic crown increased as thickness increased (P<.05). 2. The cyclic loading and thermocycling significantly decreased the fracture strength of the zirconia monolithic crowns (P<.05). 3. The standard deviation of fracture strength of the zirconia monolithic crowns was very low. CONCLUSION: The fracture strength of the zirconia monolithic crowns for the posterior area tends to be higher with thickness increased and 0.8mm or over in thickness is recommended to have similar or over the fracture strength of metal-ceramic crowns.
Axis, Cervical Vertebra ; Crowns* ; Resin Cements

Blood valproic acid levels were decreased in patients with traumatic brain injury who had been using valproic acid to control irritability and aggression, and the symptoms worsened coincident with the administration of meropenem, a carbapenem-based antibiotic. Two weeks after the discontinuation of meropenem, valproic acid levels were restored to an effective therapeutic concentration. Therefore, when valproic acid and carbapenem-based antibiotics are used together, blood valproic acid levels may decrease due to drug interaction, and irritability symptoms may worsen. Thus, close monitoring of serum valproic acid levels is required.

PURPOSE: With the process of neoangiogenesis being linked to the growth and metastasis of various tumors, anticancer therapeutics with a basis in the suppression of neoangiogenesis has recently been receiving attention. In this study, we tried to clarify the immunoreactivities of vascular endothelial growth factor (VEGF), major angiogenic inducer and thrombospondin-1 (TSP-1), major angiogenic inhibitor in human Wilms' tumor and its clinicopathological significance. MATERAILS AND METHODS: Utilizing immunohistochemical staining, we assessed the immunoreactivities of VEGF and TSP-1 in archival tissues of 29 Wilms' tumors and 25 normal kidneys. Also, we assessed the relationship between expression of each factor and clinicopathological parameters in 29 cases of Wilms' tumors. RESULTS: Immunoreactivities of VEGF and TSP-1 were detected mainly in the cytoplasm of the tubular cells in normal kidneys. In Wilms' tumors, whereas VEGF was detected in the cytoplasm of the tumor cells and peritumoral stromal tissues, but TSP-1 only in the peritumoral stromal tissues. Immunohistochemical expression patterns of each factor were divided into two groups according to the area of immunoreactivity (negative:<10%, positive: > OR =10%). VEGF immunoreactivity was detected in 25 (100%) normal kidneys and in 20 (69%) Wilms' tumors. However, TSP-1 immunoreactivity was detected in 24 (97%) normal kidneys and in 3 (10%) Wilms' tumors. Therefore, although no significant difference was observed between the expressions of VEGF and TSP-1 in normal kidney, the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors. A relatively higher rate of positive expression of TSP-1 was observed in the patients with no demonstrable lymph node metastasis. Also, as for the VEGF, maximal diameter of the tumor was larger in the positive expression group. However, it proved otherwise for TSP-1 as the negative expression group demonstrated tumors with larger maximal diameters. CONCLUSIONS: Our study demonstrated that the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors, and disease progression has a tendency to be found in the VEGF-positive cases and TSP-1 negative cases. We suggest that the growth and metastasis of Wilms' tumor may be influenced mainly by TSP-1 decrease rather than VEGF increase.
Cytoplasm ; Disease Progression ; Humans ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Thrombospondin 1 ; Vascular Endothelial Growth Factor A* ; Wilms Tumor*

Arterial cannulation for constant monitoring of arterial pressure and blood gase analyses has become commonplace in the care of the critically ill patients. The radial artery is often regarded as causing a negligible complication risk because of extensive collateral arterial flow in the hand. One of other alternative sites for arterial cannulation is femoral artery. Femoral artery cannulation has a high degree of success in very small, critically ill children. It should be considered an acceptable alternative to small-vessel cannulation when the latter is not technically achievable, or in the unstable patient where rapid establishment of reliable artery access is necessary. Arterial cannulation may cause many complications: arterial catheters can directly injure the vessels, resulting in thrombosis, occlusion, distal embolization or ischemia. Local insertion site complications, such as hematoma, hemorrhage, and infection may occur. Arterial catheter may also be a source of systemic sepsis. We report an unusual case of unintentional release of a catheter fragment into the external iliac artery in a 7-month (7.8 kg) male patient with tetralogy of Fallot, which was inadvertently inserted during right femoral artery cannulation. The catheter fragment was successfully retrieved with the Amplatz Goose Neck microsnare under fluoroscopy without any problems.
Arterial Pressure ; Arteries ; Catheterization* ; Catheters* ; Child ; Critical Illness ; Femoral Artery* ; Fluoroscopy ; Hand ; Hematoma ; Hemorrhage ; Humans ; Iliac Artery* ; Ischemia ; Male ; Neck ; Radial Artery ; Sepsis ; Tetralogy of Fallot ; Thrombosis

The purpose of this study was to investigate the displacements of cast framework by torch soldering and electric soldering techniques. Specimen had two cylinders and connecting bar that had sectioned with 0.3mm gap at mid point. 10 of total specimens were divided into two groups. In torch soldered group, soldering investment block was made and conventional torch soldering procedure was carried out. In electric soldered group, electric soldering was carried out on the master cast without soldering investment block by using electric soldering machine(Dentapunkt DP 7, Kulzer, Germany). After soldering procedure, three dimensional coordinates of two centroids of each cylinder were measured by three dimensional coordinate measuring machine. The intercentroidal displacement and global displacement were calculated and then, these values were compared and evaluated. The results were obtained as follows: 1. Intercentroidal distances of specimens decreased after both soldering procedures, and the decrease in intercentroidal distance was greater for torch soldered group than for electric soldered group 2. Global displacements of torch soldered group were greater than those of electric soldered group
Investments

We report a rescently experienced case with atypical radiologic manifestation of solid and papillary epithelial neoplasm of the pancreas in a 37 years old female patient. The tumor had heavy calcification on its capsule wall and septa. Instead of the usual encapsulated lesion with partly solid and partly cystic-hemorrhagic components, the lesion consisted of numerous fine cavitations containing air without fluid component except focal abscess fluid.
Abscess ; Female ; Humans ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancrelipase*

No abstract available.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen*

No abstract available.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen*

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation