No abstract available.
Cadaver* ; Fascia Lata* ; Fascia*

PURPOSE: We investigated the technical feasibility and clinical results of percutaneous bladder neck suspension(PBNS) using bone anchors(Vesica) which represents a minimally invasive surgical procedure for the treatment of stress urinary incontinence caused by hypermobility of the proximal urethra and bladder neck. MATERIALS AND METHODS: Among women who underwent PBNS using bone anchors for type I or type II stress urinary incontinence, 22 women were followed for at least postoperative 9 months. A miniature bone anchor was used. On each side the suture was attached to the pubocervical fascia and the vaginal wall via a broad ?Z-stitch?. Postoperative voiding status was evaluated during office follow-up visits and telephone surveys. RESULTS: Mean operation time was 32 minutes. Mean hospital stay was 0.9 days. Mean follow-up was 13 months(9 to 18 months). In the 22 patients, the procedure was successful in 18 cases(82%), with 11(50%) of the patients completely dry and 7(32%) significantly improved. Preoperative urgency was present in 10 patients(45%). Postoperative resolution rate of urgency was 60%(6 of 10 patients). In 4 cases(18%), de novo urgency was documented. Removal of the bone anchor and suture was necessary in only one patient, because of persistent vaginal infection. Other complications were transient urinary retention in 3 patients(14%), prolonged suprapubic discomfort in 1 patient(4.5%) and incidental bladder perforation in 1 patient(4.5%). Major complications such as chronic urinary retention, osteitis pubis were not noted. CONCLUSIONS: The use of this bone anchoring technique and preservation of the endopelvic fascia appears to enhance the success rate without increasing the risk to the patient and, as minimally invasive procedures, reduce the surgery time and the length of hospitalization. However, the suspension sutures of PBNS may pull through the paraurethral tissue because there is no paravesical scar formation as in open procedures. Therefore we conclude that modifications of the suspension technique should be required for the improvement of long-term results.
Cicatrix ; Fascia ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Length of Stay ; Neck* ; Osteitis ; Suture Anchors* ; Sutures ; Telephone ; Urethra ; Urinary Bladder* ; Urinary Incontinence* ; Urinary Retention

Carcinosarcoma is a highly malignant tumor characterized by dual malignant histologic differentiation of epithelial and mesenchymal components. The tumor is extremely rare in the sinonasal tract. We report a case of a 62-year-old man with carcinosarcoma involving the maxillary sinus.
Carcinosarcoma ; Maxillary Sinus

A clinical analysis of 1753 patients with dental surgery under the general anesthesia from January 1981 to December 1985 was made according to age, sex, disease, and status of intubation. The results were as follows: 1) Of 1753 patients with oral surgery, 1067 male and 686 female patients were operated on under general anesthesia and the male to female ratio was 1.6:l. 2) Of 1753 patients, there were 501 patients with oral surgery from 20 to 30 years of age and this was the most common age. 3) Benign tumors including cysts were the most common lesions operated on under general anesthesia. 4) Of 1753 patients, 1529 patients had nasotracheal intubations, but the patients with orotracheal intubations were 206, and the patients with endotracheal insertion through tracheostomy were only 18 (l%).
Anesthesia, General ; Female ; Humans ; Intubation ; Male ; Surgery, Oral* ; Tracheostomy

OBJECTIVE: New antidepressant, nefazodone is classified as a serotonin -2 antagonist/reuptake inhibitor like old antidepressant, trazodone. Nefazodone, however, differs from trazodone in that it lacks anti-histaminergic properties and in that it has some norepinephrine reuptake inhibitory properties. These differences may account for the differences between the two drugs in the side effect profiles. This study was conducted to compare the acute effects of nefazodone on the psychomotor performance with those of trazodone. METHODS: The subjects were 12 healthy male volunteers aged between 20-40 years. A single, oral starting dose of nefazodone or trazodone was administered in a double-blind, randomized latin-square design with a 1-week interval between each drug switch. Psychomotor performances were assessed at 1 hour before and at 2 hours after administration of nefazodone 50 mg, nefazodone 100 mg or trazodone 50 mg. The measures of psychomotor performance included Vienna Determination Unit for complex choice reaction time, Critical Flicker Fusion Test, and Grooved Pegboard Test. RESULTS: In the Vienna Determination Unit, when 'within drug effect' (pre- vs. post-medication) was analyzed, nefazodone 100 mg decreased complex choice reaction time in both subtest 2 and subtest 3. Nefazodone 50 mg also decreased the reaction time in subtest 3 but not in subtest 2 which was more difficult and demanding task than subtest 3. On the other hand, no significant changes in the reaction time were observed with trazodone 50 mg in either subtest 2 or subtest 3. When 'between drug effect' was analyzed, however, the differences between drugs were not found to reach statistically significant level. No significant 'between drug effect' or 'within drug effect' was observed in Critical Flicker Fusion Test and Grooved Pegboard Test. CONCLUSION: Although the differences between nefazodone and trazodone did not reach statistically significant level, the results on the complex choice reaction time suggest that al least a single starting dose of nefazodone up to 100 mg does not impair psychomotor performances and it might have a less detrimental effect than trazodone on the psychomotor performance.
Administration, Oral* ; Flicker Fusion ; Hand ; Healthy Volunteers* ; Humans ; Male ; Norepinephrine ; Psychomotor Performance* ; Reaction Time ; Serotonin ; Trazodone* ; Volunteers

BACKGROUND/AIMS: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. METHODS: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy. By spraying 0.2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. RESULTS: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/18), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening 80% (8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). CONCLUSIONS: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.
Colitis ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Diagnosis ; Dysentery, Amebic ; Humans ; Indigo Carmine ; Inflammatory Bowel Diseases ; Mucous Membrane ; Pathology ; Ulcer*

Ewing's sarcoma is an uncommon malignancy that usually occurs in children. It most commonly involves the lower extremity, with the pelvis being the next most common site. Primary Ewing's sarcoma that arises in the head and neck region is extremely rare, representing only 1-4% of all Ewing's sarcoma cases. We report a case of primary Ewing's sarcoma in the nasal cavity in a 10-year old patient with a non-specific past medical history, in which the patient received 3 trials of neoadjuvant chemotherapy, endoscopic wide excision, followed by 2 more trials of adjuvant chemotherapy. Currently, it has been 5 years since treatment and the patient did not exhibit any signs or symptoms of recurrence of the disease.
Chemotherapy, Adjuvant ; Child ; Head ; Humans ; Lower Extremity ; Nasal Cavity ; Neck ; Pelvis ; Recurrence ; Sarcoma, Ewing

Patients undergoing maintenance dialysis show an increased susceptibility to tuberculosis because host immunity is decreased secondary to malnutrition, impaired cellular immunity, acidosis and etc. Extrapulmonary tuberculosis is more prevalent in patients with end stage renal disease than in normal subjects. Among the extrapulmonary tuberculosis in patients receiving hemodialysis, the diagnosis of tuberculous spondylitis is difficult because the symptoms are non specific and attributable to uremia, and the appearance of plain radiographs is often normal during the early phase of the disease. We experienced a case of tuberculous spondylitis in a hemodialysis patient. A 55 years old female admitted with fever, weight loss and back pain. Conventional radiograph of T-spine showed no definite abnormal finding. However, chest CT revealed heterogeneously enhancing soft tissue around the T8 vertebral body and T-spine MRI showed compatible finding to tuberculous spondylitis. She received radical excision of involved vertebra and confirmed tuberculous spondylitis with histologic finding from a surgical specimen. Following the administration of anti-tuberculosis medication(isoniazid, rifampin, pyraziamide, ethambutol) and radical excision, patient's symptom and sign were improved. The patient is maintaining dialysis with anti-tuberculosis medication for 5 months.
Acidosis ; Back Pain ; Diagnosis ; Dialysis ; Female ; Fever ; Humans ; Immunity, Cellular ; Kidney Failure, Chronic ; Magnetic Resonance Imaging ; Malnutrition ; Middle Aged ; Renal Dialysis* ; Rifampin ; Spine ; Spondylitis* ; Tomography, X-Ray Computed ; Tuberculosis ; Uremia ; Weight Loss

BACKGROUND/AIMS: Heat shock proteins (HSPs) protect rats from cerulein-induced acute pancreatitis (AP) by preventing the subcellular redistribution of cathepsin B and the activation of trypsinogen. Autophagy plays a critical role in the secretion of digestive enzymes and triggering of cerulein-induced AP via the colocalization of trypsinogen and lysosomes. Therefore, using a rat cerulein-induced AP model, we investigated whether HSPs prevent AP by regulating autophagy. METHODS: Twelve hours after fed standard laboratory chow and water, the experimental groups (cerulein, water-immersion [WI]-cerulein and heat-shock [HS]-cerulein) and the control groups (control, WI, and HS) received one intraperitoneal injection of cerulein (50 microg/kg) or saline, respectively. All of the rats were sacrificed at 6 hours after injection. The severity of the AP was assessed based on the serum amylase level and the histological and electron microscopy findings. Western blotting was also performed for HSP60/70 and LC3B-II. RESULTS: WI and HS induced HSP60 and HSP70, respectively. The induced HSP60/70 effectively prevented the development of cerulein-induced AP. Autophagy developed in the rats with cerulein-induced AP and was documented by the expression of LC3-II and electron microscopy findings. The WI-stressed rats and HS-treated rats did not develop cerulein-induced autophagy. CONCLUSIONS: HSPs exert protective effects against cerulein-induced AP in rats by inhibiting autophagy.
Amylases ; Animals ; Autophagy ; Blotting, Western ; Caerulein ; Cathepsin B ; Heat-Shock Proteins ; Hot Temperature ; Injections, Intraperitoneal ; Lysosomes ; Microscopy, Electron ; Pancreatitis ; Rats ; Trypsinogen ; Water

It is important that the clinical anesthetist pay attention to the interaction of anesthetic induction agents and succinylcholine chloride(S,C,C) on the elctrolyte level especially the plasma potassium ion concentration. For instance succinylcholine chloride has a marked effect upon specific conditions such as severe burns, multiple injury, deabetes insipidus and myopathy. Also secondary plasma changes may bring about non synchronous depolarizing action on the muscle and cause cardiac arrhythmai and even cardiac arrest by the increase of potassium concentration in the plasma. With this in mind the author has randomly selected 30 patients who belong to class l physical status by the classification of the American Society of Anesthesiologist had no abnormal symptoms in respiration, circulation or endocrine and metabolism defects. This paper covers the period from the 10th of April 1979 to the 10th of May 1980 in the Department of Anesthesiology, Hanyang University Hospital. The 30 subjects were divided into 3 groups: a) propanidid with S.C.C. b) thiopental sodium with S.C.C. c) diazepam with S.C.C. The plasma concentration of potassium, sodium and calcium were observed and compared in the pre-induction (control group) and two minute post-induction(study group). The results are follows: 1) The plasma potassium ion concentration showed no any significant changes in the whole group. 2) The plasma sodium and calcium ion concentration also showed no any significant changes in the whole group.
Anesthesiology ; Burns ; Calcium* ; Classification ; Diazepam ; Heart Arrest ; Humans ; Metabolism ; Multiple Trauma ; Muscular Diseases ; Plasma ; Potassium ; Propanidid ; Respiration ; Sodium* ; Succinylcholine* ; Thiopental