Extracorporeal shock wave lithotripsy (ESWL) has proved to be an effective method of treating upper urinary tract calculi in adults. But the application of ESWL in children was less clearly defined. We report on 28 pediatric patients who were treated by ESWL with the Northgate SD-3 lithotriptor between June, 1989 and May, 1994. The patient age ranged from 2 years to 17 years, with an average age of 11.1 years. The conditions known to be associated with stone formation were urinary tract infection in 6 patients (21.4%), vesicoureteral reflux in 1 patient (3.6%) and unknown in other patients. The total average success rate of treatment was 92.9%. ESWL complications required admission and surgical management were not observed. We concluded that ESWL with the Northgate SD-3 lithotriptor is a safe and effective method of treating upper urinary tract calculi in children.
Adult ; Calculi ; Child* ; Humans ; Lithotripsy* ; Shock* ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

This study is to evaluate the clinicopathologic characteristics of esophageal cancer and to assess its surgical outcome according to these clinicopathologic features. A retrospective analysis was performed for 90 esophageal cancer patients who had undergone a radical esophagectomy or a palliative operation by the one surgeon at the Department of Surgery, Yonsei University, College of Medicine, from Jan. 1990 to Aug. 1996. The survival rates were calculated by the Kaplan-Meier method. The middle one-third of the esophagus was the most frequent site with 48 cases. T3 depth of invasion was present in 53 cases (57%) at the time of operation and a superficial depth in 18 cases (20%). The rates of lymph-node metastasis was 25% in T1; 47% in T2; 66% in T3 or more. 40 patients were in stage I, 23 in IIa, 13 in IIb, 33 in III, and 7 in IV. A transhiatal esophagectomy(THE) was performed in 28 cases, and a 3-staged radical esophagectomy (transthoracic radical esophagectomy; TTRE) was done in 56 cases. The most common early postoperative complication was hoarseness, but it disappeared within 6 months. The commonly noted late complication was esophageal stricture, and it was corrected by Savary-Guillard dilatation. The leading cause of death during the follow-up period was recurrence; it was about 30 cases(33%). The survival rates according to lymph-node metastasis were 50.1% for lymph-node negative cases and 16.3% for, lymph-node positive cases. The survival rates according to depth of invasion were 83.3% in mucosa confined cases, 46.7% in submucosa invasion cases, 30.3% in muscularis propria invasion cases, and 36.5% in adventitia invasion cases. The five-year survival rates according to stage were 56.4% in stage I, 51% in stage IIa, 48% in IIb, and 33.1% in III. From this study, it can be concluded that the frequent numbers of early esophageal lesions in our study may have been a major factor in the relatively high survival rate; also the low operative mortality rate encourages us to use surgical resection for the treatment of esophageal cancer.
Adventitia ; Cause of Death ; Dilatation ; Esophageal Neoplasms* ; Esophageal Stenosis ; Esophagectomy ; Esophagus ; Follow-Up Studies ; Hoarseness ; Humans ; Mortality ; Mucous Membrane ; Neoplasm Metastasis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: Immediate implantation presents challenges regarding site healing, osseointegration, and obtaining complete soft-tissue coverage of the extraction socket, especially in the posterior area. This last issue is addressed herein using the double-membrane (collagen membrane+high-density polytetrafluoroethylene [dPTFE] membrane) technique in two clinical cases of posterior immediate implant placement. METHODS: An implant was placed immediately after atraumatically extracting the maxillary posterior tooth. The gap between the coronal portion of the fixture and the adjacent bony walls was filled with allograft material. In addition, a collagen membrane (lower) and dPTFE membrane (upper) were placed in a layer-by-layer manner to enable the closure of the extraction socket without a primary flap closure, thus facilitating the preservation of keratinized mucosa. The upper dPTFE membrane was left exposed for 4 weeks, after which the membrane was gently removed using forceps without flap elevation. RESULTS: There was considerable plaque deposition on the outer surface of the dPTFE membrane but not on the inner surface. Moreover, scanning electron microscopy of the removed membrane revealed only a small amount of bacteria on the inner surface of the membrane. The peri-implant tissue was favorable both clinically and radiographically after a conventional dental-implant healing period. CONCLUSIONS: Secondary closure of the extraction socket and immediate guided bone regeneration using the double-membrane technique may produce a good clinical outcome after immediate placement of a dental implant in the posterior area.
Bacteria ; Bone Regeneration ; Collagen ; Dental Implantation ; Dental Implants ; Keratins ; Membranes ; Microscopy, Electron, Scanning ; Mucous Membrane ; Osseointegration ; Polytetrafluoroethylene ; Surgical Instruments ; Tooth ; Tooth Socket ; Transplantation, Homologous

No abstract available.
Monokines* ; Neutrophil Activation* ; Neutrophils*

No abstract available.
Animals ; Brain* ; Capillaries* ; Rats*

OBJECTIVES: The purpose of this study was to examine whether Symptom Management Module-Korean Brief Version(SMM-B) is effective as a psychosocial treatment of the inpatients with chronic schizophrenia. We also questioned which of demographic and clinical characteristics could be predictors of differential treatment response. METHODS: The subjects were composed of 30 inpatients with chronic schizophrenia, who were trained with weekly session of SMM-B for 5 weeks. Before and after the training, the level of psychopathology, knowledge about schizophrenia were assessed as dependent variables by using Clinical Global Impression(CGI) and Scale to Assess Unawareness of Mental Disorder(SUMD). RESULTS: Overall, patients showed improvement over the treatment period on psychopathology as well as knowledge about psychosis. Total scores of SUMD were changed from 16.9+/-4.0 before training to 12.9+/-4.2 after training(p<0.01) and scores of CGI were improved from 3.7+/-0.9 to 2.8+/-0.8 (p<0.01). However age, gender, years of education, age of onset, duration of illness, duration of admission, numbers of psychiatric admission, and clinical status evaluated by CGI were not correlated with un-awareness of psychosis. CONCLUSION: These results suggest that SMM-B could be a reliable method to improve self-awareness of psychosis in patients with chronic schizophrenia and one of important elements in rehabilitation.
Age of Onset ; Education ; Humans ; Inpatients* ; Psychopathology ; Psychotic Disorders ; Rehabilitation ; Schizophrenia*

The common arterial trunk is a congenital cardiovascular malformation in which one arterial trunk gives origin to the aortic arch, pulmonary and coronary arteries. Other cardiovascular malformations are often associated, such as ventricular septal defect, aortic arch interruption, patent arterial duct and so on. During the early period of life, the persistence of the increased pulmonary arteriolar resistance results in cyanosis. As the pulmonary vascular resistance decreases, the cyanosis disappears but signs of congestive heart failure become the main problems. We report five cases of common arterial trunk that was confirmed by autopsy at Chungnam National University Hospital, Seoul National University Hospital, and Yonsei University Severance Hospital between 1983 and 1995. The ages of these patients at autopsy were 8-28 days and four of them were male. Pulmonary arteries arose as a pulmonary trunk in two cases but three cases showed two arteries arising separately from the posterior wall of the common trunk. The type of ventricular septal defect was juxtatruncal in every case. All five cases had three leaflet truncal valves but three cases showed dysplasia of the leaflets. Interruption of aortic arch was associated in two cases. The cause of death was renal failure in two cases, cardiac failure after corrective surgery in two cases, and pulmonary edema and failure in one case.

An amelanotic malignant melanoma is characterized by little or no pigment. It is frequently misdiagnosed because it is a rare entity in general, and because of its unusual clinical features. Liposarcoma is one of the most common adult soft tissue sarcomas. We encountered a case of amelanotic melanoma with a concurrent liposarcoma. A 68-year-old man presented with a single, 1.5x1.5 cm round erythematous, eroded nodule on the left heel. A biopsy specimen showed atypical, pleomorphic tumor cells with little melanin pigment. The tumor cells were positive for S-100, HMB-45 and negative for cytokeratins. These findings were consistent with amelanotic melanoma. On positron emission tomography/computed tomography (PET/CT), a hypermetabolic lesion was found in the left buttock. This lesion was excised and diagnosed as a well-differentiated liposarcoma. An association between sarcomas and other primary malignancies has been reported. However, an association between melanoma and liposarcoma is rare.
Adult ; Aged ; Biopsy ; Buttocks ; Cytochrome P-450 CYP1A1 ; Electrons ; Heel ; Humans ; Keratins ; Liposarcoma ; Melanins ; Melanoma ; Melanoma, Amelanotic ; Sarcoma

Under the specific circumstances the appendix may be an appropriate organ for plastic repair of a large ureteral defect. We report a case of antireflux surgery using an appendiceal pedicle graft in recurrent right vesicoureteral reflux after augmentation gastrocystoplasty and uretera1 reimplantation. This graft was successfully replaced the right lower ureter to repair long defect caused by postoperative adhesion and follow up urogram showed disappearance of reflux and improvement of hydronephrosis at three months postoperatively.
Appendix ; Follow-Up Studies ; Hydronephrosis ; Plastics ; Replantation ; Transplants* ; Ureter ; Vesico-Ureteral Reflux*

OBJECTIVES: It has been reported that repetitive transcranial magnetic stimulation (rTMS), which stimulate the focal region of brain may relieve auditory hallucination in patient with schizophrenia. This study was aimed to evaluate the effect of rTMS on left and right temporoparietal cortex in schizophrenic patients with treatment-resistant auditory hallucination. METHODS: Twenty-six patients with chronic schizophrenia with treatment -resistant auditory hallucination were randomly allocated to rTMS group on left and right temporoparietal head regions. The rTMS was applied to TP3/4 region by EEG 10-20 international system at 1 Hz for 20 minutes per day for 10 treatment days. A Figure of eight TMS coil with a solid core was used for rTMS at 100% of individual motor threshold. Efficacy was evaluated with Auditory Hallucination Rating Scale (HRS), Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI) Scale on 5 and 10 days of treatment. RESULTS: Ten days administration of 1-Hz rTMS to temporoparietal cortex significant improved frequency (p<0.001) and attentional salience (p=0.038) of auditory hallucination, positive (p<0.001) and negative symptom (p=0.02), and CGI-improvement (p<0.001). There were no significant differences between right and left side stimulations. CONCLUSION: These results suggest that the low frequency rTMS on temporoparietal cortex may be useful in treating schizophrenic patients with treatment-resistant auditory hallucination and it could be a useful novel treatment option.
Brain ; Electroencephalography ; Hallucinations* ; Head ; Humans ; Schizophrenia* ; Transcranial Magnetic Stimulation*