Horseshoe kidney is a nonfatal anomaly of renal development characterized by fusion of one poles of both kidneys. Most clinical problems are caused by hydronephrosis and renal calculi. A case of horseshoe kidney with multiple renal stones and hydronephrosis in a 53 year-old woman is reported and literatures are reviewed. This case was diagnosed easily radiologically and treated successfully by pyelolithotomy & pyeloplasty.
Female ; Humans ; Hydronephrosis* ; Kidney Calculi ; Kidney* ; Middle Aged

A clinical study was conducted to compare effectiveness of IV Globulin with that of steriod in childhood acute ITP. We carried out an experiment to 36 patients of acute ITP who recovered over 50.000/mm(3) of platelet count and not to recur in 6 months. Study group consist of 10 children who were treated with steriod only (Group A), 13 children who were treated with IV Globulin (0.4g/kg/d, 5 days, Group B), and 13 children combined with steroid (Group C) Study period was from January 1988 to December 1992, folllowing results were obtained. 1) There were no significant difference in sex ratio. age distribution, pretreatment hemoglobin level, platelet count and prolonged bleeding time among study groups. 2) The days which platelet count reached to 50.000/mm(3), 100,000/mm(3) were 3.7 days (Group A), 2.1 days (Group B), and 2.3 days (Group C), respectively (p<0.05). 3) Complete response rates within 4 weeks did not show significant difference (90% in Group A, 84.6% in Group B, 92.3% in Group C), the complete response rate within 1 week were significantly different among three group (44.4% in Group A, 90.9% in Group B, 83.3% in Group C)(p<0.05). In conclusion, it is more desirable for early treatment of a childhood ITP because IV Globulin is easy to normalize platelet count in a short time.
Age Distribution ; Bleeding Time ; Child ; Humans ; Platelet Count ; Sex Ratio

No abstract available.
Mucocele* ; Sphenoid Sinus*

A total of 189 cases of primary bone tumors reviewed and analysed clinically and pathologically at the Department of Orthopedic Surgery, Presbyterian Hospital, Taegu, Korea during the 15 years period from july, 1964 to june, 1979. The results were obtained as follows: 1. In 189 cases of primary bone tumors, 87 cases (46%) were benign and 102 cases (54%) were malignant. 2. Osteochondroma was the most common benign bone tumor (31.0%) and followed by simple bone cyst (14.9%), enchondroma (14.9%) and giant cell tumor (13.8%). 3. Osteosarcoma was the most common primary malignant bone tumor (45.0%) and followed by fibrosarcoma (17.7%) and chondrosarcoma (12.8%). 4. 22 cases were solitary and 5 cases were multiple Iesions of osteochondroma. The knee joint area was the most common site of osteochondroma (59.2%) and peak incidence was in the second decade. 5. Simple bone cyst was 13 cases. The sex distribution of simple bone cyst showed 5.5 times of the male predominence. The knee joint area was the most common site of simple bone cyst (76.9%) and its peak incidence was in the first and second decade (61.5%). Seven of 13 cases of simple bone cyst were seen pathological fracture and three of its cases were recurred. 6. In 13 cases of enchondroma, 6 cases were solitary and 7 cases were multiple lesions. The common site was phalanges of the hand and its peak incidence was in the second and third decade of life. 7. Giant cell tumor was 16 cases and to be divided into pathologically Grade 1 & 11 12 cases (75%) and Grade III 4 cases (25%). The sex distribution of giant cell tumor was 8 males and 8 females. The average age of giant cell tumor was 36.1 years with the peak incidence in the third and forth decade of life. 8. The average age of osteogenic sarcoma was 23.1 years with the peak incidence in the second decade of life. The sex distribution of osteogenic sarcoma was 25 males (54.3%) and 21 females (45.7%). The common sites of osteogenic sarcoma were distal femur and proximal tibia and proximal humerus in 41 cases (89.1%). 9. The average age of fibrosarcoma was 28.1 years with the peak incidence in the second and third decade of life. The sex distribution of fibrosarcoma was 12 males (66.6%) and 6 females (33.3%). The common site of fibrosarcoma were femur and tibia in 9 cases (50%). 10. Chondrosarcoma were 13 cases. The sex distribution of chondrosarcoma showed 5.5 times of the male predominence. The knee joint area was the most common site of chondrosarcoma (46.1%) and its peak incidence was in the third and forth decade of life.
Bone Cysts ; Chondroma ; Chondrosarcoma ; Daegu ; Female ; Femur ; Fibrosarcoma ; Fractures, Spontaneous ; Giant Cell Tumors ; Hand ; Humans ; Humerus ; Incidence ; Knee Joint ; Korea ; Male ; Orthopedics ; Osteochondroma ; Osteosarcoma ; Protestantism ; Sex Distribution ; Tibia

Airway obstruction following endotracheal intubation may be fraught with danger. Foreign bodies often become lodged in the airway as a result of trauma or rupture of lung lession. Somtiems they are revealed at the time of respiratory obstruction. Injury to individual mass lession is not seen so often. We experienced two cases of airway obstruction due to dislodging of foreign bodies. By exchanging obstructed endotracheal tube or removal of extracted teeth with aid of bronchoscope, the patency of the airway could secured. The aim of this case report is to emphasize that the insertion of an endotrahceal tube does not completely guarantee the patency of the airway.
Airway Obstruction ; Anesthesia* ; Bronchoscopes ; Foreign Bodies ; Intubation, Intratracheal ; Lung ; Rupture ; Tooth

Changes of central venous pressure (CVP) after the induction of general anesthesia in patients (n= 96) with end-stage renal disease were retrospectively studied. In group 1 (hemodialysis group) patients, delta CVP was higher than group 2 (peritoneal dialysis group) patients (7.1+/-3.1 versus 5.0+/-2.2cm H2O, mean values+/-s.d.). Without any sudden increasing of circulating volume during induction period, delta CVP was led to a result. Pre-induction values of CVP and systolic blood pressure, and airway pressure were regarded as causes of increasing CVP following induction. These three varables were associated with lung function in chronic renal faiure. The induction, itself, plus positive pressure ventilation were suspected and the more profound reduction of lung function (FRC, compliance) in patients with end-stage renal disease were suggested to the reasons of increasing CVP.
Anesthesia, General* ; Blood Pressure ; Central Venous Pressure* ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Lung ; Positive-Pressure Respiration ; Retrospective Studies

Changes of central venous pressure (CVP) after the induction of general anesthesia in patients (n= 96) with end-stage renal disease were retrospectively studied. In group 1 (hemodialysis group) patients, delta CVP was higher than group 2 (peritoneal dialysis group) patients (7.1+/-3.1 versus 5.0+/-2.2cm H2O, mean values+/-s.d.). Without any sudden increasing of circulating volume during induction period, delta CVP was led to a result. Pre-induction values of CVP and systolic blood pressure, and airway pressure were regarded as causes of increasing CVP following induction. These three varables were associated with lung function in chronic renal faiure. The induction, itself, plus positive pressure ventilation were suspected and the more profound reduction of lung function (FRC, compliance) in patients with end-stage renal disease were suggested to the reasons of increasing CVP.
Anesthesia, General* ; Blood Pressure ; Central Venous Pressure* ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Lung ; Positive-Pressure Respiration ; Retrospective Studies

BACKGROUND: We previously demonstrated that a GRE/TRE composite sequence, which is located between 200 bp and 220 bp relative to the transcriptional start site of rat TRH gene, is responsible for the dexamethasone (DEX)- and TPA-induced transcriptional activation, and the transcriptional activation by DEX is mediated by interaction between glucocorticoid receptor (GR) and a TRE-binding transcriptional factor such as c-Jun. However, a non-specific binding with the transciption factors can not be excluded as the mutants used in the previous report could not inhibit the binding of GR and c-Jun completely, and it remains unclear which one of the two TRE-like sequences is critical for the interaction of the two transcription factors. METHODS: Luciferase expressing plasmids that contain a part of rat TRH promoter including the composite GRE sequence or its mutants were transfected into HeLa cells by Fugene 6. After the cells were incubated overnight with DEX or/and TPA, the luciferase activity was measured in a chemiluminometer. A gel retardation assay was performed after binding of the labeled composite sequence or its mutants with GR and c-Jun. RESULTS: DEX and TPA increased the transcriptional activity of the wild type composite sequence by 3 folds and 4 folds, respectively, and the combined stimulation increased the activity by 10 folds. The mutants of which all 6 nucleotides of the GRE half site were replaced and removed almost did not bind to GR and eould not enhance the transcriptional activity at all in response to DEX. The GRE-deleted mutant bound to c-Jun with a remarkably lower affinity and showed a lower response to TPA, whereas the GRE-replaced mutant bound to c-Jun with a similar affinity and showed a similar response to TPA compared to those of the wild type. In response to the combined simulation with DEX and TPA, the mutants showed 30-40% of the trancriptional activity of the wild type. Basal transcriptional activity of all the TRE mutants was significantly lower than that of the wild type. While they almost could not bind to c-Jun, their binding affinity to GR was comparable to that of the wild type. Whereas the DEX- and TPA-induced transcriptional activity of 5 TRE mutant was 10% and 15% of that of the wild type, it responded to those agents in a similar pattern as the wild type. The 3 TRE mutant and the mutant of both TRE sites did not respond to DEX and TPA. The GRE-deleted mutant hardly formed the DNA-protein complex as did the wild type, while the GRE -replaced mutant could form the complex in a less amount with nuclear extract of HeLa celL CONCLUSION: These results suggest that GRE/TRE composite sequence of rat TRH gene specifically binds to GR and c-Jun, providing a site for interaction between the two transcription factors, and that both TRE sites play an important role in basal transcription, and that the 3 TRE site is more critical in the interaction between GRE and TRE for DEX-induced transcriptional activation. (J Kor Endocrinol 14:278-292, 1999)
Animals ; Dexamethasone ; Electrophoretic Mobility Shift Assay ; HeLa Cells ; Humans ; Luciferases ; Mutagenesis, Site-Directed* ; Nucleotides ; Plasmids ; Rats* ; Receptors, Glucocorticoid ; Response Elements* ; Transcription Factors ; Transcriptional Activation

BACKGROUND: We previously demonstrated that the promoter of rat TRH gene has GRE half site (TGTTCT) between -210 bp and -205 bp flanking with similar sequences of TPA response element (TRE), TAGTCA, at a distance of several base pairs from the GRE half site. It promps us to hypothesize that this composite GRE/TRE sequence can provide a site for interaction between glucocorticoid receptor (GR) and c-Jun. Thus, we investigated whether the composite sequence mediates transcriptional regulation induced by dexamethasone (DEX) and 12-O-tetradecanoyl phobol-13-acetate (TPA), and whether it binds GR and c-Jun. METHODS: A luciferase expressing plasmids that contain a part of rat TRH promoter including the composite sequence or their mutants were transfected into HeLa cells by Fugene 6. After the cells were incubated overnight with DEX and TPA, the luciferase activity was measured in a chemiluminometer. A gel retardation assay was performed after binding of the labeled composite sequence or its mutants with GR and c-Jun. RESULTS: DEX increased the transcriptional activity of the plasmid containing the wild type GRE by 2.5 folds, and TPA increased the transcriptional activity by 4 folds. The simultaneous stimulation with DEX and TPA synergistically increased the transcriptional activity by 10 folds. Two mutants whose GRE half sits were altered showed no responses to DEX, and suppressed the TPA-induced or both agents-induced transcriptional activity by 50%. Two mutants whose TRE-like sites were altered suppressed the DEX-induced transcriptional activity by 20%, TPA-induced trarptional activity by 25%, and both agents-induced transcriptional activity by 50%. Gel retardation assay showed that the composite sequence fonned a complex with GR and its mutants bound to GR with remarkably less affinity. c-Jun also bound to the composite sequence to form two cornplexes with less affinity compared to the AP-1 consensus sequence. The mutants of the TRE-like sequence bound to c-Jun with a significantly lower affinity compared to that of the wild type. Simulateous binding of the composite sequence with GR and c-Jun did not form any larger complex. The complex of GR and the composite sequence was much smaller than that formed by c-Jun, suggesting that GR binds to the composite sequence as a monomer. CONCLUSION: These results suggest that the composite sequence of GRE half site and TRE-like site on the promoter of rat TRH gene provides binding sites for GR and c-Jun, which mediate the interaction between two signal transduction pathways. (J Kor Soc Endocrinol 14:265-277, 1999)
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Animals ; Base Pairing ; Binding Sites ; Consensus Sequence ; Dexamethasone ; Electrophoretic Mobility Shift Assay ; HeLa Cells ; Humans ; Luciferases ; Plasmids ; Rats ; Receptors, Glucocorticoid ; Response Elements ; Signal Transduction ; Transcription Factor AP-1

No abstract available.
Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa*