PURPOSE: The artificial erection is critical to chordee repair. We report the use of a natural erection induced by prostaglandin E(1)(PGE1) in the diagnosis and treatment of penile curvatu re as an alternative to artificial erection in children and adult patients. MATERIALS AND METHODS: Pharmacological erection was induced 14 children with a mean age of 5 years (range 1-10) and 8 adults with a mean age of 33 years (range 18-58) to diagnose and repair anomalies, such as simple penile curvature, chordee with or without hypospadias, webbed penis and Peyronie's disease. Alprostadil (1-16ng) as a agent for induce erection was used exclusively, but no agents were routinely given to reverse the erection was used exclusively, but no agents were routinely given to reverse the erections. The dose injected intracavernosally was dependent on the patient's age, penile size and response, and ranged from 0.5 to 10 micrograms. Time to and adequacy of erection, detumescence, changes in blood pressure and pulse rate were monitored. RESULTS: A dilatation of erectile tissue was achieved within 8 minutes and was judged adequate in 2 and excellent in 20. The mean duration of erection was 107 minutes, while a prolonged erection, for up to 2.5 hours, occured on 2 patients who were treated conservatively. Detumescence were occurred when the corpora were opened, but re-erected penis after closure of corpora in 7 cases who treated with Nesbit's corporeal plication or fibrous plaque excision and dermal graft. Although there were the impression of increased bleeding, there were no specific changes in blood pressure or pulse rate. CONCLUSIONS: Pharmacological erection in penile curvature is effective and reliable with no significant complications. Although PGE1 is expensive and induced slightly increased bleeding, pharmacological erection has the advantage of tumescence of the entire penis and consequently a constant and natural representation of chordee without corporeal or urethral injury. Therefore, the erection achieved by injecting PGE1 into the corpora cavemosa is a useful alternative to artificial erection in the diagnosis and treatment of penile anomalies.
Adult ; Alprostadil ; Blood Pressure ; Child ; Diagnosis ; Dilatation ; Female ; Heart Rate ; Hemorrhage ; Humans ; Hypospadias ; Male ; Penile Induration ; Penis ; Transplants

Anterior plate fixation of the cervical spine enhance anterior grafting technique and provide good primary stability to allow early mobilization without significant external support. This facilitastes nursing and shortens rehabilitation time. Although these advantages, the screw technique is risky and time-consuming since purchasing of posterior cortex is needed for obtatining maximum stability. The authors have tried to a technique of purchasing only near cortex. The objectives of this study were review of the result of this technique and the determining the factor influencing screw loosening. One hundred and five screws used in twenty-one patients for conventional cervical plate fixation from September 1990 to February 1994 were reviewed. Average age was forty-two years old ranged from nineteen to sixty-five. Patients with trauma were six and degenerative diseases were fifteen. Two screws were inserted in C3 bodies, ten in C4, thirty-two in C5, thirty-four in C6, ten in C7, two in Tl and fifteen in grafted bone. Twenty-four screws(16%) in six patients(28.6%) were loosened. Usually the first loosening was noted at about one month after operation. The incidence of loosening was significantly higher in lower cervical region(p < 0.001) and older age(p < 0.05). The disease entity or sex were not significant factor. This technique showed high rate of screw loosening especially in older age group or lower cervical lesion. We think the indication of this technique should be limited in young patient with upper cervical lesion.
Early Ambulation ; Humans ; Incidence ; Nursing ; Rehabilitation ; Spine ; Transplants

PURPOSE: Having been disappointed with standard anticoagulation therapy for acute deep vein thrombosis (DVT) in lower extremity, we started catheter-directed thrombolytic therapy. And the aim of this study was to evaluate the effects on venous function of catheter-directed thrombolytic therapy by noninvasive venous tests such as Air plethysmography (APG) and duplex ultrasonography. METHOD: 36 patients with DVT of less than 3 weeks after development into two groups according to treatment modality:Group 1; catheter-directed thrombolysis with Urokinase followed by low-molecular weight heparin (LMWH) and coumadin therapy (n=19, men; 11, women; 8, mean age 47.6 years), Group 2; conventional anticoagulation with LMWH followed by coumadin therapy (n=17; men; 12, women; 5, mean age 47.1 years). The results of lytic therapy were examined by complete phlebography on time of removal of catheter. The location and extent of thrombotic changes were followed-up with duplex scan and venous function was examined with APG. RESULT: Complete clot resolution by lytic therapy was obtained in 12 cases out of 19 cases (63.2%) in Group 1. The residual thrombi at follow-up around 1 year were detected in 4 cases in Group 1, in 11 cases in Group 2. APG parameters that were significantly different (P<0.05) between the two groups were the venous filling index:(Group 1; 1.63+/-1.36 ml/sec, Group 2; 2.66+/-1.58 ml/sec), residual volume fraction (Group 1; 27.54+/-17.40%, Group 2; 49.19+/-20.45%) and outflow fraction (Group 1; 37.79+/-7.05%, Group 2; 32.36+/-6.31 %). The parameters of APG and ultrasonography in Group 1 revealed lesser degree of reflux and smaller amount of residual thrombi. CONCLUSION: Catheter-directed thrombolytic therapy shows better results in complete resolution rate of the acute DVT, reducing remnant thrombi, and preserving venous function such as venous filling index, residual volume fraction and outflow fraction. APG and duplex scanning seem to be useful methods for a complete follow-up evaluation of limbs with DVT.
Catheters ; Extremities ; Female ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Lower Extremity* ; Male ; Phlebography ; Plethysmography ; Residual Volume ; Thrombolytic Therapy ; Ultrasonography ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis* ; Warfarin

The human chromosome analysis is widely used to diagnose genetic disease and various congenital anomalies. Many researches on automated chromosome karyotype analysis has been carried out, some of which produced commercial systems. However, there still remains much room for improving the accuracy of chromosome classification. In this paper, We propose an optimal pattern classifier by neural network to improve the accuracy of chromosome classification. The proposed pattern classifier was built up of multi-step multi-layer neural network(MMANN). We reconstructed chromosome image to improve the chromosome classification accuracy and extracted three morphological features parameters such as centromeric index(C.1.), relative length ratio(R.L.), and relative area ratio(R.A.). This Parameters employed as input in neural network by preprocessing twenty human chromosome images. The experiment results show that the chromosome classification error is reduced much more than that of the other classification methods.
Chromosomes, Human ; Classification* ; Humans ; Karyotype*

No abstract available.
Priapism*

No abstract available.
Priapism*

Pigmented fungiform papillae of the tongue is a rare disorder in Korea. It is characterized clinically by pigmentation confined to the fungiform papillae and histopathologically by the presence of melanophages in the upper dermis. We report a case of pigmented fungiform papillae of the tongue in a 21-year-old woman who had brown to violaceous dots on the fungiform papillae and pigmented patches on the right lateral dorsum of the tongue. Histological findings showed increased melanophages in the upper dermis.
Dermis ; Female ; Humans ; Korea ; Pigmentation ; Tongue* ; Young Adult

The pancreatic pseudocyst as a sequela of pancreatitis or pancreatic trauma can occur at any site in the abdomen. Its detection seems to be increasing with modern imaging tools such as abdominal ultrasound or abdominal CT scanning. But recently, we experienced a case of a pseudocyst due to a ruptured pancreatic pseudocyst which was misdiagnosed as a simple hepatic cyst by abdominal ultrasonography or abdominal CT scan. A 12-year-old male presented with recurrent epigastric pain during the past 4 years. On the abdominal ultrasound and abdominal CT scan, there was an 8x7.5 cm sized sharply defined thin-walled cyst in the left lobe of the liver. First, percutaneous (cather) drainage guided by ultrasonography was done. An exploratory laparotomy was performed because of signs of hemoperitoneum. A 8x7.5 cm sized cyst was found at the left subhepatic space, which communicated with another smaller cystic lesion in the pancreatic head. Microscopic finding of the cyst showed infiltration of inflammatory cells and granulation tissue without ephithelial lined cells which is compatible to a pseudocyst. So we report this case with a review of literatures.
Abdomen ; Child ; Diagnostic Errors* ; Drainage ; Granulation Tissue ; Head ; Hemoperitoneum ; Humans ; Laparotomy ; Liver ; Male ; Pancreatic Pseudocyst* ; Pancreatitis ; Tomography, X-Ray Computed ; Ultrasonography

Fifty two cases of displacecd supracondylar fractures were divided into three groups according to the methods of fracture stabilization. Cast immobilizations without pin fixation were included to the group 1 (12 cases), fixation with lateral pins to the group 2 (22 cases), and lateral and medial cross pins to the group 3 (18 cases). In each group we attempted a radiological analysis for the stabilization failure through measurements of the horizontal rotation and the mediolateral tilting in their preoperative, postoperative and follow-up X-rays. Stabilization failure during the follow-up period was presumpted to be present in those cases that show (1) a development or increase of the horizontal rotation in follow-up lateral X-ray, and (2) accompanied change in Baumann's angle of more than 5 degrees. The failed stabilizations were in three cases (25%) in the group 1. In the group 2 the horizontal rotations after initial fixation were developed in four fractures. However, only two (9%) of the four cases accompanied significant changes in the Baumann's angle. Loss of the initial fixation in the cross pin group was found in one case. These results demonstrate that the cross pin fixation is the most stable form. Fixation in only lateral side sometimes shows rotational instability, but this method seems to be still useful because singificant coronal tilting develops in only a few occasions of those with horizontal rotation.
Child ; Follow-Up Studies ; Humans ; Humerus ; Methods

In the review of a series of 71 clavicle shaft fracture that were treated with open reduction and internal fixation, we tried a direct comparison between two fixation modes, that is, the fixation with plate and screws (54 cases) and the intramedullary nailing with Knowles pin (17 cases). The average time to healing was not significantly different between the two group; 10.8 weeks after the plating and 11.7 weeks with Knowles pinning. The rate of successful healing within four months after the surgery were also high in both groups: one delayed union and one nonunion in the plate group, and one delayed union in the Knowles pin group. There was one loosening in the Knowles pin group, which needed reoperation. Intramedullary fixation has several advantages compared with fixation with a plate and screws. It can be performed through a shorter incision: less dissection of soft tissue is needed: and, after healing, the pin is easily removed through a small incision under local anesthesia.
Anesthesia, Local ; Clavicle ; Fracture Fixation, Intramedullary ; Reoperation