Tuberculous spondylitis is not rare disease. Today the posterior instrumentation and posterior or posterolateral fusion concomitant with the anterior decompression and anterior interbody fusion have been used for the treatment of spinal tuberculosis. The authors experienced a case of tuberculous spondylitis complicated with descending aortic pseudoaneurysm. An aneurysm is defined as a localized dilatation of an artery that is at least one-half the size greater than is expected for that artery. Pseudoaneurysm occurring after previous operation, trauma, and infection. Erosion of the thoracic aorta with the development of an fistula in the presence of infection is an unusual and difficult problem to manage. We report a case and review related articles briefly.
Aneurysm ; Aneurysm, False* ; Aorta, Thoracic ; Arteries ; Decompression ; Dilatation ; Fistula ; Rare Diseases ; Spondylitis* ; Tuberculosis, Spinal

Many investigators have reported that collagen gel contraction reflects the mechanism of wound contraction. In 1995, Tsai et al. reported that hypertrophic scar-derived fibroblasts in a connective tissue model possessed the greatest contraction potency when compared with those of normal skin and normal oral mucosa-derived CTMs. In this study, we studied the effect of collagen gel contraction by growth factors such as epidermal growth factor, platelet-derived growth factor, transforming growth factor-bata1, and transforming growth factor-bata3, Skin fibroblasts used in this study were obtained from the explant of rat skin culture. Fibroblasts were cultured in Dulbecco's modified Eagle's medium containing 10% fetal bovine serum. Growth factors were added per FPCL in the desired concentrations and we measured the collagen gel diameters in growth factor-treated FPCL on day 1,2,3, and 4 respectively after starting incubation. We examined the effects of EGF, PDGF, TGF-bata1, TGF-bata3 and the effects of combinations of TGF-bata1 + EGF, TGF-bata1 + PDGF, and TGF-bata1 + TGF-bata3 to contract a collagen gel. EGF has little influence on collagen gel contraction. TGF-bata1 and TGF-bata3 increase the collagen contraction. TGF-bata1 enhanced the contractility of collagen gel according to the concentrations. While TGF-bata3 alone had stimulatory contraction effects at low dose, high doses of TGF-bata3 decreased the potency of collagen gel contraction. A combination of TGF-bata1 and EGF minimally decrease TGF-bata1 activity. A combination of TGF-bata1and PDGF had an effect similar to TGF-bata1 activity. A combination of TGF-bata1 and TGF-bata3 decreased TGF-bata1 activity. According to reports that FPCL contraction is equivalent to the process of wound contraction, growth factors which enhance gel contraction may be related to wound contraction and wound healing. TGF-bata1 is reported to enhance scar formation in fetal wound. EGF accelerates wound healing and inhibits the promotion of hypertrophic scar formation. Compared to the effect of collagen gel contraction in this study, the combination of TGF-bata1 and TGF-bata3 that inhibited the promotion of collagen gel contraction are thought to diminish the formation of scar tissue. As well, EGF that has not enhanced collagen gel contraction is thought to diminish the production of scar tissue. We will study the interactive effects of TGF-bata3, EGF and TGF-bata1 on the contraction of collagen gels in the future.
Animals ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen* ; Connective Tissue ; Epidermal Growth Factor ; Fibroblasts ; Gels ; Humans ; Intercellular Signaling Peptides and Proteins* ; Platelet-Derived Growth Factor ; Rats ; Research Personnel ; Skin ; Wound Healing ; Wounds and Injuries*

Although the management of fractures of the calcaneus still remains controversial, open reduction and internal fixation is gaining in popularity as the method of choice for the treatment of displaced intraarticular calcaneal fractures. However, open methods can make several complications such as neurovascular injury and infection. Thus we have performed the new technique of arthroscopic reduction and minimal internal fixation for displaced intraarticular calcaneal fractures in 5 cases. The results were evaluated between 12 and 16 months after surgery. A Bohler angle was restored to 25degrees-40degrees in all cases. Anatomical reduction of articular surface were obtained from 4 cases out of 5. No complications were found except 1 peroneal tendinitis. The clinical results by Creighton-Nebraska health foundation assessment for fractures of the calcaneus were 3 excellent, 1 good and 1 fair. Even though this was a few case and a short term follow-up study, the arthroscopic assisted management of displaced intraarticular calcaneal fracture induced a little complications and satisfactory results.
Calcaneus ; Follow-Up Studies ; Tendinopathy

Solid pseudopapillary tumor of the pancreas is a rare tumor that affects young females with low malignant potential and good prognosis with more than 90% survival at 5 years. Metastasis is very rare. We report the case of a 74-year-old female who had pancreatic solid-pseudopapillary tumor and synchronous hepatic metastasis.
Aged ; Female ; Humans ; Neoplasm Metastasis ; Pancreas ; Pancreatic Neoplasms ; Prognosis

No abstract available.
Hypoglycemia*

To define indications of primary treatment in ureteroscopic stone manipulation with comparing the success rates and complications of A(11.5F rigid ureteroscopy from March 1989 to April 1993) and B(7.5F rigid ureteroscopy from May 1993 to February 1995) groups, 216 ureteroscopies were performed for ureteral stone removal between March 1989 and February 1995 in our urologic department. The overall success rates of ureteroscopic stone manipulation were obtained and compared according to stone locations, sizes and anesthesia or not. The overall success rate was 85.6%(80% in group A and 94.2% in group B respectively). The success rates in each group A and B were 60% and 77.8% in the upper ureter, 100% and 66.7% in the middle ureter, 80.0% and 95.9% in the lower ureter. There were the more success rates and the less complication rates in group B than group A. The success rates of stone removal are increased and the complications are decreased remarkably in group B(especially in the lower ureter stone). The rapid relief of ureteral obstruction and colic is possible immediately after ureteroscopic stone manipulation. So, we conclude that ureteroscopic stone manipulation is primarily indicated in the treatment of lower ureteral stones.
Anesthesia ; Colic ; Ureter ; Ureteral Obstruction ; Ureteroscopes ; Ureteroscopy

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*

Mast cells are immune-mediators producing cells and involved in neovascularization of some tumors. Such roast cell is divided into two cell types: mucosal mast cell and connective tissue mast cell. There are controversies about the roles of mast cells in suppression and metastasis of some tumors (including bladder tumor). We performed bladder mucosal biopsies in 28 patients (from September 1994 to July 1996) and observed bladder mucosal mast cell responses in bladder tumor (TCC) under toluidine blue stain (x 400). Patients were divided into 2 groups: group A was consisted of bladder tumor patients (21 cases), whereas group B was the control group (7 cases). Mast cell responses, average mucosal mast cell counts in high power field, in group A and B were 1.75+/-0.25 cells/HPF, 0.29+/-0.20 cel1/HPF respectively. We observed more mast cell responses in bladder tumor patients group. But fundamental researches will be needed to elucidate the causes of mast cell activation in bladder tumor.
Biopsy ; Connective Tissue ; Humans ; Mast Cells* ; Neoplasm Metastasis ; Tolonium Chloride ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Reiter`s disease can no longer be considerded a rare and relatively benign syndrome, defined by the clinical triad of urethritis, conjunctivitis and arthritis. In the etiology of Reiter`s disease, it can be regarded as a post-infectious syndrome after certain enteric disease or veneral infection and usually occurs in patients between 20 and 40 years old, with a male to female ratio of 10:1 in dysenteric cases and 50:1 in veneral cases. The diagnosis of Reiter`s disease should quite obious when the clinical manifestation of non specific urethritis, conjunctivitis, arthritis and mucocutaneous lesions. Recently, HLA-B27 antigen is strogly associated with Reiter`s syndrome and may be diagnosticlly useful when HLA-B27 is positive. There is no specific therapy for Reiter`s disease, but conservative treatement is aviable of acute stage oir recurrence of the disease. We have experienced a case of Reiter`s syndrome in 27 years old male and reproted with review of some literatures.
Adult ; Arthritis ; Conjunctivitis ; Diagnosis ; Female ; HLA-B27 Antigen ; Humans ; Male ; Recurrence ; Urethritis

We report a case of carcinosarcoma involving the ureter, bladder and kidney in a 63-year-old woman. The diagnosis of carcinosarcoma was confirmed by immunohistochemical stain.
Carcinosarcoma* ; Diagnosis ; Female ; Humans ; Kidney* ; Middle Aged ; Ureter* ; Urinary Bladder*