We report a case of primary adenocarcinoma of the urethra in 62 years old female. Primary carcinoma of the female urethra is an uncommon malignancy that accounts for less than 0.02 per cent of all cancers occurring in women. Adenocarcinoma is rare in the literature. Whereas squamous cell carcinoma and transitional cell carcinoma, which comprise the majority of urethral malignancies, arise form the squamous or epithelial cells lining the urethra, adenocarcinoma arises form the periurethral glands.
Adenocarcinoma* ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Epithelial Cells ; Female* ; Humans ; Middle Aged ; Urethra*

PURPOSE: Conventional intravenous nutrition has been given as a solution of amino acids combined with dextrose and a separate line delivering a lipid emulsion. This technique was unsatisfactory, however, because of difficulties in managing technical and metabolic complications. Since the first clinical use of a single solution containing all the necessary nutrients was introduced in 1976, the total nutrient admixture (TNA) system has been used. However, despite the numerous advantages of this TNA system, it has not been used worldwide because of an assumption about unstability of this admixture. This study was conducted to compare the physical stability of TNA systems using two different 2 commercially available amino acid solutions and fat emulsions. METHODS: Each group contained 600 ml of 20% dextrose, 250 ml of 10% amino acid solution, 250 ml of 10% fat emulsion, 0.2 ml of heparin, and 20 ml of electrolyte solution was investigated for 7 days while being stored 4oC and at ambient temperature. The stabilities of these admixtures were compared by noting changes in macroscopic appearance, pH, osmolarity, Zeta-potential, peroxide value, particle size and distribution, and fat composition. RESULTS: When an amino acid solution containing P 2 was used, a supernatant yellow band was observed from the 3rd day at ambient temperature. The pH and peroxide value also showed significant changes, but these changes did not exceed the product-specifications. When an amino acid solution without P 2 was used, no significant change was observed. CONCLUSION: TNA systems are physically stable at 4oC temperature for at least 7 days, but TNA systems prepared with amino acid solution containing P 2 are not stable at ambient temperature from the 3rd day. On the other hand, TNA systems prepared with an amino acid solution without P 2 are stable at ambient temperature for 7 days. Various commercially available fat emulsions containing 10% soybean oil did not affect the stability of TNA systems.
Amino Acids ; Emulsions ; Glucose ; Hand ; Heparin ; Hydrogen-Ion Concentration ; Osmolar Concentration ; Parenteral Nutrition ; Particle Size ; Soybean Oil

BACKGROUND: We studied the incidence of trauma caused by alcohol related accidents, and the effects that has on the occurrence, the extent, and the outcome to the patient. METHODS: In our study we studied trauma patients excluding pediatric patients(15 years old and under) who came to the Emergency department of Korea University Medical School Anam Hospital from the 1st of january 1996 to 30th of June 1996, looked into their medical records, and studied the records in a retrospective manner. The trauma patients were divided into two groups, a) alcohol-related and b) alcohol-non-related. The two groups were then subdivided according to their sex, age, the time they came in, the anatomical part of the trauma, the mechanism of their injury, the extent of the injury, the length of their hospital stay, the length of their ED stay and were seperately compared and analysed. Statistically, ANOVA and logistic regression analysis using SAS were used in the study and then was assessed in Chi-square analysis methods. RESULTS: The total of the trauma patients, added up to 832 people, 577: male and 255: female. Among this sum, 16 trauma patients were alcohol related(male:127 & female 36). 115 people were in the age group of 21-40. Compared to the non-alcohol related trauma group, the alcohol-related group had more facial & scalp injuries and tended to come in the hours between 0-6 AM. The cause of the injuries were mossy by fast-fighting and suicide, compared to mostly accidental-slipping injuries in the non alcohol-related group. There were no difference in the degree of the injury(ISS) and the length of hospital stay between the two groups, whereas the length of the stay at the ED was longer alcohol-related trauma patients. CONCLUSION: Alcohol related trauma patients were mostly in their 20s and 30s, came to the hospital at a late time it the reason for their visit were mossy because of fist fighting. In the Emergency department, because prompt and correct diagnosis is quite difficult to make in this group, their ED stay tended to be longer. We can conclude that measuring the blood alcohol level of these patients, continuing the psychological therapy and educating people is needed.
Diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Korea ; Length of Stay ; Logistic Models ; Male ; Medical Records ; Retrospective Studies ; Scalp ; Schools, Medical ; Suicide

OBJECTIVE: To determine whether ankle plantar flexors stretching exercise affects functional reach in elderly men. METHOD: Twenty elderly men with an average age of 78.2 years were selected for this study. A active range of motion of ankle dorsiflexion and a functional reach (FR) distance were measured before and after ankle stretching exercise. The ankle dorsiflexion was measured by goniometer in knee extended position. The FR distance was measured in standing position. Ankle plantar flexors stretching exercises were carried out by physical therapist 4 times per week for 4 weeks. At 4 weeks after the stretching exercise, we retested the active range of motion of ankle dorsiflexion and the FR distance using the same method. RESULTS: At 4 weeks after the stretching exercise, the active range of motion of right ankle dorsiflexion was increased from 2.81 +/- 3.26degrees to 5.98 +/- 4.34degrees, and the left ankle dorsiflexion was increased from 3.15 +/- 3.77degrees to 6.35 +/- 2.45degrees. The FR distance was increased form 12.22 +/- 7.54 cm to 19.69 +/- 8.59 cm after the stretching exercise. CONCLUSION: The FR distance was significantly increased after the ankle plantar flexors stretching exercise (p<0.01). This results suggest that the ankle plantar flexors stretching excercise may be capable of increasing the FR distance in elderly.
Aged* ; Ankle Joint ; Ankle* ; Exercise ; Humans ; Knee ; Male ; Physical Therapists ; Range of Motion, Articular

OBJECTIVE: To determine whether muscle fatigue affects knee joint proprioception. METHOD: Thirty healthy subjects (18 male and 12 female) with an average age of 22.1 years were selected for this study. Angular errors were measured to test propriocetive function in the knee joint. In a sitting position, the subject's dominant leg was passively positioned to the 45degrees knee flexion stimulus point for 2~4 second, while the subject concentrated on this position, the leg was passively returned to the 90o flexion position, afterward the subject was asked to duplicate the stimulus point actively. The difference, in degrees between the stimulus point and the reproduced point is an angular error. All subjects were blindfolded and underwent proprioception measurement before and after the muscle fatigue. Isokinetic exercises performed at 180 degree/sec on the Cybex Orthotron II(Cybex, a division of Lumex, Inc. USA) were used to induce the muscle fatigue. All subjects performed an isokinetic exercise with their dominant leg. Exercise was continued until 50% of the initial peak torque was reached. When the subjects were fatigued to less than 50% of the initial peak torque, the isokinetic exercises were discontinued. Then we immediately retested the proprioception using the same method. RESULTS: The mean and standard deviation of the angular error increased from 2.79+/-1.17degrees to 6.40+/-3.42degrees after muscle fatigue. CONCLUSION: The proprioception significantly decreased after the muscle fatigue(p<0.001). This result suggests that the muscle fatigue must be considered when an injured professional athlete a patient with fatigable disease is set in a rehabilitation program. Further studies are required to determine the physiological mechanisms of the role of muscle fatigue for the decreasing proprioception.
Athletes ; Exercise ; Humans ; Knee Joint ; Knee* ; Leg ; Male ; Muscle Fatigue* ; Proprioception* ; Rehabilitation ; Torque

No abstract available.
Cardiac Tamponade* ; Leukemia, Myeloid, Acute*

To investigate the effect of hyperbaric oxygenation on superoxide dismutase activity, neonatal rats (7-10 days old) and adult rats (approximately 100 days old) were continuously exposed to hyperbaric oxygen environment of 2.4ATA for 8 hours and their superoxide dismutase activity were measured. Neonatal rats, all survived through exposure, showed significant increases in the pulmonary superoxide dismutase activity at immediately and 24 hours after exposure. Adult rats, whose 8 hour survival rates were 14 %, did not show any significant increase in the activity of pulmonary superoxide dismutase as compared to the control adult rats. These findings are indicating that increased tolerance to oxygen toxicity in neonatal animals during exposure may be attributed to the increase in activity of superoxide dismutase in neonatal rats.
Adult* ; Animals ; Animals, Newborn ; Humans ; Hyperbaric Oxygenation* ; Oxygen ; Rats* ; Superoxide Dismutase* ; Superoxides* ; Survival Rate

Recently, with the remarkable theoretical progress made in anesthesiology these years, reports are being made on the results of the study on the complications, minor or major, caused by previous general anesthesia. However, .the reports on incidence vary according to the reporters. According to Riding, the recent development of anesthesiology, anesthetic inatruments, knowledge of physiology, anesthetics, induction agents and muscle relaxants are said to have reduced the incidence of complications to a great extent. Riding, Gold and Dyrberg report that the factors capable of influencing the incidence of complication, in the post-operative period include age, sex, premedicants for anesthetics, inhalation method of anesthetics, time of anesthesia, muscle relaxant, use of induction agent, acid-base imbalance and developed knowledge of physioloy, operation site, mental state of patients before operation, general condition, anesthetic technique, and. adequate selection of medicine. Working for Department of Anesthesiology, Hanyang University, from October 1976 to August 1977, we selected, out of the patients who received general anesthesia, 523 males and 372 females, totalling 895, who showed no abnormal symptoms in their respiratory systems, circulatory systems and metabolic systems and observed the incidence of complication in the light of sex, age and operation site, the factors supposed to affect the incidence. An hour prior to the general anesthesia, the patients were given intramuscular injection with premedicants atropine 0. 01 mg per kg, Valium 0. 2 mg or Demerol 1 mg per kg of body weight. For induction of anesthesia, Epontol 10 mg per kg and succinylcholine 1 mg per kg of body weight were injected in the veins, then ventilation was made for a minute with mask and then endotracheal tubes were inserted. and then a minimum amount of air was injected. into the cuff of the endotracheal tube, and the ventilation was done in a semi-closed system. During the period of maintenance, anesthesia was administered in a semi-closed system with 0. 5~l. 0% halothane, 3 L/min of nitrous oxide, 2 L/min of oxygen; and if need be, muscle relaxant was injected into the vein. In case a nondenolarizing agent was used in the course of maintenance, atropine 0. 5~1. 0 mg and neostigmine 2.0 ~ 4.0 mg were injected into the vein for reversion at the recovery time. After the patient was completely recovered, the endotracheal tube was cautiously removed, so as not to give trauma to the throat. As for method of observations, 24 hours after the patient had recovered, we visited the patient in the ward, first observing the existence or nonexistence of incidence of minor complications, and then calculating the incidence by the distribution of sex, age and operation site. The outcome of the observation of the above results by statistics and by chi square test is as follows; 1) the incidence of complications after general anesthesia was high in females. 2) Age has not affected the incidence of complications. 3) The incidence of nausea was highest in the patients with abdominal operation. 4) The incidence of sore throat was highest in the head and neck patients. 5) The incidence of fever was highest in the abdomen patients. 6) The incidence of headache was highest in the head and neck patients.
Abdomen ; Acid-Base Imbalance ; Anesthesia ; Anesthesia, General* ; Anesthesiology ; Anesthetics ; Anesthetics, Inhalation ; Atropine ; Body Weight ; Diazepam ; Female ; Fever ; Halothane ; Head ; Headache ; Humans ; Incidence ; Injections, Intramuscular ; Male ; Masks ; Meperidine ; Methods ; Nausea ; Neck ; Neostigmine ; Nitrous Oxide ; Oxygen ; Pharyngitis ; Pharynx ; Physiology ; Propanidid ; Respiratory System ; Succinylcholine ; Veins ; Ventilation

The depolarizing neuromuscular blocking agent succinylcholine, which was synthesized by Hunt and Taveau in 1906, is still regarded as the drug of choice when speed of onset and good intubating conditions matter most. This agent has several disadvantages, some of which may be unpredictable, serious and immediate, for example, muscle pain, bradycardia, rise in intragastric pressure, increase in intraocular pressure and elevation of serum potassium. These disadvantages may be regarded as the side effects of depolarization and indicate a need for a nondepolarizing neuromuscular blocking agent with rapid onset and good muscle relaxation. Simpson et al. described the neuromuscular blocking properties of the nondepolarizing .neuromuscular blocking agent, Fazadinium (AH 8165) in 1972. This initial work indicated a more rapid onset of action than occurs with succinyleholine and without muscle fasciculation or concomitant rise in plasma potassium concentration. However, Coleman et al., Young, t al., Hartley and Fidler, and Metha et al., concluded that using succinylcholine, a ignificantly greater number of patients had excellent intubating conditions at predetermined times after administration than when using Fazadinium. Several reports have indicated that administration of a small dose of nondepolarizing neuromuscular blocking agents would markedly diminish the fasciculation and muscle pains which so frequently occur, when succinylcholine is given. Many other reports have indicated that administration of a small dose of nondepolarizing neuromuscular blocking agents could attenuate or eliminate the adverse effects of succinylcholine such as increased intra-gastric pressure and intraocular pressure, bradycardia, arrhythmia and hyperkalemia. Several investigators have recommended that when small doses of nondepolarizing neuromuscular blocking aKent are given before succinylcholine administration, larger doses of succinylcholine should be given to achieve satisfactory relaxation. A comparative study using d-tubocurarine, gallamine and pancuronium for precurarization indicates that any of them successfully attenuates fasciculation. They have a little antagonizing effect of vocal cord relaxation after succinylcholine administration, but there was no difficulty during endotracheal intubation.
Arrhythmias, Cardiac ; Bradycardia ; Fasciculation ; Gallamine Triethiodide* ; Humans ; Hyperkalemia ; Intraocular Pressure ; Intubation, Intratracheal ; Muscle Relaxation ; Myalgia ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium* ; Plasma ; Potassium ; Relaxation ; Research Personnel ; Succinylcholine ; Tubocurarine* ; Vocal Cords

Wilms' tumor is the most common intra-abdominal malignant tumor of childhood. There has been a progressive improvement in the over all survival rate of children with Wilms' tumor since the introduction of radiotherapy and nephrectomy. Survival has continued to improve with the addition of chemotherapy, initially actinomycin D, and later vincristine. This paper reviewed 34 patients with Wilms' tumor seen between 1965 and 1979 with special references to the significant factors in diagnosis as well as the influence of age, stage of disease and treatment on the prognosis. The usefulness of three modalities of treatment was discussed. A cure rate of 64.9% in the intensive multimodaliy treatment group was calculated by the Life Table Method.
Child ; Dactinomycin ; Diagnosis ; Drug Therapy ; Humans ; Life Tables ; Nephrectomy ; Prognosis ; Radiotherapy ; Survival Rate ; Vincristine ; Wilms Tumor*