No abstract available.
Tetanus*

Accelerated acute rejection(AAR) is a rare condition and has a poor prognosis in graft survival following renal transplantation. To elucidate its characteristics, we analysed 14 cases(5.0%) of AAR among 279 renal transplantation. AAR is defined as a condition in which immediate postoperative urine output is good followed by decreased urine output and increase of serum creatinine level within 7 days after transplantation. The incidence of AAR was more prevalent in cadaveric donors than living donors. One year graft survival was inferior in AAR, namely 8 out 14 cases(57%), than that of the patients without AAR(95.1%). Among the factors affecting graft survival in AAR, age and sex of both donor and recipient, donor condition such as living or cadaveric donor, and preoperative HLA matching had no relevance to a graft survival. Time of onset of AAR has no effect on graft survival either. Postoperative donor lymphocytotoxic test showed positive result in one out of 3 patient despite of all negative findings in the preoperative crossmatching test. Histologic finding such as vasculitis on renal biopsy was related to graft survival. Response of treatment was 55% in initial solumedrol pulse therapy and 20% in secondary OKT3 treatment, with an overall effect of 57%. Rerejection developed in 4 out of 8 cases of graft survival group while all cases showed a good function at post operative two years. Graft survival following AAR remains low and AAR is one of the main cause of graft loss following renal transplantation. To illustrate its characteristics, more clinical analysis are required.
Allografts* ; Biopsy ; Cadaver ; Creatinine ; Graft Survival ; Humans ; Incidence ; Kidney Transplantation ; Living Donors ; Methylprednisolone Hemisuccinate ; Muromonab-CD3 ; Prognosis ; Tissue Donors ; Transplants ; Vasculitis

Each three rabbit corneas were stored in McCarey-Kaufman medium at 4 degrees C for 5, 9 and 14 days and used as donor materials in 6mm partial penetrating corneal allografts. These results were compared to that group of penetrating keratoplasties with corneas stored conventional moist chamber at 4 degrees C for 5 days. All the M-K media stored corneas for 5 and 9 days were in clear graft after keratoplasty during the observation period of 6 months but the corneas stored for 14 days were developed eventvally irreversilde opaque after grafts. At 6 months after keratoplasties allthe rabbits eyes were enucleated and sectioned for histopathologic study of endothelia with the light and electron microscopes. Endothelia of the corneas stored for 5 and 9 days showed rarely endothelial degenerative changes. But the corneas stored up to 14 days showed significant changes including of disappearanee of most endothelial membranes and cytoplasms in light microscopies and swelling of nucleus, dispersed chromatin clump, multiple small and large vacuoles in cytoplasm and occasional autolysis of cytoplasm were observed in electron microscopies.
Allografts* ; Autolysis ; Chromatin ; Cornea* ; Corneal Transplantation ; Cytoplasm ; Humans ; Keratoplasty, Penetrating ; Membranes ; Microscopy ; Rabbits ; Tissue Donors ; Transplants ; Vacuoles

Objectives: Endoscopic variceal ligation is well established metbod of treatment for esophageal varices whereas for gastric varices there has not been any systematic report of its use as a method of treatment. To evaluated its possible clinical application, the band ligation(banding) and the method of band ligation in conjuction with submucosal ethanolamine injection(banding with sclero) were tested on canine stomach, and results were assessed.
Esophageal and Gastric Varices ; Ethanolamine ; Ligation* ; Rubber* ; Stomach

A 40-year-old man attended our hospital with presenting symptoms of an acutely swollen, tender testicle and bulging mass on the inguinal area. Considered it as urgent conditions no demonstrating blood flow to the involved testicle on Color Doppler ultrasonography, we underwent scrotal exploration right away. On operative finding the right testis was so enlarged and engorged secondarily to the irreversible ischemic damage, but torsion of spermatic cord was not found. Another inguinal approach revealed herniated mass protruding from internal inguinal ring and compressing the spermatic cord. For further evaluation abdominal ultrasonography and CT scan was done and huge mass occupying right lower quadrant of abdomen and pelvic cavity was noted. The resected tumor through surgical exploration was proved to be a retroperitoneal liposarcoma pathologically. Herein we report an uncommon case of testicular infarct, mimicking torsion of spermatic cord that is a urological emergency, caused by herniated retroperitoneal mass. So the present report suggest that, when adult men attend with symptoms of acutely swollen painful testicle, we pay a more careful attention to patient,s physical findings and recommend further diagnostic evaluation.
Abdomen ; Adult ; Emergencies ; Humans ; Inguinal Canal* ; Liposarcoma* ; Male ; Spermatic Cord ; Testis ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasonography, Doppler, Color

No abstract available.
Antibodies, Anticardiolipin* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

Clinical findings, electrocardiographic voltage and left ventricular function were evaluated in 104 patients with percardial effusion. Patients were classified into three groups by the amounts of pericardial effusion measured by two-dimensional echocardiography. 49 patients had small pericardial effusion, 31 moderate effusion and 24 large effusion. In 47 patients the effusions were clinically unsuspected prior to echocardiographic examination. Pericardial friction rub was noted in 14 patients, two-thirds of whom had moderate to large effusions. There was no relationship between the size of effusion and the presence of friction rub. Total QRS amplitudes were lower in patients with moderate to large effusions than those in control group. Maximum diastolic endocardial velocity(DEVM) and E-F slope of the anterior mitral leaflet were decreased significantly in patients with moderate to large effusions as compared with those with small effusions. As a result, authors concluded that reduction in the QRS voltages in serial ECGs may suggest the presence and the amount of pericardial effusion and also DEVM and E-F slope of the anterior mitral leaflet can be sensitive measures of left ventricular relaxation in patients with pericardial effusion.
Echocardiography* ; Electrocardiography* ; Friction ; Humans ; Pericardial Effusion* ; Relaxation ; Ventricular Function, Left*

OBJECTIVE: To compare the differences of hormone replacement therapy (HRT) and reproductive, life style characteristics in postmenopausal women with and without rheumatoid arthritis (RA). METHODS: A total of 360 women, 120 rheumatoid arthritis patients and 240 age matched healthy women were randomly selected from the health care center. Subjects were labeled as rheumatoid arthritis and normal menopausal women. Each group was compared for their HRT status, life style and reproductive characteristics. RESULTS: There were significantly less HRT received subjects in RA group (50.0% vs 76.1%, respectively, OR=0.30, p<0.05). More frequently alcohol consumed in RA group (26.7% vs 11.7%, respectively, p<0.05). There was no significant difference in the history of hysterectomy and smoking as well as body mass index (BMI) between the two groups. Women with serum follicular stimulating hormone (FSH) over 40 IU/L were more frequently observed in RA group (70.0% vs 57.5%, respectively, OR=1.75, p<0.05). CONCLUSION: Increased FSH and history of alcohol drinking were more frequently observed in patients with RA, whereas history of HRT was lower in RA group comparing to that of the control. A prospective study should be designed to confirim the protective effect of HRT and reproductive characteristics on postmenopausal RA patients.
Alcohol Drinking ; Arthritis, Rheumatoid* ; Body Mass Index ; Delivery of Health Care ; Female ; Hormone Replacement Therapy* ; Humans ; Hysterectomy ; Life Style* ; Postmenopause ; Smoke ; Smoking

Between Jan. 1990 and Sep. 1996, 462 renal allografts were carried out at the Ulsan University College of Medicine and Asan Medical Center. This study was undertaken to evaluate a clinicopathologic features, to document a relationship between dosage and duration of the corticosteroids, and to figure out a treatment strategy of avascular necrosis(AVN) of bone in 13 cases of AVN of the femoral head following renal transplantation. A control group of 15 cases were randomly selected among 462 cases of renal allografts to do a comparative study with 13 cases of AVN. The diagnosis of AVN of bone was made on the basis of plain radiographs and MRI or bone scan. 1) The incidence of AVN was 2.8%(13/462). 2) In entire cases, affected site of bone was the femoral head. The main clinical manifestations were hip joint pain, limitation of weight bearing and motion. The mean onset of first bone symptoms of AVN was 5.5 months(1~9 months). 3) Clinical parameters such as age, sex, type and duration of preoperative dialysis, type of donor, rate of body weight change, and duration of follow up had no relation with the prevalence of AVN. 4) The mean total doses of corticosteroids at 1, 3, 6, and 12months post-transplantation were not differ significantly between the two groups. 5) Biochemical parameters, such as BUN/Cr., Ca, /P, /ALP., AST/ALT, cholesterol, glucose, total protein, and albumin had no relation save the preoperative BUN, total protein. 6) The mean duration of diagnosis of this condition were 12.9 months(range, 9~31 months), 6.7 months(range, 1~12 months), 6.9 months(range, 1~14 months) by X-ray, MRI, and bone scan respectively. 4/12(33.3%) cases of AVN was diagnosed by magnetic resonance imaging(MRI) at the time of the first clinical bone symptoms. 7) In AVN group, conservative management were performed in 2 cases, core decompression in 7 cases, and total hip replacement arthroplasty(THRA) were performed in 4 cases of AVN of the femoral head. From this study, we could not illustrate the precipitating factors in transplant recipients using steroid following renal transplantation. We considered that prognosis of AVN depends entirely on early diagnosis using MRI or bone scan, and proper treatment according to the stage of this condition.
Adrenal Cortex Hormones ; Allografts ; Arthroplasty, Replacement, Hip ; Body Weight Changes ; Cholesterol ; Chungcheongnam-do ; Decompression ; Diagnosis ; Dialysis ; Early Diagnosis ; Follow-Up Studies ; Glucose ; Head ; Hip Joint ; Humans ; Incidence ; Kidney Transplantation* ; Magnetic Resonance Imaging ; Necrosis* ; Precipitating Factors ; Prevalence ; Prognosis ; Tissue Donors ; Transplantation ; Ulsan ; Weight-Bearing

OBJECTIVE: To make a guideline for cytogenetic study and diagnosis through systematic analysis of types and the incidences of chromosomal abnormalities obtained from various types of congenital disorder in Korea. METHODS: The cytogenetic study was performed on 14,402 patients with suspected chromosomal abnormalities at our genetic laboratory of the medical research center between January 1, 1974 to December 31, 2004 and additionally the FISH (Fluorescence in situ hybridization) study was done on 272 patients between January 1, 1998 to December 31, 2004. RESULTS: Total number of case requiring cytogenetic study were 33 in starting year (1974) and by 1983, the number increased rapidly to 481 cases. The number of case was maximum of 894 cases in 1993 and it started to decline from 1996 to 714. Overall chromosomal aberrations were 2,100 cases (14.58%). Autosomal chromosomal abnormalities were 1,257 cases (8.73%). Among those cases, Down syndrome was 848 cases (5.89%), Edward syndrome was 38 cases (0.26%), and Patau syndrome was 6 cases (0.04%) in order of frequency. Sex chromosomal abnormalities were 843 cases (5.85%) in total. Among those cases, Turner syndrome was 527 cases (3.66%), Kleinfelter syndrome was 267 cases (1.85%). Chromosomal abnormality rate in 535 couples with recurrent spontaneous abortions was 5.98% (32 couples). And chromosomal aberration in 1068 cases with primary amenorrhea was 63.95% (683 cases). The diagnostic rate of microdeletion syndrome by FISH method was 22.71%, and marker chromosome was 20.56%. CONCLUSION: From cytogenetic analysis of 14,402 cases performed in single institute during 31 years, we performed a study on the types and the incidences of chromosomal abnormalities. We hope we could suggest a guideline for studies and treatments of congenital disorders in Korea. Along with the cytogenetic study, FISH study was also required.
Abortion, Spontaneous ; Amenorrhea ; Chromosome Aberrations ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities* ; Cytogenetic Analysis ; Cytogenetics* ; Diagnosis ; Down Syndrome ; Family Characteristics ; Female ; Hope ; Humans ; Incidence ; Korea* ; Pregnancy ; Turner Syndrome