No abstract available.
Tetanus*

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

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

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

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

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*

PURPOSE: To report a case of Vogt-Koyanagi-Harada (VKH) disease in a pregnant patient treated with intravitreal triamcinolone injection. CASE SUMMARY: A 21-year-old female in the 19th week of gestation presented with bilateral blurring of vision associated with mild headache and tinnitus. Her initial best corrected visual acuity was 0.15 in the right eye and 0.3 in the left eye. Multiple serous retinal detachment and anterior chamber inflammation were observed, and VKH disease was diagnosed. Because of her pregnancy, the patient did not want high-dose systemic prednisolone therapy which may cause an abortion or low birth weight infant when used in a pregnant patient. Therefore, an intravitreal triamcinolone (4 mg/0.1 ml) injection was given in the right eye and topical steroid eye drops were used in the left eye. After 1 day, serous retinal detachment was significantly decreased and anterior chamber inflammation disappeared in the right eye. After 1 week, no serous retinal detachment was observed. In the left eye, serous retinal detachment was decreased after using steroid eye drops. After 10 days, serous retinal detachment disappeared but anterior chamber inflammation was still observed. After 1 month, best corrected visual acuity was 1.0 in both eyes and serous retinal detachment had not recurred. On follow-up, VKH disease had not recurred and a healthy normal weight infant was delivered. CONCLUSIONS: Intravitreal triamcinolone injection is an effective and safe treatment for VKH disease in pregnant women.
Anterior Chamber ; Eye ; Female ; Follow-Up Studies ; Headache ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Inflammation ; Ophthalmic Solutions ; Prednisolone ; Pregnancy ; Pregnant Women ; Retinal Detachment ; Tinnitus ; Triamcinolone* ; Uveomeningoencephalitic Syndrome* ; Vision, Ocular ; Visual Acuity ; Young Adult

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

PURPOSE: It is known that in animal experiments, a very small transplanted kidney relative to the recipient's size caused renal failure by a hyperfiltration injury on the nephron. Currently, studies of post-transplant renal function related to the allograft size are in process at many centers, checking the weight and the volume of the transplanted kidney. The results, however, need to be analyzed because of the diverse outcomes from different analytic points. The proper discriminating point should provide sound predictable factors for obtaining better recipient and graft survival. METHODS: We analyzed the results of renal function according to the different comparative points of the ratios of the kidney weight to the recipient's body weight (KW/BW) and of the kidney volume to the recipient's body surface area (KV/BSA). Among 243 patients who underwent a renal transplant between December 1995 and July 1997, 71 cases were excluded because of early graft loss, acute rejection and incomplete data. The remaining 172 patients were grouped into two groups above and below the various comparative points of the KW/BW and KV/BSA. Thereafter, serum Cr and 24-hr urine protein at 1-yr and 2-yr post- transplantation were compared between the groups. Also we analyzed the correlation between the renal size index (KW/BW, KV/BSA) and the serum Cr, the 24-hr urine protein, and the creatinine clearance at one and two years. RESULTS: From 2.5 to 2.9 of KW/BW, there were relatively consistent results; the transplanted kidneys which had more larger sizes excreted less protein in the 24-hr urine at one year (p<0.05). However, there was no difference in serum Cr level at 1- and 2-yr post-transplantation or in the 24-hr urine protein at 2 yr. Also there were correlations between the KW/BW and the 24-hrurine protein at 1 yr and between the KV/BSA and serum Cr at 1 yr (p<0.05). CONCLUSION: We conclude that the KW/BW, rather than the KV/BSA, was more predictable for post-transplant renal function such as urinary protein excretion, especially at 1 yr. The comparative point, however, should be deliberately adopted by using different multiple point. Also a method of measuring the functional size of the kidney, other than the simple geometric size, needs to be found.
Allografts ; Animal Experimentation ; Body Surface Area* ; Body Weight* ; Creatinine ; Graft Survival ; Humans ; Kidney Transplantation* ; Kidney* ; Nephrons ; Renal Insufficiency ; Transplants