Three hundred ten bacterias isolated in significant numbers from the 276 specimens of urine during the period January 1, 1974 through December 31. 1974, were evaluated and the following results were obtained. 1. Of a total of 310 bacterial strains isolated by culture of the urine, 72.9% gram-negative and 27.1% were gram-positive. Isolated organisms include E. coli(28.1%), Klebsiella(16.1%), Streptococcus (13.1%), Staphylococcus (11.2%). Postcolon bacilli (8.1%), Enteaococcus and Pseudomonas (2.3%. each other) in order of frequency. 2. In 34 cases of acute and chronic pyelonephritis, 31 were female and only 3 were male patients. Most frequent causative organism in pyelonephritis was E. coli (61.9%) Klebsiella infection was the second most common infection in urinary tract infection (16.1%). 3. The gram-negative bacilli were relatively susceptible to Gentamicin in a range of 52.2 to 88.5% and to Kanamycin (14.3~82.7%). Penicillin G, Tetracycline and Ampicillin had nearly no effectiveness to gram-negative bacilli in this experiment.
Ampicillin ; Bacteria ; Female ; Gentamicins ; Humans ; Kanamycin ; Klebsiella Infections ; Male ; Penicillin G ; Pseudomonas ; Pyelonephritis ; Staphylococcus ; Streptococcus ; Tetracycline ; Urinary Tract Infections* ; Urinary Tract*

15 male patients who received total cystectomy with ileal conduit for bladder tumor were reviewed in relation to the incidence of urethral involvement. Of 15 patients six had recurrent transitional cell carcinoma in the urethral remnant among them one (1/15) received subsequent therapeutic urethrectomy and remaining 5 patients underwent delayed therapeutic urethrectomy after confirmation of urethral tumor but 9 of the 15 had only received total cystectomy. We concluded that the remaining urethra might constitute a potential hazard for further tumor formation. We believe that prophylactic urethrectomy is the way to prevent the recurrence of the malignancy who have multiple tumors, concurrent upper tract tumors, and involvement of the trigone or prostatic urethra.
Carcinoma, Transitional Cell* ; Cystectomy* ; Humans ; Incidence ; Male ; Recurrence ; Urethra* ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion*

Malakoplakia of the bladder is an extremely rare condition in which there are multiple round or oval, plaque like or occasionally polypoid projections of the mucosa and submucosa which may be mistaken for cancer. It is believed to be infectious in origin, secondary to a deficiency of intracellular lysosomal digestion. There is often a clinical history of urinary tract infection, and the condition is considered to be an atypical form of granulomatous response to Gram negative coliform infection. We report a case of malakoplakia of the bladder clinically simulating malignant tumor, which was treated successfully with transurethral resection and antibiotics.
Anti-Bacterial Agents ; Digestion ; Malacoplakia* ; Mucous Membrane ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract Infections

Pain in an extremity that develops following trauma, infection, thrombophlebitis and many other leaions has been recognized for years and designated by a variety of names. These syndromes appear to have the same physiopathology and response to therapy. All of them are characterized by exeessive unduly prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function and trophic changes. We have treated two cases of reflex sympathetic dystrophy. One case was only treated by stellate gangUon block repeated 26 times and the other case required surgical thoracic sympathectomy for complete recovery after 60 repeated stellate ganglion blocks. We report these two cases of reflex sympathetic dystrophy and review the literature.
Extremities ; Recovery of Function ; Reflex Sympathetic Dystrophy* ; Reflex* ; Stellate Ganglion ; Sympathectomy ; Thrombophlebitis

Clinical staging of bladder malignancy is important in assessing prognosis and planning therapy Clinical staging inaccuracies as high as high as 50% may occur when using resectional biopsy and bimannual examination. Various radiographic techniques have been used to aid in staging, including excretory urography, arteriography, lymphangiography, sonography and cystography. Seidelman et a1. reported an accuracy rate of 81% in C-T staging of bladder tumors. They suggested that C-T may be useful as a routine procedure in the initial staging of bladder malignancy but some others reported diagnostic under- or overstaging by C-T scanning. According to the report of Koss et al., most diagnostic errors in C-T staging of bladder carcinoma were related to the determination of perivesical fat involvement by tumor. Recently we experienced 4 cases of bladder carcinoma that was overstaged by C-T scanning. In 3 patients the scans were performed after cystoscopy and TUR biopsy of tumor mass, and overstaging occurred perhaps secondary to artifacts such as surgical edema produced at the time of TUR biopsy. In the other one, the scan was done before biopsy. All of them was undergone total cystectomy but perivesical or periprostatic fat involvement suggested on C-T scans was not found in the surgical pathological specimens.
Angiography ; Artifacts ; Biopsy ; Cystectomy ; Cystoscopy ; Diagnostic Errors ; Edema ; Humans ; Lymphography ; Prognosis ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urography

Caudal buprenorphine was investigated as a postoperative analgesic in a randominsed double blind study of 45 patients after abdominal surgery. AT the end of surgery, patients were given 0.3mg of caudal buprenorphine in 20 ml saline (n=30, experimental group) or no injection (n=15, control group). Pain relief was evaluated by the subsequent need for systemic analgesic(pethidine). ARterial blood gas and micturition disturbance were evaluated. In the buprenophine group, use of systemic analgesics was significantly reduced for the first 24 hours postoperatively. Arterial blood gas study values 2 hours after buprenorphine administration were within normal range. 8 patients of the buprenorphin group developed urinary retention requiring temporary Nelaton catheterization of the bladder. Caudal buprenorphine for postoperative pain control was a good alternate method of postoperative pain management.
Analgesics ; Buprenorphine ; Catheterization ; Catheters ; Double-Blind Method ; Humans ; Pain, Postoperative* ; Reference Values ; Urinary Bladder ; Urinary Retention ; Urination

Since Brown first described the eosinophilic cystitis in 1959, 42 cases has been reported in the literature. In Korea, only 1 case was reported from the National Medical Center a couple of years ago. Eosinophilic cystitis is characterized histologically by infiltration of eosinophils into the mucosa, submucosa and muscularis of the bladder and cystoscopically by elevated erythematous mucosal lesions. These lesions have been mistakenly diagnosed as bladder tumors prior to biopsy. Clinically, it presents with dramatic and recurrent episodes of dysuria and hematuria. It can occur in two different clinical setups. The first is seen in women and children and is often associated with allergic disorders and eosinophilia. The second presents in older man and is usually associated with bladder injury related to other conditions of bladder and prostate. We herein add two cases of eosinophilic cystitis, review etiologic theories and outline management.
Biopsy ; Child ; Cystitis* ; Dysuria ; Eosinophilia ; Eosinophils* ; Female ; Hematuria ; Humans ; Korea ; Mucous Membrane ; Prostate ; Urinary Bladder ; Urinary Bladder Neoplasms

Early correction of congenital cardiac defects has been facilitated by the use of deep hypothermia and cardiorespiratory arrest. Simple deep hypothermia has a number of advantages for infant open heart surgery, such as a quiet heart and bloodless operative field, reduced blood requirement, elimination of pulmonary and coagulation problems following cardiopulmonary bypass, elimination of cannulation, simple anesthetic technique, no neccessity of complicated facilities, and stable postoperative course. Deep ether anesthesia is the ideal agent for induction of deep hypothermia by surface cooling, especially when combined with ganglionic blocking agents in large quantities to elimiminate some of the undesirable effects of ether, thus improving and maintaining good peripheral perfusion. We have performed a total correction of TOF on March, 1979. Anesthesia was induced with intravenous thiopental and succinylcholine for intubation and maintained by a tight closed circuit system with ether. As soon as routine EKG, direct intra-arterial pressure, esophageal and rectal temperature monitoring devices were installed, slow intravenous administration of triflupromazine was followed by surface cooling. Surface cooling was done by the technique of covering the child with bags of crushed ice after placing the infant on an ice water blanket. After cooling, the intracardiac procedure was performed under circulatory occlusion and cardiac arrest, following cardioplegic infusion, for 45 minutes. After the intracardiac procedure, cardiac resuscitation and rewarming were accomplished by cardiopulmonary bypass technique. The patient recovered satisfactorily and was discharged on POD14 without any complication.
Administration, Intravenous ; Anesthesia ; Cardiopulmonary Bypass ; Catheterization ; Child ; Electrocardiography ; Ether ; Ganglionic Blockers ; Heart ; Heart Arrest ; Humans ; Hypothermia* ; Ice ; Infant ; Intubation ; Perfusion ; Resuscitation ; Rewarming ; Succinylcholine ; Tetralogy of Fallot* ; Thiopental ; Thoracic Surgery ; Triflupromazine ; Water

Since year of 1969. Authors have experienced five cases of seleral grafts for the repair of focal scleral traumatic defect, traumatic ectasia and necrosis after pterygium operation. The results are as follows: (1) Case 1 (13 aged, male) a large scleral defects after perforating injury of left eye was closed successfully with an onlay technique of scleral iso-graft (10 X 10mm) which was obtained from contralateral multiple ruptured eye. (2) Case 2, and 3 (17 and 23 aged, females) small focal scleral ectasias near the limbus (os) as a late complication of penetrating injuries in both cases were improved completely by electric diathermy and the onlay application of scleral allo-graft which were obtained from eye-bank eyes. (3) Case 4 (60 aged, male) a local small progressing undermined scleral necrosis near the nasal limbus (OD) which is supposed as a late complication (8 yrs later) of pterygium removal and strontium 90 irradiation on the scleral side could be cured successfull by a circular lamellar full-thickness scleral allo-graft (6mm). (4) Case 5 (60 aged, male) a much more advanced scleral necrosis and complicated uveitis (os) developed within 2 months after pterygium removal and Mitomycin C drop instillation was replac ed by a scleral allo-graft. But scleral necrosis and inflammatory processes of other. sctes were spreaded out to superior and temporal scleras within a months and then the eye was finally enucleated. Histo-pathology of an enucleated eye showed a chronic inflammatory reaction with many plasma cells and lymphocytes, occassionally giants cells.
Diathermy ; Dilatation, Pathologic* ; Inlays ; Lymphocytes ; Mitomycin ; Necrosis* ; Plasma Cells ; Pterygium ; Sclera ; Strontium ; Transplants* ; Uveitis

BACKGROUND: It is difficult to manage intractable pain from advanced carcinoma of the upper abdomen. One method used to control pain associated with these malignancies is to block the splanchnic nerve. We investigated that VAS (visual analogue scale) difference before and after splanchnic nerve block (SNB) and pain relief day. Also we studied relationship between VAS before SNB and pain relief day. METHODS: A rewiew of 70 patients who took splanchnic nerve block (SNB) from September 1994 to February 1998 was carried out to assess age, sex, primary diseases, pain sites, VAS before and after SNB, date of diagnosis, date of SNB, date of death and pain relief day, etc. RESULTS: Of 70 patients, 44 were males and the remaining 26 were females. The causes of pain were stomach cancer 28 (40%), pancreatic cancer 18 (25%), gall bladder cancer 7 (10%), hepatoma 6 (8.6%) respcectively. Average day from diagnosis to SNB was 272 and average day from diagnosis to death was 341. So, patients died on the average 69 days after they took the splanchnic nerve block in pain clinic. VAS average before SNB was 8.01 and VAS average after SNB was 3.64. Patients felt pain relief during 35 days after SNB. Pain relief day of patients who had lower VAS before SNB was longer than that of patients who had higher VAS before SNB. CONCLUSION: Early application of splanchnic nerve block will make the patients endure the cancer pain more easily.
Abdomen ; Carcinoma, Hepatocellular ; Diagnosis ; Female ; Gallbladder Neoplasms ; Humans ; Male ; Pain Clinics ; Pain, Intractable ; Pancreatic Neoplasms ; Splanchnic Nerves* ; Stomach Neoplasms