OBJECTIVE: Our purpose was to compare the expression of endothelial nitric oxide synthase in the placenta and umbilical cord of preeclamptic placenta with that of the normotensive placenta. METHOD: We compared placental endothelial nitric oxide synthase expression in preeclamptic (n=5) with in normal (n=5) pregnancies. Frozen sections of umbilical cords, chorionic plate vessels, and terminal villi were immunostained with a monoclonal endothelial nitric oxide synthase antibody. RESULTS: The age revaled no difference between control (28.1+4.2 years). and study group (26.1+4.7 years). The gestational age was statistically different between control (38.9+1.7 weeks) and study group (34.9+3.5 weeks). The neonatal body weight and placental weight were also statistically different between control (3060+528 g) and study group (2160 417 g). No difference in endothelial nitric oxide synthase immunostaining in the endothelium of the umbilical vessels and stem villous vessels was found between preeclamptic and normotensive pregnancies. In contrast, in the preeclamptic placental endothelial nitric oxide synthase immunostaining was seen in the terminal villous vessels. In the syncytiotrophoblast endothelial niric oxide synthase immunostaining appeared primary basal in location and diffuse in distribution in the preeclamptic placentas but primary apical in the normotensive placentas. CONCLUSION: Differences in endothelial nitric oxide synthase expression in terminal villous vessels and syncytiotrophblast may be a result of vascular alterations or damage that take place in the placenta in preeclampsia.
Body Weight ; Chorion ; Endothelium ; Frozen Sections ; Gestational Age ; Nitric Oxide Synthase Type III ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta ; Pre-Eclampsia* ; Pregnancy* ; Trophoblasts ; Umbilical Cord

No abstract available.
Urodynamics*

No abstract available.
Antibodies, Monoclonal* ; Chlamydia trachomatis* ; Chlamydia*

We meet much difficult problem to solve in the treatment of the forearm fractures which are not encountered in the treatment of fractures of the other long bone and there are many reports on the results of treatment of forearm fractures and many methods have been introduced. In the late 1950's ASIF compression plate was invented and developed by Muller, Allgower, and Willenegger and it has shown excellent union rate and functional results in the treatment of forearm fractures. From Jan. 1971 to Dec. 1979, we have experienced 71 cases of fresh or old forearm fractures treated by different methods and devices and among them, 53 patients, those were treated with compression plate and other various internal fixation devices, were possible to trace for more than 3 months. The Author divided the traceable patients into two groups, the one was the group treated with compression plate and the othtr one was the group treated with other various internal fixations, and compared the results in the aspect of healing time and functional results. The results were as follows; 1. Among 71 patients, 45 patients (36.6%) were fresh and 26 were old cases. Of 61 adult patients 21 cases (34.4%) exhibited severe soft tissue injury due to crushing machinary injury. 2. There was 24 (33.8%) cases of open fractures and the most common fracture site was middle one-third of both radius and ulna. 3. The period between operation and exercise was 7.3 weeks in fresh cases which were treated with compression-plate fixation and 10.3 weeks in old cases with other fixation devices. 4. The time of radlological union was comparatively rapid in compression-plate fixation group, acute cases and radial fractures when compared it with those treated with other fixation devices, old cases and ulnar fractures, respectively. Radiological union time in average was as follows; Radius, compression-plate fixation: 12.1 weeks ulna, compression-plate fixation: 12.4 weeks redius, other fixation devices 14.9 weeks ulna, other fixation devices 15.5 weeks 5. By Anderson's functional criteria, the ratio of excellent or good results was as follows, Acute compression-plate fixation: 87% Acute, other fixation devices 67% Old, Compression-plate flxation: 67% Old, Other fixation devices 23% 6. Achieved bony union in all cases in compression-plate fixation group and experienced 3 cases of non-union in the group treated with other fixation devices. Among 3, two cases of non-union were due to post-operative infection and technical failure and the other one was a solitary ulnar fracture which was treated with rush pin.
Adult ; Forearm ; Fractures, Open ; Humans ; Internal Fixators ; Radius ; Soft Tissue Injuries ; Ulna

OBJECTIVES: Anticardiolipin antibody (ACA) and lupus anticoagulant (LA) are acquired antiphospholipid antibodies (APAs), which are regarded as important risk factors far vascular thrombosis and recurrent fetal loss. Although the clinical relevance of APAs in dialysis patients is uncertain, recent studies have suggested that APAs are involved in bioincompatibility and thrombogenic complications in hemadialysis (HD) patients. METHOD: We performed a cross sectional study of ACA and LA in 50 stable HD patients and their 68 vascular accesses (52 native arteriovenous fistulae and 16 synthetic arterovenous grafts), with the analysis of factors associated with the presence of APAs and the retrospective evaluation of vascular access occlusion (VAO). LA was assessed by platelet neutralization method whereas IgG-ACA was measured by a solid phase ELISA. Values higher than 23GPLU/ml (IgG phospholipid units) were considered to be positive for IgG-ACA and positive values for LA was more than 8 seconds in prolongation of the clotting time with human platelet lysate. Vascular access survival was assessed by Kaplan- Meier method, RESULTS: The mean age of the subject (M:F 21:29) was 46 years and the mean duration of hemodialysis was 49 months. The frequency of VAO in entire subjects was 0.45+/-0.98 episodes/patient year. The median value of IgG-ACA was 16.0 GPLU/ml with a distribution from 2.7 to 46.1GPLU/ ml. The median titer of I.A was 4.5 (3.1-45.6) seconds. Fourteen patients (28%) were found to have at least one episode of VAO. In spite of comparable clinical and biochemical data according to the presence of VAO, the titers of IgG-ACA (13.6+/-7.7 vs, 20.3+/-8.7GPLIJ/ml, P<0.05) and LA (4.5+/-2.9 vs. 11.7 +/-12.6sec, P<0.05) were significantly higher in VAO group. Six out of 50 patients(12%) had an increased titer of IgG-ACA and LA was found in 11 patients(22%). No patients were positive for ACA and LA simultaneously. There was no significant difference in sex, etiology of ESRD, diabetic status, the dosage of heparin during HD or the amount of erythropoietin administered according to the presence of APAs. We could not find any significant correlation between the titer of APAs and age, duration of dialysis, blood pressure, platelet count and biochemical parameters. In the patients with positive ACA, the frequency of VAO was 1.05+/-0.12 episodes/patient year, which was significantly higher than patients without ACA (0.33+/-0.17 episodes/ patient year, P<0.05). In the patients with the presence of LA(1.06+/-0.43 vs. 0.12+/-0.06 episodes/ patients year, P<0.01). The median vascular access survival time in IgG-ACA positive patients (32.7 months) was significantly decreased compared to 66.8 months in IgG-ACA negative group. CONCLUSION: Our data suggest that the presence of APAs (ACA and/or LA) affects the event-free vascular access survival in HD patients. Therefore the evaluation of APAs status have to be included in the diagnostic strategies for the patients with recurrent VAO. Further studies are necessary to explore the pharmacologic intervention method to decrease APAs and prevent VAO in HD patients.
Antibodies, Anticardiolipin* ; Antibodies, Antiphospholipid ; Arteriovenous Fistula ; Blood Platelets ; Blood Pressure ; Dialysis ; Enzyme-Linked Immunosorbent Assay ; Erythropoietin ; Heparin ; Humans ; Kidney Failure, Chronic ; Lupus Coagulation Inhibitor* ; Platelet Count ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Thrombosis

The main cause of vesicovaginal fistula is gynecologic or obstetric manipulation, but vesicovaginal fistula as a complication of genitourinary tuberculosis is extremely rare. The diagnosis is confirmed by the histological findings, and treatment is surgical repair with antituberculous medication. We report here on the presentation and management of extensive tuberculosis that led to formation of a vesicovaginal fistula in an adult.
Adult ; Diagnosis ; Humans ; Tuberculosis ; Vesicovaginal Fistula*

No abstract available.
Humans ; Liver Cirrhosis* ; Liver*

The metastasis of renal cell carcinoma is common, but ureteral metastasis is very rare. A 68-year-old woman was evaluated for painless total gross hematuria accompanied by a blood clot. The left upper pole mass was preoperatively proven as renal cell carcinoma by CT-guided fine needle biopsy, and left radical nephrectomy was performed. Two months post operation, she visited again with the same symptom. On the ureteroscopic biopsy, left ureteral cancer was diagnosed by frozen biopsy. Left ureterectomy with bladder cuff excision was done, and pathologic examination demonstrated ureteral metastasis of renal cell carcinoma. She has been in good condition without any signs of recurrence until now. We report ureteral metastasis of renal cell carcinoma with 7 years survival time.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Renal Cell* ; Female ; Hematuria ; Humans ; Neoplasm Metastasis* ; Nephrectomy ; Recurrence ; Ureter* ; Ureteral Neoplasms ; Urinary Bladder

No abstract available.

The electrical burns constitute a unique type of thermal injury and usually consist of a limited area of cutaneous burn, but associated with deep muscle damage of variable extent. The deep tissue destruction resulting from such injury leads to high incidence of amputation. So electrical burns are different from other types of injuries requiring individualized and varied methods of treatment, such as early fasciotomy, repeated debridement, wound coverage and technique of amputation. During 5 years from Jan. 1988 to Dec. 1992, we experienced 310 cases of electrical burn. We analyzed these cases on the aspects of functional result and necessity of amputation according to the treatment variability. The result showed the extent of burn in amputation group was 11.6%, salvage group 13.1%, with no difference of extent between 2 groups(p>0.05, by qui square test). When the fasciotomy was done earlier than 12 hours after injury showed 39.1% of more than good functional result, when later than 12 hours 7.7% of more than good, that is, earlier fasciotomy resulted in better function(p < 0.05, qui square test). The amputation rate was 23.9% during the last 5 years which was a marked improvment when compared to the previous ten years(32.4%). From these results we concluded that in order to reduce the rate of amputation and to improve the function of patients, early fasciotomy, early repeated debridement and wound coverage is necessary.
Amputation ; Burns ; Debridement ; Humans ; Incidence ; Wounds and Injuries