Two cases of spontaneous kidney rupture with literatural review was presented at first in Korea. 1) 56 years male patient and 25 years male patient admitted to our department of Urology through Emergency Room after onset of 2 and 1 day. after treatment at local clinic. 2) Chief complaints were one side flank pain which was followed by total gross hematuria. 3) Preoperative diagnoses were kidney rupture due to necrotic pelvic tumor in 56 years male and hypernephroma in 25 years male patient. 4) Operation was procedured at 8 days and 4 days after admission respectively. 5) The operative procedure were nephrectomy in both cases. 6) The pathological diagnoses were pelvis rupture due to renal stone and parenchymal rupture due to renal infarction in each case.
Carcinoma, Renal Cell ; Diagnosis ; Emergency Service, Hospital ; Flank Pain ; Hematuria ; Humans ; Infarction ; Kidney* ; Korea ; Male ; Nephrectomy ; Pelvis ; Rupture ; Rupture, Spontaneous* ; Surgical Procedures, Operative ; Urology

The authors had analyzed the cases of 40 patients in military services with traumatic cervical spine injuries retrospectively. Among the 40 patients, 20 patients underwent surgical treatment. The results were summarized as follows: 1) The causes of injury were traffic accidents(45.5%), falling down(32.5%), and sports injuries(17.5%). 2) The common mechanisms of injury were flexion, vertical compression and extension. 3) Fifty percent of these patients had surgical intervention by anterior approach(10), posterior approach(8), combined anterior/posterior approach(1), and anterior approach after posterior approach(1). 4) As for the final outcome, there was no statistical difference in Frankel's neurological grade between patients treated with and without surgical stabilization procedures(p>0.005) 5) Except for the cases with progressive neurological deficits by bony fragments, disc protrusion, hematoma or other irreducible lesions, delayed surgical treatment(after 10 days)was recommended.
Hematoma ; Humans ; Military Personnel* ; Retrospective Studies ; Spine* ; Sports

PURPOSE: Good color match is a key element in facial reconstruction for good aesthetic result. To correct the wide facial soft tissue defect were usually used the tissue expanded cheek flap, deltopectoral flap or radial forearm free flap. This study is aimed to analyse the color difference after flap surgery by using chromameter. METHODS: From August 1995 to December 2006, 30 patients who underwent flap operations were chosen randomly and evaluated color differences between flap site and adjacent skin. Reconstructive procedures included tissue expanded cheek flap(n=10), deltopectoral flap(n= 10), and radial forearm free flap(n=10). The measured sites were flap center within a radius of 1cm and four points of adjacent skin along the flap margin. The colors were quantified in a three dimensional coordinate system composed of L* (brightness), a*(redness), b*(yellowness). RESULTS: There were no significant color differences between the pedicled flaps(tissue expanded cheek flap and deltopectoral flap) and adjacent skin area. On the other hand, color values of the radial forearm free flap were statistically different from those of adjacent skin area. Total color difference(delta E) of tissue expanded cheek flap and deltopectoral flap were 7.45+/-5.78 versus 9.41+/-7.09, and that of radial forearm free flap was 11.74+/-3.85. It suggests that pedicled flaps have a potential of better color match than radial forearm free flap. CONCLUSION: Thus, better esthetic results and satisfaction is more likely to be expected in pedicled flaps as long as it could be applied comparing radial forearm free flap.
Cheek ; Forearm ; Free Tissue Flaps ; Hand ; Humans ; Radius ; Skin ; Surgical Flaps

PURPOSE: Surgical reconstruction of an ischial soft tissue defect presents a challenging problem owing to a high rate of recurrence, especially in paraplegic patients. Although various muscle, musculocutaneous and fasciocuta- neous flaps have been used in the reconstruction of ischial soft tissue defect, it is still controversial which type of flaps are the best. We had performed a relatively durable adductor magnus perforator island flap based on the perforators originated from the first medial branch of the profunda femoris artery for coverage of ischial soft tissue defect where was not a region universally reconstructed by perforator flap. METHODS: From August 2005 to January 2008, the adductor magnus perforator island flap were used for resurfacing of the ischial soft tissue defects in a series of 6 patients(4 male and 2 female). Ages ranged from 26 to 67 years(mean, 47.5 years), and follow-up period from 13 to 26 months(mean, 16.7 months). Causes were 4 pressure ulcers, 1 cellulitis and 1 suppurative keratinous cyst. RESULTS: The sizes of these flaps ranged from 12 to 18cm in length and 7 to 9cm in width. The flaps survived in all patients. Marginal loss over the distal area of the flap by infection was noted in one patient, which was treated successfully with a subsequent split-thickness skin graft. Average thickness of the flap was 0.94cm, which was more thicker than other perforator flaps. Long term follow- up showed a good flap durability. CONCLUSION: In planning a reconstructive option of ischial soft tissue defect, the adductor magnus perforator island flap is a relatively large cutaneous flap with a durable thickness. With proper patient selection, careful vascular dissection and postoperative management, we recommend this flap as a good and suitable option for coverage of the ischial soft tissue defect.
Arteries ; Cellulitis ; Follow-Up Studies ; Humans ; Keratins ; Male ; Muscles ; Patient Selection ; Perforator Flap ; Pressure Ulcer ; Recurrence ; Skin ; Transplants

No abstract available.
Child* ; Humans ; Listeria monocytogenes ; Listeria* ; Listeriosis* ; Meningitis ; Sepsis

No abstract available.
Hematoma* ; Liver* ; Snake Bites* ; Snakes*

BACKGROUND AND OBJECTIVES: Interleukin (IL)-1beta has been detected in human middle ear effusion (MEE) and the MEEs of experimental otitis media. The object of this study was to investigate whether this cytokine 1) penetrates through the round window membrane (RWM) and 2) induces hearing loss. MATERIALS AND METHODS: Guinea pigs were randomly assigned as control and IL-1beta groups and each was subdivided into three different groups by applying 1 ng, 10 ng, 100 ng of IL-1beta on RWM. They underwent hearing test by auditory brainstem response (ABR) prior to experiments. In the ontrol group, 5nL of phosphate buffered saline (PBS) soaked in a small piece of gelfoam was applied on the RWM. In IL-1beta groups, three different concentrations of IL-1beta 1 ng, 10 ng, 100 ng soaked in a small piece of gelfoam were applied on the RWM. ABR measurements were performed at 3 and 6 hours after application of different concentrations of IL-1beta. At the end of 6 hours, cochleas were harvested and perilymphs were collected for assay of IL-1beta level by the ELISA method. RESULTS: At 6 hours after application, the control group animals did not show any significant hearing loss. The IL-1beta were undetectable in perilymph of control group. In IL-1beta group, IL-1beta was detected in perilymph in dose dependent increasing concentrations. There was a significant hearing loss in this IL-1beta group in dose dependent manner in 3 and 6 hours. The hearing loss in 100 ng was significant comparing to control group. CONCLUSION: The result of this study indicated that IL-1beta applied on RWM penetrate to the perilymph and caused hearing loss. The result of this study suggest that IL-1beta in MEE may cause sensorineural hearing loss in guinea pig.
Animals ; Cochlea ; Enzyme-Linked Immunosorbent Assay ; Evoked Potentials, Auditory, Brain Stem ; Gelatin Sponge, Absorbable ; Guinea Pigs* ; Guinea* ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Tests ; Hearing* ; Humans ; Interleukins ; Membranes* ; Otitis Media ; Otitis Media with Effusion ; Perilymph

BACKGROUND AND OBJECTIVES: Transient evoked otoacoustic emissions (TEOAEs) have been used as a screening test for early detection of hearing loss in newborns and infants, because most of the normal hearing show TEOAEs. But the lack of understanding about the properties of spontaneous otoacoustic emissions (SOAEs) has limited their usefulness on the clinical basis. This study was designed with the purpose to find out the properties of SOAEs and their correlation with TEOAEs. MATERIALS AND METHODS: TEOAE and SOAE tests were performed in 95 neonates (190 ears, male:female=47:48) of well baby clinic in DKUH. RESULTS: 1) The prevalence of SOAEs were 86.8% (165/190 ears):87.2% (82/94 ears) in male and 86.5% (83/96 ears) in female, 91% (86/95 ears) in the right ears and 83% (75/95 ears) in the left ears. 2) The number of peaks in SOAEs was 4.14+/-1.92 overally, 4.38+/-2.01 in right ears, 3.87+/-1.79 in left ears, and 4.34+/-1.95 in males and 3.94+/-1.88 in females. There was a significant difference between the right and the left ears. 3) The level of SOAEs was -18.4 to 22.6 dB SPL. The highest amplitude of SOAEs in each subject was 3.69+/-8.87 dB SPL. 4) The SOAE frequency was mainly between 1000 Hz and 4000 Hz, and most frequently between 3000 Hz and 4000 Hz. The mean frequency of the highest amplitude of SOAE was 2907+/-1092 Hz. 5) The highest amplitude of SOAE was correlated with the overall response amplitude of TEOAE (r=0.619, p<0.01), but not the number of peaks (r=0.086, p=0.272). CONCLUSION: Neonates have robust SOAEs, which correlated with their TEOAEs.
Ear ; Female ; Hearing ; Hearing Loss ; Humans ; Infant ; Infant, Newborn* ; Male ; Mass Screening ; Otoacoustic Emissions, Spontaneous ; Prevalence

BACKGROUND AND OBJECTIVES: Prevention of noise induced hearing loss (NIHL) can be achieved by environmental control, however, recently, there are some suggestions for the protective effects of various drugs. To find an effective drug on the protection of NIHL, we investigated the protective effects of allopurinol, platelet activating factor (PAF) antagonist, leukotriene (LT) inhibitor, superoxide dismutase-polyethylene glycol (SOD-PEG), and dexamethasone on the noise induced threshold shift in guinea pigs. MAERIALS AND METHODS: Thirty healthy guinea pigs (60 ears) were divided into control and different treatment groups to consist of five guinea pigs each. Guinea pigs were exposed to 100 dBA white noise for eight hours. Auditory Brainstem Response (ABR) were recorded before and after the noise exposure. RESULTS: Changes in ABR thresholds were 48.1+/-9.6 dB SPL in the control group, 33.1+/-3.7 dB SPL in the allopurinol group, 39.37+/-17.8 dB SPL in the PAF antagonist group, 36.25+/-10.26 dB SPL in the LT inhibitor group, 38.0+/-13.98 dB SPL in the SOD-PEG group and 46.9+/-8.8 dB SPL in the dexamethasone group. Only the allopurinol group demonstrated significantly different threshold change compared to the control group. CONCLUSION: The results of this study suggest that allopurinol may be effective in protection of noise induced threshold shift, whereas PAF antagonist, LT inhibitor, SOD, dexamethasone may not be as effective.
Allopurinol* ; Animals ; Dexamethasone* ; Evoked Potentials, Auditory, Brain Stem ; Guinea Pigs* ; Guinea* ; Hearing Loss ; Hearing* ; Noise* ; Platelet Activating Factor ; Superoxides*

Reactions to Hymenoptera stings are classified into local reactions, large local reactions, systemic anaphylactic reactions, systemic toxic reactions, and unusual reactions. They are also classified into immediate and delayed reactions. The most frequent clinical patterns are large local and systemic anaphylactic reactions. The skin, and the gastrointestinal, respiratory, and cardiovascular systems can be involved. A variety of unusual or unexpected reactions, such as acute encephalopathy, acute renal failure, nephrotic syndrome, silent myocardial infarction, diffuse alveolar hemorrhage, rhabdomyolysis, and cataracts, occur in a temporal relationship to insect stings. Here, we report a 31-year-old woman with delayed generalized edema, weight gain, and unusual reactions 24 hours after bee sting.
Acute Kidney Injury ; Adult ; Anaphylaxis ; Bees ; Bites and Stings* ; Brain Diseases ; Cardiovascular System ; Cataract ; Edema ; Female ; Hemorrhage ; Humans ; Hymenoptera* ; Insect Bites and Stings ; Myocardial Infarction ; Nephrotic Syndrome ; Rhabdomyolysis ; Skin ; Weight Gain