This study was performed to compare the results according to initial managements in 130 patients with urethral injury during the period from January, 1978 to May, 1990. The following results were obtained : 1. Among the 130 patients ranged from 6 to 70 years of age with average of 35.4 years, 71 ruptures were complete and 59 were incomplete and pelvic bone fracture was associated in 40 patients(30.8%). 2. Of these patients. 44 who had mild urethral injury were managed by observation or indwelling of Foley catheter, 27 by primary realignment and 69 by suprapubic cystostomy only as a initial management. and thereafter urethral strictures were developed in 5(13.2%). 21(77.8%) and 48 (81.4%), respectively, with no statistical difference between later two groups. 3. In the cases of urethral stricture who were treated by suprapubic cystostomy as a initial management required more complicated surgical procedures such as end to end anastomosis or staged urethroplasty for the correction than primary realignment. 4. Complications other than stricture such as impotence, urinary tract infection, stone, or fistula were developed in both groups similarly.
Catheters ; Constriction, Pathologic ; Cystostomy ; Erectile Dysfunction ; Fistula ; Humans ; Male ; Pelvic Bones ; Rupture ; Urethral Stricture ; Urinary Tract Infections

This study was performed to compare the results according to initial managements in 130 patients with urethral injury during the period from January, 1978 to May, 1990. The following results were obtained : 1. Among the 130 patients ranged from 6 to 70 years of age with average of 35.4 years, 71 ruptures were complete and 59 were incomplete and pelvic bone fracture was associated in 40 patients(30.8%). 2. Of these patients. 44 who had mild urethral injury were managed by observation or indwelling of Foley catheter, 27 by primary realignment and 69 by suprapubic cystostomy only as a initial management. and thereafter urethral strictures were developed in 5(13.2%). 21(77.8%) and 48 (81.4%), respectively, with no statistical difference between later two groups. 3. In the cases of urethral stricture who were treated by suprapubic cystostomy as a initial management required more complicated surgical procedures such as end to end anastomosis or staged urethroplasty for the correction than primary realignment. 4. Complications other than stricture such as impotence, urinary tract infection, stone, or fistula were developed in both groups similarly.
Catheters ; Constriction, Pathologic ; Cystostomy ; Erectile Dysfunction ; Fistula ; Humans ; Male ; Pelvic Bones ; Rupture ; Urethral Stricture ; Urinary Tract Infections

The plasmepsins are the aspartic proteases of malaria parasites. Treatment of aspartic protease inhibitor inhibits hemoglobin hydrolysis and blocks the parasite development in vitro suggesting that these proteases might be exploited their potentials as antimalarial drug targets. In this study, we determined the genetic variations of the aspartic proteases of Plasmodium vivax (PvPMs) of wild isolates. Two plasmepsins (PvPM4 and PvPM5) were cloned and sequenced from 20 P. vivax Korean isolates and two imported isolates. The sequences of the enzymes were highly conserved except a small number of amino acid substitutions did not modify key residues for the function or the structure of the enzymes. The high sequence conservations between the plasmepsins from the isolates support the notion that the enzymes could be reliable targets for new antimalarial chemotherapeutics.
Amino Acid Sequence ; Animals ; Aspartic Endopeptidases/*genetics ; Base Sequence ; Cloning, Molecular ; Conserved Sequence ; DNA, Protozoan/chemistry/genetics ; Human ; Molecular Sequence Data ; Plasmodium vivax/*enzymology/genetics/isolation & purification ; Polymerase Chain Reaction ; Sequence Alignment ; Sequence Analysis, DNA ; Support, Non-U.S. Gov't

No abstract available.
Collagen* ; Humans*

Intravesical instillation of Bacillus Calmette-Guerin(BCG) currently is considered the most effective treatment for recurrent superficial bladder cancer, but little is known about the mechanism of action. Total 21 patients receiving intravesical BCG treatment for superficial bladder cancer were entered into this study to investigate the cellular immune response with T-subsets and NK cell activity in peripheral blood before and after intravesical BCG instillation consisted of weekly administration with BCG for six consecutive weeks. Among the 21 patients. 11 had Grade 1 and 10 had Grade 2 bladder cancer and 14 of them had history of recurrence more than 2 times. The results showed that there were no significant differences in the changes of CD4 cell. CD8 cell as T- subsets and NK cell activity before and after treatment(P greater than 0.06 in all). Among 7 patients with recurrence after BCG treatment, there was also no difference in any immune response (P greater than 0.05 in all). Considering the response of the individual patients. We observed that recurrence rates were similar between a group containing the patients with increased value more than 20% after treatment and other in all immune parameters such as CD4. CD8, CD4/CD8 ratio and NK cell activity(P greater than 0.0S in all). We conclude that these parameters are not major contributors to the antitumor activity of BCG and had no prognostic value for the clinical outcome after BCG treatment.
Administration, Intravesical ; Bacillus* ; Humans ; Immunity, Cellular ; Killer Cells, Natural* ; Mycobacterium bovis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Despite recent improvements in operative techniques, immunosuppression and organ procurement, failure of a hepatic allograft remains an important risk to liver recipients. In the absence of any effective method of extracorporeal support, the only alternative to death for these patients is retransplantation. The causes of hepatic allograft failure were listed as primary nonfunction, technical included hepatic artery thrombosis or portal vein thrombosis, and rejection. Hepatic artery thrombosis remain one of most serious complication after liver transplantation and can be associated with one of three typical syndrome: acute, massive hepatic necrosis, biliary tract necrosis and leakage, relapsing bacteremia. The early diagnosis of hepatic artery thrombosis is very important and screening with duplex ulrtasound can allow the recognition of early hepatic artery thrombosis. The emgent revascularization of hepatic artery thrombosis in asymptomatic patient and retransplantation in symptomatic patient lead to improved graft salvage and patient survival. We report one case of hepatic retransplantation due to hepatic artery thrombosis. The patient with 30 years old man underwent primary hepatic transplantation due to liver cirrhosis with hepatocellular carcinoma. After 6th postoperative day of primary transplantation, liver transaminase began to elevate and not responded to steroid pulse therapy. Thereafter bile leakage, evident in T-tube cholangiogram was noted. Explolaparotomy was performed and showed hepatic artery thrombosis and necrosis of donor aspect of extrahepatic biliary tree. On next day, retransplantation was performed. Thereafter secondary graft function was slowly regained but the patient was recoverd and discharged.
Adult ; Allografts ; Bacteremia ; Bile ; Biliary Tract ; Carcinoma, Hepatocellular ; Early Diagnosis ; Hepatic Artery ; Humans ; Immunosuppression ; Liver ; Liver Cirrhosis ; Liver Transplantation ; Mass Screening ; Massive Hepatic Necrosis ; Necrosis ; Thrombosis ; Tissue and Organ Procurement ; Tissue Donors ; Transplants ; Venous Thrombosis

We have performed 10 primary liver transplantations between August 1993 and September 1995 in patients with end stage liver disease at Department of Surgery, Catholic University, Medical College. Donor and recipient operations were performed using modified techniques described by Starzl et al. Cyclosporine and prednisone were used as the principal immunosuppressive regimen and cyclosporine levels were monitored daily with dosage adjustment. when acute rejection was suspected based on clinical parameters, methylprednisolone was given for 2 days and if there was no response, we treated with the OKT3 monoclonal antibody. Our clinical results were as follows : 1. Mean age of donors was 32 years, ranging from 17 to 50 years, eight males, 2 females. The causes of brain death were traffic accident in 5 cases, falling down in 3 cases, and others (CVA, brain tumor). 2. Mean age of recipient was 41 years, ranging from 18 to 57 years and all were male. The indications of liver transplantation were liver circhosis related to viral hepatitis in 9 cases and alcoholic cirrhosis in one. 3. In arterial reconstruction, aortic carrel patch of common hepatic artery was sewn to hepatic-gastroduodenal bifurcation (5 transplants), to supraceliac aorta (3 transplants), and to infrarenal aorta (2 transplants). The biliary anastomosis was a choledochocholedochostomy with T-tube stent in nine and Roux-en-Y choledochojejunostomy in one transplant. 4. Average length of operation was 9 hours 28 minutes (range 7. 6-12 hours), and liver ischemia 6 hours 14 minute. An average requirements of packed red cell were 21.2 unit (range 12-31 units) 5. The surgical complication occurred in 3 patients (postoperative bleeding, hepatic arterial thrombosis and bile peritonitis), acute rejection in 5 patients, bacterial infection in 5 patients and coma in 2 patients. 6. Of the 10 patients, 6 are alive ranging from 15 days to 27 month and four patients died in the early postoperative period : one of postoperative bleeding, one of hepatic arterial thrombosis, one of acute rejection and one of neurologic complication. 7. In the consideration of prognostic factors from donor, the dosage of vasopressor and liver enzyme but not donor age were significant in early postoperative mortality. As perioperative parameters of recipients, preoperative general status, serum BUN, bilirubin, and reversibility of respiratory, renal and graft function within the first week following transplant were important.
Accidents, Traffic ; Aorta ; Bacterial Infections ; Bile ; Bilirubin ; Brain ; Brain Death ; Choledochostomy ; Coma ; Cyclosporine ; End Stage Liver Disease ; Female ; Hemorrhage ; Hepatic Artery ; Hepatitis ; Humans ; Ischemia ; Liver Cirrhosis, Alcoholic ; Liver Transplantation* ; Liver* ; Male ; Methylprednisolone ; Mortality ; Muromonab-CD3 ; Postoperative Period ; Prednisone ; Stents ; Thrombosis ; Tissue Donors ; Transplants

Leiomyoma may originate at any anatomic location of smooth muscle in the genitourinary system. The kidney capsule is the most common site for the genitourinary leiomyomas. Leiomyoma origination from the scrotum is rare. The previous reported cases presented as small, firm, nontender, slowly enlarging freely movable masses within the scrotum. We report a case of leiomyoma of the tunica dartos, a benign lesion arising from the wall of the left scrotum. It presented as a pedunculated lesion with a surface ulceration, which need to be differentiated from squamous carcinoma of the scrotum. It was treated with a simple surgical excision.
Carcinoma, Squamous Cell/pathology ; Diagnosis, Differential ; Genital Neoplasms, Male/*pathology ; Humans ; Leiomyoma/*pathology ; Male ; Middle Aged ; *Scrotum

We present a case of portal and superior mesenteric venous gas in a 31-year-old diabetic woman with a left-sided retroperitoneal abscess. Five years prior to admission, patient was diagnosed with diabetes mellitus and developed emphysematous pyelonephritis, requiring nephrectomy on the left side. A CT examination showed air distributed throughout the portal venous system and superior mesenteric vein.
Abscess/blood/*radiography ; Adult ; Female ; Gases/blood ; Humans ; Mesenteric Veins/metabolism/*radiography ; Portal Vein/metabolism/*radiography ; Retroperitoneal Space ; Tomography, X-Ray Computed

Primary localized amyloidosis is a rare disease with an excellent prognosis in most cases. We report a case of primary localized amyloidosis of the bladder that was treated with transurethral resection.
Amyloidosis/*pathology/therapy ; Bladder Diseases/*pathology/therapy ; Case Report ; Female ; Human ; Middle Age