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

No abstract available.
Collagen* ; Humans*

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

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

BACKGROUND: One of the most frequent symptoms encountered at a dermatology out patient clinic is recurrent or persistent facial erythema (red face). The face is exposed to many allergens including metals, cosmetic ingredients and environmental pollutants, therefore, it is very difficult to treat recurrent or persistent facial erythema patients if they are sensitized by these allergens. Although facial erythema could be a manifestation of various diseases, there have only been a limited number of clinical studies. OBJECTIVE: To find out how often patients with recurrent facial erythema were sensitized by contact allergens. METHODS: A total of 136 patients with recurrent or persistent facial erythema were enrolled and the patch test was done. RESULTS: First clinical impressions were allergic contact dermatitis, rosacea, atopic dermatitis, steroid induced rosacea or seborrheic dermatitis in order of frequency. Patch test was performed on 84 patients, and 70 patients (83.3%) showed positivity to one or more antigens. Common antigens included nickel sulfate, cobalt chloride, and fragrance mix in the standard patch tests, and octyl galate, thimerosal, and dodecyl galate in the cosmetic series patch tests. CONCLUSION: Based on our results, we strongly recommend patch test for patients with recurrent or persistent facial erythema.
Allergens ; Cobalt ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Dermatology ; Environmental Pollutants ; Erythema* ; Humans ; Metals ; Nickel ; Patch Tests* ; Rosacea ; Thimerosal

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

A clinical program in liver transplantation was stared at CMC in June, 1993 and since then, 24 orthotopic liver transplantations were performed (22 adult and 2 children) until July, 1998. The first 11 adult liver transplants (period I) performed from June, 1993 through June, 1997 were compared with the last 11 (period II) performed between July, 1997 and July, 1998. An analysis was made of donor and recipient characteristics, analysis of high risk group, survival data and cause of mortality, prognostic factors of donor and recipient. Mean donor age increased from 32.7 years to 37.2 years and most common cause of brain death were traffic accident and cerebrovascular accident. The highest frequency among recipient was between ages 40 and 59 and the male was predominant (21:1). The major indications for liver transplantation were liver cirrhosis due to hepatitis B or hepatitis C. High risk patients by our criteria comprised 36% of patients in period I compared with 27 % in period II. The survival rate was 45.5% in period I and a substantial improvement was observed in period II with the graft and patient survival rate of 90.9%, 100% respectively. This improved survival rate was correlated with less clinical stage, fewer high risk patient, decreased blood transfusion during operation, early recovery of respiratory and renal function in postoperative course. In conclusion, improved survival rate in period II was contributed by advanced perioperative care and more selected recipient candidate even broadening of donor organ criteria followed by early recovery of organ function.
Accidents, Traffic ; Adult ; Blood Transfusion ; Brain Death ; Hepatitis B ; Hepatitis C ; Humans ; Liver Cirrhosis ; Liver Transplantation* ; Liver* ; Male ; Mortality ; Perioperative Care ; Stroke ; Survival Rate ; Tissue Donors ; Transplants

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