The development of the microvascular surgery revolutionalized the reconstructive surgery of the lower ext tremity. Especially, the defects of the heel and sole, the weight bearing area, were quite difficult and complicate to reconstruct by conventional methods. Many papers reported successful resurfacing the heel pad by free cutaneous or myocutaneous flaps. However, only few reports were conceming the late results of the reconstructed free flaps. The authors studied the histological and histochemical changes of the free flaps under the weight bearing stress in 10 cases. 1. The authors reconstructed 10 cases of the heel pad defects by dorsalis pedis free Aaps (5 cases) and latissimus dorsi myocutaneous flaps(5 cases). 2. Before transfer, the homy layer was very thin(about 0.16–0.2 mm) and had an arrangement of basket-weave pattem in both flaps. Until one year after transfer, this layer was wom out (0.02–0.08mm) However, after one year, this layer became thick (0.05–0.7 mm) and the arrangement was compact in both free flaps. 3. The granular and prickle cell layers were also increased in thickness after one year. 4. In the suprabasilar area, friction blisters were observed before one year, especially in latissimus dorsi myocutaneous flap. However, they slowly disappeared after one year and then the epidermis was stabilized. 5. In the dermis, the contents of the amyloid and acid mucopolysaccharides were increased up to the level of those of the normal heel pad in both flaps. 6. As a conclusion, the transferred free flaps were in distress before one year. But after one year, they began to adapt well histologically and histochemically to the weight bearing stress.
Amyloid ; Blister ; Dermis ; Epidermis ; Follow-Up Studies ; Free Tissue Flaps ; Friction ; Glycosaminoglycans ; Heel ; Myocutaneous Flap ; Superficial Back Muscles ; Weight-Bearing

With the introduction of electronic medical records (EMRs), it has become possible to accumulate massive amounts of qualitative medical data. As such, EMRs have become increasingly used in clinical decision support systems (CDSSs). While CDSSs aim to reduce medical errors normally occurring in the process of treating patients by physicians, technical maturity and the completeness of CDSSs do not meet standards for medical use yet. As data further accumulates, CDSS algorithms must be continuously updated to allow CDSSs to perform their core functions. Doing so, however, requires extensive time and manpower investments. In current practice, computational systems already perform a wide variety of functions in medical settings to allow medical staff to focus on other tasks. However, no prior research has evaluated the potential effectiveness of future CDSSs nor analyzed possibilities for their further development. In this article, we evaluate CDSS technology with the consideration that medical staff also understand the core functions of such systems.

Primary hydronephrosis due to UPJ obstruction is not infrequent urologic disorder. The causes of the obstruction art categorized into extrinsic, intrinsic and ureterovascular abnormalities. The most important thing is accurate evaluation of the dynamic physiology of UPJ with the X- ray findings. We have experienced 16 cases of pyeloplasty during the last 10 years. We reported the evaluations of the cases with review of the articles. Results were. 1. Of these 16 cases, 13 were male and 3 were female and 11 were left and 5 were right hydronephrosis. 4 were children and 9 were 3rd. and 4th. decades 2. IVP, RGP, Ultrasonography and diuretic renogram were done preoperatively 3. Pyeloplasty were done by the dismembered in 13, Culp spiral flap in 2 and pyelopyeloplasty in 1. 4. Indigocarmin test, AGP, fluoroscopy and Whitaker test were done postoperatively. 5. There were improvement in 12 cases but failed in 3 cases.
Child ; Female ; Fluoroscopy ; Humans ; Hydronephrosis ; Male ; Physiology ; Ultrasonography

No abstract available.
Fetus*

A total of 28 consecutive patients underwent total cystectomy and urinary diversion from May, l978 to April, l986. The range of patient age was from 46 years old to 84 years old. The sex of patients was 24 in male and 4 in female. Histopathological diagnosis of specimen was transitional cell carcinoma in 25 cases, squamous cell carcinoma in 2 cases and carcinosarcoma in a case. Accuracy rate of clinical staging by pelvic CT scanning was low as 44%, clinical overstaging was 44% and clinical understaging was l2%. Early complication after cystectomy was occurred in l4 cases as wound infection, paralytic ileus, parastomal dermatitis, etc. Late complication was occurred in 8 cases as acute pyelonephritis, stomal stenosis, renal function deterioration and adhesive ileus. Mean follow up period of survival patients was 35.2 months with a range from 4 months to 96 months. Deaths during follow up were 8 patients and the average survival period was 20.6 months.
Adhesives ; Aged, 80 and over ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Carcinosarcoma ; Constriction, Pathologic ; Cystectomy* ; Dermatitis ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Male ; Middle Aged ; Pyelonephritis ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion ; Wound Infection

Transurethral resection of prostate is widely popular, effective and easily performable surgery with the least limitation. It is well known that absorption of the irrigant and its following events are the most important factors determining the condition of the patients postoperatively. We studied the changes in serum electrolyte and osmolarity following transurethral resection of prostate in 78 patients of benign prostatic hypertrophy. We divided the patients into two groups, A and B. group A: those were given non-electrolyte solution only during the operation. group B: those were given electrolyte solution during the operation. We compare the results of each group. We also observe the relationship of these results to the irrigating fluid volume, Operation time and resected weight. Following results were obtained. 1. Serum sodium concentration was decreased in 28 cases of group A (75.6%, avg. 5.96mEq/L). 2. Serum sodium concentration was decreased in 16 cases of group B (43.2%, avg. 5.18mEq/L). 3. Serum osmolarity was decreased in 18 cases of group A (75%, avg. 8.83mOsm/kg). 4. Serum osmolarity was decreased in 14 cases of group B (50%, avg. 6. 78mOsm/kg). 5. These changes in serum sodium concentration and osmolarity showed no significance statistically. 6. These changes in serum sodium concentration and osmolarity showed no significant correlation with the amount of irrigant, operation time and resected weight, statistically.
Absorption ; Humans ; Osmolar Concentration* ; Prostate* ; Prostatic Hyperplasia ; Sodium ; Transurethral Resection of Prostate

No abstract available.

A clinical observation was made on thirty-seven cases of benign prostatic hypertropby, admitted to the Department of Urology, Kyung Hee University Hospital during the period from January 1, 1972 to December 31, 1976. The results are summarized as follows. 1. Incidence of benign prostatic hypertrophy was 6.1 % to 607 total in-patients, 8.2% to 453 male in-patients, and 38.5% to male in-patients 50 years old or more. 2. Majority of cases was found in 7th and 8th decades(89%) with mean age of 70.4 years old. 3. Mean interval elapsed from initial symptoms to visit was 3.9 years. 4. Common symptoms were frequency in 31 cases(83. 8%). dyeuria in 27 cases(73%), retention in 25 cases(67. 6%), small urinary stream in 19 cases(51%) and hematuria is 15 cases(14%) 5. Endoscopy was performed in 31 cases. The most common finding was trabeculation and cellulation observed in 31 cases(91%), kissing of lateral lobes in 22 cases(65%), elevation of interureteric ridge in 15 cases(44%) and enlarged median lobe in 6 cases(17. 6%). 6. Amount of residual urine from 0 to 900ml with average of 207 ml. 7. Occult prostatic carcinoma was found in 3 cases(9.4%). 8. I.V.P. was performed in 35 cases. Findings included hydronephrosis in 3 cases, delayed excretion in 1 case, but normal in 31 cases. 9. Methods of operative treatment included 15 retropubic prostatectomy, 11 suprapubic prostatectomy, 6 T.U.R. 10. Mean weight of removed adenoma were 36.3 gm in retropubic prostatectomy, 41.7 gm in suprapubic prostatectomy, 12.9 gm in T.U.R. 11. Mean amount of blood transfusion was 609 ml in retropubic prostatectomy, 786 ml in suprapubic prostatectomy, but there was no transfusion in T.U.R. 12. Mean period of catheter drainage was 7.1 days in retropubic prostatectomy, 7.2 days in suprapubic prostatectomy, 5.6 days in T.U.R. 13. Mean duration of postoperative hospitalization was 10.3 days in retropubic prostatectomy, 13.7 days in suprapubic prostatectomy, 3.3 days in T.U.R. 14. Postoperative complications were urinary infection in 21 cases(65. 6%), temporary urine leakage in 6 cases, delayed bleeding in 2 cases and gastrointestinal bleeding in 1 case.
Adenoma ; Blood Transfusion ; Catheters ; Drainage ; Endoscopy ; Hematuria ; Hemorrhage ; Hospitalization ; Humans ; Hydronephrosis ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; Prostatectomy ; Prostatic Hyperplasia* ; Rivers ; Urology

No abstract available.
Hemorrhagic Fever with Renal Syndrome* ; Humans ; Proteinuria*

OBJECTIVE: The purpose of this study was to investigate the effect of clozapine on seam prolactin concentration in schizophrenic patients. METHOD: The subjects composed of 3-schizophrenic patients with hyperprolactinemia after treatment with risperidone and 9-tratment resistant chronic schizophrenic patients. Serum prolactin concentration was measured by radioimmunoassay method before clozapine administration and artier 1 and 4 week of treatment. Data were analysed by the SAS program. Statistical methods employed was Wilcoxon-sign rank test. RESULTS: 1) Clozapine had improving effect on 3 risperidone-induced hyperprolactinemic patients. 2) Clozapine did not have significant effect on serum prolactin levels in 9-tratment resistant chronic schizophrenic patients. CONCLUSION: Clozapine has minimal effects on serum prolactin levels in schizophrenic patients as well as improving effect on antipsychotics-induced hyperprolactinemia. We recommend atypical antipsychotics such as clozapine as alternative treatments for complicated hyperprolactinemia induced by other antipsychotics.
Antipsychotic Agents ; Clozapine* ; Humans ; Hyperprolactinemia ; Plasma* ; Prolactin* ; Radioimmunoassay ; Risperidone ; Schizophrenia