This is to report a clinical observation on 81 cases of genito-urinary tract injuries treated at the urology service. Capital Army Hospital, during the period from January, 1960 to July, 1963. Of 81 Cases which stood for 0.82% of all genito-urinary out patients, 58 cases (or 71.6%) occurred in the urethra, the most common site of involvement, and 6 cases (or 7.2%) showed multiple injuries. Age ranged between 21 and 10 years with the highest incidence of 58.4% in the ages between 21-25 years. In lateralyzation of injury while the kidney showed nosignificant difference the ureter was more frequently involved in the left than in the right with a ratio of 4:1. Traffic accident was listed as high as 56.9% to be most frequent cause of injury and contusion, fall, gun-shot and explosion were listed less frequently. Of associated major injuries, pelvic fracture was seen in 20 cases (33.9%) and all the urethral injuries were accompanied with injuries to gastro-intestinal tract. Of all cases herein reported, 62.3% of cases were treated surgically and the remaining 37.7%. non-surgically. Surgical intervention was necessary in 33.3% of kidney injury, 100% of ureteral injury, 67.8% of urethral injuries and 40% of genital injuries. Average hospitalization required 20.2 days for renal injury and 67.2 days for urethral injury.
Accidents, Traffic ; Contusions ; Explosions ; Hospitalization ; Hospitals, Military ; Humans ; Incidence ; Kidney ; Multiple Trauma ; Outpatients ; Ureter ; Urethra ; Urology

PURPOSE: To determine if intravitreal injection of triamcinolone acetonide (IVTA) is effective for diabetic macular edema according to the type of macular edema. METHODS: This prospective, clinical series study was carried out on 31 eyes with diabetic macular edema, which had received an intravitreal injection of 4 mg of triamcinolone acetonide. We analyzed the visual acuity and foveal thickness at post-treatment 1 week, 1, 3, and 6 months according to the type of diabetic macular edema by optical coherence tomography (OCT). RESULTS: OCT showed 3 patterns of macular edema: cystoid type (18 eyes), sponge type (7 eyes), and serous detachment type (6 eyes). Visual acuity and foveal thickness improved in all patients. The cystoid types of macular edema show better response than the other types in visual acuity and foveal thickness. CONCLUSIONS: IVTA is a good therapeutic options for diabetic macular edema. IVTA is more effective in cystoid macular edema. Furthermore, study with more patients and focal laser treatment according to the type of macular edema may be necessary for further evaluation.
Humans ; Intravitreal Injections ; Macular Edema* ; Porifera ; Prospective Studies ; Tomography, Optical Coherence ; Triamcinolone Acetonide* ; Triamcinolone* ; Visual Acuity

PURPOSE:We investigated the production of oxygen hydroxyl radicals in the striatum of neonatal rat brain after intrastriatal injection of dopamine (DA) and the effect of growth hormone (GH) on the apoptosis of striatal neurons injured by hypoxia-ischemia. METHODS:The extracellular striatal levels of 2,3-dihydroxybenzoic acid (DHBA) and 2,5-DHBA as indicators of hydroxyl radical(OH-) production were measured by in vivo microdialysis in the striatums of 7 day-old newborn rats (n=10) after direct intrastriatal infusion of dopamine hydrochloride (1.0 micromol/microL). The samples of perfused artificial cerebrospinal fluid (CSF) were collected every 10 minutes interval. The levels of DA, 2,3-DHBA and 2,5-DHBA of CSF were analysed by HPLC (high performance liquid chromatography). Also, the brains were removed at 24 hour after hypoxic-ischemic injury by Rice-Vannucci method. The coronal sections (12 micrometer) of paraffin-fixed brains were stained by TUNEL (terminal transferase-mediated dUTP nick-end-labelling) technique, and the neuronal cells undergoing apoptosis in the striatum were observed by fluorescent microscopy and compared between GH-treated (50 mg/kg, Dong-Ah Pharmacy Co.) and saline-treated rats. RESULTS:The extracellualr striatal levels of 2,3-DHBA and 2,5-DHBA increased abruptly in the first 10 minutes samples after intrastriatal injection of DA. After then, the levels declined slowely. The levels of striatal extracelluar 2.3-DHBA increased up to 621.8+/-508.7% of basal levels (P<0.05), and the levels of 2.5-DHBA increased up to 262.8+/-198.1% of basal levels (P<0.05). GH reduced markedly the number of apoptotic neuronal cells in the striatum after hypoxic-ischemic brain injury. CONCLUSION: The level of hydroxyl radicals increased abruptly after intrastriatal injection of DA and GH reduced markedly the number of apoptotic neuronal cells in the striatum after hypoxic-ischemic brain injury.
Animals ; Apoptosis* ; Brain Injuries ; Brain* ; Cerebrospinal Fluid ; Chromatography, High Pressure Liquid ; Dopamine* ; Growth Hormone* ; Humans ; Hydroxyl Radical* ; In Situ Nick-End Labeling ; Infant, Newborn* ; Microdialysis ; Microscopy ; Neurons* ; Oxygen ; Pharmacy ; Rats*

BACKGROUND AND OBJECTIVES: Several prognostic factors are known to be related to the recovery of sudden sensorineural hearing loss (SSNHL). Recent studies have suggested that cardiovascular risk factors (CVRFs) are associated with the occurrence of SSNHL. However, the value of CVRFs as a predictor of recovery in patients with SSNHL has been rarely evaluated. We aim to evaluate the prognostic value of CVRFs in relation to hearing recovery of SSNHL. SUBJECTS AND METHOD: A total of 278 patients who were diagnosed and treated for SSNHL and who underwent blood sampling and follow-ups for more than 3 months were reviewed retrospectively. We reviewed CVRFs such as age, body mass index, blood pressure, cholesterol, smoking history, the presence of diabetes mellitus and other related underlying diseases. Patients were divided into three groups (low, medium, and high CVRF groups) according to the CVRF grades. Hearing thresholds were repeatedly measured on the initial visit, 1 week, 1 month and 3 months after treatment. Treatment outcome was analyzed by comparing hearing recovery rate and post-treatment audiometric changes among the three CVRF groups. RESULTS: Seventy (25.2%), 129 (46.4%) and 79 (28.4%) patients were included into the low, medium and high CVRF groups, respectively. The hearing threshold was significantly reduced at 3 months after treatment in all three groups (p<0.001). The hearing recovery rate of the low CVRF group was significantly higher than that of the medium and high CVRF group (p=0.011). On the last visit, the high CVRF group significantly showed more poor hearing improvement than the low CVRF group did (p=0.045). CONCLUSION: Our findings suggest that the presence of CVRFs may be a poor prognostic sign for hearing recovery in patients with SSNHL.
Blood Pressure ; Body Mass Index ; Cholesterol ; Diabetes Mellitus ; Follow-Up Studies ; Hearing Loss, Sensorineural* ; Hearing* ; Humans ; Methods ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Treatment Outcome

Chromosome 11q13 deletion syndrome has been previously reported as either otodental syndrome or oculo-oto-dental syndrome. The otodental syndrome is characterized by dental abnormalities and high-frequency sensorineural hearing loss, and by ocular coloboma in some cases. The underlying genetic defect causing otodental syndrome is a hemizygous microdeletion involving the FGF3 gene on chromosome 11q13.3. Recently, a new form of severe deafness, microtia (small ear) and small teeth, without the appearance of eye abnormalities, was also reported. In this report, we describe a 1-year-old girl presenting with ptosis of the left upper eyelid, right auricular deformity, high-arched palate, delayed dentition, simian line on the right hand, microcephaly, and developmental delay. In this patient, we identified a deletion in the chromosome 11q13.2-q13.3 (2.75 Mb) region by using an array-comparative genomic hybridization analysis. The deletion in chromosome 11q13 results in a syndrome characterized by variable clinical manifestations. Some of these manifestations involve craniofacial dysmorphology and require a functional workup for hearing, ophthalmic examinations, and long-term dental care.
Coloboma ; Congenital Abnormalities ; Congenital Microtia ; Deafness ; Dental Care ; Dentition ; Eye Abnormalities ; Eyelids ; Female ; Hand ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Microcephaly ; Nucleic Acid Hybridization ; Palate ; Tooth ; Tooth Abnormalities

PURPOSE: Hypertension is a common problem in maintenance hemodialysis (HD) patients. We assessed the effects of low sodium dialysate on changes of blood pressure in maintenance HD patients. METHODS: Forty HD patients were enrolled in this cross-over study. All the patients underwent nine consecutive HD sessions with the dialysate contained 138 mEq/L sodium (conventional sodium HD), then concentrations of sodium were switched to match the patients average pre-HD plasma sodium measured during the conventional sodium phase (135 mEq/L for patients with sodium levels less than 137, 137 for patients with sodium levels over 137). Dry weight and dialysis prescription were not modified during the six weeks of the study. RESULTS: There was a significant decrease in the interdialytic weight gain (2.4+/-0.9 kg vs. 2.0+/-0.7 kg, p<0.001) and the interdialytic thirsty in low sodium HD sessions compare to conventional sodium HD sessions. Pre-HD systolic and diastolic blood pressure (BP), post-dialysis systolic BP was similar in both periods of the study. The use of low sodium dialysate is associated with significantly lower systolic BP in patients with uncontrolled hypertension (n=10,157.1+/-3.6 mmHg vs. 148.0+/-9.4 mmHg, p=0.011), but not in those with controlled hypertension. Cardio-thoracic ratio was significant decrease in low sodium dialysate HD (0.53+/-0.08 vs. 0.51+/-0.07, p=0.002). The episodes of intradialytic hypotension and related symptoms were not more frequent in low sodium dialysate HD. CONCLUSION: Low dialysate sodium concentration based on predialysis sodium levels of patients could reduce the pre-HD systolic BP, interdialytic thirsty and interdialytic weight gain in maintenance HD patients.
Blood Pressure ; Cross-Over Studies ; Dialysis ; Humans ; Hypertension ; Hypotension ; Plasma ; Prescriptions ; Renal Dialysis ; Sodium ; Thirst ; Weight Gain

BK virus nephropathy has emerged as an important cause of renal allograft dysfunction. It affects 1-10% of renal transplant patients and results in significant graft dysfunction in more than 50% of cases. A reduction in the amount of immunosuppressants is not an appropriate treatment option for advanced stage BK nephropathy; therefore, other treatment strategies need to be considered such as cidofovir, leflunomide, and intravenous immunoglobulin (IVIG) in combination with reduced immunosuppression. The use of IVIG may be a valuable treatment option in patients with BK virus nephropathy. We report our experience with IVIG rescue therapy in a patient and the progression of BK nephropathy despite leflunomide therapy.
BK Virus ; Cytosine ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Immunosuppression ; Immunosuppressive Agents ; Isoxazoles ; Kidney Transplantation ; Organophosphonates ; Transplantation, Homologous ; Transplants

BACKGROUND: Aim of study is designed to investigate whether apurinic/apyrimidinic endonuclease-1/redox factor-1 (APE1/Ref-1) expression is changed in abdominal aortic coarctation models. METHODS: Male Sprague-Dawley rats were randomly assigned with abdominal aortic coarctation, repaired group, sham, and control groups. Endothelial function was assessed with endothelium-dependent relaxations. Detection of superoxide anion and lipid peroxidation was performed by lucigenin chemiluminescence and thiobarbituric acid-reactive substances assay. APE1/Ref-1 expression was measured with Western blot and immunohistochemistry. RESULTS: In anesthetized condition, the abdominal aortic coarctation rats showed hypertension as systolic/diastolic arterial pressure of 171/114 mm Hg, compared with 114/94 mm Hg of control. Endothelium-dependent relaxations were significantly impaired in the aortic coarctation which was recovered in 1 week after coarctation repair. Superoxide production and lipid peroxidation were elevated in aortic coarctation rats. In immunohistochemistry, APE1/Ref-1 expressions were increased at aorta and kidney in aortic coarctation rats. Increased APE1/Ref-1 expression in aorta was recovered by repair of coarctation. CONCLUSIONS: Taken together, it suggests that APE1/Ref-1 expression was increased in aortic coarctation-induced hypertensive rats, suggesting a biomarker for hypertension. Impaired endothelium dependent relaxation in the aortic coarctation can be modulated by repair of coarctation or the modulation of blood pressure.
Acridines ; Animals ; Aorta ; Aortic Coarctation ; Arterial Pressure ; Blood Pressure ; Blotting, Western ; Endothelium ; Humans ; Hypertension ; Immunohistochemistry ; Kidney ; Lipid Peroxidation ; Luminescence ; Male ; Oxidation-Reduction ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Relaxation ; Salicylamides ; Superoxides

Lymphangioma is a benign tumor of lymphatic origin. Lymphangioma can occur anywhere in the body and only rarely affects the intestinal tract. Most intestinal lymphangiomas are asymptomatic and detected incidentally at autopsy or surgery. Occasionally, they may be large enough to present as a mass to cause obstruction or intussusception. Recently, we examined a case of a 27-year-old woman who complained right upper quadrant abdominal pain, increased bowel sound and weight loss. By surgical resection after the double contrast barium enema and colonoscopy, we could confirm cystic lymphangioma of the transverse colon. So we report this case with brief review of relevant literature.
Abdominal Pain ; Adult ; Autopsy ; Barium ; Colon* ; Colon, Transverse ; Colonoscopy ; Enema ; Female ; Humans ; Intussusception ; Lymphangioma ; Lymphangioma, Cystic* ; Weight Loss

Background: This study reports trends in pediatric out-of-hospital cardiac arrest (OHCA) and factors affecting clinical outcomes by age group. Methods: We identified 4,561 OHCA patients younger than 18 years between January 2009 and December 2018 in the Korean OHCA Registry. The patients were divided into four groups: group 1 (1 year or younger), group 2 (1 to 5 years), group 3 (6 to 12 years), and group 4 (13 to 17 years). The primary outcome was survival to hospital discharge, and the secondary outcomes were return of spontaneous circulation (ROSC) at the emergency department (ED) and good neurological status at discharge. Multivariate logistic analyses were performed. Results: The incidence rate of pediatric OHCA in group 1 increased from 45.57 to 60.89 per 100,000 person-years, while that of the overall population decreased over the 10 years. The rates of ROSC at the ED, survival to hospital discharge, and good neurologic outcome were highest in group 4 (37.9%, 9.7%, 4.9%, respectively) and lowest in group 1 (28.3%, 7.1%, 3.2%). The positive factors for survival to discharge were event location of a public/commercial building or place of recreation, type of first responder, prehospital delivery of automated external defibrillator shock, initial shockable rhythm at the ED. The factors affecting survival outcomes differed by age group. Conclusion This study reports comprehensive trends in pediatric OHCA in the Republic of Korea. Our findings imply that preventive methods for the targeted population should be customized by age group.