We reviewed 80 cases of hemorrhagic radiation cystitis(HRC) treated in the Department of Urology, Korea Cancer Center Hospital from March, 1985 to July, 1990. The results were obtained as follows. 1. Primary underlying diseases were 1 bladder tumor and 79 cervix cancers. Main presenting symptoms and signs on hospitalization were gross hematuria, passage of blood clots and vesical irritability symptoms. 2. The range of radiation doses to the bladder was from 5,000 to 11,086 cGy and the ratio of cases receiving irradiation over 7,000 cGy was 56.3 %(45 among 80 cases). Time elapsing between termination of radiation therapy and occurrence of HRC was ranged from 1 month to 14.5 years. 3. We performed histopathologic examination in 22 cases. Microscopically, diffuse mucosal edema and ulceration, vascular telangiectasia, submucosal hemorrhage were observed. The areas of ulceration contained acute inflammatory cells at their base and the lamina propria was hyalinized with enlarged atypical fibroblasts and endothelial cells. Of 22 cases, 4 cases of the secondary neoplasia (1 case of transitional cell papilloma, 2 cases of transitional cell carcinoma(TCC) and 1 case of adenocarcinoma), 1 case of TCC of recurrent bladder tumor and 1 case of recurrent cervix cancer invading bladder were observed. 4. Hematuria was controlled in 57 cases receiving transurethral fulguration(TUF), but repeated TUF (2-4 times) was performed for recurrent severe gross hematuria in 7 cases and the ratio of cases requiring re-hospitalization due to recurrent severe gross hematuria after TUF was 16.4%. Of complications due to treatment of HRC, no significant complication was found after TUF, but incontinence due to contracted bladder was occurred in 1 case of 3% formalin instillation.
Cervix Uteri ; Cystitis* ; Edema ; Endothelial Cells ; Female ; Fibroblasts ; Formaldehyde ; Hematuria ; Hemorrhage ; Hospitalization ; Hyalin ; Korea ; Mucous Membrane ; Papilloma ; Telangiectasis ; Ulcer ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urology ; Uterine Cervical Neoplasms

In 1960 Jacobson and Suarez introduced the operating microscope to vascular surgery and demonstrated the superiority of small vessel repair using magnification. The first clinical replantation of an arm in the western world was performed by Malt in 1962, and Komatsu and Tamai reported the successful replantation of a completely amputated thumb in 1965. To perform a digit or hand replantation, microsurgical anastomosis of blood vessels is absolutely essential to revascularize the severed part. Without accurate repair of bone, nerves and tendons in addition to vascular anastomosis, however, it is impossible to gain functional success when replanting a digit or hand. This is a difficult task because all structures must be reconstructed at the same level and time. Even if the repair of some structures has been postponed, the secondary reconstruction may also be troublesome due to circular scarring at the replantation level. Since replantation surgery has been popularized throughout the world in recent years, the replantation sucess rate has increased and the surgeons interest in functional reconstruction of replanted digits or hands has been stimulated. The authors have seen and studied 6 cases of upper Jimb and 20 cases of finger replantation from May, 1980 through January, 1982 at the department of orthopedic surgery, Yonsei University College of Medicine. The results were as follows: I. The average age was 20 years and the male to female sex ratio was 4.5:1. 2, The causes of injury are detailed as follows: electric saw(6); cutting machine(5); roller(4}; presser(2); stone(2); others(3). 3. The level of amputation in 26 replantations was as follows: thumb, 3 cases; index finger, 4 cases; middle finger, 9 cases; ring finger, 4 cases; palm, I case, wrist, 3 cases; forearm, 1 case; upper arm, 1 case. 4. The maximum ischemic times for successtul results were 16 hours in limb replantation and 22 hours in finger replantation. 5. Six limbs, with four complete and two incomplete amputations, have been replanted and all six limbs survived: Twenty digits, with nine complete and eleven incomplete amputations, have also been replanted and 6.5 cases of nine complete amputations and 10 cases ot eleven incomplete amputations survived. A total of 22.5 cases(86.5%) of replanted limbs and digits survived. 6. The results of joint motion, two point discrimination, sensory recovery and status of sweating due to recovery ot sympathetic nervous function following replantation were satisfactory. 7. In the early stage of our series, postoperative systemic heparinization was used in some cases, but recently we have achieved good recults without it. 8. Main causes of reattachment failure were tissue crushing and secondary thrombosis of the anstomosed vessels.
Amputation ; Arm ; Blood Vessels ; Cicatrix ; Clinical Study ; Discrimination (Psychology) ; Extremities ; Female ; Fingers ; Forearm ; Hand ; Heparin ; Humans ; Joints ; Male ; Orthopedics ; Replantation ; Sex Ratio ; Surgeons ; Sweat ; Sweating ; Tendons ; Thrombosis ; Thumb ; Western World ; Wrist

BACKGROUND: Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy. Some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. METHODS: We reviewed the patients' charts retrospectively and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. RESULTS: Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). CONCLUSION: Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.
Diagnosis, Differential ; Pneumoconiosis

PURPOSE: Korean red ginseng (KRG) is a potent antioxidant and a free radical scavenger. This study was designed to determine whether KRG could protect against dysfunction and oxidative stress induced by torsion-detorsion injury in rat testis. MATERIALS AND METHODS: Six-week-old male Sprague-Dawley rats were randomly divided into four groups: a sham-operated control group (C), a sham-operated and KRG-treated group (K), a 2 hours torsion and detorsion group (T), and a 2 hours torsion and detorsion and KRG-treated group (T+K). We measured testis weight and hormone levels and reactive oxygen species (ROS) from the left renal vein. Superoxide generation was measured on the basis of lucigenin-enhanced chemiluminescence in testis tissue. RESULTS: Testicular weight was significantly higher in the T+K group than in the T group; however, there were no significant differences in hormone levels between the 4 groups. The mean level of ROS and superoxide production was significantly higher in the T group than in the C group, whereas administration of KRG attenuated this increase. Upon histologic evaluation, the T group was found to have cellular disarray, a lack of cellular cohesiveness, degenerative changes in the germinal cells, and less distinct changes in the seminiferous tubules, whereas the T+K group had a germinal epithelial layer that appeared nearly normal. CONCLUSIONS: The present study demonstrated that KRG recovered the testis dysfunction in the rat testis by suppressing superoxide production.
Animals ; Humans ; Luminescence ; Male ; Oxidative Stress ; Panax ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Renal Veins ; Seminiferous Tubules ; Spermatic Cord Torsion ; Superoxides ; Testis

PURPOSE: Prognosis of papillary thyroid carcinoma (PTC) is very favorable, but PTC frequently invade adjacent soft tissue and metastases to cervical lymph node. We evaluated the pattern of cervical neck lymph node metastasis in PTC according to tumor size. METHODS: From August 2005 to January 2009, 353 patients were underwent surgery for PTC. Among these patients, total thyroidectomy with cervical neck lymph node dissection were done in 266 patients. We subdivided patients into four groups according to size and compared the clinicopathologic characters between groups. And we confirmed the factors affecting central neck node metastasis. RESULTS: The mean age of patients of diagnosis was 49.1 years and female to male ratio was 5.8:1. Cervical lymph node metastasis were in 47.0% of the total cases. Cervical lymph node metastases and invasion to adjacent structure increased with tumor size. But, there were no significant differences in tumor size, invasion to adjacent structure, multifocality or bilaterality according to cervical lymph node metastasis. Early diagnostic age and sexuality were significantly related to cervical lymph node metastasis of PTC. CONCLUSION: PTC showed the aggressiveness with increasing tumor size. Tumor size was not related to cervical lymph node metastasis. These findings suggest that tumor size can help treat PTC, can`t be used by prediction factor of cervical lymph node metastasis.
Diagnosis ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Male ; Neck* ; Neoplasm Metastasis* ; Prognosis ; Sexuality ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Extragonadal germ cell tumors are rare. accounting for approximately 38 of all germ cell tumors. Debate continues over whether these lesions originate from extragonadal site or are metastatic disease from an undetected testis primary tumor. Recently. we experienced a case of extragonadal mixed germ cell tumor in a 26-year-old male who showed complete response by combination chemotherapy with cisplatin. etoposide. and bleomycin(PVpB) and have remained disease tree for about 14 months since diagnosis. Herein we report the case with brief review of the literature.
Adult ; Cisplatin ; Diagnosis ; Drug Therapy, Combination ; Etoposide ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Testis

Spontaneous rupture of the kidney with subcapsular or perinephric hemorrhage usually occurs secondary to various kinds of underlying diseases such as benign malignant tumor. vascular disease and infection etc. We experienced 2 cases of spontaneous rupture of the kidney secondary to renal cell carcinoma in a 44-year-old female and adult Wilms' tumor in a 17-year-old male.
Adolescent ; Adult ; Carcinoma, Renal Cell ; Female ; Hemorrhage ; Humans ; Kidney* ; Male ; Rupture, Spontaneous* ; Vascular Diseases ; Wilms Tumor

BACKGROUND: Although topically applied laryngeal lidocaine is known to be effective in preventing the cardiovascular events associated with endotracheal intubation, it is still debated whether the mechanism of action of topically applied laryngeal lidocaine is via increased plasma concentration of lidocaine or via topically induced superficial anesthesia. The purpose of the present study is to observe vocal cord responses to stimulation and to find out whether topically induced superficial anesthesia with 10% lidocaine spray is effective under propofol anesthesia. METHODS: Twenty-four patients scheduled for operation on the upper or lower extremities were randomly allocated to two groups: (1) twelve patients who did not receive 10% lidocaine spray before the insertion of a laryngeal mask airway (LMA), (2) twelve patients who received 10% lidocaine spray before the insertion of LMA. The vocal cords of each patient were stimulated by the spraying of 0.2 ml distilled water or directly by bronchoscope tip, and the evoked responses were assessed by analyzing the hemodynamic and respiratory variables and vocal cord movement. The vocal cord movements elicited by the laryngeal stimulation were classified into four grades. RESULTS: There was a significant difference between the groups regarding vocal cord movement (P < 0.05). There were no differences between the groups regarding hemodynamic and respiratory variables. CONCLUSIONS: The result indicates that there is a topical anesthetic effect on the vocal cords by 10% lidocaine spray on the larynx.
Anesthesia ; Anesthetics* ; Bronchoscopes ; Hemodynamics ; Humans ; Intubation, Intratracheal ; Laryngeal Masks ; Larynx* ; Lidocaine* ; Lower Extremity ; Plasma ; Propofol ; Vocal Cords ; Water

BACKGROUND: Osteoporosis, one of the most common metabolic bone disease, might be influenced by the severity of Parkinson's disease (PD). Objectives : We investigated the relationship between the Bone Mineral Density (BMD) and the severity of PD in postmenopausal and senile women. METHODS: We measured BMD of lumbar spine (L1-L4) by Dual energy X-ray absorptiometry (DEXA; Hologic QDR-4500A). We compared BMD between patient group (30 patients with PD) and control (183 postmenopausal and senile health women). The patients were divided into two groups according to osteoporosis and analyzed the following potential factors influencing BMD in PD; age, duration of symptom, age of onset, Hoehn and Yahr stage (H-Y stage), UPDRS motor score, duration of treatment, body mass index (BMI), dominant symptom such as tremor or rigidity. RESULTS: 1. BMD was significantly decreased with aging (p <0.01) in control group, but BMD tend to decreased with aging in PD (p=0.08). 2. BMD of patient group was significantly lower than that of control group (p<0.001). 3. BMD of osteoporosis group was significantly related to BMI (p<0.05) and conversely related to H-Y staging(p <0.05), UPDRS motor score (p <0.01). 4. However, BMD of osteoporosis group were not related to age, duration of symptom, age of onset, dominant symptom and duration of treatment (p>0.05). CONCLUSION: Osteoporosis is related to H-Y stage, UPDRS motor score and BMI as well as aging in PD.
Absorptiometry, Photon ; Age of Onset ; Aging ; Body Mass Index ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Humans ; Osteoporosis ; Parkinson Disease* ; Spine ; Tremor

No abstract available.
Molecular Biology*