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

OBJECTIVE: The aim of the this study was to compare the effects of clonidine (a alpha2-adrenoceptor and imidazoline receptor agonist), yohimbine (a selective alpha2-adrenoceptor antagonist) and idazoxan (a alpha2-adrenoceptor and imidazoline receptor antagonist) on extracellular monoamines and their metabolites by using the awakening animal microdialysis and high-performance liquid chromatography with electrochemical detection (HPLC-ECD) in brain regions, which are suggested to have regulatory role in depression. METHODS: We used intracerebral microdialysis in awakening rats by inserting probe through the dorsal hippocampus and occipital cortex especially in primary visual cortex, We studied respective effects of 2.0 mg/kg of clonidine, 5.0 mg/kg of yohimbine, and 5.0 mg/kg of idazoxan on the release of MHPG (a major metabolite of norepinephrine), norepinephrine (NE), DOPAC (a major metabolite of dopamine), and 5-HIAA (a main metabolite of serotonin) by intraperitoneal administration. RESULTS: Clonidine decreased the release of MHPG, NE, DOPAC, and 5-HIAA in both dorsal hippocampus and occipital cortex regions, and there were no significant differences in releasing pattern of all monoamines and their metabolites. Both yohimbine and idazoxan enhanced the release of MHPG, NE, DOPAC, and 5-HIAA in both brain regions, but there were significant differences in releasing pattern of NE and 5-HIAA. Idazoxan induced the delayed and higher efflux of NE and 5-HIAA in the primary visual cortex than yohimbine, but not in the hippocampus. CONCLUSION: This study shows that the selective alpha2-adrenoceptor antagonists increase basal monoamine output and enhance the metabolism of them in the hippocampus and primary visual cortex, and the imidazoline receptor has modulatory role in the regulation of monoamine release in primary visual cortex than hippocampus. It also suggests that high turnover rate of serotonin and norepinephrine in primary visual cortex may contribute to the pathophysiological role in depression.
3,4-Dihydroxyphenylacetic Acid ; Animals ; Brain ; Chromatography, Liquid ; Clonidine ; Depression ; Hippocampus* ; Hydroxyindoleacetic Acid ; Idazoxan ; Metabolism ; Methoxyhydroxyphenylglycol ; Microdialysis ; Norepinephrine ; Rats* ; Serotonin ; Visual Cortex* ; Yohimbine

The antiphospholipid antibody syndrome is cha- racterized by antibodies directed against either phos-pholipids or plasma proteins bound to anionic phos- pholipids. These antibodies have been characterized by lupus anticoagulants and anticardiolipin antibodies. Patients with the antiphospholipid antibody syndrome may display a constellation of clinical features including venous and arterial thrombosis, recurrent fetal losses, and thrombocytopenia. Although the majority of patients reported have a thrombotic microangiopathy, some have also seen membranous nephopathy as well as IgA nephropathy in a patient with anti-phospholipid antibody syndrome accompanying glo-merulonephritis. Authors experienced a 37-year-old male patient who presented with generalized edema at the moment of follow-up for primary antiphos-pholipid syndrome accampanying systemic thrombotic events. Anticardiolipin antibody-IgM positivity was detected by seroligic test but no evidence for systemic lupus erythematosus was found. Kidney biopsy showed mesangial IgA deposition without th throm-botic microangiopathy of gomerular capillaries and was diagnosed finally as primary antiphospholipid syndrome with IgA nephropathy. Patient's symptom was relieved with steroids and anti platelete agents and now he is being follow-up to out patient department. This case suggests some possibility that anticardiolipin antibody may induce the IgA nephropathy. Therefore clinician should have concern about the relationship between antiphospholipid antibody and immune mediate glomerulonephritis.
Adult ; Antibodies ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid* ; Anticoagulants ; Antiphospholipid Syndrome* ; Biopsy ; Blood Platelets ; Blood Proteins ; Capillaries ; Edema ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Kidney ; Lupus Erythematosus, Systemic ; Male ; Steroids ; Thrombocytopenia ; Thrombosis ; Thrombotic Microangiopathies

Norwegian or crusted scabies is a rare, highly contagious atypical form of scabies caused by the mite Sarcoptes scabiei var. homonis. It is usually associated with advanced age, immunosuppression, physical debility, and developmental disabilities. We report here a case of Norwegian scabies in an institutionalized patient with chronic kidney disease (CKD) and Down syndrome. A 56-year-old male presented at our department with pruritic rash and general weakness of 2 months' duration. Examination showed hyperkeratotic, scaly, crusted erythematous plaques on the hands, trunk, and back of the patient. The microscopic examination of the skin scales with potassium hydroxide demonstrated numerous scabies mites. The patient was treated with hemodialysis and repeated applications of 1% lindane lotion for 2 weeks. He reported significant relief of pruritus and resolution of the skin lesions after the treatment. In addition to uremic pruritus, infectious skin diseases such as Norwegian scabies should be considered in the institutionalized patients with advanced CKD and resistant pruritus.
Developmental Disabilities ; Down Syndrome ; Exanthema ; Hand ; Humans ; Hydroxides ; Immunosuppression ; Kidney Failure, Chronic ; Lindane ; Male ; Middle Aged ; Mites ; Potassium ; Potassium Compounds ; Pruritus ; Renal Dialysis ; Renal Insufficiency, Chronic ; Sarcoptes scabiei ; Scabies ; Skin ; Skin Diseases, Infectious ; Weights and Measures

Terephthaloyl chloride, a chemical of low molecular weight, is used as an intermediate by a fabric manufacturing industry. It is known to cause gastrointestinal, respiratory and skin irritation. However, it has not been reported as a cause of occupational asthma till now. We report a case of occupational asthma caused by prolonged exposure to terephthaloyl chloride in the workplace. A 38 year-old man visited at the Allergy Clinic because of cough, dyspnea and wheezing for 5 years. He had worked at a factory for 15 years where he was involved in the process of manufacturing fabrics. At presentation, he had no symptoms and showed no abnormality on physical examination. When challenged with vapor of terephthaloyl chloride, he experienced sneezing and paroxysmal cough in a couple of minutes, followed by dyspnea and wheezing at 10 min. He also experienced urticarial rashes on the face and chest. The pulmonary function tests showed an atypical prolonged immediate airway response. PC20 methacholine decreased from 5 mg/ml to 0.79 mg/ml 24 hours after the challenge. Light microscopic examination of bronchial biopsies showed loss of epithelium, thickening of basement membrane, submucosal fibrosis, and increased inflammatory cell infiltration. The immediate drop in FEV1 and urticarial rash to terephthaloyl chloride suggests the possibility of an immediate hypersensitivity immune reaction. Further studies are needed to clarify the exact mechanism of terephthaloyl chloride induced asthma.
Adult ; Asthma ; Asthma, Occupational* ; Basement Membrane ; Biopsy ; Cough ; Dyspnea ; Epithelium ; Exanthema ; Fibrosis ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Methacholine Chloride ; Molecular Weight ; Physical Examination ; Respiratory Function Tests ; Respiratory Sounds ; Skin ; Sneezing ; Thorax

No abstract available.
Biopsy, Needle* ; Needles*

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