A clinical evaluation was made on 191 patients with urethral rupture and stricture, who had been admitted to the department of Urology during l3 years from l972 to 1984. We have tried the various methods in management of urethral rupture and stricture, such as 1) simple traction by balloon catheter 2) end-to-end anastomosis 3) perineal traction on the prostate 4) immediate cystostomy, and delayed urethroplasty in urethral rupture; 5) urethral dilatation 6) internal urethrotonry 7) end-to-end anastomosis 8) pull-through urethroplasty 9) transpubic urethroplasty 1O) scrotal inlay urethroplasty 11) perineal skin flap urethroplasty in urethral stricture. Especially, we have compared the primary realignment of urethral rupture with delayed urethroplasty Primary realignment with perineal traction on the prostate was most excellent in management of complete posterior urethral rupture, which had a low morbidity, complication, and cost. Immediate cystostomy, and delayed end-to-end anastomosis was good in management of complete anterior urethral rupture. We thought that the difference of result after primary. realignment or delayed urethroplasty of urethral rupture did not depend upon the alternative of them but the degree of urethral injury, surgeon's skill and the adequate application of them according to the state of patients at the time of urethral injury.
Catheters ; Constriction, Pathologic* ; Cystostomy ; Dilatation ; Humans ; Inlays ; Prostate ; Rupture* ; Skin ; Traction ; Urethral Stricture ; Urology

PURPOSE: The purpose of this study was to help families decrease and alleviate the burden on family care-givers taking care of elderly patients. METHOD: Data was collected by a questionnaire from 100 family members who were registered in the department of home health care nursing at 4 hospitals of H University Medical Center from September 20 to October 25, 2005. The collected data was analyzed using Mean and Standard Deviation, Pearson Correlation Coefficient, t-test and One-Way ANOVA with the Duncan's test, and Stepwise multiple regression. RESULT: The average burden on family care-givers of elderly patients with chronic diseases was 3.31. The social burden was the highest(M=3.68), the lowest was the emotional burden (M=2.95). In ADL of elderly patients with chronic diseases, all 10 questions showed an average point above 2.50. The dependency level of going up and down the stairs was the highest (M=2.88). CONCLUSION: This research is necessary for the application of a plan in the social support system in order to reduce the burden on family care-givers who are taking care of elderly patients with a chronic disease.
*Activities of Daily Living ; Adult ; Aged ; Body Burden ; Caregivers/*psychology ; Chronic Disease/*nursing/psychology ; Cost of Illness ; Dependency (Psychology) ; *Family ; Female ; Humans ; Male ; Middle Aged ; Questionnaires ; Regression Analysis ; Social Behavior

No abstract available.
Acromioclavicular Joint

Epidural steroid therapy is a commonly applied "conservative" therapy in the management of acute and chronic back pain, but it is not inherently benign. As the indications for epidural steroid injections increase so do the reports of adverse responses associated with this procedure. Although generalized erythema, retinal hemorrhage, infection, and lipomatosis have been reported, acute generalized ecchymosis has not been reported as a complication of either caudal or spinal epidural steroid injection. We describe here an unique case of transient, profound generalized ecchymosis after receiving an caudal epidural steroid injection for lumbar radiculopathy.
Back Pain ; Ecchymosis* ; Erythema ; Lipomatosis ; Radiculopathy* ; Retinal Hemorrhage

Ceruminomas are rare tumors arising from the ceruminous gland, which is a modified apocrine gland in the skin of the external ear canal. There is controversy about these rare tumors regarding their histological classification, their origin and the importance of wide excision, and there is also terminological confusion for making the diagnosis. Ceruminous adenocarcinoma is a malignant subtype of ceruminoma. We report here on a case of adenocarcinoma of the ceruminous gland in a 71-year-old male patient.
Adenocarcinoma* ; Aged ; Apocrine Glands ; Classification ; Diagnosis ; Ear Canal* ; Ear Neoplasms ; Ear, External* ; Humans ; Male ; Skin

BACKGROUND/OBJECTIVES: The leaves of Moringa oleifera (MO) and Moringa stenopetala (MS) commonly grown in Ethiopia possess potential nutritional and medicinal value. The aim of this study was to evaluate the nutritional and functional characteristics of the dried leaf powder from two Moringa species to develop sustainable nutritional supplements for Ethiopians from locally grown plant sources. SUBJECTS/METHODS: Freshly harvested and air-dried MO and MS leaves were authenticated and the nutritional contents, such as protein, ash, lipids, and selected vitamins and minerals, were analyzed using standard analytical procedures. Amino acid compositions were also determined by an amino acid analyzer. Nine-week-old mice were randomly divided into four groups to investigate the anti-obesity effects of Moringa. The first group was fed a basal diet, the second group a high-fat diet, and the others were fed a high-fat diet containing 0.1% Moringa leaf powder from each species. After seven weeks, serum indices related to lipid profiles from each mouse were analyzed. RESULTS: The present study revealed high protein (28–29%) and ash (7–11%) contents. Glutamic acid, aspartic acid, proline, and leucine were the most abundantly found amino acids in both species. The predominant minerals in the leaf powder were calcium (826–1,530 mg/100 g), potassium (794–904 mg/100 g), and magnesium (286-431 mg/100 g). Pyridoxine (475.06 mg/100 g) and vitamin E (34.2 mg/100 g) were found only in MS. Niacin was found only in MO at 32.21 mg/100 g, whereas ascorbic acid was found in both species (3.89 and 6.19 mg/100 g dry weight for MO and MS, respectively). The results of the animal study showed that mice on a high-fat diet containing 0.1% MO leaf powder alleviated the elevation of cholesterol, triglycerides, and low-density lipoprotein cholesterol induced by the high fat diet. MO was more effective than MS in preventing hypercholesterolemia and fat deposition. CONCLUSIONS: The findings in this work confirmed that Moringa leaves of both MO and MS possessed high nutritional value but MO was better at preventing the harmful effects of the high-fat diet than MS.
Amino Acids ; Animals ; Ascorbic Acid ; Aspartic Acid ; Calcium ; Cholesterol ; Diet ; Diet, High-Fat ; Ethiopia ; Glutamic Acid ; Hypercholesterolemia ; Leucine ; Lipoproteins ; Magnesium ; Mass Screening ; Mice ; Minerals ; Miners ; Moringa oleifera ; Moringa ; Niacin ; Nutritive Value ; Plants ; Potassium ; Proline ; Pyridoxine ; Triglycerides ; Vitamin E ; Vitamins

PURPOSE: Heterotopic calcification is a pathological event in which deposits of calcium salts build up, usually in the joint area or soft tissues. It can occur under many conditions and in some rare cases may develop in burn scars. In particular, ulcerations in burn scars accompanied by heterotopic calcification are difficult to treat through conservative treatment. This study reports methods for accurate diagnosis and adequate treatment of ulceration in burn scars accompanied by heterotopic calcification. METHODS: Fourteen patients who visited our hospital from March 2008 to January 2010 were subjected to this study. Their sex, age, modes of burn, degree, TBSA(%), ulcerated area, the time of occurrence of the ulcerations in the burn scars were investigated. In addition, radiological examination and biopsy was performed to diagnose heterotopic calcification. RESULTS: Among the 14 cases, 6 were male and 8 were female. The average age of the patients was 48.2(27-69 yrs). As for the mode of burn, 11 were flame burns and 3 were scalding burns. The average time of occurrence of the ulcerations in the burn scars was 4.5 months. The ulcerated areas were situated in the legs in 12 cases, arms in 1 case, and torso in 1 case. The diagnosis was confirmed through X-ray and biopsy, and skin graft was performed after wide excision. CONCLUSION: Diagnosis of the ulceration in burn scars accompanied by heterotopic calcification is possible through radiological and pathologic studies. Surgical treatment is the most reliable method of treatment, and we chose to perform skin graft after wide excision. Also, we learned that the complete removal of the calcified tissue and the inflammatory fibrotic tissues is crucial in preventing recurrence. Also, in contrast to Marjolin's ulcer, heterotopic calcification had a small size, little or no granulation tissue, and lacked fungating type ulceration. Therefore, favorable prognosis could be achieved through adequate treatment.
Arm ; Biopsy ; Burns ; Calcium ; Cicatrix ; Female ; Granulation Tissue ; Humans ; Joints ; Leg ; Male ; Prognosis ; Recurrence ; Salts ; Skin ; Torso ; Transplants ; Ulcer

Objective To investigate the associations between expression of Tensin1 protein and clinicpathological characteristics and prognoses of gastric cancer (GC) patients.Methods The retrospective casecontrol study was conducted.The clinicopathological data of 163 GC patients who were admitted to the Affiliated Hospital of Jiangsu University between July 31,2011 and December 31,2013 were collected.The GC tissues and adjacent normal tissues were taken to paraffin imbedding,and then were detected by immunohistochemistry.Observation indicator:(1) expressions of Tensinl protein in GC tissues and adjacent normal tissues;(2) association between expression of Tensinl protein in GC tissues and clinicopathological characteristics;(3) followup and survival situations;(4) prognostic factors analysis.Follow-up using telephone interview was performed to detect survival up to January 1,2017.Measurement data with skewed distribution were described as M (range).Count data were analyzed using the chi-square test or pairing chi-square test.The survival curve and rate were respectively drawn and calculated using the Kaplan-Meier method,and Log-rank test was used for survival analysis.The univariate analysis and multivariate analysis were done using the COX roportional hazard model.Results (1) Expressions of Tensinl protein in GC tissues and adjacent normal tissues:immunohistochemistry showed that Tensinl protein in GC tissues and adjacent normal tissues mainly expressed in cytoplasm.Of 163 patients,154 (66 with high expression and 88 with low expression) and 9 had respectively positive and negative expressions of Tensinl protein in GC tissues;79 (37 with high expression and 42 with low expression) and 84 had respectively positive and negative expressions of Tensinl protein in adjacent normal tissues,with statistically significant differences in positive expression ratio and expression levels (x2=64.65,12.93,P＜0.05).(2) Association between expression of Tensinl protein in GC tissues and clinicopathological characteristics:high expression rate of Tensinl protein in GC tissues were respectively 31.34％ (21/67) in GC patients with tumor metastases and 46.88％ (45/96) in GC patients without tumor metastasis,with a statistically significant difference (x2 =3.95,P＜0.05).(3) Follow-up and survival situations:all the 163 patients were followed up for 3.3-64.7 months,with a median time of 28.7 months.The 3-year cumulative disease-free survival rate and cumulative overall survival rate in GC tissues were 63.12％,74.22％ in 66 patients with high expression of Tensinl protein and 47.30％,55.74％ in 97 patients with low and negative expressions of Tensin1 protein,showing statistically significant differences in above indicators (x2 =4.58,4.11,P＜0.05).Survival analysis of subgroups showed that 3-year cumulative disease-free survival rate in GC tissues of patients with maximum tumor dimension ≥ 5 cm,nerve and / or vascular invasions and stage Ⅲ of TNM staging were 45.98％,62.79％,52.75％ in patients with high expression of Tensin1 protein and 18.11％,31.10％,32.80％ in patients with low and negative expressions of Tensin1 protein,with a statistically significant difference (x2 =5.85,7.89,4.96,P＜0.05).The 3-year cumulative overall survival rate was respectively 66.00％,75.75％,67.93％ in patients with high expression of Tensin1 protein and 30.74％,40.15％,44.67％ in patients with low and negative expressions of Tensinl protein,with statistically significant differences (x2 =7.59,9.62,4.32,P ＜ 0.05).(4) Prognostic factors analysis:results of univariate analysis showed that maximum tumor dimension,histological grade,nerve and / or vascular invasions,postoperative TNM staging,postoperative adjuvant chemotherapy and expression of Tensin1 protein were related factors affecting prognoses of GC patients [hazard ratio (HR) =3.66,2.45,2.17,3.36,0.41,0.54,95％ confidence interval (CI):2.09-6.41,1.43-4.19,1.17-4.04,1.52-7.41,0.23-0.72,0.31-0.96,P＜0.05].Results of multivariate analysis showed that maximum tumor dimension ≥ 5 cm and grade Ⅲ of histological grade were independent risk factors affecting prognoses of GC patients (HR=3.21,2.17,95％CI:1.63-6.32,1.18-3.99,P＜0.05),and postoperative adjuvant chemotherapy and high expression of Tensin1 protein were independent protective factors affecting prognoses of GC patients (HR=0.50,0.44,95％CI:0.28-0.90,0.24-0.82,P＜0.05).Conclusion High expression of Tensin1 protein may inhibit GC metastasis,and it is also an independent protective factor affecting prognoses of GC patients.

BACKGROUND: Low temperature plasma (LTP) was recently shown to be potentially useful for biomedical applications such as bleeding cessation, cancer treatment, and wound healing, among others. Keratinocytes are a major cell type that migrates directionally into the wound bed, and their proliferation leads to complete wound closure during the cutaneous repair/regeneration process. However, the beneficial effects of LTP on human keratinocytes have not been well studied. Therefore, we investigated migration, growth factor production, and cytokine secretion in primary human keratinocytes after LTP treatment.METHODS: Primary cultured keratinocytes were obtained from human skin biopsies. Cell viability was measured with the EZ-Cytox cell viability assay, cell migration was evaluated by an in vitro wound healing assay, gene expression was analyzed by quantitative real-time polymerase chain reaction, and protein expression was measured by enzyme-linked immunosorbent assays and western blotting after LTP treatment.RESULTS: Cell migration, the secretion of several cytokines, and gene and protein levels of angiogenic growth factors increased in LTP-treated human keratinocytes without associated cell toxicity. LTP treatment also significantly induced the expression of hypoxia inducible factor-1α (HIF-1α), an upstream regulator of angiogenesis. Further, the inhibition of HIF-1α expression blocked the production of angiogenic growth factors induced by LTP in human keratinocytes.CONCLUSION: Our results suggest that LTP treatment is an effective approach to modulate wound healing-related molecules in epidermal keratinocytes and might promote angiogenesis, leading to improved wound healing.
Anoxia ; Biopsy ; Blotting, Western ; Cell Migration Assays ; Cell Movement ; Cell Survival ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Hemorrhage ; Humans ; In Vitro Techniques ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Plasma ; Real-Time Polymerase Chain Reaction ; Skin ; Wound Healing ; Wounds and Injuries

PURPOSE: Severe burn patients are easily exposed to infection due to immune compromise and loss of skin barrier. But in spite of advances in burn treatment, complication due to infection has significant influence in mortality and morbidity. Broad spectrum antibiotics are used empirically to reduce bacterial infection in severe burn patients but results in suppression of normal flora and mucosal damage in intestine which facilitates fungal growth. We investigated the incidence, frequent onset time, characteristics of patients with candidemia and found appropriate time for use of antifungal agents and treatment of infection. METHODS: We reviewed the medical records of patients who were admitted to Hangang sacred heart hospital burn ICU between January 2007 and December 2008. RESULTS: In 2007 395 patients were admitted to BICU and 66 patients (16.7%) had fungal infection. In 2008 331 patients were admitted to BICU and 77 patients (23.3%) had fungal infection. Fungus was isolated in blood culture in 22 patients (5.6%) and 7 patients (2.1%) in 2007 and 2008 respectively. 20 patients out of 28 patients with candidemia received ventilator care (p=0.037), mean stay in ICU was 52.2 days in patients with positive blood culture compared with 36.5 days in patients with negative blood culture (p=0.049). Mortality in candidemia patients was 42.9% (p=0.022) which was high. CONCLUSION: Candidemia frequently occurs in patients receiving ventilator care, and as stay in ICU lengthens financial burden increases and results in higher mortality and morbidity. Lowering morbidity through strict infection control and monitoring is needed.
Anti-Bacterial Agents ; Antifungal Agents ; Bacterial Infections ; Burns ; Candida ; Candidemia ; Fungi ; Heart ; Humans ; Incidence ; Infection Control ; Intestines ; Medical Records ; Skin ; Ventilators, Mechanical