This study was conducted to investigate the effect of ascorbic acid on oxidative injury of cultured porcine retinal pigment epithelial (RPE) cells induced by t-butylhydroperoxide. The porcine RPE cells were cultured in Dulbecco's modified Eagle's medium and the culture medium was replaced with one containing 0.01 mM to 5 mM ascorbic acid and/or 0.2 mM t-butylhydroperoxide. After 2 hours incubation, the test medium was replaced with the control medium. The number of cells was counted with a Coulter counter after a 2-day incubation period. The medium was pretreated with 900 U/ml and the previous procedure was repeated to eliminate the toxic effects of hydrogen peroxide induced by ascorbic acid. Not only t-butylhydroperoxide (p < 0.01) but also ascorbic acid (p < 0.01) were found to have dose-dependent cytotoxicity on RPE cells. The cytotoxicity was more significant when both agents were added to the culture media. In the presence of catalase, the cytotoxicity of ascorbic acid became insignificant (p > 0.05). The cytotoxicity of t-butylhydroperoxide decreased when 1 mM and 5 mM of ascorbic acid was added to the culture media with catalase pretreatment (p = 0.0277). These results indicate that ascorbic acid was toxic to RPE cells in our culture model but this cytotoxicity was not detected in the presence of catalase. With catalase pretreatment, ascorbic acid in relatively high concentration provided protection against oxidative injury of t-butylhydroperoxide.
Animals ; Ascorbic Acid/*pharmacology ; Cell Count ; Cell Survival/drug effects ; Cells, Cultured ; Culture Media ; Dose-Response Relationship, Drug ; Free Radicals ; Oxidative Stress/*drug effects ; Peroxides/antagonists & inhibitors/toxicity ; Pigment Epithelium of Eye/cytology/*drug effects ; Reactive Oxygen Species/toxicity ; Swine ; tert-Butylhydroperoxide

A clinical observation was done 42 cases of bladder tumor admitted to the Department of Urology, Hanil Hospital during the period of 10 years from Jan 1. 1968 to December 31. 1977 and the following results were obtained. 1. The incidence of tumor of the bladder is 4.6 % to total number of in-patients. 2. The highest incidence of age distribution was between 40 and 69 year with 85.7 % 3. The sex ratio of male and female was 3.2: 1. 4. The most common symptom was hematuria which occurred in those case in 85.7 %. 5. 80.9 % of patients visited to our clinic within one year after initial symptom occurred 6. The I. V. P. findings showed 63.3 % of normal, 11.9 % of hydronephrosis and 4.8 % of unilateral nonvisualization 7. The tumors were located in lateral and posterior wall of the bladder ( 64.3 %) chiefly, and ""solitary"" cases were more than "" multiple "" cases. 8 The most common complication was cystitis in 33.3 %. 9. Among 42 cases, Pathologic diagnosis was as follows : Transitional cell carcinoma 38 cases, benign popilloma 1 case and undifferentiated 2. 10. The method of treatment, partial cystectomy was performed 14 cases, T. U. R. 12 chemotherapy 5, exploration 2 and no treatment 9.
Age Distribution ; Carcinoma, Transitional Cell ; Cystectomy ; Cystitis ; Diagnosis ; Drug Therapy ; Female ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Male ; Sex Ratio ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

A clinical observation was made on 78 cases of renal tuberculosis, admitted to the Department of Urology, Hanil Hospital during the period of 10 years from Jan 1, 1968 to December 31 1977. The results were summarized as follows. 1. During this period, the total number of in-patients were 907 among which 78 cases had renal tuberculosis, giving a rate of 8.6 % to total in-patients. 2. The most common age groups showed that 83.3 % of the cases in 11 to 40 years of age, and male to female ratio was 1.2: 1. 3. The site of the lesion showed right to left ratio of 48.7 % to 42.3 % and bilateral in 9.0 %. 4. Common symptoms were gross hematuria in 48.7 %, frequent urination in 46.2 %, painful urination in 35.9 %, flank pain in 34.6 % and scrotal swelling in 9.0 %. 5. 56.4 % of the cases admitted to in one month to one year period after onset of the symptoms. 6. The most common complication was pul tbc in 36 %. 7. Laboratory findings were as follows : acid urine in 83.3 %, proteinuria in 91.0 %, microscopic hematuria in 73.1 %, pyuria in 74.4 % and increased ESR in 67.9 %. 8. Urine AFB Positive findings were 25.7% in smear and 35% in culture. 9. Of blood nitrogen level of 30 patients, over 60% of cases showed normal level, and the highest level was shown by a bilateral renal tuberculosis case. 10. The excretory urographic changes in 50 cases of renal tuberculosis were nonvisualization in 44%, delayed visualization in 32%, caliectasis in 26%, narrowing or dilatation of ureter in 18% and contracted bladder in 4%. 11. Cystoscopic findings were active lesion of cystitis in 48.7% and fibrosis with trabeculation of bladder wall in 20.5%. 12. Method of treatment include chemotherapy only in 55.1%, nephrectomy in 38.5%, nephrostomy in 1.3%, cutaneous uretrostomy in 1.3% and untreated in 3.8%.
Cystitis ; Dilatation ; Drug Therapy ; Female ; Fibrosis ; Flank Pain ; Hematuria ; Humans ; Male ; Nephrectomy ; Nitrogen ; Proteinuria ; Pyuria ; Tuberculosis, Renal* ; Ureter ; Urinary Bladder ; Urination ; Urology

Burns ; Humans ; Lactic Acid ; Plasma ; Prognosis ; Retrospective Studies

PURPOSE: Chronic nonbacterial prostatitis represents a major portion of all the chronic prostatitis syndromes. Yet its pathogenesis is not definitive. Therefore, the treatment of chronic nonbacterial prostatitis in men is unclear. In this study, the patients with chronic nonbacterial prostatitis, especially those with complaints of voiding difficulty, were analyzed with conducting a urodynamic study to search for the pathophysiology and the effective treatments. MATERIALS AND METHODS: Sixty men (mean age: 38.9+/-8.3 years) diagnosed with chronic nonbacterial prostatitis were included in this study after excluding the patients with prostatic infection via the standard bacteriological methods. Thereafter, the patients were evaluated urodynamically, including measurements by uroflowmetry, cystometry and a pressure flow study. RESULTS: According to their symptoms, 37 (61.7%) patients complained of frequency, 28 (46.7%) patients complained of a weak stream, 10 (16.7%) patients complained about urgency, and 5 (8.3%) patients complained about pelvic pain. Of the 60 patients, detrusor underactivity (DU), detrusor overactivity (DO), and bladder outlet obstruction (BOO) were found in 19 (31.7%), 12 (20.0%), and 11 (18.3%) patients respectively; there were equivocal findings in 30.3% of patients. CONCLUSIONS: This study demonstrated that 42 (70%) patients suffering with chronic nonbacterial prostatitis had different urodynamically abnormal patterns such as DU, DO and BOO. A urodynamic study may to be useful in establishing a correct diagnosis and for launching the appropriate therapy for the selected group of patients who were not helped by general treatments.
Diagnosis ; Humans ; Male ; Multiple Endocrine Neoplasia Type 1 ; Pelvic Pain ; Prostatitis* ; Rivers ; Urinary Bladder Neck Obstruction ; Urodynamics*

One of the goals of anesthesia is complete, comfortable and rapid recovery without sequelae from anesthesia. We compared the recovery pattern between anesthesia with propofol and thiopental/isoflurane. The fifty patients undergoing emergency appendectomy were allocated randomly to receive one of the anesthesia with propofol or thiopental/isoflurane. All of the patients were also given fentanyl, atracurium in equivocal dosage per weight and 50% N2O. Group 1(patient No; 25) was received anesthesia with fentanyl, atracurium, N2O and continuous injection of 6~12 mg/kg/hour of propofol. Group 2(patient No; 25) was received anesthesia with thiopental, fentanyl, atracurium, N2O and 1~2 MAC(minimal alveolar concentration) of isoflurane. We studied the duration of return of self respiration from discontinuation of anesthetics and recovery pattern in time sequence. The results were as following; The group 1 compared with group 2 at early recovery phase. 1) The duration of return of self respiration from discontinuation of anesthetics retured more rapid. 2) Emergence time was more rapid. 3) Postoperative sequelae(nausea, vomiting, sedation, drowsiness, memory dysfunction, pain) rate was less severe. But at recovery phase after 24 hours, there were no significant difference in postoperative sequelae and recovery condition in both groups. Therefore, we concluded that propofol is better than thiopental/isoflurane for anesthesia of emergency appendectomy in view of early recovery pattern.
Anesthesia* ; Anesthetics ; Appendectomy ; Atracurium ; Emergencies ; Fentanyl ; Humans ; Isoflurane ; Memory ; Propofol* ; Respiration ; Sleep Stages ; Thiopental ; Vomiting

PURPOSE: The purpose of this study was to analyse the characteristics of acalculous cholecystitis (AC) compared with those of calculous cholecystitis (CC), and also to find the relationship of preoperative radiologic findings to the classification of pathological degree of inflammation of the gallbladder in AC. METHODS: Between March 1996 and June 2000 a total of 163 patients undergoing cholecystectomy for cholecystitis were divided into group AC (21 patients) and group CC (142 patients) and retrospectively studied by analyzing clinical data. RESULTS: The incidence of AC among cholecystitis cases was 12.9%. there was male preponderance in group AC whereas female preponderance in group CC (P<0.036). The pulse rate (P<0.02) and white blood cell count (P<0.003) were significantly elevated in group AC. Possible etiological factors were found in 6 cases (28%) in group AC. The rates of preoperatively observed pericholecystic fluid collection in US (P<0.033) and dilatation of the gallbladder in CT (0.012) were significantly higher in group AC than in group CC. Additionally, the rate of tube drainage during surgery was significantly higher in group AC than group CC (P<0.02). Finally, wall thickness (P<0.05), dilatation (P<0.05) of the gallbladder in CT and the total sum of findings in CT (P<0.01) and US (P<0.05) were strongly related to the degree of inflammation of the gallbladder. CONCLUSION: The majority of AC patients exhibit nonspecific clinical findings, often delaying diagnosis; however, if it develops, AC tends to display more acute and inflammatory characteristics than calculous cholecystitis. laparoscopic surgery cannot be sucessful in cases of delayed diagnosis. US, CT and scintigram are useful diagnostic tools if we interpretate each finding in relation to the severity of inflammation.
Acalculous Cholecystitis* ; Cholecystectomy ; Cholecystitis* ; Classification ; Delayed Diagnosis ; Diagnosis ; Dilatation ; Drainage ; Female ; Gallbladder ; Heart Rate ; Humans ; Incidence ; Inflammation ; Laparoscopy ; Leukocyte Count ; Male ; Retrospective Studies

Injury of diaphragm mainly occur in penetrating, crush and blunt injuries to the lower chest or upper abdomen, and it is most often secondary to automobile accidents. Diaphragmatic rupture is most frequent in blunt chest trauma and the rate is below 1% of them. Traumatic rupture of the diaphragm is responsible for the herniation of abdominal viscera. Physical finding and radiographic sign of diaphragmatic hernia is nonspecific and misreading. Therefore, the diagnosis of traumatic rupture of diaphragm may be difficult during the early period after the injury, especially when clinical features are dominated by associated injuries. Emergency surgical management is necessary when it is complicated with serious complication. We experienced the case of traumatic diaphragmatic hernia detected after the operation of femur fracture. The patient was injured by motor vehicle accident 6 days before the operation of the femur fracture. There was no specific symptom and sign and the manifestation of the diaphragmatic hernia. in radiographic studies until operation of the femur fracture was done. Diaphragmatic hernia was confirmed by chest X-ray and arterial blood gas analysis after operation of the femur fracture. The repair of the diaphragmatic hernia was directly performed after the diagnosis. The prognosis was favorable, and she was discharged to ward from intensive care unit after 1 day of operation. We must consider the possibility of traumatic diaphragmatic hernia in the patient who have the history of blunt chest or abdominal trauma.
Abdomen ; Analgesia, Patient-Controlled* ; Automobiles ; Blood Gas Analysis ; Diagnosis ; Diaphragm ; Emergencies ; Femur* ; Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Humans ; Intensive Care Units ; Morphine* ; Motor Vehicles ; Prognosis ; Rupture ; Thorax ; Viscera ; Wounds, Nonpenetrating

Fluid resuscitation is a basic treatment in hemorrhagic shock. We compared the circulatory responses to fluid resuscitation of 10% pentastarch with those of fresh whole blood and plasmanate in hemorrhagic shock. Eighteen mongrel dogs were bled 24 ml/kg and replaced by equivalent amounts of fresh whole blood(n=6, group B), pentastarch(n=6, group P) and plasmanate(n=6, group PL). Hemodynamic measurements and calculations were performed before and after bleeding and after volume therapy. The decrease of hematocrit and platelet count after volume replacement indicate that hemodilutional effect was maximum 30 min after volume therapy and significantly greater in group P than PL(p<0.05). Central venous pressure(CVP), pulmonary capillary wedge pressure(PCWP) and cardiac index(CI) were increased to 146-189%, 146-172% and 146-175% in group P, respectively during 60 min. These changes were significantly greater than group B and PL(p<0.05). There was delayed recovery of mean arterial pressure in group PL(92% 30 min after volume therapy) compared with group B and P(92% and 93% 5 min). Also group P and PL showed significant prolongation in prothrombin time and partial thromboplastin time during experiment(120 min) and these were significantly more prolonged in group P than PL(P<0.05). And group P showed similar O transport and O extraction ratio to those of group B. The increases in plasma catecholamine were observed after hemorrhage, but no significant changes 5 and 30 min after volume therapy. This suggests that the neurohumoral response to hemodilution was not marked. Mixed venous O2 saturation(SvO2) was directly proportional to CI during experiment(r=0.69, p<0.01), indicating that SvO2 can represent CI during shock and volume therapy. In conclusion, l0% pentastarch is useful as a substitute for fresh whole blood or plasmanate.
Animals ; Arterial Pressure ; Blood Transfusion, Autologous* ; Capillaries ; Dogs* ; Hematocrit ; Hemodilution ; Hemodynamics ; Hemorrhage ; Hydroxyethyl Starch Derivatives ; Partial Thromboplastin Time ; Plasma ; Platelet Count ; Prothrombin Time ; Resuscitation* ; Shock ; Shock, Hemorrhagic*

PURPOSE: During the night time decision making on patients suspicious of appendicitis is often difficult because diagnosis and timing for operation are frequently delayed. Therefore, we analyzed above cases and solution is suggested. METHODS: This retrospective study included 360 patients who underwent laparotomies for suspected appendicitis at Hanil Hospital during one year, from March 1998 to Feb. 1999. They were divided into two groups according to presenting time to physician (Day time: 6 a.m. to 6 p.m., Night time: 6 p.m. to 6 a.m.). Sex & age distribution, time of presentation to physician, duration of symptoms, symptoms & physical findings, white blood cell counts, interval from presentation to operation, hospital stay, and pathologic diagnosis were compared. RESULTS: There were no significant differences in sex & age distribution, duration of symptoms, symptoms & physical findings, white blood cell counts, pathologic diagnosis between the two groups. However, during the night time, the interval from presentation to operation was longer than that of the day time (9.15 hours versus 4.83 hours, p<0.001), the rate of delayed appendectomy during the night was 58.0%, the rate of negative laparotomy increased when appendectomy was delayed for more than 12 hours compared with less than 12 hours (28.1% vs 11.7%, p<0.01), and in the cases with perforated appendicitis, delayed appendectomy for more than 12 hours had longer hospital stay compared with less than 12 hours (12 days vs 9.44 days, p<0.01). Factors causing delayed appendectomy were related to the physician (42.5%), lack of anesthetic & nursing supports (19.5%), failure to structure the operation team (20.7%), and patient itself (17.3%). When white blood cell counts were rechecked in the next morning, levels above 10,000 cells/mm3 were highly associated with appendicitis in contrast to that below 10,000 cells/mm3 (91.7% vs 43.5%, p<0.002).
Age Distribution ; Appendectomy ; Appendicitis* ; Decision Making ; Diagnosis ; Humans ; Laparotomy ; Length of Stay ; Leukocyte Count ; Nursing ; Retrospective Studies