A 14-year old girl presented with urinary incontinence along with normally secured voluntary voiding. Careful physical examination revealed leakage of urine through a small opening near the vestibule, ventral to the urethral meatus. Cystoscopically, the right ureteral orifice was absent but otherwise normal. Nonfunctioning right kidney was found on excretory urography. A #4 ureteral catheter was inserted into the ectopic opening as high as 10cm, and the retrograde pyelogram showed dilated right ureter ending blindly at the level of lumber vertebra II with stricture at the level of the tip of the catheter. After the right nephroureterectomy, she became dry and was discharged on the 12th postoperative day. The removed kidney weighed only 8 Gm. and pathological diagnosis was congenital hypoplasia of the right kidney with ectopic ureteral opening.
Adolescent ; Catheters ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Kidney* ; Physical Examination ; Spine ; Ureter* ; Urinary Catheters ; Urinary Incontinence ; Urography

Infantile hypertrophic pyloric stenosis(IHPS) is one of the most common causes of nonbilious vomiting in early infancy, and is caused by hypertrophied pyloric muscle but its exact etiology and pathogenesis are still unknown. Fredet-Ramstedt pyloromyotomy has been accepted as the treatment of choice for IHPS. Atropine is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated a case of IHPS in a 33-day-old male infant by administering atropine sulfate intravenously. One day after atropine sulfate administration, he did not vomit any more. Ultrasonograms of the pyloric canal which were done on eight days and three weeks after atropine treatment revealed no limitation in the passage of gastric content, and no changes in the muscle thickness and length of the pyloric canal. Thereafter, he did not show up at follow ups, we received his mother's answer through phone that he did not suffer from vomiting and he was growing well at 5 months of age.
Atropine* ; Follow-Up Studies ; Humans ; Infant ; Male ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic* ; Ultrasonography ; Vomiting

Unsuspected pheochromocytoma in a surgical patients may lead to serial complications. These include extreme hypertension, taehycardia and cardiac arrythmias which lead to cardiac arrest, cerebrovascular accident and renal failure in the postoperative period. Pheochromocytoma arising in the urinary bladder is a rare tumor. We recently experienced a case of pheochromocytoma which was found during transurethral resection for biopsy of bladder tumor under spinal anesthesia. The blood pressure suddenly rose during resection. of the tumor. It was difficult to arrive at a correct diagnosis in this case because of the predominant bladder symptams without hypertenaive attack. Therefore, final diagnosis was made as the pheochromocytoms after histological examination. The resection of the tumor was performed under general anesthesia after careful studies. The patient was not treated during the preoperative period as she had no particular symptoms, but Regitine was glven during surgery. Regitine was used twice to control the transient hypertension during manipulation of the tumor. After removal of the tumor, the blood pressure was well regulated without vasopressor drugs. We report a case of pheochromocytoma of urinary bladder with successful anesthesia management and the use of neuroleptanesthetics.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Arrhythmias, Cardiac ; Biopsy ; Blood Pressure ; Diagnosis ; Heart Arrest ; Humans ; Hypertension ; Phentolamine ; Pheochromocytoma* ; Postoperative Period ; Preoperative Period ; Renal Insufficiency ; Stroke ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Patients with chronic renal failure, generally, sufferred from normocytic normochromic anemia caused by decreased level of erythropoietin. But, secondary erythrocytosis has been reported in patients with several renal diseases; renal artery stenosis or throm- bosis, polycystic kidney disease, bilateral hydronephrosis, etc. We report one case of chronic renal failure combined with polycythemia vera. The case was 32 year-old man whose chief complaints were dyspnea, back pain, itching sensation, headache. 6 month ago, the laboratory examination showed only proteinuria and hematuria without deterioration of renal function. The renal function was aggravated with an accelerated course, and bone marrow examination revealed hypercellularity (erythroid predominance), and renal biopsy showed the finding of the end stage of renal disease which may be originated from IgA nephropathy.
Adult ; Anemia ; Back Pain ; Biopsy ; Bone Marrow Examination ; Dyspnea ; Erythropoietin ; Glomerulonephritis, IGA* ; Headache ; Hematuria ; Humans ; Hydronephrosis ; Immunoglobulin A* ; Kidney Failure, Chronic* ; Polycystic Kidney Diseases ; Polycythemia Vera* ; Polycythemia* ; Proteinuria ; Pruritus ; Renal Artery Obstruction ; Sensation

No abstract available.
Artemisia*

OBJECTIVE: Atrophy and a high T2 signal of the hippocampus are known to be the principal MR imaging findings of hippocampal sclerosis. The purpose of this study was to determine whether or not individual MRI findings correlate with surgical outcome in patients with this condition. MATERIALS AND METHODS: Preoperative MR imaging findings in 57 consecutive patients with pathologically-proven hippocampal sclerosis who underwent anterior temporal lobectomy and were followed-up for 24 months or more were retrospectively reviewed, and the results were compared with the postsurgical out-come (Engel classification). The MR images included routine sagittal T1-weighted and axial T2-weighted spin-echo images, and oblique coronal T1-weighted 3D gradient-echo and T2-weighted 2D fast spin-echo images obtained on either a 1.5 T or 1.0 T unit. The images were visually evaluated by two neuroradiologists blinded to the outcome; their focus was the presence or absence of atrophy and a high T2 hippocampal signal. RESULTS: Hippocampal atrophy was seen in 96% of cases (55/57) [100% (53/53) of the good outcome group (Engel class I and II), and 50% (2/4) of the poor outcome group (class III and IV)]. A high T2 hippocampal signal was seen in 61% of cases (35/57) [62% (33/53) of the good outcome group and 50% (2/4) of the poor outcome group]. All 35 patients with a high T2 signal had hippocampal atrophy. `Normal' hippocampus, as revealed by MR imaging, occurred in 4% of patients (2/57), both of whom showed a poor outcome (Engel class III). The presence or absence of hippocampal atrophy correlated well with surgical outcome (p<0.01). High T2 signal intensity did not, however, significantly correlate with surgical outcome (p>0.05). CONCLUSION: Compared with a high T2 hippocampal signal, hippocampal atrophy is more common and correlates better with surgical outcome. For the prediction of this, it thus appears to be the more useful indicator.
Adult ; Atrophy ; Female ; Hippocampus/*pathology/*surgery ; Human ; *Magnetic Resonance Imaging ; Male ; Middle Age ; Predictive Value of Tests ; Retrospective Studies ; Sclerosis ; Support, Non-U.S. Gov't ; Treatment Outcome

BACKGROUND: The pathophysiological events resulting in keloid formation remain unclear. Overabundant levels of VEGF have been reported to contribute to excessive wound healing. There have been many studies describing the relationship between keloids and VEGF expression. However, there have been no reports about VEGF expression related to donor sites. OBJECTIVE: We investigated VEGF expression of cultured normal and keloid fibroblasts obtained from different body areas under normoxic and hypoxic culture conditions. METHODS: Normal fibroblasts from the earlobe (n=2), shoulder (n=2) and chest (n=2) as well as keloid fibroblasts from the earlobe (n=3), shoulder (n=3) and chest (n=3) were collected and cultured. VEGF expression of fibroblasts at 6 hours, 12 hours, 24 hours and 48 hours for cells maintained under normoxic and hypoxic conditions was measured by the use of RT-PCR. Paraffin-embedded tissues (normal and keloid tissue) were assayed by immunohistochemical staining. RESULTS: For the cultured normal fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition, irrespective of the donor site and time. However, for the cultured keloid fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition for cultured shoulder fibroblasts. For each donor site, VEGF expression was highest in the shoulder, followed by the chest and earlobe for cultured normal fibroblasts, irrespective of time. For the cultured keloid fibroblasts, the highest VEGF expression occurred at 6 hours for cells in the normoxic condition and the highest VEGF expression occurred at 6 hours and 12 hours for cells in the hypoxic condition. Based on immunohistochemical staining, VEGF expression of paraffin-embedded normal tissue was lower as compared to paraffin-embedded keloid tissue. For each donor site in paraffin-embedded keloid tissue, VEGF expression was highest in the shoulder, followed by the chest and earlobe. CONCLUSION: Oxygen tension and the nature of fibroblasts from different donor sites are involved in keloid pathogenesis.
Anoxia ; Fibroblasts ; Humans ; Keloid ; Oxygen ; Shoulder ; Thorax ; Tissue Donors ; Vascular Endothelial Growth Factor A ; Wound Healing

The ultrastructural changes of mitochondria in the ovarian oocytes from Graafian follicles, the ovulated tubal ova, and the various stages of preimplantation rabbit embryos have been observed with an electron microscope. From the ovarian oocytes to the 4-cell stage, mitochondria showed oval and round forms with a few cristae arranged concentrically and peripherally at the inner membrane. In 8-cell and 16-cell stages, mitochondria tended to change their forms to be elongated, and their sizes, and the outer membrane of the mitochondria had a tendency to become rough and irregular although there were few changes in the inner structure. In morula, some mitochondria began to show several transverse cristae proceeding into the matrix. Mitochondria rapidly increased in number at the late blastocyst stage. Matrix of mitochondria with transverse cristae found in the morula and in blastocyst stages was less dense than that of the earlier stages. The authors believe that the morphological changes of mitochondria during early embryonal development indicate the level of enzymatic activity at which this organelle is engaged in energy metabolism.
Animal ; Cell Membrane/ultrastructure ; Embryo/ultrastructure* ; Embryo Implantation ; Female ; Microscopy, Electron ; Mitochondria/ultrastructure* ; Organoids/ultrastructure ; Ovum/ultrastructure ; Rabbits

PURPOSE: To report a case of acquired Brown syndrome found in the left eye of a female patient who had undergone surgery for proliferative vitreoretinopathy. METHODS: A 41-year-old female patient presented with right hypertropia and esotropia. We reviewed her history, conducted an ophthalmic examination and performed surgery. RESULTS: Prior to presentation, the patient experienced a sudden decrease in visual acuity. She was diagnosed with proliferative vitreoretinopathy caused by rhegmatogenous retinal detachment, and underwent scleral buckling. After surgery, with the eye in the primary position, the right hypertropia was 9 prism diopters and the esotropia was 30 prism diopters. The patient was unable to elevate the eye in the adducted position. A forced duction test was performed and we detected a restricted elevation in adduction. By performing a tenectomy of the superior oblique muscle and a recession of the medial rectus muscle, orthophoria was obtained in the primary position, and the elevation in adduction improved. CONCLUSIONS: Herein, we report satisfactory results of a procedure in one case of acquired Brown syndrome following retinal detachment surgery.
Adult ; Esotropia ; Female ; Humans ; Retinal Detachment* ; Retinaldehyde* ; Scleral Buckling ; Strabismus ; Visual Acuity ; Vitreoretinopathy, Proliferative

We report a case of methicillin-resistant Staphylococcus aureus (MRSA) endocarditis involving tricuspid valve in small ventricular septal defect with multiple pulmonary embolism. A 36-years-old woman presented with 7 days course of fever and mental abnormality. She had small-sized ventricular septal defect (VSD) and no risk factors for the infection such as history of intravenous drug abuse and hospitalization. Methicillin- resistant Staphylococcus aureus was isolated from all three sets of blood culture drawn on admission and from the huge pulmonary embolus retrieved during operation. Resection of pulmonary emboli and patch repair of ventricular septal defect were done. Teicoplanin was administered for a total of 28 days due to febrile rash associated with vancomycin treatment after operation. She was discharged without complication.
Embolism ; Endocarditis* ; Exanthema ; Female ; Fever ; Heart Septal Defects, Ventricular* ; Hospitalization ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Pulmonary Embolism* ; Risk Factors ; Staphylococcus aureus ; Substance Abuse, Intravenous ; Teicoplanin ; Tricuspid Valve* ; Vancomycin