No abstract available.
Pregnancy*

We performed augmentation enterocystoplasties in 15 spinal cord injury patients for treatment of high pressure neurogenic bladder and severely contracted bladder to avoid indwelling catheter. A cup-patch technique of ileocystoplasty was used in 7 patients and Mainz pouch in 7 patients and Hemi-kock pouch in 1. In postoperative complications, urinary leakage was developed but subsided spontaneously in 2 patients and right ureteral obstruction was developed & solved by reimplantation in 1 patient. After a mean followup of 24 months 14 patients were continent with clean intermittent catheterization, but 1 patient was sometimes incontinent. All upper urinary tract remained stable or improved and the symptoms of autonomic dysrefexia and symptomatic urinary tract infection were disappeared. If a patient is able to and strongly motivated to perform intermittent self-catheterization, augmentation enterocystoplasty with clean intermittent catheterization is a reasonable option for the management of spinal cord injuries with high pressure neurogenic bladders.
Catheters, Indwelling ; Follow-Up Studies ; Humans ; Intermittent Urethral Catheterization ; Postoperative Complications ; Replantation ; Spinal Cord Injuries* ; Spinal Cord* ; Ureteral Obstruction ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Tract ; Urinary Tract Infections

PURPOSE: The purpose of this paper was to evaluate the treatment results according to bone union, union time, and complications, including infection of unreamed nailing of tibial fractures between closed and open fractures. MATERIALS AND METHODS: We reviewed 64 tibial shaft fractures that were treated with unreamed tibial nail. These included 42 closed fractures and 22 open fractures. RESULTS: Average union time of closed fractures was 19.8 weeks and that of open fractures was 20.2 weeks, nonunion rate were 4/42 and 3/22 in closed and open fractures. Average union time were 19.2, 20.4, 21.3 weeks in open grade I, II, llla fractures. According to the type of fractures, average union time were 18.5, 20.2, 24.6 weeks and nonunion rate were 2/29, 3/26, 2/9 in type A, B, C fractures. According to the level of fractures, average union time were 20.0, 20.3, 19.4 weeks and nonunion rate were 1/5, 4/37, 2/22 in proximal, middle, and distal fractures. There was no significant differences in average period of radiologic union, infection rate and nonunion rate between closed and open fracture group, but longer union time and higher nonunion rate in complex and comminuted fractures (P<0.05). CONCLUSIONS: We consider unreamed intramedullary nailing in the tibial shaft fractures as a good treatment modality for closed and open grade I, II, IIIa fractures
Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Tibial Fractures*

The gigantic lipoma could be categorized into subcutaneous and subfascial type. We experienced eight cases from seven patients. Five cases of them were proved to be subcutaneous gigantic lipomas, and three cases were proved to be subfascial gigantic lipomas. Among the subcutaneous type, three cases of liposarcomas were confirmed by final biopsy results. And three cases of recurrences were shown. Among the subfascial type, one case of chondrolipoma was confirmed by final biopsy result and no recurrence was not found. In brief, subcutaneous and subfascial gigantic lipoma had a specific characteristics as followings: Subcutaneous type showed asymptomatic mass with bulging, multilobulated and poorly marginated. And it was difficult for complete removal with a high recurrence rate. Radical excision and liposuction recommended for its treatment. On the other hand, subfascial type showed diffuse expansion, late onset of symptom. And it was readiness for complete removal with no recurrence after complete excision.
Biopsy ; Hand ; Humans ; Lipectomy ; Lipoma* ; Liposarcoma ; Recurrence

The survival of flap has a vital importance in the reconstructive surgery. This study was designed to investigate the relation of the survival area and the variation of flow value measured by laser Doppler flowmetry and to elucidate the effect of PGE1 on flap survival with an objective index. Sixteen New Zealand White rabbits were divided into 3 groups (8 of control group, 4 of intravenous PGE1 group and 4 of topical PGE1 group). The lower abdominal island flap (10 x 5 cm) based on the superficial epigastric pedicle was elevated and reset again at the previous location. The flow values were checked and it was taken as the value of LD. LD ratio was obtained by calculating the ratio of LD value in each experimental period to that of the baseline data taken before flap elevation. Finally, the data of flap survival area on the 8th experimental day was collected by using the plannimetry method. The results: the survival areas of intravenous PGE1 group (72.0 +/- 22.3%) and topical PGE1 group (78.0 +/- 22.7%) showed a significant increase compared to that of control group (46.5 +/- 14.3%, p < 0.01). The flap survival has the close relationship of the LD ratio measured immediately after flap elevation. The neovascularization period for the survival is considered at least 6 days. In conclusion, these experimental results can show an evident relation between the survival area of the flap and the LD ratio value measured immediately after the flap elevation. The LD ratio value measured immediately after flap elevation has the great significance as a critical limit for expecting the fate of flap survival. Therefore this value will be used as one of the beneficial standards for expecting the prognosis of microsurgical reconstruction in clinical trials.
Alprostadil* ; Laser-Doppler Flowmetry* ; Prognosis ; Rabbits

Renal medullary fibromas which are arisen from the interstitial cell of the renal medulla show small, multiple nodules on autopsy Findings over age 50, but they are very rare clinically. thus several cases have been reported until 1982. When the tumors are large. their clinical presentation is characterized by loin pain, hematuria and palpable mass. The preoperative diagnosis with radiologic studies is very difficult and the confirmative diagnosis was made with pathologic finding. Nephrectomy has been the most common useful treatment and local excision can be used. We report a case of renal medullary interstitial cell fibroma in a 17-year-old girl presented with a child-head sized palpable mass on the left upper quadrant.
Adolescent ; Autopsy ; Diagnosis ; Ejaculation* ; Female ; Fibroma ; Hematuria ; Humans ; Male ; Nephrectomy ; Spinal Cord Injuries* ; Spinal Cord*

Theoretically one might suggest the abdominoplasty can cause respiratory decompensation resulting from musculofascial plication, which reduces the respiratory reserve by decreasing intra-abdominal volume and diaphragmatic excursion. This prospective study was perfomed to evaluate the effect of abdominoplasty and the change of intraoperative Paw on the pulmonary function of 20 consecutive otherwise healthy subjects. The pulmonary function test was performed preoperatively, and repeated 2 months after the operation. Additionally, we monitored intraoperative Paw. Comparison of the pulmonary function test showed a significant decrease(p<0.001) in the mean forced vital capacity(FVC) and the mean forced expiratory volume in one second(FEV1) throughout the study period. Postoperatively, the mean FVC decreased by 11.65% and the mean FEV1 decreased by 16.15%. The mean Paw increased by 6.6cmH2O(3-12cmH2O) by musculofascial plication. And we found that the decrease in FVC and FEV1 was significantly correlated with intraoperative changing of Paw in abdominoplasty(p<0.001). FVC and FEV1 could be decreased by abdominoplasty due to decreasing intra-abdominal volume and diaphragmatic excursion, but there was no respiratory symptom clinically in all patients 2 months after the operation. In conclusion, We found that the decrease in FVC and FEV1 after 2 months of abdominoplasty was significantly correlated with intraoperative Paw change during operation. The intraoperative Paw was increased to 12 cmH2O without any respiratory symptom in this study. We suggested that the increase in intraoperative Paw less than about 10cmH2O can not affect on respiratory function clinically.
Abdominoplasty* ; Forced Expiratory Volume ; Humans ; Prospective Studies ; Respiratory Function Tests

In this study, the effects of verapamil on growth rate, apoptosis, production of transforming growth factor (TGF-beta) and fibronectin were evaluated in keloid and normal human dermal fibroblasts. Both fibroblasts were primarily cultured from earlobe keloids of three female patients and treated with various concentrations of verapamil. Cell toxicity was assessed by MTT assay, growth rate and apoptosis by FACS, and the production of TGF-beta and fibronectin by ELISA and Western blot, respectively. In the MTT50, the cell growth was more suppressed in keloid fibroblasts. In the MTT90, cell growth was more stimulated in normal fibroblasts. No significant effect appeared on TGF-beta expression but an increase in extracellular fibronectin secretion was found in keloid fibroblasts. Keloid fibroblasts responded to verapamil more sensitively, and the percentage of apoptosis was higher at the MTT50l. In brief, verapamil had growth-inhibitory effect with inducing apoptosis at the MTT50, but rather growth-stimulatory effect at the MTT90. The biphasic effect of verapamil depending on the dose might explain one of the reasons of relapse after keloid treatment with verapamil. Clinical application with high concentration (2.5mg/ml) is advised unless excessive dosage is used.
Apoptosis* ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Female ; Fibroblasts* ; Fibronectins ; Humans ; Keloid* ; Recurrence ; Transforming Growth Factor beta ; Transforming Growth Factors ; Verapamil*

A 80-year-old man presented with recently aggravated dizziness. He has taken an anti-Parkinson drug before 2 years ago. Left spontaneous down beating nystagmus was observed, also ataxic gait. Brain MRI showed diffuse brain atrophy, otherwise no abnormal finding. Rotation chair test showed decreased gain, phase lead and no asymmetry. Saccadic test showed delayed latency and decreased accuracy. And Calroic test didn't show no canal paresis. Dizziness due to Parkinsonism has been known relatively common, especially in old age. However, it is often difficult to diagnosis a Parkinson disease when old age patient present with dizziness. Hence, we report a case of old aged Parkinsonism patient who presented with acute dizziness in perspective of diagnostic careful point with literature review.
Aged ; Aged, 80 and over ; Atrophy ; Brain ; Dizziness ; Eye Movements ; Gait ; Humans ; Paresis ; Parkinson Disease ; Parkinsonian Disorders ; Saccades

OBJECTIVE: The purpose of this study was to investigate the immediate and delayed effects of electrical stimulation of sensory nerve pathway on spasticity in patients with brain lesions. METHOD: Sixteen stroke and traumatic brain injured subjects participated in this study. Electrical stimulation on the der matome of spastic muscles was applied for 30 minutes a day for 4 weeks. Spasticity was quantified through the use of a relaxation index obtained from pendulum test and a amplitude and latency from knee tendon reflex test. The measurements were performed 6 times in treatment period. The data were analyzed by repeated measures one way ANOVA. RESULTS: Relaxation index was significantly increased in treatment period (p<0.05). In each therapeutic stimulation session, relaxation index of post-stimulation was increased in comparison with that of pre-stimulation (p<0.01). The amplitude of post-stimulation was significantly decreased in comparison with pre-stimulation status in each measurement session (p<0.01). The latency of tendon reflex was not changed after stimulation. CONCLUSION: These results showed that the electrical stimulation was useful method to decrease spasticity in patients with brain lesions. Further studies are needed to explore the effects of functional improvement and the long-lasting carry over effects on spasticity in electrical stimulation.
Brain* ; Electric Stimulation ; Electric Stimulation Therapy* ; Humans ; Knee ; Muscle Spasticity* ; Muscles ; Reflex, Stretch ; Relaxation ; Stroke