PURPOSE: We investigated the possible inhibitory effect of aspirin during the initiation and post initiating stages on N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) induced bladder carcinogenesis in female rats. MATERIALS AND METHODS: Forty-five female Sprague-Dawley rats were divided into three groups. Group A received 0.05% BBN in drinking water for 12 weeks. Group B re ceived 0.05% BBN in drinking water with 0.5% aspirin in the diet for 12 weeks. Group C received control diet without added chemicals. The rats were sacrificed after 12 weeks. For identification of chemopreventive effect of aspirin, apoptosis was detected by in situ cell death detection method. The apoptotic index (AI) was calculated from the ratio of typical apoptotic cells relative to the total cells from observation of at least 1000 cells in each preneoplastic lesion among the groups. RESULTS: All cases of group A showed multiple lesions of simple and focal hyperplasia. The incidence of papilloma was 80% in group A. All cases of group B also showed multiple lesions of simple and focal hyperplasia but the incidence of papilloma was decreased to 20%. The total numbers counted of focal hyperplasia and papilloma lesions were significantly reduced in group B than in group A (p<0.001 and p<0.001, respectively). The mean AI in group A and B sequentially increased in preneoplastic lesions, as compared to that in the normal epithelium of the rat bladder. Significant differences in AI in the lesions of simple and focal hyperplasia between group A and B were noted (p<0.001 and p<0.001, respectively). CONCLUSIONS: The result suggests that aspirin significantly decreases the incidence of precancerous lesions and it can act as a chemopreventive agent for precancerous lesions of urinary bladder.
Animals ; Apoptosis ; Aspirin* ; Carcinogenesis ; Cell Death ; Diet ; Drinking Water ; Epithelium ; Female ; Humans ; Hyperplasia ; Incidence ; Papilloma ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neoplasms ; Urinary Bladder*

Purpose: To report a case of both ocular perforation due to periocular acupuncture therapy with vitrectomy in the right eye andbarrier laser photocoagulation without vitrectomy in the left eye.Case summary: A 58-year-old female presented with ocular pain and decreased visual acuity in both eye. She had received periocularacupuncture therapy 4 days earlier. Dilated fundoscopy revealed vitreous hemorrhage. B-scan ultrasonography revealedvitreous opacity. Thus, at the request of the patient, vitrectomy was performed in only the right eye, and did not performed in theleft eye. Intraoperatively, we identified retinal laceration in the temporal and inferior retina. In the left eye, the sites of retinal hemorrhagewere observed in the temporal and inferior retina in the fundus examination, and a barrier laser photocoagulation wasperformed around the lesion. At the three-month postoperative follow-up, the patient’s visual acuity was 0.5 in the right eye withoutmacular edema. In the left eye, visual acuity was 0.01 with macular edema observed on optical coherence tomography. Conclusions Authors present a case of a patient with vitreous hemorrhage and ocular perforations caused by periocular acupuncturetherapy in both eye, able to compare the results of eyes that performed vitrectomy and that did not performed vitrectomyin a same patient. The recovery of visual acuity in eye that performed vitrectomy was better than eye that did not performedvitrectomy. Therefore, we consider performing vitrectomy in patients with eye perforation.

BACKGROUND: Testicular rupture is a surgical emergency which command immediate repair. If surgery is delayed, a hematoma causes severe pain and loss of spermatogenesis as well as hormonal functions. Scrotal ultrasonography has been helpful in early diagnosis of testicular rupture. But disadvantage of ultrasonography include a relatively low signal-to-noise level, tissue nonspecificity, lack of contrast media, a small field of view, and dependence on the operators skill and the patients physique. Also the diagnostic accuracy, sensitivity or specificity of scrotal ultrasonography was variable in regard to authors. And so, a diagnostic accuracy of scrotal ultrasonography was evaluated in scrotal trauma. METHODS: We reviewed 38 patients of scrotal trauma from May, 1994 to March, 1998. 6 patients were treated conservatively following scrotal sonography and 10 patients treated only surgical exploration without ultrasonography. Surgical exploration was performed in 22 case, which were evaluated by ultrasound before surgical treatment. In a such 22 cases, diagnostic accuracy of scrotal ultrasonography was evaluated. RESULTS: We compared ultrasound before treatment with surgical exploration finding in a such 22 cases. The ultrasonographic features in 7(31.8%) out of 22 cases, which showed testicular ruptured, but surgical exploration revealed testicular rupture in 5 and epididymal rupture in 1, simple hematocele in 1. In 15(68.2%) out of 22 cases the simple hematocele was diagnosed by ultrasonography, but surgical finding feature in of the 7 cases revealed testicular rupture, epididymal rupture in 1, simple hematocele in 7. The sensitivity and specificity for the ultrasonography are 42.9% and 87.5%, and the positive and negative predictive values are 86.5% and 46.7%, respectively. Ultrasonography is low sensitive in identifying testicular rupture. CONCLUSION: Ultrasonography include a relatively low signal-to-noise level, tissue nonspecificity, lack of contrast media, a small field of view, and dependence on the operators skill and the patients physique. Therefore, early surgical exploration for saving the testis should be performed that sonographically by seeing hypoehoic peripheral lesions and disappearance of normal ovoid form of testis, hematocele in scrotal sac.
Contrast Media ; Early Diagnosis ; Emergencies ; Hematocele ; Hematoma ; Humans ; Male ; Rupture ; Sensitivity and Specificity ; Spermatogenesis ; Testis ; Ultrasonography*

The study was performed retrospectively to compare the results of anterior chamber IOL(Intraocular Lens) implantation and posterior chamber IOL implantation by scleral fixation in cases of inadequate zonular or capsular support during the extracapsular cataract extraction. A total of 27 cases were reviewed of which 11 cases had anterior chamber IOL implantation and 16 cases had posterior chamber IOL implantation by scleral fixation. The follow-up period ranged from two to twenty-four months. Nine of eleven in anterior chamber IOL group and thirteen of sixteen in posterior chamber IOL group had the final corrected vision of 0.5 or better. Vision-threatening complications included two cases of cystoid macular edema in anterior chamber IOL group, whose visual acuity was 0.1 and 0.5, and three cases of vitreous hemorrhage in posterior chamber IOL group, which had little effect on visual outcome The final visual acuity didn't show statistically significant difference between the two groups.
Anterior Chamber* ; Cataract Extraction ; Follow-Up Studies ; Lenses, Intraocular* ; Macular Edema ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage

No abstract available.
Endoscopy* ; Hemorrhage* ; Humans

Diabetic complications such as cystopathy and retrograde ejaculation are slowly progressive disease without any specific signs and symptoms so it is difficult to diagnose its complication and prevent it. Diabetic autonomic neuropathy is known as a neurologic lesion with combined involvement in cardiovascular and genitourinary systems. The purpose of this study is to assess correlation between diabetic cystopathy and heart rate variation on consecutive EKG waves and to detect early cystopathy in patients with decreased heart rate variation. We have studied 12 cases of diabetic cystopathy and 9 cases of retrograde ejaculation who were managed in Seoul Eulji Hospital from Mar. 1992 to Aug. 1993 and concluded as follows. Diabetic patients with autonomic neuropathy shows decreased heart rate variability(HRV) (CV%: 2.16+/-0.97) than diabetic patients without autonomic neuropathy (CV%: 3.29+/-0.58, P <0.0001 ), it means that decreased HRV on consecutive EKG waves well correlates to diabetic autonomic neuropathy such as cystopathy and retrograde ejaculation so we think that the measurement of HRV provides a simple test to be concerned urologic complications such as cystopathy or retrograde ejaculation.
Diabetes Complications ; Diabetes Mellitus ; Diabetic Neuropathies ; Ejaculation ; Electrocardiography* ; Heart Rate ; Humans ; Male ; Seoul ; Urogenital System

PURPOSE: To analyze clinical characteristics of refractive accommodative esotropia related with the occurrence of decompensation and cessation of spectacle use. METHODS: The records of 60 patients with refractive accommodative esotropia were reviewed. Patients were divided into a control or decompensation group. Twenty-nine patients in the control group who were followed up for long-term were divided into two groups based on spectacle use. RESULTS: In the decompensation group, the amounts of near and distant esodeviation without correction at the first visit and the frequency of failure to achieve central fusion were significantly greater than the control group (p < 0.05). Ages at the onset of esodeviation and first visit, the amount of hyperopia at the first visit, the amounts of controlled esodeviation, amblyopia, and anisometropia were not significantly different between the two groups (p > 0.05). In the group that no longer required glasses, the age at the first visit was greater and the amount of hyperopia and the near and distant esodeviations without correction at the first visit were significantly greater than the glasses-wearing group (p < 0.05). Age at the onset of esodeviation, the amount of controlled esodeviation, refractive change per year, stereopsis, amblyopia, and anisometropia were not significantly different between the two groups (p > 0.05). CONCLUSIONS: In refractive accommodative esotropia, a larger amount of esodeviation at the first visit and failure to achieve central fusion are risk factors for developing decompensation. The older age at diagnosis and smaller amounts of hyperopia and esodeviation at the first visit are predictive factors for the cessation of spectacle use.
Amblyopia ; Anisometropia ; Depth Perception ; Esotropia ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Hyperopia ; Risk Factors

This study was designed to investigate whether sectioning of the transverse carpal ligament (TCL) modifies the biomechanical behavior of the finger flexion in respect to dynamic changes of the wrist. Changes of work, load, and excursion of the flexor tendons were measured using fresh frozen cadaver hands with the wrist in 30° flexion, neutral, and 30° extension before and after division of the TCL. Change in work efficiency between intact and cut TCL groups was noted most with the wrist in flexed position (12.5%) compared to 3% in neutral wrist position and no change in wrist extension. The extended wrist group as a whole had greatest increase in the efficiency of work and load with greater than 16.2% and 14.8% changes, respectively. The significant decrease in the excursion efficiency of the flexor tendons was demonstrated when the wrist was in the flexed position. This effect was accentuated when the TCL was divided causing the bow-stringing phenomenon. The increase in the excursion of the flexor tendons could clinically result in decreased grip strength when the wrist is flexed. Furthermore, the effects of TCL division were least significant when wrist position was in extension. One could conclude from this that post-operative management after carpal tunnel release procedures should include placing the wrist in moderate extension.
Cadaver ; Fingers ; Hand ; Hand Strength ; Ligaments ; Tendons ; Wrist

Blood sugar and blood gas analysis changes caused by a 10 hour fast and a 15 hour fast were studied in sixtythree patients. In the 10 hour fast group, mean blood sugar level was 79.58+/-8.77mg/dl compared with the 15 hour fast group was 77.22+/-14.93 mg/dl. There were no remarkable changes on blood gas analysis for both the 10 hour fast group and 15 hour fast group. Neither age nor sex had any significant influence on blood sugar level or blood gas analysis. Thus, in order to make preoperative recommendations as well as to give appropriate intravenous fluids during and following operation, the anesthesiologist must be acquainted with the physiology of fasting.
Blood Gas Analysis* ; Blood Glucose* ; Fasting* ; Humans ; Physiology

PURPOSE: RFCA has been proven to be an effective and safe tool for treating different kinds of tachycardia in adults. This study was designed to analyze the efficacy of this method in children and adolescents. METHODS: Seventy-eight patients referred to Gachon Medical School, Gil Hospital for ablation of supraventricular(SVT) and ventricular tachycardia(VT) between January 1997 and February 1999 were included in this study. An electrophysiologic study was performed in the same session to assure the diagnosis, and meet the appropriate criteria for ablation. All patients had regular follow-up at our center. RESULTS: Mean age of the patients was 9.9 years. Thirty-seven patients had Wolff-Parkinson- White syndrome, atrioventricular nodal reentrant tachycardiain in 12 patients, atrial flutter in 11 patients, atrial tachycardia in 9 patients, Mahaim tachycardia in 2 patients, nodoventricular tachycardia in one patients and VT in 6 patients was found. Seventy-seven patients were treated successfully(98.7%), 75 patients were treated in a single procedure, but 2 patients needed a second attempt. RFCA treatment failed in only one patient with nodoventricular tachycardia. In three of the 77 successfully treated patients(3.9%), tachycardia recurred after 1-3 months but could be treated by a further intervention. The duration of follow up after RFCA was from 2 to 27 months. CONCLUSION: RFCA is a highly effective method in the treatment of SVT and VT in children and adolescents. The major benefit of this technique is its potential as a cure for a chronic disease. RFCA can be used as the primary treatment for SVT and VT.
Adolescent* ; Adult ; Atrial Flutter ; Catheter Ablation* ; Child* ; Chronic Disease ; Diagnosis ; Follow-Up Studies ; Humans ; Schools, Medical ; Tachycardia*