This study was conducted to set up a common mechanism for varying phases of focal segmental glomerulosclerosis(FSGS) by comparing the morphological differences between human FSGS and changes in 5/6 renal ablation animal model, which has been accepted as experimental prototype for hyperfiltration theory as pathogenesis of FSGS. Both the human and the experimental rats showed very similar changes such as segmental glomerulosclerosis, vacuole formations or inclusion of small granules of podocytes, appearance of foamy cells in the capillary lumina, eosinophilic deposits along the mesangial area, and focal atrophy of tubules with associated interstitial fibrosis. The halo, frequently seen in human FSGS, is due to detachment of visceral epithelium from basement membrane, however, did not appear in the experimental rat specimen. On the other hand, the foamy cells and hyalinization were more frequently noted in the rat series and even involved the arterioles. The mesangial proliferation never appeared in the rat series occasionally found in human FSGS. In conclusion, the pathogenesis of FSGS cannot depend solely on the hyperfiltration theory of hemodynamic derangement, but has complex impairment of visceral epithelium and cells forming the constituents of basement membrane.
Animals ; Arterioles ; Atrophy ; Basement Membrane ; Biopsy ; Capillaries ; Eosinophils ; Epithelium ; Fibrosis ; Hand ; Hemodynamics ; Humans* ; Hyalin ; Models, Animal* ; Nephrectomy* ; Podocytes ; Rats* ; Vacuoles

This study was conducted to set up a common mechanism for varying phases of focal segmental glomerulosclerosis(FSGS) by comparing the morphological differences between human FSGS and changes in 5/6 renal ablation animal model, which has been accepted as experimental prototype for hyperfiltration theory as pathogenesis of FSGS. Both the human and the experimental rats showed very similar changes such as segmental glomerulosclerosis, vacuole formations or inclusion of small granules of podocytes, appearance of foamy cells in the capillary lumina, eosinophilic deposits along the mesangial area, and focal atrophy of tubules with associated interstitial fibrosis. The halo, frequently seen in human FSGS, is due to detachment of visceral epithelium from basement membrane, however, did not appear in the experimental rat specimen. On the other hand, the foamy cells and hyalinization were more frequently noted in the rat series and even involved the arterioles. The mesangial proliferation never appeared in the rat series occasionally found in human FSGS. In conclusion, the pathogenesis of FSGS cannot depend solely on the hyperfiltration theory of hemodynamic derangement, but has complex impairment of visceral epithelium and cells forming the constituents of basement membrane.
Animals ; Arterioles ; Atrophy ; Basement Membrane ; Biopsy ; Capillaries ; Eosinophils ; Epithelium ; Fibrosis ; Hand ; Hemodynamics ; Humans* ; Hyalin ; Models, Animal* ; Nephrectomy* ; Podocytes ; Rats* ; Vacuoles

A clinical observation was made on the patients with Wilms' tumor admitted to the Yonsei University Hospital during the period from January, 1974 to December, 1981. 1. Age distribution was between 5 months to 76/12 years, the highest incidence rate was in the age group of 12 to 24 months. 2. Mass in abdomen was the most common symptom occurred in 63.2%, gross hematuria in 31.6%, abdominal distention and anorexia in 20.1% each and the others. 3. Left to right ratio was 1.7:1 and simultaneous bilateral tumor was not observed. 4. On I.V.P., 47.4% of cases revealed nonfunctioning kidney. Right renal deformity or displacement was observed in 42.1%, calcification in the tumor mass in 10.5%. 5. On treatment of Wilms' tumor, surgery, irradiation and chemotherapy was performed on 11 cases, surgery and post-op, chemotherapy 4 cases, surgery only 2 cases and irradiation and chemotherapy only 1 case each.
Abdomen ; Age Distribution ; Anorexia ; Congenital Abnormalities ; Drug Therapy ; Hematuria ; Humans ; Incidence ; Kidney ; Wilms Tumor*

BACKGROUND: We analyzed the clinical characteristics of trauma involving the liver and/or the spleen to evaluate the safety of nonoperative management. METHODS: A retrospective study was conducted on 78 cases who were treated with operative (37 cases) and nonoperative (41 cases) management at Wonkwang University Hospital from January 1995 to June 1998. Nonoperative management was done in hemodynamically stable patients. RESULTS: Three cases in the operative group (OG) and 5 cases in the nonoperative group (NOG) were children. Causes of injury were traffic accidents (66.6%), falls (15.4%), penetrating injuries (11.4%), and assaults (6.4%). Associated intraabdominal injuries were renal contusions (42%), pancreatic injuries (18%), mesenteric tearing (12%), diaphragm ruptures (9%). Associated extraabdominal injuries were chest injuries (56.5%), long bone fractures (15.2%), pelvic bone fractures (9.8%), and CNS injuries (8.7%). Mean total blood requirements were 7.0 units in the OG and 1.2 units in the NOG. Complications were 35 cases in the OG (pleural effusion, 6 cases; intraabdominal abscess, 4 cases; pneumonia, 4 cases; biloma, 3 cases) and 15 cases in the NOG (pleural effusion, 5 cases; pneumonia, 5 cases; intraabdominal abscess, 2 cases). Causes of 8 delayed operations were bowel perforations (small bowel 2 cases, and colon, 1 case), bile peritonitis (2 cases), and hemodynamically instability (3 cases). The hospitalization period was 16 days in the OG and 14 days in the NOG. Six patients in the OG died and the causes were multiple organ failures (4 cases), hypovolemic shock (1 case), and ARDS (1 case). No patient died in the delayed operation cases and the NOG, even in major injury cases aquired respiratory distress syndrom. CONCLUSIONS: Nonoperative management of traumatic liver and/or spleen injury is safe and can be tried initially under the conditions of stable hemodynamics, feasible abdominal CT, and feasible immediate operation.
Abscess ; Accidents, Traffic ; Bile ; Child ; Colon ; Contusions ; Diaphragm ; Fractures, Bone ; Hemodynamics ; Hospitalization ; Humans ; Liver* ; Multiple Organ Failure ; Pelvic Bones ; Peritonitis ; Pneumonia ; Retrospective Studies ; Rupture ; Shock ; Spleen* ; Thoracic Injuries ; Tomography, X-Ray Computed

A clinical observation was made on 31 cases of traumatic urethral injury in the Department of Urology, Wonju Christian Hospital, during the period from March 1979 to June 1982. The results were as follows: 1. The rate of the urethral injury to total genitourinary tract was 46.3%. 2. Age distribution of urethral injury was the highest in the age of 21-10 (54.8%). 3. In anterior urethral injury, the most common cause was industrial accident (63.6%), the mode of injury was blunt injury (46.5%). In posterior injury, the most common cause was traffic accident (40.0%), the mode of injury was blunt injury (80%). 4. Results from the present study show that the perineal end-to-end anastomosis performed primarily or secondarily showed higher success rate (75%)than other procedures.
Accidents, Occupational ; Accidents, Traffic ; Age Distribution ; Gangwon-do ; Urology ; Wounds, Nonpenetrating

BACKGROUND: Many physicians hesitate to discuss do-not-resuscitate (DNR) orders with patients or family members in critical situations. In the intensive care unit (ICU), delayed DNR decisions could cause unintentional cardiopulmonary resuscitation, patient distress, and substantial cost. We investigated whether the timing of DNR designation affects patient outcome in the medical ICU. METHODS: We enrolled retrospective patients with written DNR orders in a medical ICU (13 bed) from June 1, 2014 to May 31, 2015. The patients were divided into two groups: early DNR patients for whom DNR orders were implemented within 48 h of ICU admission, and late DNR patients for whom DNR orders were implemented more than 48 h after ICU admission. RESULTS: Herein, 354 patients were admitted to the medical ICU and among them, 80 (22.6%) patients had requested DNR orders. Of these patients, 37 (46.3%) had designated DNR orders within 48 hours of ICU admission and 43 (53.7%) patients had designated DNR orders more than 48 hours after ICU admission. Compared with early DNR patients, late DNR patients tended to withhold or withdraw life-sustaining management (18.9% vs. 37.2%, p = 0.072). DNR consent forms were signed by family members instead of the patients. Septic shock was the most common cause of medical ICU admission in both the early and late DNR patients (54.1% vs. 37.2%, p = 0.131). There was no difference in in-hospital mortality (83.8% vs. 81.4%, p = 0.779). Late DNR patients had longer ICU stays than early DNR patients (7.4 ± 8.1 vs. 19.7 ± 19.2, p < 0.001). CONCLUSIONS: Clinical outcomes are not influenced by the time of DNR designation in the medical ICU. The late DNR group is associated with a longer length of ICU stay and a tendency of withholding or withdrawing life-sustaining treatment. However, further studies are needed to clarify the guideline for end-of-life care in critically ill patients.
Advance Directives ; Cardiopulmonary Resuscitation ; Consent Forms ; Critical Illness* ; Hospital Mortality ; Humans ; Intensive Care Units ; Resuscitation Orders* ; Retrospective Studies ; Shock, Septic

Steroid cell tumor of ovary, first described as lipid cell tumor, is rare lesions composed entirely of cells resembling typical steroid hormone - secreting cells, that is lutein cells, Leydig cells, and adrenal cortical cells. Steroid cell tumors oftcn secret androgen and manifest themselves with symptoms of virilization. Other presentations include abdominal swelling or pain, menstrual dysfunction, postmenopausal bleeding, or rarely ascites. We experienced a case of right ovarian steroid cell tumor, not otherwise specified(NOS), manifested hirsuitism and amenorrhea in 49 - year - old patient. The tumor was about 5 cm in size, and associated with huge ascites (l3,000 ml), both pleural effusion, and elevated serum CA 125. We present a case of Meigs syndrome associated with benign ovarian steroid cell tumor with a brief review of the literature.
Amenorrhea ; Ascites* ; Dysmenorrhea ; Female ; Hemorrhage ; Humans ; Leydig Cells ; Luteal Cells ; Male ; Meigs Syndrome ; Ovary ; Pleural Effusion ; Virilism

No abstract available.

No abstract available.
Paranasal Sinuses*

No abstract available.
Leukemia, Hairy Cell*