PURPOSE: This study examined the relationship between the level of activity daily living and powerlessness of spinal cord injury patients'. METHOD: The subjects for the study consisted of 68 persons agreed above twenty below seventy had had spinal cord injury. The data were collected from November 1, 2003 to January 30, 2004. The instruments used for this study were ADL check List and Powerlessness Scale. The data were analysed by using SPSS computerlized program and included number, percentage, t-test and ANOVA, Pearson Correlation Coefficient. RESULTS: The mean of activity daily living was paraplegia 49.53+/-10.91 and tetraplegia 25.65+/-13.24. The mean of powerlessness was paraplegia 35.22+/-9.50 and tetraplegia 37.55+/-9.01. In the relationship between activity daily living and powerlessness were significant difference. CONCLUSION: in order to increase the level of activity daily living of rehabilization nurse should be helpful to provide them. Also, it could be identified that informational support was important, that is, the lesser the informational support, spinal cord injury patient don't feel the powerlessness.
Activities of Daily Living ; Humans ; Paraplegia ; Quadriplegia ; Spinal Cord Injuries* ; Spinal Cord*

We have experienced a case of 13 ring chromosome in a 40-month-old girl who demonstrated psychomotor retardation with delayed speech, growth retardation, hearing loss(left), microcephaly, trigonocephaly with flat occiput, hypertelorism, epicanthal folds, microophthalmia, broad prominamt nasal bridge, high arched palate, micrognathia, large auricles and other anomalies. Cytogenetic studies of peripheral blood lymphocytes with differential staining of chromosomes revealed 46, XX, r13. Her parents' karyotypes were normal. We reported the case with the review of the associated literatures.
Child, Preschool ; Craniosynostoses ; Cytogenetics ; Female ; Hearing ; Humans ; Hypertelorism ; Karyotype ; Lymphocytes ; Microcephaly ; Palate ; Ring Chromosomes*

No abstract available.
Osteomyelitis* ; Radionuclide Imaging*

PURPOSE: We performed laparoendoscopic single-site (LESS) partial nephrectomy in a porcine model with the objectives of overcoming the technical challenges of this surgery and exploring its feasibility. MATERIALS AND METHODS: Six partial nephrectomies were performed on a pig aged 5 months, three cases on each kidney, by four surgeons: two urologists with much experience in laparoscopic surgery (E1, E2) and two less-experienced urologists (B1, B2). While under general anesthesia, the swine was placed in a lateral flank position. Umbilical placement of an Octoport was done with a 2.5 cm incision. After dissection of the renal hilum and Gerota's fascia, a bulldog clamp was applied on the renal artery and parenchymal resection was done. Renorrhaphy was then performed with interrupted sutures with the use of a sliding knot technique. RESULTS: All six partial nephrectomies were performed successfully after repair of the vascular and collecting system at the resection margin and renorrhaphy without the need to introduce any additional ports. There were no noticeable intra- or postoperative complications. The mean warm ischemic time was 42 minutes (range, 30-60 minutes). The shortest warm ischemic time, 30 minutes, was achieved by using the early unclamping technique during renorrhaphy. The longest warm ischemic time was 60 minutes. The average number of renorrhaphy stitches was 3.2 (range, 2-5). CONCLUSIONS: LESS partial nephrectomy was successfully performed in a porcine model but resulted in a longer ischemic time than that of conventional laparoscopic surgeries. Therefore, further laboratory disciplinary efforts are needed to decrease the warm ischemic time and to improve this surgical technique.
Aged ; Anesthesia, General ; Fascia ; Humans ; Kidney ; Kidney Neoplasms ; Laparoscopy ; Nephrectomy ; Postoperative Complications ; Renal Artery ; Sutures ; Swine ; Warm Ischemia

Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

No abstract available.
Arteries* ; Heart Septal Defects, Ventricular*

Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.
Brain ; Cerebral Infarction* ; Child ; Child, Preschool ; Decompressive Craniectomy ; Diagnosis ; Enoxaparin ; Humans ; Immunoglobulins ; Inflammation ; Levofloxacin ; Magnetic Resonance Imaging ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Stroke ; Thrombophilia ; Thrombosis ; Vasculitis

In this abstract we report on two cases of aberrant breast tissue of the perineum in a 41-year-old and a 42-year-old woman with the complaint of a slowly growing vulvar mass. The masses were not fixed, they were ovoid, rubbery firm and measured 3 x 2.5 and 4 x 3 cm in size. Microscopically, they revealed normal lobular architecture with focal papillomatosis in the former.
Adult ; Breast/*pathology ; Case Report ; Choristoma/*pathology ; Female ; Human ; Perineum/*pathology

BACKGROUND: Toll like receptor (TLR), an element of innate immunity, is upregulated by Ischemia/reperfusion (IR) injury and may be involved in adaptive immune response. Immunosuppressive agents may increase or attenuate IR injury and TLR expression. To explore the involvement of TLRs in hypoxic tubular injury and modification by mycophenolic acid (MPA) rapamycin (RAP), this study examined TLR expression in hypoxia-induced human renal proximal tubular epithelial cells (HK-2). METHODS: HK-2 cells were cultured in keratinocyte-SFM media supplemented with epidermal growth factor and bovine pituitary extract. The Induction of hypoxia was achieved using GasPak pouch system. TLR 2, 3, and 4 mRNA expression was analyzed by real time RT-PCR using SYBR green and TLR 4 protein expression was evaluated by Western blot analysis. MPA at concentration of 100 nM and 1uM and RAP at concentration of 20, 50, and 100 nM were added to culture medium. RESULTS: TLR4 but noTLR2 or TLR3 mRNA expressions increased in hypoxic HK-2 cells at 24 and 48 hrs. TLR4 protein expression also increased in hypoxic HK-2 cells at 24 and 48 hrs. MPA (100 nM and 1uM) and RAP (20, 50, and 100 nM) decreased hypoxia-induced TLR4 mRNA expression in HK-2 cells compared to normoxia at 24 hrs. However, TLR4 protein expression was decreased only by RAP at 20 and 50 nM. CONCLUSIONS: The results suggest that RAP may modify hypoxic renal tubular damage by decreasing TLR4-mediated inflammatory and immune reactions.
Adaptive Immunity ; Anoxia ; Blotting, Western ; Epidermal Growth Factor ; Epithelial Cells ; Humans ; Immunity, Innate ; Immunosuppressive Agents ; Mycophenolic Acid ; RNA, Messenger ; Sirolimus ; Toll-Like Receptors

INTRODUCTION: Premature ejaculation is the most prevalent form of male sexual dysfunction, but its cause has not been well established. Recently some studies indicated that penile sensitivity is decreased in men with premature ejaculation. MATERIALS AND METHODS: To clarify the association between penile sensitivity and premature ejaculation, we evaluated penile sensitivity in 18 patients with premature ejaculation without erectile dysfunction and neurologic deficit, and 15 normal potent male volunteers by SMV-5 digital vibrometer (Teknologue, Tokyo, Japan), which has higher precision and reproducibility than analogue type biothesiometers. Vibration thresholds were recorded at the glans penis, penile shaft, and frenulum of the penis in flaccid and erectile state induced by PGE1 10 ug. We also recorded those at ulnar process and medial maleolus of the tibia. RESULTS: There was no difference in vibration threshold at the ulnar process and the medial maleolus of the tibia between the two groups (p>0.05). And we found no difference in penile sensitivity at the glans penis, penile shaft, frenulum of the penis between the two groups, in both erectile and flaccid states (p>0.05). Penile sensitivity was decreased in erectile state compared to flaccid state, but it is not statistically significant (p>0.05). CONCLUSION: Based on our results, penile hypersensitivity measured by SMV-5 vibrometer does not appear to be a major factor contributing to premature ejaculation. And further study aimed at other somatic or cognitive factors awaits implementation.
Alprostadil ; Erectile Dysfunction ; Humans ; Hypersensitivity ; Male ; Neurologic Manifestations ; Penis ; Premature Ejaculation* ; Tibia ; Vibration ; Volunteers