No abstract available.
Delivery of Health Care*

No abstract available.
Hospitals, Public*

A giant hydronephrosis containing 7,100 cc of fluid with a proved traumatic origin in a 21 year old man is presented. The patient got a forceful kick in the upper right abdomen, 6 months previously. Subsequently, there were episodes of hematuria for ten days. The second blow was added in the same region on the day before operation and progressive abdominal swelling was observed. A nephrectomy was performed transperitoneally. A huge, reddish blue, tense, thin-walled, cystic mass was obtained, measuring 37.5 by 23.0 by 13.0 cm. The collapsed hydronephrotic same weighed 570gm. The obstruction which had caused the giant hydronephrosis was found at 2.5cm. distant portion of the ureter below uretero-pelvic junction. This point was 1.5 cm. in length, hard and cicatriciallydistorted. There was dense adhesion between distorted portion of ureter and periureteral tissue. These caused occlusion of the ureteral lumen.
Abdomen ; Hematuria ; Humans ; Hydronephrosis* ; Nephrectomy ; Transcutaneous Electric Nerve Stimulation ; Ureter ; Young Adult

Obstructive uropathy due to leukemic infiltration of the prostate is a rare condition. A case of acute myeloid leukemia who was a 24 year old soldier, complained of difficulty of urination from early stage of the disease and later showed complete urinary retention is presented. Autopsy demonstrated slightly swollen, whitish yellow and infiltrated prostate. Histopathological findings revealed striking round cell infiltrations in the prostatic stroma and the bladder neck.
Autopsy ; Humans ; Leukemia, Myeloid, Acute* ; Leukemic Infiltration* ; Military Personnel ; Neck ; Prostate* ; Strikes, Employee ; Urinary Bladder ; Urinary Retention* ; Urination ; Young Adult

We have developed a real-time arrhythmia detection system using four vaviables;heart rate, QS width, morphology and axis. Because of difficulties in real-time operation on the frequency domain, time domain process are carried out. The sampling rate of the ECG signal is 240/sec by using 12 bit A/D converter and we design digital comb filter to avoid 60Hz AC interference and DC drift. The band width of the digital comb filter is 1.79 Hz and Q is 64. To design a QRS detection logic, an 8 to 20 Hz bandpass filter is design on the basis of the power spectrum of the QRS complexes derived from the simulators and patients'data. By feeding the filter output into an adaptive threshold comparator, no detection of false QRS or T waves are found, and an accurate heart rate detection is obtained.
Animals ; Arrhythmias, Cardiac* ; Axis, Cervical Vertebra ; Comb and Wattles ; Electrocardiography ; Heart Rate ; Logic

No abstract available.
Humans* ; Melanocytes* ; Tretinoin*

To our knowledge, rectal cancer arising at the anastomotic site after surgery for Hirschsprung's disease has not been reported. We report a case of mucinous adenocarcinoma arising at the anastomotic site after Soave operation 26 years ago.
Adenocarcinoma, Mucinous* ; Hirschsprung Disease* ; Mucins* ; Rectal Neoplasms

No abstract available.
Tuberculosis*

In spite of the great measure of recent success in tuberculosis withchemotherapy, it is still one of the most fundamental questions in what state ofrenal tuberculosis should be treated surgically. So as to set up a criterion onthe chemotherapy, forty-nine extirpated tuberculous kidneys were observed withmy own classification of tuberculous renal lesions. 1. The lesions were classified macroscopically and pyelographically according to the development of renal tuberculosis (1) Those with neither change of calyceo-pelvic system nor pyelographical abnormality were named Class O. representing parenchymal tubercles. (2) Those with only infiltration in the tip of papilla were named Class I, showing caliectasis or clubbing pyelographically. (3) Those with initial minor ulceration in calyceal system were named Class II, showing fuzzy irregular or moth-eaten outline pyelographically (4) Those with progressed distorted ulceration were named Class III, showing definite irregular deformity but still keeping some semblance to the original calyceal form pyelographically. (5) Those with cavitation, open or closed were named Class IV, showing irregularly outlined shadow without original anatomic form pyelographically. (6) Those with tuberculous pyonephrotic ectasis were named Class E, showing less irregularly out lined cavity shadow pyelographically. 2. Tuberculous kidneys might also be graded clinically and pyelographically with the classification of the lesions. (1) The tuberculous kidneys with early lesions,i.e. Class O, Class I and/or Class II were called minimal renal tuberculosis.(2)Those with intermediate lesions. i.e. Class III were called moderate. (3) Those with a progressed lesion, i.e. Class IV or Class E were called advanced. (4) Those with two or more lesions of Class IV and/or Class E were called far advanced. 3. The lesions belong to each Class were divided again into untreated control group and three treated groups with triple drug therapy of different durations and the macroscopical and histopathological appearances in each treated group were compared with in untreated one. 4. Macroscopically the lesions in treated kidney with remaining excretory function and without obstruction showed tendency toward clearing of caseous material in each class.5. The specific reactions in tuberculous tissue were improved histopathologically in proportion to duration of the therapy. (1) Caseous material was cleared up. (2) Epithelioid cells revealed sufficient degeneration and diminution, occasionally complete disappearing. (3) Giant cells also revealed degeneration, vacuolation and diminution, frequently complete disappearing. 6. The severity of non-specific tissue reactions in the lesions. i.e. connectivetissue reaction, parenchymal degeneration and defect, interstitial inflammation and lymphocytic infiltration was not influenced by duration of the therapy, but depended on Class of lesions at the time of therapy began. 7. The repairing reactions in the lesions were increased according as prolongation of the therapy, but there might be some variety between the different reactions. (1) Vascularization: according as the duration, but not remarkable. (2) Regeneration of epithelium: according as the duration, but only partial covering. (3) Vacuolation: significant, however, also noticed in untreated group. (4) Reducing of perifocal reaction: according as the duration, but not sufficient in the progressed lesions.8. In the more progressed tuberculous lesions, specific and non-specific tissuereactions predominsted over repairing, therefore histological healing was more delayed. 9. There were noticeable evidences of histological improving in the specimens from patients with triple drug therapy for more than three months. 10. As a result of these observations, I should like to recommend that: (1) for minimal renal tuberculosis, chemotherapy is continued; (2) for moderate, chemotherapy is tried firstly, and if the lesions are persistent or worsened surgery will be considered; (3) for advanced and far advanced, surgery including partial nephrectomy is preferable after at least three month chemotherapy.
Classification ; Congenital Abnormalities ; Drug Therapy* ; Epithelioid Cells ; Epithelium ; Giant Cells ; Humans ; Inflammation ; Kidney* ; Nephrectomy ; Regeneration ; Tuberculosis ; Tuberculosis, Renal ; Ulcer

The ability of photochemotherapy(PUVA) or UVA phototherapy to stimulate melangenesis is well known. It is now recognized that the PUVA lentigines, irregular in outline and often more darkly and unevenly pigmented than solar lentigines, are related to the additional pigmentary effects of the PUVA therapy. We present herein four cases of unusual pigmentation after one month of UVB irradiation. Raticulated dark brown pigmentation appeared on the lower extremities of the patients. Histopathologicially, an increase in melanin in the basal layer was found, but no dysplasia or malignant change. We suggest UVB as the cause of this unusual hyperpigmentation.
Humans ; Hyperpigmentation ; Lentigo ; Lower Extremity ; Melanins ; Phototherapy* ; Pigmentation* ; Psoriasis* ; PUVA Therapy