No abstract available.
Catheters*

BACKGROUND: In previous our retrospective study, we concluded that administered fluid volume, duration of operation, operative procedures and anesthetic techniques were the major factors of postoperative urinary retention. However, the administered fluid volume, age, types and duration of the operation confined to hemorrhoidectomy was questioned as a precipitating factor. The high retention rate in spinal anesthesia is also questioned. METHODS: We investigated these possible precipitating factors of urinary retention in healthy patients (n=154) undergoing hemorrhoidectomy. The patients were randomly divided into three different anesthetic techniques: caudal (2% lidocaine 300 mg with 1 : 200,000 epinephrine), spinal (0.5% tetracaine 5 mg with epinephrine 0.1 mg or 5% lidocaine 40 mg) and general (enflurane, N2O, vecuronium). Urinary retentin was searched according to above factors following surgery. RESULTS: The overall urinary retention rate was 46.1%. The retention rate in patients with spinal anesthesia was higher than that in those with other anesthetic techniques (p<0.05). There was no significant difference between patients with lidocaine and tetracaine spinal anesthesia in urinary retention rate. The administered fluid volume in patients with urinary retention was significantly higher than that of patients without retention (p<0.05). Age, duration and types of hemorrhoidectomy did not significantly affect urinary retention rate. CONCLUSIONS: Restriction of fluid administration and avoidance of spinal anesthesia are necessary in reducing postoperative urinary retention following hemorrhoidectomy.
Anesthesia, Spinal ; Epinephrine ; Hemorrhoidectomy* ; Humans ; Lidocaine ; Precipitating Factors ; Retrospective Studies ; Surgical Procedures, Operative ; Tetracaine ; Urinary Retention*

BACKGROUND: Elafin is a serine proteinase inhibitor first discovered in keratinocytes from hyperproliferative human epidermis. In addition to the proteinase inhibiting domain, elafin contains multiple transglutaminase substrate domains which enable cross-linking to extracellular and cell envelope proteins. Several characteristics of elafin suggest potential anti-microbial activity. Elafin is absent in normal skin at protein level, but is induced in inflammatory and infectious dermatoses which threat the epidermal integrity by vesicopustule formation and neutrophilic cell infiltration. Cutaneous fungal infection is one of the well-known examples of diseases characterized by such condition. The purpose of this study was to check out the possibility that elafin may be involved in the pathomechanism of fungal infection. METHODS: The biopsy samples taken from 10 cases of superficial fungal infections, 10 cases of deep and systemic mycoses, 2 cases of slide culture specimens of Candida species, were used for the immunohistochemical tissue staining for elafin expression. Polyclonal anti-elafin was used in 1:300 dilution. As control, biopsy smaples of normal skin, ichthyosis, psoriasis were used for the staining for elafin expression. RESULTS: In the normal and ichthyotic epidermis, elafin expression was virtually negative. In superficial mycoses except candidiasis, elafin was expressed in the spinous layer of infected epidermis, and fungal structures in the stratum corneum were stained with elafin antisera. In the cases of dermatophytosis of ichthyosis patients, while fungal hyphae were stained with elafin antisera, epidermal cell did not express elafin. In candidial esophagitis, elafin was expressed in the esophgeal mucosa, but spores were not stained with elafin anti-sera. In slide culture of Candida species, spores were not stained with elafin antisera, also. In cases of systemic and deep mycoses, fungal hyphae and spores were stained with elafin antisera and epidermis adjacent to severe dermal inflammatory reaction showed elafin expression. CONCLUSION: Elafin may have certain role in systemic and cutaneous fungal infection to contribute to high resistance of the epidermis against proteolysis and fungal infections, and it is shown that elafin or elafin-like protein may also be produced and utilized by fungi themselves.
Biopsy ; Candida ; Candidiasis ; Elafin* ; Epidermis* ; Esophagitis ; Fungal Structures ; Fungi ; Humans ; Hyphae ; Ichthyosis ; Immune Sera ; Immunohistochemistry ; Keratinocytes ; Mucous Membrane ; Mycoses ; Neutrophils ; Proteolysis ; Psoriasis ; Serine Proteases ; Skin ; Skin Diseases ; Spores ; Tinea

OBJECTIVE: It is not unusual to decompress two consecutive disc levels in treating patients with multiple radiculopathy or uncertain level diagnosis. However, the controversy over whether to use corpectomy or bisegmental diskectomy for anterior cervical fusion is still largely unsettled. The aim of this study is to define the properties of these two surgical options. PATIENTS AND METHODS: We performed a retrospective review of radiological data and clinical records only in patients whom the follow up period is longer than 12 months. Functional outcome, fusion rate, complication rate, and duration of anesthesia were analyzed in both groups. RESULTS: In total of 61 cases, corpectomy was performed in 34 and the bisegmental diskectomy in 27 patients. Mean follow-up periods were over 24 months in both groups. Anesthesia time was shorter in corpectomy patients(280 minutes vs. 300 minutes in segmental diskectomy). However, the bisegmental diskectomy group was better in achieving good clinical outcome(92.6% vs. 82%). Overall fusion rate in bisegmental diskectomy was 100%. Hardware failure rate was lower in bisegmental diskectomy group(11% vs. 18%). Revision was needed in 6% of corpectomy group. CONCLUSIONS: In conclusion, although the anesthesia time is slightly longer in bisegmental fusion, we believe the method of bisegmental diskectomy is better in accomplishing higher fusion rate and lower complication rate.
Anesthesia ; Diagnosis ; Diskectomy* ; Follow-Up Studies ; Humans ; Radiculopathy ; Retrospective Studies

In an attempt to investigate the effect of intracerebral hematoma on cortical blood flow and perifocal ischemia, an experimental rat model of intracerebral hematoma was used. In a total of 44 adult male rats, cortical blood flow was studied using on H2 clearance method. The ischemic zone was investigated under light microscopy. In order to potentiate the effect of intracerebral hematoma, bilateral ligation of the common carotid artery was simultaneously performed in twelve rats. Intracerebral hematoma was induced by injecting 30nl of autologous arterial blood. Ipsilateral cortical blood flow decreased to 67.4% of baseline after the formation of intracerebral hematoma in the basal ganglia ; bilateral ligation of the common carotid artery alone decreased cortical blood flow to 59.4% of baseline ; and intracerebral hematoma formation after ligation decreased the flow to 20.5% of baseline. Neurological grades were worst in the last mentioned group, and in no group was perifocal infarction detected by light microscopy. These data suggest that the occurrence of intracerebral hematoma markedly decreases the cortical blood flow. Additionally, in a situation of compromised cerebral blood flow, the development of intracerebral hematoma can lead to a further decrease in flow, resulting in a worse neurological outcome, despite the absence of detectable histological difference.
Adult ; Animals ; Basal Ganglia ; Carotid Artery, Common ; Hematoma* ; Humans ; Infarction ; Ischemia* ; Ligation ; Male ; Microscopy ; Models, Animal ; Rats*

No abstract available.
Myelitis, Transverse* ; Retrospective Studies*

No abstract available.
Humans ; Magnetic Resonance Imaging, Cine* ; Spinal Cord Diseases*

Inflammatory pseudotumors are tumor-like, benign lesions of uncertain pathogenesis and have most commonly been reported in the lungs. They occur rarely in the gastrointestinal tract and may cause small bowel obstruction due to intussusception or, less commonly, as an incidental finding on radiologic examination or screening endoscopy. We present a case of surgically proven jejunal intussusception caused by inflammatory pseudotumor.
Endoscopy ; Gastrointestinal Tract ; Granuloma, Plasma Cell* ; Incidental Findings ; Intussusception* ; Jejunum* ; Lung ; Mass Screening

There have been several reports of more than one type of porokeratosis occurring in the same family or the same individual. We hope to support the view of different phenotypic expressions of a common genetic aberration by describing an additional case of porokeratosis of Mibelli on the perianal area and DSAP on the face, forearms occurring in a 45-year-old man.
Actins* ; Forearm ; Hope ; Humans ; Middle Aged ; Porokeratosis*

PURPOSE: To evaluate the appropriate entry point of an intramedullary tibial cutting guide in total knee arthroplasty in Koreans by measuring the "intramedullary canal axis" of the proximal tibia in three dimensions. MATERIALS AND METHODS: Computed tomography was performed on 116 lower extremities from the hip to the ankle on 58 Korean cadavers. A three dimensional image of the tibia was reconstructed using the program, Bionix version 3.3. The location of intramedullary canal axis of proximal tibia passing through tibial plateau, canal axis center 1 (CAC 1), was measured. The beta' angle was defined as the angle between the tibial anatomical axis and a line perpendicular to the knee joint line. The correlations between the beta' angle and the CAC 1 mediolateral coordinates were analyzed. RESULTS: The CAC 1 is located on 56.3% from the medial cortex and 27.8% from the anterior cortex on the average. On average, the CAC 1 was located 1.2 mm medially and 15.9 mm anteriorly from the lateral tibial spine 1. The beta' angles and medial-lateral coordinates of the CAC 1 showed a significant positive correlation (r=0.418, p=0.000). CONCLUSION: When using an intramedullary guide for tibial cutting in total knee arthroplasty in Koreans, the entry point at the lateral and anterior positions from the surface center of the tibial plateau is appropriate. The lateralization of the entry point of intramedullary tibial cutting guide becomes necessary as the varus of the tibia becomes more severe. Because of the marked variability in the CAC 1, a preoperative evaluation of the CAC 1 needs to be carried out in order to properly locate the appropriate entry point of the intramedullary tibial cutting guide in total knee arthroplasty.
Ankle ; Arthroplasty* ; Axis, Cervical Vertebra* ; Cadaver ; Hip ; Imaging, Three-Dimensional ; Knee Joint ; Knee* ; Lower Extremity ; Spine ; Tibia*