No abstract available.
Humans ; Prostate* ; Ultrasonics* ; Urinary Bladder Neck Obstruction* ; Urinary Bladder*

No abstract available.
Cell Adhesion* ; Ischemia* ; Microscopy, Video* ; Reperfusion*

The reconstruction of soft tissue defects with open fracture around the knee joint is limited by its unique location. Free tissue transfer is hindered by the selection of the recipient vessel and problems of microsurgery. The arc of rotation, defect size, and location must be taken into consideration in the use of regional muscle transfer such as gastrocnemius. According to Mathes et al, the flap survival can be enhanced by selective division of the dominant segmental pedicles, only a part of which can normally be transposed safely on its minor segmental pedicle. Neovascularization, vascular proliferation, and dilatation have also been produced by the delay procedure using silicone sheets. The authors have used the delay procedures with wrapping of the gracilis or sartorius muscle which enabled distally-based transposition of these muscles. The method showed satisfactory outcome in resurfacing the wound around the knee joint. The indictions for this procedure were defects of moderate size and those difficult to reach with conventional muscle flaps. The flap could reach the upper one-third of the lower leg. Other merits are relative simplicity and reliability without significant extension of hospital stay. The drawbacks are the two operative procedures necessary and the risk of infection due to silicone sheets.
Dilatation ; Fractures, Open ; Knee Joint* ; Knee* ; Leg ; Length of Stay ; Microsurgery ; Muscles ; Silicones ; Surgical Procedures, Operative ; Wounds and Injuries*

PURPOSE: Suprapubic vibrating stimulus may improve the urinary symptom in patients with neurogenic bladder. We attempted to evaluate the suprapubic vibration effect on urodynamic study in patient with voiding dysfunction. MATERIALS AND METHODS: From October 1997 to July 1998, We have performed urodynamic studies(UDS) on 30 patients(13 males, 17 females). They had intact suprapubic sensation without lower urinary tract obstruction, who visited under the chief complaints of voiding dysfunction(frequency, voiding difficulty etc.). All patients were checked UDS before and after using a vibrating device(frequency 120Hz, mechanical output 0.081mm), which was placed on the 2?3cm above the pubic symphysis. Results of detrusor pressure were compared pre- and post-vibration at 150ml bladder filling and at strong desire to void and maximum bladder capacity. The most common underlying disease was peripheral lesions(11 cases). Results of UDS were grouped into three. Group I consisted of 11 patients with hyperactive bladder. Group II consisted of 6 patients with normal bladder, and group III consisted of 13 patients with hypoactive bladder. RESULTS: Changes of detrusor pressure at the 150ml bladder filling in group I couldn`t be measured due to early urine leakage. In group II&III, the average detrusor pressure changes of pre- and post-vibration were from 4.2+/-.6cmH2O to 3.8+/-.2cmH2O(p>0.05) and from 5.7+/-.8cmH2O to 6.7+/-.2cmH2O(p>0.05) respectively. Detrusor pressure at strong desire to void was changed from 39.0+/-8.6cmH2O to 40.0+/-0.0cmH2O in group I(p>0.05), 25.3+/-2.8cmH2O to 19.0+/-2.2cmH2O in group II(p>0.05), and from 15.0+/-.9cmH2O to 19.5+/-2.3cmH2O in group III(p<0.05). Changes of maximum bladder capacity were from 222.7+/-8.4ml to 187.5+/-1.7ml in group I(p>0.05), from the 402.0+/-2.8ml to 399.3+/-4.5ml in group II(p>0.05), and from 547.5+/-9.5ml to 520.1+/-9.6ml in group III(p<0.05). In group III, ten of the 13 patients(77%) showed the increase of detrusor pressure at strong desire to void(mean: 6.6cmH2O) and nine of the 13 patients(69%) showed the decrease in maximum bladder capacity(mean: 46.4ml)(p<0.05). CONCLUSIONS: These results suggest that the use of suprapubic vibrator may be an ancillary therapeutic tool in selected patients of voiding dysfunction with hypoactive bladder.
Humans ; Male ; Pubic Symphysis ; Sensation ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Tract ; Urodynamics* ; Vibration*

Twenty nine cases of segmental tibial fracture were treated at Ewha Womans University Hopital, Department of Orthopedic Surgery, during the period from January, 1970 to December, 1984. The following results were obtained. 1. Most common fracture level was type I, high middle segment, occurred about 12 cases (41.4%). 2. In view of the higher incidence of open fracture (16 cases, 55.1%) and comminuted fracture (22 cases, 75.9%), fracture was caused by high velocity. 3. Various external and internal fixation methods were applied, but higher union rate was seen in the cases of Küntscher nailing and plating with bone graft. 4. Excluding the cases of type V, average union rate was 28.5 weeks and open fracture (ave. 29.6 weeks) required more longer union rate than closed fracture (ave. 26 weeks). 5. Higher rate of complication (21 cases, 72.4%) was noted than other types of tibial fracture. 6. Good result was obtained for treatment of 5 cases of delayed union or non-union by plating and bone graft than any other methods.
Clinical Study ; Female ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Orthopedics ; Tibia ; Tibial Fractures ; Transplants

PURPOSE: We compared the perifoveal capillary ring state and the size of the macular ischemic area in patients with the macular edema, then analyzed the effect of grid photocoagulation on macular edema. The aim of the present study was to evaluate visual prognosis and to determine treatment modality of macular edema with macular ischemia in branch retinal vein occlusion (BRVO). METHODS: We did retrospective clinical analysis on the macular edema and macular circulatory state using clinical records, and performed fluorescein angiography in 89 patients (92 eyes) who were diagnosed with BRVO at Inha University Hospital from June 1996 through October 2000 and were followed for over 6 months. RESULTS: The incidence of macular edema was not statistically correlated with occlusion site of retinal vein, size of macular ischemic area and perifoveal capillary ring state. The initial visual acuity was a statistically significant factor in the prognosis of final visual acuity. The macular ischemic area was statistically correlated with initial visual acuity, and the perifoveal capillary ring state was not correlated with initial and final visual acuities. The improvement of visual acuity after grid photocoagulation for macular edema was noted in patients with intact perifoveal capillary ring state and small macular ischemic area. CONCLUSIONS: The only facator to final visual acuity is initial visual acuity. Prospective study is needed to evaluate effect of early treatment of macular edema with grid photocoagulation at an early stage of BRVO in patients with intact perifoveal capillary ring state and small macular ischemic area.
Capillaries ; Fluorescein Angiography ; Humans ; Incidence ; Ischemia* ; Light Coagulation ; Macular Edema* ; Prognosis* ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity

Astrocytic tumors, particularly gliosarcoma, may contain epithelial features in the form of trabecular, adenoid, papillary arrangement, and squamous metaplasia. A case of gliosarcoma with unusual epithelial feature is described. The patient was a 60-year-old male with frequent seizures. The mass was 4 cm and in the left frontal lobe. Trabecular or rarely adenoid arrangement of neoplastic astrocytes was present in the mucinous stroma, and there was a distinctive transition between the trabecular area and typical anaplastic astrocytoma. The tumor cells in the trabecular area showed positive immunostain for glial fibrillary acidic protein, but did not react with various kinds of cytokeratin. The sarcomatous area was undifferentiated and was not labeled by factor-VIII, desmin, and anti-smooth muscle actin. Occurrence and histogenesis of epithelial features in gliosarcoma are reviewed. The importance to recognize the existence of epithelial feature in malignant astrocytic tumor is emphasized.
Brain Neoplasms/surgery ; Brain Neoplasms/pathology* ; Case Report ; Epithelium/pathology ; Gliosarcoma/surgery ; Gliosarcoma/pathology* ; Human ; Magnetic Resonance Imaging ; Male ; Middle Age

Richer's syndrome is a development of a high grade malignant lymphoma in a patient with preexisting chronic 1ymphocytic leukemia, small lymphocytic lymphoma or Waldenstrom's macroglobulinemia. A rare case of Richer's syndrome arising in the spleen of a 35-year-old-man was studied by morphology, immunohistochemistry and gene rearrangement study. He has had weight loss and night sweat for last 6 months. Hepatosplenomegaly and abdominal lymphadenopathy were noted on CT scanning. Especially an ovoid radiolucent mass was found within the image of splenomegaly. Lymph nodes and liver biopsy, bone marrow aspiration and splenectomy were done. In the lymph nodes, liver and bone marrow, well differentiated small lymphocytic infiltrations were found but, in the spleen, pleomorphic, large cells with occasional multinucleated giant cells formed a nodular mass surrounded by diffuse, extensive infiltration of small well differentiated lymphocytes. The two distinctive areas in the spleen had positive staining for B-cell marker (HLA-DR and L26), negative staining for T-cell marker (UCLH1), and positive staining for IgM heavy chain and kappa light chain by immuohistochemical study. so this case was diagnosed as a diffuse large cell 1ymphoma transformed from small lymphocytic lymphoma. We made an another effort to clarify their clonality. Gene rearrangement method usingcomplementarity.determining region 3(CDR3) of immunoglobulin heavy chain (IgH) gene and T-cell receptor gamma (TCRgamma) gene by polymerase chain reaction (PCR) technique was done. The two lymphomas in the spleen demonstrated the same rearrangement pattern in both IgH and TCRgamma gene. We think these findings strongly suggest that the large cell lymphoma has the same clonality with that of the small lymphocytic lymphoma.
Male ; Humans

The factors affecting the survival rate of breast-cancer patients were studied in 185 cases treated at the Department of Surgery, College of Medicine, Chonbuk National University from January 1987 to December 1996. The results are as follows: 1) The most prevalent age group was the 5th decade (57 cases, 30.8%). 2) The most common initial symptom was a palpable mass (167 cases, 90.3%). 3) In 134 cases (72.4%), the patients visited the hospital within 6 months of the onset of the first symptom. 4) The primary tumor was located on the left side in 101 cases (54.6%) and on the right side in 84 cases (45.4%), and the most frequent tumor location was the upper outer quadrant (113 cases, 61.1%). 5) The pathological types, according to the WHO classification, were an invasive ductal carcinoma (179 cases, 96.7%) and a medullary carcimona (22 cases, 11.9%) in that order. 6) According to the TNM system, the most common stage was stage II (100 cases, 54.1%). The overall 5-year survival rates according to pathologic stage were 96.0% for Stage I, 83.1% for Stage II, 67.8% for Stage III, and 12.5% for Stage IV. 7) The estrogen and the progesterone receptor status had no significance for the survival rate. 8) The most common type of operation was a modified radical mastectomy (Patey) (150 cases, 81.0%). 9) Axillary lymph node metastases were present in 77 cases (41.6%). 10) The most common distant metastasis was the bone (12 cases, 6.5%). 11) The overall 5-year actuarial survival rate after surgery was 76.6%. The 5-year survival rates according to the number of invaded lymph-node were 83.5% for 0 nodes, 77.6% for 1~3 nodes, 57.5% for 4~9 nodes, and 49.4% in cases of more than 10 nodes.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Classification ; Estrogens ; Humans ; Jeollabuk-do ; Lymph Nodes ; Mastectomy, Modified Radical ; Neoplasm Metastasis ; Receptors, Progesterone ; Survival Rate

Hypercalcemia is a common complication in CAPD patients treated with calcium-containing phosphate binders and using the standard dialysate (SCD) calcium concentration of 3.5mEq/L. We performed a retrospective study in 25 CAPD patients to determine whether a low calcium dialysate (LCD) containing 2.5mEq/L calcium would reduce the incidence of hypercalemia with adequate control of serum inorganic phosphate levels and diminish the need to use aluminum-containing phosphate binders. All patients had previously used SCD before converting to LCD. The incidence of hypercalcemia (more than 2 episodes of corrected serum calcium > or = 10.5mg/dL) tended to be lower after converting to LCDl 0.27 (0-2.76) vs. 0 (0-1.97) episodes/patient-yearl. Intact PTH level increased from 38.8 (0.1-1599.3)pg/mL to 70.6 (9.5-1540.0)pg/mL after conversion, but there was no statistical sifnificance. Serum calcium, inorganic phosphate, alkaline phosphatase and bicarbonate levels did not change after converting to LCD. We were able to reduce aluminum hydroxide dosagel 1.09 (0-10.88) vs. 0 (0-3.26)g/day/patientl and increase calcium carbonate dosage (1.95 0.92 vs. 2.98 2.14g/day/ patient) after conversion significantly (P<0.05). The frequency of peritonitis was similar in LCD and SCD period. In conclusion, low calcium dialysate is useful in diminishing aluminum-containing phosphate binder dosage and increasing calcium carbonate dosage to maintain a similar phosphate value. Its effects on renal osteodystrophy remain to be assessed.
Alkaline Phosphatase ; Aluminum Hydroxide ; Calcium Carbonate ; Calcium* ; Humans ; Hypercalcemia ; Incidence ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Osteodystrophy ; Retrospective Studies