The intramedullary nailing for the fractured tibia has been used in selected cases of fresh diaphyseal fracture and non-union. However, with modern technical improvements, the indications could be expanded considerably. With interlocking nailing technic we can treat various types of tibia fracture, which were unsuitable for intramedullary nailing previously. Stability can be achieved with transverselyinserted bolts which anchor the implant directly to the cortical bone, thereby controllinglength, alignmentandrotation of the fracture as well as permitting early joint motion and weight bearing. Between May 1985 and Feb. 1988, interlocking nailings were performed for 54 cases oftivial fractures, of which 40 cases were acute fracture and 10 were non-union and 4 weremalunion. We obtained the following results ; 1. Closed nailing technic was accomplished in 40 cases and 14 cases were opened. 2. Dynamic and static interlocking nailings were done in 8 and 46 cases respectively. 3. Full weight could be borne on 5th postoperative day in transverse or short oblique fracture cases, 2 weeks in nonunion and malunion cases and 4 weeks in comminuted or segmental fracture cases. 4. The mean fracture healing period was 11.5 weeks in dynamic interlocking cases and 13 weeks in static nailing cases. 5. According to the functional classification of Klemm and Borner, out of 54 cases 36 were excellent, 14 were good, 3 were fair and one was poor.
Classification ; Fracture Fixation, Intramedullary ; Fracture Healing ; Joints ; Tibia ; Weight-Bearing

Renal dysplasia results from aberrant metanephric histogenesis caused fundamentally by a defect in inducer tissue or responding tissue. Dysplastic kidneys vary tremendously in gross and microscopic appearance but are characterized by abnormal organization and a mixed population of primitive structures, such as fetal or immature cartilage, dysplastic ducts, immature tubules, and undifferentiated mesenchyme. We report a case of unilateral multicystic renal dysplasia associated with an ipsilateral ectopic ureteral orifice entering a seminal vesicle cyst in a 33-year-old man. He was admitted due to primary infertility which had developed three years ago. The his semen analysis revealed oligospermia. No evidence of a family history of renal dysplasia was reported. Microscopic examination showed that the entire kidney was composed of cysts lined by flattened cells, dysplastic ducts and immature tubules surrounded by collars of spindle cells, primitive mesenchyme, and a few aberrantly formed glomeruli.
Adult ; Cartilage ; Humans ; Infertility ; Kidney ; Male ; Mesoderm ; Multicystic Dysplastic Kidney* ; Oligospermia ; Semen Analysis ; Seminal Vesicles* ; Ureter*

External genitalia trauma including penis and scrotum often accompanies with genitourinary trauma or occurs independently, especially in male. External genitalia trauma is an emergent and serious condition like urinary system trauma but it has been unnoticed in urologic field. The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important because it impacts the method of treatment however there has been no universe description about the classification of external genitalia trauma. The aim of this article is to summarize the methods of repairing defect in the penis and scrotum and the clinical application to the reparative treatment according to classification by its nature of injury.
Genitalia ; Humans ; Male ; Penis ; Reconstructive Surgical Procedures ; Scrotum

Adenoid basal cell tumor of the prostate is a rare tumorous lesion that can be misdiagnosed as adenocarcinoma of the prostate. The malignant potential of adenoid basal cell tumor remains uncertain due to small number of reported cases. This 66-year-old man presented with symptoms of urinary tract obstruction. Under the impression of benign prostatic hyperplasia, a transurethral resection of the prostate (TURP) was performed. The patient was alive with no evidence of recurrence or metastasis 15 months after TURP. Microscopically, most of the lesions were composed of nodular collections of small nests of basaloid cells with peripheral palisading, and clusters of tumor cells forming cribriform pattern. Multiple areas of basal cell hyperplasia and atypical basal cell hyperpalsia were also observed. The coexistence of basal cell hyperplasia, atypical basal cell hyperpalsia, and adenoid basal cell tumor with cribriform pattern in this case supports a morphologic continuum from the benign hyperplastic lesion to malignant neoplasia.
Adenocarcinoma ; Adenoids* ; Aged ; Humans ; Hyperplasia ; Neoplasm Metastasis ; Prostate* ; Prostatic Hyperplasia ; Recurrence ; Transurethral Resection of Prostate ; Urinary Tract

PURPOSE: To evaluate the change of iris-trabecular contact index (ITC index) after cataract surgery in acute angle closure glaucoma. METHODS: Twelve patients (17 eyes) who had a history of acute angle closure glaucoma underwent swept source optical coherence tomography before and after cataract surgery. Correlations between lens vault (LV), ITC index and intraocular pressure (IOP), anterior chamber depth (ACD), anterior chamber volume (ACV), and angle parameters were analyzed before and after cataract surgery. RESULTS: IOP (p = 0.007), ACD (p < 0.001), ACV (p < 0.001), angle parameters (p = 0.001), and ITC index (p = 0.012) were improved after cataract surgery. ITC index decreased from 88.42 ± 23.59% to 48.91 ± 35.13% after cataract surgery (p = 0.012). There was no correlation between LV and ACD (p = 0.075), ACV (p = 0.864), angle parameter (p = 0.112-0.707), or ITC index (p = 0.288) before cataract surgery. The correlations between ITC index and IOP (p = 0.021), ACD (p = 0.002), ACV (p < 0.001), and angle parameter (p = 0.001-0.030) were statistically significant before surgery but not statistically significant (p = 0.223/0.206/0.761/ 0.096-0.819) after surgery. CONCLUSIONS: ITC index significantly improved after cataract surgery, but part of angle closure was not resolved in some cases of acute angle closure glaucoma.
Anterior Chamber ; Cataract* ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Tomography, Optical Coherence

No abstract available.
Jaw* ; Osteoradionecrosis*

No abstract available.
Jaw* ; Osteoradionecrosis*

No abstract available.
Chronic Disease ; Glycemic Index

PURPOSE: To evaluate the efficacy of dynamic colpocystodefecography in patients with a pelvic organ prolapse. MATERIALS AND METHODS: A total of 63 patients, with or without stress urinary incontinence and pelvic organ prolapse, who visited our hospital between April 2002 and July 2003, were studied. All patients were available for physical examination and dynamic colpocystodefecography. The patient was seated on a radiolucent commode, which was upright on the end of a vertically oriented x-ray table. Deliberate efforts were made to ensure privacy. Fluoroscopic images were taken during resting, squeezing, Valsalva effort, voiding and defecation. RESULTS: On physical examination, cystocele, rectocele and rectal intussusception were revealed in 26 (36%), 20 (31%) and 7 cases (11%), respectively. On dynamic colpocystodefecography, cystocele, rectocele and rectal intussusception were revealed in 44 (69%), 32 (50%) and 15 cases (24%), respectively. Compared with the physical examination, 18 cases of cystocele, 12 of rectocele and 8 of rectal intussusception were newly found through dynamic colpocystodefecography. Enterocele and sigmoidocele were not found in the physical examination, but only found through dynamic colpocystodefecography in 4 and 5 cases, respectively. The degree of prolapse was more severe during defecation than voiding. CONCLUSIONS: Not all the pelvic organ prolapses were detected on physical examination. Radiological evaluation is necessary for a more accurate detection of a pelvic organ prolapse. Dynamic colpocystodefecography has the advantages of it's ability to be performed for physiological defecation and voiding status, as well as imaging of dynamic pelvic organ structures.
Cystocele ; Defecation ; Defecography ; Hernia ; Humans ; Intussusception ; Pelvic Organ Prolapse* ; Physical Examination ; Privacy ; Prolapse ; Rectocele ; Urinary Bladder ; Urinary Incontinence ; Vagina

It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-alpha(TNF-alpha), interleukin-1 beta(IL-1 beta) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF-alpha,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 X 3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P > 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P > 0.05, p > 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.
Abdomen ; Animals ; Anoxia ; Capillaries ; Edema ; Endothelial Cells ; Endothelium ; Hemorrhage ; Inflammation ; Interleukin-1 ; Interleukin-8* ; Ischemia ; Leukocytes ; Necrosis ; Neutrophils ; Perfusion ; Rats ; Reperfusion Injury* ; Reperfusion* ; Skin ; Thrombosis