No abstract available.
Aneurysm* ; Renal Artery*

It has been known that the hypothermia have protective effect on neuronal survival after ischemic damage. We performed this study to evaluate the effect of the small changes in postischemic body temperature on the histopathological change of hippocampus in the transient global cerebral ischemia model. Mongolian gerbils were subjected to this study. Nine animal subgroups were investigated, including naive gerbils who underwent sham operation or carotid artery occlusion with postischemic rectal temperature maintained at 32.5, 34.5, 36.5 and 38.5C respectively. Carotid occlusion was maintained for 10 minutes and then reperfusion started. During ischemia, body temperature was maintained 36.5degrees C in all animals. For one hour after ischemia, body temperature was maintained constant at 36.5degrees C in the normothermia group, 38.5 degrees C in the hyperthemia group, 34.5 degrees C in mild hypothermia group, and 32.5 degrees C in moderate hypothermia group respectively. Seven days after the operation, the surviving animals were decapitated and perfusion fixated. After preparing coronal brain slices, viable neurons in hippocampal region were counted using cresyl violet staining. There were significant differences in the hippocampal neuronal survival in normothermia and hyperthermia groups compared with shamoperated group(P<0,01), and neuronal damages in mild and moderate hyperthemia groups were not significantly different from sham operated. Survival rate at postischemic 7th day was also significantly lower in hyperthermia group. We could confirm the protective effect of hypothermia on ischemic neuronal damage by histopathological study. Also hyperthemia was observed to aggravate neuronal death, Careful control of body temperature might have clinical effect in ischemic stroke.
Animals* ; Body Temperature ; Brain ; Brain Ischemia ; Carotid Arteries ; Fever ; Gerbillinae ; Hippocampus ; Hypothermia ; Ischemia* ; Models, Animal* ; Neurons* ; Perfusion ; Reperfusion ; Stroke ; Survival Rate ; Viola

Because nonspecific colonic ulcer is an unusual condition and varies markedly in clinical presentation and course, preoperative clinical diagnosis of nonspecific colonic ulcer is very difficult, But now, preoperative clinical diagnosis can he made by advent of colonofiberscopy. And, it is very important to diagnose this disease early, because late diagnosis make a poor prognosis. We report a case of nonspecific colonic ulcer diagnosed by repeated colonofiberscopy and treated with surgery.
Colon* ; Delayed Diagnosis ; Diagnosis ; Prognosis ; Ulcer*

Several cases of ruptured pregnant uterine horn have been documented. However, there have been few reported cases of ectopic tubal pregnancy in a unicornuate with rudimentary horn. So we report this case with a brief review literature.
Animals ; Female ; Horns* ; Pregnancy ; Pregnancy, Tubal* ; Uterus*

BACKGROUND: Vascular endothelial growth factor (VEGF) is an angiogenic peptide that enhances microvascular perfusion. Recently, VEGF is known to have neurotrophic effect and rescues neurons from cell death induced by serum deprivation. To investigate the serial changes in VEGF expression and neuroprotective properties of VEGF during acute ischemia. METHODS: Human cortical-neuroblastoma hybrid cell line (A1G11), human neuroglioma cell line (H4), and human vascular endothelial cell line (ECV304) were placed in the glucose/serum free media and incubated in the hypoxic chamber (94% N2/5% CO2/1% room air) at 37 degrees C. Cell viability was determined by MTT assay. Western blot analysis was performed to detect VEGF and its receptor (VEGFR) expression. To test the protective effect of VEGF, human recombinant VEGF165 was used. RESULTS: Morphological changes and the decrease of cell viability were observed following 6 hr ischemia. In A1G11 cells, VEGF expression was not noted until 3 hr ischemia, but was induced after 6hr and continued to 12 hr and then diminished. In H4 and ECV304, the change of VEGF expression was not observed. VEGFR-2/Flk-1 expression was induced from 6 hr (peak level) to 12 hr in A1G11, and induced after 3 hr and continued to 12hr in ECV304. Administration of VEGF increased cell viability in A1G11 cells at 6 hr, 12 hr and 18 hr ischemia (p=0.009, p=0.01 p=0.013), but not in H4 or ECV304 cells ( p>0.05). CONCLUSION: Ischemia induces VEGF production in neurons and VEGF may exert a direct neuron-specific protective effect through VEGFR-2/Flk receptors during the acute phase of ischemic neuronal injury.
Blotting, Western ; Cell Death ; Cell Line ; Cell Survival ; Endothelial Cells ; Humans ; Hybrid Cells ; Ischemia* ; Neurons ; Perfusion ; Vascular Endothelial Growth Factor A*

PURPOSE: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. METHODS: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. RESULTS: The mean age of the patients was 4.8+/-3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8+/-2.1, 3.0+/-1.9, 3.4+/-1.9, and 2.4+/-2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8+/-2.2 and 4.0+/-2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5+/-5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. CONCLUSION: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.
Abdominal Pain ; Appendicitis ; Ascites ; Child ; Child, Preschool ; Diarrhea ; Fever ; Gastroenteritis ; Humans ; Inflammatory Bowel Diseases ; Medical Records ; Mesenteric Lymphadenitis ; Retrospective Studies ; Vomiting

A rat model of focal cerebral ischelma has been established by mhe tecbnique of elecvrocamtery for me middle oerebral artery occlusion (MCAO). We investigated mhe effect of naloxone pretreatment on the size of infarction and the regional cerebral blood flow (rCBF) Another purpose of this study was to determine the effecbve dose (high-or lowdose) in focal cerebral ischemia. The rats were given Img/Kg I.v. (low-dose), 4mg/Kg I.v. (high-dose) of naloxone 30 min before MCAO and infused continuously with 0.5mg/Kg/hr (low dose) or 2mg/Kg/hr (high-dose) over next I hour by am infusion pump. The control group was given normal salin of the same amount by the same method. Dunng the peDod of saline amd naloxone infusion, mean arterial blood pressure was monitored. Arterial blood gas analysis and blood glucose measuremert were performed just after MCAO. The rectal temperature of rat was maintained within 37)0.5C by a heating lamp. Twenty-fow hours after MCAO, eight 2mm-thick coronal sections of one rat brain were stained by TTC solution and the size of infarction was described as the percentage of ipsilateral hemisphere. The rCBFs were measured by an autoradiography using 14C-iodoantipyrine and the chamges of rCBFs were analyzed by three methods of (1) rCBF ratio, (2) 1 mm-serial rCBF measurement of cerebral cortex, and (3) areas of rCBF below critical values(<25, 25-50, <50ml/100g/min). The results were as follows; 1. There was no significamt chamge of blood pressure during the infusion of saline. Iow-dose and high-dose naloxones 2. Arterial blood gas amalysis amd blood glucose measurement showed that there were no significant differences of pH, PC02, PO2 and blood glucose between saline and low dose and high-dose naloxone groups 3. High-dose naloxone pretreatment reduced significantly the size of infarction(p<0.05 vs saline-treated group by Mann-Whitney U test). 4. High-dose naloxone pretreatment improved significantly the rCBF ratios of caudate head and CA 3 area (p<0.05 vs. saline-treated group by Mann-Whitney U test) There was no significant improvement of rCBF ratios in the low-dose naloxone treated group. 5. One-mm serial rCBF measurement of cerebral cortex indicated that while low-dose naloxone group showed no improvement of rCBF of cerebral cortex, high-dose nalox one pretreatment produced an improvement of rCBF in penumbra and its neighboring area 6. The area below 25ml/100g/min or rCBF was reduced significantly by high-dose naloxone pretreatment(high-dose naloxone group: 15.0+4.1mm2, saline group:23.3)5.3 mm2, p <0.05). In summary these results indicate that high-dose naloxone pretreatment reduced the size of infarction and improved the rCBFs in the focal cerebral ischemia of rats.
Animals ; Arterial Pressure ; Arteries ; Autoradiography ; Blood Gas Analysis ; Blood Glucose ; Blood Pressure ; Brain ; Brain Ischemia* ; Cerebral Cortex ; Head ; Heating ; Hot Temperature ; Hydrogen-Ion Concentration ; Infarction* ; Infusion Pumps ; Models, Animal ; Naloxone* ; Rats*

A 41-year-old heterosexual African man was evaluated for persistent urethral discharge, pneumaturia and watery diarrhea. Radiographic and endoscopic procedures established the diagnosis of a rectourethral fistula. The differential diagnosis of an acquired rectourethral fistula and the significance of AIDS are discussed.
Acquired Immunodeficiency Syndrome/*complications ; Adult ; Case Report ; Diverticulum/*complications/diagnosis ; Human ; Male ; Rectal Fistula/*complications/diagnosis ; Urethral Diseases/*complications/diagnosis

PURPOSE: Reported incidence of urinary incontinence after a radical prostatectomy (RP) varies between studies. This may be due not only to the definition of incontinence applied, but also how the information is acquired. We investigated the differences in perception of post robot-assisted laparoscopic RP (RALP) urinary incontinence acquired through doctor interviews and patient-reported questionnaires. MATERIALS AND METHODS: Of 238 consecutive men who underwent RALP by a single surgeon between July 2005 and February 2008, we evaluated 66 men using the International Consultation on Incontinence Questionnaire (ICIQ) at various time points after surgery. Each patient's ICIQ results were considered to be the patient's perceptions of urinary incontinence. The physician at the same time directly interviewed the patients about the number of pads used and considered complete continence to be equivalent to the use of no pads or safety liners. RESULTS: Of the 66 patients, the physician reported that 34 (51.5%) had obtained complete continence. However, analysis of the questionnaires of these 34 patients revealed that only 5 (14.7%) patients reported that they never leaked during the past 4 weeks. Most patients (11 patients, 32.4%) who did not use any pad did in fact reported leakage of a small or moderate amount of urine about once a day. CONCLUSION: Our results indicate that there are discrepancies in the perception of urinary incontinence between doctor and patient after RALP. Non-use of pads is not equivalent to obtaining complete urinary continence. Therefore, the number of pads used is not a good measure to determine the status of complete urinary continence.
Aged ; Aged, 80 and over ; Biopsy ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Perception ; Physician-Patient Relations ; Prostatectomy/*adverse effects/methods ; Questionnaires ; Robotics ; Treatment Outcome ; Urinary Incontinence/*etiology

Metanephric adenoma is rare renal adenoma. In some cases, it is difficult to distinguish from other renal neoplasms such as Wilms' tumor or renal cell carcinoma on the basis of clinical and histologic findings. A unique case of metanephric adenoma of left kidney is reported in 35-year-old foreign woman presenting with intermittent left flank pain for 3 months. Computed tomography revealed a heterogeneous enhanced mass, 7.5x 6.8cm in diameter, at the lower pole of the left kidney. Laparoscopic radical nephrectomy was performed under the clinical impression of hypovascular renal cell carcinoma or oncocytoma. The resected mass, measuring 8x7cm, was well circumscribed and its cut surface was tan-pink. Microscopically, the tumor cells had small scant cytoplasms, containing round and uniform nuclei. There was no mitosis or cellular atypia indicating a malignant transformation. The histological diagnosis was metanephric adenoma. The patient was healthy without recurrence or metastasis 6 months after surgery.
Adenoma* ; Adenoma, Oxyphilic ; Adult ; Carcinoma, Renal Cell ; Cytoplasm ; Diagnosis ; Female ; Flank Pain ; Humans ; Kidney ; Kidney Neoplasms ; Laparoscopy ; Mitosis ; Neoplasm Metastasis ; Nephrectomy* ; Recurrence ; Wilms Tumor