No abstract available.
Salivary Ducts*

Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

No abstract available.
Eating* ; Liver* ; Pneumonia* ; Sharks*

No abstract available.
Arnold-Chiari Malformation* ; Meningomyelocele*

INTRODUCTION: Premature ejaculation is the most prevalent form of male sexual dysfunction, but its cause has not been well established. Recently some studies indicated that penile sensitivity is decreased in men with premature ejaculation. MATERIALS AND METHODS: To clarify the association between penile sensitivity and premature ejaculation, we evaluated penile sensitivity in 18 patients with premature ejaculation without erectile dysfunction and neurologic deficit, and 15 normal potent male volunteers by SMV-5 digital vibrometer (Teknologue, Tokyo, Japan), which has higher precision and reproducibility than analogue type biothesiometers. Vibration thresholds were recorded at the glans penis, penile shaft, and frenulum of the penis in flaccid and erectile state induced by PGE1 10 ug. We also recorded those at ulnar process and medial maleolus of the tibia. RESULTS: There was no difference in vibration threshold at the ulnar process and the medial maleolus of the tibia between the two groups (p>0.05). And we found no difference in penile sensitivity at the glans penis, penile shaft, frenulum of the penis between the two groups, in both erectile and flaccid states (p>0.05). Penile sensitivity was decreased in erectile state compared to flaccid state, but it is not statistically significant (p>0.05). CONCLUSION: Based on our results, penile hypersensitivity measured by SMV-5 vibrometer does not appear to be a major factor contributing to premature ejaculation. And further study aimed at other somatic or cognitive factors awaits implementation.
Alprostadil ; Erectile Dysfunction ; Humans ; Hypersensitivity ; Male ; Neurologic Manifestations ; Penis ; Premature Ejaculation* ; Tibia ; Vibration ; Volunteers

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

No abstract available.
Stents*

Neuroimmunology is a rapidly expanding field in the medicine and there has been great advancement in the understanding of the pathogenesis of autoimmune diseases during the past decade. In neurology, immune mechanism has been implicated in the pathogenesis of more than twenty neurological diseases. The understanding of the immunological mechanism of these diseases has helped clinicians in management of these diseases. In many neurological diseases with immunological deterioration, multiple sclerosis and Guillain-Barre syndrome are relatively common diseases that share common features like demyelination. But multiple sclerosis is a disease of central nervous system and Guillain-Barre syndrome is a syndrome developed in peripheral nervous system. This review will describe the recent advances in clinical immunology with regard to general aspects of autoimmune diseases of neurological system, pathogenesis of two common autoimmune diseases, multiple sclerosis and Guillain-Barre syndrome.
Allergy and Immunology ; Autoimmune Diseases ; Central Nervous System ; Demyelinating Diseases ; Guillain-Barre Syndrome* ; Multiple Sclerosis* ; Neurology ; Peripheral Nervous System

No abstract available.
Sterilization, Tubal*

Recently chronic angiopathy of diabetes mellitus has become serious complication of diabetes mellitus. Chronic angiopathic complication of diabetes mellitus is divided into macrovascular disease and microvascular disease. Macrovascular disease includes coronary arterial disease, cerebrovascular disease, foot lesion and microvascular disease includes diabetic retinopathy, nephropathy and neuropathy. It is well known that microvascular disease'is relatively unique in diabetic patients and macrovascular disease is frequently found in non diabetic patients, although prevalence rate is still high in diabetic patients. This finding supports the view that microvascular disease and macrovascular disease have different pathogenesis. The authors evaluated and invested the 180 patients with diabetes mellitus who have taken neurologic examination and NCV studies f rom January 1, 1990 to September 30, 1992. The results were as followed: 1.There is a significant tendency that diabetic patients with neuropathy are accompanied by other microangiopathy (retinopathy or nephropathy) than diabetic patients without neuropathy. 2.Between diabetic patients with peripheral neuropathy and without peripheral neuropathy, there is no difference in the prevalence of macroangiopathy.
Diabetes Complications* ; Diabetes Mellitus ; Diabetic Neuropathies* ; Diabetic Retinopathy ; Foot Diseases ; Humans ; Neurologic Examination ; Peripheral Nervous System Diseases ; Prevalence