A retrospective study was made of 10 consecutive patients who underwent mandibular reconstruction with PCBM from December 1994 to July 1996. Free autogenous iliac bone in the from of particulate cancellous bone and marrow was densely packed into the crib that was adapted to bridge the mandibular discontinuity defect. Frozen-treated autogenous mandibular bone, splitted autogenous rib, and titanium mesh(Dumbach, Leibinger) were used as cribs carrying the PCBM. All ten cases underwent successful healing with the formation of a continuous bony union with the remaining mandible. The rate of resorption was assessed by sequential panoramic radiographs. The mean horizontal dimension of the madibular defects was 44mm and the mean vertical dimension of the reconstructed segments was 23mm. The bony height of the reconstructed segments retained about 90% of the bony height of over a 1-year period. We confirmed that PCBM grafts were the most successful and predictable grafts in mandibular discontinuity reconstruction.
Bone Marrow* ; Humans ; Infant Equipment ; Mandible ; Mandibular Reconstruction* ; Retrospective Studies ; Ribs ; Titanium ; Transplants ; Vertical Dimension

No abstract available.
Aneurysm*

PURPOSE: To evaluate the usefulness and effectiveness of transurethral coagulation and incision of the ejaculatory duct for hematospermia caused by ejaculatory duct cyst and obstruction. MATERIALS AND METHODS: Twenty-six patients with hematospermia were enrolled. Ejaculatory duct cyst or obstruction was diagnosed by transrectal ultrasound or MRI, revealing seminal vesicle hypertrophy and cystic dilated ejaculatory ducts. One patient had hematospermia associated with infertility. The mean age of the patients and their duration of symptoms were 42.7 years (range, 25-67 years) and 16 months (range, 1-60 months), respectively. All patients underwent transurethral management for treatment of their ejaculatory duct obstruction in the form of incision and coagulation of the ejaculatory duct. We used a 9.5 Fr rigid ureteroscope (Stortz(R), Germany) and a Bugbee electrode. Patients were followed for more than 3 months after the procedure. RESULTS: All patients reported improvement of hematospermia and disappearance of midline cysts, except for one patient. The one case, ureteroscope failed to pass through verumontanum. A ejaculatory duct cyst was found in 18 cases. Calculi were present in the seminal vesicle and ejaculatory ducts in 7 patients and were removed with endoscopic instruments. One infertile patient regained reproductive ability after the procedure. Postoperative complications, such as epididymitis, orchitis, or retrograde ejaculation were not observed. CONCLUSIONS: Transurethral incision and coagulation was a safe and effective treatment option for hematospermia caused by ejaculatory duct obstruction and is considered to be a successful treatment option for infertility secondary to ejaculatory duct obstruction.
Calculi ; Ejaculation ; Ejaculatory Ducts ; Electrodes ; Endoscopy ; Epididymitis ; Hemospermia ; Humans ; Hypertrophy ; Infertility ; Male ; Orchitis ; Postoperative Complications ; Seminal Vesicles ; Ureteroscopes

We have cloned a alpha-COP homolog, ancop, from Aspergillus nidulans by colony hybridization of chromosome specific library using alpha-COP homologous fragment as a probe. The probe DNA was amplified with degenerated primers designed by comparison of conserved region of the amino acid sequences of Saccharomyces cerevisiae alpha-COP, Homo sapiens HEP-COP, and Drosophila melanogaster alpha-COP. Full length cDNA clone was also amplified by RT-PCR. Comparison of genomic DNA sequence with cDNA sequence obtained by RT-PCR revealed 7 introns. Amino acid sequence similarity search of the anCop with other alpha-COPs gave an overall identity of 52% with S. cerevisiae, 47% with human and bovine, 45% with Drosophila and Arabidopsis . In upstream region from the transcription start site, a putative TATA and CAAT motif were also identified.
Amino Acid Sequence ; Arabidopsis ; Aspergillus nidulans* ; Aspergillus* ; Base Sequence ; Clone Cells ; Coatomer Protein* ; DNA ; DNA, Complementary ; Drosophila ; Drosophila melanogaster ; Humans ; Introns ; Saccharomyces cerevisiae ; Sequence Homology ; Transcription Initiation Site

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Mortality*

The simultaneous occurrence of a renal cell carcinoma and a urothelial carcinoma in the same kidney is uncommon. Here we report the case of a 79-year-old woman with ipsilateral synchronous renal cell carcinoma and urothelial carcinoma. She was referred to our hospital for gross hematuria and right flank pain. A computed tomography scan showed a 15x20 mm enhanced lesion on the upper calyx and a 12x15 mm mass on the lateral aspect of the right kidney. We thus suspected a renal pelvis tumor and performed right hand assisted laparoscopic nephroureterectomy with bladder cuff excision (HALSNU). Gross findings were multiple, pale yellowish papillary masses on the upper and lower major calices, of which the largest one measured 16x20 mm. A separated solid mass measuring 12x16 mm was also noted on the anterior midportion of the kidney. The former was a urothelial carcinoma and the latter was a chromophobe renal cell carcinoma. We present a rare case of a chromophobe renal cell carcinoma and a urothelial carcinoma in the same kidney.
Aged ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Hand ; Hematuria ; Humans ; Kidney ; Kidney Pelvis ; Urinary Bladder

PURPOSE:Carotid endarterectomy may benefit patients with bilateral carotid stenosis by improving cerebrovascular hemodynamics of ipsilateral as well as contralateral cerebral hemispheres. We investigated cerebrovascular hemodynamics after carotid endarterectomy in patients with contralateral carotid occlusion by acetazolamide stress brain SPECT. MATERIALS AND METHODS: Subjects were 14 symptomatic patients (all men, mean age 66 yrs) with carotid stenosis (> 50%) with contralateral carotid occlusion. Acetazolamide stress Tc-99m ECD brain SPECTs were performed within 2 weeks before and after carotid endarterectomy using one day protocol. Cerebral blood flow (CBF) and cerebrovascular reserve (CVR) were assessed visually. In 12 patients, correlation between the patency of proximal anterior cerebral or anterior communicating arteries (A1/A-comm) and the improvement of CBF or CVR after endarterectomy was assessed. RESULTS: Preoperative SPECT showed reduced CBF in 2 ipsilateral and 10 contralateral hemispheres. CVR was reduced in 4 ipsilateral and 9 contralateral hemispheres. Of 12 hemispheres with reduced CBF, 2 hemispheres (16.7%) showed improvement of CBF after endarterectomy. However, reduced CVR was improved in all 4 ipsilateral and 7 of 9 (78%) of contralateral hemispheres after endarterectomy. Three of 4 with stenotic A1/A-comm and 4 of 8 with patent A1/A-comm had reduced contralateral CVR. Reduced contralateral CVR improved in all 3 patients with stenotic A1/A-comm and 3 of 4 with patent A1/A-comm. CONCLUSION: Acetazolamide stress brain SPECT demonstrated improvement of compromised cerebrovascular reserve in not only ipsilateral but also contralateral hemispheres of patients with contralateral carotid occlusion after carotid endarterectomy, and may, therefore, be useful for evaluating cerebral blood flow and cerebrovascular reserve after carotid endarterectomy.
Acetazolamide* ; Arteries ; Brain Ischemia ; Brain* ; Carotid Stenosis* ; Cerebrum ; Endarterectomy ; Endarterectomy, Carotid* ; Hemodynamics ; Humans ; Male ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: A 10-year retrospective lumboperitoneal(LP) shunt surgery was reviewed in order to verify the several prognostic factors including the etiology, the findings of brain computed tomography(CT) and/or magnetic resonance imaging(MRI), and the effect of lumbar drainage which have been implicated in the result of LP shunt. PATIENTS AND MEHTODS: A series of 32 patients who underwent LP shunt surgery between March 1988 and May 1998 for the management of communicating hydrocephalus was reviewed. RESULTS: The etiology of communicating hydrocephalus was subarachnoid hemorrhage(SAH) in 19 cases(59.4%), head trauma in 10 cases(31.2%), intracerebral hemorrhage in 2 cases(6.3%), meningitis in 1 case(3.1%), tumor in 1 case(3.1%), and idiopathic in 2 cases(6.3%). The mean follow-up period was 1.2 years(range, 2 week to 8.5 year). Among them, twenty four patients(75%) were clinically improved after shunt operation. The result of LP shunt was not related to the etiologies and many findings of brain CT/MRI such as ventricular index, Evan's index, periventricular low density, obliteration of cerebral sulci and cortical atrophy. However, the result of LP shunt was significantly related to the effect of preoperative lumbar drainage(p=0.0184). CONCLUSION: This result suggests that the effect of preoperative lumbar drainage has a significant role in predicting the result of LP shunt in patients with communicating hydrocephalus.
Atrophy ; Brain ; Cerebral Hemorrhage ; Craniocerebral Trauma ; Drainage ; Follow-Up Studies ; Humans ; Hydrocephalus* ; Meningitis ; Retrospective Studies

No abstract available.
Choriocarcinoma* ; Female ; Lung Neoplasms* ; Lung* ; Pregnancy

Angiokeratoma of the vulva is a relatively rare, benign condition that usually presents as single or a few isolated papules mainly on the labia majora. It is histologically identical to angiokeratoma of the scrotum. A 50-year-old woman presented with a one year history of nonpruritic lesions on the vulva. Her skin lesions used to bleed vith subtle trauma. Several dark purplish papules, ranging in diameter from 3 to 5mm, were noticed on both labia majora. A biopsy confirmed the diagnosis of angiokeratoma. A simple electrodesiccation of all lesions was performed under local anesthesia. The patient has remained asymptomatic nd without recurrence for the follow-up period of 10 months without any recurrence.
Anesthesia, Local ; Angiokeratoma* ; Biopsy ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Recurrence ; Scrotum ; Skin ; Vulva*