Female urethral injury are very uncommon and encountered during traffic accident, trauma, instrumentation, operation and delivery. Treatment modalities are determined by the level of urethral injury. The result was better in the cases of rapid operative treatment than delayed one. In this report the clinical findings, patterns of injury and surgical managementof 4 cases were reviewed.
Accidents, Traffic ; Female* ; Humans

No abstract available.
Foot*

The role of the long head of biceps brachii tendon in the stahilization of the head of the humerus is a highly interesting issue in recent studies. But, it is not well understood. Congenital absence of biceps long head tendon ot the hilateral shoulder joint is very rare and on review of literatures, we could not find any case reported. We experienced one case which was confirmed by magnetic resonance imaging and arthroscopic examination of the shoulder, and report it with review of literatures.
Head* ; Humerus ; Magnetic Resonance Imaging ; Shoulder Joint* ; Shoulder* ; Tendons*

As upper-gastrointestinal endoscopy has been more widely used for the diagnosis and treatment of upper gastrointestinal diseases, some complications such as bleeding, perforation, arrhythmia, aspiration pneumonia, infection, and drug reaction of premedication were reported. Also a few case of salivary gland swelling complicated by endoscopy was described, but the precise mechanism of this benign complication is not well-known. The hypothesized mechanisms for salivary gland swelling are 1) air distension of blind branchial cleft remmants, 2) compression of its duct between the mylohyoid and hyoglossus muscles from pressure above, during a time of increased salivary flow from oral stimulation, 3) forward and downward dislocation of gland by the force that occurs when endoscope pushes the tongue, and 4) reaction to topical anesthesia less likely. Here we report 5 cases of salivary galnd swelling with a review of the literature, explaining possible mechanism of each case.
Anesthesia ; Arrhythmias, Cardiac ; Branchial Region ; Diagnosis ; Dislocations ; Endoscopes ; Endoscopy* ; Gastrointestinal Diseases ; Hemorrhage ; Muscles ; Pneumonia, Aspiration ; Premedication ; Salivary Glands* ; Tongue

No abstract available.
Animals ; Rats* ; Urinary Bladder*

Synchronous neoplams are uncommon condition but the incidence is now being increased. The situation is rare when these tumors comes from different origin. We experienced the case with synchronous sigmoid colon cancer and anal squamous cell carcinoma with rectal mucosal metastasis. The patient was 61 years old male. He complained of intermittent hematochezia since 3~4 months ago. The patient underwent anterior resection for colon cancer and wide excision for anal squamous cell carcinoma. After surgical operation, postoperative adjuvant chemotherapy (5-FU + Leucovorin) and radiotherapy were done. In this case, we could preserve the anal sphincter using combined therapy. We think that this type of management may be useful treatment in patients with colon cancer and anal squamous cell cancer simultaneously.
Adenocarcinoma* ; Anal Canal ; Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Colon, Sigmoid* ; Colonic Neoplasms ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Metastasis* ; Neoplasms, Squamous Cell ; Radiotherapy ; Sigmoid Neoplasms

We reviewed the 43 medical records of patients with cellulitis or erysipelas who had been admitted at the depar1ment of dermatology of Seoul National University Hospital and followed them up for mean 21.6 months. The results were as follows. 1. The sex ratio of patients with cellulitis was 1:1.4 and the average age was 49 years. 2. The lower extremity as the most frequently invloved site of cellulitis with the frequency of 58.1% (25 cases), with the head and neck being involved in 16 cases(37.2%) and trunk and upper extremity in 1 case each(2.3% ). 3. The portals of infecticin were suspected in 33 cases(76% ), where tinea pedis was detect,ed in 18 cases(41.9%), previous skin infeection 10 cases(23.3%) and trauma in 9 cases(20.9%). 4. Initial systemic symptoms were fever(76.7%), chill(65.1%) and headache(37.2%). Erythema(100%), local heating(90,7%), tenderness(88.4%), swelling(86.0%), ulcer(16.3%), bulla(14.0%), lymphangitis(9.2%) and lymphadenit,is(9.2%) were found in the skin lesions. 5. The laboratory findings revealed leukocytosis in 35.7%, elevaed ESR in 86.8% positive 6. ASO titer in 63.0% and positive CRP in 80%, Microorganism. were detected in only 1 of 15 blood cultures, in 2 of 4 bulla fluid cultures and in 7 of 9 bus cultures. There was no growth of causative microorganisms in 3 tissue cultures and 9 saline needle aspiration cultures. Penicillin was used as primary antibiotics in 19 cases, which changed to another antibiotics due to lack of improvement in 3 cases and cefazolin was used in 21 cases, which changed in 2 cases due to the same reason. 7. Average admission priod was 11 days(range from 3 to 20 days) and 30.2% of patients wit.h cellulitis experienced recurrence, but 48% on low extrernity in contrast with 6.7% on head and neck.
Anti-Bacterial Agents ; Cefazolin ; Cellulitis* ; Dermatology ; Erysipelas ; Head ; Humans ; Leukocytosis ; Lower Extremity ; Medical Records ; Neck ; Needles ; Penicillins ; Recurrence ; Seoul ; Sex Ratio ; Skin ; Tinea Pedis ; Upper Extremity

BACKGROUND: Kerationcytes make up the vast majority of cells within the epidermis. Recent attention has focused on the role keratinocytes may play in the induction of T cell mediated inflammatory responses in skin, particularily because keratinocytes, when activated by immunologic stimuli, express MHC class llAg and secrete cytokines. But in experimentally induced lichenoid tissue reaction by interferon-nu, MHC class ll Ag was not essential for the enhanced T cell trafficking. There is growing evidence that keratinocyte intercellular adhesion molecule-1 (ICAM-1) expression is involved in the epidermal trafficking of T lymphocytes. OBJECT: To investigate the kinetics of expression of the HLA-DR and ICAM-1 on cultured human keratinocytes by recombinant-interferon-nu(IFN) and phorbol myristate acetate(PMA), and the influence of the HLA-DR and ICAM-1 and the stimulation of peripheral blood mononuclear leukocytes(PBML). RESULTS: 1. 1 U/ml of IFN can induce HLA-DR and ICAM-1 on keratinocytes. Expression of both antigens were increased in a dose and exporsure time dependent fashion. But expression of HLA-DR was less sensitive to IFN than ICAM-1 2. ICAM-1 induction was more rapid than HLA-DR. Keratinocytes expressed HLA-DR 6hours after IFN treatment amd increased rapidly after 12 hours. 3. HLA-DR positive keratinocytes were decreased more rapidly that ICAM-1 positive kerationcytes. 4. Proliferations of PBML were slightly inhibited when cultured with keratinocytes which were treated or not treated with IFN. But IFN treated keratinocytes stimulated the PBML more than untreated keratinocytes. Proliferaton of PBML by IFN treated keratinocytes were inhibited by anti-ICAM monoclonal antibody 5. PMA treated keratinocytes stimulated the PBML more than untreated keratinocytes. Proliferation of PBML by PMA treated keratinocytes was inhibited by anti-ICAM monoclonal antibodies and anti-LFA-1 monoclonal antibodies. CONCLUSION: These results suggest that keratinocytes can express not only HLA-DR but also ICAMP1 may play a important role in initiating immunologic response. Complete clarification of the function of HLA-DR and ICAM-1 positive keratinocytes requires furthe5r study
Antibodies, Monoclonal ; Cytokines ; Epidermis ; HLA-DR Antigens* ; Humans* ; Intercellular Adhesion Molecule-1* ; Keratinocytes* ; Kinetics* ; Myristic Acid ; Skin ; T-Lymphocytes

BACKGROUND: Complete clearance of the lesions by using calcipotriol alone have not been re-ported commonly in the treatment of psoriatic patients. Moreover, lesional and perilesional irritation are reported in some patients using calcipotriol, which may result in premature termination of the treatment due to impairing the compliance. OBJECTIVE: A clinical study was conducted to determine whether, in the topical treatment of psoriasis, a combination of calcipotriol cream and methylprednisolone aceponate was more effective than calcipotriol monotherapy. METHODS: Twenty-one psoriasis patients who had the symmetric lesions on the right and left lower legs were enrolled in the study. A combination of calcipotriol cream and methylprednisolone aceponate therapy was done on the left lower legs, whereas calcipotriol alone was applied on the right lower legs twice daily. PASI score and adverse events were recorded at each visit (1, 2, 3, 4, 6 week). The overall therapeutic result was also assessed by the physician and patients. RESULTS: The initial PASI score was 7.09 on both legs. After 6 weeks, the mean PASI score was 3.85 on the left leg, and 5.70 on the right leg (p<0.05). In the physicianOs global assessment, the percentage of patients who showed the improvement of more than half of lesions was 29% in the monotherapy and 62% in the combination therapy area. Two patients complained of mild itching sense on monotherapy, but there was no specific side effect on combination area. CONCLUSION: The combination therapy was more effective, as assessed by all evaluated variables. Furthermore, this combination reduces the adverse effects caused by long-term use of topical corticosterois as well as the irritation associated with. calcipotriol.
Compliance ; Humans ; Leg ; Methylprednisolone* ; Pruritus ; Psoriasis*

Ulcerative colitis is a chronic, inflammatory disease of colon which is rare in Korea. In the course of ulcerative colitis numerous extraintestinal complication may develop on the joints, skin, liver, kidney, vessel, oral cavity and eyes. The most common ocular lesions complicated in patients with ulcerative colitis are episcleritis and iritis. And the cases of retinal vascular disease in associated with ulcerative colitis are extremely rare. We experienced nonischemic central retinal vein occlusion complicated in a patient with ulcerative colitis, who is 32-year-old male and complained decreased visual acuity and metamorphosis.
Adult ; Colitis, Ulcerative ; Colon ; Humans ; Iritis ; Joints ; Kidney ; Korea ; Liver ; Male ; Mouth ; Retinal Vein* ; Retinaldehyde ; Scleritis ; Skin ; Ulcer* ; Vascular Diseases ; Visual Acuity