No abstract available.

PURPOSE: To evaluated the effectiveness of abdominal ultrasonography as the initial diagnostic method in blunt renal trauma. MATERIALS AND METHODS: This study was undertaken to compare computerized tomography with abdominal ultrasonography in radiographic staging of blunt renal trauma(Renal Injury scale grade I-V by Moor) except vascular injury. During 3-years period(May 1994 to March 1997), emergency computerized tomography was performed in 66 patients with blunt renal trauma, simultaneously 34 patients among 66 patient were scanned by abdominal ultrasonography. RESULTS: Gross hematuria were present 48% of renal trauma cases. The degree of hematuria showed not correlation with the severity of renal injury(p-value=0.213, by Chi-square test). In diagnostic agreement of abdominal ultrasonography compared to computerized tomography, the diagnostic agreement of minor renal injury(x=0.544, by k2 statistics) was higher than that of major renal injury(r=0.375, by k2 statistics). The overall diagnostic agreement of abdominal ultrasonography in detecting adjacent organ injury was 0.321 (k value). CONCLUSIONS: In ultrasonography imaging, we concluded that minor blunt rectal trauma is not necessary other radiologic evaluation, but major blunt renal trauma should be evaluated by computerized tomography for proper diagnosis of combined injury and diagnostic staging of renal trauma. Renal trauma associated Intraabdominal injury should undergo with ultrasonography-guided paracentesis. Based under result of our study, we suggest the use of abdominal ultrasonography as the initial diagnostic method in blunt renal trauma compatible for prompt diagnosis and treatment.
Diagnosis ; Emergencies ; Hematuria ; Humans ; Paracentesis ; Ultrasonography* ; Vascular System Injuries

Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

No abstract available.

PURPOSE: The aim of this work was to evaluate nuclear histone acetylation level and total histone acetyltransferase (HAT) and deacetylase (HDAC) activity in ejaculated sperm and their relevance to conventional sperm parameters. MATERIALS AND METHODS: Thirty-three normozoospermic men were included in this study. Semen samples were processed by swim-up and then immunostained by six acetylation antibodies (H3K9ac, H3K14ac, H4K5ac, H4K8ac, H4K12ac, and H4K16ac). Our preliminary study verified the expression of HAT/HDAC1 in mature human sperm. From vitrified-warmed sperm samples, total HAT/HDAC activity was measured by commercially available kits. Nuclear DNA integrity was also measured by TUNEL assay. RESULTS: The levels of six acetylation marks were not related with conventional sperm parameters including sperm DNA fragmentation index (DFI) as well as HAT/HDAC activity. However, sperm DFI was positively correlated with HAT activity (r=0.038 after adjustment, p<0.02). HAT activity showed a negative relationship with HDAC activity (r=-0.51, p<0.01). Strict morphology was negatively correlated with acetylation enzyme index (=HAT activity/HDAC activity) (r=-0.53, p<0.01). CONCLUSION: Our works demonstrated a significant relationship of acetylation-associated enzyme activity and strict morphology or sperm DFI.
Acetylation ; Adult ; DNA Fragmentation ; Epigenesis, Genetic ; Histone Acetyltransferases/*metabolism ; Histones/*metabolism ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Protein Processing, Post-Translational ; Semen Analysis ; Spermatozoa/*metabolism

BACKGROUND: The purpose of this study was to describe a pure lower motor neuron disease in adults that is isolated to the upper limbs over time and to emphasize a differential diagnosis from other motor neuron diseases or motor neuropathies. METHODS: We reviewed retrospectively five male patients who had a bilateral upper limb weakness without any sensory changes confirmed by clinical and electrophysiological examinations at least 2 years after onset. RESULTS: Initially weakness remained largely confined to the arms. It then progressed slowly during the follow-up periods ranging from about 5 to 7 years since onset. However, weakness and muscle atrophy spared the lower limbs, respiratory and bulbar musculatures. The patients did not develop any bulbar dysfunctions or pyramidal tract signs. They were still able to ambulate at the end of follow-up. CONCLUSIONS: Brachial amyotrophic diplegia presenting with severe weakness that is completely confined to the upper limbs over time, without upper motor neuron signs, might be a stable and relatively benign variant of motor neuron disease. It should be differentiated from other motor neuropathies.
Adult ; Amyotrophic Lateral Sclerosis ; Arm ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Motor Neuron Disease ; Motor Neurons ; Muscular Atrophy ; Pyramidal Tracts ; Retrospective Studies ; Upper Extremity

PURPOSE: The goal of cystometry is the reproduction of the patient's clinical status to improve diagnosis and therapy. However practitioner should know that various factors such as temperature and speed of saline infusion can change the cystometry finding. The ice water test(IWT) is known as a simple method that it discriminate between upper and lower motor neuron lesion. The aim of this study is to clarify the relationship of factors occurred during cystometry and the usefulness of IWT. Materials and Methods: On the first study(Apr 1997 to Jun 1997), cystometry was performed in 60 patients with voiding difficulty. In this study we determined cystometry finding according to alteration of temperature(1 degrees C, 37 degrees C) and speed (20ml/min, 50ml/min) of saline infusion during consecutive cystometry. On the second study(Jun 1997 to Aug 1997), IWT was performed in 68 patients with voiding difficulty. The IWT was performed after cystometry with the patient in the supine position. The bladder was completely emptied, and 100ml of sterile 1 degrees C saline was infused within 250-300ml/min. In patient with a maximal cystometry capacity below 200ml, a volume of about half the capacity was infused. The test was considered positive if a sustained bladder contraction above 20cmH2O was registered or some of the cold saline was expelled within 1 minute. RESULTS: There was no relation between speed and temperature of infused saline about maximal bladder capacity, detrusor pressure and compliance during cystometry. Positive result of IWT was found in 31 (54.4%) among 57 patients with neurologic lesion and in 29(63.0%) among 46 patients with upper motor neuron lesion. In contrast, 10(90.9%) among 11 patients with non-neurological lesion and 8(72.7%) among 11 patients with lower motor neuron lesion was negative. Specificity for discrimination of upper motor neuron lesion and lower motor neuron lesion was 72.7%. CONCLUSIONS: It is concluded that cystometry finding was no relation between speed and temperature of infused saline about maximal bladder capacity, detrusor pressure and compliance during consecutive cystometry. The IWT is a simple supplementary urodynamic test that increases the precision of the diagnosis of upper motor neuron lesion. Thus, it was close enough to be used as a available procedure for subclinical upper motor neuron lesion.
Compliance ; Diagnosis ; Discrimination (Psychology) ; Humans ; Ice* ; Motor Neurons ; Reproduction ; Sensitivity and Specificity ; Supine Position ; Urinary Bladder ; Urodynamics ; Water*

Cardiovascular disease (CVD) is the major cause of mortality in type 2 diabetes mellitus. CVD is a clinical manifestation of atherosclerosis, a chronic and progressive inflammatory disease characterized by a long asymptomatic phase. Progression of atherosclerosis can lead to the occurrence of acute cardiovascular events. Atherosclerosis can be identified during the subclinical phase by several methods, including using biomarkers, pulse wave velocity, augmentation index, flow-mediated dilation, carotid ultrasound, and calcium score. The appropriate criteria for identifying asymptomatic patients with type 2 diabetes who should undergo CVD screening and therapeutic intervention remain controversial. Non-invasive methods, such as markers of subclinical atherosclerosis, may aid in risk stratification and the design of tailored therapies for patients with type 2 diabetes mellitus.
Atherosclerosis ; Biomarkers ; Calcium ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Humans ; Mass Screening ; Pulse Wave Analysis ; Risk Assessment

No abstract available.
Meconium* ; Prospective Studies* ; Statistics as Topic*

Peritoneal carcinomatosis is a common cause of noncurability and the most common type of recurrence in surgical operations for gastric cancer. Activated carbon particles are taken up selectively by lymphatic tissues, which seem to be a primary site of peritoneal carcinomatosis in the peritoneal cavity, and adsorb a large amount of anticancer agent, such as mitomycin C, which is subsequently released slowly and for long periods. We carried out a retrospective study to determine if activated carbon particles adsorbing mitomycinC ( MMC-CH ) could improve the survival of patients who underwent radical resection for gastric cancer with serosal invasion and peritoneal dissemination and to evaluate the prognostic factors in patients receiving intraperitoneal MMC-CH therapy from January 1993 to January 1996. Those in the control group received no intraperitoneal chemotherapy and those in the MMC-CH group were given 50mg mitomycinC as MMC-CH before the surgical wound closure into the peritoneal cavity. The 3-year survival rates for the MMC-CH group in the case of S2 were 55%, and 17% in the case of S3. But the 3-year survival rate for the control group in the case of S2 was 32% and there was no survivor in S3 cases. In the cases of peritoneal dissemination, there were no survivor for the control group, but the 3-year survival rate for the MMC-CH group was 13%. The difference between the two groups was not statistically significant except positive papanicolaou smear and S3 cases at 3-year survival rates. There was a significant difference in morbidity after surgery between these two groups especially due to fever & hypotension and anastomotic leakage. Multivariative analysis using simple regression model in MMC-CH group has confirmed that the serosal invasion, positive Pap. smear and high stage had a significant impact on the survival rate after gastric resection. In conclusion, intraperitoneal chemotherapy with MMC-CH is effective in prolonging the survival time by prophylatic effect on peritoneal recurrence after curative resection of gastric cancer without significant complication and especially indicated in the cases of positive serosal invasion, positive Pap. smear in peritoneal cytology and high stage.
Anastomotic Leak ; Carbon* ; Carcinoma ; Drug Therapy* ; Fever ; Humans ; Hypotension ; Lymphoid Tissue ; Mitomycin* ; Papanicolaou Test ; Peritoneal Cavity ; Prognosis* ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate ; Survivors ; Wounds and Injuries