No abstract available.
Follow-Up Studies* ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Upper Extremity*

In the orthopaedic field, some elective surgeries such as joint replacement, spinal surgery and limb salvage procedures for musculoskeletal tumors frequently need various amounts of blood transfusions. However, homologous transfusion occasionally results in various side effects, such as allergic reaction, febrile reaction, and the transmission of infectious diseases such as syphilis, hepatitis and AIDS, ctc. Recently, these complications especially in elective surgery might result in medicolegal or social problems. Risks from transfusions in elective surgery can be minimized with prebanked autologous transfusion. To evaluate the necessity of prehanked autogenous transfusion, fifty five patients who had unilateral hybrid total knee arthroplasty (noncemented at the femoral side and cemented at the tibial and patellar sides) were operated on by the same surgeon from April 199S to July 1997 and had autogenous shed blood transfusion were evaluated for postoperative blood loss, amount of autogenous shed blood, amount of transfusion, hemoglobin and hematocrit. The results were as follows: 1. The distribution of preoperative hemoglobin was from 9.6g/dL to 16.5g/dL (average: 1.8g/dL). 2. The distribution of the amount of blood loss for three days postoperatively was from 156ml to 2001 ml (average: 798ml). 3. The distrihution of the amount of transfusion of autogenous shed blood was from 30ml to 600ml (average: 448ml). 4. There were two patients who had febrile reactions above 38 after transfusion of autogenous shed blood. 5. Forty-six patient(84%) had a homologous transfusion and the average amount of transfusion was 1.9 pint. 6. Total amount of homologous transfusion was decreased according to the increased amount of hemoglobin and the amount of transfusion was statistically decreased above the level of I 3g/dL(Students t-test, P=0.0005). 7. There were no significant differences in the amount of homologous transfusion between age, sex, type of disease, type of implants. In conclusion, most of our patients(84%) needed homologous blood transfusion in unilateral hyhrid total knee arthroplasty and the amount of transfusion decreased in patients who had hemoglobin above 13.0g/dL. So we recommend preparing banked autogenous hlood preoperatively in patients who have a lower hemoglobin level in unilateral hyhrid total knee arthroplasty.
Arthroplasty* ; Blood Transfusion* ; Communicable Diseases ; Hematocrit ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Knee* ; Limb Salvage ; Postoperative Hemorrhage ; Social Problems ; Syphilis

PURPOSE: To evaluate the usefulness of a gracilis muscle flap for the reconstruction of a complete posterior urethral stricture, where previous treatment had failed. MATERIALS AND METHODS: Between March 1998 and April 2006, 56 patients, in whom previous urethroplasty or visual internal urethrotomy had failed, were treated with a gracilis muscle flap. All patients had been referred from other institutions. Of the 56 treated patients, 32(group I) underwent perineal urethroplasty, using a stepwise approach of urethral mobilization, including bulbar urethra mobilization, separation of the corporal bodies, inferior pubectomy and retrocrural urethral re-routing 24(group II) underwent perineal urethroplasty, with a gracilis muscle flap for replacement of the dead space, using a stepwise approach. RESULTS: The mean stricture lengths were 2.7(0.5-5.5) and 3.5cm(1.0-6.5) in groups I and II, respectively(p=0.135). The success rates were 87.5 and 95.8% in groups I and II, respectively(p=0.279). The success rates of patients with urethral stricture of greater than 3cm were 71.4 and 100% in groups I and II, respectively(p=0.037). The success rates of patients who had undergone previous perineal urethroplasty were 82.6 and 100% in groups I and II, respectively(p=0.045). A gracilis muscle flap made no difference to the incidences of erectile dysfunction and incontinence. The incidences of restricture were 15.6 and 0% in groups I and II, respectively (p=0.042). CONCLUSIONS: Our results showed that a gracilis muscle flap can be useful method with a stricture greater than 3cm in length and in patients having undergone previous perineal urethroplasty.
Constriction, Pathologic ; Erectile Dysfunction ; Humans ; Incidence ; Male ; Urethra ; Urethral Stricture*

Most gastrointestinal stromal tumors (GISTs) arise from the proper muscle layer of the upper gastrointestinal (GI) tract and have a low malignant potential. They are sometimes accompanied by symptoms, but in most cases are detected by chance. Endoscopic surgery of subepithelial tumors in the upper GI tract has been actively performed, and its merits include the need for fewer medical devices compared with other surgical procedures and post-resection organ preservation. However, because endoscopic procedures are still limited to small or pilot studies, a multidisciplinary approach combining laparoscopy and endoscopy is needed for more effective and pathologically acceptable management of GISTs. Many new endoscopic surgeries have been developed, and this review describes the current status of and the new approaches for endoscopic surgery of GISTs in the upper GI tract.
Endoscopy ; Gastrointestinal Stromal Tumors* ; Laparoscopy ; Organ Preservation ; Pilot Projects ; Upper Gastrointestinal Tract*

OBJECTIVE: To assess the efficacy and safety of ultrasound-guided intragestational injection of methotrexate (MTX) and systemic intramuscular MTX in the management of cesarean scar pregnancies. METHODS: This was a retrospective case-control study that included women diagnosed with cesarean scar pregnancy at CHA Bundang Medical Center unit between 2009 and 2015. The 26 cases were managed with local injection of MTX under ultrasound guidance and 15 cases were treated with systemic intramuscular of MTX. After the procedure, serial follow-up sonographic examination and serum beta-human chorionic gonadotropin (β-hCG) measurement were performed. RESULTS: The mean initial β-hCG level was 20,610.73 mIU/mL and ranged from 263.00–71,316.50 mIU/mL. Mean gestational age was 6.3 weeks and ranged from 4.8 to 8.5 weeks. The majority of ectopic cases were treated successfully and follow-up β-hCG level declined abruptly following the first dose of MTX. The rate of success of local MTX treatment was significantly higher than that of systemic MTX treatment. It was 93.75% vs. 73.33%, respectively (P < 0.05). CONCLUSION: Ultrasound-guided intragestational injection of MTX is an effective method for the management of cesarean scar pregnancies and is associated with minimal side effects and high treatment success.
Case-Control Studies ; Chorionic Gonadotropin ; Cicatrix ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Methods ; Methotrexate ; Pregnancy ; Retrospective Studies ; Ultrasonography

No abstract available.
Cesarean Section* ; Female ; Pregnancy ; Pulmonary Embolism*

Slipped capital femoral epiphysis is a rare disease in Korea, but the incidence has being increased according to the changes of body contour and life style. Now we have more concern about slipped capital femoral epiphysis, especially the factors which contribute to the final result of treatment. Many factors such as severity of slip, stability of slipped epiphysis, whether closed reduction was done or not, whether severe complication like avascular necrosis or chondrolysis has occurred or not have effect on the result. We analyzed 20 cases of slipped capital femoral epiphysis, which occurred in 16 adolescence in view of which factors contributed to the final satisfactory result. In our study, the difference in the duration of symptoms, instability of slipped epiphysis, patients age, association with obesity or acute trauma and the number of pins had much effect on the final results and whether the reduction was done or not, the kinds of pins and association with endocrinopathy made a little difference. But further studies are necessary because the number of cases is not sufficient and the length of follow up period is not long.
Adolescent ; Epiphyses ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Life Style ; Necrosis ; Obesity ; Rare Diseases ; Slipped Capital Femoral Epiphyses*

A putative polypeptide hormone identified as amylin[islet amyloid polypeptide] is synthesized and co-localized with insulin in B cells of pancreatic islets in several animal species including man. However, there is growing evidence that somatostatin cells are also expressed and contained amylin in the pancreatic islets of the rat The aim of the present study was to investigate the immunocytochemical expression of the amylin within the endocrine pancreas of the man, rabbit and guinea pig, with special reference to the possible ability of islet cells other than insulin cells to synthesize amylin. For this purpose serial sections of the pancreatic islets were stainedimmunocytochemically using anti-amylin, anti-insulin, anti-glucagon, anti-somatostatin antisera. In serial sections of pancreatic islets of the man and rabbit, it was shown that amylin immunoreactivity occurred in insulin-reactive B cells predominantly located in interior of the islets. In contrast, amylin immunoreacivity appeared in glucagon-reactive A cells peripherally located in the islets of the guinea pig. These results suggest that in both the man and rabbit, amylin is synthesized by B cells for subsequent co-secretion with insulin, and that in guinea pig, amylin is synthesized by A cells for co-secretion with glucagon. It thus appears that amylin release may be mediated by different secretory mechanisms according to animal species.
Amyloid ; Animals ; B-Lymphocytes ; Glucagon ; Guinea Pigs* ; Guinea* ; Immune Sera ; Immunohistochemistry ; Insulin ; Islet Amyloid Polypeptide* ; Islets of Langerhans* ; Rats ; Somatostatin-Secreting Cells

No abstract available.
Breast Neoplasms* ; Breast* ; Survival Rate*

The purpose of this study was to establish the role of apoptosis in the developing renal corpuscle in the prenatal rat kidney. Kidneys from 14-, 16-, 18-, and 20-day-old fetuses[E-14, E-16, E-18, and E-20] were preserved by immersion or perfusion via the heart using Bouin`s fixative. Apoptosis was detected`by in situ nick end labeling method using ApopTag kit. In kidneys from E-14, apoptotic cells and bodies were found only in the mesenchymal tissue surrounding the developing nephrons. In kidneys from E-16, E-18, and E-20, apoptotic cells and bodies were located mainly in the columnar distal epithelium of the renal vesicle[future parietal epithelium] as well as in the parietal epithelium of the renal corpuscles of S-shaped bodies, stage III and IV nephrons. Apoptosis was not observed in the proximal part of renal vesicles or in the podocytes in renal corpuscles. In contrast, strong bel-2 immunoreactivity was present in the proximal part of the renal vesicle and in podocytes in S-shaped bodies, but gradually decreased in stage III and IV nephrons. The distal part of the renal vesicle had weak staining for bcl-2, and there was no bel-2 immunoreactivity in the parietal epithelium of S-shaped bodies, and stage III and IV nephrons. We conclude that bcl-2 is involved in the regulation of apoptosis during the differen-tiation of the parietal epithelium of Bowmann`s capsule.
Animals ; Apoptosis* ; Epithelium* ; Heart ; Immersion ; In Situ Nick-End Labeling ; Kidney* ; Nephrons ; Perfusion ; Podocytes ; Rabeprazole* ; Rats*