OBJECTIVE: Rebamipide is a propionic acid derivative that has an action of the inhibition of superoxide production and removal of hydroxyl radical with the sperm incubation and cryopreservation. In the present study, to investigate whether rebamipide is useful to treat male infertility and sterility, the author observed the antioxidative effects in patient with male infertility and also examined its absorption and distribution in rat genital organ. METHODS: To measure the distribution of rebamipide in reproductive organ in the rat, carbon indicated rebamipide, 14C-OPC-12759, was orally administered to 10 Spraque-Dawley rats and its organ concentration in serum, liver, kidney, stomach, duodenum, colon, urinary bladder, seminal vesicle, epididymis and testicle were measured each time after 0.5, 1, 2, 4, 8 and 24 hours by using HPLC fluorescent method. The concentrations in semen were measured by HPLC fluorescent method in a sample of 50 infertile males who took 900 mg of rebamipide daily for 3 months. To measure the antioxidative effect and fertility rate for 3 months, each month before and after the treatment, sperm motility, vitality, the oxygen free radical formation, level of peroxidation, fetilizing capacity of semen sample which were obtained from infertile male patients by masturbation after at least 48 hours abstinence were analyzed by computer assisted semen analyzer, eosin-nigrosin stain, chemiluminescence, thiobarbituric acid method and hypo-osmotic swelling test. Simultaneously in a sample that wanted baby, both pregnancy and delivery were researched. RESULTS: The 14C-OPC-12759 concentration in the body of white rats was highest in gastrointestinal organ like stomach, smal intestine and duodenum and followed by genital organ like seminal vesicle, testis and epididymis. The rebamipide concentration in semen of infertile males was 220.77+/-327.84 ng/mL (SD) which showed a large deviation but it was higher than serum which was 126+/-76 ng/mL (SD). In the infertile males, after the treatment with rebamipide, the level of seminal reactive oxygen species (ROS) and lipid peroxidation have significantly decreased in duration of the treatment (p<0.05) and sperm vitality and fertilizing capacity except sperm motility significantly improved on post treatment of 2~3 months (p<0.05). Out of the 41 cases who hoped for pregnancy, 15 cases (36.6%) became pregnant and 12 cases had childbrith, 2 cases had miscarriage and one case is ongoing. The side effect was observed in 1 case (2%) which experienced diarrhea but it was lost spontaneously. CONCLUSIONS: We conclude from this study that rebamipide showed relatively high tendancy of absorption and excretion in the genital organ. In infertile males who had elevated ROS in semen, by specifically inhibiting the cell damage from the antioxidation, a way to preserve sperm motility, vitality and fertilizing capacity was confirmed.
Abortion, Spontaneous ; Absorption* ; Animals ; Birth Rate ; Carbon ; Chromatography, High Pressure Liquid ; Colon ; Cryopreservation ; Diarrhea ; Diethylpropion ; Duodenum ; Epididymis ; Female ; Genitalia ; Hope ; Humans ; Hydroxyl Radical ; Infertility ; Infertility, Male ; Intestines ; Kidney ; Lipid Peroxidation ; Liver ; Luminescence ; Male ; Masturbation ; Oxygen ; Pregnancy ; Rats ; Reactive Oxygen Species ; Semen ; Seminal Vesicles ; Sperm Motility ; Spermatozoa ; Stomach ; Superoxides ; Testis ; Urinary Bladder

Pseudocyst of the auricle presents as a non-inflammatory, fluctuant swelling on the upper half or third section of the ear, due to intracartilaginous accumulation of fluid. Histological examination shows an intracartilaginous cavity without an epithelial lining. The etilogy and pathogenesis of this disorder remains unknown, but the lesion is likely to be due to localized de-generation of cartilage. The degenerated cartilage is replaced by a vascular fibrous tissue from which there is serious exudation, and a clinical cystic swelling is formed. We describe in this report three cases of pseudocyst of the auricle, of which one was treated successfully by surgical excision and a pressure dressing, and the others by aspiration and steroid injection therapy. In all cases, the skin lesions had not recurred, and the patients were left with an excellent cosmetic result.
Bandages ; Cartilage ; Ear ; Humans ; Skin

BACKGROUND: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration (2x2 anchor with 4x4 suture stands). METHODS: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using 2x2 anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medialrow stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. RESULTS: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. CONCLUSIONS: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.
Arthroscopy ; Atrophy ; Classification ; Humans ; Magnetic Resonance Imaging ; Muscular Atrophy ; Rotator Cuff* ; Shoulder ; Suture Anchors ; Sutures ; Tears* ; Tendons

A clinical investigation of the patients with pustulosis palmaris et plantaris (PPP) was made on 36 patients who were seen at the Department of Dermatology, Seoul National University Hospital, from January 1986 through June 1987. The results were summarized as follows : 1. In this series of 36 patients, 14 patients(38.9%) were male and 22 patients (61.1%) were female. Females are more subject to the affection than males. 2. The mean age of onset in male was 30.6 years and in female it was 38.4 years, indicating a earlier onset in male. The peak age of incidence in male was between 20 and 29 years and in female, between 40 and 49 years. 3. The sites of involvement were mostly bilateral hands and feet. 4. the season of the year did not influence the severity of the skin lesions in 68.9%. 5. Nine patients(28.1%) had psoriasis-like skin lesions and 14 patients(43.1%) had nail changes out of 32 patients with PPP. 6. No direct relationship could be found between pustular eruptions and focal infections, such as tonsilitis, otitis, dental abscess and sinusitis. 7. Remmission of the pustular eruptions could be achieved in 5 out of 10 patients treated with etretinate and in 4 out of 11 patients treated with ketoconazole for more than 4 weeks' treatment
Abscess ; Acitretin ; Age of Onset ; Dermatology ; Etretinate ; Female ; Focal Infection ; Foot ; Hand ; Humans ; Incidence ; Ketoconazole ; Male ; Otitis ; Palatine Tonsil ; Psoriasis* ; Seasons ; Seoul ; Sinusitis ; Skin

Between 1984 and 1996, 8 patients who were suffered from stage g Kienbock's disease underwent interpositional arthroplasty using pronator quadratus pedicled bone. Patients comprised 2 males and 6 females, with an average age of 33 years(range 19-47). Range of motion of the wrist, residual pain, grip strength, and carpal height ratio of the patients were analyzed. The follow-up period was between 1.5 years and 12.5 years(average 5.5 years). The arc of flexion-extension of the wrist was increased from average 74 degrees preoperatively to 96 degrees postoperatively. Among eight patients, five were free of pain and three had intermittent pain during heavy work. None of eight patients had any discomfort in daily work and changed his or her occupation. The grip strength was average 83% of the normal side. Carpal height ratio was average 0.48 preoperatively and was not changed postoperatively. Clinical results, assessed by Lichtman-Evans criteria, showed 4 good and 4 fair. The interpositional arthroplasty using pronator quadratus pedicled bone was considered as a very effective method for the treatment of stage III Kienbock's disease.
Arthroplasty* ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Occupations ; Osteonecrosis* ; Range of Motion, Articular ; Wrist

Open long bone fracture is frequently difficult to reduce and maintain, especilly when there is extensive soft tissue damage. Infection, instability, malalignment and soft tissue complication often result in prolonged mobidity or failure. The Hoffmann's apparatus have merits, that can easily correct distracted, angular or rotational deformity of fracture site during early post-operative period, and stable fixation facilitates easily to the care of soft tissue injury. In addition, the affected limb can be elevated with balanced suspension, possible early exercise of neighboring joints. But we have exerienced some problems during treatment of fracture with Hoffmann's transfixation method. From February 1980 to December 1981, Hoffmann's transfixation method was employed in treatment of twenty-one patients that considered to have a poor prognosis with conversional forms of treatment. The results were obtained as follows; 1. For correction of distracted, angular, or rotational deformity, the fracture site should be reduced accurately. 2. Hoffmann pins should be transfixed as one plane and parrallel to each other. 3. Rigidity of fixation can be increased by increasing number of pins, actually three or more pins should be applied at each fragment of fracture. 4. Hoffmann's apparatus is more complex for management, more expensive and requires skillful technique compared with other external fixation apparatus. 5. The lateral view of fracture site could not be confirmed accurately due to overlapping of Hoffmann's adjustable connecting rod and bony shadow. 6. The main cause of injuries was due to traffic accidents in 17 cases (81%), involving tibia in 18 cases, femur in 2 cases and humerus in 1 case. 7. In the sixteen cases which could be assessed, the average times for external transfixation was 13.9 weeks and then followed by early weight bearing with P.T.B. cast or brace. The average time of bony union was 26.4 weeks. 8. The final result was excellent in 7 cases, good in 5 cases, acceptable in 3 cases, poor in 1 case.
Accidents, Traffic ; Braces ; Congenital Abnormalities ; Extremities ; Femur ; Fractures, Bone ; Fractures, Open ; Humans ; Humerus ; Joints ; Methods ; Prognosis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing

A retrospective study has been made of 784 cases of road traffic casualties who were treated at the Soon-Chun-Hyang Hospital between July 1980 and December 1981. This study was conducted to find out the nature and pattern of the traffic accident from the clinical and epidemiological standpoints. In additions, the mode of injury from the road accidents were persued which might help to reduce the misdiagnosis rate. The results obtained were as follows: l. In this survey, male dominated in numbers (casualty rate, 70%). The highest incidence was in the age group between 31–40 year (26.5%). The predominance was found in younger casualties (ages between 21–50 years, 72.1% of all casualties). 2. The large number of casualties followed the rush hours. There was a peak between 10PM to midnight. The explanation for this high incidence during the hours was the hurry-up life due to midnight crufew, pedestrian's carelessness and hurry-scurry, and the negligence of traffic rules, the poor labor conditions and weariness due to drivers long continuous working hours, especially in taxi drivers. The highest seasonal incidence was in October. 3. The high incidences were in drivers and students; the drivers were the commonest victims in car passenger accidents and students were injured by pedestrians accidents respectively. The causes of high risk of injury in drivers were intimately related with their vocational aptitudes, the employment status, the driving attitudes and car maintainances; and in students, their carelessness and emotional instability, unsolved mass transportation system and their negligence of traffic rules were listed as the causative factors. 4. Over 51.8% of all casualties were injured by passenger car accidents, and 21.5% were by truck and other types of special vehicles. 5. Approximately 60% of victims were injuried in the road as pedestrian and other 40% were in the car as passengers. In general, the pedestrian injuries were more serious than those sustained in the car as passengers. 6. About 40% of total pedestrian casualties sustained injury at pedestrian's cross road. 7. About 80%of injured drivers were in the drunken state on arrival, and 20.4% of pedestrians were also heavily drunken. 8. The trauma risk was about twice higher in the front-seated passengers than the rear-seated ones in the car. In buses, the highest incidence was in the passengers seated in the front 1/3 of the seats. 9. Orthopaedic (40.5%) and head injuries (38.2%) were the commonest types of the injuries among the hospitalized casualties; about 35% of total patients had the tibial fractures. 10. Of the 784 cases, 479(61.6%) victims arrived hospital within 30 minutes after accident, and among them only 94 cases (12%) were transported by ambulance from the accident site to the hospital.
Accidents, Traffic ; Ambulances ; Aptitude ; Craniocerebral Trauma ; Diagnostic Errors ; Employment ; Humans ; Incidence ; Male ; Malpractice ; Motor Vehicles ; Occupations ; Pedestrians ; Retrospective Studies ; Seasons ; Tibial Fractures ; Transportation

OBJECTIVES: Over the last 30 years, despite the increasing sophistication in medical care, the mortality of acute renal failure(ARF) has remained virtually unchanged at 40-50%, but the reasons remain unknown. This study intend to identify prognostic risk factors influencing survival and predict the mortality in ARF patients. METHODS: We retrospectively analyzed 152 patients with ARF who required renal replacement therapy, or whose serum creatinine level above 5 mg/dl, from Jan. 1988 to May. 1995. Multiple factors which may influence mortality were evaluated by univariate and multivariate analysis. RESULTS: 1) Of the 152 patients, 97 were male and 55 were female. The mean age was 47 years and the overall mortality was 36.8%. 2) Based on the univariate analysis, age>60 years, cause of ARF, APACHE II score, number of failing organs, peak serum creatinine level, PaO2, coma, hypotension, ARDS, GI bleeding, ventilatory support, need for antiarrhythmics, DIC, cardiovascular failure, pulmonary failure, neurological failure, and gastrointestinal failure were all significant factors discriminating between survivors and nonsurvivors(p<0.05) 3) By multivariate analysis, hypotension, coma, ventilatory support, and age over 60 years were significant independent predictors influencing survival in ARF patients and logistic equation and logit score were as follows : z=-2.04+1.32(age over 60)+2.18(hypotension)+2.88 (ventilatory support) + 3.28(coma) P=ez/(1+ ez) 4) In ROC(receiver-operating characteristic)curve, when the cutoff point was 0.2, maximum sensitivity was 75% and maximum specificity was 82%. CONCLUSION: In ARF, prognostic risk factors for mortality were age over 60 years, hypotension, assisted ventilation and coma. The logit score by multiple analysis is a reliable predictor of mortality in ARF patients, however the further studies are required to confirm these results.
Acute Kidney Injury* ; APACHE ; Coma ; Creatinine ; Dacarbazine ; Female ; Hemorrhage ; Humans ; Hypotension ; Male ; Mortality* ; Multivariate Analysis ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors* ; Sensitivity and Specificity ; Survivors ; Ventilation

It is already well known that there are relatively many patients in Korea who have hepatitis B surface antigen. Anesthesiologists are often put into such a dilemma that they can't decide definitely whether going on procedures or not for HBsAg positive patients with or without mildly impaired liver function. The effects of enflurane, isoflurane and regional anesthesia on the liver function were compared in 85 patients with hepatitis B surface antigen. All the patients were randomly divided into 3 groups of enflurane(n=8), isoflurane(n=60) and regional anesthesia(n=17), and subdivided into 4 groups according to the preoperative value of liver functuion test and the presence of hepatitis B e antigen. Liver function tests were performed preoperatively, and on the 1st, 3rd and 7th, days postoperatively. Postoperative values of liver function tests were compared to preoperative ones within each group, and were also compared between groups. The results showed no significant differences between groups of hepatitis B eantigen positive and hepatitis B e antigen negative, but showed slight differences between anesthetics or anesthetic methads. In conclusion, anesthetic management of hepatitis B surface antigen positive patients could be performed without regard to the presence of hepatitis B e antigen. However, regional anesthesia seemed to be better than inhalation anesthesia in patients with hepatitis B surface antigen.
Anesthesia, Conduction* ; Anesthesia, Inhalation ; Anesthetics ; Enflurane* ; Hepatitis B ; Hepatitis B Surface Antigens* ; Humans ; Isoflurane* ; Korea ; Liver Function Tests ; Liver*

Postoperative nausea and vomiting is a troublesome problem in pediatric patients undergo- ing strabismus surgery. We compared the effects of ondansetron with those of droperidol and placebo within the 24hrs postoperative period. 54 children, who admitted to Presbyteri- an Medical Center to receive strabismus operations, with ASA physical status 1, were as- signed to one of three groups according to uncontrolled parallel comparative study design. A standard anesthetic technique consisting of thiopental-vecuronium for induction and N2O-O2-enflurane for maintenance of anesthesia was used. The data showed that ondansetron 0. 067mg/kg i.v. before induction was significantly more effective in preventing emesis (n=19, 100%) than placebo(n=17, 58.8%). But, there was no significant difference between droperidol group and placebo group. In conclusion, ondansetron(0.067mg/kg) given intravenously before induction to prevent postoperative nausea and vomiting in patients undergoing elective strabismus surgery in children was effective.
Anesthesia ; Child* ; Droperidol* ; Humans ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting* ; Postoperative Period ; Strabismus* ; Vomiting