No abstract available.

PURPOSE: Delirium in the elderly is common in the postoperative period but there are only few reports on detailed studies of this condition. Number of urologic patients with postoperative delirium was increas ed in our hospital for recent 24 months. The clinical characteristics of patients with postoperative delirium was analyzed retrospectively. MATERIALS AND METHODS: We selected the patients with postoperative delirium from 1010 patients who had undergone urological surgery under general or spinal anesthesia in the period from Jan. 1997 to Dec. 1999. Diagnosis of postoperative delirium was established with Diagnostic and Statistical Manual of Mental Disorders(DAM-III-R) by psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric disorder, relationship with anesthesia, drugs, and surgical procedures, concomittant medical conditions, and complications were retrospectively reviewed. RESULTS: Postoperative delirium was observed in 13 patients (1.3%). All patients were male and mean age was 70.4 years (46-86 years). Surgical procedures included TURP(8 patients), cystectomy (3 patients), nephroureterectomy (1 patient), and bladder rupture repair (1 patient). Delirium became apparent between one day and two days after the operation (mean 32.2 hours) and lasted for up to 7 days (mean 53 hours). Several factors such as older age (>65 years), male patient, longterm medication, past history of CVA, memory impairment, hearing difficulty, traumatic brain contusion, and obsessive personality were thought to be risk factors of postoperative delirium. Treatment with Haloperidol(R) intramuscular injection (2.5-5mg, every 30 minutes, 2-4 times until symptom resolution was achieved) with or without Ativan(R) intravenous injection (2mg) were effective. Complete symptom recovery was seen in 92.3% (12/13) of patients. One patient (7.7%) with previous history of dementia had persistent memory disturbance and disorientation during follow-up periods. CONCLUSIONS: Generally, postoperative delirium is an acute transient confusional state without considerable sequeles. Treatment is sedation and prevention of inadvertent accident associated with confusional state. Urologic surgeon must be attentive to the development of this illness especially when high risk factors were present.
Aged ; Anesthesia ; Anesthesia, Spinal ; Brain Injuries ; Cystectomy ; Delirium* ; Dementia ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Male ; Memory ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Rupture ; Urinary Bladder

Horizontal Mattress Suture Technique on Microvascular Anastomosis of rat (body weight: 200-250 gm) femoral artery was evaluated. The present study was conducted to compare the horizontal mattress suture with simple interrupted suture on the suture time, patency rate of the sutured vessels, and the histological changes of surgical site of the vessel wall during wound healing period. The mean suture time of the vessel wall with horizontal mattress suture technique was 15 min 49 sec ± 2.14, which is significantly shorter than that of simple interrupted suture technique. The patency rate of the sutured vessel in both groups was statistically not different each other till post-operative 3rd day but patency rate of horizontal mattress suture was higher than that of simple interrupted suture at post-operative 3rd week. The histological findings such as intimal noss, medial degeneration and intimal regeneration were similar in both groups.
Animals ; Femoral Artery ; Rats ; Regeneration ; Suture Techniques* ; Sutures* ; Wound Healing

Extravasation of toxic chemotherapeutic 'agents cause severe skin ulceration and necrosis which often need secondary surgical intervention. Still, there were not established antidote agent in case of extravasation with mitomycin-c. Dimethyl sulfoxide is known as an effective chemical scavenger of toxic hydroxyl free radical and sodium thiosulfate also was demonstrated significant protector from mitomycin-c induced ulceration by a few experimental studies. Author investigated necrotic area of mitomycin-c injected site and compare to the effectiveness of topical treatment with dimethyl sulfoxide and intradermal injection of sodium thiosulfate according to starting times, forty five mice were divided into 3 groups. Control group(n=5) had no treatment after subcutaneous injection of mitomycin-c. Experimental group I and 11 were 20 mice treated dimethyl sulfoxide and sodium.
Animals ; Dimethyl Sulfoxide ; Injections, Intradermal ; Injections, Subcutaneous ; Mice ; Mitomycin* ; Necrosis* ; Skin Ulcer ; Sodium* ; Ulcer

No abstract available.
Cervix Uteri* ; Female

No abstract available.
Bone Regeneration* ; Bone Substitutes*

No abstract available.
Free Tissue Flaps*

Multilocular cystic renal cell carcinoma appears to be a distinct and rare subtype of renal cell carcinoma with characteristic gross and microscopic features. Multilocular cystic renal cell carcinoma should be separated from multilocular cyst, multilocular cystic nephroma, and renal cell carcinoma with cystic degeneration. We present a case of multilocular cystic renal cell carcinoma. A 61-year-old man presented with right flank pain for 4 years. The computerized tomography revealed multilocular cystic mass in the upper pole of right kidney. The cystic mass measured 4.5x4 cm. The cyst was multilocular and locules not communicated with each other. The solid area was not present. Microscopically, the locules were lined by flat or cuboidal neoplastic clear cells. The clear cells were focally aggregated in the septa. The nephron was not present in the septa.
Male ; Humans ; Cysts

It is important to predict the prognosis of patient with cancer. Well known parameters predicting the prognosis are staged and degree of differentiation. Recently, the prognostic and diagnostic significance of silver-stained nucleolar organizer regions(Ag-NORs) and flow cytometric DNA analysis are introduced. This study aims to detect the diagnostic significance of Ag-NORs in breast lesions, and to correlate the number of Ag-NORs and cellular ploidies in breast carcinoma. In addition, the existence of heterogeneity according to the sample in the same patient is studied Sixty six paraffin blocks(two primary lesions and the two metastatic lymph nodes in 13 patients, and one primary lesion and one metastatic lymph node I 10 patients) of breast carcinoma, 30 paraffin blocks of fibroadenoma and 23 paraffin blocks of normal breast are studied. The numbe of Ag-NORs increase from normal breast(mean 1.45) through fibroadenoma(mean 1.60) to carcinoma(mean 2.43). It was significantly different between each lsions(P<0.0005). The number of Ag-NORs increased in the aneuploidy carcinoma than that in the euploidy one(P<0.05). But, there was difference between the number of Ag-NORs and DNA index according to the sample area in the same patient with carcinoma. In conclusion, the number of Ag-NORs is diagnostically significant in breast lesions and is correlated with cellular ploidies in breast carcinoma. In addition, Ag-NORs and cellular ploidies are heterogenous in the same patient.
Neoplasm Metastasis

No abstract available.
Cryptococcosis*