A number of chronic inflammatory lesions of unknown etiology in man have recentlybeen understood by the mechanism of so called auto-immune disease and a series of experimental study using animals have been extensively undertaken to reproduce the lesion. Experimental chronic inflammatory diseases induced by repeated injection of homologous or heterologous tissue antigen with adjuvant are based upon immunological process and these are readily reproducible. The author has experimentally studied on any allergic destruction of the epididymis of the rat on immunologic process as in other particular organs and tissue. A total of 59 white healthy male rats were divided into 7 major experimental groups of injection as follows. Group 1: six rats, control, injection with normal saline alone. Group 2: six rats, injection with adjuvant only. Group 3: six rats. injection with epididymal tissue only. Group 4: twenty-three rate, injection with rat epididymal tissue plus adjuvant. A. seven rats, sacrificed on the 64th day B. ten rate, sacrificed on the 92nd day C. six rats, sacrificed on the 128thday Group 5. six rate, injection with rat epididymal tissue plus adjuvant plus prednisolone. Group 6: six rats, injection with rabbit epididymal tissue only Group 7: six rats, injection with rabbit epididymal tissue plus adjuvant Injections were given into the abdominal muscle of the rat once s week for 8 weeks as scheduled in the text and the animals of all groups except the group 4, were sacrificed 8 days after the final injection. In the group 4, animals were further divided into 3 subgroups which were sacrificed on the 61st, 92nd and l28th day of the experiment, respectively. The epididymis and other organs of allexperimental animals were studied histopathologically and the following results were obtained; 1. In all rats of the group 1 receiving homologous epididymal tissue with adjuvant, the epididymis revealed relatively marked and significant inflammatory changes. Histopathology included edema, congestion, fibrosis in the interstitial tissue, and infiltration of inflammatory cells mainly composed of lymphocytes, histiocytes, plasma cells and eosinophils. Flattening and hyperplasia of the epithelial cells and cellular exsudation were observed in the tubules. 2. In the group 1, the lapse of time after injection provoked more marked inflammatory changes. Diffusely mild or moderate degree of inflammation observed on 61st day, was changed to diffusely moderate or marked inflammation on 92nd day and then to significantly more chronic lesion with less exsudation and more fibrosis on 128th day. 3. Homologous tissue antigen without adjuvant andheterologous tissue antigen with or without adjuvant caused no inflammatory changes. 4. Inflammatory changes induced by homologous tissue antigen with adjuvant seem to be readily inhibited or prevented by simultaneous administration of prednisolone.
Abdominal Muscles ; Animals ; Edema ; Eosinophils ; Epididymis ; Epididymitis* ; Epithelial Cells ; Estrogens, Conjugated (USP) ; Fibrosis ; Histiocytes ; Humans ; Hyperplasia ; Inflammation ; Lymphocytes ; Male ; Plasma Cells ; Prednisolone ; Rats

No abstract available.
Transurethral Resection of Prostate*

With the advent of improyed external fixation device, femoral lengthening has gained renewed popularity in recent years in the treatment of unequal leg length. Wagner(1971) and De Bastiani et al(1987), among others, have made epochal contribution in this field. During the period from May 1984 to May 1987, 25 patients with leg length discrepancy underwent femoral lengthening using Wagner's or De Bastianis distractable external fixators at the Department of Orthopedic Surgery, Seoul National University Hospital. There were 6 patients below 16 years of age admitted to the Children's Hospital, and 19 patients were 16 years or older. The mean age was 18.2 years, ranging from 3 years to 36 years. The underlying etiology included residual poliomyelitis in 20 patients, epiphyseal injury in 2 patients, congenital short femur in 1 patient, septic hip residua in 1 patient, and cerebral palsy in 1 patient. The mean leg length discrepancy was 4.5cm, ranging from 1.3cm to 7.4cm. The mean length gained was 4.1cm, ranging from 1.8cm to 6.4cm. All except two patients had two stage procedures with iliac crest strut bone graft. The mean time required for radiological consolidation of bone graft was 4.8 months. The plate and screws used for osteosynthesis was removed after the medullary canal has been re-established. Six patients had removal of the plate and screws between 8 months and 25 months after the second stage osteosynthesis. Technical errors included 1 case of incomplete osteotomy which required manual clasis, and another case of faulty insertion of Schanz screws that required reinsertion. Five cases (33.3%) had the minor pin tract infection. Schanz screw breakage occurred in a case of one stage femoral lengthening. Loosening of plate and screws was seen in three cases. One case had delayed union requiring augmentation bone graft. Stiff knee with less than 90°of flexion was encountered in one case. One case sustained fracture of patella during physiotherapy. Despite of a long list of complication, the ultimate goal of leg length equalization was successfully achieved in all the cases.
Cerebral Palsy ; External Fixators ; Femur ; Hip ; Humans ; Knee ; Leg ; Orthopedics ; Osteotomy ; Patella ; Poliomyelitis ; Seoul ; Transplants

Disseminated intravascular coagulation (DIC) is a pathological syndrome in which activation of coagulation cascade leads to fibrin clot formation, consumption of platelets and coagulation factors, and secondary fibrinolysis. We report a case of severe postoperative hemorrhagic diathesis due to DIC. A 59-year-old man was scheduled for reduction of tibia fracture and anatrophic nephrolithotomy of staghorn calculi. On the fifth postoperative day, second operation was performed for nephrectomy due to perirenal hematoma. Two days later, third operation was performed for hemostasis because of the continuous bleeding. Coagulation tests showed positive DIC profiles of thrombocytopenia, hypofibrinogenemia, increased fibrin degradation products, and prolonged prothrombin time and thrombin time. The patient recovered uneventfully and discharged on the 59th postoperative day.
Blood Coagulation Factors ; Calculi ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; Hematoma ; Hemorrhage* ; Hemorrhagic Disorders ; Hemostasis ; Humans ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Prothrombin Time ; Thrombin Time ; Thrombocytopenia ; Tibia

BACKGROUND: The purpose of this study was to compare prospectively two different anesthetic techniques with isoflurane or propofol for postoperative nausea, vomiting and recovery after tonsillectomy in children. METHODS: Sixty children, ASA physical status I, were assigned randomly to one of two groups. In group I, anesthesia was induced with thiopental 5 mg/kg and maintained with isoflurane 1~1.5 vol%. In group P, anesthesia was induced with fentanyl 1 mcg/kg, propofol 2 mg/kg and maintained with propofol infusion 5~10 mg/kg/hr. Both group received vecuronium 0.1 mg/kg for tracheal intubation and were ventilated with 33% O2 in N2O. The time to extubation, time to eye opening, PACU time, incidence and numbers of postoperative nausea and vomiting, and degree of sedation were recorded as well as perioperative complications. RESULTS: There were no significant difference in the duration of anesthesia and PACU time between two groups. The time to extubation and eye opening of group P were significantly shorter than group I (p<0.05). The degree of sedation and incidence of postoperative nausea and vomiting of group P were significantly lower than group I (p<0.05). But the frequency of intraoperative bradycardia was significantly higher in group P than group I (p<0.05). CONCLUSIONS: Propofol-fentanyl anesthesia results in less nausea and vomiting during postoperative period and more rapid recovery compared to isoflurane anesthesia and may be recommended in children undergoing tonsillectomy and adenoidectomy.
Adenoidectomy ; Anesthesia* ; Bradycardia ; Child* ; Fentanyl ; Humans ; Incidence ; Intubation ; Isoflurane* ; Nausea ; Postoperative Nausea and Vomiting* ; Postoperative Period ; Propofol* ; Prospective Studies ; Thiopental ; Tonsillectomy* ; Vecuronium Bromide ; Vomiting*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic* ; Sterilization, Tubal*

No abstract available.
Neurofibromatoses* ; Scoliosis*

PURPOSE: Unilateral testicular torsion is usually associated with damage to both the affected and the contralateral testis and thus with diminished fertility. This study was preformed to evaluate whether the capsaicin prevents contralateral testicular damage and how long the protection lasts. MATERIALS AND METHODS: Eight groups of 8 male Sprague-Dawley rats(5 weeks old; 150~180 g) were studied. Groups 1 and 5 were sham-operated controls, groups 2 and 6 were testicular torsion controls, groups 3 and 7 underwent sham operation 24 hours after intraperitoneal administration of 0.5 cm3 of capsaicin, and groups 4 and 8 had testicular torsion performed 24 hours after the intraperitoneal administration of 0.5 cm3 capsaicin. The contralateral testis of each animal was harvested at 24 hours after the operation(groups 1~4) or at 4 weeks(groups 5~8). The weight, histologic findings, and extent of apoptosis were evaluated. RESULTS: At 4 weeks, the weight of the contralateral testis and the diameter of the seminiferous tubules were decreased in the testicular torsion groups. The histologic grade and spermatogenesis was significantly lower in groups 6 and 8. The apoptosis index was significantly higher in groups 2, 6, and 8. CONCLUSIONS: Capsaicin prevents early contralateral testicular damage from unilateral torsion(within 24 hours). However, these effects are not sustained at 4 weeks.
Animals ; Apoptosis ; Capsaicin* ; Fertility ; Humans ; Male ; Rats* ; Rats, Sprague-Dawley ; Seminiferous Tubules ; Spermatic Cord Torsion* ; Spermatogenesis ; Testis*

The potential visual acuity predicted by the laser interferometer (LI) was compared with the postoperative best corrected visual acuity (BCVA) measured by Hans visual acuity chart in 30 eyes of 28 patients with diabetes mellitus (group 1) and 36 eyes of 35 patients with previous retinal surgery or other ocular disease (group 2) to determine the predictive accuracy of LI in complicated cataracts. 55 eyes of 51 patients without diabetes mellitus or any other ocular diseases were served as control. In control group, the LI closely estimated (in the range of +/-25%) postoperative BCVA in 33 eyes (60%), underestimated in 15 eyes (27%), and overestimated in 7 eyes (13%). In group 1, the LI closely estimated in 16 eyes (54%), underestimated in 10 eyes (33%), and overestimated in 4 eyes (13). In group 2, the LI closely estimated in 16 eyes (45%), underestimated in 7 eyes (19%), and overestimated in 13 eyes (39%). There was no significant difference in predictability between group 1 and control group (P=0.82, chi-square test). But, there was significant difference between group 2 and control group (P=0.03, chi-square test), and LI tended to overestimate potential vision in patients with complicated cataracts (P=0.01, chi-square test).
Cataract* ; Diabetes Mellitus ; Humans ; Retinaldehyde ; Visual Acuity

PURPOSE: Our purpose in this study is to evaluate the effectiveness of bronchial and nonbronchial systemic arteries for the control of hemoptysis. MATERIALS AND METHODS: Seventy patients with massive or recurrent hemoptysis underwent percutaneous transcatheter embolotherapy between 1991 and 1993. Retrospectively we reviewed 77 cases of bronchial artery embotization and 32 cases of nonbronchial systemic artery embolization in the 70 patients. RESULTS: Immdiate control of hemoptysis was achieved in 33 of 39 patients with massive hemoptysis(84.6%) and 20 of 24 patients with recurrent hemopt ysis(83.3%). In 32 cases, nonbronchial systemic arteries contributed significantly to areas of pathologic pulmonary tissue and frequently were the major arterial supply. CONCLUSION: Bronchial artery embolization is an effective and life saving procedure in non-surgical candidates. Recognition and occlusion of nonbronchial systemic arteries that feed to hypervascular pulmonary lesions is essential for successful percutaneous embolotherapy of hemoptysis.
Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis* ; Humans ; Retrospective Studies