PURPOSE: Patients requiring urethral reconstruction due to failed hypospadias repairs present a considerable technical challenge. Herein we report the experience of redo urethroplasties for complicated recurrent hypospadias. MATERIALS AND METHODS: From 1987 to 1997, we performed redo urethroplasty in 11 cases with complicated recurrent hypospadias. Types of recurrent hypospadias were coronal (1 case), distal shaft (4 cases), mid-shaft (1 case), and penoscrotal (5 cases) hypospadias. The interval between the last operation and redo operation was distributed from 8 months to 5 years. We analysed preoperative status, operative methods and their complications retrospectively. RESULTS: We performed urethroplasties using scrotal skin flap or buccal mucosal graft in only 2 cases. In spite of a paucity of usable penile skin, we performed urethroplasties with maximal use of remaining penile skin. Mathieu method was used in one case with coronal type. Mustarde operation was used in 4 cases with distal shaft hypospadias. And in 5 cases with penoscrotal type, we used Thiersch-Duplay method. Six of 11 patients had complications such as urethrocutaneous fistulas (4 cases) or recurrent hypospadias (2 cases) which were managed successfully later. CONCLUSIONS: Urethroplasty using penile skin maximally such as Mathieu, Mustarde, or Thiersch-Duplay methods appears to achieve success in patient with recurrent hypospadias subsequent to previous failed repairs.
Female ; Fistula ; Humans ; Hypospadias* ; Male ; Mustard Plant ; Retrospective Studies ; Skin ; Transplants

A rare case of intramedullary Cysticercosis, at the thoracic cord is introduced which was misdiagnosed as intramedullary tumor and was confirmed after operation. After myelogram developed progressive paraplegia, which was not improved after operation. The myelographic finding of intramedullary Cysticercosis can't differenciate from intramedullary tumor and we have to consider this condition making diagnosis of intramedullary tumor.
Cysticercosis* ; Diagnosis ; Paraplegia

Tethered cord syndrome is one of the spinal dysraphism with low-lying conus medullaris frequently associated with spinal lipoma, diastematomyelia and thick filum. The clinical manifestation is variable from no overt symptoms for a long time to back pain, scoliosis, progressive neurological deficit of legs and incontinence. Therefore the diagnosis requires a strong clinical suspicion and aggressive investigation. We experienced a case of 1 day-old male infant who was presented with small soft mass on sacral area. Spinal ultrasonography and spine MRI revealed tethered cord associated with intradural lipoma. We reported a case of tethered cord syndrome with brief review of literatures.
Back Pain ; Conus Snail ; Diagnosis ; Humans ; Infant ; Leg ; Lipoma ; Magnetic Resonance Imaging ; Male ; Neural Tube Defects* ; Scoliosis ; Spinal Dysraphism ; Spine ; Ultrasonography

Plate fixation is being regarded as one of the reliahle fixation method in the management of tibial fractures. But this technique may leave many complications including infection. However, delayed local infection which developed several weeks after open reduction on the tibia has been rarely described as a complication in the literatures. The purpose of this study is to evaluate the contributing factors to the delayed locaI infection in tibial fracture treated with plate fixation. Authors reviewed and analyzed the 60 cases of tihial fracture that were treated with plate and screws from 1989 to 1996. Analyses dealt with fracture classification, laboratory and radiographic findings and the site of plate application. We defined a delayed local infection as a condition in which patient has infection signs on Jaboratory and physical examination at or over 8 week post-operation without any evidence of osteomyelitis on plain radiographs. We found 7 cases of delayed local infection out of 60 tibial fractures from 8 to 21 weeks postoperatively with an average of 14.1 weeks. All the 7 cases that had been treated with plate on medial aspect of tibia were treated by administration of antibiotics without surgery such as debridement or removal of hardwares. Authors concluded that the medial plating was the most important factor of the development of delayed local infection(Z=1.78).
Anti-Bacterial Agents ; Classification ; Debridement ; Humans ; Osteomyelitis ; Physical Examination ; Tibia ; Tibial Fractures*

Renal cell carcinoma takes up 85 per cent of primary malignant renal tumors. It frequently metastasizes to the adrenal gland, lung, bone, liver and nephrectomy site but rarely to the head and neck area. When metastasizes to head and neck area, it involves the gingiva, tongue, palate, parotid gland, uvula, mandible, and lip. When tumors are found in the salivary gland consisting of clear cells, it is impartant to carry out differential diagnosis of various primary tumors with clear cell and metastatic renal cell carcinoma. Patients' medical history, review of system, and pathologic findings would be helpful factors in the differential diagnosis. In this paper, we report on a case of renal cell carcinoma which had metastasized to the psubmandibular gland after a radical nephrectomy.
Adrenal Glands ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Gingiva ; Head ; Lip ; Liver ; Lung ; Mandible ; Neck ; Nephrectomy ; Palate ; Parotid Gland ; Salivary Glands ; Submandibular Gland* ; Tongue ; Uvula

BACKGROUND: Antidromic reentrant tachycardia(ART), in which an accessory atrioventricular pathway is used as the anterograde limb of an atrioventricular reentrant tachycardia, has been documented clinically in less than 10% of patients with the Wolff-Parkinson-White(WPW) syndrome. The wide QRS complex makes the distinction between antidromic AV reentrant tachycardia and ventricular tachycardia somewhat difficult. The purpose of this study is to evaluate the clinical and eoectrophysiologic characteristics of the antidromic reentrant tachycardia. METHODS AND RESULTS: During the electrophysiologic study of 355 patients, from December 1986 to April 1995, referred for evaluation of Wolff-Parkinson-White syndrome, 18(5.1%) patients had preexcited reciprocating tachycardia. 1) The age of the antidromic reentrant rnchycardia patients ranged from 15 to 53 years(28+/-12) and the mean age was younger than that of orthodromic reentrant tachycardia(ORT)patients(p<0.05). 2) Thirteen were male patients, five were females. 3) There were associated heart diseases in 3 cases. Two patients had Egstein's anomaly and ond had valvular heart disease. 4) The locations of accessory pathways(APs) documented on surface ECG were 7 left side(39%), 9 right side(50%)< 1 posteroseptal side(5.5%), and 1 anteroseptal side. 5) Nultiple bypass tracts were documented by electrophysiologic study in 7/18(38.9%) cases with ART, more common than cases with ORT(20/337(5.9%))(p<0.05). 6) 25 accessory pathways were documented by EPS in 18 patients(10 ;eft side, 11 right side, 2 posteroseptal side and 2 anteroseptal side). ART patients had more right sided AP(11/25,44%) than those with ORT(98/357, 27.5%), but ART patients had less posteroseptal AP(2/25, 8%)than those with ORT(63/357, 17.6%). 7) The types of ECG patterns naturally occurred were LBBB(11 cases), RBBB(6cases), and atrial fibrillation(4 cases). 8) The types of induced tachycardia in electrophysiologic study were 11 antidronic reentrant tachycardia, 10 orthodromic reentrant tachycardia, 7 reentrant tachycardia using two accessory bypass tracts, 3 AVnodal reentrant tachycardia, and 5 atrial fibrillations. CONCLUSION: ART patients were younger and had more multiple tracts than those with ORT. ART patients had less posteroseptal AP than ORT patients and more right sided AP than ORT patients. The posteroseptal AP was used as retrograde limb only.
Accessory Atrioventricular Bundle ; Atrial Fibrillation ; Electrocardiography ; Extremities ; Female ; Heart Diseases ; Heart Valve Diseases ; Humans ; Male ; Tachycardia ; Tachycardia, Reciprocating ; Tachycardia, Ventricular ; Wolff-Parkinson-White Syndrome

Spinal muscular atrophy(SMA) is the second most common fatal disease of childhood with autosomal dominant mode of inheritance, and in its less severe form the third most common neuromuscular disease of childhood after Duchenne muscular dystrophy. The genetic defect was found to be on the long arm of chromosome 5(5q11.2-q13.3) where many genes and microsatellite markers were missing. One of the most important genes is the Survival Motor Neuron(SMN) gene which is homozygously missing in 90% of SMA patients. Another important gene, the Neuronal Apoptosis Inhibitory Protein(NAIP) gene was found to be defective in 67% of SMA type I patients. Studies so far suggest SMA occurs when the genes on the long arm of chromosome 5 are mutated or deleted. Recently our hospital encountered 2 SMA patients of type I and II respectively. These patients both had homozygously defective SMN genes but intact NAIP genes. We are reporting these cases with bibliographic review and discussion. Korean SMA patients presumably have defects in SMN genes similar to those found in European patients, although the siginificance of NAIP genes remains to be established. SMN gene defects can be easily diagnosed using PCR and restriction enzymes, and this method could be applied towards convenient prenatal diagnosis and towards screening for family members at risk.
Apoptosis ; Arm ; Chromosomes, Human, Pair 5 ; Diagnosis* ; Humans ; Mass Screening ; Microsatellite Repeats ; Muscular Atrophy, Spinal* ; Muscular Dystrophy, Duchenne ; Neuromuscular Diseases ; Neurons ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Wills

No abstract available.
Eosinophils* ; Histamine*

No abstract available.
Budesonide* ; Humans

No abstract available.
Animals ; Catalase* ; Glutathione* ; Lung* ; Rats*