The 6 patients with neglected rupture of the Achilles tendon were treated by end to end anastomosis using the V-Y tendinous flap originated by Abraham in 1975. A tendinous flap was developed over the tendon by making an inverted V incision, which was then repaired in a Y fashion. The postoperative results were satisfactory with no functional disability of the ankle and with recovery of muscle strength for periods of 8 months to 15 months, but slight limited dorsiflexion of the ankle in two cases were noticed. The advantages of this method are: 1. Optimum functional recovery. 2. Recovery of muscle strength and tendon contour. 3. Prevention of late stretching or possible rupture of the healed tendon at the rupture site.
Achilles Tendon ; Ankle ; Humans ; Methods ; Muscle Strength ; Rupture ; Tendons

No abstract available.
Erectile Dysfunction* ; Evoked Potentials, Somatosensory* ; Male

We experienced a case of primary aldosteronism due to adrenal adenoma. The patient was 45-year old female, whose main complaints were weakness, headache, and fatigue. By use of abdominal CT scan, ultrasonogram, adrenal angiogram and by result of clinical laboratory findings, we conculuded the diagnosis of adrenal adenoma, and confirmed it by surgical and pathologucal findigs. The clinical sympyoms disappeared after left adrenalectomy, and laboratory findings of renin, aldosterone, electrolutes were normalized but hypertension persisted, so she has been managed by antihypertensives.
Adenoma ; Adrenalectomy* ; Aldosterone ; Antihypertensive Agents ; Diagnosis ; Fatigue ; Female ; Headache ; Humans ; Hyperaldosteronism* ; Hypertension* ; Middle Aged ; Renin ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Carbon monoxide (CO) is produced during the degradation of hemoglobin to heme (iron protoporphyrin) and present in various tissues including brain. CO is believed to activate soluble guanylate cyclase to exert its action on the smooth muscles. the effects of CO and its relationships to adrenergic or cholinergic mechanisms were studied using the isolated rabbit corpus cavernosal strips, and the effects of CO and NO were further investigated. MATERIALS AND METHODS: Using adult New Zealand rabbits, the corpus cavernosal strip was carefully prepared from rabbit penis and suspended in an 10ml organ bath containing Tyrode solution. When a stable tension level of the strip had been attained, drugs were added to the organ bath the change of motility of the strip was recorded on a computerized polygraph. RESULTS: The NO donor, sodium nitroprusside (SNP) and CO caused a dosedependent relaxation of the cavernosal strip of the rabbit penis. Pretreatment of SNP and CO had no effect on contraction induced by adrenergic drugs and the effects of SNP and CO was not affected by atropine. The relaxation effects of SNP were inhibited by NO scavenger pyrogallol, inhibitor of soluble guanylate cyclase 1H-[1,2,4] oxadiazolo[4,3-a] quinoxalin-1-one (ODQ) and methylene blue. The relaxation effects of CO were significantly inhibited by ODQ and methylene blue. the relaxation effects by acetylcholine were inhibited by NO synthase inhibitor L-nitroarginine methyl ester (NAME) and deendothelialization, but not affected by zinc protoporphyrin (ZnPP), the heme oxidase inhibitor. On the immunostaining of heme oxidase (HO) in corpus cavernosal smooth muscle strip, the positive staining for HO was observed in the perivascular nerve fibers. CONCLUSIONS: The relaxation effect of NO was confirmed, and CO exerts an endothelium dependent relaxing effect on the cavernosal strip of the rabbit penis similar to NO. This action is seem to be mediated by soluble guanylate cyclase, and the actions of CO is also mediated by similar guanylate cyclase system.
Acetylcholine ; Adrenergic Agents ; Adult ; Atropine ; Baths ; Brain ; Carbon Monoxide* ; Carbon* ; Endothelium ; Guanylate Cyclase ; Heme ; Humans ; Male ; Methylene Blue ; Muscle, Smooth ; Nerve Fibers ; Nitric Oxide ; Nitric Oxide Synthase ; Nitroprusside ; Oxidoreductases ; Penis ; Pyrogallol ; Rabbits ; Relaxation ; Tissue Donors ; Zinc

No abstract available.
Pregnancy* ; Pyelonephritis*

Most stress urinary incontinence require a surgical correction for stabilizing the urethrovesical junction Many procedures had been applied for the treatment of stress urinary incontinence. Recently we experienced two cases of stress urinary incontinence, corrected by endoscopic suspension of bladder neck with percutaneous nephrostomy needles, ang good results were obtained. Herein we reported a more simple and safe modified procedure with some literatures.
Neck ; Needles ; Nephrostomy, Percutaneous ; Urinary Bladder ; Urinary Incontinence*

No abstract available.
Male ; Penile Erection*

No abstract available.
Blood Donors* ; HIV* ; Humans ; Mass Screening*

No abstract available.

Paraneoplastic pemphigus is a distinct and rare autoimmune disease characterized by extensive and painful mucosal ulcerations and polymorphic desquamated skin lesions in the setting of an underlying neoplasm, typically of lymphoreticular origin. Thus difficulties in the management of anesthesia can be expected. A 66-years-old man was scheduled for removal of intraabdominal sarcoma associated with paraneoplastic pemphigus. Physical examination showed multiple erythematous bullae, crusts, plaques and target-like lesions on the whole body and desquamated erythematous skin lesions on the back and extremities. In the operating room, his right femoral artery was cannulated with a 20 G, 12.7 cm CVP catheter and left femoral and subclavian veins with 14 G, 20 cm CVP catheters, respectively. After application of 4 % lidocaine spray, his oropharynx and supraglottic area were evaluated under direct laryngoscopy and revealed multiple ulcerations on oral mucosa, but no distinct lesion on supraglottic area. Anesthesia was induced by rapid-sequence method with fentanyl, thiopental sodium and succinylcholine followed by endotracheal intubation. The endotracheal tube was held by a roll gauze around the neck and its cuff was minimally inflated to avoid overpressure against his tracheal wall. After the end of surgery, his oral cavity was suctioned with no remarkable bleeding, and tracheal wall including cuff-contacted area was evaluated under fiberoptic bronchoscopy, revealed intact wall without any bulla or ulceration. The patient was transferred to intensive care unit for proper postoperative management after extubation of endotracheal tube.
Anesthesia ; Autoimmune Diseases ; Bronchoscopy ; Catheters ; Extremities ; Femoral Artery ; Fentanyl ; Hemorrhage ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine ; Mouth ; Mouth Mucosa ; Neck ; Operating Rooms ; Oropharynx ; Pemphigus* ; Physical Examination ; Sarcoma ; Skin ; Subclavian Vein ; Succinylcholine ; Suction ; Thiopental ; Ulcer