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

No abstract available.
Pregnancy* ; Pyelonephritis*

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.
Male ; Penile Erection*

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*

PURPOSE: The aim of this study is to investigate the colonization rate of Methicillin-resistant Staphylococcus aureus (MRSA) in neonates by different clinical characteristics, to presume the origin of MRSA acquisition, and to identify the risk factors associated with MRSA colonization. METHODS: We retrospectively reviewed the medical records of 1,733 neonates admitted to Seoul Eulji hospital Neonatal Intensive Care Unit between January 2008 and December 2011. Nasal, inguinal and rectal swab specimens were obtained upon admission and each week until discharge. We classified the route of MRSA acquisition as; hospital associated (HA-MRSA) and community associated (CA-MRSA) according to the case definition. RESULTS: Among 1,733 neonates, 415 (23.9%) were colonized with MRSA. Gestational age, birth weight, delivery type, maternal antibiotics usage before delivery, birth place and care place before admission were influencing factors in colonization of MRSA. The colonization rate was significantly high in neonates without maternal prophylactic antibiotics use before delivery than in the other group (relative risk 2.77, 95% CI 1.88-4.07; P<0.01), and outborns showed higher MRSA colonization rate compared to inborns (relative risk 2.28, 95% CI 1.17-4.42; P=0.015). CONCLUSION: We identified the neonatal MRSA colonization rate to be 23.9%. We estimated HA-MRSA colonization rate to be 10% (51/511) and CA-MRSA colonization rate to be 36% (309/858). We ascertained that risk factors in MRSA colonization in neonates were prophylactic use of antibiotics in mothers and the birth place.
Anti-Bacterial Agents ; Birth Weight ; Colon ; Gestational Age ; Humans ; Hypogonadism ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mitochondrial Diseases ; Mothers ; Ophthalmoplegia ; Residence Characteristics ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus

To investigate incidence of acute gastroenteritis (AGE) caused by Yersinia enterocolitica and Y. pseudotuberculosis (referred to as Y. enterocolitica-pseudotuberculosis complex) in children, seropositive rates to major 8 serotypes of Y. enterocolitica-pseudotuberculosis complex antigens among 467 sera of three groups of subjects (298 acute gastroenteritis; AGE, 108 miscellaneous pediatric diseases; MPD, and 61 healthy medical students; HMS) were investigated by bacterial agglutination test using standardized, heat-killed, phenolized, smooth 0 antigens. In addition, cross-reactions between yersinia agglutinins and Widal agglutinins in patients with AGE caused by Y. enterocolitica-pseudotuberculosis complex were examined in paired serum specimens. Seropositive rates to Y. enterocolitica-pseudotuberculosis complex among three groups, AGE, MPD, and HMS, were 36.5%, 13.8%, and 14.7%, respectively. Of 109 seropositive AGE patients, the most common type-specific agglutinin which showed predominating agglutinin titer to one of 8 serotypes of Y. enterocolitica-pseudotuberculosis complex antigens was PO4b (27.5%), followed by PO2a (23.8%), EO3 (16.5%), PO5a (13.7%), PO5b (9.1%), PO3 (4.5%), EO9 (2.7%), and POlb (1.8%), in orders. The Widal agglutinins cross-reacted to Y. pseudotuberculosis PO4b antigen, but the yersinia agglutinins were differentiated from Widal agglutinins by rising agglutinin titers in paired serum specimens taken one to three weeks apart. In conclusion, acute gastroenteritis caused by Y. pseudotuberculosis in children must be regarded as a fairly common enteric disease in children.
Agglutination Tests ; Agglutinins ; Child* ; Gastroenteritis* ; Humans ; Incidence ; Phenol ; Students, Medical ; Yersinia enterocolitica* ; Yersinia*

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