Bladder mucosa has been reported as an excellent tissue for construction of a neourethra. We used bladder mucosa in 3 cases when there was inadequate foreskin to create a neourethra. Two cases were penoscrotal hypospadias with chordee which were repaired in one stage operation and one case was scrotal hypospadias with severe chordee which was repaired in two stage operation. The. sizes of harvested bladder mucosa were 4x 1.5cm, 10 x 3.5cm and 15 x 3cm respectively. Two minor and one major complications occurred. The minor complications were urethral stricture in one case which was managed with urethral dilation and penile swelling after self-voiding in one case which required urinary diversion for several days. In one case severe problem with entire neourethra stricture necessitated internal urethrotomy and intermittent urethral dilatation. In all cases sufficient graft tissue could be obtained and there were no urethrocutaneous fistulas. Thus, the use of bladder mucosal graft in hypospadias repair is feasible in cases in which previous repairs have railed or in which sufficient foreskin for neourethral reconstruction is lacking.
Constriction, Pathologic ; Dilatation ; Female ; Fistula ; Foreskin ; Hypospadias* ; Male ; Mucous Membrane ; Transplants* ; Urethral Stricture ; Urinary Bladder* ; Urinary Diversion

BACKGROUND: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation. METHODS: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring. RESULTS: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases. CONCLUSIONS: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.
Acromioclavicular Joint ; Clavicle* ; Follow-Up Studies ; Humans ; Methods ; Radiography ; Shoulder

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Humans ; Hypercholesterolemia*

Recently LHRH analog has been interested in the endocrine management of metastatic prostatic. cancer. But the effect of LHRH analog therapy on the prostate has not been previously documented definitely. And the initial flare phenomenon may be developed after initiation of LHRH analog therapy, but the definite method to block this phenomenon has not been introduced. To assess the effect of LHRH analog administration on the prostate, The author observed the weight and histopathologic changes of rat prostate during the administration of a potent LHRH analog (leuprolide acetate) for 6 weeks. And the author intended to present a possible method to block the initial flare phenomenon by observation of the weight and histopathologic changes of rat prostate after local testicular irradiation with a minimal dose(500 rad) producing Leydig cell dysfunction. The following results were obtained: 1. The prostate weight in control group was progressively increased during experimental periods At 0 day, 3 weeks and 6 weeks of experimental period, the prostate weights were 0.44gm, 0 58gm and 0.64gm respectively. 2. The prostate weight in leuprolide treated group was significantly decreased at 3 weeks(0.40+/-0.02gm) and 6 weeks (0.30+/-0.04gm) of administration in contrast to the age-matched control group (p<0.05). 3. The prostate weight in testicular irradiation group was significantly decreased at 3 weeks(0.44+/-0.04gm) and 6 weeks(0.42+/-0.02gm) after irradiation in contrast to the age-matched control group(p<0.05). But its change was less prominent than leuprolide treated group. 4. The pathologic change of prostate after leuprolide administration was the vacuolization of acinar cells. The vacuolization was noticed at 2 weeks of administration and pro gressively increased to the 6 weeks. 5. The pathologic change of prostate after testicular irradiation was the progressively increased vacuolization of acinar cells during experimental periods, but its change was less significant than leuprolide treated group. These results suggest that LHRH analog develops the progressive vacuolization of acinar cells, causing the regression of acinar cells and prostatic atrophy as well as the possible inhibition of normal prostatic growth and that local testicular irradiation prior to LHRH analog therapy may be a possible method to block the initial flare phenomenon.
Acinar Cells ; Animals ; Atrophy ; Gonadotropin-Releasing Hormone* ; Leuprolide ; Prostate* ; Rats* ; Testis ; Weights and Measures

We assessed the degree of mydriasis induced by 1% tropicamide and 2.5% phenylephrine compared with that induced by 1% tropicamide and 10% phenylephrine in 100 patients with diabetes. Additionally we studied the difference of pupillary dilatation according to duration of dibetes, severity of retinopathy, and performance of photocoagulation. Maximum dilated pupillary diameter was 7.25+/-1.27mm in 2.5% phenylephrine group and 7.32+/-1.36mm in 10% phenylephrine group, respectively the difference in pupillary dilatation between two groups was not statistically significant. We advise the use of the 2.5% phenylephrine in patients with diabetes, who already exhibit a higher prevalence of vascular disease and autonomic nerve system dysfunction because 2.5% phenylephrine may produce a lower incidence of side effects than 10% concentration and have the same effect of pupil dilatation as 10% phenylephrine.
Autonomic Pathways ; Dilatation* ; Humans ; Incidence ; Light Coagulation ; Mydriasis ; Phenylephrine* ; Prevalence ; Pupil ; Tropicamide ; Vascular Diseases

C-erbB-2, one of epidermal growth factor receptor gene family, may have an important role in progression of transitional cell carcinoma (TCC of the urinary bladder. We herein immunohistochemically examined 52 bladder TCC specimens for expression of c-erbB-2 gene product to investigate its prognostic value. Interrelationship between expression of c-erbB-2 and stage, grade, expression of proliferating cell nuclear antigen (PCNA), and clinical outcomes were analyzed. Overexpression of c-erbB-2 was significantly higher in invasive tumors as compared with superficial tumors and in high grade tumors as compared with low grade tumors (p<0.005). However, there were no significant correlations between the degree of expression of c-erbB-2 and progression-free survival in patients with superficial bladder TCC as well as actual-survival in patients with invasive bladder TCC. There also was no significant correlation between the expression of c-erbB-2 and PCNA. These results suggest that c-trbB-2 may be an important marker of malignant potentials and invasiveness of bladder TCC, but immunohistochemical study for its expression in bladder TCC may not provide additional prognostic information to stage and grade of the tumors.
Carcinoma, Transitional Cell ; Disease-Free Survival ; Genes, erbB-2 ; Humans ; Proliferating Cell Nuclear Antigen ; Receptor, Epidermal Growth Factor ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Cystic teratoma on the floor of the mouth is infrequent disease and known as congenital origin. Teratoma has no sex distribution. Treatrnent of the cystic teratoma is completely surgical excision and recurrence is rare. The authors have experienced a case of cystic teratoma on the floor of the mouth in neonate. We reported this case with review of literatures.
Humans ; Infant, Newborn* ; Mouth* ; Recurrence ; Sex Distribution ; Teratoma*

We have experienced an unusual case of hemorrhagic renal cyst in the rt. kidney at 58 years old woman. The Rt. kidney was enlarged, and showed a few subcapsular ischemic areas The color of kidney was dark brown. As the cyst at lower pole of rt. kidney was dissected, hemorrhagic fluid visualized in the cystic cavity. The final pathologic finding was renal cyst associated with malignant change and renal cell carcinoma at another renal parenchyma. Herein, hemorrhagic renal cyst, a rare clinical entity, was reported with review of literatures.
Carcinoma, Renal Cell ; Female ; Humans ; Kidney ; Middle Aged

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin* ; Rabbits* ; Wound Healing* ; Wounds and Injuries*