A clinical observation was made on 12 children who showed severe hydroureteronephrosis on urography and long term follow up was performed after each etiologic reconstructive surgery. There were U. P. J. stricture(6 cases) and V-U reflux (6 cases) We observed the progressive improvement of renal function in spite of irreversible change on urography as a result of dismembered pyeloplasty (Anderson-Hynes) in U. P. J. stricture and vesicoureteroplasty (Politano Leadbetter) in V-U reflux. We thought that the consideration of reconstructive surgery than only nephrectomy for the correction of hydronephrosis in children was desirable, though there was irreversible change of the renal parenchyme on urography, because we found mostly the difference of degree of renal parenchymal destruction between the operative finding and the radiologic study.
Child* ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Nephrectomy ; Urography

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.
Adenoma, Oxyphilic* ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Nephrectomy

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.
Adenoma, Oxyphilic* ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Nephrectomy

Previously, we made a study report on the genotype disturbution and the gene frequency of angiotensin I-converting enzyme (ACE) in Korean population, and on the association between hypertension and genetic variance of ACE. This time, we have investigated a rapid mismatch-PCR/RFLP assays for the variant of the angiotensin II type 1 receptor (AT1R) gene (an A C transversion at position 1166 of AT1R gene), a mutation which may interact with the ACE polymorphism in the determining of risk of myocardial infarction. The genotype distributions of Koreans' angiotensin II type I receptor gene were AA (66.3%):AC (28.1%):CC (5.6%), thus the AA genotype was most numerous, and the allele frequency was A:C = 0.803:0.197. Genotype distributions were shown as AA (76.8%):AC (20.9%):CC (2.3%), the allele frequency was A:C = 0.872:0.128 in the male group, and AA (47.4%):AC (41.0%):CC (11.6%), A:C = 0.679:0.321 in the female group. Differences were highly significant between the male and female groups (p<0.0001). Genotype distributions between angiotensin II type I receptor gene and angiotensin converting enzyme gene showed that there is no significance between AT1R genotypes and ACE genotypes in total subjects (p>0.05).
Angiotensin II* ; Angiotensins* ; Female ; Gene Frequency ; Genotype ; Humans ; Hypertension ; Male ; Myocardial Infarction ; Peptidyl-Dipeptidase A* ; Polymorphism, Genetic ; Receptor, Angiotensin, Type 1*

Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

No abstract available.

No abstract available.
Humans

BACKGROUND: The angiotensin converting enzyme(ACE) is a key component of the renin-angiotensin system thought to be important in the pathogenesis of hypertension and cadiovascular diseases. Deletion polymorphism in the ACE gene may be a risk factor for myocardial infarction. The insertion/deletion(I/D) polymorphism of the ACE detected by PCR analysis appears to be associated with hypertension in Koreans and its nucleotide was subcloned into T-vector and its nucleotide sequences were determined. We also examined an association between hypertension and genetic variance of ACE. METHODS AND RESULTS: We identified the angiotensin I-converting enzyme genotype in 127 hypertensive and 189 normotensive Korean subjects. The distribution of ACE genotype II, ID, DD were 39.2%, 40.2%, 20.6% respectively and the frequency for ACE alleles I and D were 0.593 and 0.407, respecively in all subjects. The frequency of D allele in Korean males is higher than that of Korean females(male; 0.438 : female; 0.267), and the frequency of I allele in Korean females is higher than that of Korean males(female; 0.733 : male; 0.562). Genotype distributions of angiotensin I-converting enzyme genes in Korean normal adult population were different from that of Caucasians(P<0.001). There were no significant differences in genotype frequency between the hypertensive control group(n=127) and the normotensive group(n=189). CONCLUSIONS: We observed significant differences of ACE genotype distribution between the male group and the female group in total(P=0.001) and in hypertensive Korean subjects(P=0.013).
Adult ; Alleles ; Angiotensins* ; Base Sequence ; Female ; Gene Frequency* ; Genotype* ; Humans ; Hypertension ; Male ; Myocardial Infarction ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Renin-Angiotensin System ; Risk Factors

BACKGROUND: Opioid based patient-controlled analgesia (PCA) effectively provides adequate pain control after spine surgery, often at the expense of high incidence of postoperative nausea and vomiting (PONV). This study was designed to compare the effect of ramosetron with ondansetron for preventing PONV in highly susceptible patients using PCA following spine surgery under general anesthesia. METHODS: Seventy female patients, aged 18 to 65, scheduled for elective lumbar spine surgery, were randomly allocated into either ondansetron group (Group O, n = 35) or ramosetron group (Group R, n = 35). In patients assigned to group O, ondansetron 4 mg was injected and 12 mg was added to the PCA regimen. In patients assigned to group R, ramosetron 0.3 mg was injected and 0.3mg was added to the PCA regimen. The PCA regimen consisted of fentanyl 25microgram/kg (total volume including saline: 100 ml) and was programmed to deliver 2 ml/hr as background infusion and 0.5 ml per demand with a 15 min lockout. The incidence and severity of PONV, pain score, total amount of administered rescue analgesic and rescue antiemetic were assessed following 48 hrs after surgery. RESULTS: The incidence of PONV showed no significant differences between groups during 48 hrs after surgery. There were no differences in the severity of nausea, pain score, total amount of administered rescue analgesic and rescue antiemetic between groups. CONCLUSIONS: Ramosetron prophylaxis for preventing PONV is as effective as ondansetron in highly susceptible patients using fentanyl based PCA following spine surgery under general anesthesia.
Aged ; Analgesia, Patient-Controlled ; Anesthesia, General ; Benzimidazoles ; Female ; Fentanyl ; Humans ; Incidence ; Nausea ; Ondansetron ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Spine

One thousand one hundred forty nine (1149) young women, 13-21 years of age, were examined by urinalysis and bacteriologic methods for the frequency and natural course of asymptomatic bacteriuria. Five percent (58/1149) of the women were found to have a significant bacteriuria, of which 58.6% (34/58) had a transient colonization in the urinary tract and another 41.4 % had a persistent bacteriuria. 66.7% (16/24) of recurrent bacteriuric subjects had gram negative rod bacilli. In 8.6%(5/58) of asymptomatic bacteriuric subjects, symptomatic urinary tract infection developed within 6 months. An incidence of pyuria in asymptomatic urinary tract infection is 80%, but a sensitivity of pyuria to bacteriuria was low in asymptomatic urinary tract infection. A predictive value for detection of asymptomatic bacteriuria by pyuria was 19%. With urine collection by urethral catheterization a chance of contamination can be diminished, but may not be eliminated a chance of contamination from urethral mucosa. Randomized double blind study showed that asymptomatic bacteriuria can be effectively controlled by daily single dose of trimethoprim sufamethoxazole for five days.
Bacteriuria* ; Colon ; Double-Blind Method ; Female ; Humans ; Incidence ; Mucous Membrane ; Pyuria ; Trimethoprim ; Urinalysis ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Urine Specimen Collection