Skin wart is an infectious disease of human papillomavirus(HPV). Its clinical and histopathologic characteristics are largely determined by lesion sties, viral type and host immunity. The infected basal cells and keratinocytes of the epidermis are induced to proliferate by the viral genome. It is, however, not well known how htose factors give rise to histopathologic alterations in the infected basal cells and keratinocytes. So, evaluation of correlation between HPV antigen expression in the wart tissues and clinical and histopathologic charateristics was done on 83 cases of skin warts. The age of patients ranged from 2 to 83 years. Thirty six(43.3%) cases were diagnosed before the age of third decade. The sex ratio was nearly same. Verruca vulgaris was most common(46 cases), followed by verruca plana(26 cases) and verruca palmoplantaris(11 cases). HPV antigen expression was observed in 43 out of total 83(51.8%). It was noted in 47.8%(22/46) of verruca vulgaris, in 46.2%(12/26) of verruca plana and in 81.8%(9/11) of verruca palmoplantaris. HPV antigen-positive groups included more younger patient's age and more higher PCNA than those of HPV negative groups. HPV positive groups also tend to have shorter duration of disease and more numerous mitoses than HPV negative groups. HPV antigen-positive groups showed lower inflammation grade than that of HPV negative groups(p<0.05). The higher the inflammaton grade is, the lower the HPV antigen expression rate. In summary, HPV antigen expression in cutaneous wart tissue is significantly correlated with the proliferative activity of the lesion. It is also significantly correlated with the inflammation that is considered to be the result of cell-mediated immune reaction.
Humans

Statistical survey was made on out-patients and in-patients in the Department of Urology, Seoul National University Hospital during the period from January to December in 1964. Of 2,873 out-patients including 2,346 males and 527 females, 234 cases (171 males and 63 females) were hospitalized and various operations were performed on 195 occasions. The following tables are self-explanatory.
Female ; Humans ; Male ; Outpatients ; Seoul ; Urology*

No abstract available.
Biopsy, Fine-Needle* ; Giant Cell Tumors* ; Giant Cells*

The fibrous dysplasia, divided into 3 categories of the monostotic, polyostotic and extraskeletal forms, is a relatively rare disease which was first reported by Well in 1922 and shows a characteristic findings replacing the medullary cavity of noe or more bones by the pathologically proliferating fibrous connective tissues. In a consequence, the structural integrity of the diseased bone becomes weakened and suffers frequent episodes of pathologic fracture and deformities of the bone, which are most common around the hip. Various operative methods and instruments have been tried to manage the pathologic fracture around the hip recently. The authors report a satisfactory resnlt of total hip replacement for the pathologic fracture in a patient of the fibrous dysplasia involving the proximal half of the right femur.
Arthroplasty, Replacement, Hip ; Congenital Abnormalities ; Connective Tissue ; Femur ; Fractures, Spontaneous ; Hip ; Humans ; Rare Diseases

Diarrheal disorders in childhood are the second most common cause of child deaths worldwide. Nutritional rehabilitation is the most important factor among treatments when diarrheal disorders develop and has a general beneficial effect on the patient's condition, intestinal function, and immune response. Breast milk is the most nutritious food for treating acute and chronic diarrhea in infants. Until now, many infant formulas have been developed, and particularly, special formulas for treating acute or chronic diarrhea are commonly used. Lactose-free formulas, soy based formulas, and hydrolyzed and amino acid-based formula are typical formulas. In general, replacement with specialized lactose-free formulations is unnecessary in children with persistent diarrhea, and it has been reported that infants that are not severely compromised have food allergy and intestinal failure. However, a general knowledge does not always applied to all populations because the genetic, economic or environmental factors are different. Physicians should know about the components and characteristics of special formulas in order to coach parents to use these formulas properly.
Child ; Diarrhea ; Food Hypersensitivity ; Humans ; Infant ; Infant Formula ; Milk, Human ; Parents

The bleeding duodenal varices are a rare complication in patients with portal hypertension, but present a difficult diagnostic problem. If there is no bleeding esophageal, gastric fundal varices or ulcer in a patient with upper gastrointestinal bleeding and portal hypertension, the possibility of bleeding duodenal varices should be kept in mind. Thorough endoscopic examination of the entire duodenal mucosa is essential to document bleeding from duodenal varices. As an initial treatment, endoscopic sclerotherapy has had limited success in controlling active duodenal variceal bleeding. However, rebleeding rate is high, surgical treatment including shunt operation may be required for permanent control of bleeding and portal decompression. We report three cases of duodenal varices causing massive hemorrhage. All the patients had portal hypertension caused by liver cirrhosis of various etiologies and had varices in their esophagus. The second portion of the duodenum was the site of duodenal varices in all cases. The management was tailored to the condition of each patient, but only one patient among three survived.
Decompression ; Duodenum ; Esophageal and Gastric Varices ; Esophagus ; Gastrointestinal Hemorrhage* ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Mucous Membrane ; Sclerotherapy ; Ulcer ; Varicose Veins*

Short gaps in the ureter may be spanned by uretero-ureterostomy, or if in proximity to the bladder, by uretero-neocystostomy Longer defects defy such anastomoses and most surgeons have employed nephrostomy, ureterostomy and cutaneous ureterostomy or uretero-sigmoidostomy in this condition to avoid further damage to the affected kidney. These procedures are not ideal, do not solve the problem of reconstructing the ureter and often lead to a diminution of renal function. For the past several decades investigators have attempted to insert or construct a conduit that could adequately substitute for the ureter. For this purpose, inorganic tubes of polyethylene, vitallium, tantalum and autogenous tissues such as ileal loops, oviduct, bladder flaps and blood vessel grafts have been utilized without success. In 1954, Hardin attempted to reconstruct the ureteral detect by homologous ureteral transplantation. He concluded that homologous ureteral grafts failed because of stenosis, dehiscence and leakage. By the time proliferating capillary vascular buds have permeated the free graft, necrosis and scar formation have taken place. He utilized polyethylene tubing as a splint catheter for a maximum of seven days in two of five experimental dogs and no splint catheter at all in the other three. He was unable to observe the dogs for long periods since the animals died on the 30th. 65th and 70th postoperative days. Complete ureteral stenosis had occurred in all dogs. An attempt to reestablish the ureteral defect with autogenous ureteral transplantation is described. Mongrel dogs, weighing from 15~25kg were utilized without special preoperative preparation. Pentothal sodium was administered intravenously for anesthesia. The right ureter was exposed through paravertebral incision retroperitoneally in two dogs simultaneously by two operative groups. The middle third of the right ureter was mobilized. A 3 to 7cm segment of the right ureter was removed and transplantated to the other dog. In 4 of 10 dogs, a splint catheter of polyethylene tubing slightly longer than the transplanted graft was inserted. In 6 dogs, a splint catheter was inserted from the renal pelvis to the bladder making it easy to remove the polyethylene tubing subsequently. The ends of the ureter were anastomosed with 4-0 chromic catgut using for interrupted sutures. The wound was closed without drainage. The splint catheter was removed in the fourth to sixth postoperative week. The animals were sacrificed after one to six months and an autopsy was performed. The results are summarized in Table 1. Gross and microscopic changes in the graft in all dogs were contracture, shrinkage or thickening, calcification or ossification within the graft, and round cell infiltration. Hydronephrosis also was seen in all animals. Animals sacrificed after one to two months postoperatively showed epithelial loge and degenerative changes, but the animals sacrificed after six months showed partial normal epithelial lining and capillarization in the submucosal layer of the transplanted segment. No fistula was seen, and at the time of sacrifice, the NPN and creatinine were elevated.
Anesthesia ; Animals ; Autopsy ; Blood Vessels ; Capillaries ; Catgut ; Catheters ; Cicatrix ; Constriction, Pathologic ; Contracture ; Creatinine ; Dogs ; Drainage ; Fistula ; Humans ; Hydronephrosis ; Kidney ; Kidney Pelvis ; Necrosis ; Oviducts ; Polyethylene ; Research Personnel ; Sodium ; Splints ; Sutures ; Tantalum ; Thiopental ; Transplants ; Ureter* ; Ureterostomy ; Urinary Bladder ; Vitallium ; Wounds and Injuries

A satisfactory method is needed for reestablishing continuity where the ureteral wall has been lost or compromised over a long segment. Experimental efforts to replace the ureteral segments with grafts of free fascia, skin, blood vessels and a pedicled fallopian tube have been reported; however, the results were not considered satisfactory. In 1943, Lord, Stefko and Stevens attempted to replace ureteral segments with free peritoneal flaps splinted with vitallium tubes. Slough and graft necrosis occurred prior to epithelialization. I believed that this failure was due to a disturbance of the blood supply. With this impression I utilized a pedicled peritoneal flap to develop an adequate blood supply. Mongrel dogs, weighing from 15~20kg, were used without special preoperative preparation. Pentothal sodium was administered intravenously for anesthesia. The right ureter was exposed through a paravertebral incision retroperitoneally. The middle third of the right ureter was mobilized. A 3 to 5 cm segment of the right ureter was removed. A pedicled peritoneal flap was fashioned and threaded on a thin polyethylene tubing the ends of which were then passed into the proximal and distal ureter. The ends of ureter were anastomosed with the ends of peritoneal tube using 4-0 chromic catgut. This procedure was technically difficult due to the extreme thinness of the peritoneal grafts. The wound was closed without drainage (Atlas 1: A,B,C, and D). No urinary diversion was performed. Determination of B.U.N. and creatinine were done preoperatively and just prior to sacrificing the animals. Dog No. 1 exhibited vomiting and a poor appetite on the 14th postoperative day, B.U.N. and creatinine were markedly elevated to 73.0mg% and 3.8mg% respectively on the 21st postoperative day compared with 9.8mg% and 1.4mg% preoperatively. Observations at the time of sacrifice revealed the replaced ureteral segment to be dilated and adherented to the surrounding tissues, leakage of urine into the peritoneum, no epithelialization of the peritoneal graft, and severe hydronephrosis of the right kidney. Dog No. 3 also developed a poor appetite on the 14th postoperative day and was sacrificed on the 20th postoperative day. The B.U.N. and creatinine were elevated to 75mg% and 2.8mg% respectively prior to sacrificing. The replaced segment was adherented to the surrounding tissues and showed abscess formation with leakage of urine. No organisms were found by culture. The right kidney showed marked hydronephrosis. Dog No. 4 was examined by intravenous pyelography on the 20th postoperative day when the B.U.N. elevated to 47.3mg%. There was no visualization of right collecting system at 30 minutes. The dog died on the 30th postoperative day. The replaced segment was shrunken and adherented to the surrounding tissues. Right hydronephrosis and hydroureter was found. Uremia developed in all dogs by the second or third postoperative week and severe adhesions, shrinkage and urinary leakage occurred in association with hydronephrosis and hydroureter.
Abscess ; Anesthesia ; Animals ; Appetite ; Blood Vessels ; Catgut ; Creatinine ; Dogs ; Drainage ; Fallopian Tubes ; Fascia ; Female ; Hydronephrosis ; Kidney ; Necrosis ; Peritoneum ; Polyethylene ; Skin ; Sodium ; Splints ; Thinness ; Thiopental ; Transplants ; Uremia ; Ureter* ; Urinary Diversion ; Urography ; Vitallium ; Vomiting ; Wounds and Injuries

A number of authors have supported and emphasized that mobilization of the ureter even for a short distance, would lead to injury of this structure. Benson stated that careful preservation of the ureteral would supply and avoidance of gross denudation will prevent delayed necrosis and fistula formation. Similarly Masterson, Hamm and Duffy contended that interference with blood supply during mobilization is the most important cause of injury to the ureter. This most likely can happen in Wertheim operation, Bricker's procedure and ureterocutaneostomy. Bricker, a pioneer in the use of ileum, stated that mobilization of the ureter should be carried out no longer than necessary. Usually 5cm being adequate. This amount of mobilization is safe if the blood supply remains intact. In author's clinical experience, ureteral mobilization even for considerable distance has been carried out without ill effect in ureterocutancostomy and Wertheim operation. To investigate the development of ureteral injury during surgery author undertook following experimental work. Experiments were carried out on healthy mongrel dogs weighing from 15 to 20 kg. Intravenous pentothal sodium was used. The ureter was approached through a right paravertebral incision. The dogs were divided into two groups. In the first series of four dogs (Group A), each ureter was meticulously isolated without ligation of vessels. The wound was closed in layers without drainage. During the fifth and eighth postoperative day, the animals were sacrificed and autopsied after intravenous or retrograde pyelography as well as blood hemistry was done. In the second series of four dogs (Group B), each ureter was isolated as in Group A and wrapped in a rubber tube to evaluate the interference with vascular supply. From the 12th to 24th postoperative day, the animals were sacrificed and autopsied immediately after intravenous or retrograde pyelography was done and blood chemistry examined. Group A: No fistula, infection and necrosis of the ureter was found. There was no hydronephrosis, hydroureter or infection. The croscopic section of the ureter and kidney showed no significant changes. BUN and creatinine just before the sacrifice was within normal limit. Group B: Two out of four dogs developed ureteral fistula and ecrosis associated with marked hydronephrosis and hydroureter. The middle third of the ureter in the remaining two dogs showed mild necrosis in association with marked hydronephrosis and hydroureter. In even clinical cases in ureterocutaneostomy and Wertheim operation, the length of the isolation during operation was measured. The average length of mobilization was about seven to twelve centimeter. perative check up with intravenous or retrograde pyelography and blood chemistry on patients in a period of eight weeks and two and one half years were done. Out of clinical cases, there were no ureteral injury. The functional restoration of the kidney was revealed by intravenous or retrograde pyelography and BUN and creatinine follow up examination. Summary 1. Dog ureter can be isolated from the surrounding tissues, for its entire length without developing fistula, necrosis or infection provided the blood supply as left intact. 2. When the ureter is mobilized and wrapped in a rubber tube, dilatation, necrosis and fistula formation is produced. These alterations are most marked at the middle third of the ureter. 3 In eleven clinical cases, the ureter was mobilized between seven to twelve centimeter in ureterocutaneostomy and Wertheim operation, no ureteral injury was found.
Animals ; Chemistry ; Creatinine ; Dilatation ; Dogs ; Drainage ; Fistula ; Follow-Up Studies ; Humans ; Hydronephrosis ; Ileum ; Kidney ; Ligation ; Necrosis ; Rubber ; Sodium ; Thiopental ; Ureter* ; Urography ; Wounds and Injuries

No abstract available.
Child* ; Humans ; Interleukin-6* ; Nephritis* ; Purpura, Schoenlein-Henoch*