A 14-year old girl presented with urinary incontinence along with normally secured voluntary voiding. Careful physical examination revealed leakage of urine through a small opening near the vestibule, ventral to the urethral meatus. Cystoscopically, the right ureteral orifice was absent but otherwise normal. Nonfunctioning right kidney was found on excretory urography. A #4 ureteral catheter was inserted into the ectopic opening as high as 10cm, and the retrograde pyelogram showed dilated right ureter ending blindly at the level of lumber vertebra II with stricture at the level of the tip of the catheter. After the right nephroureterectomy, she became dry and was discharged on the 12th postoperative day. The removed kidney weighed only 8 Gm. and pathological diagnosis was congenital hypoplasia of the right kidney with ectopic ureteral opening.
Adolescent ; Catheters ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Kidney* ; Physical Examination ; Spine ; Ureter* ; Urinary Catheters ; Urinary Incontinence ; Urography

The records of fifty two cases of the ileal conduit at the Seoul National University Hospital during a 6-year period from January 1, 1975 to December 31, 1980 were reviewed. 1. There were 42 males and 10 females (ratio of 4.2:1) ranged in age from 5 to 74 years with peak incidence in the 6th decade. 2. The most common indication of this procedure was bladder tumor and other indications were neurogenic bladder, bilateral ureteral stricture, genitourinary tuberculosis, actinomycosis, urethral stricture. urethral cancer and colon cancer. 3. Seventy seven percent of patients with abnormal renal function preoperatively improved postoperatively. 4. Operative mortality was 3.8%. Early complication included wound infection and disruption, sepsis, obstruction and urine leakage in ileoureteral junction, pneumonia, fecal leakage from ileoileal junction, postoperative acute renal failure, bleeding from ileal loop, and urethral bleeding. Late complication included intestinal obstruction, parastromal dermatitis, acute pyelonephritis, ureteral obstruction and incisional hernia. 5. Thirty three of 43 patients developed bacteriuria, 30.3% of the patients showed mixed infection and major causative organisms were Pseudomonas, Enterobacter, E. coli and Serratia.
Actinomycosis ; Acute Kidney Injury ; Bacteriuria ; Coinfection ; Colonic Neoplasms ; Constriction, Pathologic ; Dermatitis ; Enterobacter ; Female ; Hemorrhage ; Hernia ; Humans ; Incidence ; Intestinal Obstruction ; Male ; Mortality ; Pneumonia ; Pseudomonas ; Pyelonephritis ; Seoul ; Sepsis ; Serratia ; Tuberculosis ; Ureter ; Ureteral Obstruction ; Urethral Neoplasms ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Bladder, Neurogenic ; Urinary Diversion* ; Wound Infection

Down syndrome is the most common autosomal chromosomal abnormality characterized by mental and growth retardation, and by various typical features including prominent epicanthal fold, oblique palpebral fissure, flat nasal bridge, short and broad hand, wide toe interspace, etc. The overall incidence has been shown to be 1:800 deliveries, increasing with advancing maternal age. However, twin cases are extremely rare, and thus far only 500 cases were reported worldwide. We have recently observed 10-day-old male monozygotic twins with Down syndrome, born to a mother of 30 years of age with one normal child. Both have VSD confirmed by 2D-echocardiography, in addition to various typical features. Cytogenetic examination revealed that both have karyotypes of 47, XY, +21. This is the first report in Korea as the authors are aware of.
Child ; Chromosome Aberrations ; Cytogenetics ; Down Syndrome ; Hand ; Humans ; Incidence ; Incontinentia Pigmenti* ; Karyotype ; Korea ; Male ; Maternal Age ; Mothers ; Toes ; Twins, Monozygotic

No abstract available.
Genetic Therapy* ; Oligonucleotides*

BACKGROUND: The effect of arterial carbon dioxide tension (PaCO2) during ischemia and reperfusion has been a controversial issue. In this study, the effect of PaCO2 during ischemia and reperfusion was evaluated by 31P magnetic resonance spectroscopy (MRS). METHODS: Incomplete global cerebral ischemia was induced by ligation of carotid artery under lowered mean blood pressure (mean blood pressure= 40 mmHg) for 30 minutes followed by 2 hours of reperfusion. Eighteen cats were divided into 3 groups: For group 1 (n=6) (control group), animals were subjected to normocarbia (PaCO2=28~33 mmHg) during ischemia and reperfusion, for group 2 (n=6), animals were subjected to hypocarbia (PaCO2=18~23 mmHg) during ischemia and reperfusion, and for group 3 (n=6), animals were subjected to normocarbia during ischemia and hypocarbia during reperfusion. RESULTS: For group 1, the energy metabolism measured by [PCr/Pi] was recovered about 74.7 6.4%. For group 2, the energy metabolism failed to be completely recovered by 120 minutes of reperfusion (69.3 7.3%), whereas for group 3, the energy matabolism was completely recovered by 120 minutes of reperfusion (97.6 2.4%). There were statistically significant differences between group 1 and group 3 (p<0.05). The changes in pH were not significantly different among the groups. CONCLUSION: In this study, a condition of hypocarbia during reperfusion seems better for the energy metabolism after incomplete global ischemia of cats.
Animals ; Blood Pressure ; Brain Ischemia ; Brain* ; Carbon Dioxide ; Carotid Arteries ; Cats* ; Energy Metabolism* ; Hydrogen-Ion Concentration ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy ; Reperfusion

There were 122 infertile males who received testicular biopsy in our department during the period from 1978 to 1980. Among them, 20 patients were diagnosed to have Sertoli cell only syndrome by pathologic finding. A cumulative clinical investigation was undertaken in 20 patients with Sertoli cell only syndrome using history taking, orchidometer, semen analysis, and plasma hormonal assay (FSH. LH, & Testosterone). We found the interesting relationship between the size of the testis and plasma hormonal levels. 1. In pathologic finding, Sertoli cell only syndrome was 16%, spermatic arrest 16%, hypospermatogenesis 15%, peritubular fibrosis 15%, and normal testis accompanying obstruction of efferent duct 22%. 2. The size of the testis was average 12ml, and plasma FSH was increased to average 27.43 IU/L, plasma LH was also increased to average 25.9 IU/L, but plasma testosterone was within normal ranges (average 5.58 ng/ml).
Biopsy ; Fibrosis ; Humans ; Male ; Oligospermia ; Plasma* ; Reference Values ; Semen Analysis ; Sertoli Cell-Only Syndrome* ; Testis* ; Testosterone

BACKGROUND: Effective oral loading of carbamazepine (CBZ) is very important as it is the most often administered drug for partial and generalized seizures. The pharmacokinetics and tolerability of a single oral loading of controlled-release form of carbamazepine (CBZ-CR) were assessed in 38 adult patients at risk for seizure. METHODS: CBZ-CR was administered to 38 adults (22 had had CBZ just before entry into the study and 16 had not) at a dosage of 20 mg/kg as a single loading. Side effects and serum levels of CBZ and CBZ-10,11-epoxide (CBZ-E) were evaluated at 0, 2, 4, 6, 8, 12, 18, 24 h after the loading. Correlations between the frequency of side effects and other parameters (maxium serum concentration : Cmax, time to maximum concentration Tmax and area under the concentration time curve (AUC) of CBZ and CBZ-E) were also assessed. RESULTS: Mean CBZ serum levels (percentage of subjects with level > 4 Mg/ml shown in parenthesis) were 0.0 (0%), 3.2 (30%), 6.1 (79%), 7.2 (92%), 7.7 (95%), 7.7 (95%), 7.7 (95%) and 7.1 Mg/ml (95%) at 0, 2, 4, 6, 8, 12, 18 and 24 h after loading. Cmax and Tmax were 8.42 Mg/ml and 13.2 h respective-ly. Although side effects developed in 15 patients (39%), there were no significant neurotoxic side effects. The frequen-cy of the history of CBZ use was not different (p<0.05) in the two groups (one had side effects, another had not). Cmax, Tmax, and AUC of CBZ and CBZ-E were also not different (p<0.05). CONCLUSIONS: A single oral loading dose of CBZ-CR provides therapeutic serum concentrations quickly (in most patients within 6h) and is well tolerated. Rapid loading with CBZ-CR appears to be a useful alternative for the management of patients with a high risk of seizures.
Adult ; Anticonvulsants ; Area Under Curve ; Carbamazepine* ; Humans ; Pharmacokinetics ; Seizures

No abstract available.
Artemisia*

BACKGROUND: The pathophysiological events resulting in keloid formation remain unclear. Overabundant levels of VEGF have been reported to contribute to excessive wound healing. There have been many studies describing the relationship between keloids and VEGF expression. However, there have been no reports about VEGF expression related to donor sites. OBJECTIVE: We investigated VEGF expression of cultured normal and keloid fibroblasts obtained from different body areas under normoxic and hypoxic culture conditions. METHODS: Normal fibroblasts from the earlobe (n=2), shoulder (n=2) and chest (n=2) as well as keloid fibroblasts from the earlobe (n=3), shoulder (n=3) and chest (n=3) were collected and cultured. VEGF expression of fibroblasts at 6 hours, 12 hours, 24 hours and 48 hours for cells maintained under normoxic and hypoxic conditions was measured by the use of RT-PCR. Paraffin-embedded tissues (normal and keloid tissue) were assayed by immunohistochemical staining. RESULTS: For the cultured normal fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition, irrespective of the donor site and time. However, for the cultured keloid fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition for cultured shoulder fibroblasts. For each donor site, VEGF expression was highest in the shoulder, followed by the chest and earlobe for cultured normal fibroblasts, irrespective of time. For the cultured keloid fibroblasts, the highest VEGF expression occurred at 6 hours for cells in the normoxic condition and the highest VEGF expression occurred at 6 hours and 12 hours for cells in the hypoxic condition. Based on immunohistochemical staining, VEGF expression of paraffin-embedded normal tissue was lower as compared to paraffin-embedded keloid tissue. For each donor site in paraffin-embedded keloid tissue, VEGF expression was highest in the shoulder, followed by the chest and earlobe. CONCLUSION: Oxygen tension and the nature of fibroblasts from different donor sites are involved in keloid pathogenesis.
Anoxia ; Fibroblasts ; Humans ; Keloid ; Oxygen ; Shoulder ; Thorax ; Tissue Donors ; Vascular Endothelial Growth Factor A ; Wound Healing

Posterior lumbar fusion is a safe and effective surgical method for diseases, such as lumbar stenosis, spondylolisthesis, lumbar instability, spinal deformity, and tumor. Pedicle screw (PS) fixation was first introduced by Bouche and has been adopted as the gold standard for posterior lumbar fusion. Santoni and colleagues introduced a new methodological screw insertion technique that uses a cortical bone trajectory (CBT), described as that from a medial to lateral path in the transverse axial plane and caudal to the cephalad path in the sagittal plane through the pedicle for maximum contact of the screw with the cortical bone. Owing to the lower invasiveness, superior cortical bone contact, and reduced neurovascular injury incidence, the CBT technique has been widely used in posterior lumbar fusion; however, these advantages have not been proven in clinical/radiological and biomechanical studies. We designed the present study to review the existing evidence and evaluate the merit of CBT screw fixation. Six electronic databases were searched for relevant articles published in August 2020 using the search terms “cortical bone trajectory,” “CBT spine,” “CBT fixation,” “cortical pedicle screws,” and “cortical screws.” Studies were analyzed and divided into the following groups: “biomechanics investigation,” “surgical technique,” and “clinical/radiological studies.” Most studies compared CBT and PS fixation, and the CBT screw fixation method showed better or similar outcomes.