Stasis dermatitis is one of the important skin manifestations of venous stasis. Therefore, the searching for the cause of venous stasis is importrnt. Two cases of stasis dermatitis with inferior vena caval obstruction are reported and possible etiologic factor is discussed. Case I The patient, 38-year-old carpenter, was admitted at Choong Buk Medical Center in April, 1974 with superficial venous engorgement of the lower extremities which had begun to appear two years after severe blunt trauma to both legs in 1962. 5 years prior to admission, abdomial venous engorgement and abdominal fullness developed and was exaggerated gradually. Since 2 years prior to admission, he has been suffered from the recurrent exudative ulcer on the right lower leg The physical examination revealed mild icteric sclera, hepatomegaly, abdominal distension, tortuous venous engorgement on the abdomen, the lateral chest wall and the lower extremities, and edematous scaly brawny pigmentation of the lower legs. Esphagogram showed no esphageal varices. Inferior vena cavogram showed complete obstruction at the level of upper border of 2nd lumbar vertebra and well developed collateral circulation, Findings of skin biopsy on the right lower leg showed moderate acanthosis, increased pigmentation of bosal cell layer in the epidermis, capillary proliferation, diffuse inflammatory cell infiltration with increased fibrosis and hemosiderin granules in the dermis. Case II The patient. 36-year-old farmer, was admitted at Dept. of Dermatology, St. Mary's Hospital, Catholic Medical College in Sept., 1973.The physical examination revealed hepatomegaly, abdominal distension, superficial venous engorgement on the abdomen, the neck and the lower extrcmities, severe edema and pigmentation of the lower legs, and the multiplc. Exudative ulcers on the left lower leg. Liver scanning showed somewhat general enlargement with some mottlings along the margin and relative prominance of the left lobe. Liver biopsy revealed findings of non specific chrcnic hepatitis. Inferior vena cavogram through the left femoral vein showed complete obstruction at the level between 11th and 12th thoracic vertebrae.His peripheral edema and ascites was much subsided after adequate bed rest and the skin lesion improved with scar formation.
Abdomen ; Adult ; Ascites ; Bed Rest ; Biopsy ; Capillaries ; Cicatrix ; Collateral Circulation ; Dermatitis* ; Dermatology ; Dermis ; Edema ; Epidermis ; Femoral Vein ; Fibrinogen ; Fibrosis ; Hemosiderin ; Hepatitis ; Hepatomegaly ; Humans ; Hyperemia ; Leg ; Liver ; Lower Extremity ; Neck ; Physical Examination ; Pigmentation ; Sclera ; Skin ; Skin Manifestations ; Spine ; Thoracic Wall ; Ulcer ; Varicose Veins

No abstract available.
Cervix Uteri* ; Conization* ; Female

PURPOSE: We wanted to determine and report on the outcome of combined gemcitabine/cisplatin chemotherapy for patients suffering with locally advanced or metastatic urothelial cancer. MATERIALS AND METHODS: Between July 1999 and December 2004, 43 selected patients were enrolled in this study. Group 1 (the adjuvant chemotherapy group) had undergone radical surgery with removal of evident tumor from the following primary sites: bladder (n=8), renal pelvis (n=7) and ureter (n=3). Group 2 (the salvage chemotherapy group) had undergone palliative surgery with a remnant tumor at the following primary sites; bladder (n=23) and renal pelvis (n=2). All the patients were given gemcitabine/ciplatin and they evaluated for the therapeutic effect and toxicity. The patients were initially treated with gemcitabine 1000 mg/m2 intravenously for 30 minutes on days 1, 8 and 15 of a 28-day cycle, and cisplatin 70 mg/m2 was administered intravenously on day 1 using prehydration measures. RESULTS: Group 1: The median follow-up period was 16.5 months. The mean age was 63 years (males: 15 cases, females: 3 cases), and eleven patients (61%) remained alive. The estimated median relapse-free survival period and 2-year survival rate were 24 months and 63%, respectively. Group 2: the median follow-up period was 20 months, the mean patient age was 63.8 years (males: 22 cases, females: 3 cases), and nine patients (36%) remained alive. The overall response and 2-year survival rates were 36% and 43%, respectively. Toxicities: Grade 3 toxicities developed in 14 cycles during the total 232 cycles. Grade 4 toxicity did not occur. CONCLUSIONS: The results of this study confirm that adjuvant and salvage chemotherapy with using gemcitabine and cisplatin is tolerable and safe.
Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Female ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Palliative Care ; Survival Rate ; Ureter ; Urinary Bladder ; Urologic Neoplasms

No abstract available.
Abortion, Induced* ; Female ; Patient Acceptance of Health Care*

No abstract available.
Abortion, Induced* ; Female ; Patient Acceptance of Health Care*

BACKGROUND: Sarcoidosis is a systemic granulomatous disorder of unknown origin and characterized by accumulation of T cells and macrophages. Various cytokines may play crucial roles In the activation of T cells and macrophages, and thereby in the formation of granulomas. However, little is known about the balance between proinflammatory cytokines and antiinflamatory cytokines in the development of sarcoid granulomas and disease activities. In the present study, we measured IL-6, IL-8 and IL-10 in the bronchoalveolar lavage fluid(BALF) from patients with pulmonary sarcoidosis 13 find out whether there is an imbalance between proinflammatory cytokines and antiinflammatory cytokines in the lung. METHODS: Fourteen subjects with the diagnosis of sarcoidosis and six healthy volunteers were included. BALF was concentrated ten-fold by pressure ultrafiltration and each cytokine levels were measured by ELISA method. Active sarcoidosis was defined by major organ involvement or clinically progressive diseases. RESULTS: The mean IL-6 love]s in the BALF of the active sarcoidosis group were significantly increased than in controls or inactive sarcoidosis group(p < 0.05). Meanwhile, the IL-8 levels were increased and IL-10 levels were decreased in the active sarcoidosis group than in controls or inactive sarcoidosis group without significance(p>0.05). In active pulmonary sarcoidosis patients, the IL-6 love]s in BALF correlated with the BALF CD4/CD8 ratio(r=0.768, p < 0.05) and IL-8 levels(r=0.564, p < 0.05). CONCLUSIONS: The data presented showed that proinflammatory cytokine IL-6 is important in the pathogenesis of sarcoidosis and decreased tendency of anti-inflammatory cytokine IL-10 might also be involved in the development of granulomatous inflammation in sarcoidosis.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Cytokines ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Granuloma ; Healthy Volunteers ; Humans ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Interleukins* ; Lung ; Macrophages ; Sarcoidosis ; Sarcoidosis, Pulmonary* ; T-Lymphocytes ; Ultrafiltration

STATEMENT OF PROBLEM: Titanium is widely used as an implant material for artificial teeth. Also, studies on surface treatment to form a fine passive film on the surface of commercial titanium or its alloys and improving bioactivity with bone have been carried out. However, there is insufficient data about the biocompatibility of the implant materials in the body. PURPOSE: The purpose of this study was to examine whether the precipitation of apatite on titanium metal is affected by surface modification. MATERIALS AND METHODS: Specimens chemically washed for 2 minute in a 1:1:1.5 (in vol%) mixture of 48% HF, 60% HNO3 and distilled water. Specimens were then chemically treated with a solution containing 97% H2SO4 and 30% H2O2 at 40 degrees C for 1 hour, and subsequently heat-treated at 400 degrees C for 1 hour. All specimens were immersed in the HBSS with pH 7.4 at 36.5 degrees C for 15 days, and the surface were examined with TF-XRD, SEM, EDX and XPS. Also, commercial purity Ti specimens with and without surface treatment were implanted in the abdominal connective tissue of mice for 4 weeks. Conventional aluminium and stainless steel 316L were also implanted for comparison. RESULTS AND CONCLUSIONS: The results obtained were summarized as follows. 1. An amorphous titania gel layer was formed on the titanium surface after the titanium specimen was treated with a H2SO4 and H2O2 solution. The average roughness was 2.175 micrometer after chemical surface treatment. 2. The amorphous titania was subsequently transformed into anatase by heat treatment at 400 degree C for 1 hour. 3. The average thickness of the fibrous capsule surrounding the specimens implanted in the connective tissue was 46.98 micrometer in chemically-treated Ti, and 52.20, 168.65 and 100.95 micrometer, respectively in commercial pure Ti, aluminum and stainless steel 316L without any treatment.
Alloys ; Aluminum ; Animals ; Connective Tissue ; Hot Temperature ; Hydrogen-Ion Concentration ; Mice ; Stainless Steel ; Titanium* ; Tooth, Artificial ; Water

The authors had performed stereotactic surgery to diagnose and treat 2 cases of neurocysticercosis under the local anethesia. Generally, such the open surgery need a general anethesia which may increase the chance of brain parenchyml injury. However, the stereotactic surgery has the advantage of being an easy and precise procedure under local anethesia. The authors reviewed the literature and discussed the stereotactic surgery in the diagnosis, and treatment of neurocysticercosis.
Albendazole ; Brain ; Diagnosis ; Neurocysticercosis* ; Praziquantel

The volumetric caudal epidural steroid injection has been advocated to facilitate the delivery of medications to the lesion site. This study was aimed to examine the actual spreading patterns of this technique, using epidurogram. A total of 32 patients with chronic low back pain accompanied by radiculopathy of various causes (degenerative spondylosis, herniated nucleus pulposus, spondylolisthesis, and spinal stenosis) were included. The volumetric caudal epidural injection of the 10 mL mixture of contrast medium 5 mL, 0.5% bupivacaine 1 mL, triamcinolone 1.5 mL (60 mg) and normal saline 25 mL was performed. Immediately after the cessation of the first spread, the subsequent solution of another 10 mL of contrast medium 5 mL, 0.5% bupivacaine 1 mL and normal saline 4 mL was injected. This procedure was repeated serially until the total volume to be 50 mL. Continuous fluoroscopic imaging was obtained after each injection. Average time taken to complete the study was 37 sec per every 10 mL. The spreading levels of the mixture were distributed mainly at mid to lower lumbar area in the majority of the patients. During the subsequent injections, the levels were not changed significantly. This was thought to be due to the minimal resistance in cephalad direction, anatomic variations and Starling effect of epidural space.
Adult ; Aged ; *Anesthesia, Epidural ; Anesthetics, Local/*pharmacokinetics ; Bupivacaine/*pharmacokinetics ; Chronic Disease ; Female ; Fluoroscopy ; Glucocorticoids, Synthetic/pharmacokinetics ; Human ; Low Back Pain/*drug therapy ; Male ; Middle Age ; Spinal Diseases/drug therapy ; Triamcinolone/pharmacokinetics

PURPOSE: A model and a program was developed for training surgeons in laparoscopic urethrovesical anastomosis in order to improve the laparoscopic suture technique for urologists with no previous experience. MATERIALS AND METHODS: The procedures were performed on a pelvic trainer using a videolaparoscopic unit. The program consisted of a simple suture, urethrovesical anastomosis with interrupted sutures, and urethrovesical anastomosis with continuous sutures. The trainees enrolled in this study were 5 residents from the urologic department who had little experiences in laparoscopic suturing. The trainees performed each procedure 10 times and the elapsed time was recorded. Univariate analysis of the general linear model was used to assess the significance of progression. RESULTS: In the first lesson of the simple suture, the mean elapsed time was 5.45+/-3.00 minutes (range 2.78-9.83minutes) and each trainee demonstrated a difference in the elapsed time for suturing. After the tenth lesson was complete, the mean elapsed time was 1.48+/-0.17 minutes (range 1.35- 1.70 minutes) and the time differences between each trainee decreased. In urethrovesical anastomosis with interrupted sutures, the mean elapsed time decreased from 24.07+/-3.97 minutes at the 1st lesson (range 16.13- 29.47 minutes) to 13.10+/-2.53 minutes (range 11.75-19.47 minutes) after 10 lessons. In urethrovesical anastomosis with continuous sutures, the mean time decreased from 39.61+/-3.60 minutes (range 34.41-45.71 minutes) after one lesson to 30.42+/-5.75 minutes (range 19.50-38.82 minutes) after 10 lessons. There were significant differences in the elapsed time up to the 2nd lesson compared with the 10th lesson in all procedures (p-value<0.05). CONCLUSIONS: The skills of the trainee can be improved by a model and a program for training laparoscopic urethrovesical anastomosis. In particular, urethrovesical anastomosis, in which many urologists find difficulty, may become more accessible using this model and program.
Anastomosis, Surgical ; Laparoscopy ; Linear Models ; Suture Techniques ; Sutures