Penile horn is a peculiar form of penile wart disclosing excessive keratosis with unknown etiology. A case of penile horn arising on the circumcised wound 2 years after circumcision is presented with review of literatures.
Animals ; Circumcision, Male ; Female ; Horns* ; Keratosis ; Male ; Warts ; Wounds and Injuries

A case of 28 year-old female having vesico-sigmoido-ileal fistula associated with large bladder stone due to long-standing foreign body was presented with review of literatures.
Adult ; Female ; Fistula* ; Foreign Bodies ; Humans ; Urinary Bladder Calculi

PURPOSE: To evaluate the specific findings of angiography for various causes of gastrointestinal bleeding. MATERIALS AND METHODS: We retrospectively analyzed 35 patients of gastrointestinal bleeding detected by angiography, between April 1987 and July 1993. There were 28 men and 7 women, 19 to 83 years old (mean, 47 years). Of these 35 cases of gastrointestinal bleedings, there were 12 gastric bleedings, 4 duodenal bleedings, 9 small intestinal bleeings, 6 ileocecal bleedings, and 4 large intestinal bleedings. RESULTS: Of 35 cases, we could diagnose the specific cause of bleeing in 13 patients (37%) by angiography. Of these 13 cases, there were 4 cases of gastric ulcers showing contrast pooling in ulcer crater, 5 cases of vascular malformations showing anomalous vascular mass with early dilated venous drainage, 2 cases of direct invasion of hepatocellular carcinoma showing invasion of hypervascular mass into small bowel, one case of pseudoaneurysm at gastroduodenal artery in a patient of acute pancreatitis, and one case of small intestinal lymphoma showing contrast pooling in a irregular dilated small intestinal lumen. CONCLUSION: in gastrointestinal bleeding, angiography is useful not only in detecting the bleeding site, but also for evaluating the specific causes such as gastric ulcers or vascular malformations.
Aged, 80 and over ; Aneurysm, False ; Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis* ; Drainage ; Female ; Hemorrhage* ; Humans ; Lymphoma ; Male ; Pancreatitis ; Retrospective Studies ; Stomach Ulcer ; Ulcer ; Vascular Malformations

PURPOSE: To evaluate the radiological findings and effectiveness of radiological interventions in patientswith iatrogenic vascular injuries. MATERIALS AND METHODS: We analyzed 50 patients with iatrogenic vascularinjuries treated with radiological intervention. The causes of injuries were surgery(n=20), cardiovascularintervention(n=15), non-cardiovascular radiological intervention(n=14), and endoscopic intervention(n=1). Theinjury had resulted in hemorrhage in 35 cases. The iliac and/or femoral, hepatic, and renal vessels were commonlyinjured. Angiography, ultrasonography with Doppler examination, CT, and CT angiography were performed to diagnosevascular injuries and guide the radiological intervention. The mean follow-up period was 23 months and in 16 caseswas more than one year. RESULTS: The major radiological findings were extravasation, pseudoaneurysm,arteriovenous shunt, or vascular obstruction. To control these lesions, radiological interventions such asembolization(n=36), local urokinase administration, stent insertion, foreign body removal, ultrasonography-guidedcompression, or stent-graft insertion were performed. The clinical problems were immediately controlled by thesingle trials of radiological interventions and did not recur in 40 cases (80%). CONCLUSION: Radiologicalexaminations and interventions are useful in cases with iatrogenic vascular injuries.
Angiography ; Follow-Up Studies ; Foreign Bodies ; Hemorrhage ; Humans ; Stents ; Ultrasonography ; Urokinase-Type Plasminogen Activator ; Vascular System Injuries*

In portal hypertension, hepatopetal flow is rerouted away from the liver through collateral pathways to low pressure systemic vessels. Information about collateral pathways is relevant, especially when interventional procedure or surgery is contemplated, because inadvertent disruption of these veins can cause significant bleeding. Dynamic CT and spiral CT with a bolus injection of contrast material have to a significant extent recently replaced angiography. The porto-systemic collateral pathways have, however, been classified and described according to location or frequency in a majority of previous reports. This essay illustrates variable porto-systemic collateral blood flow pathways, with CT and angiography correlation.
Angiography* ; Hypertension, Portal* ; Liver ; Portasystemic Shunt, Surgical ; Portography ; Tomography, Spiral Computed ; Veins

PURPOSE: To describe the clinical outcome of AMT (amniotic membrane transplantation) for corneal ulcers, persistent epithelial defects, corneal perforations, and neurotropic ulcers. METHODS: We performed AMT on 10 cases of corneal ulcer, 5 cases of persistent epithelial defect, 2 cases of corneal perforation, and 3 cases of neurotropic ulcer from Agust 1999 to May 2002. Amniotic membrane was obtained from the women undergoing elective Cesarean section or normal delivery. We had applied one or two layers of fresh amniotic membrane, that is used within 4hours after resection, over the ulcer bed and anchored by interrupted and running suture technique with 10-0 Nylon. After AMT, Topical eye drops was used three times a day. RESULTS: After AMT, Visual acuity was improved in 6 eyes of 10 corneal ulcer patients and maintained in 3 eyes. In all patients the persistent epithelial erosion was healed and pain was subsided between 6 and 12 days after surgery. There were no leakage in corneal perforation patients, and stable ocular surface were achieved after mean period 15.5 days. The ocular surface was restored by AMT in all neurotropic ulcer patients. CONCLUSIONS: The AMT is an effective method for managing corneal ulcer or ocular surface diseases, that are refractory to conventional treatment. The AMT shortened the usage of broad spectrum antibiotics , increased compliance, and decreased corneal opacity and neovascularization.
Amnion* ; Anti-Bacterial Agents ; Cesarean Section ; Compliance ; Corneal Opacity ; Corneal Perforation ; Corneal Ulcer* ; Female ; Humans ; Membranes ; Nylons ; Ophthalmic Solutions ; Pregnancy ; Running ; Suture Techniques ; Ulcer ; Visual Acuity

PURPOSE: Monitoring pneumococcal carriage rates is important. We developed and evaluated the accuracy of a real-time reverse transcription polymerase chain reaction (RT-PCR) protocol for the detection of Streptococcus pneumoniae. METHODS: In October 2014, 157 nasopharyngeal aspirates were collected from patients aged <18 years admitted to Chung-Ang University Hospital. We developed and evaluated a real-time PCR method for detecting S. pneumoniae by comparing culture findings with the results of the real-time PCR using genomic DNA (gDNA). Of 157 samples, 20 specimens were analyzed in order to compare the results of cultures, realtime PCR, and real-time RT-PCR. RESULTS: The concordance rate between culture findings and the results of real-time PCR was 0.922 (P <0.01, Fisher exact test). The 133 culture-negative samples were confirmed to be negative for S. pneumoniae using real-time PCR. Of the remaining 24 culture-positive samples, 21 were identified as S. pneumonia-positive using real-time PCR. The results of real-time RT-PCR and real-time PCR from 20 specimens were consistent with culture findings for all S. pneumoniae-positive samples except one. Culture and real-time RT-PCR required 26.5 and 4.5 hours to perform, respectively. CONCLUSIONS: This study established a real-time RT-PCR method for the detection of pneumococcal carriage in the nasopharynx. Real-time RT-PCR is an accurate, convenient, and time-saving method; therefore, it may be useful for collecting epidemiologic data regarding pneumococcal carriage in children.
Child* ; DNA ; Humans ; Methods ; Nasopharynx ; Pneumonia ; Polymerase Chain Reaction* ; Real-Time Polymerase Chain Reaction ; Reverse Transcription* ; RNA* ; Streptococcus pneumoniae

No abstract available.
Osteoblasts* ; PPAR gamma

PURPOSE: To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) and stent insertion incentral venous steno-occlusion. MATERIALS AND METHODS: Between August 1992 and January 1998, 11 patients with symptomatic central venous steno-occlusion(six stenoses and five occlusions) underwent pereutaneous treatment. Eleven PTAs were performed and stents were introduced in two patients because of incomplete PTA. During follow-up, a total of eight revisions were performed in five patients with recurrence(six stenoses and two occlusions). Success and long term patency rates were evaluated. The length and degree of the lesion and degree of residualstenosis, as well as pressure gradient through the lesion and decrease of the gradient after PTA, were correlated with patency rates. Complications during the procedures and follow-up period were evaluated. RESULT: The overall success rate was 89.5%; those of primary and revision intervention were 90.9% and 87.5%, respectively. Primary and revision patency rates were 72.7% and 50%, respectively, at 6 months, and 40% and 25% at 12 months. In five patients who underwent revision, primary and secondary patency rates were 80% and 100% at 6 months, 40% and 80% at 12 months, and 0% and 60% at 18 months. Only reduction of the pressure gradient after PTA correlated significantly with patency rates. No significant complications observed during the procedures follow-up period. CONCLUSION: PTA and stent insertion is effective for the treatment of central venous steno-occlusion.
Angioplasty* ; Brachiocephalic Veins ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Stents*

BACKGROUND: The bispectral index (BIS) has been used as an indicator of a sedative state and has been considered to be related to anesthetic agents and noxious stimulus. In this study, we measured the BIS, blood pressure (BP) and heart rate (HR) during induction of anesthesia after premedication with or without midazolam or morphine and evaluated the bispectral index as an indicator of an objective evaluation of midazolam premedication and relation to the cardiovascular response to the anesthetic induction. METHODS: Seventy five patients scheduled to undergo elective surgery under general anesthesia were divided into 3 groups. Each group received midazolam and glycopyrrolate (midazolam group, n = 25), or morphine and glycopyrrolate (morphine group, n = 25), or glycopyrrolate only (control group, n = 25) as premedication (midazolam 0.08 mg/kg IM, morphine 0.05 mg/kg IM, glycopyrrorate 0.2 mg IM). Then, anesthetic induction (propofol 2 mg/kg, succynylcholine 1 mg/kg) was done. The bispectral index, blood pressure, and heart rate were measured at before induction, after propofol injection, and intubation. RESULTS: The Bispectral index was significantly lower in the midazolam group and the morphine group compared with the control group before anesthetic induction. Blood pressure was not significantly different among the three groups. Heart rate was significantly lower in the midazolam group compared with the control group before anesthetic induction. CONCLSIONS: Midazolam or morphine premedicated patients appear to maintain a stable heart rate and have a low BIS at before induction. The Bispectral index could be objectively used in midazolam-premedicated patients when evaluating the degree of sedation and predicting hemodynamic changes, and probably in morphine-premedicated patients also.
Anesthesia ; Anesthesia, General ; Anesthetics ; Blood Pressure ; Glycopyrrolate ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Midazolam* ; Morphine* ; Premedication* ; Propofol