A new method of urinary diversion via Skinner`s modification of Koch continent ileal reservoir was tried. With this method continence with storage of urine under low pressure is well maintained so that no external applicances are necessary. Ileorenal reflux is also prevented with this nipple forming technique. From May l986 to September l986, 4 patients underwent urinary diversion that included creation of a modified Koch pouch by Skinner. Previous urinary diversion was by ureterocutaneous diversion in 1 patient. A total of 3 patients underwent radical cystectomies for bladder cancer In 1 patient, simultaneous urethrectomy was done because of carcinoma in situ in the urethra. There were no operative mortalities. All patients are continent and without reflux to the upper urinary tract. The volume capacity of pouch is more than 400ml. The pouch is emptied by self-catheterization every 4 to 6 hours during the day and once at night. Postoperative follow-up presently is short and it is impossible to check late complications. Although preliminary, this clinical trial suggests that the quality of life for patients can be improved markedly by the modified Koch continent ileal reservoir.
Carcinoma in Situ ; Colonic Pouches* ; Cystectomy ; Follow-Up Studies ; Humans ; Mortality ; Nipples ; Quality of Life ; Urethra ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urinary Tract

No abstract available.
Intracranial Arteriovenous Malformations* ; Risk Factors*

No abstract available.
Immunosuppression* ; Prognosis* ; Transplantation*

Involucrin is a recently recognized structural component of mature squamous epithelial cells and is considered as a marker of normal eratinocyte differentiation and ma.turation. In this study peroxidase-antiperoxidase techniques were used to assess involucrin expression in histologic sections of normal skin and a variety of epidennal tumors including squamous cell carcinomas(25 cases), keratoacanthomas(11 cases), basal cell carcinomas(20 cases), trichoepitheliomas(5 cases), Howens diseases(12 cases), arsenic keratoses(10 cases), actinic keratoses(10 cases) and Pagets diseases(2 cases). The results were as follows : l. In normal skin, the upper third of the viable epidermis showed diffuse cytoplasmic staining for involucrin. In hair follicles, the lower area of inner root sheath and inner area of the outer root sheath stained positively. The sebareous glands did not stain, but the ducts of sebaceous glands were positive. 2. Keratoacanthomas showed a relatively homogeneous staining pattern for inirolucrin ', all cells except basal cells stained with mild to moderate intensity. In contrast, squamous cell carcinomas disclosed a highly irregular involucrin staining pattern with marked variation in staining intensity from cell to cell. 3. Basal cell carcinomas were negative for involucrin except squamous horn cysts, and the epidermis overlying basal cell carcinomas showed the field effect, that is, the epidermis overlying the tumors exhibited diffuse, homogeneous positive staining of cells in all layers of the epidermis. 4. ln trichoepitheliomas, the involucrin reactivity was negative as in basal cell carcinoma.s, but the field effect was not observed. 5. In Elowens disease, actinic keratosis, arsenic keratosis and Pagets disease, the positivit.y for involucrin staining extended deeper into the stratum malpighii than was observed wit,h normal epidermis. And areas showing irregular patchy pattern of involucrin staining were considered to have the potentiality of malignant invasive change much more than the negative or homogeneous areas. Paget's cells were negative for involucrin as the adjoining keratinocytes in the lower portion af epidermis.
Actins ; Animals ; Arsenic ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cytoplasm ; Epidermis ; Epithelial Cells ; Hair Follicle ; Horns ; Keratinocytes ; Keratoacanthoma ; Keratosis ; Keratosis, Actinic ; Sebaceous Glands ; Secobarbital ; Skin

It is difficult to know whether the presence of infection in the plantar ulcer in patients with leprosy or not. Because routine bacteriology is often unhelpful, we need to investigate diagnostic method in this situation. C-reactive protein(CRF) levels have been known to be useful in detecting infection in some diseases. In this study, CRP levels were measured in 20 leprosy patients with plantar ulceration and 14 patients with leprosy alone. The results were as follows : 1. There was no elevation of CRP levels in patients with leprosy alone, and in the majority of patients with ulcers. 2. Of 20 patients with plantar ulcers, four had raised CRP levels one had clinically obvious infection, and three had erythematous skin of uncertain cause surrounding their ulcers. 3. Treatment with an appropriate antibiotics reduced CRP levels to normal, which was associated with clinical improvement. Therefore, it is suggested that increased CRP levels can be a useful probe for detecting significant bacterial infection in plantar ulcers of leprosy patients.
Anti-Bacterial Agents ; Bacterial Infections ; Bacteriology ; Foot Ulcer ; Humans ; Leprosy* ; Skin ; Ulcer*

Clinical study on 62 patients (26 males and 36 females) with neurofibromatosis seen during past ten years at the Department of Dermatology, Pusan National Universitg Hospital, was made the variable clinical manifestations of the disease and Riccardis ciassification were emphasized. The results were as follows . 1) Family history was noted in 32 cases(51.6%) and exhibited autosomal dominant inheritance pattern. 2) Cutaneous neurofibromas were found in 52 cases(83.8%). 3) Cafe-au-lait spots, measuring greater than 1.5cm in its longest diameter, were found in 60 cases(96.8%) and 44 cases(71.0%) had more than 6 in number. 4) Among associated abnormalities were,' mental retardation(20,9%), skeletal abnormalities(11.2%), seizure, severe headache, etc. 5) According to Riccardis classification, 38 cases could be classified as type I, 28 cases(73.7%); type II, 0 case ; type III, 1 case(2.6%); type IV, 3 cases(7, 9%); type V, 1 case(2.6%); type VI, 4 cases(10.5%); type VII, l case(2.6%); and type VIII, 0 case.
Busan ; Cafe-au-Lait Spots ; Classification* ; Dermatology ; Headache ; Humans ; Inheritance Patterns ; Male ; Neurofibroma ; Neurofibromatoses* ; Seizures

Short umbilical cord syndrome, also known as the limb-body wall malformation complex and the body stalk anomaly, is a poorly defined sporadic group of congenital anomaly charaterized by a complex set of disruptive abnormalities having in common the failured closure of the ventral body wall. This disorder is charaterized by a short or absent umbilical cord and disruption of the lateral body wall, spine, limbs, face, and cranium, isolated or in combination. Recently, we present a case of short umbilical cord syndrome which found in a term baby, so we report a case of short umbilical cord syndrome with brief review of literature.
Extremities ; Skull ; Spine ; Umbilical Cord*

No abstract available.
Allografts*

No abstract available.
Hyperlipoproteinemias*

Heorrhage and infarct-like necrosis of anterior lobe of the pituitary gland is one of the characteristic pathologic findings of the autopsied cases of Korean Hemorrhagic Fever (KHF) patients, but there has been rare reports of hypopituitarism in patients with KHF. Recently we have experienced a patient with hyponatremia who had recovered from KHF. He was admitted to our hospital due to nausea, vomiting, and epigastric discornfort. To determine the function of the anterior pituitary gland, hormonal levels of target galnds and pituitary gland were measured, and combined pituitary stimulation test was performed. ACTH, GH, and prolactin deficiency were confirmed by combined pituitary stimulation test in this patient. There was no evidence of hypothalamic or other pituitary diseases by brain MRI. Our experience shows that KHF can be a cause of hypopituitarism and these findings should alert physicians the possibility of hypopituitarisrn in patients who had recovered from KHF.
Adrenocorticotropic Hormone ; Brain ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hyponatremia ; Hypopituitarism* ; Magnetic Resonance Imaging ; Nausea ; Necrosis ; Pituitary Diseases ; Pituitary Gland ; Pituitary Gland, Anterior ; Prolactin ; Vomiting