Spontaneous Subcapsular hematoma of the kidney is relatively uncommon. Although several cases have been recorded in the literature, the diagnosis was seldom made preoperatively. Selective renal angiography provide an excellent means of diagnosing this lesion prior to surgery. Case I: A 37 years male was admitted with the right flank pain and hematuria. Excretory urogram showed moderate hydronephrosis and a cystic shadow compressing upper calices. Selective renal angiography showed strip-like curvilinear capsular density outside the nonopacifying mass. By exploration, blood clots, about 300 c. c., between renal parenchyma and renal capsule was evacuated. The cause of the hematoma is uncertain whether it is from ruptured aneurysm or due to hydronephrosis. Case II : A 54-year-old woman was hospitalized with right flank discomfortness and mild fever. Intravenous pyelogram revealed increased size of the right kidney and angiogram demonstrated the compressed and flattened renal parenchyma by a nonopacifying mass and renal capsule on the outer margin of the mass. Blood clots, about 200 c.c., inside the renal capsule which compressed renal parenchyma was evacuated.
Aneurysm, Ruptured ; Angiography ; Diagnosis ; Female ; Fever ; Flank Pain ; Hematoma* ; Hematuria ; Humans ; Hydronephrosis ; Kidney* ; Male ; Middle Aged

Ankylosing spondylitis is a chronic inflammatory disease of unknown etiology that affects spine, sacroiliac joint, and the large joints of the extremities, and lead to fibrous or bony ankylosis and deformity. The rigid ankylosed spine of ankylosing spondylitis is prone to fracture by minimal trauma, and the resulting fractures likely to be unstable and damage to spinal cord or cauda equina. The authors report a case of paraplegia in ankylosing spondylitis after open reduction of the femoral trohanteric fracture.
Ankylosis ; Cauda Equina ; Congenital Abnormalities ; Extremities ; Femur ; Joints ; Paraplegia ; Sacroiliac Joint ; Spinal Cord ; Spine ; Spondylitis, Ankylosing

Yonsei University College of Medicine, Seoul, Korea Maffucci's syndrome is characterized by dysccondroplasia with hemangiomata. Since Angelo Maffucci (1881) first described this entity, 105 cases and some more were reported in the literature till 1976. We recently observed a patient suffering from this disorder. The patient is 21 year-old girl, who has multiple hemangiomes on her right foot, right buttock, left wrist and enchondromas on both proximal phalanx, distal phalanx of both great toes and proximal, middle phalanx of right second toe. The disease started at age of 11 and these lesions grew rapidly last 3 years. The diagnosis was based on clinical, radiological and histological findings. Because of its rarity, we report it with brief review of literature.
Buttocks ; Chondroma ; Diagnosis ; Female ; Foot ; Humans ; Korea ; Osteochondrodysplasias ; Seoul ; Toes ; Wrist

Several stresses are known to induce synthesis of heat shock protein. The present study was performed to see whether pulmonary ischemia, induced by the bronchial artery occlusion, produced HSP70 in cat lung. To this aim we compared experimental and control groups of cats with respect to the HSP70 production in the lung. Experimental animals were subjected to 10-min bronchial artery occlusion followed by reperfusion. The interval between the end of the occlusion and the end of the reperfusion was 1 hour, 4 hours and 8 hours, whereas control animal was not subjected to any manipulation except anesthesia. According to the interval differences, experimental animals were divided into 1HR, 4HRs and 8HRs groups. To determine the induction of HSP70 in each group, total proteins of lung tissues were extracted and separated by PAGE electrophoresis. Immunoblotting with a mouse monoclonal anti-HSP70 IgG antibody revealed that HSP70 was not detected in the pulmonary tissues resected from control, 1HR or 4HRs groups. In contrast, HSP70 expression in 8HRs group was marked. These results suggest that pulmonary ischemia by the bronchial artery occlusion produces HSP70 in a delayed
Anesthesia ; Animals ; Bronchial Arteries* ; Cats* ; Electrophoresis ; Heat-Shock Proteins ; Immunoblotting ; Immunoglobulin G ; Ischemia ; Lung* ; Mice ; Reperfusion

BACKGROUND: Depressive symptoms are common in the medically ill patients although depressive disorders are considerably underdiagnosed and undertreated. Therefore, we examined the characteristics of depressive tendency in medical inpatients. METHODS: The patient group-144 subj.cts(90 males, 54 females) were selected from medical inpatients of Kae Jung hospital. 158 subjects(106 male, 52 females) with no prior history of diseases were selected for the control group. The Beck Depression Inventory(BDI) and Hamilton Rating Scale for Depression(HRSD) was used for both groups from June to December 1997. RESULTS: The patient group had a significant higher BDI and HRSD score than controls(p<0.01). In the patients, 31.3% had scores on the BDI greater than the cutting score of 21, and 26.4% had scores on the HRSD greater than the cutting score of 22. In the patients, demographic and medical variables were evaluated with respect to depression. those in their 60's, with education level of elementary school and below. the divorced, bereaved and separated, and having duration of illness more than one year were statistically more depressed, but depression was not associated with sex, religion and medical diagnosis. CONCLUSIONS: This study indicates that depressive tendency may be a common phenomena in medically ill patients. Therefore, we should suspect depression in the management of these patients.
Depression ; Depressive Disorder ; Diagnosis ; Divorce ; Education ; Humans ; Inpatients* ; Male

BACKGROUND: The expression of adhesion molecules contribute to development of systemic diseases. Vascular cell adhesion molecule-l(VCAM-1) is an endothelial cell membrane glycoprotein that has been implicated in leukocyte/endothelial cell interactions in inflammation. OBJECTIVE: The aim of this study was to characterize the surface expression and regulation of VCAM-1 on two different endothelial cells. METHOD: We examined the effects of the expression of VCAM-1 in two different endothelial cells, isolated from human umbilical cords and human glomerulus. Expression of VCAM-1 was measured by enzyme-linked immunosorbent assay(ELISA) and flow cytometry. RESULTS: In human umbilical cord endothelial cells(HUVECs), both interleukin-l B(IL-lB) and tumor necrosis factor-a (TNF-a) increased VCAM-1 expression. VCAM-1 expression increased by TNF-a was higher than that increased by IL-lB. In human glomerular endothelial cells(HGECs), IL-lB and TNF-a markedly increased VCAM-1 expression. Conclusion. The regulation of VCAM-1 appears to be somewhat different in HGECs compared with HUVECs. These differences between the responsiveness of the two cells may possibly indicate inherent differences in endothelial cell derived from different vascular beds.
Cell Adhesion ; Cell Communication ; Cytokines* ; Endothelial Cells* ; Flow Cytometry ; Humans* ; Inflammation ; Membrane Glycoproteins ; Necrosis ; Umbilical Cord ; Vascular Cell Adhesion Molecule-1*

No abstract available.
Humans ; Kidney Transplantation* ; Kidney* ; Living Donors* ; Renal Artery* ; Tissue Donors*

BACKGROUND: The ProSeal laryngeal mask airway (PLMA) is a new laryngeal mask device with a larger cuff and a drainage tube. This study was designed to assess the usefulness and the safety of the PLMA in a laparoscopic cholecystectomy. METHODS: Forty patients undergoing a laparoscopic cholecystectomy were randomly allocated to two groups; an endotracheal tube (ETT) group or a PLMA group. Anesthesia was induced with intravenous fentanyl and propofol and maintained with TCI-propofol. Blood pressure, heart rate, peak inspiratory pressure, peripheral O2 saturation (SpO2), end-tidal CO2 tension (PETCO2) and PaCO2 was measured during the operation. The incidence of gastric content regurgitation and gross pulmonary aspiration were evaluated. Postoperatively, SpO2, the visual analogue scale (VAS) of pain, nausea and vomiting (PONV), and sore throat were evaluated at 30 minutes intervals in post-anesthetic care unit (PACU) and at night. RESULTS: There were no significant differences in intraoperative PIP, SpO2, PETCO2, postoperative SpO2, VAS scores, PONV, and sore throat between the two groups. Gross pulmonary aspiration was not found in either group, but minimal gastric regurgitation occurred in 2 cases of the ETT group and 1 case of the PLMA group. CONCLUSIONS: We concluded that there were no differences in patient safety and adequate ventilation for a laparoscopic cholecystectomy between the ETT group and PLMA group. Moreover, there were no increases in blood pressure and heart rate in PLMA group during insertion/intubation.
Anesthesia ; Blood Pressure ; Cholecystectomy, Laparoscopic* ; Drainage ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Laryngeal Masks* ; Laryngopharyngeal Reflux ; Nausea ; Patient Safety ; Pharyngitis ; Postoperative Nausea and Vomiting ; Propofol ; Ventilation ; Vomiting

Since the development of ultrasonography and computerized topography scanning, the diagnosis of uric acid stone the urinary system has not been difficult. But recently, we experienced a case of uric acid stone that was misdiagnosed as renal pelvis tumor.
Diagnosis ; Kidney Pelvis* ; Ultrasonography ; Uric Acid*

Pulmonary atelectasis is a common complication following surgery under general anesthesia. However, collapse during anesthesia and surgery is rare, and usually is not diagnosed until the surgical procedure is well under way. Total or segmental lung collapses are usually resulted from the obstruction of bronchial pathway by secretions such as mucus, blood and pus etc. We experienced acute lung collapse of right upper lobe during left thoracotomy. We assumed that the cause of the atelectasis was an obstruction of right superior lobar bronchus by mucus. The possible cause of lung collapse is described.
Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation* ; Bronchi ; Inhalation* ; Lung ; Mucus ; Pulmonary Atelectasis* ; Suppuration ; Thoracotomy*