PURPOSE: A retrospective review of the medical records of 168 patients who were evaluated for renal transplantation was undertaken to determine whether a voiding cystourethrography (VCUG) influenced the surgi cal care of the recipient. MATERIALS AND METHODS: Between June 1989 to May 1998, 168 patients received a transplantation at our center. These patients proceeded to transplantation, with all of them receiving a VCUG as part of their evaluation. We compared incidence of postoperative complications between normal VCUG group and abnormal group during follow up period (mean 31. 6 months). RESULTS: An urologic abnormality was identified by VCUG in 15 (8.9%) of 168 patients and all of them were vesicoureteral reflux (VUR). In 15 patients with VUR, grade of VUR were grade I in 2, grade II in 10, grade III in 2 and grade IV in 1. None of them with VUR required surgical intervention and had postoperative complications related to VUR. CONCLUSIONS: The VCUG is not essential for the preparation of potential recipients for renal transplantation and should be utilized selectively in individuals with a history of urologic disease or when urinary tract abnormalities are identified by physical examination or an abnormal urine analysis.
Follow-Up Studies ; Humans ; Incidence ; Kidney Transplantation* ; Medical Records ; Physical Examination ; Postoperative Complications ; Retrospective Studies ; Urinary Tract ; Urologic Diseases ; Vesico-Ureteral Reflux

The purpose of this study was to investigate the possibility of distraction osteogenesis in membranous onlay bone graft on the mandible and to clarify the histology of bone repair during distraction osteogenesis in the membranous onlay bone in a dog model. Four dogs, 5 months of age at the beginning of the experiment, were used for this study. The zygomatic arch was exposed in the subperiosteal plane and the full-thickness zygomatic arch was harvested to 3 centimeters in length. The lateral surface of the mandibular body was exposed in the subperiosteal plane and the membranous onlay bone graft was performed with firm contact using screws. The osteotomy on the membranous onlay bone graft and underlying mandibular body was carried down week 1 in dog 1, week 2 in dog 2, week 3 in dog 3, and week 4 in dog 4 after membranous onlay bone graft. The external distraction device was applied to the mandibular body. Mandibular distraction was started 7 days after the operation at a rate of 1mm per day for a total of 10 mm distraction over 10 days. After completion of distraction, the distraction device was left in place for 6 weeks bony consolidation of the distracted area. Radiographs were carried out at 2 weeks, 4 weeks and 6 weeks after distraction. New bone between the native underlying mandibular segments was generated in the distracted zone in all dogs. The new bone between the native underlying mandibular segments was generated in the distracted zone in all dogs. The new bone between segments of membranous onlay bone graft was not generated in dog 1, but it was generated in dogs 2, 3 and 4. However, in dog 2 and 3, the new bone between segments of the distracted membranous onlay bone graft presented less firmness with fibrous tissue than that of the native underlying mandibular segment. Histologically, the distracted gap between segments of the membranous onlay bone graft was composed of much fibrous tissue in the central zone while activated osteoblastic cells formed new bone in the margins of the distracted gap in dogs 2 and 3. In dog 4, there were abundant osteoblastic activities in the distracted gap and the new bone appeared as nearly-normal cortical bone. In conclusion, these findings suggested that membranous onlay bone graft had an osteogenic capacity and that distraction osteogenesis was possible in membranous onlay bone graft.
Animals ; Dogs* ; Inlays* ; Mandible ; Osteoblasts ; Osteogenesis, Distraction* ; Osteotomy ; Transplants* ; Zygoma

BACKGROUND: Pain following shoulder surgery is usually severe and difficult to control using conventional postoperative pain control maneuvers. Therefore, we investigated the pain control efficacy, PONV (postoperative nausea vomiting) and complications by the use of a continuous brachial plexus block in patients who had undergone shoulder surgery. METHODS: Thirty three shoulder surgery patients were enrolled in this study. According to the Borgeat's modified lateral technique, 30 ml of 0.37% ropivacaine were injected into the patients, which was followed by insertion of a continuous brachial plexus catheter into the plexus sheath. The operation was then conducted under general anesthesia, and postoperative pain was evaluated in the recovery room 12, 24, 36, and 48 hr after surgery. In addition, nausea and vomiting was calculated using the visual analogue scale (VAS) and sedation was evaluated using the modified Ramsay score. A total of 400 ml of 0.2% Ropivacaine was administered at a rate of 8 ml/hr to control the postoperative pain for 2 days. In addition, other neurological complications were investigated, and the catheter tips were cultured after they were removed to determine if any infection had occurred. RESULTS: The postoperative pain scores were below 2 on the 10 cm VAS, and the level of nausea and vomiting was also satisfactorily (< 2/10 cm VAS). In addition, the mean sedation score of the patients in the recovery room was 2. There were complications including motor weakness (24%), dyspnea (15%), Hornor's syndrome (9%), postauricular numbness (9%) and metallic taste (3%), however, there were no patients who complained of neurological symptoms after one month of follow-up, and no signs of infection were found when the results of catheter tip cultures were evaluated. CONCLUSIONS: The use of a continuous interscalene brachial plexus block is a feasible method of postoperative pain control for patients who undergo major shoulder surgery.
Anesthesia, General ; Brachial Plexus* ; Catheters ; Dyspnea ; Follow-Up Studies ; Humans ; Hypesthesia ; Nausea ; Nerve Block ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Recovery Room ; Shoulder* ; Taste Disorders ; Vomiting

Total abdominal hystrectomy is the most common surgery of Gynecology. It's complication are taken very important. Although neuropathy, especially femoral nerve injury, is rare, recently we have experienced a case of femoral neuropathy after total abdominal hystrectomy. We present this case with a brief review of literature.
Femoral Nerve* ; Femoral Neuropathy ; Gynecology

In the management of the traumatized gravid and her fetus, diagnostic tests and therapy should be directed primarily at the care of the mother and should not be delayed or compromised because of the pregnancy. Because many factors can damage when the mother is unconscious, fetal well-being should be assessed by serial biophysical profile scoring. If the mother's condition is stable as in the chronic vegetative state, elective delivery might best be performed at a gestational age of 32 to 34 weeks.
Diagnostic Tests, Routine ; Fetus ; Gestational Age ; Humans ; Mothers ; Persistent Vegetative State* ; Pregnancy*

The authors report a case of 21-year-old, neurologically normal female who presented with a teratoma contained in a cervical meningocele. The concurrence of a congenital neoplasm within the spine associated with spina bifida cystica seems to be a very rare event. The radiographic studies, histological examinations, treatment and follow up findings in this case are presented with a review of the literature.
Female ; Follow-Up Studies ; Humans ; Meningocele* ; Spina Bifida Cystica ; Spine ; Teratoma* ; Young Adult

Mouse monoclonal antibody was used for this study. This study was undertaken to define the prognostic value of the expression of Cathepsin-D in 121 breast cancer patients. The results were as follows: 1) Overall, 53.7% of patients were positive for Cathepsin-D 2) Positive staining did not correlate with age, estrogen receptor status,tumor size, axillary nodal status, tumor stage, menopausal status, pathologic grade, DNA ploidy and S-phase fraction.
Animals ; Breast Neoplasms* ; Breast* ; DNA ; Estrogens ; Humans ; Mice ; Ploidies

STUDY DESIGN: A prospective study. OBJECTIVES: To determine the usefulness of local bone obtained from laminectomy and decortication as graft bone instead of autogenous iliac bone in posterolateral lumbar spinal fusion. MATERIALS AND METHODS: Thirty-one patients underwent posterolateral lumbar spinal fusion with pedicle screw instrumentation. Local bone was inserted in the right side of intertransverse space and autogenous iliac bone was in the left side. We compared fusion rate in the radiographs at postoperative 6 week, 3 month, 6 month and 1 year. RESULTS: Radiographic fusion grading of local bone was 20 cases of grade 1, 8 cases of grade 2, 2 cases of grade 3 and 1 case of grade 4. Fusion grading of autogenous iliac bone was 24 cases of grade 1, 4 cases of grade 2 and 3 cases of grade 3. Bone fusion was complete after 9.1 months in local bone and 7.2 months in autogenous iliac bone. No significant differences was found between the two groups. CONCLUSION: The local bone in posterolateral lumbar fusion is appropriate for satisfactory fusion instead of autogenous iliac bone if the amount of local bone is sufficient and decortication of the fusion bed is proper.
Humans ; Laminectomy ; Prospective Studies ; Spinal Fusion ; Transplants*

Type I thyroplasty, we know, could not overcome the large posterior glottal chink and arytenoid adduction have been proved to be uneffective in the cases of unilateral vocal cord paralysis with vocal cord atrophy or bowing deformity. So we performed type I thyroplasty in conjunction with arytenoid adduction and tried to compare the postoperative results with that of arytenoid adduction. We experienced 8 cases of arytenoid adductions and 6 cases of combined operations in the cases of unilateral vocal cord paralysis. All 14 patients had large posterior glottal chink. In order to compare the postoperative voice results of two groups as objective as possible, we performed preoperative and postoperative videoimage analysis(chink size, interarytenoid distance) and computer-assisted voice analysis(MPT, Jitter, Shimmer, S/N ratio). As a results, the postoperative voice outcome is superior with the combined operation than with the arytenoid adduction only in the cases of unilateral vocal cord paralysis with large glottal chink.
Atrophy ; Congenital Abnormalities ; Humans ; Laryngoplasty* ; Vocal Cord Paralysis* ; Vocal Cords ; Voice

PURPOSE: Open reduction and internal fixation of calcaneal fracture using plate has been used. While numerous plates have been manufactured, most of the conventional plates are designed for westerners, realistically the size is larger for Korean. The domestic products, on the other hand, often have the undesirable screw holes and path. Therefore, we measured the radiologic parameter of Korean calcaneus for providing the plate and screw hole placements. MATERIALS AND METHODS: We measured the outer lines and angles with over the 20 years old 291 females and 322 males. A: Length of inferior plane of calcaneus, B: Length of anterior plane of calcaneus, C: Length from line A to sinus tarsi, D: Length from line A to posterior point of posterior facet, E: Length from line A to calcaneal tuberosity, F: Length of posterior facet, G: Length from anterior point of line A to C, H: Length from line C to line D, a: Angle between A and B, b: Gissane angle, c: Bohler angle, d: Calcaneal pitch angle using Marosis m-view(R). RESULTS: Mean A, B, C, D, E, F, G, H were 63.6, 26.4, 23.2, 43.7, 40.5, 26.9, 12.8, 18.1 mm. Mean a, b, c, d angle were 105.8, 122.4, 32.4, 20.5degrees. Male's calcaneus is significantly bigger than female's (p<0.001). CONCLUSION: AP calcaneus length 63.6 mm, maximal height 43.7 mm is considered to be helpful in making the Korean calcaneal plate.
Calcaneus ; Female ; Hand ; Humans ; Male