PURPOSE: To emphasize the significance of urethral abnormalities as the cause of vesicoureteral reflux in children. MATERIALS AND METHODS: Current literatures were evaluated and the data in my laboratories were added. RESULTS: Vesicoureteral reflux in boys which is more common in neonates and infants, has the tendency of quicker spontaneous resolution compared to girls in spite of its bilaterality and high grade. On the other hand, vesicoureteral reflux in girls, more commonly found after the first year of life, shows slower spontaneous resolution than boys although it shows lower grades when compared to boys. Such findings are attributed to sexual difference and the urethra is suspected to play an important role. The urethra influences the bladder function through sphincter to bladder reflex during the filling phase, and urethra to bladder reflex during the voiding phase. Cobb's collar which is an obstructive urethral lesion in males, is supposed to disappear after a short existence during fetal or neonatal period. However, if it causes severe obstruction or fails to disappear, it is suspected to result in the typical male type of vesicoureteral reflux caused by voiding dysfunction and increased intravesical pressure created by obstruction itself and urethral instability. Meanwhile, urethral abnormalities in girls such as mucosal web or female hypospadias causes vaginal voiding leading to dysfunctional voiding after toilet training and consequently results in vesicoureteral reflux through bladder instability, increased intravesical pressure and urinary tract infection as well as urethral instability. CONCLUSIONS: Since the meaning of surgery in vesicoureteral reflux, in view of kidney preservation, is becoming limited to the extent of recognizing the merit of surgical correction as merely discontinuing prophylactic antibiotics, studies of urethra in children with vesicoureteral reflux is another filed in (pediatric) urology which requires more active research and treatment.
Anti-Bacterial Agents ; Child* ; Female ; Hand ; Humans ; Hypospadias ; Infant ; Infant, Newborn ; Kidney ; Male ; Reflex ; Toilet Training ; Urethra ; Urinary Bladder ; Urinary Tract Infections ; Urology ; Vesico-Ureteral Reflux*

Nitric Oxide (NO) is an important mediator in various pathological conditions. The list of agents known to activate the NO pathway continues to expand and now includes bacterial products, cytokines, cAMP-elevating agents, trauma, and ozone. The activation of the L-arginine-dependent NO pathway via NO synthase is an important mechanism to stimulate both antimicrobial capability and cytotoxicity of phagocytes. NO has both beneficial and detrimental effects on host responses including lung injury. The effects of NO on the host were intensively investigated in lung injury, bovine pneumonic pasteurellosis (51). However, there was no description about the effect on the primary agent of the disease, Pasteurella haemolytica Al. Therefore, we investigated the effect of NO produced from bovine alveolar macrophages on the growth of Pasteurella haemolytica Al which is the primary agent of bovine pneumonic pasteurellosis. With the exogenous source of NO, sodium nitroprusside (SNP), the growth of the bacterium was dose-dependently inhibited by NO produced from SNP when measured by XTT colorimetric assay and standard plate count method. Also, same effect was observed in AM-derived NO. The effect was bacteriostatic rather than bactericidal.
Animals ; Cytokines ; Lung Injury ; Macrophages, Alveolar* ; Mannheimia haemolytica* ; Nitric Oxide Synthase ; Nitric Oxide* ; Nitroprusside ; Ozone ; Pasteurella* ; Pasteurellosis, Pneumonic ; Phagocytes ; Thiram

This is a statistical observation based on data of deaths occurred in the first army group(1A) of Republic of Korea Army (ROKA) and data brought to Wonju Army Hospital for medicolegal autopsy by all of Military Police Corps (MPC) in 1A during the year of 1996. The report aims to reveal facts on various causes of death of military members in attempt to analyse 70 cases statistically and differences between military members and civillians. The following are the summary of results ; 1. The total numbers of death in 1A were 70 cases and autopsy rate was 17.1%(12 cases). All cases were males. 2. The violent deaths were 60 cases(85.7%) and the natural deaths were 10 cases(14.3%). 3. The percentage of deaths of soldiers was 81.4%(the most), sergeants was 8.6%, officers was 5.7%, others was 4.3%. The group of the private (25.7%) and the private first class (25.7%) was the leading group of death by the rank. 4. For deaths due to injuries, the percentage of deaths due to gunshut injury was 51.2%, traffic accident was 30.1%, explosion of bomb was 7.0%, fall was 7.0% and blunt injury was 4.7%. 6. For the natural deaths, 10 cases were recorded and death due to neoplasm was taking the most of the total percentage with 40%. 7. For the violent deaths, the percentage of accidental death was 42.4%, suicide was 40.7% and homicide was 16.9%. These results suggest that suicide by firearm and traffic accident including military owned vehicle could be the major cause of death in army, and intensive management for group of the private and the private first class could be important to reduce the number of death.
Accidents, Traffic ; Autopsy ; Bombs ; Cause of Death ; Explosions ; Gangwon-do ; Homicide ; Hospitals, Military ; Humans ; Male ; Military Personnel ; Police ; Republic of Korea ; Suicide ; Wounds, Nonpenetrating

No abstract available.
Hyoid Bone ; Orthognathic Surgery ; Recurrence

No abstract available.

After the introduction of the central parenchymal pedicle by Hester(1985) and the round-block technique by Benelli (1988), several variations of periareolar reduction mammoplasty have been used by many authors. Periareolar reduction mammoplasty is a less aggressive procedure than traditional techniques and it produces less conspicuous periareolar scars while maintaining an acceptable overall result. We experienced 120 cases (60 patients) of periareolar reduction mammoplasty during the period from May 1994 to February 1998. We present the analysis of 60 cases of periareolar reduction mammoplasty. Periareolar reduction mammoplasty utilizing central parenchymal pedicle was performed in the first 40 patients, while a procedure utilizing the inferior dermal pedicle was done in the next 20 cases consecutively. The range of follow-up was from 1 to 5 years. Complications such as nipple areolar complex necrosis and sensory changes were reduced when the inferior dermal pedicle used. There were 5 cases of nipple areolar complex necrosis and sensory changes were reduced when the inferior dermal pedicle used. There were 5 cases of nipple areolar complex necrosis (6.2%), including 1 case of near total necrosis in cases utilizing the central parenchymal pedicle. But in the technique using inferior dermal pedicle, there was no skin flap necrosis. The central parenchymal pedicle technique has several advantages such as a wide operation field permitting complete breast contouring and better mobility of the remaining breast tissue. However, inferior dermal pedicle technique has relative superiority over central parenchymal pedicle technique in terms of anatomical rationale, as well as in the rate of complications without causing limitations in breast mobility for contouring. Such complications as nipple areolar complex necrosis, skin flap necrosis and sensory change of nipple were reduced when the inferior dermal pedicle technique was used. It is much easier to preserve the 4th intercostal nerve to the nipple anatomically. Periareolar reduction mammoplasty utilizing the inferior dermal pedicle is thought to be a reliable, reproducible method.
Breast ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Intercostal Nerves ; Mammaplasty* ; Necrosis ; Nipples ; Skin

Limb salvage operation in primary malignant bone tumors is increasing recently, according to the improvement of diagnostic methods, surgical technique and adjuvant chemotherapy. The purpose of this study is to obtain the interim results of survival rate and the functional grade of the limb in primary malignant bone tumors treated by limb salvage operation. Between 1985 to 1993, 63 primary malignant bone tumors treated by limb salvage operations. Tumor prosthesis arthroplasty was performed in 49 patients, resection arthrodesis in 9 patients, and IM nailing with cement molding in 5 patients. Autoclave autograft was combined in 2 patients. Adjuvant chemotherapy and postoperative radiotherapy were performed in selected patients. The average follow-up period was 50 months(ranged 12 months to 116 months). In the cases of osteosarcoma, estimated survival rate was 61.9% based on Kaplan-Meier survival plot. In the parosteal sarcoma, the survival rate was 87.5% and 80% in chondrosarcoma patients. According to functional grading by Enneking, 66% was excellent, 20% was good, 11% was fair and one patients was poor. Complications occurred in 16 patients:wound infection was developed in 6 patients, local recurrence in 4, peroneal nerve palsy in 2 patients and femoral stem loosening in 2 patients. Fracture in resection arthrodesis and pulmonary metastasis were also occurred. Reoperation was performed in 10 patients at average 31 months after initial operation. Revision tumor persthesis arthroplasty was performed in one patient due to local recurrence and in 2 patients due to femoral stem loosening. Three amputations were done due to recurrence of tumor. IM nailing with cement molding was performed in one patient due to deep infection and repeated arthrodesis was done in a fracture patients. Scheduled custom-made tumor prosthesis arthroplasty was performed within a year in 2 patients treated with IM nailing with cement molding. In conclusion, with the careful preoperative assessment, adjuvant chemotherapy and skillful surgical technique, limb salvage operation would provide the primary malignant bone tumor patients for longer survival and better quality of life.
Amputation ; Arthrodesis ; Arthroplasty ; Autografts ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Extremities ; Follow-Up Studies ; Fungi ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma ; Paralysis ; Peroneal Nerve ; Prostheses and Implants ; Quality of Life ; Radiotherapy ; Recurrence ; Reoperation ; Sarcoma ; Survival Rate

No abstract available.
Female ; Mammaplasty*

No abstract available.
Diagnosis* ; Osteoma, Osteoid*

Although the incidence of tuberculosis of the bone and joints is being decreased with good nutrition, hygine and the development of preventive medicine, it is still a common disease in our clinic. One hundred and ninty-eight cases of tuberculosis of the bone and joints were studied in the Department of Orthopedic Surgery, Seoul National University Hospital for 10 years from January, 1966 to December. 1975. The results were as follows: 1. Total cases of tuberculosis of the bone and joints were 588 Among them, peripheral bone and joints excluding the spine occupied 198 cases (34%). 2. Sex ratio was 1.7 : 1 (male : female). Age distribution showed the group below 10 years was 78 cases (39%). On the other hand, 7 cases were over 51 years old. 3. More than 50% of patients visited hospital after one year from the onset. 4. One-third of all cases had been given some management before admission and the most common treatment was anti-tuberculous chemotherapy (25%). 5. Erythrocyte sedimentation rate was definitly increased in 41%. 6. Associated tuberculous lesionsoe of extraskeletal system were confirmed in 66 cases (33%). Among them, active pulmonary tuberculosis were 51 cases (77%) 7. Various treatments (conservative, curettage, synovectomy, arthrodesis, etc.) had been carried out. However, surgical managements for saving the range of motion must be considered always before arthrodesis.
Age Distribution ; Arthrodesis ; Blood Sedimentation ; Clinical Study ; Curettage ; Drug Therapy ; Hand ; Humans ; Incidence ; Joints ; Orthopedics ; Preventive Medicine ; Range of Motion, Articular ; Seoul ; Sex Ratio ; Spine ; Tuberculosis ; Tuberculosis, Pulmonary