Median raphe cyst is known as congenital lesion of the perineum and genitalia, but its etiology is unclear. Most investigators believe that the median raphe cyst represent defects in the embryologic developenient bf the male genitalia. Simple surgical excision is effective in most cases. We report our experience with two cases of median raphe cyst without specific symptoms. Even though median raphe cyst is asymptomatic, surgical therapy is worth applicable because it relieve a patient from cosmetic and psychotic problem.
Genitalia ; Genitalia, Male ; Humans ; Male ; Perineum ; Research Personnel

No abstract available.
Otoacoustic Emissions, Spontaneous*

In order to establish the predicted normal values of the systolic time intervals the duration of the systolic time intervals measured from simultaneous recordings of the electrocardiogram, the phonocardiogram and the carotid pulse tracing. The subjects studied were 160 healthy males and 160 females. The mean ages of males and females were 29 and 31 years old, respectively. The transformation period was not closely related to heart rate, and its mean values for males and females were 58 and 56 msec., respectively, and the mean for males and females combined was 57 msec. The remainder of the systolic time intervals, however, showed a significant linear and inverse relation to heart rate. Thus, based upon these data regression equations for the prediction of the normal values of electromechanical systole, left ventricular ejection time, mechinical systole, precjection period andisovolumiccontraction time for males, females, and males and females combined were obtained.
Adult ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Reference Values* ; Systole*

This report dealt with the case of 58 year old male with thrombotic thrombocytopenic purpura syndrome. The patient had an occlusion of the left middle cerebral artery on the carotid angiogram. The clinical course of the case with disseminated intravascular coagulation was fulminant. Literatures on pathophysiology, treatment, pathology and clinical course disseminated intravascular coagulation were reviewed.
Disseminated Intravascular Coagulation* ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery* ; Pathology ; Purpura, Thrombotic Thrombocytopenic

Actinomycosis is a chronic, granulomatous suppurative disease caused by Actinomyces species. Actinomyces is an anaerobic, gram positive organism that requires special techniques for culture and isolation. Actinomycosis is characterized by formation of multiple abscesses, draining sinuses, abundant granulations (sulfur granule) and dense fibrous tissue. The three major clinical presentations include the cervicofacial, thoracic, and abdominal regions. Since A. israelii is a normal inhabitant of the oral cavity, to make a definitive diagnosis it must be recovered from closed tissue spaces, draining sinuses, or abscesses, or it must be shown to be invasive in histopathologic sections. The drug of choice is penicillin. Because of the dense fibrous tissue surrounding the colonies of organisms and the concentration of organisms in clusters, high doses of pharmacologic agents must be used for long periods, and radical surgical excision should accompany antibiotic therapy if possible. We report three cases of abdominal actinomycosis, preoperatively impressed as appendicitis and pelvic abscess, which was diagnosed by a histological study of operative specimens. The possible pathogenic mechanisms causing clinical symptoms are discussed.
Abscess ; Actinomyces ; Actinomycosis* ; Appendicitis ; Diagnosis ; Mouth ; Penicillins

As the incidence of victims of traumatic craniocerebral injury in children has increased in modern times, we retrospectively analyzed 103 cases of surgically treated craniocerebral injuries among patients under the age of 15 who were admitted from January 1991 to December 1994. We classified the materials, i.e. 1) cause and incidence of craniocerebral injury, 2) clinical symptoms, 3) diagnosis and operation, 4) outcome and complication, and 5) period of hospitalization. The results were as follows: 1) The male to female ratio was 1.9:1(male patients 68, female patients 35). 2) The incidence peaked at the age of 6 and was mostly distributed from the age of 6 to 10. 3) As for time distribution most of the accidents occurred between 3 and 6 in the afternoon. 4) The main cause of craniocerebral injuries was attributed to traffic accidents (54 cases, 52.4%) and the second most common cause was falls from heights(30 cases, 29.1%). 5) In 85 cases, the Glasgow coma scale 13-15 before operation was observed. 6) Depression fractures were found to be the most common lesion in our cases. 7) In 48 cases(46.6%) a craniotomy was the operative procedure performed and in 40 cases(38.8%) an elevation of the depressed bone was performed. 8) In 93 cases, the Glasgow outcome scale 4-5 after operation was observed. 9) The many sequelae of operation were neurological deficit, cognitive impairent, and post-traumtic seizure. 10) The average period of hospitalization was 18.7 days(s.d=18.1). The cause and incidence of surgically treated pediatric head injuries were similar to those of total pediatric head injuries. A high GCS score at admission predicts a good outcome and fewer sequelae. However, papillary abnormalities and a neurological deficit at admission were poor prognostic factors. This study confirms that pediatric head injuries treated surgically provide better results than in adults.
Accidents, Traffic ; Adult ; Child ; Craniocerebral Trauma* ; Craniotomy ; Depression ; Diagnosis ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head* ; Hospitalization ; Humans ; Incidence ; Male ; Retrospective Studies ; Seizures ; Surgical Procedures, Operative

The effect of mitomycin on the corneal endothelial cell density was evaluated between the mitomycin group of 23 eyes who underwent trabeculectomy with mitomycin and the control group of 20 eyes who underwent trabeculectomy. The mitomycin(0.2 mg/ml) was applied under the scleral flap, Tenon's capsule or conjunctiva during trabeculectomy for 2-5 minutes(average: 4 minutes) and was irrigated with 50ml of balanced salt solution. Average central endothelial cell loss in the mitomycin group was 10.1 +/- 7.1% and 8.4 +/- 8.3% in the control group(P>0.05, t-test). A shallow anterior chamber with iridocorneal touch(Spaeth's grade 1 and 2) was developed in 12(52%) of 23 eyes in the mitomycin group and 9(45%) of 20 eyes in the control group(P>0.05, chi-square). The average central endothelial cell loss was 12.7 +/- 8.3% in 21 eyes with iridocorneal touch and 5.9 +/- 5.4% in 22 eyes that maintained their anterior chamber(P<0.05, t-test). In 21 eyes with iridocorneal touch average central endothelial cell loss was 12.6 +/- 7.8% in the mitomycin group, and 12.8 +/- 9.5% in the control group(P>0.05, t-test). In 22 eyes that maintained their anterior chamber, average loss was 7.1 +/- 5.4% in the mitomycin group, and 4.8 +/- 5.4% in the control group(P>0.05, t-test). These findings suggest that intraoperative use of mitomycin(0.2 mg/ml) during trabeculectomy is unlikely to cause profound corneal endothelial cell loss and iridocorneal touch after the filtering surgery is associated with greater loss of endothelial cells.
Anterior Chamber ; Conjunctiva ; Corneal Endothelial Cell Loss ; Endothelial Cells* ; Filtering Surgery ; Mitomycin* ; Tenon Capsule ; Trabeculectomy*

Visual field defects being associated with severe closed head injury is well known. The nature and frequency of these association have been reported in a few literatures. Some hypotheses have been advanced to explain the field defects, but no prospective pathological study of the visual pathways in a large number of cases with closed head injury has been made. These hypotheses as to why vision is impaired after head injury have not explained most cases, if not at all. Authors have experienced a case of traumatic, complete bitemporal hemianopsia associated with macular sparing on the right and macular splitting on the left eye in 29 year old man. The patient had a head injury with traffic accident, which caused fractures of the frontal bone and orbital roofs. The various pathogenic possibilities of the chiasmal damage and consequent visual field defects are discussed.
Accidents, Traffic ; Adult ; Craniocerebral Trauma* ; Frontal Bone ; Head Injuries, Closed ; Head* ; Hemianopsia* ; Humans ; Orbit ; Visual Fields ; Visual Pathways

The patient is a 17 month old girl admitted to the Korea General Hospital with histories of irritability, walking disturbance and right sided weakness. On admission, she had seizure followed by coma. Skull x-ray showed widely separated all cranial sutures. A left carotid angiogram revealed a space occupying lesion in the left frontotemporoparietal region with shifting of the midline to the right. At operation, a darkish hemorrhagic tumor with relative clear demarcation was explored after evacuation of massive intracerebral hematoma. The tumor was extended to the midline. The main mass was removed with difficulty. Additional fragments of the necrotic tumor tissue infiltrated in the surrounding structures were also removed. It was not directly connected to or have invaded the ventricular wall. On microscopic examination, the tumor was largely made up of solid sheets and cords of round or ovoid cells with darkly stained nuclei. In areas, typical ependymal rosettes as well as pseudorosettes, gliomatous features and occasional formation of tubule are presented. We think the tumor represents those rare tumors called ependymoblastoma of Rubinstein.
Cerebral Hemorrhage* ; Coma ; Cranial Sutures ; Female ; Hematoma ; Hospitals, General ; Humans ; Infant ; Korea ; Neuroectodermal Tumors, Primitive* ; Seizures ; Skull ; Walking

The patients with end stage renal disease show several complications such as artherosclerosis, anemia and increased susceptibility to infection by damage due to oxygen free radicals. Superoxide dismutase(SOD) is directly linked to the fate of the highly reactive oxygen metabolites. If there is an alteration in the activity of SOD, this alteration may contribute to the complications by reactive oxygen species in patients with end stage renal disease. In this experiment, SOD activity and the effect of cyanate on the activity of SOD was studied to understand the mechanism of several complications mediated by oxygen free radicals in patients with end stage renal disease. SOD activity in the plasma and erythrocytes from patients with end stage renal disease was significantly lower than those from healthy controls. It is known that underproduction of SOD leads to excess production of superoxide and reduced iron favoring hydroxyl radical formation. The results in this experiment suggest that there is an overproduction of superoxide anion in patients with end stage renal disease. The overproduction of superoxide anion may contribute the patients with end stage renal disease susceptible to oxidant damages. To evaluate if cyanate could carbamylate SOD, SOD was incubated with cyanate. The level of carbamylated SOD increased as the time of exposure to cyanate increased from 0 hour to 72 hours. Furthermore, the degree of carbamylation of SOD increased as cyanate concentration in the incubation media rose from 20mM to 1M. There appears to be a maximum degree of carbamylation at a concentration of 1,000mM cyanate. To test the hypothesis that in vitro carbamylation of SOD alters its biological activity, SOD activity was measured after incubation with cyanate. The activity of carbamylated SOD decreased as the time of exposure to cyanate increased from 0 hour to 72 hours. Furthermore, the activity of carbamylated SOD decreased as cyanate concentration in the incubation media rose from 20mM to 1M and when albumin was added to the reaction mixture, the loss of SOD activity was prevented. These results are consistent with the hypothesis that SOD is also carbamylated and lost biological activity in end stage renal disease patients by cyanate, and that the degree of carbamylation depends on both the concentration of cyanate and the length of exposure. Also, these suggest that albumin may prevent carbamylation of SOD at least in vitro condition.
Anemia ; Erythrocytes ; Free Radicals ; Humans ; Hydroxyl Radical ; Iron ; Kidney Failure, Chronic ; Oxygen ; Plasma ; Reactive Oxygen Species ; Superoxide Dismutase* ; Superoxides* ; Uremia