A clinical evaluation was made in 168 spinal cord injuries who visited the department of urology in Korea Veterans Hospital and received follow up studies during the period from May, 1986 to May, l987. The results were as follow; l. 82 cases(51.8%) had thoracic lesions, 55(32.7%)cervical and 26(15.5%) lumber. 104 cases (61.99%) were complete and 64(38.1%) incomplete. 2. The cause of the spinal cord injury was falldown( 45.2%), gunshot(29.l%),traffic accident(25.O%) and etc. 3. 12 cases died during the follow-up at our hospital. The cause of death was renal failure (25%) and septicemia from bed sore(25%). 4. In view of complications according to voiding pattern, there were no difference in cases with renal stone, but high incidences of bladder stone, chills and fever, V-U; reflux, bacteriuria and epididymitis in the group having the indwelling catheter 5. Factors associated with a statistically. significant reduction in Ccr included renal calculi, chills and fever and V-U reflux, but other factors not found to be statistically significant included years since injury. bladder calculi, bacteriuria and extent of injury.
Bacteriuria ; Catheters, Indwelling ; Cause of Death ; Chills ; Epididymitis ; Fever ; Follow-Up Studies* ; Hospitals, Veterans ; Incidence ; Kidney Calculi ; Korea ; Male ; Renal Insufficiency ; Sepsis ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder Calculi ; Urology

OBJECTIVE: To determine whether the size of a perfusion defect seen at myocardial perfusion MR imaging represents the extent of irreversibly damaged myocardium in acute reperfused myocardial infarction. MATERIALS AND METHODS: In nine cats, reperfused myocardial infarction was induced by occlusion of the left anterior descending coronary artery for 90 minutes and subsequent reperfusion for 90 minutes. At single-slice myocardial perfusion MR imaging at the midventricular level using a turbo-FLASH sequence, 60 short-axis images were sequentially obtained with every heart beat after bolus injection of gadomer-17. The size of the perfusion defect was measured and compared with both the corresponding unstained area seen at triphenyl tetrazolium chloride (TTC) staining and the hyperenhanced area seen at gadophrin-2-enhanced MR imaging performed in the same cat six hours after myocardial perfusion MR imaging. RESULTS: The sizes of perfusion defects seen at gadomer-17-enhanced perfusion MR imaging, unstained areas at TTC staining, and hyperenhanced areas at gadophrin-2-enhanced MR imaging were 20.4+/-4.3%, 29.0+/-9.7%, and 30.7+/-10.6% of the left ventricular myocardium, respectively. The perfusion defects seen at myocardial perfusion MR imaging were significantly smaller than the unstained areas at TTC staining and hyperenhanced areas at gadophrin-2-enhanced MR imaging (p < .01). The sizes of both the perfusion defect at myocardial perfusion MR imaging and the hyperenhanced area at gadophrin-2- enhanced MR imaging correlated well with the sizes of unstained areas at TTC staining (r = .64, p = .062 and r = .70, p = .035, respectively). CONCLUSION: In this cat model, the perfusion defect revealed by myocardial perfusion MR imaging underestimated the true size of acute reperfused myocardial infarction. The defect may represent a more severely damaged area of infarction and probably has prognostic significance.
Animal ; Cats ; Contrast Media ; Gadolinium ; Gadolinium DTPA/diagnostic use ; *Magnetic Resonance Imaging ; Mesoporphyrins/diagnostic use ; Metalloporphyrins/diagnostic use ; Myocardial Infarction/*pathology/therapy ; *Myocardial Reperfusion ; Myocardium/pathology ; Support, Non-U.S. Gov't

OBJECTIVE: The purpose of this study was to evaluate the survival rate of vitrified blastocyst according to the freezing vessels, equilibration time in cryoprotectant and artificial dehydration method. METHODS: Human blastocysts were vitrified after loading onto the plastic straw, open-pulled straw (OPS), electron microscopy grid (EM grid) for 1.5 min or 3 min. They also were directly plunged into LN2 within 30sec. For artificial shrinkage of blastocysts, 36 gauge fine needle was pushed at the cellular junction of the trophectoderm into the blstocoele cavity until it shrank without damage of inner cell mass. RESULTS: The survival rate of vitrified blastocysts on plastic straw, OPS, EM grid as freezing vessels were 26.7, 13.0 and 60.5%, respectively. The survival rate of EM grid was significantly higher than that of plastic straw and OPS (p<0.05). For 1.5 min equilibrium, the survival rates of early blastocyst (EB), middle blastocyst (MB) and late blastocyst (LB) were 64.4, 81.0, and 20.0% respectively. For 3 min equilibrium, the survival rates of EB, MB, and LB were 69.9, 50.0 and 57.5% respectively. The survival rates of EB and MB were significantly higher than that of LB in 1.5 min equilibrium group (p<0.05), however, the significance was not observed in 3 min equilibrium groups. In cytoplasmic shrinkage before vitrification, the survival rates of EB, MB and LB were 92.9, 100 and 75.9% respectively. The survival rate of MB was significantly higher than that of LB (p<0.05). The survival rates of vitrified blastocysts by artificial dehydration and slow-frozen blastocysts were not significantly different as 88.9 and 66.7%, respectively. CONCLUSION: This study showed that the vitrification of human blastocysts using EM grid and artificial dehydration is an effective method. Therefore, these methods would be an useful techniques for blastocyst cryopreservation.
Blastocyst* ; Cryopreservation ; Cytoplasm ; Dehydration ; Freezing ; Humans* ; Microscopy, Electron ; Needles ; Plastics ; Survival Rate ; Vitrification*

Necrotizing fasciitis is a relatively uncommon infectious disorder where a bacterial organism penetrates the subcutaneous tissues and superficial fascia, ultimately causing necrosis of vast areas of soft tissue. Although invasive Streptococcus spp., most commonly group-A streptococci, is the most frequent cause of this disorder, in a single organism-infection, necrotizing fasciits caused by Klebseilla pneumoniae is becoming more frequently reported, perhaps due to the recent increase in the frequency of diabetes and liver diseases. Necrotizing fasciitis caused by K. pneumoniae is usually secondary to hematogenous dissemination, most commonly caused by trauma or liver abscess and usually results in multiple organ failure. The progression of the disease is so rapid that the mortality rate is high despite aggressive surgical intervention and extensive use of antibiotics at an early disease stage. Here we report a case of necrotizing fasciitis caused by hematogenously spread K. pneumoniae from incompletely treated chronic otitis media in a patient with alcoholic liver cirrhosis and diabetes.
Anti-Bacterial Agents ; Fasciitis, Necrotizing* ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess ; Liver Cirrhosis, Alcoholic ; Liver Diseases ; Liver Diseases, Alcoholic ; Mortality ; Multiple Organ Failure ; Necrosis ; Otitis Media* ; Otitis* ; Pneumonia ; Streptococcus ; Subcutaneous Tissue

Pleomorphic dermal sarcoma (PDS) is a rare mesenchymal neoplasm sharing histopathological features with atypical fibroxanthoma (AFX), but has additional features of deep invasion of the superficial subcutis, tumor necrosis and vascular/perineural invasion. It is not well documented in the literature because of its rarity, and its clinical course has been debated due to the lack of homogenous criteria. We describe here the case of a 91-year-old female with a 6-month history of a solitary, asymptomatic, well-defined, 3.4-cm-sized, reddish, hard, protruding mass on the lateral aspect of the right upper eyelid. On the basis of initial punch biopsy results, storiform cellular infiltrate of pleomorphic spindle and polygonal cells with frequent atypical mitoses, the lesion was identified as AFX. Following the initial biopsy, micrographic surgery was performed and a tumor-free margin was confirmed. Considering the conservation of the periocular function and the advanced age of the patient, we planned secondary intention healing rather than primary suturing. After surgery, skeletal muscle infiltration was found and the diagnosis was revised to PDS by a pathologist based on the currently accepted criteria for PDS. There has been no evidence of recurrence or periocular functional defects during a 2-year follow-up without adjuvant therapy. Although the PDS is highly malignant, complete excision under micrographic surgery can prevent recurrence without adjuvant therapy. Also, the secondary intention healing is an effective method for closure of large defects on the face.
Biopsy ; Diagnosis ; Eyelids* ; Female ; Follow-Up Studies ; Histiocytic Sarcoma ; Histiocytoma, Malignant Fibrous ; Humans ; Intention* ; Methods ; Mitosis ; Muscle, Skeletal ; Necrosis ; Recurrence ; Sarcoma*

Pleomorphic dermal sarcoma (PDS) is a rare mesenchymal neoplasm sharing histopathological features with atypical fibroxanthoma (AFX), but has additional features of deep invasion of the superficial subcutis, tumor necrosis and vascular/perineural invasion. It is not well documented in the literature because of its rarity, and its clinical course has been debated due to the lack of homogenous criteria. We describe here the case of a 91-year-old female with a 6-month history of a solitary, asymptomatic, well-defined, 3.4-cm-sized, reddish, hard, protruding mass on the lateral aspect of the right upper eyelid. On the basis of initial punch biopsy results, storiform cellular infiltrate of pleomorphic spindle and polygonal cells with frequent atypical mitoses, the lesion was identified as AFX. Following the initial biopsy, micrographic surgery was performed and a tumor-free margin was confirmed. Considering the conservation of the periocular function and the advanced age of the patient, we planned secondary intention healing rather than primary suturing. After surgery, skeletal muscle infiltration was found and the diagnosis was revised to PDS by a pathologist based on the currently accepted criteria for PDS. There has been no evidence of recurrence or periocular functional defects during a 2-year follow-up without adjuvant therapy. Although the PDS is highly malignant, complete excision under micrographic surgery can prevent recurrence without adjuvant therapy. Also, the secondary intention healing is an effective method for closure of large defects on the face.
Biopsy ; Diagnosis ; Eyelids* ; Female ; Follow-Up Studies ; Histiocytic Sarcoma ; Histiocytoma, Malignant Fibrous ; Humans ; Intention* ; Methods ; Mitosis ; Muscle, Skeletal ; Necrosis ; Recurrence ; Sarcoma*

No abstract available.
Picibanil* ; Pleural Effusion, Malignant*

We present a case of a 19-year-old male with portal vein gas embolism resulting from accidental ingestion of 35% hydrogen peroxide. Hydrogen peroxide is a commonly used germicidal cleansing agent. When it is applied to tissues, catalase causes its rapid molecular decomposition with the release of oxygen bubbles. The patient recovered without sequelae. Hyperbaric oxygenation may be of benefit in patients with respiratory compromise or central nervous system symptoms from gas embolism in hydrogen peroxide ingestion.
Catalase ; Central Nervous System ; Detergents ; Eating* ; Embolism, Air* ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Hyperbaric Oxygenation ; Male ; Oxygen ; Portal Vein* ; Young Adult

Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.
Bradycardia ; Cardiomyopathies* ; Coronary Angiography ; Coronary Artery Disease ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Failure ; Hormone Replacement Therapy* ; Humans ; Hypopituitarism ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; Takotsubo Cardiomyopathy ; Thyroxine

Flexible fiberoptic colonoscopy is extensively used for the diagnosis and management of colorectal disease. Many possible complications can occur. The most common and most serious complications are hemorrhage, perforation and respiratory problems. Colonic perforation usually results in a fatal and emergent condition. However, management of iatrogenic colonic perforation has been controversial. The choice between the medical versus the surgical approach has been dependent on the mechanism of the perforation, bowel preparation, location, size of the defect and severity of symptoms. We report here a case where colonic perforation emerged during endoscopic submucosal resection of a rectal tumor. The rectal perforation was accompanied with pneumoperitoneum, subcutaneous emphysema, pneumoretroperitoneum and pneumomediastinum. As the bowel preparation was excellent, intravenous antibiotics and total parenteral nutirition were administered. The patient was treated successfully without any complications.
Anti-Bacterial Agents ; Colon ; Colonoscopy ; Diagnosis ; Hemorrhage ; Humans ; Mediastinal Emphysema* ; Pneumoperitoneum* ; Rectal Neoplasms ; Retropneumoperitoneum* ; Subcutaneous Emphysema*