Palliative open nephrostomy was done on 50 cases with advanced pelvic malignancy and benign conditions in the Department of Urology, Seoul National University Hospital during the period of March, 1979 to July, 1982. The results were as follows: 1. 20.5% (9/44) of our patients died without being discharged from the hospital after nephrostomy. 2. In advanced pelvic malignancy, only 52.6% of patients alive at 3 months and only 26.3% alive 6 months. 3. In advanced pelvic malignancy, the post-nephrostomy complication was 46.7% and the most common complication was various urinary problems. 4. The cause of death was multifactorical and impossible to define precisely. The nephrostomy complications were at least in part contributory to the deaths. 5. The terminal malignancy patients who might not expected to live six months and to lead a useful, relatively comfortable life outside the hospital after treatment could not have benefited from nephrostomy. Unavoidable cases, we recommended percutaneous nephrostomy and passage of ureteral catheters instead of open nephrostomy.
Cause of Death ; Humans ; Nephrostomy, Percutaneous ; Seoul ; Urinary Catheters ; Urology

Dermatomyositis is a disease of unknown etiology characterized by inflammation and degeneration of skeletal muscles and cutaneous abnormalities. Cardiac involvement in dermatomyositis-polymyositis is thought to be rare. In recent year, however, there has been an increasing number of reports on cardiac abnormalities in adult dermatomyositis and polymyositis due to development of noninvasive diagnostic techniques. Categorically, these abnormalities have included electrocardiographic changes, cardiac arrhythmias, congestive heart failure, coronary artery disease, and pericarditis. A 56-year-old woman was admittied to the Ewha womans University Hospital with dyspnea and palpitation. She was diagnosed as having dermatomyositis and followed up our department of Dermatology. Electrocardiogram showed a paroxysmal supraventricular tachycardia at as rate of 195/min. The patient was treated with 240mg/day verapamil p.o, 60mg/day prednisone p.o, there was marked improvement of symptoms. Systematic study of cardiac function utilizing echocardiography, Holter monitoring, thallium-201-scan, and gated blood pool studies were conducted in five newly diagnosed patients with dematomyositis-polymyositis. A significant elevation of serum CPK-MB is indicative of cardiac involvement. Cardiac involvement is a serious prognostic sign. We report a case with the review of the literature.
Adult ; Arrhythmias, Cardiac ; Coronary Artery Disease ; Dermatology ; Dermatomyositis* ; Dyspnea ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Female ; Heart Failure ; Humans ; Inflammation ; Middle Aged ; Muscle, Skeletal ; Pericarditis ; Polymyositis ; Prednisone ; Prognosis ; Tachycardia, Supraventricular* ; Verapamil

BACKGROUND: Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. MATERIAL AND METHOD: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. RESULT: After surgical correction peak aortic gradient fell from 58.4+/-17.6, to 23.7+/-17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6+/-24.3 to 143.7+/-27.1 mmHg and from 1.78+/-0.4 to 1.76+/-0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10+/-0.2, to 1.27+/-0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2+/-24.9 to 57.1+/-27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. CONCLUSION: We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.
Aorta ; Aortic Valve Stenosis* ; Blood Pressure ; Child ; Equidae ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardium ; Oxygen Consumption ; Reoperation ; Stroke Volume

Ranunculus tachiorei is a member of the buttercup family (Ranunculaceae) which contains unsaturated lactone and protoanemonine. Protoanemonine is formed by the breakdown of the glycoside Ranunculin after injury to the plant and causes severe vesiculation and linear streaks after contact with field buttercups(Ranunculus spp.) The amount of protoanemonine in buttercups varies widely with the species of plant and its stage of growth, the highest content being at the time of flowering. We report a case of primary irritant dermatitis due to contact with Ranunculus Tachiorei which was applied for the folk treatment of Bell palsy.
Bell Palsy ; Dermatitis, Irritant* ; Flowers ; Humans ; Plants ; Ranunculus*

Ureteral reimplantation has been used widely for the correction of ureterovesical reflux, terminal ureteral stricture, ureteral obstruction, ectopic ureteral opening, megaureter, renal transplantation and ureteral injury, etc. The ultimate purpose of the ureteral reimplantation is for the preservation of renal function and upper urinary tract. since the concept of ureterovesical reflux reported by Sampson in 1903, many types of surgical procedure of ureteral eimplantation have been developed and performed for various ureteral obstructive problems. There is also increasing tendency of ureteral reimplantation in out country. To determine the efficacy of ureteral reimplantation, we reviewed and evaluated the records of 34 patients(40 ureters) who underwent ureteral reimplantation at the Department of Urology, Seoul National University Hospital during the period from March, 1979 to February, 1983. And following results were obtained: 1. Ureteral reimplantation was performed in cases of ureterovesical reflux, ureteral stricture, megaureter, bladder tumor, failed previous reimplantation and surgical injury. 2. Thirty two ureters were reimplanted with the method of Politano-Leadbetter, five ureters with Glenn Anderson, one ureter with Cohen and one ureter with transureteroureterostomy with Boari-flap method. 3. Mean duration of ureteral stenting was 6 days(3-10 days). 4. Complications had been observed in 11 cases which included persistent pyuria, persistent reflux, acute pyelonephritis, paralytic ileus, vesicocutaneous fistula and obstruction. 5. Postoperative pyelographic appearances were improved in 10/13(76.9%) cases. We made a conservative treatment in patients with persistent urinary tract infection.
Constriction, Pathologic ; Fistula ; Humans ; Intestinal Pseudo-Obstruction ; Intraoperative Complications ; Kidney Transplantation ; Pyelonephritis ; Pyuria ; Replantation* ; Seoul ; Stents ; Ureter* ; Ureteral Obstruction ; Urinary Bladder Neoplasms ; Urinary Tract ; Urinary Tract Infections ; Urology

BACKGROUND: Conventional echocardiography provides fundamental information about mitral valve morphology and function but is often subjective and has a relatively low specificity in evaluating valve calcific deposit, which is critical information for the preoperative decision. We hypothesized that mitral valvular calcification could be detected in standard two-dimensional echocardiograms of mitral valve in vivo by evaluating regional gray level(echo amplitude) using computerized image analysis so that we could overcome the subjectivity and low specificity of conventional echocardiography. METHODS: We tested this hypothesis by performing standard 2.5MHz two-dimensional echoes on mitral valve and myocardium in 30 patients with mitral stenosis, scheduled to undergo mitral valve replacement. We compared gray level of each region of interest in mitral valve and myocardium in stop-frame images with the degree of calcifications identified by pathologic and radiographic examinations. RESULTS: Ratio of mean gray level of mitral valve to mean gray level of myocardium was the most reliable value in evaluating degree of calcification. Quantitatively, region of calcification displayed the ratio of significantly higher value than that of no calcification. In case of anterior mitral valve, the ratio of the evident calcified region was greater than 3.11, that of the region without calcification was less than 2.42 and that of microcalcification was betwwn 2.42 and 3.11. For posterior mitral valve, the ratio of the evident calcified region was greater than 3.50, that of the region without calcification was less than 2.19 and that of microcalcification was between 2.19 and 3.50. The sensitivity and specificity of this method for assessment of degree of calcification was 75% and 100% for anterior mitral valve and 9% and 87.5% for posterior mitral valve. CONCLUSION: Mitral valvular calcification could be detected quantitatively in standard two dimensional echocardiograms of mitral valve in vivo by evaluating regional gray level(echo amplitude) using computerized image analysis.
Echocardiography ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Myocardium ; Sensitivity and Specificity

No abstract available.
Humans ; Interleukin-2* ; Leukemia*

No abstract available.
Anemia, Iron-Deficiency* ; Iron*

No abstract available.
Leukemia*

The auther had utilized the continuous irrigation with saline and antibiotics to 1 case of serpent corneal ulcer and 2 cases alkaline burn by Lippas' original technique. Two cases of alkaline burn were healed up without any complications and one case of serpent corneal ulcer showed relatively good result. According to review through a few literature, the method of continuous irrigation is much better one than any other systemic or local administration of the drug to the particular external ocular disease.
Anti-Bacterial Agents ; Burns* ; Corneal Ulcer*