We report one case of bilateral testicular torsion. A 400 gm male infant, born by cesarean section due to induction failure at 42 weeks gestation, was hospitalized at 9 days of age secondary to bilateral testicular mass. Physical examination revealed an healthy baby with enlarged, firm, nontender mass on both sides of the scrotum. Transillumination of the mass showed no transmission of light. Laboratory data included a normal CBC and a urinalysis. Ultrasonogrophy showed well encapsulated 0.9 x 0.9 x 1.0 cm sized and 1.5 x 1.3 x 1.3 cm sized homogenous hypoechoic solid mass in left and right testicles respectively, remainder testicular parenchyme showed normal structure. Exploration of the testes was performed at 25-days old under general anesthesia. Exploration revealed a infarction of the right testes secondary to spermatic cord torsion, evidenced by clockwise turns outside the tunica vaginalis of 270 degrees. Left testes was infarcted but a quarter of them seemed normal. Orchiectomy on right and fixation on left testes were performed respectively. Left spermatic cord seemed to be detorted spontaneously. Postoperatively the infant did well and discharged 5 days after operation. Follow up examination during the next 3 months have shown appropriated sized testicle with normal colorization and arterial pulse. Testicular scan performed at age 39 days showed good perfusion of left testes.
Anesthesia, General ; Cesarean Section ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn* ; Infarction ; Male ; Orchiectomy ; Perfusion ; Physical Examination ; Pregnancy ; Scrotum ; Spermatic Cord ; Spermatic Cord Torsion ; Testis* ; Transillumination ; Urinalysis

The main goals of treatment of malignant bone tumor are the prolongation of life survival and the improvement of quality of life. In growing children, however, leg length discrepancy (LLD) is one of major problem in the treatment of malignant bone tumors. Therefore, the precise understanding of growth in children is essential, and the prediction of LLD is critical in deciding the time and options of surgery. In addition, to use the adequate method of growth expectation, periodic follow-up and collaboration with patient's parents are needed.
Child ; Cooperative Behavior ; Humans ; Leg ; Life Support Care ; Parents ; Quality of Life

No abstract available.
Humans

The Her-2/neu protooncogene encodes a transmembrane tyrosine kinase that is structurally homologous to the receptor for epidermal growth factor. Its amplification and overexpression are associated with poor prognosis in breast cancer patients. Neu differentiation factor is a ligand for Her-2/neu protooncogene and was detected in ras-transformed rat fibroblasts. Heregulin (human homologue of neu differentiation factor) is a 44-kilodalton glycoprotein that stimulates tyrosine phosphorylation and induces growth arrest or stimulation and differentiation in human breast cancer cell lines. In this study we examined the expression of heregulin mRNA by nested reverse transcription (RT) PCR with fresh tissue, Her-2/neu protein, ICAM-1 and steroid receptors by immunohistochemistry, and DNA ploidy pattern by flow cytometry with paraffin-embedded tissue in invasive breast carcinoma. We compared the data with nodal status, lymphovascular invasion, steroid receptor status and DNA ploidy pattern. For RT-PCR to heregulin mRNA, 38 cases of fresh breast cancer tissue were obtained. Total 68 cases of invasive breast carcinoma tissue were fixed in formalin, which were used for routine histology, immunohistochemistry and flow cytometry. The results are as follows; 1) Heregulin mRNA was expressed in 86.1% of patients with invasive breast carcinoma and 100% of patients with benign breast lesion using nested RT-PCR analysis. 2) Her-2/neu protein was overexpressed in 50.0% of tumors using immunohistochemistry. The expression of Her-2/neu protein was significantly correlated with high counts of lymph nodes with metastasis (p<0.05), and high nuclear grade (p<0.05). 3) Her-2/neu protein overexpression was significantly correlated with a high DNA index(p<0.05). All of the tumors showing Her-2/neu protein overexpression and no heregulin mRNA expression revealed near tetraploid DNA content. However, both Her-2/neu overexpression and heregulin mRNA expressing tumors revealed near tetraploidy in 38.9% and diploidy in 50.0%. Based on these results, heregulin mRNA expression rate was 86.1% in human invasive breast carcinoma. Her-2/neu protein overexpression is associated with high positive lymph node number and DNA index. Statistically significant reverse correlation with lymph node metastasis is not present.
Animals ; Breast Neoplasms* ; Breast* ; Cell Line ; Diploidy ; DNA* ; Epidermal Growth Factor ; Fibroblasts ; Flow Cytometry ; Formaldehyde ; Glycoproteins ; Humans* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Lymph Nodes ; Neoplasm Metastasis* ; Neuregulin-1* ; Phosphorylation ; Ploidies* ; Polymerase Chain Reaction ; Prognosis ; Protein-Tyrosine Kinases ; Rats ; Receptors, Steroid ; Reverse Transcription ; RNA, Messenger* ; Tetraploidy ; Tyrosine

No abstract available.
Child* ; Colon* ; Constipation* ; Enema* ; Fecal Incontinence* ; Humans

This study investigated the stress of community residents in Kwang-Ju and Chonnam areas by using the General Health Questionnaire(GHQ-60) as a instrument of stress measurement. The number of subject were 445 residents who lived in three areas (large city, middle city, and rural area) and they were individually interviewed in March, 1994. The result of study showed that the degrees of stress measured by GHQ-60 were statistically significant in the residents' area, age. sex variables: (a) the residents in middle city among three area had the highest level of stress: (b) the resident who were more than 60 in age had the highest level of stress: (c) the female resident had more stress than male residents: (d) particularly, the residents who were more than 60 years old in the middle city had the highest level of stress. Further, the results of factor analysis showed that there were three factors of social dysfunction, depression and anxiety, and psychosomatic symptom. The social dysfunction factor was statistically significant in both age and resident area variables. The depression and anxiety factor was statistically significant in the residents' area, age. sex variables. The psychosomatic symptom factor was statistically significant in both age and sex variables. The study suggested that they should give a special attention to solve the old people's stress because stress was closely related to residents age.
Anxiety ; Depression ; Factor Analysis, Statistical ; Female ; Gwangju ; Humans ; Jeollanam-do ; Male ; Mass Screening* ; Middle Aged ; Surveys and Questionnaires*

BACKGROUND: Tetracaine has been the most commonly used long-acting spinal anesthetic agent. Recently, hyperbaric bupivacaine was introduced to be useful agent, and has been reported to produce the better quality of anesthesia. The aim of the present investigation was to compare the anesthetic effects of 0.5% hyperbaric bupivacaine and 0.5% hyperbaric tetracaine spinal anesthesia. METHODS: 40 ASA Class I patients undergoing lower extremity operation were randomly distributed to two groups. Group A (n=20) received 15mg, 0.5% bupivacaine in 8% glucose, while Group B (n=20) received 15mg, 0.5% tetracaine in 10% glucose in the lateral decubitus position (L3,4 interspace). We evaluated the sensory and motor blockade, cardiovascular effects and the incidence of tourniquet pain. RESULTS: The mean maximum cephalad spread of analgesia was higher in bupivacaine group (T5) than in tetracaine group (T6) and the spread time was more rapid in bupivacaine group (13.1 +/- 3.3min.) than in tetracaine group (15.8 +/- 4.3min.), but there were no statistical significances. Tetracaine group was earlier onset of motor block and the duration of complete motor block in tetracaine group was significantly longer than in bupivacaine group. The mean decrease in systolic and diastolic blood pressure was 10% to 25% in both groups and more marked in tetracaine group. The incidence of tourniquet pain was greater in tetracaine group than in bupivacaine group. CONCLUSIONS: The quality of anesthesia obtained with bupivacaine may be superior to that produced by tetracaine. We concluded that 0.5% hyperbaric bupivacaine was suitable for short orthopedic or lower abdominal surgery because of less incidence of hypotension, shorter duration of motor block and lower incidence of tourniquet pain.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Blood Pressure ; Bupivacaine ; Glucose ; Humans ; Hypotension ; Incidence ; Lower Extremity ; Orthopedics ; Tetracaine* ; Tourniquets

We reviewed 37 skin biopsies obtained from 35 patients with secondary syphilis during the period of 9 years from January 1980 to June 1988, which had been diagnosed by dark field examination, serologic tests for syphilis, and identification of spirochetes by immunoperoxidase method (avidin-biotin complex) in the skin biopsies. We investigated the histologic features of the skin lesions in secondary syphilis according to the types and patterns of inflammatory cell infiltration in the dermis, vascular reactions and epidermal changes. We matched these histologic findings with the clinical features of the skin lesions. The results were as follows; 1) The histologic patterns of dermal infiltrate in order of frequency were as follows; junctional pattern in 14 biopsies (38%), lichenoid pattern in 10 biopsies (27%), diffuse pattern in 5 biopsies (14%), patchy pattern in 3 biopsies (8%), normal pattern in 3 biopsies (8%) and undertermined in 2 biopsies (5%). 2) The dermal infiltration of plasma cells was found in 24 biopsies (65%). All the biopsies of diffues and lichenoid patterns, 7 biopsies of junctional and one biopsy of patchy pattern showed plasma cells but none in normal pattern. 3) Eosinophils were observed in the dermis in 11 biopsies (30%). There was no difference in incidence of eosinophils in the dermis among morphologic patterns. However, they were frequently seen in the dermis and epidermis of condyloma lata (4 of 7 biopsies). 4) The vascular changes in the dermis included endothelial cell swelling in 23 biopsies (62%), endothelial cell proliferation in 22 biopsies (60%) and vascular dilatation in 10 biopsies (27%). They were most commonly observed in the lichenoid pattern followed by diffuse and junctional patterns. Three cases showed lymphocytic vasculitis. 5) Epidermal changes were seen in all of the biopsies exocytosis, parakeratosis, hydropic change of basal cells, acanthosis, spongiosis, keratinocyte necrosis and hyperkeratosis in the order of frequency. 6) In relation to the clinical manifestations, junctional pattern (14 biopsies) consisted of 6 papulosquamous lesions, 5 macules and 3 papules. Lichenoid pattern (10 biopsies) consisted of 7 papulosquamous lesions and 3 papules. All the biopsies showing diffuse pattern (5 biopsies) appeared in condyloma lata. Patchy pattern (3 biopsies) consisted of 2 macules and 1 papule. All of the normal pattern (3 biopsies) appeared in macules. In conclusion, with dermal and epidermal changes, the acknowlegement of the 5 basic histologic patterns in secondary syphilis seems to be very helpful for the diagnosis of syphilis.
Incidence ; Biopsy

The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993. 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft. fractures. 3. The Im erlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open-with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major-complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of . fracture and then made early joint motion exercise and ambulation.
Congenital Abnormalities ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Joints ; Tibia ; Tibial Fractures* ; Walking ; Wounds and Injuries

There are several different methods of purifying Treponema pallidum(TP) from rabbit testicular tissue. Among them, we compared the use of differential centrifugation, which has been most widely used, to Percoll density gradient centrifugatian, a newly applied method, in purifying TP from rabbit testicular tissue by checking the protein concentration of the TP suspension, hemagglutination assay using sheep erythrocytes sensitized by TP, IgM-TP-enzyme-linked immunosorhent, assay(IgM-TP-ELISA) and eJect,ron microscopic observation. The protein concent,ration af TP antigen suspension (2x10(8)TP/ml) purified by Percoll density gradient centrifugation (lower band) was the lowest (129.0pg/ml) when compared to those purified by differential centrifugation (324.0pg/ml) and Percoll density gradient centrifugatian (upper band) (560.2pg/ml). Sheep erythrocytes sensitized by TP purified by Percoll density gradient centrifugation(lower band) showed the same resiilts as those using a commercii1 TPHA kit when tested with positive and negative control sera. The sensitivity and specificity of the IgM-TP-ELISA were 88.5%(23/26') and 86.4%(19/2Z) respectively using TP as an antigen purified by differential centrifugation. The rates were 96.29% (25/26) and 95.5%(2l/22) using TP purified by Percoll density gradient centrifugation. As shown by the electron microscopy, T. pizllida purified by clifferential centritugation and Percoll density gradient centrifugatiori were structurally unaltered, and Percoll-purified TP contained much less tissue debris than TP prepared by differ ential centrifugation. Therefor e, Percoll density gradient centrifugation is considered to be a better method of purifying TP from rabbit testicular tissue when compared to differential centrifugatian, as a matter of fact, Perrol1 density gradient centrifugation has been applieci successfully in the study of the physiology, recombinant DNA techniques, and antigenic structure of TP and to the preparation of the antigen for the FTA-ARS and TP-ELISA
Centrifugation ; Centrifugation, Density Gradient ; DNA, Recombinant ; Erythrocytes ; Hemagglutination ; Microscopy, Electron ; Physiology ; Sensitivity and Specificity ; Sheep ; Treponema pallidum* ; Treponema*