No abstract available.

Two cases of spontaneous kidney rupture with literatural review was presented at first in Korea. 1) 56 years male patient and 25 years male patient admitted to our department of Urology through Emergency Room after onset of 2 and 1 day. after treatment at local clinic. 2) Chief complaints were one side flank pain which was followed by total gross hematuria. 3) Preoperative diagnoses were kidney rupture due to necrotic pelvic tumor in 56 years male and hypernephroma in 25 years male patient. 4) Operation was procedured at 8 days and 4 days after admission respectively. 5) The operative procedure were nephrectomy in both cases. 6) The pathological diagnoses were pelvis rupture due to renal stone and parenchymal rupture due to renal infarction in each case.
Carcinoma, Renal Cell ; Diagnosis ; Emergency Service, Hospital ; Flank Pain ; Hematuria ; Humans ; Infarction ; Kidney* ; Korea ; Male ; Nephrectomy ; Pelvis ; Rupture ; Rupture, Spontaneous* ; Surgical Procedures, Operative ; Urology

Effective noninvasive modalities such as radiotherapy and pharmacologic treatments have become highly developed in the treatment of intractable cancer pain. Although epidural narcotics have been considered particularly useful, limitations still remain in their effectiveness for some patients. Surgical therapy can be a useful alternative to these treatments. Cordotomy is one of the most effective surgical treatments. The first percutaneous cordotomy was attempted by Mullan and his associates in 1963. Rosomoff and his associates modified the procedure using radiofrequency two years later. Cordotomy was widely used by the late 1960's but due to its limited effectiveness and serious complications it was abandoned until 1980 when a new electrode was developed by Levin. A thermocouple cordotomy electrode such as the Levin electrode allows monitoring of impedance and tissue temperature. A radiofrequency lesion can be made by increasing the current directly to the desired temperature rather than by gradual heating with the usual incremental increases in lesion current and time. With the use of this electrode, consistent clinical effects are assured and operating time is reduced. The chances of boiling or charring are also minimized. Since this electrode was developed, cordotomy has received renewed attention virtually everywhere except in Korea. Five terminal cancer patients in whom conservative treatments had failed were treated by cordotomy using the three types of thermocouple electrodes: the levin cordotomy electrode; the TCE thermocouple electrode, and the Kanpolat CT electrode. Due to the small number of patients, a comparison of the effectiveness of these three types could not be made. Although complete pain relief was not achieved in every case, dosages of narcotics could be reduced as a result of this procedure. There were no serious complications except a transient paralysis of the ipsilateral arm in one case and headaches in four cases.
Arm ; Cordotomy* ; Electric Impedance ; Electrodes* ; Headache ; Heating ; Hot Temperature ; Humans ; Korea ; Narcotics ; Paralysis ; Radiotherapy ; Trout

This experiment was performed to study the morphological responses of the thymic cortex of the mice after administration of BCG. Healthy adult mice weighing 25gm each were divided into normal and experimental groups. BCG[0.03X108-0.32X108 CFU] were injected subcutaneously to the animals every other day, and animals were sacrificed at 4 days, 1 week, 2 weeks and 8 weeks following the first injection. Thymus were removed immediately after sacrifice and transferred to cold phosphate buffered 2.5% glutaraldehyde-1.5% paraformaldehyde solution[pH 7.3], and cut into small pieces. Tissue samples were fixed for 2-3 hours in the same fixative, postfixed with phosphate buffered 1% osmium tetroxide solution[pH 7.3], dehydrated in a graded series of alcohol, and embedded in araldite mixture. Ultrathin sections stained with uranyl acetate and lead citrate were observed with a JEM 100CX-II electron microscope. The observed results were as follow : 1. In the early BCG treated groups, a few eosinophile leucocytes were observed, but more eosinophils were observed in later groups. Some elongated and bar-shaped lysosomes with eletron lucent gap were often obserced in the macrophages. 2. Cortical population of thymocytes in the thymus were reduced, whereas territoris of the epithelial reticular cells were expanded especially in 2 weeks and 8 weeks groups. Some portion of the thymic cortex exhibited large intercellular spaces, and a few nuclear bodies filled with materials of medium density were observed in the epithelial reticular cells. 3. In the 8 weeks groups, macrophages, plasma cells and eosinopile leucocytes and developing eosinophile leucocytes were often observed in the thymic cortex. Distended cisternae of granular endoplasmic reticula and newly forming prosecretory granulses in the Golgi complex were ovserved in som plasma cells. From the above results, it was suggested that repeated treatment with BCG could induce disturb the maturation and differentiation of the T lymphocytes. In turn, BCG, if repeatedly injected, may disturb the immunological medchanism.
Adult ; Animals ; Citric Acid ; Eosinophils ; Extracellular Space ; Golgi Apparatus ; Humans ; Lysosomes ; Macrophages ; Mice* ; Mycobacterium bovis* ; Osmium Tetroxide ; Plasma Cells ; T-Lymphocytes ; Thymocytes ; Thymus Gland

The polyglandular autoimmune syndrome designates the dysfunction of endocrine and nonendocrine system involving two or more organs on the basis of an autoimmune mechanism. The autoimmune nature of these diseases has been based on the presence of lymphocytic infiltration in the affected gland, organ specific autoantibodies in the serum, cellular immune defects and an association with the HLA DR/DQ genes or immune response genes. This syndrome is usually classified into three classes and their etiology or pathogenesis is still not completely understood. A 28-year-old woman developed vitiligo and insulin dependent diabetes mellitus during the treatment of Graves' disease with antithyroid drug. She had a tendency of spontaneous ketonemia and serum c-peptide levels were low(0.21, 0.16ng/mL: fasting and glucagon stimulated). Thyrotrophin binding inhibitor immunoglobulin and pancreas iIslet cell cytoplasmic antibody were positive. We report here a case of polyglandular autoimmune syndrome, type III manifesting Graves' disease, vitiligo, and insulin dependent diabetes mellitus.
Adult ; Autoantibodies ; Bone Diseases ; C-Peptide ; Cytoplasm ; Diabetes Mellitus ; Fasting ; Female ; Genes, MHC Class II ; Giant Cells ; Glucagon ; Granuloma ; Graves Disease ; Humans ; Immunoglobulins ; Insulin ; Ketosis ; Pancreas ; Pedigree ; Thyrotropin ; Vitiligo

No abstract available.
Carcinoma, Transitional Cell* ; Tuberculosis, Renal* ; Ureter*

Paratuberculosis (PTB) is caused by Mycobacterium avium subsp. paratuberculosis (MAP) and is one of the most widespread and economically important diseases in cattle. After birth, calves are raised with natural breast feeding without separation from their mothers in most Korean native cattle (Hanwoo breed) farms. Vertical transmission of PTB has been reported, but the exact PTB infection route has not been revealed in Hanwoo farms. Calves of MAP seropositive dams were tested for MAP presence and MAP antibodies in feces and tissues. MAP was detected in calf tissues by using polymerase chain reaction. Expressions of genes reported to be prognostic biomarkers of MAP infection changed in both calves and cows (p < 0.05). Expression of two genes (HGF and SERPINE1) were significantly decreased in MAP-infected cattle and their offspring (p < 0.01). The results suggest that biomarker gene expression profiles can be useful in detecting early stage MAP infection. Based on the results, complete eradication of MAP may be possible if accurate diagnostic methods to detect infected calves are added to the current PTB eradication strategy, which, because infected individuals are likely to develop into fecal MAP shedders at any time, includes isolation of new born calves and feeding sterilized colostrum.
Agriculture* ; Animals ; Antibodies ; Asymptomatic Infections ; Biomarkers* ; Breast Feeding ; Cattle* ; Colostrum ; Feces ; Humans ; Mothers ; Mycobacterium avium subsp. paratuberculosis ; Paratuberculosis* ; Parturition ; Polymerase Chain Reaction ; Transcriptome

PURPOSE: End-stage ankle arthritis is frequently combined with ankle-hindfoot deformity or ankle instability and therefore additional surgical procedures are often required when performing total ankle arthroplasty. We report the short term clinical and radiographic results of the total ankle arthroplasty with/without the combined adjunctive surgical procedures. MATERIALS AND METHODS:The study is based on the 17 ankles (16 patients) of end-stage ankle arthritis that were treated with HINTEGRA(R)Total ankle prosthesis (Newdeal, Lyons, France) total ankle arthroplasty (TAA) from 2004 to 2007 with at least 12 months follow-up. The combined adjunctive procedures as well as the VAS pain score, AOFAS score, radiographic measurements and patient satisfactions were evaluated. RESULTS:Average follow-up period was 29 months (13~55 months) , and the age was average 62 years (39~75 years) old. Among total of 17 ankles, varus deformity and lateral ankle instability were found in 4 cases and 3 cases respectively. Twenty additional procedures such as Achilles triple hemisection (9), calcaneal displacement osteotomy (4) and lateral ankle ligament reconstruction (3) were performed in adjunct to TAA in 13 ankles. VAS pain score improved from preoperative average 8.4 (7~10) to 2.0 (0~5) and the AOFAS functional score improved from 41.8 points (13~71 points) to 90.6 (77~100 points) at final follow-up. Ninety-four percent of the patients were satisfied with the surgery. CONCLUSION: We confirmed that many adjunctive combined surgical procedures are often necessary in addressing the end-stage ankle arthritis (74%) with total ankle arthroplasty. We also achieved quite good clinical and radiographic short term results, although the long term follow-up study with larger number of cases are needed in the future.
Animals ; Ankle ; Arthritis ; Arthroplasty ; Congenital Abnormalities ; Displacement (Psychology) ; Follow-Up Studies ; Humans ; Ligaments ; Osteotomy ; Prostheses and Implants

PURPOSE: To estimate the shape of root and pulp canal using a dental cone beam computed tomography (CBCT) and to evaluate the accuracy of imaging reformation. MATERIALS AND METHODS: CBCT images were obtained with incisors, premolars, and molars as the destination by using PSR 9000NTM Dental CT system (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan) and i-CAT (Imaging Sciences International, Inc, USA) cone beam CT unit that have different kind of detector and field of view, and compared these with the shape and the size of actual root and root canal. RESULTS: When the measuring value of cone beam computed tomography concerning to each root's bucco-lingual diameter and mesio-distal diameter was compared with the value of the actual root, it reveals an error range -0.49 ~+0.63 mm at PSR900N and -0.97~+1.14 mm at i-CAT(P.0.05). It was possible to identify and measure PSR 9000NTM Dental CT system to the limit 0.48+/-0.06 mm (P.0.05) and i-CAT CBCT to the limit 0.86+/-0.09 mm (P.0.05) on estimating the size and the shape of root canal. Two kinds of CBCT images revealed the useful reproducibility to estimate the shape of root, but there was the difference to estimate the shape of root according to apparatus. The reproducibility of root shape in the image of three-dimensions at PSR 900N is low such as 0.65 mm in a case of minute root canal. CONCLUSIONS: CBCT images revealed higher accuracy of the imaging reformation for root and pulp and clinically CBCT is a useful diagnostic tool for the assessment of root and canal. However, there are different qualities of imaging reformation according to CBCT apparatus and limitation of reproducibility for minute root canals.
Bicuspid ; Cone-Beam Computed Tomography* ; Dental Pulp Cavity* ; Incisor ; Molar ; Radiography, Dental ; Tomography, X-Ray Computed ; Tooth*

PURPOSE: To evaluate the clinical outcome of proximal plantar fasciitis after nonoperative treatment, and also to find the correlation of the heel pain with the plantar fascia thickness measured by ultrasonography. MATERIALS AND METHODS: The study is based on 41 patients, 46 feet of the proximal plantar fasciitis that were treated conservatively with at least 12 months follow-up. All were treated with heel pad, Achilles and plantar fascia stretching and pain medications for at least 3 months. Heel ultrasonography was performed at the beginning of the treatment to measure the plantar fascia (PF) thickness and the echogenicity. PF thickness over 4 mm and less were grouped in to group A and B respectively to compare the clinical outcome. RESULTS: Average thickness of the PF at the calcaneal attach was 5.2 mm. Symptom duration before the treatment was average 13.2 month; group A being 14.6 months and group B being 9.0 months with no significant difference (p=0.09). As functional evaluation, Roles-Maudsley score improved from 3.4 initially to 2.3 at final follow-up, while morning heel pain also improved from average VAS pain score of 7.2 to 4.0. However Maudsley and VAS score both didn't show statistical difference between the 2 groups (p>0.05). CONCLUSION: Plantar fasciitis improved substantially with the nonoperative treatments. However, the 2 groups, divided according to 4 mm thickness by ultrasonography, didn't show significant difference in either symptom duration or in the clinical outcomes.
Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Foot ; Heel ; Humans