Myeloid body formation is an ultrastructural feature of gentamicin induced nephrotoxicity in human being and experimental animals. The origin of the myeloid body is not satisfactorily understood and morphological verification of the developing process of this structure is not fully accomplished. We injected 100 mg/kg/12 hour of gentamicin in 20 Spraque-Dawley rats and examined the ultrastructural feature of the proximal convoluted tubular cells of the kidney every 30 minutes in the first 4 hours, and in 5 hours, 6 hours, 12 hours, 24 hours and 48 hours after injection of gentamicin, with a TEM and a SEM. Myeloid bodies were noted as concentric layers of membranous structures of degenerated endoplasmic reticulum and mitochondria in the lysosome. The number and size of the myeloid body containing lysosomes were increased with time. We can deduce from this observation that injured cell organelles by diffusible gentamicin within the cells are autophagocytosed by lysosomes which were also injured by the drug from pinocytotic vesicles, and incompletely digested organellar remnants are retained in the lysosomes as myeloid bodies. So we think that the myeloid body formation is a result of an exaggerated and a pathologic autophagocytic process due to cell injury induced by gentamicin.
Animals ; Endoplasmic Reticulum ; Gentamicins* ; Humans ; Kidney ; Lysosomes ; Mitochondria ; Organelles ; Rats*

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

No abstract available.
Fetal Weight* ; Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Parturition* ; Weight Gain*

We performed scleral grafting with autogenous temporalis fascia and autogenous conjunctiva in 32 patients (32 eyes) in scleral necrosis after pterygium excision. The average age of patients was 54.3 years (range, 38 to 74 years). Nine of them were male and twenty-three were female. The intervals between pterygium excision and scleral necrosis were from 2 months to 23 years (mean, 6.2 years). After the mean follow-up 6.6 months, in 29 eyes graft was stably adhered but in three eyes graft was melted. Conjunctival wound dehiscence and conjunctival necrosis were noticed in three eyes and one eye respectively. There were no cases showing significant difference between the preoperative and the postoperative visual acuity and intraocular pressure. Autogenous temporalis fascia appears to be a good alternative to homologous sclera for scleral reinforcement.
Conjunctiva ; Fascia* ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Male ; Necrosis* ; Pterygium* ; Sclera ; Transplants* ; Visual Acuity ; Wounds and Injuries

For many years, members of medical profession have believed that the shorter symptoms to diagnosis interval(SDI) might be related to early stages and that the prompt treatments might improve survival rates in cancer patients. But this notion has been challenged by many researches for many years. This study was conducted to investigate the effects of SDI on the cancer survival for 221 stomach cancer cases, 106 lung cancer cases, 74 liver cancer cases and 59 cervix cancer cases. These cancer cases are registered ones in Kanghwa Cancer Registery Program from 1987 to 1991. Relationships among SDI, stages of cancers, operation rates, and survival were analysed. Results are as follows: 1. SDI was not related to stages of cancer. There were no difference in the distribution of stages among five SDI subgroups. 2. This data did not support that SDI affects the survival of stomach cancer patients. The cancer stages did affect survival in stomach cancer patients though. 3. Our data did not support that SDI affects cancer survival. A Cox proportional hazard model showed that SDI does not play a important role in cancer survival controlling age, gender, stage and other variables in the model. Further studies are highly expected to clarify the relationships between SDI and cancer survivals. Researches with bigger sample size and more sophisticated variables would be needed.
Diagnosis* ; Humans ; Liver Neoplasms ; Lung Neoplasms ; Proportional Hazards Models ; Sample Size ; Stomach Neoplasms ; Survival Rate ; Uterine Cervical Neoplasms

We conducted experimental studies to evaluate the possibility of Dacron patch for artificial sclera and to gain basic data for practical approach. Forty eyes of twenty rabbits were randomly assigned to experimental or control eye in both eyes. The lamellar-thickness scleral resection was performed and followed by implantation of Dacron and homologous scleral patch respectively. We examined them after one, two, four and 12 weeks. Grossly adhesion of Dacron patch was stable after four weeks. Histologically Dacron graft evoked an outer capsule and a well-vascularized granulomatous foreign body reaction. There were fibrous and vascular ingrowth securety anchored graft to bed and adhesion was uniform and firm throughout the tissue. Attachment of homolgous graft to bed was poor after 1 week but stable after two weeks. Dacron patch appears to be a good alternative to homologous sclera for scleral reinforcement.
Fibroblasts ; Foreign-Body Reaction ; Polyethylene Terephthalates* ; Rabbits ; Sclera ; Transplants*

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

BACKGROUND: Video-assisted thoracic surgery (VATS) is being used as a therapeutic modality in many diseases in which thoracotomy has been used. We studied that the VATS can substitute the thoracotomy in benign esophageal disease. MATERIAL AND METHOD: Group I (n=18) underwent video-assisted thoracic surgery, and group II (n=19) thoracotomy. Group I includes 14 leiomyomas and 4 achalasias. Group II includes 16 leiomyomas and 3 achalasias. Operative technique is enucleation in the leiomyoma and modified Heller's myotomy in the achalasia. Analyzing factors of operation-efficacy are anesthetic time, operation time, hospital stay, chest tube drainage amount and chest tube removal day. The degree of the postoperative pain is assessed by the frequency of opioid analgesics injection. RESULT: There was no death in both groups. There were 5 complications in the group I and 2 in the group II. Prolonged pleural effusion and restenosis of achalasia occurred to 1 patient in each group. In the group I, there were 1 temporaty vocal cord palsy and 2 mucosal tear leading to thoracotomy. There were no differences in anesthesia time, operation time, hospital stay, total chest tube drainage amount, chest tube removal day and frequency of opioid analgesics injection. The amount of the chest tube drainage at POD 1 day was significantly lower in group I (155.6+/-77.8cc) than in group II (572.8+/-280.1cc) (p<0.05). CONCLUSION: The results of our data showed that video-assisted thoracic surgery for benign esophageal disease is as effective as thoracotomy and in addition, cosmetic effect is much better. We concluded VATS may be a substitute for thoracotomy in benign esophageal disease.
Analgesics, Opioid ; Anesthesia ; Chest Tubes ; Drainage ; Esophageal Achalasia ; Esophageal Diseases* ; Humans ; Leiomyoma ; Length of Stay ; Pain, Postoperative ; Pleural Effusion ; Thoracic Surgery, Video-Assisted* ; Thoracotomy* ; Vocal Cord Paralysis

Intra-carotid urokinase (UK) infusion in 20 patients with acute internal carotid artery (ICA) territorial ischemic stroke achieved immediate recanalization in 45% and the clinical outcome in patients with recanalization was superior to that of patients without recanalization. The procedure was most effective in patients with smaller arterial occlusions: 7 of 10 patients with MCA branch occlusions (M2 to M4) achieved recanalization compared to only 2 of 10 with distal ICA or M1 occlusions, which should be an important issue for the critical evaluation of the efficacy of thrombolytic therapy (TT). Hemorrhagic transformation was observed in 9 patients on CT scan; petechial hemorrhage in 5 and intraparenchymal hematoma formation in 4. Among 4 patients with hematoma formation, clinical deterioration was seen in 3 cases and the angiography at the immediate end of the UK infusion showed recanalization in only one patient. The average dose of UK in patients with parenchymal hematoma formation was higher than that of patients without hemorrhagic transformation (123.3 x 10(4) units vs 101 x 10(4) units). The administration of a large dose of UK, probably more than 100 x 10(4) units, and the absence of immediate recanalization seemed to increase the risk of parenchymal hematoma formation. Despite the effort of investigators, the in-hospital time delay for the TT was significant which was mainly related to the time consuming preparation for angiography especially during night. A more effective system for the earlier intervention of acute ischemic stroke needs to be developed.
Adult ; Aged ; Angiography ; Brain Ischemia/*drug therapy/radiography ; Carotid Artery Thrombosis/*drug therapy/radiography ; Female ; Human ; Male ; Middle Age ; Support, Non-U.S. Gov't ; Thrombolytic Therapy/*methods ; Tomography, X-Ray Computed ; Urinary Plasminogen Activator/*administration & dosage

Mucinous adenocarcinoma of the prostate is very rare tumor and comprises about 0.4% of all prostatic carcinomas. The metastatic form of mucinous adenocarcinoma of the prostate is similar to that of the adenocarcinoma of the prostate. Common sites of metastasis are pelvic lymph node and bone. At presentation, half of patients have evidence of metastasis to pelvic lymph nodes, bone, brain, liver, bladder and seminal vesicles. Especially, epididymal metastasis from mucinous adenocarcinoma of the prostate is uncommon and only 15 cases was reported in the literature. We report a case of mucinous adenocarcinoma of the prostate with metastasis to the epididymis and discuss the clinicopathologic features of this lesion.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Brain ; Epididymis ; Humans ; Liver ; Lymph Nodes ; Male ; Mucins* ; Neoplasm Metastasis* ; Prostate* ; Prostatic Neoplasms ; Seminal Vesicles ; Urinary Bladder