A clinical observation was made on 13 patients who had undergone augmentation colocystoplasty for contracted bladders, admitted to the Department of Urology, Chonnam University Hospital during the period from January 1977 to December 1982. The following results were obtained: 1. Of the 13 patients 8Were male and 5 were female, ranging in age from 15 to 60 years (average 31.1 years) and the prevalent age group of contracted bladder was the 3rd decade, being 46% of total. 2. The most common cause of contracted bladder was tuberculous cystitis (92%). 3. These patients were disabled severely by marked symptoms of frequency, nocturia, dysuria for 2 to 8 years (average 3.7 years) and all patients were no longer responsive to conservative management. And colocystoplasty was satisfactory procedure that produced relief of symptoms in over 90 percent of the patients. 4. The preoperative bladder capacity had contracted down 15-140ml (average 53.3ml) and the postoperative bladder capacity was increased to 90-250ml (average 148.2ml). 5. Renal function usually was preserved or more improved. 6. Additional operative procedures during cystoplasty included nephrectomy (6 cases), ureteroneocystostomy (4 cases) including ureteral tailoring (3 cases). 7. Complications were urinary tract infection (8cases) wound infection (3cases) external urinary fistula (1case), persistent urinary incontinence (1 case) and necrosis of isolated sigmoid segment (1 case).
Colon, Sigmoid ; Cystitis ; Dysuria ; Female ; Humans ; Jeollanam-do ; Male ; Necrosis ; Nephrectomy ; Nocturia ; Surgical Procedures, Operative ; Ureter ; Urinary Bladder ; Urinary Fistula ; Urinary Incontinence ; Urinary Tract Infections ; Urology ; Wound Infection

Atlanto-axial instability in children with Down syndrome(trisomy 21) has become a wel! Known entity and it has been reported frequently since it was first reported over 25 years ago. However, symtomatic atlanto-axial dislocation associated with cord compression is relatively rare and it had seldom been reported. We recently experienced a 14-year-old mongoloid female with progressive quadriparesis, who have no prior cervical inflammation and we detected atlanto-axial dislocation with ossculum terminale and cord compression through radiological evaluations. We report a case of symptomatic atlanto-axial dislocation in Down syndrome with review.
Adolescent ; Child ; Dislocations* ; Down Syndrome* ; Female ; Humans ; Inflammation ; Quadriplegia

There are many different kinds of histological types of nasal masses. But there were few studies based on the clinical consideration of benign nasal neoplasms in comparison with its histologic types. In this study we compare and analyze the benign nasal neoplasm in wish to guide for a diagnosis and management. Twenty-seven patients with benign nasal neoplasms excluding inverted papilloma, antrochoanal polyp and dentigenous cyst from March 1996 and June 2003 were selected for this study. Their clinicopathologic records were reviewed retrospectively. The male-female ratio was 1 : 1.25 and the right to left ratio was 1 : 1.7. Bening nasal neoplasms were frequently found in the fifth decade. Hemangioma was the most common benign nasal neoplasm. Nasal obstruction was the most common symptom. Benign nasal masses were frequently found at the inferior turbinate and vestibule. When the masses were found, they were smaller than 1 cm in most cases. An endoscopic and transnasal approach was the most commonly utilized approach method during surgery. There were no recurrent cases during the average 41 months follow up. In conclusion, there is no statistical significance between benign nasal neoplasm and the patient's sex and age. But, they were frequently found in left side rather than the right side. Surgical treatment seemed to be extremely useful in the case of benign nasal neoplasms.
Diagnosis ; Follow-Up Studies ; Hemangioma ; Humans ; Nasal Obstruction ; Nose ; Nose Neoplasms* ; Papilloma, Inverted ; Paranasal Sinuses ; Polyps ; Retrospective Studies ; Turbinates

BACKGROUND AND OBJECTIVES: Laryngotracheal stenosis (LTS) in burned patients with inhalation injury have features distinct from other stenosis after intubation or tracheotomy. However, the risk factors for LTS in burned patients with inhalation injury have not been thoroughly assessed. The aim of this study is to identify the risk factors for and evaluate the pattern of LTS in burned patients with inhalation injury. SUBJECTS AND METHOD: From May 2005 to April 2007, 227 burned patients with inhalation injury treated at the Hangang Sacred Heart Hospital, Hallym University Medical Center were investigated retrospectively. The risk factors analyzed for LTS in burned patients with inhalation injury were gender, age, duration of intubation, size of the endotracheal tube, previous tracheotomy, number of intubations, severity of inhalation injury. RESULTS: Among 81 patients who survived and could be followed up until the study period, 10 (12%) patients developed LTS. The stenosis involved the subglottis.cervical trachea (5), subglottis.cervical tracheal and glottis (1), glottis (4). According to Myer-Cotton classification, there were 6 (60%) patients with grade III, IV stenoses on subglottis.cervical trachea. The number of intubations and previous tracheotomy were found to be risk factors for the development of LTS in burned patients with inhalation injury. CONCLUSION: LTS by inhalation injury is usually shown on web at the anterior and posterior glottic areas or circumferential narrowing of the subglottis. Repeated endotracheal intubations and previous tracheotomy in patients with inhalation injury may increase the prevalence of LTS.
Academic Medical Centers ; Burns ; Burns, Inhalation ; Constriction, Pathologic ; Glottis ; Heart ; Humans ; Inhalation ; Intubation ; Intubation, Intratracheal ; Laryngostenosis ; Prevalence ; Retrospective Studies ; Risk Factors ; Trachea ; Tracheal Stenosis ; Tracheotomy

BACKGROUND AND OBJECTIVES: Inhalation injuries can produce a wide spectrum of negative clinical effects. Respiratory failure remains one of the leading causes of death in burned patients with inhalation injury. Despite advances in understanding of inhalation injury, few studies have focused on histopathologic findings of tracheal mucosa. The purpose of this study is to investigate histopathologic changes of tracheal mucosa in burned patients with inhalation injury. SUBJECTS AND METHOD: Tracheotomy was performed on 31 patients who was admitted to the Hospital center from May 2005 to March 2006. Thirty-one patients were divided into two groups : patients with inhalation injury (group I)(n=16), patients without inhalation injury (group II)(n=15). Tracheal mucosa were taken out during the tracheotomy. The tracheal mucosa were read blindly by one pathologist. RESULTS: Histopathologic examination showed the following finding in the tracheal mucosa of all patients in the group I : epithelial ulceration. Different findings were observed in the group I as time passed by after inhalation injury, such as interstitial edema, inflammatory cell infiltration, capillary dilatation, and increased fibrosis. No abnormal findings were observed in the tracheal mucosa in the group II. CONCLUSION: Inhalation injuries cause histopathologic damages to tracheal mucosa. The different histopathologic findings of tracheal mucosa that take place in time following inhalation injuries suggest to process an inflammatory reaction. The study in related to clinical features should be needed due to tracheal mucosa injury may produce respiratory complications.
Burns* ; Burns, Inhalation ; Capillaries ; Cause of Death ; Dilatation ; Edema ; Fibrosis ; Humans ; Inhalation* ; Mucous Membrane* ; Respiratory Insufficiency ; Trachea ; Tracheotomy ; Ulcer

BACKGROUND AND OBJECTIVES: The posterior branch of the greater auricular nerve is a sensory nerve that serves the skin over the mastoid process and the postero-inferior region of the auricle. The greater auricular nerve is often sacrificed in parotidectomy, even though its posterior branch can be preserved. By cautious dissection of the greater auricular nerve it is possible to preserve the posterior branch in 69 per cent of the operations. However, the efficiency of this procedure is not clear. So, we have compared the patients whose nerve had been preserved with those sacrificed, to evaluate the validity of the posterior branch of greater auricular nerve preservation during parotidectomy. SUBJECTS AND METHOD: Thirty patients undergoing parotidectomy were divided into two groups. Fifteen patients underwent parotidectomy with preservation of the posterior branch of the greater auricular nerve (group A) and they were compared with fifteen patients who underwent parotidectomy with sacrificing the nerve (group B). Using questionnaire, we have researched about numbness, pain or other subjective symptoms on peri-auricular area after parotidectomy and the function of the nerve has been tested by two point tactile discrimination test and temperature sensitivity test. RESULTS: Postoperatively, twenty-nine patients felt lack of sensitivity, pain, itching or other symptoms. These symptoms recovered within 12 months, subjectively. However, in group B, permanent sensory loss was found in three patients. The two-point discrimination test revealed in group B, the decreased sensitivity on the operated side in comparison with the unoperated side (p=0.008). It also showed the decreased sensitivity on operated side in group B, compare with group A (p=0.012). CONCLUSION: From this study, despites of no significant difference on subjective symptoms, there was objective improvement on function of the greater auricular nerve. It seems reasonable to spare the greater auricular nerve during parotidectomy.
Discrimination (Psychology) ; Humans ; Hypesthesia ; Mastoid ; Parotid Gland ; Pruritus ; Surveys and Questionnaires ; Sensation* ; Skin

BACKGROUND AND OBJECTIVES: Frey's syndrome is one of the potential sequelae of parotidectomy. Various medical and surgical treatments have been used in attempt to avoid this embarrassing condition. Recently, interposing barriers between the overlying skin flap and the parotid bed, such as the sternocleidomastoid (SCM) muscle flap, have been used to prevent this condition. The purpose of this study was to evaluate the preventive impact of using this flap on the incidence of Frey's syndrome and to identify the degree of severity in this syndrome between the use of SCM flap and no muscle flap. SUBJECTS AND METHOD: 40 patients who underwent superficial parotidectomy from June 1996 to August 2003 were divided into two groups. One group had SCM flap reconstruction (n=20), and the other did not (n=20). A subjective clinical questionnaire and the objective Minor's starch test were used to evaluate the incidence of this syndrome. A grading system was used to divide Frey's syndrome into mild or severe Frey's syndrome to determine its severity. The test of Pearson-x2 was applied. RESULTS: The association between sweating, flushing, or pain and the use of the flap was not significant. Also, there was no significant association with Minor's starch test and the use of the flap. There was a significant association with mild Frey's syndrome and the presence of the flap (p=0.014). CONCLUSION: It would seem that the sternocleidomastoid muscle flap does not reduce the incidence of Frey's syndrome, but does decrease the degree of severity in Frey's syndrome.
Flushing ; Humans ; Incidence ; Parotid Gland ; Surveys and Questionnaires ; Skin ; Starch ; Sweat ; Sweating ; Sweating, Gustatory*

BACKGROUND AND OBJECTIVES: Respiratory failure remains one of the leading causes of death in burn patients with inhalation injury. Obtaining and maintaining a secure airway are both essential and challenging. Although different airway managements are performed in burn patients with inhalation injury, its exact indications and timing remain controversial. The purpose of this study is to define the principle of airway management in burn patients with inhalation injury. SUBJECTS AND METHOD: A retrospective study was performed on 177 burn patients with inhalation injury who were admitted to Hangang Sacred Heart Hospital at Hallym University Medical Center from July 2002 to June 2005. RESULTS: Severty-seven patients underwent mask O2 supply for initial airway management. A total of 77 patients survived. One hundred patients underwent endotracheal intubation for initial airway management. Of these, 42 patients underwent tracheotomy after endotracheal intubation. A total of 42 patients reported abnormal chest X-ray findings. Of these, 10 patients survived and had significant improvement in PaO2/FiO2 ratios within 3 days following tracheotomy. CONCLUSION: In most cases, laryngotracheal edema subsides within 72 hours, permitting short periods of airway management. Deterioration of respiratory function permits prolonged intubation and ventilator support. Although tracheotomy does not improve general condition, it offers some advantages in terms of pulmonary toilet, patient comfort and airway security. If patients show deterioration of respiratory function, tracheotomy should be performed earlier.
Academic Medical Centers ; Airway Management* ; Burns* ; Burns, Inhalation ; Cause of Death ; Edema ; Heart ; Humans ; Inhalation* ; Intubation ; Intubation, Intratracheal ; Masks ; Respiratory Insufficiency ; Retrospective Studies ; Thorax ; Tracheotomy ; Ventilators, Mechanical

Polymorphisms of the prion protein gene (PRNP) havebeen detected in several cervid species. In order toconfirm the genetic variations, this study examined theDNA sequences of the PRNP obtained from 33 captivesika deer (Cervus nippon laiouanus) in Korea. A total ofthree single-nucleotide polymorphisms (SNPs) at codons100, 136 and 226 in the PRNP of the sika deer wereidentified. The polymorphic site located at codon 100 hasnot been reported. The SNPs detected at codons 100 and226 induced amino acid substitutions. The SNP at codon136 was a silent mutation that does not induce any aminoacid change. The genotype and allele frequencies weredetermined for each of the SNPs.
Animals ; Base Sequence ; DNA/chemistry/genetics ; Deer/*genetics ; Genetic Variation ; Molecular Sequence Data ; Polymerase Chain Reaction/veterinary ; Polymorphism, Single Nucleotide ; Prions/*genetics ; Sequence Analysis, DNA

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by fat accumulation in the liver. MASLD encompasses both steatosis and MASH. Since MASH can lead to cirrhosis and liver cancer, steatosis and MASH must be distinguished during patient treatment. Here, we investigate the genomes, epigenomes, and transcriptomes of MASLD patients to identify signature gene set for more accurate tracking of MASLD progression. Methods: Biopsy-tissue and blood samples from patients with 134 MASLD, comprising 60 steatosis and 74 MASH patients were performed omics analysis. SVM learning algorithm were used to calculate most predictive features. Linear regression was applied to find signature gene set that distinguish the stage of MASLD and to validate their application into independent cohort of MASLD. Results: After performing WGS, WES, WGBS, and total RNA-seq on 134 biopsy samples from confirmed MASLD patients, we provided 1,955 MASLD-associated features, out of 3,176 somatic variant callings, 58 DMRs, and 1,393 DEGs that track MASLD progression. Then, we used a SVM learning algorithm to analyze the data and select the most predictive features. Using linear regression, we identified a signature gene set capable of differentiating the various stages of MASLD and verified it in different independent cohorts of MASLD and a liver cancer cohort. Conclusions We identified a signature gene set (i.e., CAPG, HYAL3, WIPI1, TREM2, SPP1, and RNASE6) with strong potential as a panel of diagnostic genes of MASLD-associated disease.