No abstract available.
Lissencephaly* ; Walker-Warburg Syndrome

PURPOSE: We compared the outcome of transurethral electro-vaporization of the prostate (TVP) with that of transurethral resection of the prostate (TURP) in patient with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Fifty-four patients with BPH were treated with TVP (Group I) and sixty-two with TURP (Group II). Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 and 3 months. Efficacy parameters evaluated included American Urological Association (AUA) symptom score, peak urinary flow rate (Qmax) and post-void residual urine volume (ml). Safety parameters evaluated included incidence of side effects, operative time, postoperative catheterization time, change in hematocrit and serum sodium. RESULTS: The mean prostate size was 28.4+/-4.8gm in GroupI and 37.1+/-5.3gm in Group II. The mean operation time was shorter in Group I (48.2+/-10.5min) than in Group II (75.2+/-32.6min) (p<0.05). The change of hematocrit (%) was lower in Group I (from 40.2+/-4.1 to 38.7+/-4.1) than in Group II (from 40.3+/-3.8 to 34.9+/-5.5), (p<0.05). The mean catheterization time was 3.2+/-1.2 days and 4.9+/-1.9 days (p<0.05). The change of peak urinary flow rate, post-void residual urine volume, AUA symptom score, incidence of postoperative complications was not significantly different between each group. CONCLUSIONS: Although the TURP is the gold standard for the treatment of symptomatic BPH with high success rate, significant morbidities are associated with this procedure. Our early clinical experience highlights several advantages of electro-vaporization, particulary the low incidence of postoperative morbidity.
Catheterization ; Catheters ; Follow-Up Studies ; Hematocrit ; Humans ; Hyperplasia ; Incidence ; Operative Time ; Postoperative Complications ; Prostate* ; Prostatic Hyperplasia* ; Sodium ; Transurethral Resection of Prostate

BACKGROUND: Calcipotrol, topical vitamin D analogue, has been demonstrated to have an effect for the treatment of psoriasis with good tolerability. It is required to have comparative studies with the other topical agents which are widely used for the treatment of psoriasis. OBJECTIVE: Our purpose is to compare calcipotriol with desoxymethasone ointemtn in their therapeutic efficacy and ability to affect dermal inflammatory cellular events. METHODS: This study was a randomized, double blind, right/left comparison over 8weeks in 10 patients. The ointments were applied twice daily to the lesions of psoriasis. Clinical efficacy, as measured by the Psoriasis Area and Severity Index(PASI) was assessed at 2, 4, 6 and 8weeks after starting treatments. The changes in the numbers of dermal immunocytes were assessed on frozen and paraffin-embedded sections by using immunohistochemical stain methods before and after the treatemtns. RESULTS: Reduction of PASI was statistically significant at all time points for both of the treatments (P<0.01) but there was no significant defference between the two treatment modalities. At the completion of 8 weeks of treatments, the mean PASI reduction was 65 percents and 67 percents for calcipotriol and desoxymethasone ointments, respectively. On immunohistochemical staining, the numbers of LCA and HLA-DR positive cells were decreased significantly(P<0.05), and IL-2R and CD4 positive cells were not significaltly reduced in each group after the treatment. CONCLUSION: Calcipotriol ointment was as effective as desoxymethasone ointment, judged by the PASI and the dermal inflammatory cellular events on immunohistochemical staining.
Dermatitis, Atopic ; Desoximetasone* ; HLA-DR Antigens ; Humans ; Ointments* ; Psoriasis* ; Vitamin D

No abstract available.
Circumcision, Male* ; Female ; Male ; Sensation*

No abstract available.
Humans ; Hyperbilirubinemia, Hereditary* ; Siblings* ; Twins, Monozygotic*

Heel cord advancement(HCA), which has been applied for the correction of equinus deformity in spastic cerebral palsy, has some theoretical advantages. However, HCA has also theoretical disadvantage that the procedure remove the tensile force exerting to the calcaneal apophysis. In order to evaluate the effect of HCA on the calcaneal growth, we compared the changes of calcaneal and foot lengths between the operated feet and non-operated feet after HCA. Among the 54 patients who had been treated with HCA at Seoul National University Childrens Hospital from March 1990 to August 1995, we excluded the cases who had been treated bilaterally, and also excluded hemiplegic patients in whom the ipsilateral feet were already shortened and the growth rates are different between the ipsilateral and contralateral foot. Seven patients who met the criterior of this study were included for the evaluation. There were 3 diplegics and 4 paraplegics, and average age at operation was 10 years and 6 months(range; 7 year 8 months-16 year 5 months). Average follow-up period was 3 years and 5 months(range; 2 years-4 years 9 mos). Total calcaneal lengths, anterior and posterior part of calcaneal lengths were measured on the standing lateral radiographs of the foot and ankle. Ratios of the operated limb over the non-operated limb were calculated for the three parameters. Ratios of posterior part of calcaneal lengths decreased significantly(P=0.031). Ratios of total calcaneal lengths decreased and ratios of anterior part of calcaneal lengths increased. However, the changes of two ratios were not significant. Ratios of posterior part calcaeal lengths over total calcaneal length decreases significantly(P=0.016). In conclusion, HCA can cause calcaneal growth retardation, especially posterior part of calcaneus, due to removal of physiologic tensile force of Achilles tendon.
Achilles Tendon ; Ankle ; Calcaneus ; Cerebral Palsy* ; Child ; Equinus Deformity ; Extremities ; Follow-Up Studies ; Foot ; Heel* ; Humans ; Muscle Spasticity* ; Seoul

To define the risk factors affecting the early major morbidity and mortality after multiple-valve operations, the preoperative, intraoperative and postoperative informations were retrospectively collected on 124 consecutive patients undergoing a multiple-valve operation between October 1985 and July 1996 at the department of Thoracic and Cardiovascular Surgery of Pusan Paik Hospital. The study population consists of 53 men and 71 women whose mean age was 37.9+/-11.5 (mean+/-SD) years. Using the New York Heart Association (NYHA) classification, 41 patients (33.1%) were in functional class II, 60 (48.4%) in class III, and 20 (16.1%) in class IV preoperatively. Seven patients (5.6%) had undergone previous cardiac operations. Atrial fibrillations were present in 76 patients (61.3%), a history of cerebral embolism in 5 (4.0%), and left atrial thrombus in 13 (10.5%). The overall early mortality rate and postoperative morbidity was 8.1% and 21.8% respectively. Among the 124 cases of multiple-valve operation, there were 57 (46.0%) of combined mitral valve replacement (MVR) and aortic valve replacement (AVR), 48 (38.7%) of combined MVR and tricuspid annuloplasty (TVA), 12 (9.7%) of combined MVR, AVR and TVA, 3 (2.4%) of combined MVR and aortic valvuloplasty, 2 (1.6%) of combined MVR and tricuspid valve replacement, and others. The patients were classified according to the postoperative outcomes; Group A (27 cases) included the patients who had early death or major morbidity such as low cardiac output syndrome, mediastinitis, cardiac rupture, ventricular arrhythmia, sepsis, and others; Group B (97 cases) included the patients who had the good postoperative outcomes. The patients were also classified into group of early death and survivor. In comparison of group A and group B, there were significant differences in aortic cross-clamping time (ACT, group A:153.4+/-42.4 minutes, group B:134.0+/-43.7 minutes, p=0.042), total bypass time (TBT, group A:187.4+/-65.5 minutes, group B:158.1+/-50.6 minutes, p=0.038), and NYHA functional class (I:33.3%, II:9.7%, III:20%, IV:50%, p=0.004). In comparison of early death (n=10) and survivor (n=114), there were significant differences in age (early death:45.2+/-8.7 years, survivor:37.2+/-11.6 years, p=0.036), sex (female:12.7%, male:1.9%, p=0.043), ACT (early death:167.1+/-38.4 minutes, survivor:135.7+/-43.7 minutes, p=0.030), and NYHA functional class (I:0%, II:4.9%, III:1.7%, IV:35%, p=0.001). In conclusion, the early major morbidity and mortality were influenced by the preoperative clinical status and therefore the earlier surgical intervention should be recommended whenever possible. Also, improved methods of myocardial protection and operative techniques may reduce the risk in patients with multiple-valve operation.
Aortic Valve ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Busan ; Cardiac Output, Low ; Classification ; Female ; Heart ; Heart Rupture ; Humans ; Intracranial Embolism ; Male ; Mediastinitis ; Mitral Valve ; Mortality* ; Retrospective Studies ; Risk Factors* ; Sepsis ; Survivors ; Thrombosis ; Tricuspid Valve

No abstract available.
Neurofibroma, Plexiform* ; Urinary Bladder*

No abstract available.
Angina Pectoris* ; Electrocardiography* ; Pheochromocytoma*

PURPOSE: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. METHODS: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. RESULTS: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), PaCO2<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and PaCO2<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). CONCLUSION: Overall, dizziness, time interval between onset of symptoms and ingestion, DeltaDBP and PaCO2<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and PaCO2<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.
Adult* ; Dizziness ; Eating ; Humans ; Logistic Models ; Poisoning* ; Respiration, Artificial ; Retrospective Studies ; Tetraodontiformes* ; Tetrodotoxin