We report bilaterally fractured Hydroflex implants in 2 patients. One fracture was complete and three were incomplete. All the fractures occurred at the junction of the rear reservoir and the inflation chamber.
Adult ; Case Report ; Equipment Design ; Human ; Male ; *Penile Prosthesis ; Prosthesis Failure

The clinical course of individual patient with renal cell carcinoma (RCC) is variable and difficult to predict accurately. The values of various classical prognostic factors in RCC remain ill-defined. Data on molecular analysis of oncogene and tumor suppressor genes including p53 may provide useful prognostic information for RCC. We herein investigated the prognostic value of multiple clinical and pathological parameters as well as p53 mutation in 40 patients with pathologically confirmed RCC. Mutations of p53 gene were analyzed by immunohistochemical staining using monoclonal antibody for p53 protein( M1801). On univariate analysis using log-rank test multiple parameters showed prognostic value, including clinical stage ( Robson), nuclear grade, mutation of p53, cell type, body weight loss, anemia, and increased serum level of calcium and erythrocyte sedimentation rate. However, on multivariate analysis using Cox's proportional hazard model only three parameters including stage(p <0.001 ), nuclear grade(p < 0.05), and mutation of p53(p<0.05) were found to have significant independent prognostic value. These results suggest that in RCC clinical stage and nuclear grade are two most important prognostic factors and analysis of p53 mutation may provide additional important prognostic information.
Anemia ; Blood Sedimentation ; Calcium ; Carcinoma, Renal Cell* ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Multivariate Analysis ; Oncogenes ; Proportional Hazards Models ; Somatotypes ; Weight Loss

Nucleolar organizer regions(NORs) are intranucleolar segments of DNA coding for ribosomal RNA and contribute to the regulation of cellular protein synthesis. Since NOR-associated proteins are argyrophilic, silver staining method has been used for demonstration of NORs. The numbers of argyrophilic NORs(AgNORs) have been shown to be correlated with DNA ploidy and have prognostic value in diverse human neoplasms. However, the prognostic value of AgNORs in renal cell carcinoma(RCC) remain ill defined. We herein investigated the prognostic value of AgNORs in 39 patients with RCC. There was no significant relationship between mean number of AgNORs (m AgNORs) per nucleus and Robson stage and Fuhrman nunlear grade. However, there was significant relationship between the percentage of tumor cells with more than five AgNORs per nucleus (p AgNORs) and Robson stage and nuclear grade (p<0.05). There was significant difference in survival rate between patients with RCC in whom AgNORs were two or less and in whom AgNORs were greater than two(p<0.05). The patients with a low p AgNORs(less than 8%) have a better prognosis than those with a high p AgNORs. These results suggest that number of AgNORs may be a clinically useful prognostic marker for patients with RCC.
Carcinoma, Renal Cell* ; Clinical Coding ; DNA ; Humans ; Nucleolus Organizer Region* ; Ploidies ; Prognosis ; RNA, Ribosomal ; Silver Staining ; Survival Rate

BACKGROUND: For the diagnosis or evaluation of airway obstruction in bronchial asthma and chronic obstructive lung disorders, various parameters derived from the forced expiratory volume curve and maximal expiratory flow volume cutie have been used. Recently the peak expiratory flow(PEF) measured by the peak flow meter is widely used because of its simplicity and convenience. But there were still no data of the predicted normal values measured by the peak flow meter in Korea. This study was to obtain the predicted normal value of PEF and to know the accuracy of this value 18 predict FEV1. METHOD: The measurements of PEF by the MiniWright peak flow meter and several parameters derived from the forced expiratory volume and maximal expiratory flow volume curves by the Microspiro HI 501(Chest Co.) were done in 129 men and 125 women without previous history of the respiratory diseases. The predicted normal values of parameters according tc the age and the height were obtained, and the regression equation of FEV1 by PEF was calculated. RESULTS: The predicted normal values of PEF(L/min) were 2.45 Age(year)+1.36 Height(cm)+427 in men and -0.96 Age(year)+2.01 Height(cm)+129 in women. FEFmax derived from the maximal expiratory flow volume cutie was less than by 125 L/min in men art 118 L/min in women respectively compared to PEF. FEV,(ml) predicted by PEF was 5.98 PEF(L/min) 303 in men and 4.61 PEF(L/min) 291 in women respectively. CONCLUSION: The predicted normal value of PEF measured by the peak flow meter was calculated and it could be used as a standard value of PEF while taking care of patients with airway obstruction FEV1, the gold standard of ventilatory function could be predicted by PEF to a certain extent.
Airway Obstruction ; Asthma ; Diagnosis ; Female ; Forced Expiratory Volume ; Humans ; Korea ; Lung ; Male ; Maximal Expiratory Flow-Volume Curves ; Reference Values

A variety of technique of dynamic pharmacocavernosometry have been described to evaluate cavernous veno-occlusive function: however, there is no uniquely reliable and standard method so far After intracavernous (IC) injection of 45 mg papaverine and 2.5 mg phenblamine, we performed gravity cavernosometry(GC) and pump cavernosometry(PC), ie, measurement of saline infusion rate needed to obtain and to maintain an erection and measurement of pressure decay for 30 seconds and pressure drop time to 75 mmHg when pump was turned off at 150 mmHg IC pressure. Final diagnosis of venous leakage was made by cavernosoeraphy done at 90 mmHg IC pressure. The parametric values measured by each method to diagnose venous leakage and correlation among these methods were analyzed. The etiology of impotence in 45 patients studied was psychogenic in 8, venogenic in 21, combined arteriogenic and venogenic in 16. The measurement of induction flow rate was less reliable(p<0.05) for the diagnosis of venous leak than the other methods of PC and GC (p<0.01). The standard deviations of the induction and maintenance flow rate and pressure drop time were similar to or even higher than mean values. There was correlation among all these methods. Therefore, GC and PC, particularly measurement of the intracorporeal pressure decay are believed to be valuable methods for diagnosis of the corporal-venous leakage.
Diagnosis ; Erectile Dysfunction ; Gravitation ; Humans ; Male ; Papaverine

We evaluated the conditions required for sutures tied to a post for tibial fixation during anterior cruciate ligament (ACL) reconstruction. Harvested porcine tendon was used as a graft material and nonabsorbable suture was used for sutures. Samples were tested for ultimate tensile load and elongation according to thread numbers, knot numbers, suture techniques and stitch numbers. As thread numbers were increased, ultimate tensile load was increased and elongation was decreased. However, more than 4 strands of threads provided the sufficient ultimate tensile load more than 454 N of normal ACL for daily activities. As knot numbers were increased, ultimate tensile load was increased, but elongation was decreased. In terms of failure mode, unraveling occurred 100% in 3 and 4 knots, 81.2% in 5 knots, 54.5% in 6 knots, and 0% in 7 knots. Suture techniques and stitch numbers didn't significantly affect the ultimate tensile load and the elongation. For sutures tied to a post for tibial fixation in ACL reconstruction, more than 4 threads, more than 7 knots, and more than 4 stitches provide adequate ultimate tensile load and elongation.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction* ; Knee ; Suture Techniques* ; Sutures* ; Tendons* ; Transplants

BACKGROUND: The causes of hepatic dysfunction after exposures to the halogenated inhaled anesthetics may be free radical, metabolites of inhaled anesthetics, immune reaction and hypoxic damage by decreasing total hepatic blood flow. The present study was performed to comparison of estimated hepatic blood flow and systemic hemodynamic changes between the general anesthesia with enflurane and thoracic epidural anesthesia in rabbits. METHODS: In general anesthesia group with enflurane, anesthesia was performed with enflurane 2vol% and 100% oxygen for 60 minutes. In thoracic epidural anesthesia group, epidural block was done at T5 level with 0.4 ml/kg of 1% lidocaine. Hepatic blood flow was estimated by clearance of indocyanine green according to the constant infusion method before and 30, 60 minutes after anesthesia. Heart rate, mean arterial pressure, central venous pressure and splanchnic vascular resistance were measured at the same time in both groups. RESULTS: Heart rate was decreased significantly in thoracic epidural anesthesia group and mean arterial pressure and central venous pressure were decreased significantly in both groups at 30, 60 minutes. Hepatic blood flow was decreased at 30, 60 minutes in both groups. Splanchnic vascular resistance was increased significantly 30, 60 minutes in thoracic epidural anesthesia group. There were significant differences in mean arterial pressure and splanchnic vascular resistance between two groups. There was no difference in hepatic blood flow between two groups. CONCLUSIONS: The decreased hepatic blood flow was caused by decreased mean arterial pressure in general anesthesia group with enflurane and by increased splanchnic vascular resistance in thoracic epidural anesthesia group.
Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Anesthetics ; Arterial Pressure ; Central Venous Pressure ; Enflurane ; Heart Rate ; Hemodynamics* ; Indocyanine Green ; Lidocaine ; Oxygen ; Rabbits ; Vascular Resistance

We describe a case of posterolateral capsular heterotopic ossification requiring a surgical excision after a PCL (Posterior Cruciate Ligament) reconstruction using the modified inlay method and PLCS (posterolateral corner sling) with a tibia tunnel. A 21-year-old female patient had suffered a blunt proximal tibial direct trauma 6 months earlier. She did not experience limb ischemia or a pulse deficit before she visited our out patient clinic. She had not suffered any trauma in other sites, and showed a range of motion of 0 to 30degrees at 4 months after surgery. There was no specific finding on the X-ray images. Arthroscopic adhesiolysis was performed and her range of motion increased to 0 to 120degrees. However, 6 months after the initial operation, she showed ankylosis and heterotopic ossification at the posterior aspect, which was surgically removed at 12 months postoperatively. After the second surgery, there was no recurrence and she showed a 0 to 140degrees range of motion at postoperative 42 months.
Ankylosis ; Extremities ; Female ; Humans ; Inlays* ; Ischemia ; Ossification, Heterotopic ; Osteogenesis* ; Posterior Cruciate Ligament* ; Range of Motion, Articular ; Recurrence ; Tibia* ; Young Adult

BACKGROUND: Intraoperative low dose dobutamine test with transesophageal echocardiography may offer a simple, cost effective and widely available mean of detecting contractile reserve in coronary artery disease. The purpose of this study was to determine the effect of low dose dobutamine infusion on ventricular function in patients undergoing coronary artery bypass graft and to predict the post-pump response of dysfunctional myocardial segments to surgical revascularization. METHODS: This study was performed in 23 patients undergoing coronary artery bypass graft. After transesophageal echocardiographic images of transgastric left ventricular short axis view at mid-papillary muscles level were obtained, the percentage of systolic wall thickening(PSWT) was evaluated. The ejection fraction by modified Simpson's method and hemodymic changes were measured simultaneously. RESULTS: The clinical accuracy of intraoperative low dose dobutamine test for PSWT was followed; Sensitivity-76%, specificity-94.7%, positive predictive value-95%, negative predictive value-75% and overall accuracy-84.1%. Ejection fraction increased from 49.0 13.1% to 56.3 11.5%(dobutamine infusion) and 59.5 12.1%(post-pump) significantly(P<.05). During dobutamine infusion and post-pump, cardiac index increased significantly(P<.01). CONCLUSIONS: Intraoperative low dose dobutamine by transesophageal echocardiography is a potentially useful test for prediction of the post pump response of regional systolic function and global ventricular function to coronary revascularization.
Axis, Cervical Vertebra ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Transesophageal* ; Heart ; Humans ; Muscles ; Transplants ; Ventricular Function

BACKGROUND: To determine if tibial positioning affects the external rotation of the tibia in a dial test for posterolateral rotatory instability combined with posterior cruciate ligament (PCL) injuries. METHODS: Between April 2007 and October 2007, 16 patients with a PCL tear and posterolateral rotatory instability were diagnosed using a dial test. The thigh-foot angle was measured at both 30degrees and 90degrees of knee flexion with an external rotation stress applied to the tibia in 2 different positions (reduction and posterior subluxation). The measurements were performed twice by 2 orthopedic surgeons. RESULTS: In posterior subluxation, the mean side-to-side difference in the thigh-foot angle was 11.56 +/- 3.01degrees at 30degrees of knee flexion and 11.88 +/- 4.03degrees at 90degrees of knee flexion. In the sequential dial test performed with the tibia reduced, the mean side-to-side difference was 15.94 +/- 4.17degrees (p < 0.05) at 30degrees of knee flexion and 16.88 +/- 4.42degrees (p = 0.001) at 90degrees of knee flexion. The mean tibial external rotation was 5.31 +/- 2.86degrees and 6.87 +/- 3.59degrees higher in the reduced position than in the posterior subluxation at both 30degrees and 90degrees of knee flexion. CONCLUSIONS: In the dial test, reducing the tibia with an anterior force increases the ability of an examiner to detect posterolateral rotary instability of the knee combined with PCL injuries.
Adolescent ; Adult ; Biomechanics ; Female ; Humans ; Joint Instability/*diagnosis/physiopathology ; Knee Joint/*physiopathology ; Male ; Middle Aged ; *Physical Examination ; Posterior Cruciate Ligament/*injuries/physiopathology ; Range of Motion, Articular ; Tibia/*physiopathology ; Young Adult