No abstract available.
Animals ; Carcinogenesis* ; Dimethylnitrosamine* ; Female* ; Humans ; Mice*

The superior vena cava syndrome can occur when an extrnsc compression or intralurninal occlusion impedes blocxl flow through this vessel. We report a case of superior vena cava syndrome with tirc nbophlebitis on the right forearm in 57 year old male patient who used steroids (p.o) for 25 years.
Forearm ; Humans ; Male ; Middle Aged ; Steroids ; Superior Vena Cava Syndrome* ; Vena Cava, Superior*

OBJECTIVE: This study was aiming at estimating the joint effects of various risk factors associated with uterine cervix cancer in Korea. METHODS: Data obtained from a case-control study were analyzed with a multiplicative model. RESULTS: After adjustment for age and husband's educational attainments, the family history of cervical cancer (OR=2.1, 95% CI=1.2-3.9), unstable marital status due to separation, by death or divorce, etc. (OR=2.8, 95% CI=1.7-4.6), and a large number of deliveries (> or = 3 vs. nulliparous OR=6.5, 95% CI=1.4-29.9) increased the risk of uterine cervix cancer. Conversely, first sexual intercourse at an older age (> or = 25 years vs. <19 years OR=0.4, 95% CI=0.2-0.6) and husband's circumcision (OR=0.7, 95% CI=0.5-1.0) decreased the risk. In the multiplicative model, the highest joint risk (OR=39.2, 95% CI 5.9-258.9) was observed in women with a family history of uterine cervical cancer, an unstable marital status, where the ex-husband was not circumcised, with 3 or more delivery experiences, and having her first sexual intercourse when younger than 19 years of age. However, women without a family history of uterine cervix cancer, married to a circumcised husband, having had her first sexual intercourse at 25 years or older, and nulliparous, showed the lowest joint effect (OR=0.3, 95% CI=0.1-0.5). CONCLUSION: As carcinogenesis is a complex action involving various factors, we consider a joint effects approach to be appropriate in an epidemiological study on risk factors for uterine cervix neoplasms.cervix neoplasm.
Carcinogenesis ; Case-Control Studies ; Cervix Uteri* ; Circumcision, Male ; Coitus ; Divorce ; Epidemiologic Studies ; Female ; Humans ; Joints* ; Korea* ; Male ; Marital Status ; Models, Statistical ; Risk Factors ; Spouses ; Uterine Cervical Neoplasms

We present a case of generalized grannuloma annulare with perforating and subcutaneous forms which occurred in a 15-year-old girl. Two years ago, multiple umbilicated, match head to pea sized, erythematous papules were noted on the upper extremities. Then the patient also experienced crusted or ulcerated erythematous papular lesions on the lower legs. Recently, tender, subcutaneous nodules appeared on both soles. The biopsy specimens from the skin lesions of the hand and the sole showed typical findings of granuloma annulare in the dermis and the subcutis, respectively. On the histopathological examination of the calf lesion, palisading granuloma as well as transepidermally eliminating dermal collagenous and necrotic material were seen. The skin lesions were almost completely improved by treatment with dapsone, 100mg a day, for 8 weeks orally.
Adolescent ; Biopsy ; Collagen ; Dapsone ; Dermis ; Female ; Granuloma Annulare* ; Granuloma* ; Hand ; Head ; Humans ; Leg ; Peas ; Skin ; Ulcer ; Upper Extremity

A case of malignant mixed mesodermal tumor (MMMT) developed after radiation therapy for a uterine cervix cancer is described. The patient was a 62-year-old female at the time of diagnosis of stage Ib squamous cell carcinoma of the cervix and a total of 12,000 rads of x-ray was administered on the pelvic area. Five years later she manifested vaginal spotting and rectal pain. Endometial curettage and biopsy revealed carcinosarcoma. Radical hysterectomy was done and a 5x3x2 cm sized polypoid mass was noted in the uterine cavity. Microscopically, the tumor showed intimate admixture of adenocarcinomatous and sarcomatous areas. The sarcomatous stroma was composed of compactly arranged atypical spindle cells with frequent mitoses, merging into a loosely textured reticular areas and abundant amount of heterologous elements such as skeletal muscle and cartilage. The rhabdomyosarcomatous element was confirmed by PTAH staining and immunohistochemical staining for myoglobin and desmin. Multiple metastases to the liver, lung, and lymph nodes appeared within one year of total abdominal hysterectomy and bilateral salpingo-oophorectomy. In spite of palliative radiotherapy, she expired one month later.
Female ; Humans ; Biopsy ; Neoplasm Metastasis

BACKGROUND: Pigment production and acidification of ribose are most frequently used biochemical tests for the differentiation of three enterococcal species carrying vanC genes such as Enterococcus gallinarum, Enterococcus casseliflavus, and Enterococcus flavescens. However, pigment production may occasionally be negative in E. casseliflavus, and some of E. casseliflavus may be negative or delayed reaction with ribose fermentation test. So, we performed this study to find out biochemical tests capable of distinguishing the strains possessing vanC genotypes. METHOD: A total of 17 enterococci composed of 14 clinical isolates with motility or pigment positive strains and three ATCC strains(E. gallinarum ATCC 49573, E. casseliflavus ATCC 25788, and E. flavescens ATCC 49997) Were tested by multiplex PCR of the vanC genes(vanC-1, vanC-2 and vanC-3)and various biochemical tests. RESULTS: Among the 17 isolates including three ATCC control strains, four were genotyped as VanC-1, 11 were VanC-2, one were vanC-2/3, and any of vanC genes were not detected in one clinical isolate, respectively, Among the enterococci with vanC genotype, acid production from alphaD-cyclodextrin and hippurate hydrolysis were positive only in VanC-1 gneotype(E. gallinarum), acid production from glycerol and methyl-alpha-D-mannopyranoside were positive only in vanC-2 genotype(E. casseliflavus), and acid production from rhamnose and pigment production were negative only in VanC-1 genotype. Acid production from alphaD-cyclodextrin was negative only in vanC-2 genotype. The positive rate of ribose fermentation of VanC-1, VanC-2, and VanC-2/3(E. flavescens) genotype were 100%, 82%, and 0%, respectively. CONCLUSION: Acid production from rhamnose, alphaD-cyclodextrin, betaD-cyclodextrin, glycerol and methly-alphaD-mannopyranoside, pigment production, and hippurate hydrolysis test were useful biochemical tests for differentitating E. gallinarum form E. casseliflavus. The production of acid from alphaD-cyclodextrin, glycerol, methyl-alpha-D-mannopyranoside and were suitable biochemical tests for differentiating E. casseliflavus from E. flavescens.
Enterococcus ; Fermentation ; Genotype ; Glycerol ; Hydrolysis ; Multiplex Polymerase Chain Reaction ; Phenotype* ; Rhamnose ; Ribose

A clinical observation was made on 5 cases of congenital posterior urethral valves admitted recently to the Department of Urology, Busan National University Hospital. The results were following: 1. Age distribution showed; 1 case (20%) under 6 months, 2 cases (40%) between 6 and 12 months, 2 cases (40%) over 6 years old. 2. The symptoms of urinary dribbling, weak stream, frequency and difficult urination were observed in all 5 cases. Abdominal mass, abdominal pain, fever, vomiting and failure to thrive were observed in 4 cases (80%) . Enuresis was observed in 2 cases (40%) . Hypertension and gross hematuria were observed in 1 case (20%) . 3. IVP revealed bilateral hydronephrosis and hydroureter in all cases. Vesicoureteral reflux was observed in 3 cases (60%) , in which 2 cases were unilateral and the other 1 case was bilateral and bladder diverticulum appeared in 3 cases (60%). Voiding cystourethrogram was performed on 4 cases, and in all of these 4 cases (100%) dilatation of posterior urethra and cut-off at the membranous level and a thin stream in the bulb and 2 cases (50%) bladder neck contracture due to congenital posterior urethral valves had developed. 4. Endoscopic examination was performed on 5 cases, in which 3 cases (60%) were young's type I, and remaining 2 cases 140%) were Young's type III. 5. All 5 cases were treated by transurethral electrofulguration of the valves and one case of them was performed bilateral ureteroneocystostomy 3 years after valve ablation but in the case with marked bilateral hydronephrosis and vesicoureteral reflux a cystostomy was also performed. 6. The follow up study was performed in 4 cases with the follow-up period from five months to 36 months and mean duration of 2 years. All 4 cases had excellent results with much improved urinary stream and Renal condition after operation, but in 2 cases intermittent incontinence occurred for 3 years and 1 year respectively. In all 4 cases much diminished hydronephrosis and urethral dilation on IVP were observed. The posterior urethral dilatation became nearly normalized and abnormal findings of bladder improved on voiding cystourethrogram, but in 2 cases with bladder diverticulum 1 showed nonspecific interval changes during 3 years and the other 5 months. In 2 cases with vesicoureteral reflux, 1 showed loss of vesicoureteral reflux spontaneously 1 month after the operation and the other showed persistent vesicoureteral reflux for 1 year, which was observed to be improving.
Abdominal Pain ; Age Distribution ; Busan ; Child ; Contracture ; Cystostomy ; Dilatation ; Diverticulum ; Enuresis ; Failure to Thrive ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Hydronephrosis ; Hypertension ; Neck ; Rivers ; Urethra ; Urinary Bladder ; Urination ; Urology ; Vesico-Ureteral Reflux ; Vomiting

A clinical observation was made on 5 cases of congenital posterior urethral valves admitted recently to the Department of Urology, Busan National University Hospital. The results were following: 1. Age distribution showed; 1 case (20%) under 6 months, 2 cases (40%) between 6 and 12 months, 2 cases (40%) over 6 years old. 2. The symptoms of urinary dribbling, weak stream, frequency and difficult urination were observed in all 5 cases. Abdominal mass, abdominal pain, fever, vomiting and failure to thrive were observed in 4 cases (80%) . Enuresis was observed in 2 cases (40%) . Hypertension and gross hematuria were observed in 1 case (20%) . 3. IVP revealed bilateral hydronephrosis and hydroureter in all cases. Vesicoureteral reflux was observed in 3 cases (60%) , in which 2 cases were unilateral and the other 1 case was bilateral and bladder diverticulum appeared in 3 cases (60%). Voiding cystourethrogram was performed on 4 cases, and in all of these 4 cases (100%) dilatation of posterior urethra and cut-off at the membranous level and a thin stream in the bulb and 2 cases (50%) bladder neck contracture due to congenital posterior urethral valves had developed. 4. Endoscopic examination was performed on 5 cases, in which 3 cases (60%) were young's type I, and remaining 2 cases 140%) were Young's type III. 5. All 5 cases were treated by transurethral electrofulguration of the valves and one case of them was performed bilateral ureteroneocystostomy 3 years after valve ablation but in the case with marked bilateral hydronephrosis and vesicoureteral reflux a cystostomy was also performed. 6. The follow up study was performed in 4 cases with the follow-up period from five months to 36 months and mean duration of 2 years. All 4 cases had excellent results with much improved urinary stream and Renal condition after operation, but in 2 cases intermittent incontinence occurred for 3 years and 1 year respectively. In all 4 cases much diminished hydronephrosis and urethral dilation on IVP were observed. The posterior urethral dilatation became nearly normalized and abnormal findings of bladder improved on voiding cystourethrogram, but in 2 cases with bladder diverticulum 1 showed nonspecific interval changes during 3 years and the other 5 months. In 2 cases with vesicoureteral reflux, 1 showed loss of vesicoureteral reflux spontaneously 1 month after the operation and the other showed persistent vesicoureteral reflux for 1 year, which was observed to be improving.
Abdominal Pain ; Age Distribution ; Busan ; Child ; Contracture ; Cystostomy ; Dilatation ; Diverticulum ; Enuresis ; Failure to Thrive ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Hydronephrosis ; Hypertension ; Neck ; Rivers ; Urethra ; Urinary Bladder ; Urination ; Urology ; Vesico-Ureteral Reflux ; Vomiting

A clinical evaluation was done on Il patients with postrenal acute renal failure who were admitted to the Busan National University Hospital during the period of 6 years and 8 months from Jan. 1976 to Aug. 1982. The results were as follow. 1. The patients were mean ages of 44.3 years, being thought somewhat older than other cause of renal failure. And the male was more frequently affected than the female. 2. The 2 most common causes of postrenal acute renal failure in 11 patients were malignant neoplasms (5 patients; 1 bladder Ca. 3 cervical Ca. and 1 retroperitoneal metastatic Ca.) and ureteral calculi (5 patients; 2 bilateral and 3 unilateral in solitary renal unit). 3. Ureteral obstructions were bilateral in 7 patients (14 ureters) and unilateral in 4 patients (4 ureters) in the solitary kidney. The involved site of ureteral obstructions were bilateral lower ureters in 5 patients (10 ureters), bilateral upper ureters in 1 patient (2 ureters), unilateral right upper ureter and left lower ureter in 1 patient 12 ureteral, and unilateral lower ureter in 4 patients (4 ureter). 4. Seven patients were treated with urinary diversion, 3 with ureteral catheterization and 1 with ureterolithotomy. Among 7 patients of urinary diversion, nephrotomy was done in 6 patients and double-barreled ureterocutaneostomy in 1 patient. 5. The prognosis was excellent in 10 patients and 1 patient was expired due to uremia and generalized marasmus following malignant neoplasm.
Acute Kidney Injury* ; Busan ; Female ; Humans ; Kidney ; Male ; Prognosis ; Protein-Energy Malnutrition ; Renal Insufficiency ; Uremia ; Ureter ; Ureteral Calculi ; Ureteral Obstruction ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters ; Urinary Diversion

BACKGROUND: Epidural morphine has side effects, especially pruritus, nausea, and vomiting. Butorphanol has been added in studies to reduce these side effects in post cesarean patients. The purpose of this study was to evaluate the side effects and analgesic efficacy when a combination of epidural morphine and butorphanol was administered in patients having combined local anesthetic and opioid epidural infusion. METHODS: Sixty patients having epidural anesthesia for cesarean section were randomly divided into two groups. Group M (n=30) received a bolus of 0.25% bupivacaine 4 ml, morphine 2 mg, and saline 0.75 ml, whereas group B (n=30) received a bolus of 0.25% bupivacaine 4 ml, morphine 2 mg, and butorphanol 1.5 mg (0.75 ml). Continuous epidural infusion was done by Two-day Infusor containing either 0.25% bupivacaine 75 ml, morphine 5 mg, and saline 20 ml in group M or 0.25% bupivacaine 75 ml, morphine 5 mg, butorphanol 4 mg (2 ml), and saline 18 ml in group B. We compared the side effect and analgesic effect of group M to those of group B for 2 days. RESULTS: The incidence of pruritus and vomiting were reduced significantly in group B (p<0.05). There were no significant differences between both groups in the incidence of nausea or other side effects as well as no differences in analgesic effect. CONCLUSIONS: We conclude that the addition of butorphanol to morphine in combined local anesthetic and opioid epidural infusion for postoperative analgesia decreases the occurrence of pruritus and vomiting without significant increase of other side effects and adverse effect on analgesia.
Analgesia ; Anesthesia, Epidural ; Bupivacaine ; Butorphanol* ; Cesarean Section* ; Female ; Humans ; Incidence ; Infusion Pumps ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting