Percutaneous drainage of liver abscess is an effective treatment, but the success rate is low for liver abscess that has septa and is multilocular. We experienced one case of successful treatment of multilocular liver abscess using administration of Urokinase into an abscess cavity during the course of percutaneous drainage.
Abscess ; Catheters* ; Drainage* ; Liver Abscess* ; Liver* ; Urokinase-Type Plasminogen Activator*

The primary goal in the treatment of the nail bed avulsion injury is complete regrowing of the nail plate without any deformity. There are many procedures for treatment of the nail bed avulsion injury as a split-thickness skin graft, full-thickness nail bed graft, reverse dermal graft or split-thickness nail bed graft. From February, 1984 to June, 1985 at In-Chon Gill Hospital, 13 cases of nail bed avulsion injury were treated with split-thickness nail bed grafts. The intact residual part of the injured nail bed or the toe nail bed was served as a donor site. The results were as followings; 1. The incidence of nail bed avulsion injury of all hand injuries was 9.7%. 2. The main cause of injury was the industrial accident and more prevalent in the left hand. 3. The good result was obtained in the split-thickness nail bed graft for the nail bed avulsion injury, but in nail root portion, the poor result was noticed. 4. The average time for normal nail appearance is six months.
Accidents, Occupational ; Animals ; Congenital Abnormalities ; Gills ; Hand ; Hand Injuries ; Humans ; Incheon ; Incidence ; Skin ; Tissue Donors ; Toes ; Transplants

Permanant ileostomy is necessary in the case of a total proctocolectomy for a cancerous change in the distal rectum due to ulcerative colitis or familial adenomatous polyposis coli, but the fecal content after a conventional ileostomy is usually liquid or semiliquid. Sometimes, this resultes in dehydration and some nutrient loss. Nahm-gun Oh has designed an antiperistaltic ileostomy for formed stool evacuation. About a 25 cm length of the most distal ileum is cut, this segment is reversed, and then the antiperistaltic ileostomy is performed. The authors have performed antiperistaltic ileostomies in 6 cases of familial adenomatous polyposis or ulcerative colitis with a cancerous change in the low rectum. During the past 5 years and 7 months at the Department of Surgery, Pusan National University Hospital, we found that the profuse ileostomy discharge of the conventional ileostomy was decreased in the antiperistaltic ileostomy group, and that the antiperistaltic ileostomy discharge had a liquid component which was markedly decreased compared to that of the conventional ileostomy discharge. In addition, the antiperistaltic ileostomy discharge appeared to be much more solid and less voluminous. In conclusion, the antiperistaltic ileostomy should be considered for creating the effect of a reservoir by producing intestinal stasis proximal to the segment. The antiperistaltic ileostomy is effective in reducing the daily amount of ileostomy discharge and is convenient for stoma care due to the diminished water content in the discharge.
Adenomatous Polyposis Coli ; Busan ; Colitis, Ulcerative ; Dehydration ; Ileostomy* ; Ileum ; Rectum

The primary factors determining nasal tip outline are shape and position of the alar cartilages. The relation of the alar cartilages to the upper lateral cartilages, septum, and soft tissue envelope defines the conformation of the tip-lobule complex. Plunging tip is a condition as long nose, tip drooping and becomes more accentuated with aging. Hanging columella is a prominent downward bowing of the columella. Plunging tip and hanging columella are common causes of acute nasolabial angle.Correction of the plunging tip in the long nose is usually achieved satisfactorily through shortening of the lateral walls by excising an adequate amount of cartilage from the septal, lateral, and alar cartilage. Tip rotation in a cephalic direction can be achieved commonly by resection of the cephalic portion of the lateral crura, excision of a triangular segment of the caudal margin of the septum and a cartilaginous septal transfixion incision involving excision of a superiorly based triangle of septum with cephalic rotation of the entire nasal lobule.Modification of the caudal margin of the septum is done to achieve three goals: (1) cephalic rotation of the tip, (2) shortening of nasal length, and (3) alterations in the nasolabial angle. We have elevated and rotated in a cephalic direction nasal tip by means of resection of cephalic portion of lateral crura, resection of the caudal margin of the septum and mucous membrane, and /or invagination technique for correction of the plunging tip and hanging columella. From March 1996 to February 1998, we have performed the tip-plasty in 7 patients of the plunging tip and hanging columella. We have found good cosmetic results with improved nasolabial angle.
Aging ; Cartilage ; Humans ; Mucous Membrane ; Nose

Although the definition of male pseudohermaphroditism remains controversial, male pseudohermaphrodites will be defined as chromatin-negative individuals who have testis with the failure of normal development of the normal male. Also included are those individuals who may have more than one cell line, but at least one cell line, containing a Y chromosome and no cell line having two X chromosomes. Gonadal histologic findings may be either testicular or streak, but not ovarian. Male pseudohermaphroditism can result as a consequence of 1) absent M(llerian regression, 2) Inadequate synthesis of testosterone, 3) inadequate synthesis of dihydrotestosterone and 4) androgen receptor deficiency. We have seen 5 cases of male pseudohermaphroditism with manifestations of penoscrotal or perineal hypospadias, pubertal virilization, cryptorchism or atrophied testes, and feminization. Four cases had been reared as male and one case as female. All revealed chromatin-negative pattern in buccal smear and testes. After the plausible discussion, two cases were decided to be reared as female and three were as male.
46, XY Disorders of Sex Development* ; Androgen-Insensitivity Syndrome ; Cell Line ; Cryptorchidism ; Dihydrotestosterone ; Female ; Feminization ; Gonads ; Humans ; Hypospadias ; Male* ; Testis ; Testosterone ; Virilism ; X Chromosome ; Y Chromosome

Most of malignant tumors in the urinary bladder is transitional cell carcinoma (TCC) deriving from the urothelium. Clinical stage and histopathologic grading of the TCC of the urinary bladder is important in the determination of the patient's prognosis. To investigate the correlation between the prognostic factors and the expression of the various oncoproteins and growth factors in each grade of the TCC, immunohistochemical stains for c-erbB2, c-myc, c-fos, bcl-2, p53, proliferating cell nuclear antigen (PCNA), and transforming growth factor-alpha (TGF-alpha) were performed in the formalin fixed paraffin embedded tissues of the TCC (Grade I; 15 cases, Grade II; 20 cases, Grade III; 15 cases) of the urinary bladder. The immunoexpression rate of c-erbB2 was immunoexpression 78.0% in the grade I, 85.0% in the grade II, and 95.0% in the grade III TCC. The immunoexpression rate of c-myc, c-fos and bcl-2 was below 5% in each grades of TCC. The p53 immunoexpression was identified in 11.5%, 24.3% and 30.6% of the grade I, II, and III TCC, respectively. The PCNA and TGF-alpha expression was 53.0% and 27.6% in the grade I, 77.3% and 32.7% in the grade II, and 78.2% and 37.3% in the grade III TCC, respectively. These results suggest that the expressions of c-myc, c-fos, bcl-2, and TGF-alpha are similar in each grade of the TCC and the positivity of c-erbB2, p53, and PCNA shows an increasing tendency for the higher grade TCC of the urinary bladder. Therefore, c-erbB2, p53, and PCNA are clinically useful predictors of the patient's prognosis.
Carcinoma, Transitional Cell* ; Coloring Agents ; Formaldehyde ; Intercellular Signaling Peptides and Proteins ; Oncogene Proteins ; Paraffin ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Transforming Growth Factor alpha* ; Urinary Bladder* ; Urothelium

Intramedullary spinal cord metastases (ISCM) account for only 3.4% of symptomatic metastases to the spinal cord. The survival of patients with ISCM is characteristically short, often no longer than 2 months, due to a rapid neurologic deterioration and the presence of widespread metastases, including metastases to the brain. We report two cases of ISCM arising from primary sphenoid sinus carcinoma and primary lung cancer along with a review of the literature. The case of ISCM from the primary sphenoid sinus is the third case of secondary syringomyelia due to ISCM in the world literature, and ISCM from the primary lung cancer is the first case reported in Korea. One case showed a slow progression of symptoms and a longer survival (26 months after the radiotherapy to the spine), and the other showed a rapid deterioration of symptoms with a shorter survival. More effective palliation can be achieved if the disease is diagnosed at an early stage when the neurologic deficits are still reversible.
Brain ; Humans ; Korea ; Lung Neoplasms ; Neoplasm Metastasis* ; Neurologic Manifestations ; Radiotherapy ; Sphenoid Sinus ; Spinal Cord* ; Syringomyelia

No abstract available.
Animals ; Cats* ; Muscle Spindles* ; Muscle Weakness*

Twenty cases of the rheumatoid arthritis was carried out the histopathological observation from the affected synovial membrane at the knee joint by the Cops biopsy needle, at the Department of Orthopedic Surgery, Chosun University Hospital. The authors researched the difference to compare with the histological finding and its clinical features. The following results were obtained. 1. The average age was 36.9 years old and the sex ratio between the male and female was 1:2.7. 2. The erythrocyte sedimentation rate and protein amont in the synovial fluid was elevated than the normal value. 3. The most common clinical sign was the morning stiffness with multiple joint pain and moderate swelling, tenderess in the involved joint. 4. The test of rheumatoid factors revealed positive about 70% in the serum and 100% in the joint fluid. 5. The characteristic histological finding on the light microscopical examination was the hyperplasia of surface lining cells, deposition of the fibrin with the fibrinoid necrosis, and vascular hypertrophic changes of the blood vessel in all of those cases. 6. The histological finding had no difference to compare with the clinical course.
Arthralgia ; Arthritis, Rheumatoid ; Biopsy ; Blood Sedimentation ; Blood Vessels ; Female ; Fibrin ; Humans ; Hyperplasia ; Joints ; Knee Joint ; Knee ; Male ; Necrosis ; Needles ; Orthopedics ; Reference Values ; Rheumatoid Factor ; Sex Ratio ; Synovial Fluid ; Synovial Membrane

BACKGROUND: Noninvasive estimation of pulmonary artery pressure is an important component of echocardiographic studies. A number of methods are available for estimation of pulmenary pressure, each with varying degrees of reported accuracy. To assess accuracy and difficulties, noninvasive pulmonary artery pressure estimates were performed in infants and children with congenital heart diseases. METHODS: Noninvasive estimates from 8 methods were compared with catheterization measurements. Systolic pressure was estimated by the Burstin method and from perak tricuspid regurgitation velocity, and also from systolic pressure gradients through the VSD(ventricular septal defect) and PDA(patent ductus arteriosus). Mean pressure was estimated by acceleration time divided by ejection time measured from Koppler spectrum obtained at the right ventricular out flow tract. Diastolic pressure was estimated from pulmonary regurgitation velocity spentrum at end-diastolic, and also from diastolic pressure gradient through the patent ductus arteriosus. RESULTS: IN systolic pressure, Burstin and tricuspid regurgitation velocities estimates correlated significantly(r=0.92, 0.90 respectively), whereas VSD and PDA estimates correlated less well with catheterization estimates(r=0.83, 0.65 respectively). The mean pressure, measured from RVOT(right ventricular outflow tract) Doppler spectrum corresponded well with catheterization pressure(r=0.89), whereas those obtained from the main pulmonary artery correlated less well(r=0.74). The diastolic pressure estimates from pulmonary regurgitation velocity spectrum, revealed good correlation(r=0.79), but those from diastolic Doppler spectrum at PDA correlated less well with catheterization estimates(r=0.63). CONCLUSION: All of eight Doppler echocardiographic methods seemed to be easily performable for estimation of pulmonary artery pressure. But, the degree of accuracy was variable. Because a pressure estimante from only a single method may be in error, care should be taken in combining use of other(one or two) methods.
Acceleration ; Blood Pressure ; Catheterization ; Catheters ; Child ; Ductus Arteriosus, Patent ; Echocardiography* ; Echocardiography, Doppler ; Heart Diseases ; Humans ; Infant ; Pulmonary Artery* ; Pulmonary Valve Insufficiency ; Tricuspid Valve Insufficiency