Candida glabrata infection of urinary bladder in a Chinchilla Persian cat

A 5-year-old castrated male Chinchilla Persian cat weighing 4.84 kg was referred for hematuria. The cat had a history of urethrostomy and bacterial cystitis. In urine culture, Candida glabrata was cultured on Sabouraud dextrose agar. Based on these results, the cat was diagnosed with Candida cystitis. Subsequently, oral administration of fluconazole was initiated. Urine culture was negative at 31 days after administration. This case describes the diagnosis and treatment of Candida glabrata infection of urinary bladder in a cat with a history of urethrostomy.

Acute kidney injury caused by administration of zaltoprofen in a cat

A 5-year-old, 2.7 kg, spayed female Scottish Fold cat presented with hematemesis after administration of oral zaltoprofen, a non-steroidal anti-inflammatory drug, by the owner. Diagnostic imaging and blood analyses indicated development of acute kidney injury (AKI) resulting from zaltoprofen ingestion. To correct dehydration and anemic conditions, the cat received intravenous fluid therapy with whole blood transfusion and peroral N-acetylcysteine. Clinical signs resolved, but persistent azotemia was unresolved indicating that AKI could progress to chronic kidney disease. This case suggests that although zaltoprofen may have low adverse effects on humans, administration of zaltoprofen in cats can have serious adverse effects.

Histomorphometric analysis of an immediate non-functional loaded implant in dogs

The purpose of this study was to investigate the effects of immediate non-functional loading by analyzing histomorphology around the implant tissues in dogs. Five eight- to nine-month-old full-grown dogs weighing around 12 kg were used in the study. Group I (control group) comprised those in which delayed loading was applied to the right side of the mandible, and Group II (experimental group) consisted of dogs in which immediate loading was performed on the left side of the mandible. Resorbable blast media (RBM)-treated double-threaded US III implants measuring 3.5 mm in diameter and 11 mm long were used in the study. Each animal received four implants in each group, for a total of 40 implants. Cemented type abutments were used after implantation. An 8-week period was allowed for bone healing and an abutment was placed after exposing the periosteum for loading. An implant sample was obtained from bone blocks taken when the dogs were killed at 16 weeks after loading. A Mann-Whitney U-test was performed to evaluate statistical significance. Student's t-test was used for the histological evaluation. The bone formation ratio in Groups 1 and 2 was 88.23 and 86.41%, respectively. No significant difference in new bone formation was observed in the two groups. As no significant difference was seen in new bone formation between the delayed and immediate loading groups, early loading might be possible after implant placement.

The Correlation of Valsalva Leak Point Pressure Maximum Urethral Closure Pressure and Urethral Hypermobility according to Symptom Grade in the Diagnosis of Genuine Stres Incontinence

PURPOSE: We evaluated the correlation of Valsalva leak point pressure, maximum urethral closure pressure, and urethral hypermobility in the diagnosis of genuine stress incontinence. MATERIALS AND METHODS: From January 1997 to January 1999, one hundred thirteen patients with genuine stress incontinence had undergone three measures determined in a standardized fashion. We compared three parameters with symptom grades of genuine stress incontinence. RESULTS: Of the total 113 patients, genuine stress incontinence were grade I in 39, II in 43 and III in 31. There were significant difference in the incidence between grade III and grade I or II in Valsalva leak point pressure, maximum urethral closure pressure, and urethral hypermobility(p<0.05). Valsalva leak point pressure was the most significnat correlation with symptom grade(r=0.4), but there were not correlation among Valsalva leak point pressure, maximum urethral closure pressure, and urethral hypermobility in grade III geniune stress incontinence patients and 66.7% of grade III genuine stress incontinence patients had urethral hypermobility. CONCLUSIONS: With these results, Valsalva leak point pressure is good indicator for intrinsic sphincter deficiency. But intrinsic sphincter deficiency should be diagnosed by composites of historic, urodynamic, anatomic, and other clinical factors.

A Case of Bladder Stone from suture material after McDonald operation / 대한비뇨기과학회지

Bladder stones attached to foreign bodies such as non-absorbable suture are not common. Migration of non-absorbable suture through tissues may offer stone formation. In this report, we present a case of bladder calculus in 38-year-old woman who underwent McDonald operation for incompetent cervix during pregnancy. This calculus was formed on a retained intravesical suture material, and we removed the stone containing nonabsorbable suture material transurethrally.

A Comparison of Transurethral Resection of Prostate and Transurethral Electrovaporization of Prostate in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: To evaluate comparative efficacy and safety of transurethral resection of the prostate(TURP) and electrovaporization(TVP), we reviewed the records of sixty patients with benign prostatic hyperplasia(BPH) who underwent TURP or TVP. MATERIALS AND METHODS: Sixty symptomatic patients formed the subject of this study. Preoperative and postoperative international prostate symptom score(I-PSS), uroflow- metry, operative details, and complications were recorded in each patient. Baseline, 6 and 12 months follow-up data were used for analyses. RESULTS: We compared 30 men treated by TURP with 30 men treated by TVP from March 1996 to July 1997. There were no significant difference in the preoperative patient characteristics including age, symptom duration, I-PSS, peak urinary flow rate and prostate volume on TRUS between the two groups. In the TURP group, mean I-PSS decreased from 20.5 at preoperation to 7.9 and 6.4, and mean peak urinary flow rate increased from 7.5ml/sec at preoperation to 15.8ml/sec and 17.3ml/sec at 6 and 12 months, respectively(p<0.01). In the TVP group, mean I-PSS decreased from 18.2 at preoperation to 8.0 and 6.8, and mean peak urinary flow rate increased from 8.4ml/sec at preoperation to 15.6ml/sec and 15.7ml/sec at 6 and 12 months, respectively(p<0.01). The changes of hemoglobin(2.1+/-0.7 versus 0.9+/-0.2g/dl) and hematocrit(4.9+/-1.2 versus 2.4+/-0.7%) were greater with TURP than with TVP(p<0.01). There was no significant difference in operation time(42.6+/-19.5 versus 40.5+/-21.7minutes, p=0.69). Catheterization time(4.5+/-1.6 versus 2.9+/-1.3days) and hospitalization time(5.9+/-1.9 versus 4.2+/-1.7days) were longer with TURP than with TVP(p<0.01). CONCLUSIONS: TURP and TVP were effective surgical procedures to treat patients with symptomatic BPH. Both significantly improved subjective symptoms and increased peak urinary flow rate. Morbidity, catheterization time, and hospital stays were less with electrovaporization. With this results, we conclude that TVP is an effective and safe alternative surgical modality for the treatment of BPH.

A Case of Spontaneous Adrenal Hemorrhage in an Adult / 대한비뇨기과학회지

Adrenal hemorrhage may rarely occur into normal adrenal gland without precipitating cause or an underlying systemic disease in adult. We report a case of spontaneous unilateral adrenal hemorrhage in 65-year-old female who had intermittent flank pain without underlying disease and review the literature.

A Clinical Study of the Tibial Plafond Fractures / 대한정형외과학회잡지

A fracture of the distal tibial articular surface is fortunately an uncommon injury, since it can be exeptionally difficult to manage. The term plafond is gar'nering general acceptance since there is no anatomic name for the specific location of this fracture. The term was introduced more than 50 years ago in American orthopaedic literature to describe these injuries. The literal meaning of plafond is the underside of a floor, i.e., a ceiling, so the term refers to that portion of the distal articular surface of the tibia which articulates with the superior articular surface of the talus. It excludes the medial malleolar joint surface. Fracture of the plafond have also been called compression, pylon, Malgaigne and explosion fractures. A plafond fracture is defined as one caused primarily from direct axial compression resulting in elevation andgor displacement of all or part of the distal articular surface of the tibia, excluding isolated or combined fractures of the medial and posterior malleoli that are recognizably caused by rotational forces. We reviewed 16 cases(14 patients) of tibial plafond fractures treated at the Department of Orthopaedic Surgery of Soan Chun Hyang University Hospital during 8.5 years period from June 1974 to December 1982. The longest duration of follow-up was 5 years and 6 months, the shortest, 6 months, and the average, 1 year and 6 months. They were classified according to Moore et al., and assessed according to the criteria of Joy et al. The following results were obtained: l. Of the 14 patients, male were 12, female were 2. 2. The average age of the patients was 38 years old. 3. The most common causative injury was fall-down. 4. The most common type in radiological study was dorsiflexion type. 5. In method of treatment, operative treatment was done in 9 cases and non-operative in 6 cases. 6, The average duration of the cast immobilization in non-operative treatment was 12 weeks and operative, 10 weeks. 7. Better results were obtained by operative treatment than non-operative treatment. 8, The complications were encounted in 1 case of non-operative, 2 cases of operative treatment. 9. We agree that the accurate anatomical reduction with rigid internal fixation assures better results in the tibial plafond fracture.

A Consideration for Metallic Failure of internal Fixation Devices in Treatment of Long Bone Fractres / 대한정형외과학회잡지

The ten cases of metallic failure after I-M nailing & plate fixation who were treated at depart tment of orthopaedic surgery, Soon Chun Hyang University during nine years from June, 1974 to May, 1983 were clinically analysed. The survey as summerized as follows: l. Of the ten cases, six cases were seen the breakage of plate, two cases were the loosening of screw, one case was the brakage of nail & one case was the angulation of nail. Of the six cases of plates, two cases were DCP, three cases were ordinary plate & one case was Thornton plate. 2. Of the six cases who metallic failure occurred as plate failure, five cases were the femur fractures, one case was the tibia fracture. All case who metallic failure occurred as nail failure were ferumr fractures. Of the two cases of screw loosening, one case was the fermur fracture. One case was the tibia fracture. 3. The average interval between operation and metallic failure. 1) The plate breakage was 6.3 months. 2) The screw loosening was 7 months. 3) The nail breakage was 6 months. 4) The nail angulation was 8 months. 4. The causes of failure after internal fixation. 1) The causes of plate breakage.

Some Clinical Observation on 306 Cases of Gastric Ulcer / 대한소화기내시경학회지

A clinical analysis was carrried out on 306 pts c Gastric ulcer who have visited the Depart on Internal Medicine. Daegue Catholic Hospital during the period from August 1980 to June l982. The result were as follows: of the total 306 cases, 249(81%) cases were male and 57(19%) cases were female, Male to female ratio was 4. 3: 1. Thirsty two percent of the cases blonged to the 6 tb decade, 25.5% to 5 th and 19% to 7 th decade. (continue...)

A Clinical Experience of Closed Intramedullary Nailing for Long Bone Fracture / 대한정형외과학회잡지

The new trial to apply the closed I-M nailing for 23 cases of long bone fracture has been used our department, loss of hematoma, further damage to periosteum and soft tissue were prevented; the risk of infection was reduced; and the early functional use of extremities without additional superflous external fixation could be made. The results obtained were as follows; 1. There was no case of non-union or other complication. 2. The average bone union rate was 26.1 weeks in femur, 22 weeks in tibia, or 11.5 weeks in forearm. 3. The advantages is simple method and be able to do early ambulation without following muscular atrophy or ankylosis. 4. The patients were satisfactory about cosmetic problem after operation. 5. The merits of this operation were the short hospitalization and early adaptation of social activity. 6. In conclusion, closed I-M nailing is method of choice for long bone shaft fracture when internal fixation is indicated and our operative is useful and simple.

Clinical Analysis of the 784 Traffic Accident Victims / 대한정형외과학회잡지

A retrospective study has been made of 784 cases of road traffic casualties who were treated at the Soon-Chun-Hyang Hospital between July 1980 and December 1981. This study was conducted to find out the nature and pattern of the traffic accident from the clinical and epidemiological standpoints. In additions, the mode of injury from the road accidents were persued which might help to reduce the misdiagnosis rate. The results obtained were as follows: l. In this survey, male dominated in numbers (casualty rate, 70%). The highest incidence was in the age group between 31–40 year (26.5%). The predominance was found in younger casualties (ages between 21–50 years, 72.1% of all casualties). 2. The large number of casualties followed the rush hours. There was a peak between 10PM to midnight. The explanation for this high incidence during the hours was the hurry-up life due to midnight crufew, pedestrian's carelessness and hurry-scurry, and the negligence of traffic rules, the poor labor conditions and weariness due to drivers long continuous working hours, especially in taxi drivers. The highest seasonal incidence was in October. 3. The high incidences were in drivers and students; the drivers were the commonest victims in car passenger accidents and students were injured by pedestrians accidents respectively. The causes of high risk of injury in drivers were intimately related with their vocational aptitudes, the employment status, the driving attitudes and car maintainances; and in students, their carelessness and emotional instability, unsolved mass transportation system and their negligence of traffic rules were listed as the causative factors. 4. Over 51.8% of all casualties were injured by passenger car accidents, and 21.5% were by truck and other types of special vehicles. 5. Approximately 60% of victims were injuried in the road as pedestrian and other 40% were in the car as passengers. In general, the pedestrian injuries were more serious than those sustained in the car as passengers. 6. About 40% of total pedestrian casualties sustained injury at pedestrian's cross road. 7. About 80%of injured drivers were in the drunken state on arrival, and 20.4% of pedestrians were also heavily drunken. 8. The trauma risk was about twice higher in the front-seated passengers than the rear-seated ones in the car. In buses, the highest incidence was in the passengers seated in the front 1/3 of the seats. 9. Orthopaedic (40.5%) and head injuries (38.2%) were the commonest types of the injuries among the hospitalized casualties; about 35% of total patients had the tibial fractures. 10. Of the 784 cases, 479(61.6%) victims arrived hospital within 30 minutes after accident, and among them only 94 cases (12%) were transported by ambulance from the accident site to the hospital.

Clinical Consideration on the Treatment of Fractures by Hoffmann's Transfixation Method / 대한정형외과학회잡지

Open long bone fracture is frequently difficult to reduce and maintain, especilly when there is extensive soft tissue damage. Infection, instability, malalignment and soft tissue complication often result in prolonged mobidity or failure. The Hoffmann's apparatus have merits, that can easily correct distracted, angular or rotational deformity of fracture site during early post-operative period, and stable fixation facilitates easily to the care of soft tissue injury. In addition, the affected limb can be elevated with balanced suspension, possible early exercise of neighboring joints. But we have exerienced some problems during treatment of fracture with Hoffmann's transfixation method. From February 1980 to December 1981, Hoffmann's transfixation method was employed in treatment of twenty-one patients that considered to have a poor prognosis with conversional forms of treatment. The results were obtained as follows; 1. For correction of distracted, angular, or rotational deformity, the fracture site should be reduced accurately. 2. Hoffmann pins should be transfixed as one plane and parrallel to each other. 3. Rigidity of fixation can be increased by increasing number of pins, actually three or more pins should be applied at each fragment of fracture. 4. Hoffmann's apparatus is more complex for management, more expensive and requires skillful technique compared with other external fixation apparatus. 5. The lateral view of fracture site could not be confirmed accurately due to overlapping of Hoffmann's adjustable connecting rod and bony shadow. 6. The main cause of injuries was due to traffic accidents in 17 cases (81%), involving tibia in 18 cases, femur in 2 cases and humerus in 1 case. 7. In the sixteen cases which could be assessed, the average times for external transfixation was 13.9 weeks and then followed by early weight bearing with P.T.B. cast or brace. The average time of bony union was 26.4 weeks. 8. The final result was excellent in 7 cases, good in 5 cases, acceptable in 3 cases, poor in 1 case.

Treatment of Subtrochanteric Fracture of the Femur / 대한정형외과학회잡지

Subtrochanteric fracture of the femur is more difficult to treat than other bone fracture. Subtrochanteric fracture occurs in bone that is predominently cortical and biomechanical analyeis of stress in the femur ahowed that there is a high concentration of stress in the subtrochanteric region. These two factors, involvement of cortical bone tissue and concentration of stress, frequently have been mentioned as reasons for the high incidence of complications in the treatment of these fractures. The authors treated 23 cases of subtrochanteric fracture of the femur in 1974 through 1981, at the Department of Orthopaedic Surgery, School of Medicine, Soon Chun Hyang College. The results were as follows: 1. Of 23 cases of subtrochanteric fracture, 15 cases occurred in man, 8 cases in woman. 2. The most common cause of fracture was due to traffic accident. 3. Of 23 cases of subtrochanteric fracture, 9 cases were type lI, and 7 cases were type I & II by Fielding's classification. 4. 19 cases out of 23 were treated by means of the open reduction and internal fixation. As the internal fixation material, we used Kuntscher nail, Smith-Peterson and Thornton plate, Compression hip screw and plate until December 1978, and Zickel nail from January 1979. 5. The mean duration of bony union in subtrochanteric fracture treated by Zickel nail was shorter than the other implants. The incidence of complications such as coxa vara, delayed union, metal breakage occurred higher in the cases treated by Kuntscher nail, Smith-Peterson nail and Thornton plate, Campression hip screw and plate. 6. Zickel nail is one of the good implant for the treatment of subtrochanteric fracture of the femur.

Experience of Microsurgery Using Dorsalis Pedis Artery / 대한정형외과학회잡지

Since the introduction of surgical microscope in microvesael surgery by Jacobson and Suarez in 1960, many surgeons have succeeded replantation, transplantation of composite segment of tissues so called free fiap-free bone graft and toe to hand transfer. McCraw & Furlow reported successfully transfered dorsal foot flap using dorsalis pedis artery in 1975 and Cobett transfered great toe to band for reconstruction of the amputated thunb. The authors experienced six cases of microsurgery using dorsalis pedis artery durig the recent two years in the department of Orthopaedic surgery of Soon Chun Hyang College and results in this paper. 1. Four cases out of six were dorsalis pedis free flap, one case was second toe to thumb and tbe other one was reconstruction of an amputated thumb in one stage using iliac bone graft and dorsalis pedis flap. 2. One case out of four cases of dorsalis pedis free flap was performed for reconstruction of contracted first web and the other cases were performed for foot. 3. Five cases out of six were successfully transfeed, one case which was toe to thumb was failed. The cause. of fail was probably due to post-operative hematoma. 4. Composite tissue using dorsalis pedis artery is one of the good donor site for composite tissue transfer for not only skin defect and scar contracture of the hand and foot but also reconstruction of the amputated fingers because it has several advantages; an acceptable thickness, a constant arterial supply, venous drainage through the saphenous system, and constant innervation through the terminal branches of the superficial and deep peroneal nerve.

Complication of the Kuntscher Nailing in Fracture of the Femoral Shaft / 대한정형외과학회잡지

Several techniques are now avallable for the treatment of fractuers of the shaft of the femur. We must be aware of the advantages, disadvantages and Ilmitation of each if we are to select the proper treatment for each patient. During last decades treatment had been varied markedly from time to time and from place to place. Before Word War II, most fractures of the femoral shaft were treated conservatively either by skeletal traction or by manipulation and immobilization in a spica cast. After medullary fixation was Introduced during that war, it became popular, and until 1960 many surgeons considered it as the treatment of choice for most of these fractures. If the case is properly selected the medullary fixation is almost perfect, provlded no complications develop; convalescence can be shortened and resldual disability can be decreased. We had experienced 14 complications among the 78 cases of Kuntscher nailing from may, 1974, to May, 1980. The results are as follows: 1. We operated 78 cases with Kuntscher nail among the 121 femoral shaft fractures. 2. 14 (17.95%) complications developed among the 78 cases of the Kuntscher nailing. 3. Technical errors were incarcerated nailing with thick nail, too long nail and thin nailing. 4. Early postoperative complications within a year were infection, bendlng, bursitis, angulation and rotation. 5. Late complications after one year were proximal or distal migration and refracture.

The Expreience of Treatment of Trochanteric Fracture of the Femur / 대한정형외과학회잡지

It has been emphasized that the treatment of choice for the trochantric fracture of the femur is open reduction and rigid internal fixation to reduce complications by early ambulation. The incidence of trochanteric fracture of the femur in the young age group has been considerably increased in recent years because of increased traffic and industrial accidents. The author treated 38 cases of trochanteric fracture of the femur in the year 1974 through 1979, at the Department of Orthopaedic Surgery, School of Medicine, Soon Chun Hyang College. The results were as follows: 1. In sex distribution, 24 out of 38 were males and 14 were females. 16 cases out of 24 male patients were in the age group 20-40 and 9 cases out of 14 female were over 60 years of age. Over all mortality was 7.9%. 2. The numbers of patients of type I and III were 11 cases in each type out of 38 trochanteric fracture. 3. 26 cases out of 38 cases were treated by open reduction and internal fixation and the others were by traction and cast. 4. The applied metal devices were 3 types: Smith-Peterson nail and Thornton or McLaughlin plate, compression hip screw, and multiple pinning. 5. Mean duration of bony union is shorter in the group of open reduction and internal fixation (13 weeks) than the group of traction and cast (15 weeks). The cause of difference is that the 6 out of 9 cases of type IV and V were included in conservative group. 6. The incidece of the complications such as coxa vara, slipping screw, long nail and traction palsy occurred higher in the group fixed with Smith-Peterson nail and plate than the group fixed with compression hip screw.

Treatment of Patella Fracture / 대한정형외과학회잡지

The results of treatment upon 56 cases of fracture of the patella, during the period from July 1975 to October 1978 at the department of orthopedic surgery, Soon Chun Hyang Medical College have been analysed. In sex distribution, 47 were male and 9 were female cases. The incidence was remarkably higher in male and the age group of 20-40. 2. 39 cases were fractured by direct force and 17 cases were indirect force. The most common cause of fracture was traffic accident. 3. The most common site of fracture was midpole and 27 cases were communited type. 4. Our methods of treatment were simple cast, circlege wire loop, tension band technique, partial and total and total patelletomy, etc. as indicated. 5, The mean duration of rehabilitation in the group of immobilized in 10 of flexion was shorter than that of full extension group.

Artificial prosthesis of the knee joint combining with homogenous bone transplantation / 대한정형외과학회잡지

Here, we report a case of artificial prosthesis of the knee joint combining with homogenous bone transplantation for the treatment of giant cell tumor of the right distal femur. At one year follow up, the patient complains almost no pain nor tenderness at operative site and ambulates with partial weight bearing with crutches. The X-ray finding shows satisfactory bony union with progressive bony remodelling.

6 Cases of Salmonella Ostemyelitis / 대한정형외과학회잡지

Since Maisonneuve mentioned osteomyelitis complicated by typhoid fever for the first time in 1835, numerous investigators had reported salmonella osteomyelitis. The authors recently experienced six cases of salmonella osteomylitis: four cases in lumbar spine and the remainders in bones adjacent to elbow. Four cases were in adult male ranging from 18 to 35 years old and the others were in a male, age of thirteen and female, age of seven in elbow respectively. The two among four spondylitic cases and two cases of long bone ostemyelitis were surgically treated, and the other two spondylitic cases were conservatively treated. Salmonella osteomylitis was confirmed in surgically treated group by culture of pus obtained from pathologic lesion, and conservatively treated group was diagnosed by history, clinical manifestation, laboratory data and especially characteristic progress of roentgenographic change. The causative organisms were paratyphoid group D in all cases. Review of literature was done with report of six cases of salmonella osteomyelitis.