No abstract available.
Hypnotics and Sedatives*

A kidney containing more than 1,000ml fluid in its collecting system is generally defined as giant hydronephrosis. The clinical manifestations of giant hydronephrosis are indistinct. The patient seems to seek medical help late due to tolerable symptoms and particularly in the state of poor economic condition. We present a giant hydronephrosis of contents of 60 liters associated with ureteropelvic junction stricture on a 43-year-old woman. The final diagnosis was performed by exploration of abdomen and nephrectomy was done.
Abdomen ; Adult ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Hydronephrosis* ; Kidney ; Nephrectomy

PURPOSE:BK virus associated nephropathy (BKVAN) affects 1-10% of kidney transplant (KT) patients and it produces a progressive destruction of allograft. Reducing immunosuppression is the only way to save the graft, while it needs tight monitoring of the graft rejection and graft survival is poorer in advanced case. Leflunomide has immunosuppressive effect and also antiviral activity. Addition of leflunomide may improve BK virus clearance and graft survival. METHODS:6 KT patients with biopsy proven BKVAN (Histological pattern B) were treated with leflunomide and reduced immunosuppression. All patients were monitored with serial determination of viral load in blood and graft function. RESULTS:BKVAN was diagnosed at 14 months (7-28) post transplant, at that time median serum creatinine concentration was 2.8 mg/dL (1.8-3.6). 12.5 months (6-16) later of leflunomide treatment, median serum creatinine was 2.3 mg/dL and no graft loss was found. CONCLUSION:Leflunomide therapy with reduced immunosuppression may be effective in the treatment for BKVAN.
Biopsy ; BK Virus ; Creatinine ; Graft Rejection ; Graft Survival ; Humans ; Immunosuppression ; Isoxazoles ; Kidney ; Kidney Transplantation ; Transplantation, Homologous ; Transplants ; Viral Load ; Viruses

The orbital wall resection with removal of tumor in patient who has malignant tumor in paranasal sinuses or nasal cavity causes enophthalmos, dystopia, or severe facial deformities. The methods of reconstruction of orbital wall have been used skin graft, muscular sling, parietotemporal fascial calvarial bone flap, and free flaps. The parietotemporal fascial calvarial bone flap has been used as a pedicle flap, but it can not be used in reconstruction of medial wall of the orbit because it has a short vascular pedicle. Therefore we designed the galeal-frontalis- pericranial-calvarial bone flap which is a new pedicled bone flap for reconstruction of orbital wall. We used this flap in 2 patients who have orbital wall defect following resection of malignant tumor arising from the nasal cavity or maxilla. The outcome was gratifying in all two patients. We think that this flap is a new useful method in reconstruction of the orbit.
Congenital Abnormalities ; Enophthalmos ; Free Tissue Flaps ; Humans ; Maxilla ; Nasal Cavity ; Orbit* ; Paranasal Sinuses ; Skin ; Transplants

Localization of epileptogenic zone in central epilepsy is difficult because of extent and rapidity of ictal spread. Epilepsy surgery in central region is challenging because of the risk of sensorimotor deficitsrelated to excision of eloquent areas. We present a case of 27- year-old woman with a successful surgical treatment for intractable epilepsy from the central region.
Epilepsy ; Female ; Humans

A polyetherurethane (PU) film containing 0.1% zinc diethyldithiocarbamate (ZDEC) is the international standard reference material for testing the in vitro cytotoxicity of polymer based biomaterials. Nowadays, culturing L929 or BALB/3T3 cells in direct contact or in an extract dilution condition is the most frequently using method for evaluating the cytotoxicity from biomaterials and medical devices. However, the results often vary, because it is directly related to the cellular functions and the mechanism of the toxicity of the contacting cells. In this study, 13 cell lines originating from various tissues were used to detect the cytotoxic activities of a PU film containing 0.1% ZDEC (PU-ZDEC). The correlation between the reactivity zone size and the relative cytotoxicity by quantifying the released total protein from each cell in the direct contact testing method was investigated. Hepa-1c1c7 cells demonstrated the highest sensitivity in the reactivity zone size, while CHO/dhFr(-) cells were the most sensitive in terms of the relative cytotoxicity. A correlation between the two processes in each cell line was not found (r=-0.478). In the extract dilution method, which involved cultivating the cells in the medium with various ZDEC concentrations prepared by diluting the PU incubation, the cytotoxicity increased with increasing ZDEC concentration in all cell lines. The BALB/ 3T3 cells demonstrated the highest sensitivity in the extract dilution method. No correlation in a comparison of the relative cytotoxicity from the direct contact method with the extract dilution method in each cell line, was found (r=-0.445). In this experiment, Hepa-1c1c7, BALB/3T3, CHO/dhFr(-) and L-929 cells among the 13 types of cell lines were the sensitive cell lines according to the two methods. The preliminary results suggest that a comparison of at least one or more cytotoxicity testing methods and many cell lines is necessary for an in vitro cytotoxicity test of biomaterials.
Animal ; Cell Line ; Cell Survival/drug effects ; Ditiocarb/*toxicity ; Hamsters ; Human ; Mice ; Polyurethanes/*toxicity ; Support, Non-U.S. Gov't ; Toxicology/*methods

Femoral hernias are very uncommon in children and very easily misdiagnosed. During a period of three years, three children of femoral hernia were treated by one pediatric surgeon at Severance Hospital. Only one case was diagnosed correctly before surgery; the other two were thought to be either an indirect inguinal hernia or groin mass. Only one patient had curative hernioplasty (McVay hernioplasty) at the first operation; the other two did not have curative hernioplasty at the first operation. Femoral hernia in childhood is a challenging clinical problem because of its rarity and similar clinical presentation as indirect inguinal hernia. The frequency with which an incidental indirect inguinal hernia sac or patent processus vaginalis can be found at surgery can perpetuate a misdiagnosis. The absence of an expected indirect inguinal hernia sac or an apparent recurrence of an indirect inguinal hernia should lead to consideration of possible femoral hernia.
Child* ; Diagnostic Errors ; Groin ; Hernia, Femoral* ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Recurrence

The development of endometrial stromal sarcomas (ESSs) in foci of endometriosis is extremely rare, and few cases have been reported in the literature to date, particularly with regard to multiple extrauterine ESS. Here we report a case of endometrial stromal sarcoma with multiple metastasis that arose from an ovarian endometriotic lesion. The literature is also briefly reviewed.
Endometriosis ; Female ; Neoplasm Metastasis ; Ovary ; Sarcoma, Endometrial Stromal

Congenital constriction band of the trunk is a rare congenital malformation. A 14-year-old girl with a congenital circumferential constriction band around the waist is described. Seven other cases of congenital constriction band on the trunk are reviewed in the literature. This malformation is probably related to the amniotic band syndrome such as constriction band on the limbs. The surgical treatment of this constriction band was W-plasty and produced good cosmetic results.
Adolescent ; Amniotic Band Syndrome ; Constriction* ; Extremities ; Female ; Humans ; Infant, Newborn

PURPOSE: Tuberculosis of the thyroid gland is very rare and some cases were reported in Korea since 1968. We experienced a case of tuberculous thyroiditis and found a old case in our medical center. This report is about the two case and the review of all cases reported about tuberculosis of the thyroid gland in Korea. METHODS: We present the case of a 55-year-old woman with thyroid tuberculosis who has been treated with antituberculous medication because of tuberculous meningitis during 6 months. We performed thyroid isthmectomy and she is now taking the antituberculous drugs. We found a case of 40- year-old woman who underwent extended thyroid lobectomy, Lt. in 1985 at our medical center. We reviewed the 18 literatures with 29 cases of tuberculosis of the thyroid gland reported in Korea and analyzed total 31 cases (reported 29 cases and our 2 cases). RESULTS: 28 patients were women and only 2 patients were over 60 years old. 26 patients had complained the neck mass. Duration of symptoms were below 6 months in 18 cases. There were associated symptoms like as weight loss, easy fatigue or generalized weakness, dysphagia, palpitation, fever, chills and/or anorexia. Only 9 patients had underlying tuberculosis - 2 meningitis, 2 pneumonia, 3 lymphadenopathy and 2 pneumonia combined with meningitis. But 3 patients were newly diagnosed as old or active pulmonary tuberculosis at the time of diagnosis of thyroid tuberculosis. Thyroid function was normal in 9 cases and abnormal in 5 cases. 3 cases were diagnosed nonoperatively and 15 patients of surgically treated 28 cases were underwent lobectomy. AFB stain was positive in only 13 cases and 2 cases were positive of culture with negative AFB stain. All of cases were diagnosed by pathology as granulomatous tuberculosis with caseous necrosis. CONCLUSION: Either surgical resection plus antituberculous medications or only medications are effective and recurrences were not reported after any initial treatments. So preoperative evaluation is very important and will guide the patient and the surgeon to the most effective management.
Anorexia ; Chills ; Deglutition Disorders ; Diagnosis ; Fatigue ; Female ; Fever ; Humans ; Korea ; Lymphatic Diseases ; Meningitis ; Middle Aged ; Neck ; Necrosis ; Pathology ; Pneumonia ; Recurrence ; Thyroid Gland* ; Thyroiditis ; Tuberculosis* ; Tuberculosis, Meningeal ; Tuberculosis, Pulmonary ; Weight Loss