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

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax

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

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

No abstract available.
Hypertension*

Retrocaval ureter is a congenital venous anomaly, in which the ureter passes behind and is compassed by inferior vena cava. We experienced a case of multiple urothelial cell carcinoma in retrocaval ureter in 68 years old male. He was treated with transurethral resection of bladder tumor and right nephroureterectomy with bladder cuff excision.
Aged ; Carcinoma, Transitional Cell ; Humans ; Male ; Retrocaval Ureter* ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Vena Cava, Inferior

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