No abstract available.
Adult* ; Humans ; Molecular Epidemiology* ; Oxalobacter formigenes* ; Seoul*

OBJECTIVE: Few studies have reported the outcome of mechanical thrombectomy with Solitaire stent retrival (MTSR) in subtypes of acute ischemic stroke. The purpose of this study was to evaluate the efficacy and result of MTSR in acute cardioembolic stroke. METHODS: Twenty consecutive patients with acute cardioembolic stroke were treated by MTSR. The angiographic outcome was assessed by thrombolysis in cerebral infarction (TICI) grade. TICI grade 2a, 2b, or 3 with a measurable thrombus that was retrieved was considered as a success when MTSR was performed in the site of primary vessel occlusion, and TICI grade 2b or 3 was considered as a success when final result was reported. Clinical and radiological results were compared between two groups divided on the basis of final results of MTSR. Persistent thrombus compression sign on angiogram was defined as a stenotic, tapered arterial lumen whenever temporary stenting was performed. The clinical outcomes were assessed by the modified Rankin Scale (mRS) at 3 months. RESULTS: The failure rate of MTSR was 20% (4/20) and other modalities, such as permanent stenting, were needed. Final successful recanalization (TICI grade 2b or 3) was 80% when other treatments were included. The rate of good outcome (mRS≤2) was 35% at the 3-month follow-up. Failure of MTSR was significantly correlated with persistent thrombus compression sign (p=0.001). CONCLUSION: Some cases of cardioembolic stroke are resistant to MTSR and may need other treatment modalities. Careful interpretation of angiogram may be helpful to the decision.
Cerebral Infarction ; Follow-Up Studies ; Humans ; Intracranial Embolism ; Mechanical Thrombolysis ; Stents* ; Stroke* ; Thrombectomy* ; Thrombosis

PURPOSE: Oxalobacter formigenes is an intestinal flora degrading oxalate in the gut. However, microbiological detection of this organism is quite difficult. We tried to develop a simple, rapid and cost-effective PCR method for detecting Oxalobacter formigenes from fecal specimens and to determine whether O. formigenes could be detected from frozen fecal specimens as well as fresh stool. MATERIALS AND METHODS: Whole bacterial DNA was isolated directly from fresh and frozen stool samples obtained from 30 healthy volunteers known to be free from urolithiasis and from fresh stool samples obtained from 38 patients with urolithiasis. Genus specific oligonucleotide sequences corresponding to homologous regions residing in the oxc gene that encodes for oxalyl-coenzyme A decarboxylase were designed. A PCR-based assay was done in both fresh and frozen stool samples and the nucleotide sequences were analyzed to determine the details of oxc. RESULTS: PCR product of 416-bp molecular size encoding oxc gene was detected in 23 (77%) of 30 healthy volunteers and in 14 (37%) of 38 patients with urolithiasis. In healthy volunteers, the results of PCR for the fresh and the frozen stool proved identical in each subject. The nucleotide sequence analysis revealed that the sequence of the amplified product was compatible with that of oxc gene. CONCLUSIONS: O. formigenes could be identified easily and efficiently by this PCR-based detection system. Furthermore, as the PCR-based assay results in the frozen fecal samples were identical as that of fresh stool, immediate processing of the fecal samples may not be necessary to detect O. formigenes in the clinical setting.
Base Sequence ; DNA, Bacterial ; Healthy Volunteers ; Humans ; Oxalobacter formigenes* ; Polymerase Chain Reaction* ; Urolithiasis

We report a case of an acute spontaneous epidural hematoma (EDH) due to skull base metastasis in a 46-year-old male patient with hepatocellular carcinoma (HCC). The patient presented with the acute onset of severe headache followed by unconsciousness, and computed tomography showed a large EDH in the right temporal and parietal lobes with midline shift. Emergency evacuation of the EDH was performed, and the hemorrhage was determined to be secondary to skull base metastasis of HCC.
Carcinoma, Hepatocellular ; Emergencies ; Headache ; Hematoma ; Hemorrhage ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Parietal Lobe ; Skull ; Skull Base ; Unconsciousness

Metastatic carcinomas are the largest group of malignant tumors of the liver. But parenchymal liver metastasis from cystic ovarian adenocarcinoma is very rare. We report a case in which the resection of metastatic liver neoplasm from ovarian serous cystadenocarcinoma was done 7 yr after initial treatment. A 48-yr-old oriental housewife complained of easy fatigability and right lower quadrant discomfort. The hepatic mass was detected by ultrasonographic examination. Serum albumin, bilirubin, and aspartate aminotransferase/alanine aminotransferase were normal. Alkaline phosphatase level was slightly increased at 146 IU/L. A tumor marker study showed alpha-fetoprotein 0.97 IU/mL, carcinoembryonic antigen 0.965 ng/mL, cancer antigen 125 1,267 ng/mL and CA 19-9 106.1 ng/mL. The operation involved cholecystectomy and segmentectomy VI and VII of the liver. The patient recovered from the surgery without any complication. On the 10th postoperative day, the patient received a single-regimen chemotherapy with paclitaxel (Taxol, 155 mg/m2 BSA) and was discharged. She has been carefully followed-up without any evidence of recurrence after completion of the remaining 5 cycles of chemo-therapy, at intervals of three weeks.
Cystadenocarcinoma, Serous/*secondary/*surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms/*secondary/*surgery ; Middle Aged ; Ovarian Neoplasms/*pathology ; Tomography, X-Ray Computed

OBJECTIVE: To evaluate the effectiveness of hysteroscopy and the incidence of endometrial polyps in women with endometriosis. METHODS: A total of 99 patients determined to be with infertility by laparoscopic procedure from March 1999 to February 2000 were prospectively analyzed at Ajou University Hospital, Suwon, Korea. The study group was 63 patients with endometriosis and the control group consisted of 36 patients without endometriosis. The presence of endometriosis was documented laparoscopically and scored according to The American Fertility Society Classification. We confirmed the presence of endometrial polyps by pathologic examination after polypectomy. We compared the results of the operation to that of the hysterosalpingogram(HSG) and transvaginal sonogram(TVS) before the procedure. RESULTS: Among the 99 patients with infertility, endometrial polyps were found in 40 of 63 women(63.5%) with endometriosis but in only 10 of 36 women(38.5%) without endometriosis. The greater the degree of endometriosis was accompanied by increased incidence of endometrial polyps, and in particular, women with stage three endomeriosis or higher all showed the presence of endometrial polyps. The sensitivity and specificity of the HSG detecting the presence of an endometrial polyp is 55.3%, 87.2%, and that of the TVS is 78.9%, 95.7%. DISCUSSION: The presence of endometrial polyps is significantly associated with the presence of endometriosis, and therefore hysteroscopy should be performed in patients with endometriosis who have not been confirmed with endometrial pathology by HSG or TVS.
Classification ; Endometriosis* ; Female ; Fertility ; Gyeonggi-do ; Humans ; Hysteroscopy* ; Incidence ; Infertility ; Korea ; Laparoscopy ; Pathology ; Polyps* ; Prospective Studies ; Sensitivity and Specificity

PURPOSE: To investigate the alteration of lower extremity movement during maintaining balance test with their eyes closed in chronic ankle instability (CAI) patients compared to healthy group with and without plantar cutaneous sensation. METHODS: Ten healthy volunteers (age, 23.40±2.22 years; height, 165.42±6.67 cm; weight, 60.93±13.42 kg) and 10 CAI patients (age, 23.90±2.56 years; height, 166.89±10.50 cm; weight, 67.43±12.96 kg), were recruited. Subjects immersed both feet in an ice water for 10 minutes and performed three trials of a single-leg stance balance test with their eyes closed while standing on a force plate for 10 seconds. RESULTS: CAI group showed increased knee flexion, reduced knee external rotation, and hip internal rotation compared to the healthy group from single-limb stance with eyes closed after diminished plantar cutaneous sensation. However, there was no significant interaction between group and time. CONCLUSION: These findings indicate that the postural kinematic analyses revealed that individuals with CAI used different strategy of controlling their lower extremities, which alters transverse plane motion of hip and knee compared to the healthy group in order to compensate for their ankle deficits after freezing the plantar cutaneous.
Ankle ; Foot ; Freezing ; Healthy Volunteers ; Hip ; Humans ; Ice ; Knee ; Lower Extremity ; Sensation ; Water

PURPOSE: The efficacy of the prostate-specific antigen (PSA), prostate-specific antigen density (PSAD), digital rectal examination (DRE) and transrectal ultrasonography (TRUS) for diagnosing prostate cancer in Koreans was investigated. MATERIALS AND METHODS: The medical records from a selected population of 346 patients (30 to 93 years old, mean age 66.0) who had visited the department of Urology in Seoul National University Hospital from January 1994 to December 2000 were reviewed retrospectively. All patients a transrectal ultrasonography-guided biopsy. The student's t test was used for statistical analysis. RESULTS: Prostate cancer was detected in 119 (34.4%) out of 346 patients. PSA, PSAD, TRUS, and DRE showed a sensitivity of 95.8%, 88.2%, 66.4% and 61.3%, a specificity of 26%, 49.3%, 66.5% and 55.9%, and a positive predictive value of 40.4%, 47.7%, 51% and 42.2%, respectively. The positive predictive value from the combination of PSAD and TRUS was 67%, which was the highest when two among the four methods were selected and combined. The detection rate for prostate cancer was 23% (31 out of 135 patients) when the PSA level was between 4 and 10ng/ml, and was 20.9% (18 out of 86 patients) when PSA level was between 4 and 10ng/ml and the DRE findings were negative. CONCLUSIONS: In detecting prostate cancer, PSA showed the highest sensitivity and TRUS showed the highest specificity and positive predictive value. PSAD might be a useful method for diagnosing prostate cancer when combined with TRUS. A TRUS-guided biopsy should be done in patients when the PSA level is between 4 and 10ng/ml in Korea.
Biopsy ; Digital Rectal Examination* ; Humans ; Korea ; Mass Screening* ; Medical Records ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Retrospective Studies ; Sensitivity and Specificity ; Seoul ; Ultrasonography* ; Urology

PURPOSE: S-plasty for pilonidal disease reduces the tension on the midline by distributing it diagonally and flattening the natal cleft. The aim of this study was to evaluate the outcomes of S-plasty on simple midline primary closure and the clinical features of pilonidal patients in a low incidence country. METHODS: S-plasty was applied on 17 patients from July 2008 to October 2010. Data of these patients were collected with computerized prospective database forms during a perioperative period and via telephone interview for follow-up. Surgical site infection (SSI) was defined according to the Center for Disease Control guidelines. The severity of surgical site infection was graded. RESULTS: All patients were treated with primary S-plasty. Two patients (11.7%) developed low grade SSI. The average healing time after S-plasty was 18.1 days. No recurrences were observed. The mean follow-up period was 13.5 months (range, 6 to 33 months). CONCLUSION: We have shown that primary S-plasty for pilonidal disease is simple, and its surgical outcomes are compatible to the results of other surgical treatments. We present primary S-plasty as a feasible treatment option in a low incidence country.
Centers for Disease Control and Prevention (U.S.) ; Follow-Up Studies ; Humans ; Incidence ; Interviews as Topic ; Perioperative Period ; Pilonidal Sinus ; Recurrence ; Surgical Flaps ; Surgical Wound Infection ; Wound Closure Techniques ; Wound Healing

OBJECTIVE: Traditionally, it is generally recommended that antiplatelet agent should be discontinued before surgery. However, decompressive craniectomy (DC) in patients with traumatic brain injury (TBI) is performed emergently in most cases. Therefore, DC cannot be delayed to the time when the effect of antiplatelet agent on bleeding tendency dissipates. In this study, we evaluated the effect of preinjury antiplatelet therapy on hemorrhagic complications after emergent DC in patients with TBI. METHODS: We retrospectively investigated patients with TBI who underwent emergent DC between 2006 and 2015. The patients were separated into two groups according to the use of preinjury antiplatelet agent: group 1 (patients taking antiplatelet agent) and group 2 (patients not taking antiplatelet agent). The rate of hemorrhagic complications (postoperative epidural or subdural hemorrhage, newly developed, or progression of preexisting contusion or intracerebral hemorrhage within the field of DC) and the rate of reoperation within 7 days after DC were compared between two groups. RESULTS: During the study period, DC was performed in 90 patients. Of them, 19 patients were taking antiplatelet agent before TBI. The rate of hemorrhagic complications was 52.6% (10/19) in group 1 and 46.5% (33/71) in group 2 (p=0.633). The rate of reoperation was 36.8% (7/19) in group 1 and 36.6% (26/71) in group 2 (p=0.986). No statistical difference was found between two groups. CONCLUSION: Preinjury antiplatelet therapy did not influence the rate of hemorrhagic complications and reoperation after DC. Emergent DC in patients with TBI should not be delayed because of preinjury antiplatelet therapy.
Brain Injuries* ; Cerebral Hemorrhage ; Contusions ; Decompressive Craniectomy* ; Hematoma, Subdural ; Hemorrhage ; Humans ; Platelet Aggregation Inhibitors ; Postoperative Hemorrhage ; Reoperation ; Retrospective Studies