Occult bladder injury may sometimes go unrecognized during tension-free vaginal tape (TVT) procedures. We report a case of occult intraperitoneal bladder injury that occurred during a TVT procedure. There was no sign of bladder perforation on the initial cystoscopy, which was performed just after the insertion of the trocar. Signs of general peritonitis appeared after the patient started to void the next day. A postoperative cystogram and cystoscopy showed an intraperitoneal bladder injury and a pinhead-sized ulcerative lesion in the right lateral wall of the bladder. We suspect that at the time of initial cystoscopy, the trocar passed through the submucosal area without violating the bladder mucosa. The occult bladder injury may have been caused after the initial cystoscopy by advancing the rough edge of the prolene tape during the extraction of the trocar. This report is the first description of such an occult bladder injury during a TVT procedure.
Vagina/surgery ; Urologic Surgical Procedures/adverse effects ; Urinary Incontinence, Stress/*surgery ; Urinary Bladder/*injuries/radiography ; *Postoperative Complications ; Peritonitis/diagnosis/etiology ; Humans ; Female ; Cystoscopy ; Adult

Popliteal artery compression rarely occurs after posterior cruciate ligament (PCL) reconstruction using the tibial inlay technique that allows for direct visualization of the surgical field. However, we experienced a popliteal artery compression after PCL reconstruction performed using the technique, which eventually required re-operation. Here, we report this rare case and discuss reasons of popliteal artery compression.
Inlays ; Popliteal Artery ; Posterior Cruciate Ligament

BACKGROUND: Recently, the trend pursuing slimness is significantly increasing in adolescents. Because of distorted body image, excessive body weight control can cause problems of health. The goal of this study is to investigate the factors of distorted body image and its problems. METHODS: The survey was performed in a high school of Jindo island on May, 2000. All of 258 students in 1st and 2nd grade participated in this study by questionnaires. Thirteen truthless questionnaires were excluded in this study. Therefore 245 student were selected. RESULTS: Only 20% of 245 repliers were satisfied with their body figure. In male, 24.1% wanted weight loss, and 39.8% wanted weight gain. In female, 73% wanted weight loss. In a populations(BMI<20), 70 males wanted weight loss, whereas 35(52.2%) among 67 females want weight loss. According to these result, female stuedents wanted strongly weight loss than male. The factors which most influenced body figure were sports star in males(36.1%), and movie stars in female.(43.8%) A group of 58.4% of repliers has experienced body weight control. A group of 37% in male and 39.6% in female suffered from side effects. 77% of total hoped to be educated about adequate body weight control method. CONCLUSION: Almost of adolescents dissatisfied with their body figure, Many adolescent who is not obese attempt weight loss, and are sufferd from side effects. Therefore, it is required for effective education about body weight control and social attitude permitting adequate body image.
Adolescent ; Body Image* ; Body Mass Index ; Body Weight ; Education ; Female ; Hope ; Humans ; Male ; Sports ; Weight Gain ; Weight Loss ; Surveys and Questionnaires

A Case of the epidermoid cyst with highly unusual location which is occurred in the interhemispheric fissure is reported. Intracranial epidermoid tumor develops predominantly in the cerebellopontine angle and parasellar regions. There has been no literally reported case the epidermoid developed in the interhemispheric fissure. The patient was 31-year-old man with the chief complaint of generalized seizure which was the first attack occurred one day before admission. The lesion with the size of about 3cm in diameter demonstrated by MRI was completely removed through posterior interhemispheric approach. The patient's postoperative recovery was unremarkable and without neurological deficit.
Adult ; Cerebellopontine Angle ; Epidermal Cyst* ; Humans ; Magnetic Resonance Imaging ; Seizures

Carcinoid tumors arising in the extrahepatic bile duct are very rare, accounting for only 0.2%~2% of all gastrointestinal carcinoid tumord. We experienced one case of a carcinoid tumor in the common bile duct. A 43-years-old man was unexpectedly found to have a carcinoid tumor of the common bile duct. This patient had no obstructive jaundice, yet we thought that this tumor was a clinically malignant tumor, so we performed pylorus preserving pancreatoduodenectomy. Pathologically, an ill-demarcated mass that measured 1.5x1.5cm in size had invaded into the pancreas. Immunohistochemically, the mass was founded to be chromogranin, synaptophysin and CD56 positive. The patient who underwent curative resection is alive and disease-free at time of this publication. This report also reviews the relevant literature on carcinoid tumors in the common bile duct.
Bile Ducts, Extrahepatic ; Carcinoid Tumor* ; Common Bile Duct* ; Humans ; Jaundice, Obstructive ; Pancreas ; Pancreaticoduodenectomy ; Publications ; Pylorus ; Synaptophysin

PURPOSE: Breast cancer is second most common cancer in women. Most of the patients with breast cancer treated with mastectomy take breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C-V flap technique after breast reconstruction only with the breast expander. METHODS: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C-V flap technique, who received breast reconstruction only with the breast expander. As we have predicted decrease in the size of reconstructed nipple, we designed flap a little larger than wanted nipple size. Nipple splint was applied for 4-6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. RESULTS: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There were no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. CONCLUSION: The authors experienced 17 patients of nipple reconstruction using the C-V flap technique after breast reconstruction only with the breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction only with the breast expander is safe and reliable. It is considered that a long-term study is necessary.
Absorption ; Breast ; Breast Neoplasms ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mastectomy ; Necrosis ; Nipples ; Splints

PURPOSE: Gynecomastia is an abnormal increase in the volume of the male breast. Subcutaneous mastectomy was the first surgical treatment for gynecomastia. But because of the complications such as nerve injury and scar formation, subcutaneous mastectomy has been substituted with liposuction. Recently various techniques including ultrasound-assisted liposuction has been used for treatment of gynecomastia. The purpose of this study is to evaluate the results of XPS(R) microresector (Shaver) for treatment of gynecomastia. METHODS: 17 patients, 33 breasts of gynecomastia, Simon grade I or II have been treated with XPS(R) microresector (Shaver). The mean age was 24.5. The subcutaneous tissue and glandular tissue were removed with XPS(R) microresector (Shaver). The operation time, the weight of removed tissue and patients' satisfaction score were accessed. RESULTS: The mean operation time was 78.2 minutes. The mean weight of removed tissue was 113.8 g. There were no significant complications such as necrosis, hematoma, infection or scar contracture. Patients' satisfactory score of scar, shape and confidence were 8.4, 8.2 and 8.4 respectively. As the average score was 8.3, most of the patients were satisfied with their breasts. CONCLUSION: The authors have treated 17 patients suffering from gynecomastia with XPS(R) microresector (Shaver). We obtained short operation time, early recovery, minimal operative scar and less complications with XPS(R) microresector (Shaver) for the treatment of gynecomastia, and patients were satisfied with the results of our method. We concluded that XPS(R) microresector (Shaver) is an alternative option for the treatment of gynecomastia.
Breast ; Cicatrix ; Contracture ; Gynecomastia ; Hematoma ; Humans ; Lipectomy ; Male ; Mastectomy, Subcutaneous ; Necrosis ; Stress, Psychological ; Subcutaneous Tissue

Intravenous pyogenic granuloma is a rare form of lobular capillary hemangioma and typically consists of an intraluminal polyp attached to the wall of a vein by a fibro-vascular stalk. It rarely occurs in the finger and its character is not enough to diagnosis clinically. Therefore, we report intravenous pyogenic granuloma which occurs in dorsal side of mid-phalanx with magnetic resonance imaging and pathological findings.
Diagnosis ; Fingers* ; Granuloma, Pyogenic* ; Hemangioma ; Magnetic Resonance Imaging ; Polyps ; Veins

BACKGROUND: Acute pancreatitis is a fairly common abdominal disorder that can be easily confronted in the emergency department(ED) and is one of the most complex and clinically challenging of all abdominal disorders. Currently, there is no gold standard for the diagnosis of acute pancreatitis. We evaluated the usefulness of the actim Pancreatitis(R) rapid test, which has been recently developed in Europe, as a screening test of acute pancreatitis in our emergency department. METHODS: We prospectively studied the urinary trypsinogen-2 dipstick tests(actim Pancreatitis(R), Medix Biochemica, Kauniainen, Finland) of 200 patients with acute abdominal pain who were treated at our ED. All urine samples were collected from the patients within 12 hours of arrival at ED. We also measured serum amylase assay in the laboratory and compared the sensitivities and the specificities of the two test. Acute pancreatitis was diagnosed by authors according to standardized criteria. Abdominal USG or CT was performed when a patient with a normal serum amylase level had a typical clinical presentation. RESULTS: The actim Pancreatitis(R) rapid test was positive in 22 of the 25 patients with acute pancreatitis(sensitivity, 88.0 percent). The test was also positive in 6 of 175 patients without pancreatitis(specificity, 96.6 percent). The serum amylase assay had a sensitivity of 68.0 percent(with a cutoff value of 300 U per liter for the upper reference limit) and a specificity of 90.9 percent. But there were no statistical differences between the correlation coefficients of the two tests as diagnostic tool CONCLUSION: In patients with acute abdominal pain who are seen in the emergency department, the actim Pancreatitis(R) urinary dipstick test has a high degree of probability as a screening test for acute pancreatitis. Also it can easily and rapidly be use at the bedside.
Abdominal Pain ; Amylases ; Diagnosis ; Emergencies ; Emergency Service, Hospital ; Europe ; Humans ; Mass Screening* ; Pancreatitis* ; Prospective Studies ; Sensitivity and Specificity

PURPOSE: Surgical excision of the subcutaneous tissues, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice in treating osmidrosis for several decades. However, long periods of postoperative immobilization of a shoulder joint, partial necrosis of skin flaps or the possibility of hematoma and scars have occurred frequently. So we used XPS(R) microresector(Shaver) in procedure which requires removal of soft tissue for comparing results between surgical excision and the laters. METHODS: From January 2007 to February 2008, a total of 20 patients(8 male and 12 female) underwent XPS(R) microresector(Shaver) assisted aspiration for treating osmidrosis. The mean age of the subjects was 21.9, and we tried to analyze some advantages of XPS(R) microresector(Shaver). RESULTS: The average operation time was 61.6 minutes. This results can show that the patients who received XPS(R) microresector(Shaver) assisted aspiration can accomplish better outcomes than any other procedures in terms of operation time at least. Moreover, no significant postoperative complications occurred in our studies. Subjects have been followed up from 2 months to 1 year and among these patients, no one suffered from critical complications. CONCLUSION: In brief, XPS(R) microresector(Shaver) is able to shorten the time of operation and simplify the procedures relatively and this device has more superiorities in wound healing by maintaining of vascularized dermal skin flaps. It means that XPS(R) microresector (Shaver) can prevent flap necrosis, axillary hair loss and minimalize scarring and bleeding. Thus, we expect that these advantages can lead to better patient's comfort and self-confidence than several previous procedures.
Cicatrix ; Hair ; Hematoma ; Hemorrhage ; Humans ; Immobilization ; Male ; Necrosis ; Postoperative Complications ; Shoulder Joint ; Skin ; Subcutaneous Tissue ; Wound Healing