Cholangiocarcinoma is synonymous with bile duct carcinoma, and can originate in a small intrahepatic bileduct(peripheral type), a major intrahepatic duct including the hepatic hilus, an extrahepatic duct, or near thepapilla of Vater(central type). In a sense bile duct carcinoma of the peripheral type is cholangiocarcinoma of theliver; it has the same gross configuration as hepatocellular carcinoma, resulting in difficulty to differentiateon the CT. The authors studied CT findings of 14 cases of pathologically proven peripheral type cholangiocarcinomaof the liver during the last 4 years. The results were as follows: 1. Of 14 cases, 8 were female and 6 were male,and the age ranged from 5th to 7th decades. 2. Preoperative clinical diagnosis were as follows: hepatoma 8 cases,abscess 5 cases and metastasis 1 case in order of frequency. 3. Diagnosis were confirmed by hepatic lobectomy in 7cases, wedge resection in 5 cases and needle biopsy in 2 case. 4. Labratory findings were not specific, but therewere only 2 cases with elevated alpha-fetoprotein level. 5. Associated diseases were gallstones in 1 case,intrahepatic duct stones, in 1 case, extrahepatic duct stones in 2 cases, acute or chronic cholecystitis in 5cases and CS in 3 cases. 6. Angiographic and scintigraphic findings were helpful in differential diagnosis fromhepatoma but ultrasonography was non-specific. 7. The number of tumor were solitary in 12 cases and multiple in 2cases. Among solitary cases, the site of involvement of the liver were right lobe in 8 cases and left lobe in 4cases. 8. Common CT features of the intrahepatic peripheral cholangiocarcinoma of the liver were irregular,inhomogeneous, occasionally peripherally enhancing, low density liver mass, frequently accompained by diffuse orsegmental dilatation of the intrahepatic bile duct. If there were normal alphafetoprotein level, positive skinand/or stool examination for CS and difuse or segmental dilatation of the intrahepatic duct in low density livertumor on the CT, one should consider peripheral cholangiocarcinoma of the liver than hepatoma.
alpha-Fetoproteins ; Bile Ducts ; Bile Ducts, Intrahepatic ; Biopsy, Needle ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cholecystitis ; Diagnosis ; Diagnosis, Differential ; Dilatation ; Female ; Gallstones ; Humans ; Liver ; Neoplasm Metastasis ; Ultrasonography

With the increasing number of surgery for incontinence, voiding dysfunction after anti-incontinence surgery will continue to be a problem. The patient with postoperative voiding dysfunction may present with primarily storage symptoms or voiding symptoms, or a combination of both. Detailed knowledge of the preoperative voiding status may aid in the diagnosis of voiding dysfunction. Diagnosis is based on history, physical examination, urinalysis and postvoid residual volume, but additional informations from urodynamic study and cystoscopy are useful. Patients with postoperative voiding dysfunction should be initially treated conservatively with intermittent or continuous catheterization, fluid restriction, anticholinergics and pelvic floor physiotherapy. When conservative treatment fails, surgical intervention should be done. It is important to distinguish between midurethral sling and other procedures because the timing and type of intervention vary. In case of midurethral sling, loosening or cutting the tape has had excellent results. Prevention of obstruction during surgery may be the best way to avoid reoperation.
Catheterization ; Catheters ; Cholinergic Antagonists ; Cystoscopy ; Humans ; Pelvic Floor ; Physical Examination ; Reoperation ; Residual Volume ; Suburethral Slings ; Urinalysis ; Urodynamics

Although conventional barium study has been used for diagnosis of gastrointestinal lymphoma, CT is superior tobarium study in the evaluation of its extent and relationship to the bowel, lymph node enlargement, and distantmetastasis. The authors analyzed CT features of 21 cases of pathologically proven gastrointestinal lymphoma forrecent 5 years. The results were as follows: 1. In a total 21 cases of gastrointestinal lymphomas, 13 cases wereprimary gastrontestinal lymphoma and others were secondary. But there was no difference in CT featurs betweenthem. 2. Male predominates over female(17:4), and type age ranged from 5 to 73 years old, most common
Abdominal Pain ; Barium ; Colon ; Diagnosis ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Male ; Mesentery ; Methods ; Omentum

Rhabdomyosarcoma originating from the chest wall is a rare malignant tumor in children and was considered to be guarded in prognosis previously. However, recent advances in multidisciplinary treatment of rhabdomyosarcoma in children have improved the disease free survival rate. Authors report a case of alveolar rhabdomyosarcoma, stage III, originating from the chest wall who is surviving free of disease for 15 months with aggressive chemotherapy and radiotherapy.
Child ; Disease-Free Survival ; Drug Therapy ; Humans ; Prognosis ; Radiotherapy ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Alveolar* ; Thoracic Wall* ; Thorax*

No abstract available.
Humans ; Infant, Newborn* ; Liver*

Mesenchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristics of a highly malignant tumor. The authors experienced a case of mesenchymal chondrosarcoma ocurring in a 33-year-old man, which had invaded the soft tissues of the chest wall and had been incompletely removed, and recurred in the adjacent T10 vertebra 4 years later. The patient presented with severe back pain and paraparesis at admission. Radiographic studies of the vertebra showed an aggressive osteolysis of the vertebral body, pedicle, lamina, compression of the spinal cord, and soft tissue invasion. The tumor was totally removed by an anterior and posterior combined approach. The removed vertebral body was replaced with a titanium mesh cage, and the thoracic spine was stabilized by both anterior and posterior fixations with instruments. The pathological and the clinical characteristics of mesenchymal chondrosarcoma are discussed.
Adult ; Back Pain ; Chondrosarcoma, Mesenchymal* ; Humans ; Osteolysis ; Paraparesis ; Spinal Cord ; Spine* ; Thoracic Wall ; Titanium

No abstract available.
Toxoplasma* ; Toxoplasmosis*

PURPOSE: We analyzed the patients who needed reoperation after undergoing a thoracolumbar spine operation and investigated the causes, pattern of timing, medical history and clinical outcome after reoperation. MATERIALS AND METHODS: Out of 2,198 patients who underwent spine surgery for thoracolumbar spine disease from 1988 to 2011, we targeted 193 patients who underwent reoperation. We studied the causes, operative method of initial surgery, time-variant causes and outcome of reoperation. RESULTS: The number of patients who underwent thoracolumbar spine reoperation was 193 out of 2,198 and the reoperation rate was 8.7%. We researched time-variant causes of reoperation. In six weeks after the initial operation, exploration for hematoma and neurologic deficit was 18 (26.8%), recurred heniated intervertebral disc (HIVD) was 18 (26.8%), and surgical site infection was 17 (25.4%). From six weeks to six months, recurred HIVD was 10 (47.6%), surgical site infection was 7 (33.3%), and after six months, adjacent segmental disease (ASD) was 38 (35.7%), recurred HIVD was 26 (23.2%), and implant related problem was 17 (16.0%). CONCLUSION: Causes of thoracolumbar spine reoperation included complications (2.8%); infection, hematoma, neurologic deficit, incomplete decompression, and natural courses (5.9%); ASD, recurred HIVD, implant related problem, instability after decompression, tumor recur, progression of deformity.
Congenital Abnormalities ; Decompression ; Hematoma ; Humans ; Intervertebral Disc ; Neurologic Manifestations ; Reoperation ; Spine

OBJECTIVES: To evaluate the efficacy of GnRH antagonist cetrorelix in women undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) and to determine changes in serum hormone concentrations during cetrorelix administration. METHODS: We performed a clinical trial on 30 patients undergoing COH with highly purified follicular stimulating hormone (HP-FSH) and gonadotropin releasing hormone antagonist (GnRHant), cetrorelix. FSH was administrated from day 2 or 3 of cycle with fixed dose and adjusted according to individual response. 0.25 mg of cetrorelix was injected daily subcutaneously from stimulation day 5 until the day of hCG administration. Daily ultrasound monitoring was performed for growing follicles and serum levels of luteinizing hormone (LH), estradiol (E2) and progesterone were measured daily during cetrorelix administration. Up to 4 embryos were transferred. RESULTS: Mean age of enrolled patients was 32.0+/-3.4 years (mean +/-S.D.). All of 30 patients underwent oocyte pick-up, and embryo transfer was done in 28 patients. The total and mean numbers of received oocytes were 196 and 6.5+/-4.7, the number of fertilized eggs was 111, and the fertilization rate was 56.6%. Total duration of FSH administration was 9.2+/-2.2 days and mean of 24.3+/-7.7 ampules of HP-FSH was administered. Total duration of cetrorelix administration was 5.7+/-1.9 days. Serum LH and progesterone levels were maintained in the range of 1.4~2.9 mIU/mL and 0.3~0.6 ng/ mL, which respectively reflected effective prevention of premature LH surge. Clinical pregnancies were achieved in 9 patients, and overall clinical pregnancy rate was 30.0% per oocyte retrieval, and 32.1% per embryo transfer. CONCLUSION: GnRH antagonist is safe and convenient for COH for IVF-ET and effective with optimal pregnancy rate.
Embryo Transfer ; Embryonic Structures ; Estradiol ; Female ; Fertilization ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Oocyte Retrieval ; Oocytes ; Ovulation Induction* ; Pregnancy ; Pregnancy Rate ; Progesterone ; Sperm Injections, Intracytoplasmic ; Ultrasonography ; Zygote

OBJECTIVE: To figure out the more optimal method for freezing and thawing the sperm, we compared with the sperm motility after handling of the sperm based on the different types of freezing and thawing methods. METHODS:Twenty four adult males who visited our infertility clinic from Aug 2004 to Feb 2005 were enrolled. We applied two kinds of freezing method to normal sperm according to WHO standard criteria; automatic slow freezing method (Auto) and manual vapor freezing method (Manu). We also use two different methods of thawing; a 37 degreesC warm water bath (37 degreesC) and 22 degreesC room temperature thawing (22 degreesC). Mean motile percent (MMP) was compared by the freezing methods and thawing methods respectively. We also evaluated the motility in four different ways of freezing and thawing combination. A written informed consent was obtained from each client. This study was approved by IRB. RESULTS: MMP by the freezing method was 56% in Auto group and 52% in Manu group. It was significantly different (P=0.037). In thawing method, it was 59% in 37 degreesC group and 49% in 22 degreesC group (P=0.000). Each of freezing and thawing methods was joined to make four different types of freezing and thawing combinations. In MMP there were 63% in Auto/37 degreesC, 50% in Auto/22 degreesC, 56% in Manu/37 degreesC and 48% in Manu/22 degreesC (P>0.05). CONCLUSION: The automatic method in freezing and room temperature in thawing showed respectively the highest MMP. In four different types of freezing and thawing combinations, Auto/37 degreesC MMP was the highest. There was no statistical difference. This means that all four types of freezing and thawing methods might be used clinically. If further study of larger population or comparison of fertility is done, we would have a better result.
Adult ; Baths ; Ethics Committees, Research ; Fertility ; Freezing ; Handling (Psychology) ; Humans ; Infertility ; Informed Consent ; Male ; Sperm Motility ; Spermatozoa ; Water