No abstract available.
Gallbladder* ; Lithotripsy*

Most renal cell carcinomas are solid but contain small cystic areas. Sometimes the cystic component predominates and such lesions are called cystic renal cell carcinomas. The radiographic and pathologic findings of cystic renal cell carcinoma are often more confusing and less specific than the findings of solid renal cell carcinoma. Multilocular cystic renal cell carcinoma is one form of cystic renal cell carcinoma variants and results from intrinsic multiloculated growth. A presumptive diagnosis of multilocular cystic renal cell carcinoma was made preoperatively in a 38-year-old woman and it was treated with radical nephrectomy, so we report this case with brief review of the literatures.
Adult ; Carcinoma, Renal Cell* ; Diagnosis ; Female ; Humans ; Nephrectomy

Since continent urinary diversion and bladder substitution after cystoprostatectomy have been offered as alternative to standard urinary diversion, increasing numbers of patients seek to avoid a wet stoma. So since 1988 we have used a pouch constructed from a combination of large and small bowel(Mainz pouch), which offers a low pressure reservoir of adequate capacity, antirefluxing ureteral reimplantation and continent reservoir. Initial applications of the Mainz pouch were for bladder augmentation after subtotal cystectomy and for continent urinary diversion. Current indications have been extended to complete bladder substitution after radical cystectomy with anastomosis of the pouch to the membranous urethra. A total or 15 patients underwent a Mainz pouch procedure ;6 for bladder augmentation, 8 for continent urinary diversion and 1 for total bladder substitution after radical cystectomy. All bladder augmentation cases, 4 of 8 diversion cases and substitution case are completely dry day and night. There are no significant perioperative morbidity and mortality.
Cystectomy ; Humans ; Mortality ; Replantation ; Ureter ; Urethra ; Urinary Bladder ; Urinary Diversion

No abstract available.
Dipyridamole* ; Heart Ventricles*

While a sprain of the hamstring muscle is relatively common in athletes or those who participate in physically active sports, a complete rupture of the proximal hamstring is relatively rare. A rupture of the long head of the biceps femoris without rupture of the semimembranosus and semitendinosus muscles has rarely been reported. In this study, we saw relatively favorable outcomes after reattachment with a suture anchor at the ischial tuberosity in two patients who had a rupture of the long head of the biceps femoris.
Athletes ; Head ; Humans ; Muscles ; Rupture* ; Sports ; Sprains and Strains ; Suture Anchors

Loss of the urethral floor with total urinary incontinence is a difficult problem that is infrequently encountered by the urologist. The techniques required for the urethral reconstruction are different and can be much more; delicate and demanding than the typical vesicovaginal fistula repair. Herein we report a case of the female urethral loss caused by chemical injury 3 years age and treated using bulbocavernous myocutaneous flap successfully.
Female* ; Humans ; Myocutaneous Flap* ; Urinary Incontinence ; Vesicovaginal Fistula

PURPOSE: To report a case of multiple serous chorioretinopathy after facial herpes zoster. CASE SUMMARY: A 48-year-old male visited our clinic due to visual disturbance in the left eye which occurred 3 days after left facial pain and vesicles. Chemosis and multiple serous retinal detachments were found. The patient was diagnosed with multiple serous chorioretinopathy due to herpes zoster virus and was started on intravenous acyclovir at a dose of 10 mg/kg every 8 hours for 9 days and herpes eye ointment 5 times daily. After the initial treatment, oral prednisolone 60 mg was given daily for 6 days. Skin lesions were cleared, and abnormal fundus and visual acuity improved after treatment. CONCLUSIONS: Ophthalmopathy including multiple serous chorioretinopathy should be considered in managing herpes zoster ophthalmicus patients.
Acyclovir ; Facial Pain ; Herpes Zoster Ophthalmicus ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Male ; Middle Aged ; Prednisolone ; Retinal Detachment ; Skin ; Visual Acuity

The recording of middle cerebral artery (MCA) flow veloeity by transcrsnisl Doppler technique offers s new, noninvasive, and continuous technique for studies of cerebral circu lation. The influence of changes in PaCO2 on MCA flow velocity were observed during hypothermic cardiopulmonary bypass(CPB) surgery by means of transcranial Doppler tech- niques. In ten patients who were undergoing hypothermic CPB surgery, the right MCA flow velocity was measured before initiation of CPB(prebypass period) and after the termination of CPB (postbypass period). During steady state CPB(constant hematocrit, constant temperature, and constant total pump flow), baseline MCA flow velocity(CPB I period) was measured and then repeated after specific alteration of PaCO2 achieved by changing of fresh gas flow to oxygenetors(CPB II period). And carbon dioxide reactivity defined as percent change of MCA flow velocity per mmHg changes in PaCO2 was observed during stable hypothermic CPB. MCA flow veocity showed no statistical difference between the prebypass value(56.9+/-13.5 cm/sec) and the postbypass value(64.7+/-29.7 cm/sec). PaCO2 of 20.5+/-2.5 mmHg was associated with MCA flow velocity of 25.2+/-10.1 cm/sec in the CPB I period while PaCO2 of 27.1+/-3.5 mmHg was associated with MCA flow velocity of 35.3+/-12.9 cm/sec. MCA flow velocity carbon dioxide reactivity during steady state hypothermie CPB was 6.68+/-2.26 %/ mmHg. These results have demonstrated that the response of MCA flow velocity to changes in PaO2 was well maintained during hypothermic CPB and the use of transcrsnial Doppler would give valuable results in the study of cerebral circulation during hypothermic CPB.
Blood Flow Velocity* ; Carbon Dioxide* ; Carbon* ; Cardiopulmonary Bypass* ; Hematocrit ; Humans ; Middle Cerebral Artery

We studied the effect of stellate ganglion block on the mean blood flow velocity and carbon diaxide reactivity of the middle cerehral artery in nine healthy volunteers. Mean blood flow velocity of the right middle cerebral artery was measured under normocapnia and carbon dioxide reactivity to end-tidal PCO2 of 30 mmHg, 40 mmHg, and 50 mmHg was assessed before and after right stellate ganglion block. End-tidal PCO2 was controlled by hyperventilation and rebthing technique. Mean blood flow velocity was measured using transcranial Doppler sonography, and carbon dioxide reactivity was expressed as the percentage change in mean blood flow velocity per unit change in end-tidal PCO2. There was no difference in mean blood flow velocity under normocapnia (37.7+/-1.1 mmHg) between the values measured before stellate ganglion block (60.3+/-4.9 cm/sec) and the values measured after stellate ganglion block (58.6+/-4.9 cm). Mean blood flow velocity increased as end-tidal PCO2 increased from 30 mmHg to 40 mmHg, and from 40 mmHg to 50 mmHg (p<0.01) both before and after stellate ganglion block. Carbon dioxide reactivity of mean blood flow velocity did not change after stellate ganglion block. Heart rate decreased from 77.1+/-3.5 beats/min to 70+/-2.5 beats/min when end-tidal PCO2 was controlled from 30 mmHg to 40 mmHg after stellate ganglion block (p<0.05). Mean arterial blood pressure did not change after stellate ganglion block at any end-tidal PCO2 level. These results suggest that stellate ganglion block does not induce the change of mean blood flow velocity and carbon dioxide reactivity of the middle cerebral artery.
Arterial Pressure ; Arteries ; Blood Flow Velocity* ; Carbon Dioxide* ; Carbon* ; Healthy Volunteers ; Heart Rate ; Hyperventilation ; Middle Cerebral Artery* ; Stellate Ganglion* ; Ultrasonography, Doppler, Transcranial

PURPOSE: Colorectal perforation is a rare malady, but it usually presents abdominal emergency with high morbidity and mortality. It is very difficult to diagnose stercoral, idiopathic, or steroid induced perforation because these are very rare, but they show high mortality. The aims of this study are to: 1) evaluate and compare the characteristics of stercoral, idiopathic and steroid induced perforation with other perforations; and to 2) guide the diagnostic approach and treatment of these rare colon perforations. METHODS: We retrospectively reviewed thirty five patients underwent surgery for colorectal perforation at the Department of Surgery, Daedong Hospital, from November 1996 to January 2005. Age, gender, perforation site, grade of peritonitis, methods of operation and mortality rates were compared between the various causes. Logistic regression was used to evaluate their effect on mortality. RESULTS: There were 10 cases of iatrogenic colorectal injuries (28%), 7 of steroid induced colorectal perforation (20%), 5 of stab (14%), 4 of diverticulitis (11%), 4 of stercoral (11%), 3 of idiopathic (8%), and 2 of cancer induced perforation (5%). Total mortality rate of all the cases was 28.5% (10 out of 35) but the mortality of stercoral, steroid induced and idiopathic perforation was 57% (8 out of 14). The mortality rate was higher in older age group (60 years above) (40%), stercoral (75%), steroid induced (57%) and idiopathic (33%), preoperative systemic inflammatory response (SIRS) (42%), preoperative septic shock (83%), abnormal WBC count (10,000/mm3 above or 4,000/mm3 below) (53%), left colon perforation (36%) and diffuse peritonitis (56%). The mortality rate was lower in young age group (13%), iatrogenic (10%), stab (0%), right colon perforation (10%) and localized peritonitis (5%). The peritonitis grade (Hinchey's stage) of idiopathic group, cancer and stercoral was worse (III-IV grade: 75%, 100%, 75%) than that of diverticulitis, iatrogenic and stab (III-IV grade: 25%, 30%, 40%). CONCLUSION: The stercoral, steroid induced and idiopathic colorectal perforation was rare, difficult to diagnose but it showed high mortality. The characteristics of these are an older age, presenting with a high peritonitis grade, preoperative SIRS, preoperative septic shock, and occurrence below the splenic flexure. If surgeons encounter these perforations, they should perform prompt surgical management and intensive postoperative care to reduce the mortality.
Colon ; Colon, Transverse ; Diverticulitis ; Emergencies ; Humans ; Logistic Models ; Mortality ; Peritonitis ; Postoperative Care ; Retrospective Studies ; Shock, Septic