The success and rapid spread of laparoscopic cholecystectomy have prompt the application of laparoscopic approach to abdominal surgical problems. As better in- strumentation is introduced, more complicated surgical procedrues will be performed. In some hematologic disorders, splenectomy was required to cope with these disorders. So laparoscopic splenectomy also has been perfomed inspite of several specific difficulties for handling and mobilization of a parenchymatous organ and the retrieval of the specimen. We experienced a case of idiopathic thrombocytopenic purpura which was treated safely and successfully by laparoscopic splenectomy in 35-year-old female. This technique allows the patient to return to normal activity sooner than with open splenectomy.
Adult ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

Two cases of ureteral fibrous polyp showing serpiginous filling defect on IVP are presented with characteristic radiologic features; easy flow of contrast medium around polyp. Prolapsed polyp in urinary bladder, and less ureteral obstruction or renal damage than in epithelial lesions. These rediologic findings enable to differentiation of ureteral fibrous polyps from malignant tumor, which is helpful for determining therapeutic approach.
Polyps* ; Ureter* ; Ureteral Obstruction ; Urinary Bladder

No abstract available.
Bone Regeneration* ; Bone Substitutes*

PURPOSE: To evaluate the pattern of distant lymph node metastasis in colorectal carcinoma and its correlation with distant organ metastasis. MATERIALS AND METHODS: We retrospectively reviewed abdominal CT scans of 46 patients with pathologically proven colorectal carcinoma. RESULTS: The incidence of distant lymphadenopathy in colorectal carcinoma was 30.4%(14/46). The most commonly involved distant lymph node was the left paraortic lymph node below the renal hilum(9/25). The most common type of distant lymphadenopathy was solitary type(7/14) and all of these lymphadenopathies were noted in the left paraortic lymph node below the renal hilum. Six cases of left sided colorectal carcinoma showed left paraortic lymphadenopathy with solitary type. The incidence of distant organ metastasis was 17. 4%(8/46) and markedly increased if distant lymphadenopathy was multiple and confluent, or confluent type(5/7). CONCLUSION: The incidence of distant lymphadenopathy in colorectal carcinoma was not high and the most common lymphadenopathy was the left paraaortic lymph node with solitary type below the renal hilum. The possibility of distant organ metastasis was high if distant lymphadenopathy was multiple and confluent, or confluent type.
Colorectal Neoplasms* ; Humans ; Incidence ; Lymph Nodes* ; Lymphatic Diseases ; Neoplasm Metastasis* ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to evaluate and compare the prophylactic effect of brimonidine 0.2% and apraclonidine 0.5% in preventing intraocular pressure(IOP) elevation in patients undergoing laser iridotomy. METHODS: The 24-hour, placebo-controlled, randomized, clinical trial was conducted to determine the efficacy of brimonidine 0.2% and apraclonidine 0.5% in controlling IOP after combined argon and Nd:YAG laser peripheral iridotomy. The 110 eyes(56 eyes with angle closure glaucoma, 54 eyes with narrow occludable angle) were randomized to receive brimonidine 0.2%, apraclonidine 0.5% or artificial tear(as placebo) 20 minutes before the procedure. IOP was measured before and 1, 2, and 24 hours after the procedure by masked observer using Goldmann applanation tonometry. The difference between preoperative(baseline) IOP and the highest postoperative IOP was recorded as the maximum IOP rise. RESULTS: The mean of maximum IOP rise was 1.1+/-5.6 mmHg in the brimonidine group, 1.0+/-2.9 mmHg in the apraclonidine group and 4.7+/-7.6 mmHg in the placebo group. There was statistically significant decrease in IOP in both drug groups compared to the placebo group(p<0.05). The incidence of maximum IOP rise greater than 5 mmHg was 18.2%(6/33 eyes) in the brimonidine group, 11.4%(4/35 eyes) in the apraclonidine group and 42.9%(18/42 eyes) in the placebo group. But no statistical difference was found between the brimonidine group and apraclonidine group(p>0.05). CONCLUSIONS: Both brimonidine 0.2% and apraclonidine 0.5% were significantly effective in preventing IOP spike following laser iridotomy procedure. There was a tendency toward less efficacy with brimonidine 0.2% compared to apraclonidine 0.5%, but this was statistically insignificant.
Argon ; Glaucoma, Angle-Closure ; Humans ; Incidence ; Intraocular Pressure* ; Manometry ; Masks ; Brimonidine Tartrate

No abstract available.
Diagnosis* ; Pancreas* ; Ultrasonography*

Leprosy is a granulomatous disease primarily affecting the peripheral nerves. The pathogenesis would be related to the cell-mediated response to mycobacterial antigens, metabolic and biochemical change of Schwann cell, circulating demyelinating factors and other autoimmune process. A specific nerve tissue protein, S-100 protein, has been demonstrated in normal nerves and nerve complexes. The stains of S-100 protein in dermal nerves of leprosy patients have been suggested in assessing the presence of nerve damage. We have estimated the concentration of S-100 protein in the sera of 64 leprosy patients(38 lepromatous leprosy, 26 tuberculoid leprosy) and that of 20 normal controls without neurologic disorders by ELISA. The results obtained were as follows: 1. The mean S-100 protein concentration was 0.0042ng/ml in a total of 64 leprosy patients, with 0.0062ng/ml in lepromatous type and 0.018ng/ml in tuberculoid type. The controls showed 0.0017ng/ml. 2. The analysis of age and serum S-100 protein concentration in both types showed lower value in the fifties of tuberculoid type(p<0.05). With the increase of age, mean S-100 protein concentration in both types tended to increase, but there was no significant correlation(p>0.05). 3. The analysis of duration of illness and serum S-100 protein concentration in both types showed higher value in the forties and fifties in lepromatous type(p<0.05). With the increase of duration of illness, mean S-100 protein concentration tended to increase in lepromatous type and slightly decreased in tuberculoid type, but there was no significant correlation(p>0.05). 4. The mean S-100 protein concentration of patients with neurologic symptoms was 0.0577ng/ml, in contrast with 0.0016ng/ml in patients without neurologic symptoms (p<0.05). In conclusion, the measurement of serum S-100 protein would play a potential role of a useful marker of assessing nerve damage in leprosy patients, esp, with neurologic symptoms.
Coloring Agents ; Enzyme-Linked Immunosorbent Assay ; Humans ; Leprosy* ; Leprosy, Lepromatous ; Nerve Tissue ; Nervous System Diseases ; Neurologic Manifestations ; Peripheral Nerves ; S100 Proteins*

To evaluate the effectiveness of computed tomography for the differential diagnosis of cervical lymphadenopathy, we reviewed CT scans of 26 patients with cervical lymphadenopathy retrospectively. These included 10 patients with tuberculous lymphadenitis, 11 patients with metastasis and 5 patients with lymphoma, We evaluated the CT scans with a special attention to internal nodal density, feature of contrast enhancement and location of lymphadenopathy. Tuberculous lymphadenitis involved multiple nodes unilaterally and showed central low density with even or uneven rim enhancement, usually occurring in young patients (mean: 31.6 years). Two cases with tuberculous lymphadenitis showed calcifications within the lymph nodes. Lymphoma involved unilateral or bilateral nodes and appeared as conglomerated isodense mass with even rim enhancement. Metastasis involved multiple nodes unilaterally and showed focal, diffuse of mixed pattern of central low density with variable rim enhancement, usually occurring in old patients (mean: 59.4 years). Locations of most frequent lymph node involvements were internal jugular group (76%), spinal accessory group (54%) and retropharyngeal group(12%).
Diagnosis, Differential ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Neoplasm Metastasis ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

PURPOSE: To evaluate the patterns of pseudo-lesions present on spiral CT hepatic arteriography (CTHA). MATERIALS AND METHODS: One hundred and seventy five patients (161 men and 14 women, aged 15-70 years [mean, 52 years]) who underwent spiral CTHA for the detection of hepatic lesions were retrospectively reviewed.Pseudo-lesion type was determined by comparing hyperattenuating lesions on CTHA with the findings of ultrasonography, conventional or multi-phase CT, Lipiodol CT, angiography, CT arterial portography(CTAP), and follow-up of spiral CTHA. Pseudo-lesions were classified according to site, size and shape. RESULTS: A total of 77 pseudo-lesions were found in 56 of the 175 patients(32.6%), and were classified into the following types :peritumoral(n=18), segment I(n=3), segment IV(n=3), gallbladder fossa (n=13), subsegmental (n=3), subcapsular(n=13), straight line sign (n=10), arterioportal shunt (n=13), and technical error (n=1). Fifteen of 77 pseudo-lesions(19.5%) showed hyperattenuation on CTHA and iso attenuation on CTAP, in contrast to adjacent liverparenchyma. CONCLUSION: In patients with hepatic mass, it is very important to understand the characteristicsite, shape and size of pseudo-lesions for the correct interpretation of CT and subsequent management of thepatient.
Angiography* ; Ethiodized Oil ; Female ; Gallbladder ; Humans ; Male ; Retrospective Studies ; Tomography, Spiral Computed*

No abstract available.
Colony-Stimulating Factors* ; Granulocytes* ; Humans ; Isotretinoin* ; Leukemia, Promyelocytic, Acute* ; Wound Infection* ; Wounds and Injuries*