No abstract available.
Blood Glucose* ; Humans ; Infant, Newborn ; Infant, Premature*

No abstract available.
Meningioma* ; Radiosurgery*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Purpose: We assessed the effects of preoperative bladder compliance on the long-term functional outcomes, especially focused on postoperative storage symptom changes, after laser prostatectomy. Materials and Methods: From January 2008 to March 2014, 1,608 men who underwent laser prostatectomy, including holmium laser enucleation or photo-vaporization of the prostate, were included in the analysis. We divided patients into 3 groups according to bladder compliance on a baseline urodynamic study: <12.5, 12.5–25, ≥25 mL/cmH2O. A multivariable analysis was performed to determine the impact of bladder compliance on changes in long-term functional outcomes after laser prostatectomy. Results: Bladder compliance was less than 12.5 mL/cmH2O in 50 (3.1%), 12.5–25 mL/cmH2O in 232 (14.4%) patients. As bladder compliance decreased, the baseline International Prostate Symptom (IPSS) total score and storage sub-score were increased; the voiding sub-score remain unchanged. At postoperative 12 and 36 months, absolute improvements in the IPSS total score and storage sub-score were higher in <12.5 mL/cmH2O group compared to other groups, although those were equivalent at postoperative 1 months. On the multivariable analysis, decreased bladder compliance <12.5 mL/cmH2O was significantly associated with superior improvement in storage sub-score at postoperative 36 months, although it was not associated with voiding sub-score. Conclusions In patients with preoperative bladder compliance <12.5 mL/cmH2O, storage symptoms could be further improved at 36 months after laser prostatectomy compared to others. Thus, laser prostatectomy could be a considerable treatment option for patients with severely decreased bladder compliance.

Objectives: Despite precise iliosacral (IS) screw placement, we encountered a case of a neurological deficit due to a bony fragment that remained around the nerve root after reduction of the fracture gap in a patient with a pelvic ring injury.Summary of Literature Review: Percutaneous IS screw fixation is a commonly used procedure because it enables an adequate fixation force to be secured through a minimally invasive method in patients with pelvic ring fractures. Percutaneous IS screw fixation using C-arm fluoroscopy has been well described. In addition, several studies have investigated methods to prevent neurological damage. Materials and Methods: A 48-year-old man was diagnosed with a lateral compression type 1 pelvic ring fracture. Bilateral IS screw fixation was performed in the patient, who had no preoperative neurological abnormalities. He complained of pain around the sacroiliac joint that radiated to the lower leg after percutaneous IS screw fixation, and he was diagnosed with S1 radiculopathy on electromyography. Results: While reviewing the patient’s preoperative computed tomography images, a bony fragment in the fracture gap on the left S1 root was noted. After confirming S1 root entrapment, decompressive laminectomy was performed. Conclusions Surgeons should be aware that postoperative neurological symptoms may be caused by a bony fragment resulting from the fracture, regardless of screw malposition in percutaneous IS screw fixation. Preoperative planning with meticulous image review and intraoperative neurological monitoring, as well as using full-threaded screws, may help to prevent this problem.

PURPOSE: To evaluate the role of linac based radiosurgery (RS) in the treatment of meningiomas, we retrospectively analyzed the results of clinical and follow up CT/MRI studies. METHODS AND MATERIALS: From the 1988 July to 1998 April, twenty patients of meningioma had been treated with 6 MV linear accelerator based radiosurgery. Of the 20 patients, four (20%) were male and 16 (80%) were female. Mean age was 51 years old (22~78 years old). Majority of intracranial location of tumor for RS were parasagittal and sphenoid wing area. RS was done for primary treatment in 6 (30%), postoperative residual lesions in 11 (55%) and regrowth after surgery in 3 (15%). Mean tumor volume was 5.72 cm3 (0.78~15.1 cm3) and secondary collimator size was 2.04 cm (1~3 cm). The periphery of tumor margin was prescribed with the mean dose of 19.6 Gy (9~30 Gy) which was 40~90% of the tumor center dose. The follow up duration ranged from 2.5 to 109 months (median 53 months). Annual CT/MRI scan was checked. RESULTS: By the follow up imaging studies, the tumor volume was reduced in 5 cases (25%), arrested growth in 14 cases (70%), and increased size in 1 case (15%). Among these responsive and stable 19 patients by imaging studies, there showed loss of contrast enhancement after CT/MRI in four patients. In clinical response, nine (45%) patients were considered improved condition, 10 (50%) patients were stable and one (5%) was worsened to be operated. This partly resulted in necrosis after surgery. CONCLUSION: The overall control rate of meningiomas with linac based RS was 95% by both imaging follow-up and clinical evaluation. With this results, linac based RS is considered safe and effective treatment method for meningioma.
Female ; Follow-Up Studies ; Humans ; Male ; Meningioma* ; Middle Aged ; Necrosis ; Particle Accelerators ; Radiosurgery* ; Retrospective Studies ; Tumor Burden

PURPOSE: To evaluate the recovery of continence after robot-assisted laparoscopic prostatectomy (RALP) and open radical retropubic prostatectomy (RRP). MATERIALS AND METHODS: We identified 258 patients who underwent surgery by a single surgeon to treat localized prostate cancer. The patients were divided into two groups according to operative method. In group 1, 146 consecutive patients underwent RALP, and in group 2, 112 patients underwent RRP. To compare the interval until the return of urinary continence between the two groups, we used the Kaplan-Meier method and the log-rank test and Cox proportional hazard regression analyses. RESULTS: Differences between the two groups were found in mean estimated blood loss (EBL; p<0.001) and the rate of nerve sparing (p=0.004). When continence was defined as the use of 0 to 1 pad per day, 100% of group 1 and 98.2% of group 2 reported continence at 12 months (p=0.189). When continence was defined as no pad use, however, there was a significant difference between the two groups at 12 months: group 1, 95.7%, and group 2, 70.7% (p<0.001). The factors affecting time until no pad use in the univariate analysis with a Cox proportional hazards model were operation method, age, neurovascular bundle saving, membranous urethral length (MUL), EBL, and apical shape. In the multivariate analysis, only operation method, age, and MUL retained significance. CONCLUSIONS: Our study suggests that RALP is an independent factor for the recovery of continence and that RALP has advantages for postoperative continence recovery and the quality of continence compared with RRP.
Humans ; Multivariate Analysis ; Proportional Hazards Models ; Prostatectomy ; Prostatic Neoplasms ; Robotics ; Urinary Incontinence

Malakoplakia is an uncommon granulomatous disease most frequently found in the bladder or ureter. Howevcr, it has been reyorted in almost every ather organ and structure, the colon is the most common site of malakoplakia outside the urogenital tract and colonic carcinoma is the most commonly associated disease. A case of malakoplakia of the colon in a 54-year-old female is reported. Sigmoidoscopy revealed multiple whiteyellowish nodules simulating polypoid lesion at 10cm from the anal verge. The biopsy showed characteristically comprised submucosal proliferations of histiocyte and chronic inflammatory cells with typical cytoplasmic inclusions known as Michaelis-Gutmann bodies. Intravenous pyelogram showed no evidence of involvement of the urinary system. These nodules were removed by endoscopic polypectomy, So far, this is the first case of isolated colonic malakoplakia in Korea.
Biopsy ; Colon ; Female ; Histiocytes ; Humans ; Inclusion Bodies ; Korea ; Malacoplakia* ; Middle Aged ; Rectum ; Sigmoidoscopy ; Ureter ; Urinary Bladder

PURPOSE: This study was carried out to evaluate the impact of combined splenectomy with total gastrectomy on survival and postoperative morbidity in advanced gastric cancer. PATIENTS AND METHODS: We performed a retrospective analysis of 193 patients who underwent curative resection among 289 patients with total gastrectomy during the period of Sep. 1983 through Dec. 1995 at the Department of Surgery, Korea University Hospital. RESULTS: Out of 11 clinicopathologic factors, 5 were associated with splenectomy through univariate analysis. The incidence of splenectomy increased when the patients with advanced gastric cancer had Borrmann type III, Gross T3 & T4 stage, greater than 4 cm of tumor size, Serosal invasion, or UICC stage IIIb, IV (p<0.05). Postoperative complication occurred more commonly in splenectomy group than in non-splenectomy group (20.2% vs 16.9%). The 5-year survival rate of Stage II was lower in splenectomy group than in non-splenectomy group (63.5% vs 83.5%) but that of Stage III was higher in splenectomy group than in non-splenectomy group (22.8% vs 17.3%), there was no significant difference between the survival rates across different stages. CONCLUSION: We could not find any beneficial effect of splenectomy in gastric cancer patients who underwent curative total gastrectomy in this retrospective analysis. There was no clinical evidence to support splenectomy as a general policy in patients with total gastrectomy. We conclude that the randomized prospective clinical trials using more precise criteria for the indication of splenectomy are needed in order to assess the beneficial effect of splenectomy.
Gastrectomy* ; Humans ; Incidence ; Korea ; Postoperative Complications ; Prognosis* ; Retrospective Studies ; Splenectomy* ; Stomach Neoplasms* ; Survival Rate

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy