No abstract available.
Leiomyosarcoma* ; Uterine Inversion*

We report a case of vaginal leiomyoma in a female patient, which presented with a palpable paraurethral mass with several urinary symptoms such as frequency, urgency and dysuria. The physical examination revealed a localized, mobile, nontender mass in the anterior vaginal wall. Pelvic magnetic resonance (MR) imaging showed a malignant-looking vaginal mass co-existing with multiple uterine leiomyomas. The diagnosis was made through transvaginal ultrasound-guided needle biopsy. The surgical excision was accomplished without any complication. Despite the rarity, a few cases of malignant lesion presented with paraurethral mass were previously reported. The surgical excision and pathological confirmation of the benignancy is necessary.
Biopsy, Needle ; Diagnosis ; Dysuria ; Female ; Humans ; Leiomyoma* ; Magnetic Resonance Imaging* ; Physical Examination

PURPOSE: We report the results of microvascular anastomosis using a microvascular anastomotic coupler (MAC) system. MATERIALS AND METHODS: Twenty cases (12 patients) of venous anastomoses performed using a coupler system were examined. The patients' age, gender, preoperative diagnosis, donor tissue, vessel diameters, size of coupler, time for anastomosis, patency rate immediately after surgery and the final survival rate of the transferred tissue were evaluated. RESULTS: The mean time for anastomosis using the coupler system was 3 min and 15 sec. The immediate patency rate after anastomosis was 100% without any leakage of blood or thrombus formation. At the final follow up, the transferred tissue survived in all cases. CONCLUSION: Microvascular anastomosis using a coupler system in orthopaedic reconstructive surgery can shorten the vascular anastomosis time and significantly reduce the total ischemic time of the transferred tissue. This system can be easily used after a short training period. This system minimizes the intimal damage of the vessel, easily overcomes the diameter discrepancy and provides secure fixation at the anastomosis site. This system can be a good strategy for substituting the conventional suture anastomosis.
Follow-Up Studies ; Glycosaminoglycans ; Humans ; Survival Rate ; Sutures ; Thrombosis ; Tissue Donors

No abstract available.
Perfusion*

OBJECTIVES: Inhalation exposure to humidifier disinfectants has resulted to various types of health damages in Korea. To determine the epidemiological correlation necessary for presuming the legal causation, we aimed to develop a method to synthesize the entire evidence. METHODS: Epidemiological and toxicological studies are systematically reviewed. Target health problems are selected by criteria such as frequent complaints of claimants. Relevant epidemiologic studies are reviewed and the risk of bias and confidence level of the total evidence are evaluated. Toxicological literature reviews are conducted on three lines of evidence including hazard information, animal studies, and mechanistic studies, considering the source-to-exposure-to-outcome continuum. The confidence level of the body of evidence is then translated into the toxicological evidence levels for the causality between humidifier disinfectant exposure and health effects. Finally, the levels of epidemiological and toxicological evidence are synthesized. RESULTS: Under the Special Act revised in 2020, if the history of exposure and the disease occurred/worsened after exposure were approved, and the epidemiological correlation between the exposure and disease was verified, the legal causation is presumed unless the company proves the evidence against it. The epidemiological correlation can be verified through epidemiological investigations, health monitoring, cohort investigations and/or toxicological studies. It is not simply as statistical association as understood in judicial precedents, but a general causation established by the evidence as a whole, i.e., through weight-of-the-evidence approach. CONCLUSIONS The weight-of-the-evidence approach differs from the conclusive single study approach and this systematic evidence integration can be used in presumption of causation.

BACKGROUND: Staple closure of bronchial stump was compared with manual suture closure among 100 cases of pneumonectomy during the recent 5-year period. We have reviewed the incidence of bronchpleural fistula between autosutured group and manual sutured group. MATERIAL AND METHOD: During the recent 5-year period, 100 patients underwent pneumonectomy at Hanyang University Hospital. Staple closure of bronchial stump was performed in 65 patients and manual suture in 35 patients. There were 55 males and 10 females in the autosutured group, and 26 males and 9 females in manual sutured group, which showed no significant statistical difference between the two groups. The mean ages of patients for autosutured group and manual sutured group were 56.7+/-10.3 years and 61.4+/-9.2 years, respectively, which showed no significant statistical difference between the two groups. There were 38 cases of left pneumonectomy and 27 cases of right pneumonectomy in autosutured group, and 22 cases of left pneumonectomy and 13 cases of right pneumonectomy in manual sutured group. There were 53 cases of malignancy and 12 cases of benign imflammatory disease in autosutured group, and 27 cases of malignancy and 7 cases of benign imflammatory disease in manual sutured group. RESULT: The incidence of bronchopleural fistula was 6.1% in autosutured group and 5.7% in manual sutured group. The incidence of other postoperative complication between the two groups showed no significant statistical difference. CONCLUSION: The incidence of bronchopleural fistula between autosutured group and manual sutured group was not different stastically. Both method for closure of bronchial stump can be performed in pneumonectomy.
Female ; Fistula* ; Humans ; Incidence ; Male ; Pneumonectomy* ; Postoperative Complications ; Surgical Staplers ; Sutures*

BACKGROUND: Patients with hypertrophic cardiomyopathy(HCMP) may present a wide spectrum of clinical and morphological manifestations. There was little literature regarding clinical and morphological features of HCMP in Korea. METHODS: 1) Study population : Among 18, 183 patients who unerwent echocardiography from June 1990 to Qctober 1993 at Yonsei cardiovascular center Echocardiography laboratory, 65 patients with HCMP were enrolled to study population. All patients with HCMP have at least onesegment of left ventricular wall measuring 17mm or more in thickness at end diastole. 2) Two dimensional echocardiography : All standard views were performed and recorded with Super VHS video tape. All records were reviewed and the maximal wall thickness was measured at video monitor by aid of electronic caliper of our echocardiographic machine. 3) Dopple echocardiography : Peak velocity of E and A wave and deceleration time were measured. The intracavitary peak systolic pressure gradient was also measured using continous wave Doppler at the site of abnomal mosaic pattern in color flow interrogation. RESULTS: 1) Mean age of the patients was 50+/-15 ranging from 11 to 84 and the sex ratio was 2.3:1(male:female). 2) The type 3(involving all segments except inferior wall) was the most frequently observed in Korean(47%). 3) The mid anterior septum was the most frequently involved segment(71%) and the non-obstructive type was perdominant(78%). 4) There was 17 cases of apical HCMP and 4 cases of mid ventricular obstructive type. 5) There was no significant correlation between symptoms and dynamic obstruction. 6) The EA ratio had statistically significant difference between obstructive and non-obstructive groups probably due to mitral regurgitation. CONCLUSION: The type 3 was the most frequent type of HCMP in Korean and the non-obstructive type was more frequently observed than obstructive type. Among the all left ventricular segments, the mid anterior septum was most frequently involved.
Blood Pressure ; Cardiomyopathy, Hypertrophic* ; Deceleration ; Diastole ; Echocardiography* ; Humans ; Korea ; Mitral Valve Insufficiency ; Sex Ratio

There are no known data of recession point of inferior oblique muscle (IO) in Korean.The purpose of this study was to determine the accurate reinsertion point of IO and compare the previous data with ours.Thirty-one Korean cadaver orbits were dissected to expose the full length of extraocular muscles and sclera, and then we measured the length from the recession point of IO to lateral edge of insertion of inferior rectus muscle (IR)and to inferior edge of insertion of lateral rectus muscle (LR).Eight mm recession point of IO was measured 6.9 +/-0.6 mm posteriorly along the inferior border of LR from inferior edge of LR insertion, and 4.6 +/-1.5 mm inferiorly.For 10 mm recession, it was 5.6 +/-1.3 mm posteriorly and 6.6 +/-2.0 mm inferiorly.For 12 mm recession, it was measured 4.7 +/-0.7 mm posteriorly and 8.4 +/- 1.5 mm inferiorly.And for 14 mm recession, it was 3.7 +/-1.7 mm posteriorly and 9.5 +/-2.0 mm inferiorly. Eight mm recession point of IO was measured 3.5 +/-0.6 mm posteriorly along the lateral border of IR from the lateral edge of IR insertion, and 6.5 +/-0 .8 mm laterally.For 10 mm recession, it was 2.9 +/-1.0 mm posteriorly and 3.6 +/- 1.0 mm laterally.For 12 mm recession, it was measured 3.3 +/-0.6 mm posteriorly and 2.3 +/-0.6 mm laterally.For 14 mm recession, it was 3.0 +/-1.5 mm posteriorly and 0.5 +/-0.9 mm laterally.The cord length on a straight line from 14 mm recession point of IO to the scleral exit site of the inferior temporal vortex vein was 6.6 +/-1.4 mm (range 4~9 mm).The distance from IO recession points to IR insertion site and to LR insertion site were compared in ten paired eyes, and the difference was not statistically significant (p>0.05).We made anatomical studies to evaluate the proper placement of scleral reinsertion site of IO in Korean.
Cadaver ; Muscles ; Orbit ; Sclera ; Veins

The percutaneous transcatheter closure of secundum atrial septal defect has recently become an increasingly widespread alternative to surgical closure in many centers. Although immediate, short, and intermediate term results of percutaneous transcatheter septal closure are promising, the procedure is not free from inherent complications that could be lethal. We report a case of device embolization necessitating emergent surgical retrieval.
Heart Septal Defects, Atrial

BACKGROUND: Brachial plexus is invested by a fascial envelope, which forms a perineural and perivascular space that extends all the way from the cervical intervertebral foramen to the distal axilla. Therefore a single injection of a local anesthetic into any sites of this space can provide anesthesia of the entire brachial plexus. Nowadays many methods of brachial plexus block have been developed but there are some severe complications and they can't prevent tourniquet pain completely. METHODS: We have performed parascalene technique for brachial plexus block in 206 cases from Jan., 1992 to Dec.,1994. We studied the cases retrospectively by reviewing patients' anesthesia records. The technique for parascalene block is the injection of local anesthetic solution into the lower part of the posterior triangle of the neck at the point 1.5~2.0 cm above the clavicle at the lateral border of the anterior scalene muscle. RESULTS: We could provide the proper anesthesia for the upper extremity and shoulder operation without any remarkable complications except Honor's syndrome of 3 cases. And there were no tourniquet pain in all 96 cases who had used tourniquet. CONCLUSIONS: The parascalene approach is the useful, safe and reliable method for brachial plexus block.
Anesthesia ; Anesthetics ; Axilla ; Brachial Plexus* ; Bupivacaine ; Clavicle ; Lidocaine ; Neck ; Retrospective Studies ; Shoulder* ; Tourniquets ; Upper Extremity*