Chemical rhizotomy with the intrathecal alcohol injection was firstly attempted by Dogliotti in 1931, and with phenol in 1955 by Maher. The intrathecal neurolytic injection was a very simple, effective and nonsurgical procedure without any great danger. Good indications for the procedure are the bilateral pelvic and lower limb pain syndrome, well circumscribed pain in limited area and in poor general condition. We have reported two cases of intractable pain of limited area, successfully relieved by chemical rhizotomy, and discussed the importance of the procedure and presented the review of literatures.
Lower Extremity ; Pain, Intractable* ; Phenol ; Rhizotomy

Dermoid cysts are the most common type of ovarian neoplasms occurring during a woman's reproductive life and account for 25% of all premenopausal ovarian neoplasms. Intraoperative spillage of dermoid cyst materials may lead to febrile morbidity, ileus, peritonitis, adhesion or fistula formation. Rarely, malignant element spillage, if present, may also lead to cancer dissemination. The management of dermoid cyst is controversal. Recently, laparoscopic surgery for ovarian cysts has been increasingly accepted. But, in view of the high risk of intraperitoneal rupture of large sized cysts, many surgeon still prefer the laparotomic approach. Recently, we did laparoscopic salphingo-oophorectomy to the patient having 20cm sized dermoid cyst. Intraoperative spillage of cyst material occurred, but patient recovered without any postoperative complication. So, we present this case with brief review of the literatures.
Dermoid Cyst* ; Female ; Fistula ; Humans ; Ileus ; Laparoscopy* ; Ovarian Cysts ; Ovarian Neoplasms ; Peritonitis ; Postoperative Complications ; Rupture ; Teratoma

OBJECTIVE: The objective of this study was to compare laparoscopic surgery with laparotomy for surgical management of ovarian dermoid cysts. METHODS: One hundred and fifteen patients were managed with laparoscopy and eighty two patients were managed with laparotomy. Two groups were compaired for age, marrital status, parity, tumor size, operation type, previous surgery, operating time, blood loss, pre-, and postoperative hemoglobin change, hospital stay, complications and recurrences. RESULTS: Unilateral slapingo-oophorectomy was the most common type of operation in either group. Between twenty one and thirty was the most common age in either group and para 0 in laparoscopy and para 2 in laparotomy group was the most common. Unilateral ovarian cystectomy was significantly more common for para 0 in laparoscopy group (p=0.035). Number of singles were significantly higher in laparoscopy group (p=0.046). Tumor size was significantly larger in laparotomy group (6.1 vs 7.8 cm). Operating time was shorter for unilateral ovarian cystectomy in laparoscopy group. Blood loss, pre-, and postoperative hemoglobin change, hospital stay was significantly less in laparoscopy group. Febrile morbidity was higher in laparotomy group (p<0.001). However no major complications were noted in either group. CONCLUSION: We conclude that operative laparoscopy has many advantages in the management of ovarian dermoid cysts. However tumor size was a relative limitations for laparoscopy compaired with laparotomy.
Cystectomy ; Dermoid Cyst* ; Female ; Humans ; Laparoscopy* ; Laparotomy* ; Length of Stay ; Parity ; Recurrence

Atrial septal aneurysm (ASA) was reported as a cause of unknown origin of central or peripheral thromboembolism with patent foramen ovale, aortic debris and spontaneous echo contrast. Especially the paradoxical right to left shunt via micro-fenestration on this sac may be the important cause of this embolism. We report a case of 39 year-old female patient who had atrial septal aneurysm with multiple renal infarction. Symptom was improved with aneurysmectomy and patch closure, then long term anticoagulation has been continued.
Adult ; Aneurysm* ; Embolism ; Female ; Foramen Ovale, Patent ; Humans ; Infarction* ; Thromboembolism

BACKGROUND AND OBJECTIVES: The objective of this study was to assess the short- and long-term clinical outcomes and valvular changes after percutaneous mitral valvuloplasty (PMV) in Sejong Hospital. SUBJECTS AND METHOD: Four hundred sixty-seven patients received PMV (Ed-already defined above) using the Inoue Balloon at Sejong hospital from 1990 to 2002. Short and long-term results, restenosis-free survival rate and prognostic factors for each result were analyzed by Chi-square, Cox regression analysis, Life table method and Cox proportional hazard model. RESULTS: After PMV, mitral valve area increased from 0.94+/-0.21 cm2 to 1.76+/-0.37 cm2 and the success rate (MVA>1.5 cm2 or increased by at least 50% without the development of moderate to severe mitral regurgitation) was 78.9%. Age (< or =50 years, p=0.018), echo score (< or =9, p=0.05) and pre-procedural mitral valve area (MVA, > or =1.1 cm2, p=0.001) were independent favorable prognostic factors for short-term result. As for the development of moderate to severe mitral regurgitation, pre-procedural MVA (< or =1.0 cm2, p=0.031) and echo score (>9, p=0.043) were independent predictive factors. Median restenosis-free survival was 82.98 months and the restenosis-free survival rate was 70.9% at 3 years post-PMV, 48.1% at 6 years and 29.6% at 10 years. The independent prognostic factor for restenosis-free survival rate was left atrial dimension (LAD< or =60 mm, p=0.015). In addition, echo score (< or =8, p=0.412), pre-procedural MVA (> or =1.0 cm2, p=0.24) and ejection fraction (EF> or =55%, p=0.146) had an effect on the good long-term results of PMV from multivariate analysis. CONCLUSION: PMV was a very successful treatment method for mitral stenosis. Pre-procedural MVA was a representative predictive factor for short and long-term outcomes and the development of mitral regurgitation.
Balloon Valvuloplasty ; Echocardiography ; Humans ; Life Tables ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Multivariate Analysis ; Proportional Hazards Models ; Survival Rate

BACKGORUND: To choose optimal potassium free solutions in chronic renal failure patients, we studied the effects of 0.45% or 0.9% saline solutions on the serum sodium concentrations of patients undergoing kidney transplantation surgery. METHODS: Sixty two patients, ASA physical status iii iV, undergoing kidney transplantation surgery, were allocated to receive either 0.45% saline (n = 26) or 0.9% saline solutions (n = 36). The patients received 2 L of 0.45% or 0.9% saline solutions with a CVP of 10 mmHg prior to a renal vein anastomosis. Serum sodium and potassium concentrations were measured before (Na0, K0) and after the administration of 2 L of 0.45% or 0.9% saline solutions (Na2, K2), respectively. RESULTS: Serum sodium concentrations decreased after the administration of 0.45% saline solutions, and after administrating 2 L of 0.9% saline, the serum sodium concentrations increased in patients with baseline serum sodium concentrations lower than 136 mEq/L. When we administered 0.9% saline, which had a sodium concentration lower than the serum sodium concentration, the serum sodium concentration measured after 2 L of 0.9% saline infusion proportionally decreased in patients with baseline serum sodium concentration greater than 136 mEq/L (P<0.001). CONCLUSiONS: For ideal fluid selection in chronic renal failure patients, this study suggests a 0.45% saline solution for chronic renal failure patients with a baseline serum sodium concentration below the normal range and a 0.9% saline solution for patients with a baseline sodium concentration within the normal range.
Humans ; Kidney Failure, Chronic* ; Kidney Transplantation ; Potassium ; Reference Values ; Renal Veins ; Sodium Chloride ; Sodium*

The present study was carried out to investigate morphological characteristics of pseudosclerotia of Grifola umbellata formed by artificial cultures. Isolate G. umbellata DUM GUS-01 was obtained from sclerotium cultivated in field. The fungal isolate was cultured on PDYM broth, PDYMA(potato dextrose yeast malt agar) and oak sawdust media at 20degrees C under the dark condition. G. umbellata DUM GUS-01 showed a volumetric increment of fungal lumps rather than mycelial growth. Particularly, G. umbellata DUM GUS-01 produced a large amount of melanin pigments in all culture treatments. The color of the fungal mass has been changed into grey gradually, and then formed melanized rind-like structure on its superficial part. The fungal structures which were covered with melanized rind-like layer were named as pseudosclerotia of G. umbellata. The pseudosclerotia of G. umbellata DUM GUS-01 formed a new white mycelial mass, which was swollen out of the melanized rind structure for its volumetric increment. When the pseudosclerotia were sectioned, their structure was discriminated from two structures such as a melanized rind-like structure layer formed by aggregation of aged mycelia and a white mycelial mass with high density. As results of scanning electron microscopic examination, the pseudosclerotia of G. umbellata DUM GUS-01 which were formed in in vitro conditions were similar to the sclerotia of G. umbellata cultivated in natural conditions except for the crystals formed in medula layer of natural sclerotia. Although size, solidity of rind structure and mycelial compactness of pseudosclerotia were more poor than those of natural sclerotia, the morphological structure and growth pattern of pseudosclerotia were very similar to those of natural sclerotia. Therefore, it is probable to induce pseudosclerotia to sclerotia of G. umbellata in in vitro conditions. Consequently, it seems that the induced pseudosclerotia can be used as inoculum sources to substitute natural sclerotia in field cultivation.
Fungal Structures ; Glucose ; Grifola* ; Melanins ; Yeasts

Parachute mitral valve is a rare congenital cardiac anomaly in which the chordae tendineae of both leaflets of the mitral valve insert into a single papillary muscle. We diagnosed a 54-year-old adult with dyspnea after upper respiratory infection, who was proven to have the parachute mitral valve. To the best of our knowledge, this is the oldest patient reported with this congenital anomaly. The clinical, echocardiographic and MRI findings are described. We recommended surgery for anomalous lesion, but the patient refused. After medical treatment, the patient recovered uneventfully and remained asymptomatic during a follow-up of 13 months.
Adult* ; Chordae Tendineae ; Dyspnea ; Echocardiography ; Follow-Up Studies ; Heart Defects, Congenital ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mitral Valve* ; Papillary Muscles