PURPOSE: While the safety and efficacy of laparoscopic adrenalectomy are relatively well documented, this procedure remains challenging for pheochromocytoma. The purpose of our investigation was to assess the perioperative profiles of laparoscopic adrenalectomy (LA) with those of open adrenalectomy (OA) in patients with pheochromocytoma. MATERIALS AND METHODS: Between January 1997 and October 2005, 31 patients with pheochromocytoma underwent surgical removal, including 15 LA and 16 OA. The LA was performed via a lateral decubitus transperitoneal approach. The mean tumor size was similar in both groups (LA 6.0cm vs. OA 5.7cm). All patients underwent extensive preoperative medical preparation with alpha-blockers. The intraoperative hemodynamic instabilities and perioperative profiles were retrospectively analyzed. RESULTS: No conversion to open surgery was required with either procedure and no mortality was observed. Hypertensive crisis (systolic blood pressure>200mmHg) and severe tachycardia (heart rate>100/min) were more common in the OA group (LA 13.3 and 26.7% vs. OA 56.3 and 62.5%). The mean operating times for both groups were similar (LA 182.0+/-47.0 min vs. OA 183.1+/-66.5 min), but the duration of hospitalization was shorter in the LA group (LA 5.3+/-2.2 days vs. OA 6.8+/-1.0 days). The estimated blood loss was greater in the OA group (LA 103.3+/-44.2ml vs. OA 159.4+/-66.8ml). Intravenous morphine was needed in 56.3% of the OA, but in only 13.3% of the LA group. There were no significant differences in the postoperative complications between the two groups. CONCLUSIONS: The laparoscopic resection of pheochromocytomas can be accomplished safely and effectively. A short hospital stay, with minimal perioperative morbidity and the eradication of endocrinopathy, support the minimally invasive approach for adrenalectomy in patients with pheochromocytoma.
Adrenalectomy* ; Conversion to Open Surgery ; Hemodynamics ; Hospitalization ; Humans ; Laparoscopy ; Length of Stay ; Morphine ; Mortality ; Pheochromocytoma* ; Postoperative Complications ; Retrospective Studies ; Tachycardia

With porcine vertebrae, the static and dynamic holding power of the pedicle screws under various conditions were measured to understand the biomechanical nature of the transpedicular screw fixation in spine. The objectives of the present study were; (1) to find the correlation between the insertion depth of the screw and the resulting holding power, (2) to determine the effect of bone cement augmentation on the screw fixation in a loosened hole, and (3) to assess the load-sharing mechanism between the cortical and the cancellous one surrounding the screw in this fixational system. The geomorphological characteristics of each porcine vertebra was measured directly with a micro-caliper. The bone mineral density of the specimens was also measured. Material with screw was holded in the fixed cross head of material testing system(Autograph E-10T). Testing force was applied and graph was obtained in the chart record. The results of the static pull-out tests in this study showed that there was a statistically-significant positive correlation between the screw diameter and the pull-out resistance(p < 0.05). The strength of the fixation did not actually increase as much as the insertion depth of the screw increased in these tests(r=0.457). In low-cycle fatigue tests, the increased number of cycles was required to clinical failure in the deeper-inserted crews. Considering the mechanical failure, a statistically-significant positive correlation between the failure cycle and the insertion depth was observed in both deep and shallow insertion groups(p < 0.05). Nonpressurized PMMA augmentation appeared to restore the ability of the screws to withstand pullout loading of the original value. On the effect of the cortical and cancellous bone, the most important factor was the cortical bone of the entrance near the screw.
Bone Density ; Fatigue ; Head ; In Vitro Techniques ; Pedicle Screws ; Polymethyl Methacrylate ; Spine

PURPOSE: A common side effect of the scalp reduction is a creation of a 'slot' with the hair growing in the opposite directions away from the scar. Overcoming the unnatural appearance of the slot has been a vexing problem in the scalp reduction surgery. None of the conventional corrective surgical techniques provides a complete and satisfactory aesthetic result. The Frechet flap is a triple transposition flap used for the correction of the slot defect secondary to scalp reduction surgery, seldom needing further scar revision. The Frechet technique provides a solution to the problem of the central slot concealment that is unattainable by other means, such as; Z-plasty and mini-graft. METHODS: Authors applied the Frechet technique to Asian patients who had undergone scalp reduction and operated on 4 patients from March, 2000 to January, 2001. Average follow-up period was 13 months. Patients with long scars passing through the temporoparietoccipital zone were excluded. All the undermining was performed in the subgaleal plane, reaching the upper auricular sulcus and stopping just above the nuchal ridge. RESULTS: None of the patients experienced infection, hematoma, nor any permanent hair loss. Transient telogen effluvium at the distal end of flap 2 and 3 was noticeable in one case. CONCLUSION: In conclusion, the results are aesthetically satisfactory without any significant complications.
Asian Continental Ancestry Group ; Cicatrix ; Follow-Up Studies ; Hair* ; Hematoma ; Humans ; Scalp

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.
Chest Pain ; Contrast Media* ; Coronary Angiography* ; Diatrizoate Meglumine ; Electrocardiography* ; Humans ; Ioxaglic Acid ; Osmolar Concentration

Amyloidosis of the prostate is a rare disease. With more patients undergoing biopsy of the prostate to exclude malignancy, the likelihood of identifying primary or secondary amyloidosis of the prostate has increased. We report a case of amyloidosis of the prostate in a 70-year-old man. The diagnosis was made from prostatic biopsy. Later, he was diagnosed with prostatic adenocarcinoma after transurethral resection of the prostate due to persistent lower urinary tract symptoms.
Adenocarcinoma ; Aged ; Amyloidosis* ; Biopsy ; Diagnosis ; Humans ; Lower Urinary Tract Symptoms ; Prostate* ; Rare Diseases

Amyloidosis of the prostate is a rare disease. With more patients undergoing biopsy of the prostate to exclude malignancy, the likelihood of identifying primary or secondary amyloidosis of the prostate has increased. We report a case of amyloidosis of the prostate in a 70-year-old man. The diagnosis was made from prostatic biopsy. Later, he was diagnosed with prostatic adenocarcinoma after transurethral resection of the prostate due to persistent lower urinary tract symptoms.
Adenocarcinoma ; Aged ; Amyloidosis* ; Biopsy ; Diagnosis ; Humans ; Lower Urinary Tract Symptoms ; Prostate* ; Rare Diseases

No abstract available.
Neuralgia ; Spinal Cord Compression ; Spinal Cord Diseases

BACKGROUND AND OBJECTIVES:In order to analyze and understand the oculomotor system completely, it is essential to measure horizontal, vertical, and torsional eye movements. We developed a new system of 3-dimensional videooculography that can accurately estimate the pupil center and measure torsional eye movement in real time while minimizing the errors caused by upper eyelid droop, eyelashes, corneal reflection, and eye blinking. MATERIALS AND METHOD:For accurate estimation of the center and diameter of the pupil, the edges of the pupil were searched by using a sector-form window and circle fitting was performed using the least square regression. Torsional eye movement was measured using polar cross-correlation technique with modification to lessen the errors produced by the change in pupil size. Calibrations were performed and to verify the proposed system, the linearity between the measured and actual eye movements was measured. Also, the results of the proposed system were compared with those of another commercialized system. RESULTS: The linearity between the measured and actual eye movements showed errors of less than 1%. The spatial resolutions of the system for horizontal, vertical, and torsional eye movements were 0.3, 0.4, and 0.2, respectively whereas the temporal resolution was 30 frames/sec. In comparison to the commercialized system, our system showed less artifact by eye blinking when measuring vertical eye movement. CONCLUSION:We proposed an algorithm and a system for measuring horizontal, vertical, and torsional eye movements which minimized the influence of partial eyelid closure, eyelashes, corneal reflections, and change in pupil size.
Artifacts ; Blinking ; Calibration ; Eye Movements* ; Eyelashes ; Eyelids ; Pupil

Acute vestibular syndrome (AVS) is characterized by the rapid onset of dizziness/vertigo accompanied by nausea/vomiting, gait unsteadiness, and nystagmus lasting a day or more. Some patients with AVS have potentially dangerous central etiologies. AVS caused by central etiologies without significant other neurologic deficit, so called pseudo-vestibular neuritis (pseudo-VN), could be difficult to be differentiated from acute vestibular neuritis. In addition to imaging studies, bedside oculomotor examination-head impulse test, nystagmus and test of skew)-is essential to identify patients with pseudo-VN. Among several central causes of AVS, brain tumor is extremely rare. We report a case of vascular tumor involving the anterior inferior cerebellum with AVS presentations.
Brain Neoplasms ; Cerebellum ; Gait ; Humans ; Neuritis ; Neurologic Manifestations ; Nystagmus, Pathologic ; Vertigo ; Vestibular Neuronitis

BACKGROUNDS: Standardization of nucleic acid amplification techniques (NAT) which can be achieved by the use of standard to validate reproducibility and sensitivity in each assay run is necessary before the introduction of such methods for routine screening of blood and blood products for viral contaminants. The objective of this study was to analyze the serological and genotypic characteristics of HCV positive plasmas and to manufacture the HCV RNA national standard candidate. METHODS: We obtained three plasmas from Blood Transfusion Research Institute, Korea, with highly positive HCV RNA plasmas (#37, #40, #46) and with normal plasma for dilution. All the plasmas were confirmed by enzyme immunoassay (EIA) test for anti-HIV, HBsAg, anti-HCV and by polymerase chain reaction(PCR) for HBV DNA, HIV RNA, HCV RNA. The genotypes of those were confirmed by INNO-LiPA HCV II. HCV RNA national standard candidate was manufactured by dispensing the diluted plasma into about 2,000 vials. Each vial was rapidly frozen using liquid nitrogen and was kept in refrigerator at -70 degrees C. RESULTS: All plasmas were identified as anti-HIV, HBsAg, HBV DNA, and HIV RNA negative plasmas. The genotypes of those were confirmed as 1b for #37, 1b or 2 for #40 and 2a or 2c for #46, respectively. Sample #37 was selected as the candidate material. After manufacturing, we obtained 1,944 vials for the candidate. CONCLUSION: In this study, we analyzed HCV positive plasmas and manufactured the HCV RNA national standard candidate. In near future, this material would be established for national standard to increase in the safety of blood and blood products in Korea.
Academies and Institutes ; Blood Transfusion ; DNA ; Genotype ; Hepacivirus ; Hepatitis B Surface Antigens ; HIV ; Immunoenzyme Techniques ; Korea ; Mass Screening ; Nitrogen ; Nucleic Acid Amplification Techniques ; Plasma* ; RNA*