A colonic intussusception caused by an intraluminal lipoma is a rare disease in adults, in whom it usually has a definite organic cause. In fact, it is either caused by a benign or a malignant condition, both of which occur at similar rates. However, little literature is available on laparoscopic procedures for use in cases of adult colonic intussusceptions. Recently, a 52-year-old woman was admitted to our hospital with abdominal pain of one-month duration. Abdominal computed tomography showed an intussusception with a fat-containing mass in the right hepatic area. Colonoscopy showed a colon lumen occupied by the mass. A right hemicolectomy was performed laparoscopically, and the cause of the intussusception was found to be a lipoma. Before obtaining histological confirmation, we carefully perform a laparoscopic procedure, which required consideration of the relations between the involved colonic segment and other conditions such as the location of main vessels, the anatomical exposure with respect to colonic mobilization and the location of specimen retrieval.
Abdominal Pain ; Adult ; Colon ; Colon, Ascending ; Colonoscopy ; Female ; Humans ; Intussusception ; Laparoscopy ; Lipoma ; Rare Diseases

Heterotopic prostatic tissue has been reported in a variety of sites within and outside the urinary tract. Extra-urethral ectopic prostatic tissue is a distinct entity and may be more common than previously thought. We report a case of heterotopic prostatic tissue in 71-year-old man. Pelvic CT scan showed a well circumscribed cystic mass in the retrovesical space. Grossly, the tumor was 7.5 7.0 2.8 cm and revealed an ovoid unilocular cyst containing grayish amorphous granular materials. The prostatic origin of the tissue was confirmed by immunohistochemical staining for prostate specific antigen.
Aged ; Humans ; Prostate-Specific Antigen ; Tomography, X-Ray Computed ; Urinary Tract

Eight neonates with transient tricuspid insufficiency are presented which was confirmed clinical and two dimensional echocardiographic assessment. We found that two dimensional Doppler echocardiography was very useful in the detection of transient tricuspid insufficiency during neonatal age as noninvasive method. Transient tricuspid insufficiency is a clinical disorder in the newborn period caused by myocardial dysfunction, secondary to asphyxia with or without hypoglycemia and associated with right ventricular overloading caused by pulmonary hypertention. The clinical diagnosis was based on a history of perinatal distress, distinctive murmur, ECG changes, biochemical abnormalities and myocardial imaging. 1) The sex ratio of TTI was 1:1. 2) The average gestational age was 34 weeks and mean body weight was 2.06 Kg, respectably. 3) Major symptoms were dyspnea, cyanosis, and tachypnea. 4) Tricuspid regurgitation was detected from the lst day to the 4th day of the life and was improved from the 7th day to the 30th day of the life. 5) The peak velocity through tricuspid valve ranged from the 2.7 m/sec to 4.0 m/sec and the estimated right ventricular pressure ranged from 39 mmHg to 74 mmHg. 6) Associated diseases were neonatal hyperbilirubinemia (100%), prematurity (87.5%), atrial right to left shunt (87.5%), patent ductus arteriosus (75%), hyaline membrane disease (25%), and transient tachypnea of newborn (12.5%).
Asphyxia ; Body Weight ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Dyspnea ; Echocardiography* ; Echocardiography, Doppler ; Electrocardiography ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Hyperbilirubinemia, Neonatal ; Hypoglycemia ; Infant, Newborn ; Sex Ratio ; Tachypnea ; Transient Tachypnea of the Newborn ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ventricular Pressure

A 49 years old male patient who suffered from deterioration of posterior neck pain, left hand numbness, left lower limb pain and gait disturbance for 3 years visited our outpatient department. He had been diagnosed as non-dysraphic cervical intradural lipoma and operated in August 1990. On the radiologic images, we found the regrowth of non-dysraphic cervical intradural lipoma from C2 to C7 level, which surrounds and compresses the cervical spinal cord. Previous subtotal laminectomy from C2 to C7 and severe cervical lordosis were also found. Appropriate debulking of lipoma mass without duroplasty was successfully done with intraoperative neurophysiological monitoring (IONM). We are following up the patient for 24 months via outpatient department, his neurologic symptoms such as hand numbness, gait disturbance, left lower limb pain and posterior neck pain have improved. We describe a rare case of regrowth of non-dysraphic cervical intradural lipoma.
Animals ; Gait ; Hand ; Humans ; Hypesthesia ; Intraoperative Neurophysiological Monitoring ; Laminectomy ; Lipoma* ; Lordosis ; Lower Extremity ; Male ; Neck Pain ; Neurologic Manifestations ; Outpatients ; Spinal Cord ; Spinal Dysraphism*

OBJECTIVE: The purpose of this study is to evaluate clinical and radiological outcomes analysis of the laminoplasty in the elderly patients, and to compare with the non-elderly patients. METHODS: A retrospective study of the short term result in patients who had treated with the laminoplasty for cervical spondylotic myelopathy (CSM) was performed. From January 2008 to December 2012, total 62 patients were operated with single open-door technique because of CSM; 28 patients were the elderly and 34 patients were the non-elderly. We evaluated some factors including sex, symptom duration, estimated blood loss during operation, operation time, hospitalization day, complications, pre- and postoperative modified Japanese Orthopedic Association (mJOA) score, recovery rate of mJOA score, achieved mJOA score, mean cervical canal width and expansion ratio of antero-posterior diameter in order to identify difference between the two group. Clinical outcomes were calculated with the recovery rate of mJOA score at the time of one year after operation. RESULTS: Mean age were 71.9 in the elderly group and 52.9 in the non-elderly group. Although postoperative mJOA score in the elderly group was lower than that of the non-elderly group, achieved mJOA score was statistically same between the two groups. Other clinical and radiological outcomes were also statistically same. CONCLUSION: We conclude that the laminoplasty also assures good clinical outcomes in the elderly patients with CSM, same as in the non-elderly group.
Aged* ; Asian Continental Ancestry Group ; Hospitalization ; Humans ; Orthopedics ; Retrospective Studies ; Spinal Cord Diseases*

Objective: If empirical antibiotics must be administered, the pharmacy needs to deliver the drug to emergency patients as soon as possible. The purpose of this study was to investigate the impact of the installation of an automated dispensing cabinet system in an emergency center. Methods: A retrospective study was conducted through the analysis of medical records in an emergency medical center for 12 months before and after the installation of the system. The order-to-antibiotic time and door-to-antibiotic time were collected retrospectively through a system log analysis. For the satisfaction survey, nursing providers who use the dispensing system were administered a survey questionnaire related to the system. Results: This study covered 1,292 prescriptions before and 1,377 after the introduction of the system in the emergency center. It was observed that the average time from the order-to-drug administration decreased (48.7±57.9 vs. 41.1±52.3, P=0.001) after the introduction of the system. The door-to-drug administration time also showed a decrease (293.6±260.2 vs. 267.4±221.1, P=0.006). A satisfaction survey was conducted on 38 users of the system who agreed to participate and respond. The score of the satisfaction survey was 3.63±0.44. The user response showed that they were most satisfied with the prevention of medication errors (4.00±0.62) and system control (4.00±0.57). Conclusion The automated dispensing cabinet system in an emergency center can shorten the order-to-drug time and door-to-drug time. In addition, it helps to improve the satisfaction and work efficiency of emergency medical workers related to medication dispensation.

PURPOSE: Carcinoembryonic antigen (CEA) is the most widely used tumor marker for detecting colorectal cancer. This study was designed to evaluate the level of serum CEA that is associated with recurrence after potentially curative surgery for colorectal cancer. METHODS: We retrospectively investigated the pre- and post-operative levels of serum CEA in 246 patients with colorectal cancer and they had undergone potentially curative surgery from 1996 through 2005. RESULTS: The pre-operative CEA level was significantly associated with the number of metastatic lymph nodes, the tumor size and the recurrence rate. The feature that was associated with recurrent disease on multivariate analysis was the pre-operative level of serum CEA. CONCLUSION: In order to detect the recurrence of colorectal cancer, we should closely follow up with frequent checks of the CEA level after surgery for those patients who had a high preoperative CEA level.
Carcinoembryonic Antigen ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Recurrence ; Retrospective Studies

We describe a 75-year-old man with a cervico-thoraco-lumbar spinal epidural abscess was extended to the psoas muscle. The patient complained high fever and back pain, followed by weakness of the lower extremities. He had received multiple epidural injections in a local pain clinic just few days before the onset of fever. The multi-segmental epidural abscess which was demonstrated by MRI compressed dural sac and cord. The best way to recommend him was to undergo a surgical decompression, but he refused the surgery. Next, we chose nonsurgical treatment such as longstanding parenteral antibiotic therapy and percutaneous drainage of psoas abscess. We could cultivate a causative organism and chose appropriate antibiotics. The patient experienced immediate relief of fever and the improvement of laboratory findings, gradual relief of back pain and full neurological recovery.
Aged ; Anti-Bacterial Agents ; Back Pain ; Decompression, Surgical ; Drainage ; Epidural Abscess ; Fever ; Humans ; Injections, Epidural ; Lower Extremity ; Pain Clinics ; Psoas Abscess ; Psoas Muscles

To evaluate a new reliable sclerosant of the gallbladder, we attempted gallbladder ablation with 10% phenol, and the results compared with those from using 95% ethanol which had been used previousy as gallbladder sclerosing agent in laboratory animals in other reports. After laparotomy, ligation of the cystic dusts with silk and cannulation of gallbladder with 18 gauge angiocatheter were done. Then, transcatheter administration of two different scleroing agents was performed in 8 rabbits respectively and normal saline in four rabbits as a control. Additionally, preliminary washing with each agent were implemented to prevent the dilutional effect of residual bile and bleeding. All animals survived without complication. Eight animals were used for each agent, four each being sacrified two weeks and six weeks after adminstration of sclerosing agents respectively. In our results, 10% phenol was more effective than 95% ethanol in denuding the gallbladder epithelium and promoting fibrosis of gallbladder wall, And it was relatively safe in regard to the dilutional effect of residual fluid and bleeding during procedure. Toxic effects on the liver evaluated by examination of histologic specimen were non-specific except for edematous swelling on some cases, which had also been observed on others including control group. 10% phenol can be considered to be a promosing sclerosant for gallbladder ablation, but further study of its toxicity is needed before its application on human gallbladder.
Animals ; Animals, Laboratory ; Bile ; Catheterization ; Dust ; Epithelium ; Ethanol ; Fibrosis ; Gallbladder* ; Hemorrhage ; Humans ; Laparotomy ; Ligation ; Liver ; Phenol* ; Rabbits* ; Sclerosing Solutions ; Sclerosis* ; Silk