No abstract available.
Neurofibroma, Plexiform* ; Urinary Bladder*

No abstract available.
Depression* ; Myocardial Ischemia*

A giant cutaneous horn (GCH) is a morphological description of huge, conical, dense, hyperkeratotic protrusion. Because of its bizarre shape and associated risk of malignancy, GCH requires proper treatment. A 48-year-old male patient visited our department with a GCH on a burn scar of his right hand. It had started to develop about 8 months previously. At initial physical examination, the lesion presented as a hard, dark brown mass of basal area 4×3.5 cm², and height 3.5 cm. Preoperative biopsy confirmed the absence of malignancy. We performed excision of the entire GCH, and biopsy and repaired the resulting defect with full-thickness skin graft. Histopathologic results revealed that all surgical margin were negative for malignancy. Microscopically, the lesion exhibited marked regular acanthosis, parakeratosis and hyperkeratosis with granular layer loss. At 3 months postoperatively, no complication was observed. According to Mantese et al., 58.56% of GCHs originate from malignant or premalignant lesions. And thus, a histopathologic examination is mandatory, and if an accompanying malignant lesion is found, additional resection should be undertaken. In another study, it was concluded the risk of premalignancy or malignancy depends on development time. In our case, the GCH had grown from a burn scar, this has not been previously reported in Korea. Surgeons need to be aware cutaneous horn harbors risks of premalignancy or malignancy, and that histopathological evaluation is indispensable for treatment decision making.
Animals ; Biopsy ; Burns* ; Cicatrix* ; Decision Making ; Hand ; Horns* ; Humans ; Korea ; Male ; Middle Aged ; Parakeratosis ; Physical Examination ; Skin ; Surgeons ; Transplants

We report a case of trichoblastic fibroma involving the scrotum in a 60-year-old man. Trichoblastic fibroma is very rare and benign trichogenic tumor that has both epithelial and mesenchymal components and histologically recount the embryologic development of the hair follicle. The diagnosis was confirmed by histopathologic examination.
Diagnosis ; Fibroma* ; Hair Follicle ; Humans ; Middle Aged ; Scrotum*

Syncopes are the most common non-epileptic attacks mimicking epileptic seizures. Among them, cardiogenic syncope is potentially life threatening. A 49 year old man was refered for the recurrent episodes of loss of consciousness with tonic posture and upward eyes deviation. The electrocardiogram showed polymorphologic ventricular tachycardia during attacks, which normalized after that. He was treated with isoproterenol and symptoms subsided. Here, we report a case of ventricular tachycardia manifested as epileptic seizures.
Electrocardiography ; Epilepsy* ; Isoproterenol ; Posture ; Seizures ; Syncope ; Tachycardia, Ventricular* ; Unconsciousness

PURPOSE: Periappendiceal abscess (PAA) is a severe complicated appendicitis with high morbidity. Non-surgical treatment followed by interval appendectomy (IA) is associated with lower complication rate compared with emergency surgery (ES) and minimally invasive surgery (MIS) can be done more often. The purpose of this study is to assess the incidence and factors predictive of complications of surgery for PAA and to evaluate the clinical effectiveness of IA as a treatment policy to increase MIS. METHODS: Retrospectively, we reviewed 171 patients undergoing surgery for PAA between 2011 and 2016 at Ulsan University Hospital. The incidence and influence of different factors were assessed by univariate and multivariate analyses. RESULTS: In 171 patients, 28 (16.4%) developed postoperative complications, which included; wound complications (7.6%), intra-abdominal abscess (4.1%) and ileus (2.9%). In both analyses, only ES was independently associated with postoperative complications; (Relative risk, 15.0; 95% Confidence interval, 2.4~92.5). Comparing the IA and ES groups revealed that operative time, complication rate, laparoscopic approach, postoperative hospitalization, postoperative antibiotic use and bowel resection rate were significantly different. The postoperative complication rate of patients with PAA in ES group was 28.7%, which was statistically higher than that of IA group (3.6%). Especially, MIS rate was more than 9-times greater in the IA group (98.8% vs. 10.3%, p<0.001). Although the IA group required additional hospitalization, there was no statistical difference between the two groups in total length of hospital stay. CONCLUSION: Morbidity was high for patients who had emergency surgery for PAA. ES was the only factor associated with postoperative morbidity. IA can reduce the postoperative complication rate and allowed MIS to be used more often as a useful treatment policy for PAA.
Abdominal Abscess ; Abscess* ; Appendectomy* ; Appendicitis ; Emergencies ; Hospitalization ; Humans ; Ileus ; Incidence ; Length of Stay ; Minimally Invasive Surgical Procedures ; Multivariate Analysis ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Ulsan ; Wounds and Injuries

PURPOSE: Mesh non-fixation in TEP is associated with lower cost and shorter operative time, and it is safe and recommended when performed by an experienced surgeon. In performance of TEP surgery using a non-fixation mesh, particularly by a non-experienced surgeon, prevention of mesh migration is an important issue for mesh application. The aim of this study was to report on a fixation method using a non-preformed mesh encircling a cord structure without the use of tacks, staples, or fibrin sealants in TEP surgery. METHODS: A total of 41 patients who had undergone mesh-encircling TEP without fixation from December 2008 (first case of surgery) to June 2012 were analyzed. RESULTS: The mean follow-up period was 23.2 months (12~35 months). Three patients complained of scrotal discomfort, and one patient complained of scrotal edema, but they were resolved with conservative management. There was no recurrence during the follow up period. CONCLUSION: The method of mesh-encircling TEP without fixation material and no additional mesh in which the slit of the mesh is wrapped around the cord structure using an overlay suture is a simple and safe technique without compromising recurrence or chronic pain.
Chronic Pain ; Edema ; Fibrin Tissue Adhesive ; Follow-Up Studies ; Hernia, Inguinal* ; Humans ; Operative Time ; Recurrence ; Sutures

BACKGROUND: The effects of omega-3 polyunsaturated fatty acids (PUFAs) on cerebral vessels have not been clarified until now. Thus we investigated the efficacy of omega-3 PUFAs supplementation on cerebral blood flow velocity and vascular resistance via transcranial doppler (TCD). METHODS: Consecutive twenty patients (13 male and 7 female) with at least 1 cerebrovascular risk factor or a known cerebrovascular disease were enrolled. Patients were treated with omega-3 PUFAs (1 g, two times per day) for 12 weeks. Cerebral blood flow velocity, resistance index, and pulsatile index were checked before and after 12 weeks of treatment using TCD. RESULTS: The change of resistance index in right MCA (from 0.58 +/- 0.07 to 0.55 +/- 0.07, p = 0.042) and left PCA (from 0.56 +/- 0.07 to 0.53 +/- 0.06, p = 0.037) showed significant improvement after 12 weeks of omega-3 PUFAs treatment. The changes in other vessels, however, failed to show any significant changes compared to the baseline. CONCLUSIONS: Omega-3 PUFAs treatment showed feasible efficacies for cerebral vascular resistances in this open label trial. To confirm these results, larger samples of patients and longer period of follow-up is warranted.
Blood Flow Velocity ; Fatty Acids, Unsaturated ; Follow-Up Studies ; Humans ; Male ; Passive Cutaneous Anaphylaxis ; Risk Factors ; Vascular Resistance*

Authors requested to change the name of the hospital to proper name.

Objective: : This retrospective study investigated the clinical and angiographic characteristics of ruptured true posterior communicating artery (PCoA) aneurysms in comparison with junctional PCoA aneurysms presenting with a subarachnoid hemorrhage. Methods: : The medical records and radiological data of 93 consecutive patients who underwent three-dimensional rotational angiography and surgical or endovascular treatment for a ruptured junctional or true PCoA aneurysm over an 8-year period were examined. Results: : The maximum diameter of the ruptured true PCoA aneurysm (n=13, 14.0%) was significantly smaller than that of the ruptured junctional PCoA aneurysms (n=80, 4.45±1.44 vs. 7.68±3.36 mm, p=0.001). In particular, the incidence of very small aneurysms <4 mm was 46.2% (six of 13 patients) in the ruptured true PCoA aneurysm group, yet only 2.5% (two of 80 patients) in the ruptured junctional PCoA aneurysm group. Meanwhile, the diameter of the PCoA was significantly larger in the true PCoA aneurysm group than that in the junctional PCoA aneurysm group (1.90±0.57 vs. 1.15±0.49 mm, p<0.001). In addition, the ipsilateral PCoA/P1 ratio was significantly larger in the true PCoA aneurysm group than that in the group of a junctional PCoA aneurysm (mean PCoA/P1 ratio±standard deviation, 2.67±1.22 vs. 1.14±0.88; p<0.001). No between-group difference was identified for the modified Fisher grade, clinical grade at admission, and 3-month modified Rankin Scale score. Conclusion : A true PCoA aneurysm was found to be associated with a larger PCoA and ruptured at a smaller diameter than a junctional PCoA aneurysm. In particular, the incidence of a ruptured aneurysm with a very small diameter <4 mm was significantly higher among the patients with a true PCoA aneurysm.