Sclerosing hemangiomas are rare benign neoplasms in pulmonary parenchyme, We analyzed CT findings of two cases of sclerosing hemangiomas of the lung in two adult females. Chest radiograph showed well-circumscuribed, round soft tissue mass with calcification in right lower lobe of one patient and without calcification and moderate or marked contrast enhancement was clearly demonstrated with CT scan. CT findings of contratst enhancement and contour of calcification allow differentiation of sclerosing hemangioma from other venign neoplasms or postinflammotory pseudotusrs of the lung.
Adult ; Female ; Histiocytoma, Benign Fibrous* ; Humans ; Lung ; Pulmonary Sclerosing Hemangioma* ; Radiography, Thoracic ; Tomography, X-Ray Computed

PURPOSE: In 2004, a joint effort was undertaken between Dong-a University Hospital, Busan, Korea and Singapore General Hospital, Singapore, to promote laparoscopic radical prostatectomy (LRP) to yet another level by enhancing the human performance using a master-slave manipulator, the da VinciTM System. Herein, we report our initial experience of employing robotic telepresent technology to perform a LRP. MATERIALS AND METHODS: A 6-port modified transperitoneal approach was used. The da VinciTM System (Intuitive Surgical, Inc., California) consists of three components: a surgeon console, a robotic manipulator and a vision cart. Cable-driven mechanical "Endowrist" instruments are capable of delivering a complete range of motion at the instrument tips, allowing a total of 6 degrees of freedom. RESULTS: Five robotic-assisted LRP were performed. The mean patient age PSA and Gleason score were 65 years, 7.8ng/ml and 6.2, respectively. Overall, the system functioned well, without significant intraoperative errors. The mean operative time was 185 minutes in 2 patients with preservation of the neurovascular bundle, and 154 minutes in 2 patients with non-nerve sparing. In one patient, a bilateral pelvic lymphadenectomy was performed, with an operative time of 195 minutes. The mean blood loss and hospital stay were 245cc and 2.5 days, respectively. All patients maintained continence at 3 month follow-up. CONCLUSIONS: Intuitive hand-eye coordination, superb depth of perception and "Endowrist" instruments allowed tissue handling and suturing quite feasible during the LRP. Continuous effort is underway to further the surgical experience and advances in robotic technology. We believe robotic surgical systems will greatly facilitate and improve the LRP procedure.
Busan ; Follow-Up Studies ; Freedom ; Hospitals, General ; Humans ; Joints ; Korea ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Neoplasm Grading ; Operative Time ; Prostatectomy* ; Range of Motion, Articular ; Robotics ; Singapore

Rosai-Dorfman disease (RDD) is an idiopathic histioproliferative disorder of lymph node and extranodal site. Bone involvement is very rare. We report a case of extranodal RDD of the tibia in 32-year old male. The patient presented with pain with no evidence of lymphadenopathy. Clinico-radiologic diagnosis was metastatic carcinoma or Langerhans cell histiocytosis, but, histopathologic examination confirmed the diagnosis with RDD. We performed curettage on the osteolytic lesion of tibia. In South Korea, there was no report about RDD of the extremity and we want to report this case with review of the literature.
Curettage ; Diagnosis ; Extremities ; Histiocytosis, Langerhans-Cell ; Histiocytosis, Sinus* ; Humans ; Korea ; Lymph Nodes ; Lymphatic Diseases ; Male ; Tibia*

PURPOSE: Chronic pelvic pain syndrome (CPPS) is treated by use of various protocols. We compared tamsulosin monotherapy with tamsulosin in combination with antibiotics or anti-inflammatory agents and evaluated the efficacy of these treatments in patients with CPPS. METHODS: Patients (n=107) who were younger than 55 years and diagnosed with CPPS were randomly assigned to treatment with tamsulosin at 0.2 mg (group A), tamsulosin at 0.2 mg plus anti-inflammatory drugs (group B) or tamsulosin at 0.2 mg plus antibiotics (group C) daily. We applied the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS) to evaluate 100 patients who were treated for 12 weeks (7 withdrew). Scores of the three groups were compared by analysis of variance and we also evaluated subscores, which included pain, voiding and quality of life (QoL). RESULTS: All three groups showed statistically significant decreases in NIH-CPSI score, IPSS and subscore scores (P<0.05). There were no statistically significant differences between the groups except for the QoL domain of the IPSS (group A vs. C; P<0.01). CONCLUSIONS: Tamsulosin monotherapy for 12 weeks was effective for treating patients with CPPS, compared with combination therapy with antibiotics or anti-inflammatory drugs.
Academies and Institutes ; Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Humans ; Pelvic Pain ; Prostate ; Prostatitis ; Quality of Life ; Sulfonamides

PURPOSE: To evaluate the safety and efficacy of a laparoscopic nephroureterectomy in patients with a transitional cell carcinoma of the renal pelvis and ureter. MATERIALS AND METHODS: All patients underwent a nephroureterectomy for an upper tract transitional cell carcinoma. Of these, 23 and 22 underwent a laparoscopic nephroureterectomy (LNU) and open nephroureterectomy (ONU), respectively, between January 2002 and June 2006. After the nephrectomy had been performed, a 5-6cm modified Gibson incision was created to allow dissection of the lower ureter and bladder cuff, and extraction of the intact specimen. A retrospective analysis was performed on the operating time, blood loss, analgesic requirement, ambulation time, interval to resume oral intake, hospital stay, complications and follow-up results for both groups. RESULTS: The LNU was superior to the ONU with regard to the mean operation time; 275 (190-390) versus 258 (180-400) (p=0.259), blood loss; 188 (130-250) versus 488ml (350-750) (p<0.05), ambulation time; 2.5 versus 3.3 days (p<0.05), interval to resume oral intake 2.1 versus 2.8 days (p<0.05), and hospital stay; 8.3 versus 11.1 days (p<0.05). Complications developed in 4 and 5 of the LNU and ONU patients, respectively, but all were resolved with conservative management. The mean follow-up duration of the LNU and ONU groups were 29 versus 14 months, respectively. CONCLUSIONS: Based on our experience, a laparoscopic nephroureterectomy is better tolerated with respect to pain, has less blood loss, shorter hospital stays, ambulation time and time to oral intake. LNU is safe for an upper tract transitional cell carcinoma, and is also an efficacious alternative to open surgery. However, a long-term follow-up will be warranted to ascertain accurate oncologic data.
Carcinoma, Transitional Cell* ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Length of Stay ; Nephrectomy ; Retrospective Studies ; Ureter ; Urinary Bladder ; Urinary Tract* ; Walking

PURPOSE: The purpose of this study was to evaluate the oncologic outcomes of parosteal osteosarcoma (POS) and to ascertain the fates of patients after local recurrence (LR). MATERIALS AND METHODS: The authors retrospectively reviewed 22 POS patients with an average follow-up of 114 months (range: 36-235 months). Seven of the 22 patients were referred after LR. There were 17 Stage IB and 5 Stage IIB (G2, 2; dedifferentiation, 3). Tumors were located in the femur (11) and in other locations (11). Initial surgical margins were wide in 10, marginal in 5, and intralesional in 7. Correlations between clinico-pathologic variables and LR and clinical courses after LR were evaluated. RESULTS: The 10-year overall survival rate was 85.7%. Three (14%) patients developed distant metastasis and all of them succumbed to the disease. Nine (41%) patients developed LR. Tumor location, resection type, and surgical margin were found to be correlated with LR. At final follow-up, 7 of the 9 patients that experienced local failure achieved no evidence of disease. CONCLUSION: A substantial risk of misdiagnosis exists, especially for POS in other than a femoral location. Recurrent tumor re-excision is possible in most cases; however, patients with an aggressive recurrence pattern deserve special attention.
Diagnostic Errors ; Femur ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteosarcoma ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: We analyzed the oncologic characteristics and outcome of patients with inflammatory myofibroblastic tumor of extremities. MATERIALS AND METHODS: Among the soft tissue tumor patients who were treated between 1999 and 2012, 5 patients who were pathologically confirmed as the inflammatory myofibroblastic tumor of extremities were analyzed retrospectively. RESULTS: There were 1 man and 4 women with mean age of 44 years (37-55 years). The average follow up was 34.6 months (8-87 months). All patients underwent surgical treatment. Only 1 patient had wide resection margin and remaining 4 had marginal (3) or intralesional (1) resection margin. All of 4 patients without wide resection margin developed local recurrence at 10.3 months (8-19 months). Malignant transformation to fibrosarcoma was occurred in 2 patients who developed local recurrence, and 1 patient developed multiple metastases to lung, liver and lymph nodes and expired at 37 months. Three of 5 patients had tumor location abutted to or invasion to major arteries and 1 patient had tumor invading sciatic nerve. CONCLUSION: It is observed that inflammatory myofibroblastic tumor of extremities is usually located near the major neurovascular structure. Wide resection should be considered as the initial surgical treatment because this tumor showed a high local recurrence rate and possibility of malignant transformation.
Arteries ; Extremities ; Female ; Fibrosarcoma ; Follow-Up Studies ; Humans ; Liver ; Lung ; Lymph Nodes ; Myofibroblasts ; Neoplasm Metastasis ; Recurrence

Retrocaval ureter is a rare congenital anomaly that causes symptomatic hydronephrosis. Despite difficulties in the intracorporeal suturing, a retrocaval ureter is thought to be a good candidate for laparoscopic surgery, especially from the cosmesis. Laparoscopic ureteroureterostomy has advantages compared to conventional open surgery in terms of less pain, decreased blood loss, smaller operative wound and shorter hospital stay. Herein, we report our initial experience of laparoscopic ureteroureterostomy in a patient with a retrocaval ureter.
Humans ; Hydronephrosis ; Laparoscopy ; Length of Stay ; Retrocaval Ureter* ; Sutures ; Ureter ; Wounds and Injuries

PURPOSE: This study was conducted to analyze the efficacy of photoselective vaporization of the prostate (PVP) with the use of a 980 nm diode laser for benign prostatic hyperplasia (BPH) according to postoperative period. MATERIALS AND METHODS: Data were collected from 96 patients who were diagnosed with BPH and who underwent PVP with the 980 nm K2 diode laser. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and post-void residual volume (PVR), were assessed and compared with preoperative baseline values. RESULTS: The mean prostate volume was 45.3+/-15.6 g, the mean operative time (lasing time) was 22.9+/-18.3 minutes, the total amount of energy was 126+/-84 kJ, and the Foley catheter maintenance period after PVP was 24.8+/-5.6 hours. At 1 month, significant improvements were noted in IPSS (11.7+/-6.6), QoL score (2.3+/-1.1), Qmax (12.7+/-6.1 ml/sec), and PVR (41.9+/-30.5 ml). After 3 months, all follow-up parameters showed significant improvements that were sustained throughout a period of 6 months after PVP. CONCLUSIONS: PVP using a K2 diode laser is a minimally invasive and effective surgical method for improvement of BPH and is associated with minimal morbidity.
Catheters ; Follow-Up Studies ; Humans ; Lasers, Semiconductor ; Operative Time ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Residual Volume ; Urodynamics ; Volatilization

PURPOSE: We analyzed the oncologic outcome of the malignant transformed benign giant cell tumor of bone. MATERIALS AND METHODS: Between January 2000 and February 2012, 5 cases were referred with suspicious malignant transformation of benign giant cell tumor. No patients underwent radiation therapy. RESULTS: After referral, all patients received the wide excision of the tumor and its' pathologic diagnosis were osteosarcoma. As classified by the location of tumor lesion, 3 cases were located in the distal femur, 1 case was in the distal radius and 1 case was in the proximal femur. The average latent period between diagnosis of benign giant cell tumor and diagnosis of secondary malignant giant cell tumor was 49.2 months. (range, 24-126 months) The mean follow-up period was 21.6 months. There were subsequent local recurrence in 2 cases and 3 patients developed distant metastasis. All patients with lung metastasis were dead. CONCLUSION: Malignant transformation of benign giant cell tumor of bone can be occurred within 5 years. Therefore, when benign giant cell tumor suspicious malignant transformation, it is necessary to do more aggressive treatment.
Femur ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Humans ; Lung ; Neoplasm Metastasis ; Osteosarcoma ; Radius ; Recurrence ; Referral and Consultation