Small bowel obstruction (SBO) is a common complication after abdominal surgery, and can occur due to many reasons. However, cryptorchidism can cause SBO in patients with no history of abdominal surgery. We report the case of a 67-year-old man with SBO caused by adhesions between an undescended testis and the terminal ileum.
Adult* ; Aged ; Cryptorchidism* ; Humans ; Ileum ; Intestinal Obstruction ; Male

PURPOSE: We report a case of orbital B-cell lymphoblastic lymphoma in a 7-year-old boy. METHODS: A 7-year-old boy presented with proptosis and periorbital swelling of his left eye following a periorbital blunt trauma 1-month prior. During the course of routine ophthalmologic and radiologic examinatinos, the swelling spontaneously subsided without specific treatment. An outpatient follow-up was planned, but the swelling recurred 6 months later. An orbital CT and MRI showed an irregular mass with an indistinct margin in the left orbit, for which an incisional biopsy was performed. RESULTS: The orbital mass consisited of monotonous small to medium sized lymphoid cells with evenly dispersed open chromatin, thin nuclear membrane and inconspicuous nucleoli. Immunohistochemistry revealed that the cells were positive for CD79a and TdT, but negative for CD3 and CD5. These findings were compatible with a diagnosis of B cell lymphoblastic lymphoma. CONCLUSIONS: Lymphoblastic lymphoma of the orbit should be suspected and considered in the differential diagnosis for children with acutely progressing orbital mass.
B-Lymphocytes* ; Biopsy ; Child ; Chromatin ; Diagnosis ; Diagnosis, Differential ; Exophthalmos ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymphocytes ; Magnetic Resonance Imaging ; Male ; Nuclear Envelope ; Orbit* ; Outpatients ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Nerve sheath myxoma or neurothekeoma, a rare cutaneous neoplasm probably originating from the nerve sheath, is classified into three groups as classical, cellular, and mixed types based on cellularity, mucin content and growth patterns. Only two cases of nerve sheath myxoma have been reported in the Korean literatures. We report a case of nerve sheath myxoma occurring on the scalp of a 29 year-old woman. It was identified as the mixed type by histopathological, immunohistochemical and electronmicroscopic findings.
Adult ; Female ; Humans ; Mucins ; Neurothekeoma* ; Scalp ; Talus

Kawasaki disease is an acute febrile vasculitis of childhood and leading cause of acquired heart disease in children. The illness occurs predominantly in young children and only occasionally occurs in teenagers and adults. So we report a case of adolescent-onset Kawasaki disease associated with congestive heart failure and development of coronary dilatation. A 16-year-old girl presented with fever, truncal rash, congestive heart failure due to myocarditis, bilateral conjunctival injection, strawberry tongue, redness of hands and feet, and cervical adenopathy. After Kawasaki disease was diagnosed, intravenous gamma globulin(2 g/kg) and aspirin(70 mg/kg/day) were administered. On the 20th hospital day, echocardiography showed moderate dilatation of right coronary artery. Four months after the discharge, follow up echocardiography showed sustained dilatation of right coronary artery.
Adolescent* ; Adult ; Child ; Coronary Vessels ; Dilatation ; Echocardiography ; Estrogens, Conjugated (USP)* ; Exanthema ; Female* ; Fever ; Follow-Up Studies ; Foot ; Fragaria ; Hand ; Heart Diseases ; Heart Failure* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Tongue ; Vasculitis

Kawasaki disease is an acute febrile vasculitis of childhood and leading cause of acquired heart disease in children. The illness occurs predominantly in young children and only occasionally occurs in teenagers and adults. So we report a case of adolescent-onset Kawasaki disease associated with congestive heart failure and development of coronary dilatation. A 16-year-old girl presented with fever, truncal rash, congestive heart failure due to myocarditis, bilateral conjunctival injection, strawberry tongue, redness of hands and feet, and cervical adenopathy. After Kawasaki disease was diagnosed, intravenous gamma globulin(2 g/kg) and aspirin(70 mg/kg/day) were administered. On the 20th hospital day, echocardiography showed moderate dilatation of right coronary artery. Four months after the discharge, follow up echocardiography showed sustained dilatation of right coronary artery.
Adolescent* ; Adult ; Child ; Coronary Vessels ; Dilatation ; Echocardiography ; Estrogens, Conjugated (USP)* ; Exanthema ; Female* ; Fever ; Follow-Up Studies ; Foot ; Fragaria ; Hand ; Heart Diseases ; Heart Failure* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Tongue ; Vasculitis

PURPOSE: To comparatively analyze treatment-related adverse events and the treatment dropout rate between immunochemotherapy and target therapy in Korea. MATERIALS AND METHODS: Forty-nine subjects with metastatic renal cell carcinoma (21 target therapy recipients and 28 immunochemotherapy recipients) who underwent either 6-week cycles of sunitinib treatment (50 mg once daily for 4 weeks on and 2 weeks off) or 8-week cycles of immunochemotherapy (combination of interleukin [IL]-2, interferon [IFN]-alpha, and 5-fluorouracil [FU]) were enrolled. Treatment-related toxicity was objectively graded and quantitative analysis was performed with a scoring system. Patient compliance was categorized into three classes (1: administration as scheduled, 2: dose modification required, 3: discontinuation required). RESULTS: Compared with those of the immunochemotherapy group, subjects of the sunitinib-treatment group had higher occurrence rates of mucositis-stomatitis (43% vs. 10%), hand-foot syndrome (38% vs. 0%), diarrhea (33% vs. 14%), and hypertension (33% vs. 14%). According to the toxicity-grade-based scoring system, the total incidence and severity of toxicities were not significantly different between the two groups (p>0.05), whereas high-grade hematologic toxicities were more frequent in the immunochemotherapy group. The dropout rate of the immunochemotherapy group was significantly higher than that of the sunitinib group (administration as scheduled: 52% vs. 21%, p=0.026; discontinuation required: 19% vs. 50%, p=0.037). CONCLUSIONS: The results of this study are indicative of a comparable treatment-related toxicity profile of sunitinib and greater adherence to the treatment protocol in comparison with immunochemotherapy in patients with metastatic renal cell carcinoma (mRCC).
Carcinoma, Renal Cell ; Clinical Protocols ; Diarrhea ; Fluorouracil ; Hand-Foot Syndrome ; Humans ; Hypertension ; Immunotherapy ; Incidence ; Indoles ; Interferons ; Interleukins ; Korea ; Patient Compliance ; Patient Dropouts ; Pyrroles

Myoepitheliomas are well-established to occur in the salivary glands, but they have also been described in the breast, upper aerodigestive tract, skin, and soft tissues. We report here on a unique case of primary myoepithelioma that occurred in the right testis of a 28-year-old man. The tumor was entirely confined to the testis and it was clearly separated from the epididymis. Histopathology revealed mixed architectural patterns in which the reticular areas merged into the chondromyxoid stroma. The tumor cells, which were focally immunoreactive to pancytokeratin and S-100 protein, were round to ovoid and spindly arranged in cords, strands, and fascicles. They showed mild nuclear pleomorphism, sparse mitotic figures and a low Ki-67 proliferative index. There was no ductal differentiation in the tumor. To the best of our knowledge, there has been only one case report of a primary testicular myoepithelioma in the English medical literature.
Adult ; Breast ; Epididymis ; Humans ; Male ; Myoepithelioma ; S100 Proteins ; Salivary Glands ; Skin ; Testis

PURPOSE: The aim of this research was to compare surgical outcomes and complications of obese and non-obese patients who underwent open radical nephrectomy (ORN) and laparoscopic radical nephrectomy (LRN). MATERIALS AND METHODS: The data of 26 ORN patients and 30 LRN patients between January 2006 and December 2008 were analyzed. Patients with a body mass index (BMI) of 25.0 kg/m2 or more were defined as obese, and those with a BMI of <25.0 kg/m2 were defined as non-obese. All patients were divided into two groups according to the criteria above to compare demographic and clinical and pathologic parameters. RESULTS: The mean BMIs of the 15 obese patients in the ORN group and the 13 obese patients in the LRN group were 26.8+/-1.1 and 27.7+/-2.4, respectively. LRN was enormously effective for lowering estimated blood loss (EBL) and postoperative days compared with ORN. Operation times and EBL in ORN were affected by obesity, both of which were increased. In contrast, the data of both LRN groups indicated similar outcomes. The perioperative data of obese patients revealed LRN to have reduced blood loss (143.0+/-62.7 vs. 446.7+/-222.4 ml, p=0.001) and not significantly different postoperative days (7.3+/-2.2 vs. 8.4+/-1.5 days, p=0.065). Operation time, however, did not differ significantly among obese patients between ORN and LRN. The complications due to LRN had no relation with obesity, whereas ORN had an increased complications rate (34.6% vs. 3.8%). CONCLUSIONS: This study shows that LRN is more effective than ORN for both obese and non-obese patients with regard to perioperative outcomes and complication rates.
Body Mass Index ; Carcinoma, Renal Cell ; Humans ; Laparoscopy ; Nephrectomy ; Obesity

PURPOSE: Although its incidence has decreased with the widespread use of less invasive surgical techniques including laparoscopic surgery, postoperative ileus remains a common postoperative complication. In the field of urologic surgery, with the major exception of radical cystectomy, few studies have focused on postoperative ileus as a complication of laparoscopic surgery. The present study aims to offer further clues in the management of postoperative ileus following urological laparoscopic surgery through an assessment of the associated risk factors. METHODS: The medical records of 267 patients who underwent laparoscopic surgery between February 2004 and November 2009 were reviewed. After excluding cases involving radical cystectomy, combined surgery, open conversion, and severe complications, a total of 249 patients were included for this study. The subjects were divided into a non-ileus group and an ileus group. The gender and age distribution, duration of anesthesia, American Society of Anesthesiologists Physical Status Classification Score, body mass index, degree of operative difficulty, presence of complications, surgical procedure and total opiate dosage were compared between the two groups. RESULTS: Of the 249 patients, 10.8% (n = 27) experienced postoperative ileus. Patients with ileus had a longer duration of anesthesia (P = 0.019), and perioperative complications and blood loss were all correlated with ileus (P = 0.000, 0.004, respectively). Multiple linear regression analysis showed that the modified Clavien classification was an independent risk factor for postoperative ileus (odds ratio, 5.372; 95% confidence interval, 2.084 to 13.845; P = 0.001). CONCLUSION: Postoperative ileus after laparoscopic urologic surgery was more frequent in patients who experienced more perioperative complications.
Age Distribution ; Anesthesia ; Body Mass Index ; Cystectomy ; Humans ; Ileus ; Incidence ; Laparoscopy ; Linear Models ; Medical Records ; Postoperative Complications ; Risk Factors ; Urology

OBJECTIVE: To compare the diagnostic value between Phalen's test and reverse Phalen's test using a morphological change of the median nerve and the carpal tunnel seen by high-resolution ultrasonography and to research on an ultrasonography as an available tool for the screening and follow up aid-test of the carpal tunnel syndrome (CTS). METHOD: A cross-sectional area and a flattening ratio of the median nerve, and a cross-sectional area of the carpal tunnel were measured in neutral, maximally flexed (Phalen's test), and maximally extended (reverse Phalen's test) positions in 59 wrists of 30 normal subjects. RESULT: The cross-sectional area of median nerve was significantly decreased in maximal flexion (p<0.01), and in maximal extension (p<0.01). The mean flattening ratio of median nerve was revealed significant change in maximal flexion (p<0.01), and in maximal extension (p<0.01). The mean cross-sectional area of the carpal tunnel was significantly decreased in maximal flexion (p<0.01), and in maximal extension (p<0.01), with comparing to neutral position, respectively. CONCLUSION: Phalen's test reveals higher degree of irritation to median nerve. The high-resolution ultrasonography is suggested as an available tool for the screening and follow up aid-test for the CTS.
Carpal Tunnel Syndrome ; Follow-Up Studies ; Mass Screening ; Median Nerve* ; Ultrasonography ; Wrist*