Lymphoma of the prostate is exceedingly rare. Much more common than primary lymphoma of the prostate id secondary involvement of malignant lymphomas originating at other sites. A variety of treatments have bee n used, including prostatectomy, radiotherapy or combinations of chemotherapy and radiotherapy. Generally, the prognosis is very poor, and there is currently no consensus regarding treatment. We report on a patient with T-cell lymphoma who presented with symptoms of bladder neck obstruction. The patient has been asymptomatic and under complete remission after completion of doxorubicin-based chemotherapy for 2 cycles.
Bees ; Consensus ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Lymphoma ; Lymphoma, T-Cell* ; Prognosis ; Prostate* ; Prostatectomy ; Radiotherapy ; T-Lymphocytes* ; Urinary Bladder Neck Obstruction

We experienced a case of arteriovenous hemangioma showing Dariers sign on the forehead of a 43-year-old man. He presented with a single, 1 * 1.5cm sized, violaceous, asymptomatic nodule with a history of an intermittent wheal at the lesional site. This skin lesion showed Dariers sign clinically and proliferation of mast cells histopathologically with the punch biopsy specirnen suggesting urticaria pig- mentosa. Howerer, we could diagnose it as a arteriovenous hemangioma on complete excision, as the specimen showed arteriovenous proliferation with increased mast cells in a perivascular pattern. This case showed confusing clinical signs and showed the importance of complete excision for the diagnosis of a small skin tumor especially when a vascular proliferating tumor is suspected.
Adult ; Biopsy ; Diagnosis ; Forehead ; Hemangioma* ; Humans ; Mast Cells ; Skin ; Urticaria

Perforation of the biliary tree mostly results from injury to the bile duct during surgery or procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and spontaneous bile duct perforation is rare in adults. As the clinical picture varies, early diagnosis and treatment of spontaneous biliary peritonitis is difficult. A 52-year-old male patient presented with abdominal pain and intractable ascites. He already experienced severe abdominal pain 2 months ago and underwent percutaneous pigtail drainage for the ascites at nearby hospital. ERCP showed large filling defect with leakage of contrast media from the mid common bile duct (CBD) into the peritoneal cavity. We performed endoscopic sphincterotomy and extracted CBD stones with basket and balloon catheter. Then fully covered self expandable metal stent was placed in CBD. After the procedure, the symptom was improved and the amount of pigtail drainage from abdominal cavity was dramatically decreased. 6 weeks later, removing the metal stent, there was no more leakage of contrast media into peritoneal cavity. We report a very rare case of spontaneous bile leakage which was successfully managed with placement of metal stent.
Abdominal Cavity ; Abdominal Pain ; Adult ; Ascites ; Bile ; Bile Ducts ; Biliary Tract ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Contrast Media ; Drainage ; Early Diagnosis ; Humans ; Male ; Middle Aged ; Peritoneal Cavity ; Peritonitis ; Self Expandable Metallic Stents ; Sphincterotomy, Endoscopic ; Stents*

Perforation of the biliary tree mostly results from injury to the bile duct during surgery or procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and spontaneous bile duct perforation is rare in adults. As the clinical picture varies, early diagnosis and treatment of spontaneous biliary peritonitis is difficult. A 52-year-old male patient presented with abdominal pain and intractable ascites. He already experienced severe abdominal pain 2 months ago and underwent percutaneous pigtail drainage for the ascites at nearby hospital. ERCP showed large filling defect with leakage of contrast media from the mid common bile duct (CBD) into the peritoneal cavity. We performed endoscopic sphincterotomy and extracted CBD stones with basket and balloon catheter. Then fully covered self expandable metal stent was placed in CBD. After the procedure, the symptom was improved and the amount of pigtail drainage from abdominal cavity was dramatically decreased. 6 weeks later, removing the metal stent, there was no more leakage of contrast media into peritoneal cavity. We report a very rare case of spontaneous bile leakage which was successfully managed with placement of metal stent.
Abdominal Cavity ; Abdominal Pain ; Adult ; Ascites ; Bile ; Bile Ducts ; Biliary Tract ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Contrast Media ; Drainage ; Early Diagnosis ; Humans ; Male ; Middle Aged ; Peritoneal Cavity ; Peritonitis ; Self Expandable Metallic Stents ; Sphincterotomy, Endoscopic ; Stents*

OBJECTIVE: The history of gestational diabetes (GDM) is a high risk for the development of type 2 diabetes mellitus (T2DM). The purpose of this study is to investigate the genetic association of LEP and LEPR gene polymorphisms and the development of T2DM in Korean women of history of GDM. METHODS: Women diagnosed as GDM during pregnancy from January 1992 to December 2002 were recruited. Those women with a T2DM at the time of study were classified as T2DM positive group, and without T2DM, as T2DM negative group. 2 genes (LEP and LEPR genes) and 8 SNPs (LEP-632G>A, +4950G>A, +4998A>C, and LEPR-141013T>C, -186A>G, +5193G>A, +7187A>C, +27265A>G) were selected. The TaqMan assay for genotyping and the statistical analysis for phenotypic and genetic factors between 2 groups were analyzed. RESULTS: A total of 54 women, T2DM positive (n=20) and T2DM negative (n=34) were enrolled. At the time of diagnosis of GDM, HbA1c, 50 g and 100 g oral glucose tolerance test, and insulin level were significantly associated between T2DM positive and negative groups (P<.05). In analysis of genetic risk to T2DM, the significant association related with any SNPs was not shown between T2DM positive and negative groups. CONCLUSION: In Korean women having past history of GDM, there was no relationship between 2 genes and the development to T2DM. To clarify a effect of candidate genes related with development of T2DM, there will need more samples and genes.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational ; Female ; Glucose Tolerance Test ; Humans ; Insulin ; Polymorphism, Single Nucleotide ; Pregnancy

PURPOSE: Traditional transcutaneous incision and transconjunctival incision methods are commonly used in the lower blepharoplasty. The transconjunctival method leaves no visible scars nor does it change the shape of lower eyelid contour and the surgical technique is not difficult. However removal of excess baggy skin is not possible through this method. Therefore, the transconjunctival incision method is useful only for patients who still have normal elasticity of the lower eyelids and fat that is protruding only anterocaudally. The Author will introduce a technique, which complements the limitations of these two methods mentioned above. METHODS: The author combined the transconjunctival approach and lower blepharoplasty with only the excised skin flap method. This method does not go beyond the previous methods but does apply the advantages of them. RESULTS: From March 2007 to October 2010, this new technique was performed in a total of 62 patients. Fat was removed and repositioned through transconjunctival incision. Drooped skin was excised as in the traditional blepharoplasty but only the skin flap was elevated. This prevents post-operative complications such as ectropion, sclera show, and deformation of the shape of the lower eyelids or under-resection of fat. All patients were satisfied with the post-operative appearance. CONCLUSION: The author was able to get satisfactory results while avoiding complications of traditional transcutaneous technique with this combined technique of the transconjunctival approach and the lower blepharoplasty method of skin flaps only.
Blepharoplasty ; Cicatrix ; Complement System Proteins ; Ectropion ; Elasticity ; Eyelids ; Humans ; Sclera ; Skin

OBJECTIVES: To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the performance of hospitals. METHODS: Data from 564 CABGs performed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic regression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, R2, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. RESULTS: The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission, acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and R2 were 0.791 and 0.101, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were not significantly different. CONCLUSION: Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may be an indicator for evaluating hospital performance in Korea.
Angina Pectoris ; Coronary Artery Bypass ; Electrocardiography ; Heart Failure ; Hospital Mortality ; Hospitals, General ; Humans ; Korea ; Logistic Models ; Medical Records ; Mortality* ; Risk Adjustment ; Risk Factors ; Transplants

A schwannoma is one of the most common neoplasms in the central and peripheral nervous systems, but schwannomas of the sciatic nerve are rare. Treatment is a surgical excision and the overall prognosis is good. But functional loss occurs when a neurectomy is performed with inevitable cause. We report one case of a successful sural nerve graft after resection of a schwannoma in a sciatic nerve and we present a brief review of the literature.
Neurilemmoma* ; Peripheral Nervous System ; Prognosis ; Sciatic Nerve* ; Sural Nerve* ; Transplants

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.