Urethral stricture usually follows the urethral rupture and periodical urethral soundation, which is an annoying procedure for. patients, is the usual method of treatment throughout their life. A case of urethral stricture who was successfully treated with modified Cecil's Operation, is presented.
Humans ; Rupture ; Urethral Stricture*

PURPOSE: Since the introduction of short vein bypass (SVB), many have reported its feasibility when long vein bypass (LVB) cannot be performed due to limited vein conduit. However, the presence of inflow-vessel disease may affect graft patency and thus require endovascular treatment prior to surgery. Our study aims to analyze the results between SVB and LVB. MATERIALS AND METHODS: From 2009 to 2013, 27 bypass procedures were reviewed retrospectively. Outcomes such as patency rate, postoperative ankle brachial index (ABI) and limb salvage rate between SVB and LVB were compared. Wound healing time and primary patency rate were analyzed and the former was also analyzed according to the respective angiosome and revascularization type. RESULTS: There were 11 males and 16 females and the mean age was 66.6+/-12.3 years. Twenty four patients had TransAtlantic Inter-Society Consensus (TASC) D and 3 patients had TASC C lesions below knee. The 1-year cumulative patency rate between SVB and LVB were 63% and 66%, P=0.627. The limb salvage rate (100% vs. 73%; P=0.280) and postoperative ABI (0.592 vs. 0.508; P=0.620) were higher in the SVB group than in the LVB group, although the differences were not significant. There was no difference in wound healing time by angiosomal revascularization type. In situ vein graft showed higher patency rate than reversed greater saphenous vein (75% vs. 61%; P=0.00) CONCLUSION: The results of SVB were similar to those of LVB. SVB is feasible in the setting of limited conduit availability, in combination with endovascular treatment in the presence of proximal lesions.
Ankle Brachial Index ; Consensus ; Extremities* ; Female ; Humans ; Ischemia* ; Knee ; Limb Salvage ; Male ; Retrospective Studies ; Saphenous Vein ; Transplants* ; Veins* ; Wound Healing

Prolapse of bladder through vesico-vaginal fistula is quite a rare urological problem. A 38-year-old woman was admitted to the Woo Sok University Hospital with a baby head sized round mass attached to the vagina. Patient had a prolapse of uterus after having her second child birth about 10 years ago and cauterization with corrosives for the treatment of prolapse of uterus was undergone for two times. About one year prior to the admission, the prolapse of uterus recurred and cauterization with corrosives was tried again, resulting vesico-vaginal fistula through which the bladder was everted and prolapsed. Under the general anesthesia, the everted and prolapsed bladder was reduced manually in normal position and vesico-vaginal fistulectomy was performed with good result.
Adult ; Anesthesia, General ; Caustics ; Cautery ; Child ; Female ; Fistula* ; Head ; Humans ; Parturition ; Prolapse* ; Urinary Bladder* ; Uterus ; Vagina ; Vesicovaginal Fistula

BACKGROUND/AIMS: Many recent studies have shown excellent outcomes of surgical resection for ruptured hepatocellular carcinoma (HCC). In addition, there are several reports suggesting that a ruptured HCC did not increase the risk for peritoneal dissemination of a tumor after surgical resection. However, the impact of HCC rupture on recurrence and patient survival has not yet been clarified. METHODS: The medical data of patients who underwent surgical resection for ruptured HCC in our center between January 2011 and December 2015 were retrospectively reviewed. The outcomes of the patients were investigated. RESULTS: Among 128 patients who underwent surgical resection for HCC, 5 patients (3.9%) had a ruptured HCC. All patients underwent elective operation in a stable condition. Transarterial chemoembolization (TACE) was performed for achieving hemostasis in four patients except one who achieved spontaneous hemostasis. Two patients had tumor recurrence and one patient died due to HCC recurrence during the median follow-up duration of 28.3 months (range, 24.3–62.3 months). One patient who developed late intrahepatic recurrence at 40.0 months after resection was managed well by means of radiofrequency ablation and TACE and is now alive for 5 years without any evidence of viable tumor. However, the other patient who showed early peritoneal seeding at 1.9 months after resection finally died despite aggressive treatments. CONCLUSIONS: Rupture of HCC might result in peritoneal seeding of the tumor in the early postoperative stage, which could lead to a poor result. Nonetheless, surgical resection may be the best treatment option yielding good survival, even for a ruptured HCC.
Carcinoma, Hepatocellular* ; Catheter Ablation ; Follow-Up Studies ; Hemostasis ; Humans ; Recurrence ; Retrospective Studies ; Rupture

New Cervicography and HPV-DNA test, a adjunctive Pap Smear test, are an innovative cervical cancer surveillance system. The purpose of this study was to investigate the role of HPV-DNA test and cervicography as a pap smear in early detection of cervical cancer. Pap smear, cervicography, and HPV-DNA test data were obtained from 161 patients who visited the Department of Obstetrics and Gynecology, Chunan Hospital, Soonchunhyang University from November 1997 to April 1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either pap smear or cervicogram, and by naked eye. Specimens were taken either by colposcopically directed biopsy or large loop excision of the transformation zone. Results were as follows: 1. Pap smear results were normal in 40 cases (24.8%), RCC (reactive cellular change) or ASCUS (atypical squamous cells of undetermined significance) in 74 cases (46%), and abnormal (above low grade squamous intraepithelial lesion) in 47 cases (29.2%). 2. New Cervicographic findings were negative in 93 cases (57.8%), benign or suspicious atypical in 14 cases (8.7%), and positive in 54 cases (33.5%). 3. The sensitivity (94.6% vs 67.7%, p<0.01), and the false positive rate (19.8% vs 14.6%, p<0.01) of cervicography were significantly higher than for pap smear. The specificity (83.0% vs 86.2%, p<0.01), and the false negative rate (5.4% vs 32.3%, p<0.01) of cervicography were significantly lower than for pap smear. 4. When New Cervicography and Pap smear were used together, the sensitivity was higher than for pap smear in New Cervicography used alone (p<0.01) and the specificity was lower than for pap smear or cervicography used alone (p<0.01). 5. When cervicography and pap smear and HPV-DNA test were used concurrently, the sensitivity was higher than for cervicography and pap smear used together (p<0.01), and the specificity was lower than for cervicography and pap smear used together (p<0.01). The three screening test combination is a useful interval screening method to detect cervical cancer. The detection rate of cervical cancer will be increased. Thus, we believe that cervicography and HPV testing can be important adjuntive tests for cervical cytology, final tool in precancerous cervical lesions prevention. Combination of these three tests is sensitive enough to institute "interval screening" into society.
Biopsy ; Chungcheongnam-do ; Gynecology ; Humans* ; Mass Screening* ; Obstetrics ; Papilloma* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

New Cervicography and HPV-DNA test, a adjunctive Pap Smear test, are an innovative cervical cancer surveillance system. The purpose of this study was to investigate the role of HPV-DNA test and cervicography as a pap smear in early detection of cervical cancer. Pap smear, cervicography, and HPV-DNA test data were obtained from 161 patients who visited the Department of Obstetrics and Gynecology, Chunan Hospital, Soonchunhyang University from November 1997 to April 1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either pap smear or cervicogram, and by naked eye. Specimens were taken either by colposcopically directed biopsy or large loop excision of the transformation zone. Results were as follows: 1. Pap smear results were normal in 40 cases (24.8%), RCC (reactive cellular change) or ASCUS (atypical squamous cells of undetermined significance) in 74 cases (46%), and abnormal (above low grade squamous intraepithelial lesion) in 47 cases (29.2%). 2. New Cervicographic findings were negative in 93 cases (57.8%), benign or suspicious atypical in 14 cases (8.7%), and positive in 54 cases (33.5%). 3. The sensitivity (94.6% vs 67.7%, p<0.01), and the false positive rate (19.8% vs 14.6%, p<0.01) of cervicography were significantly higher than for pap smear. The specificity (83.0% vs 86.2%, p<0.01), and the false negative rate (5.4% vs 32.3%, p<0.01) of cervicography were significantly lower than for pap smear. 4. When New Cervicography and Pap smear were used together, the sensitivity was higher than for pap smear in New Cervicography used alone (p<0.01) and the specificity was lower than for pap smear or cervicography used alone (p<0.01). 5. When cervicography and pap smear and HPV-DNA test were used concurrently, the sensitivity was higher than for cervicography and pap smear used together (p<0.01), and the specificity was lower than for cervicography and pap smear used together (p<0.01). The three screening test combination is a useful interval screening method to detect cervical cancer. The detection rate of cervical cancer will be increased. Thus, we believe that cervicography and HPV testing can be important adjuntive tests for cervical cytology, final tool in precancerous cervical lesions prevention. Combination of these three tests is sensitive enough to institute "interval screening" into society.
Biopsy ; Chungcheongnam-do ; Gynecology ; Humans* ; Mass Screening* ; Obstetrics ; Papilloma* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

Ankylosing spondylitis (AS) is a heterogeneous and systemic rheumatic disorder of unknown cause that is characterized by inflammation of the spine and sacroiliac joints. It is more common in young men. The disease is frequently associated with peripheral arthritis, enthesitis, anterior uveitis and high prevalence of HLA-B27. In some patients with AS, peripheral arthritis can occurs earlier than spinal symptom and more commonly affects the lower extremities than the upper extremities. Unlike men, women appear to have milder or atypical AS, especially at juvenile onset. However, involvement of the hands is extremely rare. Juvenile AS, defined as onset of disease prior to the age of 16 years, is considered a pediatric form of AS. On the other hand, although the atlantoaxial subluxation has been infrequently observed in patients with ankylosing spondylitis, atlantoaxial bony ankylosis has not been described in the literature. We describe a 23-year-old woman with juvenile AS who developed the atlantoaxial bony ankylosis and the hand involvement mimicking rheumatoid arthritis. Besides the rheumatoid-like hands and atlantoaxial bony ankylosis, she has shown the typical features of spondyloarthrpathy such as bilateral sacroiliitis, inflammatory spinal pain, enthesitis, severe arthritis of both hip joints, and positive HLA-B27 test.
Ankylosis* ; Arthritis ; Arthritis, Rheumatoid ; Female ; Hand* ; Hip Joint ; HLA-B27 Antigen ; Humans ; Inflammation ; Lower Extremity ; Male ; Prevalence ; Sacroiliac Joint ; Sacroiliitis ; Spine ; Spondylitis, Ankylosing* ; Upper Extremity ; Uveitis, Anterior ; Young Adult

Central venous cannulation via an internal jugular vein has become a common procedure in the management and monitoring of severely ill patients. Although complications such as carotid artery puncture or pneumothorax have been reported, hemothorax is relatively uncommon. We describe a case of hydrohemothorax and subclavian artery laceration which occurred during right internal jugular vein cannulation. A 44-year-old female patient was admitted for laparoscopic adrenalectomy under general anesthesia. For central venous pressure monitoring, central venous cannulation performed. However, dilator overinsertion injured the right subclavian artery. This led to a massive ipsilateral hydrohemothorax requiring thoracotomy for subclavian artery repair. This case suggests that central venous cannulation should be done carefully and improves awareness of the potential for dilator induced injury.
Adrenalectomy ; Adult ; Anesthesia, General ; Carotid Arteries ; Catheterization* ; Central Venous Pressure ; Female ; Hemothorax ; Humans ; Jugular Veins* ; Lacerations* ; Pneumothorax ; Punctures ; Subclavian Artery* ; Thoracotomy

Eosinophilic gastroenteritis is an unusual disease that is associated with various clinical gastrointestinal manifestations. Its severity depends on the area involved as well as the wall layer involved. Eosinophilic gastroenteritis often causes abdominal pain, nausea, vomiting and diarrhea. To date, there has been an extremely rare case of eosinophilic gastroenteritis with systemic symptoms, such as fever or lymphadenopathy (LAP). We experienced a case of a 68-year-old-woman with fever and abdominal pain. Abdominal computed tomography revealed diffuse wall thickening of the gastric antrum as linitis plastica. Multiple hot uptakes of lymph nodes were visualized on fludeoxyglucose-positron emission tomography. The gastric biopsy pathological report demonstrated eosinophilic infiltration without malignant cells. We could not exclude malignancy and performed an exploratory laparoscopy. A lymph node specimen showed reactive hyperplasia, and her illness was finally diagnosed as eosinophilic gastroenteritis. Herein, we report the case with a brief review.
Abdominal Pain ; Biopsy ; Diarrhea ; Enteritis ; Eosinophilia ; Eosinophils ; Fever ; Gastritis ; Gastroenteritis ; Hyperplasia ; Laparoscopy ; Linitis Plastica ; Lymph Nodes ; Lymphatic Diseases ; Nausea ; Pyloric Antrum ; Vomiting

Portal vein thrombus has been detected in patients with liver cirrhosis, pancreatitis, ulcerative colitis, septicemia, myeloproliferative disorder, and neoplasm. The formation of portal tumor thrombus by hepatocellular carcinoma is well recognized, because of its high incidence, and subsequent development of portal hypertension such as rupture of varices, ascites and liver failure indicates the poor prognosis. In gastric cancer, portal hypertension as an initial presentation is extremely rare. Herein we report a case presenting as portal hypertension caused by tumor thrombus without invasion of liver parenchyma. It is presumed to be intraluminal tumor thrombus originating from primary foci of gastric adenocarcinoma. Tumor thrombus in the portal vein is demonstrated on the PET-CT.
Adenocarcinoma/*diagnosis/pathology/radionuclide imaging ; Endoscopy, Gastrointestinal ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Hypertension, Portal/*diagnosis ; Male ; Middle Aged ; Positron-Emission Tomography and Computed Tomography ; Stomach Neoplasms/*diagnosis/pathology/radionuclide imaging