No abstract available.
Gallbladder* ; Lithotripsy*

No abstract available.
Dipyridamole* ; Heart Ventricles*

Most renal cell carcinomas are solid but contain small cystic areas. Sometimes the cystic component predominates and such lesions are called cystic renal cell carcinomas. The radiographic and pathologic findings of cystic renal cell carcinoma are often more confusing and less specific than the findings of solid renal cell carcinoma. Multilocular cystic renal cell carcinoma is one form of cystic renal cell carcinoma variants and results from intrinsic multiloculated growth. A presumptive diagnosis of multilocular cystic renal cell carcinoma was made preoperatively in a 38-year-old woman and it was treated with radical nephrectomy, so we report this case with brief review of the literatures.
Adult ; Carcinoma, Renal Cell* ; Diagnosis ; Female ; Humans ; Nephrectomy

Since continent urinary diversion and bladder substitution after cystoprostatectomy have been offered as alternative to standard urinary diversion, increasing numbers of patients seek to avoid a wet stoma. So since 1988 we have used a pouch constructed from a combination of large and small bowel(Mainz pouch), which offers a low pressure reservoir of adequate capacity, antirefluxing ureteral reimplantation and continent reservoir. Initial applications of the Mainz pouch were for bladder augmentation after subtotal cystectomy and for continent urinary diversion. Current indications have been extended to complete bladder substitution after radical cystectomy with anastomosis of the pouch to the membranous urethra. A total or 15 patients underwent a Mainz pouch procedure ;6 for bladder augmentation, 8 for continent urinary diversion and 1 for total bladder substitution after radical cystectomy. All bladder augmentation cases, 4 of 8 diversion cases and substitution case are completely dry day and night. There are no significant perioperative morbidity and mortality.
Cystectomy ; Humans ; Mortality ; Replantation ; Ureter ; Urethra ; Urinary Bladder ; Urinary Diversion

While a sprain of the hamstring muscle is relatively common in athletes or those who participate in physically active sports, a complete rupture of the proximal hamstring is relatively rare. A rupture of the long head of the biceps femoris without rupture of the semimembranosus and semitendinosus muscles has rarely been reported. In this study, we saw relatively favorable outcomes after reattachment with a suture anchor at the ischial tuberosity in two patients who had a rupture of the long head of the biceps femoris.
Athletes ; Head ; Humans ; Muscles ; Rupture* ; Sports ; Sprains and Strains ; Suture Anchors

BACKGROUND: Neointimal hyperplasia, as the most important mechanism of restenosis after intracoronary artery stenting, its severity is closely correlated with the degree of local inflammatory reaction initiated by vasular injury during stenting procedure. So, we proceeded this study to determine whether inflammatory markers such as CD11b/CD18 (Mac-1) adehsion molecules of neutrophils, sICAM-1 (soluble intercellular adhesion molecule-1), ESR, and CRP increase or not in the peripheral circulation after coronary artery stenting, and whether there is any association between these findings and the degree of later restenosis. METHOD: 32 patients (chronic stable angina 4, unstable angina 17, acute myocardial infarction 11) underwent single vessel coronary artery stenting were enrolled in our study. Blood samples were obtained from peripheral vein just before coronary artery stenting and 48 hours thereafter. The degrees of CD11b/CD18 expression on the surface of neutrophils were analyzed by flow cytometry with monoclonal antibodies, and sICAM-1 by ELISA method. At each times, ESR and CRP were also measured. Follow-up coronary artery angiography was performed with QCA analysis at least 6 months later. We compared the each 48 hours values with the baseline (just before procedure) values. Percentage increments (as a ratio 48 hours values to baseline) of CD11b/CD18 expression, sICAM-1, ESR, and CRP levels were also compared with the results of follow-up QCA analysis. RESULTS: Restenosis (diameter stenosis > or = 50%) occurred in 6 patients (19%) at follow up angiography. 48 hours values of CD11b/CD18 expression, sICAM-1, ESR, and CRP were significantly elevated from the baseline values (each p values, CD11b : < 0.0001, CD18 : 0.01, sICAM-1 : < 0.0001, ESR : 0.005, and CRP : 0.001). The percentage increments of CD11b/CD18 expression were more elevated in restenosis group than nonrestenosis group (CD11b : 341+/-215%/74+/-95%, CD18 : 84+/-60%/17+/-37%, each p < 0.001, 0.001). There was some positive correlation between the percentage increments in the expression of CD11b and the late loss index at the follow up angiography (r=.43, p<0.05). CONCLUSIONS: Through this study, we found that the activation of neutrophils was occurred, and that sICAM-1 level was increased after coronary artery stenting in the peripheral blood. There was some correlations between the degree of CD11b expression on the surface of neutrophils and the severity of late lumen loss of inserted stents. The measurements of increased neutrophil adhesion molecules of CD11b/CD18 levels at 48hrs after coronary stenting may have a value as the predictor of subsequent late restenosis.
Angina, Stable ; Angina, Unstable ; Angiography ; Antibodies, Monoclonal ; Arteries ; Constriction, Pathologic ; Coronary Vessels* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Follow-Up Studies ; Humans ; Hyperplasia ; Myocardial Infarction ; Neutrophils* ; Stents* ; Veins

PURPOSE: To report a case of multiple serous chorioretinopathy after facial herpes zoster. CASE SUMMARY: A 48-year-old male visited our clinic due to visual disturbance in the left eye which occurred 3 days after left facial pain and vesicles. Chemosis and multiple serous retinal detachments were found. The patient was diagnosed with multiple serous chorioretinopathy due to herpes zoster virus and was started on intravenous acyclovir at a dose of 10 mg/kg every 8 hours for 9 days and herpes eye ointment 5 times daily. After the initial treatment, oral prednisolone 60 mg was given daily for 6 days. Skin lesions were cleared, and abnormal fundus and visual acuity improved after treatment. CONCLUSIONS: Ophthalmopathy including multiple serous chorioretinopathy should be considered in managing herpes zoster ophthalmicus patients.
Acyclovir ; Facial Pain ; Herpes Zoster Ophthalmicus ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Male ; Middle Aged ; Prednisolone ; Retinal Detachment ; Skin ; Visual Acuity

PURPOSE: Colorectal perforation is a rare malady, but it usually presents abdominal emergency with high morbidity and mortality. It is very difficult to diagnose stercoral, idiopathic, or steroid induced perforation because these are very rare, but they show high mortality. The aims of this study are to: 1) evaluate and compare the characteristics of stercoral, idiopathic and steroid induced perforation with other perforations; and to 2) guide the diagnostic approach and treatment of these rare colon perforations. METHODS: We retrospectively reviewed thirty five patients underwent surgery for colorectal perforation at the Department of Surgery, Daedong Hospital, from November 1996 to January 2005. Age, gender, perforation site, grade of peritonitis, methods of operation and mortality rates were compared between the various causes. Logistic regression was used to evaluate their effect on mortality. RESULTS: There were 10 cases of iatrogenic colorectal injuries (28%), 7 of steroid induced colorectal perforation (20%), 5 of stab (14%), 4 of diverticulitis (11%), 4 of stercoral (11%), 3 of idiopathic (8%), and 2 of cancer induced perforation (5%). Total mortality rate of all the cases was 28.5% (10 out of 35) but the mortality of stercoral, steroid induced and idiopathic perforation was 57% (8 out of 14). The mortality rate was higher in older age group (60 years above) (40%), stercoral (75%), steroid induced (57%) and idiopathic (33%), preoperative systemic inflammatory response (SIRS) (42%), preoperative septic shock (83%), abnormal WBC count (10,000/mm3 above or 4,000/mm3 below) (53%), left colon perforation (36%) and diffuse peritonitis (56%). The mortality rate was lower in young age group (13%), iatrogenic (10%), stab (0%), right colon perforation (10%) and localized peritonitis (5%). The peritonitis grade (Hinchey's stage) of idiopathic group, cancer and stercoral was worse (III-IV grade: 75%, 100%, 75%) than that of diverticulitis, iatrogenic and stab (III-IV grade: 25%, 30%, 40%). CONCLUSION: The stercoral, steroid induced and idiopathic colorectal perforation was rare, difficult to diagnose but it showed high mortality. The characteristics of these are an older age, presenting with a high peritonitis grade, preoperative SIRS, preoperative septic shock, and occurrence below the splenic flexure. If surgeons encounter these perforations, they should perform prompt surgical management and intensive postoperative care to reduce the mortality.
Colon ; Colon, Transverse ; Diverticulitis ; Emergencies ; Humans ; Logistic Models ; Mortality ; Peritonitis ; Postoperative Care ; Retrospective Studies ; Shock, Septic

We studied the effect of stellate ganglion block on the mean blood flow velocity and carbon diaxide reactivity of the middle cerehral artery in nine healthy volunteers. Mean blood flow velocity of the right middle cerebral artery was measured under normocapnia and carbon dioxide reactivity to end-tidal PCO2 of 30 mmHg, 40 mmHg, and 50 mmHg was assessed before and after right stellate ganglion block. End-tidal PCO2 was controlled by hyperventilation and rebthing technique. Mean blood flow velocity was measured using transcranial Doppler sonography, and carbon dioxide reactivity was expressed as the percentage change in mean blood flow velocity per unit change in end-tidal PCO2. There was no difference in mean blood flow velocity under normocapnia (37.7+/-1.1 mmHg) between the values measured before stellate ganglion block (60.3+/-4.9 cm/sec) and the values measured after stellate ganglion block (58.6+/-4.9 cm). Mean blood flow velocity increased as end-tidal PCO2 increased from 30 mmHg to 40 mmHg, and from 40 mmHg to 50 mmHg (p<0.01) both before and after stellate ganglion block. Carbon dioxide reactivity of mean blood flow velocity did not change after stellate ganglion block. Heart rate decreased from 77.1+/-3.5 beats/min to 70+/-2.5 beats/min when end-tidal PCO2 was controlled from 30 mmHg to 40 mmHg after stellate ganglion block (p<0.05). Mean arterial blood pressure did not change after stellate ganglion block at any end-tidal PCO2 level. These results suggest that stellate ganglion block does not induce the change of mean blood flow velocity and carbon dioxide reactivity of the middle cerebral artery.
Arterial Pressure ; Arteries ; Blood Flow Velocity* ; Carbon Dioxide* ; Carbon* ; Healthy Volunteers ; Heart Rate ; Hyperventilation ; Middle Cerebral Artery* ; Stellate Ganglion* ; Ultrasonography, Doppler, Transcranial

The successful closure of a fistula clearly involves application of spectrum of techniques depending variable factors. There was variety of opinions regarding the timing and optimum surgical technique for repair of fistula. Several muscles and myocutaneous flaps are applicable to a variety of tissue defects. The gracilis muscle is especially useful as adjuncts for wound coverage, vaginal or penile reconstruction and as interpositional tissue for the closure of various fistulas. We experienced two cases of female urinary tract fistula treated with gracilis muscle flap successfully.
Female* ; Fistula* ; Humans ; Muscles ; Myocutaneous Flap ; Urinary Tract* ; Wounds and Injuries