Palliative endourologic treatment was done in 94 cases for ureteral obstruction secondary to advanced malignancy The average survival was 4.2 months. The obstruction were caused by metastases or invasion of cancer in all patients. First we tried to insert a double J stent(STENT), when it failed percutaneous nephrostomy(PCN) was performed. Initially 16 patients were treated by STENT and 8 patients by PCN. The SIENT was changed 2.2 times on the average in all patients. 75% of the patients who had been treated by STENT experienced only one or two times of STENT changes before dying. Patency period of the STENT was 57.6 days on the average. The patency period was shorter in the patients who showed gross hematuria at the time of STENT insertion. Although survival was not so long, 60.6% patients were able to return to their homes. The endourologic management of the upper urinary tract obstruction will play a more important role and offer a better quality of life for end stage cancer patients.
Hematuria ; Humans ; Neoplasm Metastasis ; Pregnenolone Carbonitrile ; Quality of Life ; Stents ; Ureteral Obstruction ; Urinary Tract*

PURPOSE: To evaluate the efficiency of lateral plate fixation using minimally invasive plate osteosynthesis (MIPO) technique as a treatment of distal tibial metaphyseal fracture. MATERIALS AND METHODS: Among the patient who were treated from March, 2002 to September, 2004, the cases of twenty patients with distal tibial metaphyseal fracture treated by lateral plate fixation using MIPO technique who were able to be followed up for at least one-year period were reviewed in this study. According to AO/OTA classification, five were type A1, twelve cases were type A2 and other three cases were type A3, and among them two cases were open fracture type I according to the Gustillo-Anderson classification. Radiologic studies and clinical assessment described by Daniel et al and complication following the treatment were evaluated. RESULTS: At a mean of 16.4 weeks (range 11 to 23), all fractures united without secondary procedures. According to clinical assessment, all cases had good and excellent result, and there were no complications. CONCLUSION: The lateral plate fixation using MIPO technique of distal tibial metaphyseal fracture is an efficient method of treatment with high functional recovery rate which minimize soft tissue damage, decreases the risk of infection and incidence of nonunion at the same time as the classic MIPO technique does, and it is a useful alternative method when there is a anteromedial soft tissue damage.
Classification ; Fractures, Open ; Humans ; Incidence

PURPOSE: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. MATERIALS AND METHODS: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. RESULTS: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. CONCLUSION: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.
Ankle ; Arthritis ; Humans

PURPOSE: To evaluate the clinical result of two stage reimplantation of infected total knee arthroplasties, using an antibiotics impregnated articulating cement spacer. MATERIALS AND METHODS: Out of total 7 cases with infected total knee arthroplasties, 4 cases treated with two stage reimplantation, using an antibiotics impregnated articulating cement spacer were included in this study. After the treatment of infected total knee arthroplasties, the treatment of infection was evaluated by physical examination, radiologic studies, and hematologic studies. The results were evaluated using the Hospital for Special Surgery Knee Score (HSS). RESULTS: As results, 4 infected knee cases treated with two stage reimplantation did not have reinfection at the time of the follow up, and physical, laboratory, and radiologic studies were all within normal range. The range of motion of the reimplanted knees were from -5degrees in extension to 130 degrees in flexion, with an average of 117 degrees. The average score of the Hospital for Special Surgery Knee Score was 87. CONCLUSION: In conclusion, two stage arthroplasties, using antibiotics impregnated articulating cement spacer was an effective therapy not only for the treatment of the infection after the total knee arthroplasty but also effectiveness for recovery of the knee function.
Anti-Bacterial Agents* ; Arthroplasty* ; Follow-Up Studies ; Knee* ; Physical Examination ; Range of Motion, Articular ; Reference Values ; Replantation*

The brain metastasis of prostatic carcinoma is rare and is distinguished by its poor prognosis in cases which are not surgically resectable. Herein we described a 72 year old male with brain metastasis from prostatic carcinoma, which regressed with chemotherapy. Pathological examination of a transrectal needle biopsy disclosed moderatedly differentiated adenocarcinoma of the prostate. Magnetic resonance imaging of brain demonstrated a brain tumor at the occipital lobe suspected to be a metastasis of prostatic carcinoma. The tumor could not be detected on the brain MRI after 3 months of chemotherapy.
Adenocarcinoma* ; Aged ; Biopsy, Needle ; Brain Neoplasms ; Brain* ; Drug Therapy* ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis* ; Occipital Lobe ; Prognosis ; Prostate

A case of xanthoma of the liver in a 61-year-old Korean woman with multiple myeloma, hyperlipidemia and xanthoma of the skin is described. Microscopically, the liver showed a multiple xanthomatous collection of foamy histiocytes as well as diffuse sinusoidal infiltration of the foam cells. This hepatic accumulation of foam cells seems to be related to hyperlipidemia of the patient. The mechanism of hyperlipidemia in multiple myeloma is discussed.
Case Report ; Female ; Human ; Hyperlipidemia/blood/*complications ; Liver Diseases/blood/*complications ; Middle Age ; Multiple Myeloma/blood/*complications ; Xanthomatosis/blood/*complications

No abstract available.
Angiotensin II* ; Angiotensins* ; Animals ; Hemorrhage* ; Rats*

Today, percutaneous nephrostomy and other related renal procedures are routine in most hospitals. This technique provides safe, rapid and direct access to the upper urinary tract for various diagnostic and therapeutic maneuvers. It has become a vital tool for the urologists who have been able to diagnose and treat ever more diverse pathologies of the urinary tract without open operation. Percutaneous nephrostomy was done on 276 cases with advanced malignancy and benign conditions during the period of March, 1985 to December, 1993. We were successful in using percutaneous nephrostomy as urinary diversion to ureteral obstruction or urinary leakage in 27l cases( 98% ). In four fifths of patients, obstruction was due to neoplasm, with the cervical cancer the leading cause. The post-nephrostomy complications were bleeding in 10 cases, enterocutaneous fistula in 4, perinephric abscess in 3 and sepsis in 1. Percutaneous nephrostomy proved to be ideally suited in condition of obstructive uropathy and urine leakage.
Abscess ; Hemorrhage ; Humans ; Intestinal Fistula ; Nephrostomy, Percutaneous* ; Pathology ; Pregnenolone Carbonitrile ; Sepsis ; Ureteral Obstruction ; Urinary Diversion ; Urinary Tract ; Uterine Cervical Neoplasms

We report a rare case of acquired multiple coronary-cameral fistulae. A 46-year-old man presented to the cardiology department clinic complaining of recently aggravated exertional chest pain. He had been treated 10 years ago for an acute ST segment elevation myocardial infarction (STEMI) with percutaneous coronary intervention (PCI). During revascularization, diffuse multiple fistulae from the left anterior descending (LAD) artery to the left ventricle (LV) had been observed. The current chest pain was evaluated by elective coronary angiography but no significant stenosis was observed. However, newly developed diffuse fistulae from the distal right coronary artery (RCA) to LV were found during angiography, as well as LAD-LV coronary fistulae. Multiple coronary-cameral fistulae were thought to be causing chest pain. A beta-blocker was prescribed and, after 3 months of follow-up, exertional chest pain had subsided without further complication.
Angiography ; Arteries ; Cardiology ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Fistula ; Follow-Up Studies ; Heart Ventricles ; Ischemia ; Myocardial Infarction ; Percutaneous Coronary Intervention

PURPOSE: Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). METHODS: A retrospective analysis was made on 46 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. RESULTS: Median follow-up time was 30 months(range 2-102 months). All patients underwent radionuclide scans and voiding cystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). CONCLUSION: In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.
Child* ; Follow-Up Studies ; Humans ; Hypertension ; Multicystic Dysplastic Kidney* ; Nephrectomy ; Prognosis ; Renal Insufficiency ; Retrospective Studies ; Ultrasonography ; Urinary Tract