No abstract available.
Rectus Abdominis* ; Thigh*

No abstract available.
Rectus Abdominis* ; Thigh*

We experienced a case of adenocarcinoma arising in sacrococcygeal teratoma. The patient was a 52-year-old woman. She was admitted due to one month of sacral pain. She had a sacral mass since birth. On physical examination, anal fistula was present at the perianal area and pus drainage was noted. MR image showed multiple variable-sized cysts with inhomogeneous density. Resected specimen, mesuring 12.5 7.0 cm in diameter, showed multiple variable-sized cystic lesions admixed with grayish solid portion. The cysts contained mucoid material. The microscopic examination showed mature teratoma composed of cysts lined by pseudostratified ciliated columnar epithelium, intestinal mucosa, mature cartilage, bone, and fat tissue. A moderately differentiated adenocarcinoma developed from the cystic area in the mass.
Adenocarcinoma* ; Adult ; Cartilage ; Drainage ; Female ; Humans ; Intestinal Mucosa ; Middle Aged ; Mucous Membrane ; Parturition ; Physical Examination ; Rectal Fistula ; Suppuration ; Teratoma*

Endometriosis in the abdominal wall following Cesarean section is one of the very rare condition among the extrapelvic endometriosis. Although benign, endometriosis possesses the unique ability to invade tissue and to disseminate or metastasize by hematogeneous, lymphatic route, or direct implantation. We reported the case with brief review of the literature.
Abdominal Wall* ; Cesarean Section* ; Endometriosis* ; Female ; Pregnancy

Macrostomia is a relatively rare malformation. There have been many surgical methods for the correction of macrostomia. The old method, a simple straight line closure , did not include reconstruction of the orbicularis oris muscle. Postoperatively, a depressed scar and severe contraction on the cheek were found, especially with animation. As a result, many authors have known that reconstruction of the orbicularis oris muscle was very important to avoid a depressed scar for the correction of macrostomia. The tendency toward lateral displacement of the reconstructed commissure has been attributed to linear scar contraction, and Z-plasty is advocated to prevent this deformity. However, we found that the Z-plasty scar may be conspicuous when the patient smiles. So we performed reconstruction of the orbicularis oris muscle to avoid a depressed scar, and straight line closure to avoid a conspicuous scar. In order to prevent linear scar contracture due to straight line closure, we overcorrected the new commissure. We treated 6 cases of macrostomia form May 1, 1996 to April 30, 1999 using straight line closure and reconstruction of the orbicularis oris muscle. Periods of follow-up were from 12 months to 35 months, with an average of 20,2 months. Every patient was analyzed clinically by ordinary scale method and anthropometrically by the ratio of abnormal distances to normal distances between cheilion and crista philtri. In 3 clinical assessments : symmetry of the commissure was excellent: degree of the scar at rest was good: and degree of depression with animation was excellent. The anthropometrical ratio was 1:1.05. Despite the fact that the linear scars were perpendicular to the minimal skin tension lines, the scars were inconspicuous. The muscle repair provided reconstruction to the modiolus and gave a natural appearance to the commissure, however it did not seem to provide sufficient bulkiness around the commissure. The straight line skin closure and repair of the orbicularis oris muscle provide effective functional and aesthetic reconstruction.
Cheek ; Cicatrix ; Congenital Abnormalities ; Contracture ; Depression ; Follow-Up Studies ; Humans ; Macrostomia* ; Skin

Long COVID has emerged as a global medical challenge, characterized by persistent symptoms such as fatigue, dyspnea, and exercise intolerance following a coronavirus disease 19 (COVID-19) infection. The protracted nature of these symptoms necessitates the development of effective therapeutic approaches to alleviate the burden on individuals’ well-being and the healthcare system at large. While current pharmacological interventions offer limited efficacy, the exploration of alternative strategies becomes imperative. Exercise training has demonstrated promise in ameliorating long COVID symptoms, yet consensus regarding the optimal exercise modalities remains elusive. In light of this, the present review aims to elucidate the impact of exercise on long COVID symptoms and shed light on exercise prescriptions that have exhibited proven efficacy in the treatment and management of this syndrome.

BACKGROUND: PTCA is often unsuccessful in a patient with chronic total occlusion of coronary arteries with success rates varying from 60 to 70%. Success rates are related to the duration of total occlusion, longer occlusions being associated with lower success rates. Chronic total occlusion may be associated with thrombi superimposed on the stenotic lesion. We used an intra-coronary bolus of urokinase followed by a prolonged urokinase infusion in an attempt to lyse the lesion and allow for passage of the PTCA wire during subsequent angioplasty. The purpose of prolonged durokinase infusion was to reduce the clot sufficiently to recanalize the coronary artery and make it more amenable to PTCA. METHODS: Study patients: We were included six patients who developed total occlusion for more than 3 weeks and good collateral channels of Grade 2 or more and previous attempts at angioplaty had failed. Procedures: All patients underwent dual catheter system and incremental dose protocol of intracoronary urokinase infusion. RESULTS: The mean duration of occlusion was calculated to be 65.3+/-2.7 weeks and urokinase dose ranged from 130,000 to 200,000U/hr and treatment lasted 21.7+/-1.4 hours in our study. The prolonged urokinase infusion resulted in reperfusion of the occluded dvessel in 5 of the 6 patients(83%), with or without the complementary balloon inflation. One patient failed to recanalize the occluded vessel because cardiac tamponade was developed during the prolonged urokinase infusion. CONCLUSION: We concluded that the prolonged urokinase infusion in occluded coronary artery appeared to increase the likelihood of successful PTCA in patients with chronic total occlusion of coronary arteries.Also, in carefully selected patients, prolonged urokinase infusion in occluded coronary artery was relatively safe and well tolerated.
Angioplasty ; Cardiac Tamponade ; Catheters ; Coronary Vessels* ; Humans ; Inflation, Economic ; Reperfusion ; Urokinase-Type Plasminogen Activator*

The optimal management of uveal melanoma is still a matter of controversy. To determine the effect of Gamma Knife surgery on patients with uveal melanoma, the authors reviewed the outcome of five operations performed between September 1993 and August 1996. The mean age of the patients was 60.7(range 42 to 76) years; the median follow-up period was 10 months, and four patients were followed up for more than 6 months. The mean tumor volume was 3442mm3(mean diameter 15.3mm) and all patients were irradiated with a mean maximum dose of 74Gy (range 60-80Gy), using a 50% isodose on the tumor margin. In one patient, the tumor disappeared completely 32 months after Gamma Knife surgery; because the tumor did not regress, one patient subsequently required enucleation, and two remained stable. During a mean follow-up period of 10 months, vision was preserved in two patients, but one went blind; in one, enucleation was performed because the tumor did not regress. These results suggest that in cases of uveal melanoma Gamma Knife surgery can effectively control local tumors, can spare the eyeball, and may prevent loss of vision.
Follow-Up Studies ; Humans ; Melanoma* ; Tumor Burden

Thirty consecutive patient seen in a pediatric out patient and emergency department, in whom the diagnosis of intussusception was considered, had an ultrasound examination of the abdomen before the barium enema. The peak age was 5~12 month (range 4~34 month). Intussusception was detected by ultrasonography in all 25 cases proved by barium enema (sensitivity 100%). Normal findings on ultrasonography correlated with a negative barium enema results in 5 of 5 cases (negative predictive value=100%). No intussusception was missed by ultrasonography. To determine which patient would most benefit from ultrasonography, we divided patients into either a high risk group (100% intussusception) or a low risk group (37.5% intussusception) on the basis of clinical symptoms. We conclude that ultrasonography can be used as a rapid sensitive screening procedure in the diagnosis or exclusion of childhood intussusception. Probability of surgical reduction was associated with size of of total thickness and external rim thickness.
Abdomen ; Barium ; Child* ; Diagnosis* ; Emergency Service, Hospital ; Enema ; Humans ; Infant* ; Intussusception* ; Mass Screening ; Ultrasonography*

Benign prostatic hyperplasia is one of the most common afflictions in an aged man, but the surgery has been the only therapeutic option in the treatment of benign prostatic hyperplasia. Recently, other alternative therapeutic modalities such as pharmacological, hormonal, less invasive treatment(laser, stents, thermotherapy, etc.) were developed. The prostatic laserthermia is one of the new therapeutic tool being evaluated for the treatment of BPH. The aim of this study is that the prostatic laserthermia will be an alternative therapeutic modality for BPH as transurethral resection of prostate(TURP). A total of 92 patients(ages 49 to 90 years) who were diagnosed as BPH were included in the study, underwent uroflowmetry, transrectal ultrasound and AUA symptom scoring. 34 of 92 patients were treated with TURP. And 58 of the 92 patients were treated with prostatic laserthermia. After the treatments, each patients were followed by uroflowmetry and AUA symptom score at post operative 1, 3 and 6 months. In TURP group, the preoperative peak flow rate was changed from 8.33+/-4.5ml/sec, to 14.65+/-4.74 ml/sec, 14.67+/-4.08 ml/sec and 14.60+/-4.63 ml/sec, at postoperative lst, 3rd and 6th month respectively. The amount of average residual urine was decreased from 158.l+/-121.6 ml, to 41.9+/-22.3 ml, 43.3+/-27.1 ml and 58.2+/-27.5 ml, at 1st, 3rd and 6 month respectively. Also the AUA symptom score was decreased from 22.5+/-7.0, to 9+/-4.7, 9.3+/-4.3 and 9.5+/-5.2, at postoperative 1st, 3rd and 6th month. In prostatic laserthermia group, the preoperative average peak flow was 9.33+/-6.30 ml/sec, changed to 11.46+/-5.20 ml/sec, 11.67+/-5.40 ml/sec and 11.72+/-5.27 ml/sec at postoperative lst. 3rd and 6th month. The preoperative average mean flow was 4.75+/-2.87 ml/sec, increased to 5.47+/-2.69 ml/sec, 5.l8+/-2.69 ml/sec and 5.28+/-3.06 ml/ sec at 1st, 3rd and 6th month. The preoperative average residual urine was 130.9+/-154.7 ml/sec, decreased to 59.9+/-66.6 ml/sec, 50.6+/-57.0 ml/sec and 31.3+/-45.7 ml/sec at postoperative lst, 3rd and 6th month. The preoperative average AUA symptom score was 27.0+/-5.9, decreased 19.1+/-8.1, 18.4+/-8.7 and 17.5+/-9.1 at 1st, 3rd and 6th month. When comparing the parameters between two treatment groups, improvement of peak flow rate was greater in TURP than in Prostatic laserthermia group(p<0.01). Decrease of AUA symptom score and amount of residual urine also were greater in TURP than in prostatic laserthermia group. As the result TURP is more effective than prostatic laserthermia in peak flow rate at 1st month and AUA symptom score at lst, 3rd and 6th month t < 0.05). But laserthermia also appears to be as effective as TURP in the decrease of postvoid residuals. It could be suggested that prostatic laserthermia is an alternative therapeutic modality of BPH, especially old man who has some risk factors for operation. Key Word : transurethral resection, laserthermia.
Humans ; Hyperthermia, Induced ; Prostatic Hyperplasia* ; Risk Factors ; Stents ; Transurethral Resection of Prostate* ; Ultrasonography