PURPOSE: To avoid prolonged recovery time and scar tenderness in open carpal tunnel release and possible nerve or tendon injuries by bulky instruments in endoscopic techniques, we tried to percutaneously release the transverse carpal ligament using simple, thin instruments. MATERIALS AND METHODS: We performed carpal tunnel release percutaneously through a single small incision on the wrist with curved mosquito and meniscectomy hook knife under general or regional anesthesia in 41 wrists of 27 patients during the last 5 years and followed up for at least one year. Before and after release, endoscopic examinations were done to rule out space occupying lesions or other anormalies and to confirm complete release. RESULTS: According to the Cseuz's criteria, 38 cases (93%) showed excellent or good results, which was compatible to open or endoscopic technique with special instruments and there was no major neurovascular injury except one superficial palmar arch laceration associated with the second palmar incision in complicated case. CONCLUSIONS: From earlier experience, we learned that this simple technique may be used successfully with low cost without any fear of complication.
Anesthesia, Conduction ; Cicatrix ; Culicidae ; Humans ; Lacerations ; Ligaments ; Tendon Injuries ; Wrist

Variation in the facial pattern and effect of the rotational jaw growth on the facial proportion were studied in serial cephalometric radiographs of 40 Korean children (35 boys, 15 girls) ranging in age from 6 to 13 years. According to Y-axis (N-S-Gn) growth change during the 7 years of period, the subject who had exhibited "wave-like" manner of Y-axis growth change within +/- 2degrees was classified to the Parallelwise group and the subject who had exhibited Y-axis increase more than +/- 2degrees was classified to the Clockwise rotation group and the subject who had exhibited Y-axis decrease more than -2degrees was classified to the Counterlockwise rotation group. For the comparison of each group, a total of 22 morphologic variables were employed and the data were analyzed by means of computer morphometrics and statistical methods. On the basis of the finding of this study, the following trends were eatablished: 1. The Parallelwise group was 75%, the Clockwise rotation group was 12.5% and the Counterclockwise rotation group was 12.5%. 2. The growth pattern of cranial base was related to the rotation of mandible. 3. Maxillary prognathism was occured in the Counterclockwise rotation group and the rotation of palatal plane was occured in the Clockwise rotation group. 4. Mandibular prognathism was occured in the Parallelwise and the Counterclockwise rotation groups, especially in the Counterclockwise rotation group. 5. The degree of maxillo-mandibular divergency was constant in the Clockwise rotation group but decreased in the Counterclockwise rotation and the Parallelwise groups, especially in the Counterclockwise group. 6. There were no differences in the size of the anterior upper facial height (N-ANS) and the posterior lower facial height ((Go-Me)-PNS) but there were differences in the size of the anterior lower facial height (ANS-Me) and the posterior upper facial height ((S-N)-PNS) between each group. 7. The growth increment and the size of the facial gepth was not relater to the growth pattern of the face but the growth increment and the size of the facial height was related to the growth pattern of the face. 8. Proportional change due to the facial growth rotation was concentrated in the anterior lower face. 9. The most apparent difference between each group was happened in the size of the posterior cranial base (S-Ba) and the facial length (S-Gn).
Child ; Humans ; Jaw ; Mandible ; Prognathism ; Skull Base

No abstract available.
Choriocarcinoma* ; Female ; Pregnancy

PURPOSE: Bacillus Calmette-Guerin(BCG) immunotherapy is the treatment of choice for adjuvant therapy of superficial bladder cancer. The outcomes of a 6 week course of BCG immunotherapy was compared with those of a modified 6 3 maintenance therapy. MATERIALS AND METHODS: Between January 2001 and June 2007, 123 patients with a superficial bladder cancer were treated with a transurethral resection of the bladder tumor(TURBT) and intravesical BCG. For the 93 patients, BCG was administered over a six week course. For the remaining 30 patients, BCG was administered for six weeks followed by three weekly instillations at 3, 6, 12, 18, 24 and 36 months. The recurrence rate, time to recurrence and progression rate were assessed and analyzed. RESULTS: In the six week therapy group, the overall recurrence rate, mean recurrence interval and median follow up was 31.2%(29/93), 15.9 months and 19.4 months, respectively. The recurrence rate according to stage and grade was 27.6%(8/29), 33.9%(21/62) and 0%(0/2) on Ta, T1 and carcinoma in situ(CIS), respectively, and 29.6%(21/71), 40%(8/20) in low grade and high grade, respectively. Five cases in the T1 high grade and 1 case in T1 low grade group progressed to T2. In maintenance therapy, the overall recurrence rate, mean recurrence interval and median follow up was 16.7%(5/30), 16.4 months and 24.8 months, respectively. The recurrence rate according to stage and grade was 14.3%(1/7), 14.3%(3/21) and 50%(1/2) on Ta, T1, CIS, respectively, and 15.0%(3/20), 12.5%(1/8) in low grade and high grade, respectively. One case in the CIS sub group progressed to T4a. CONCULSIONS: These results show a lower recurrence rate in the modified 6 3 maintenance therapy group than in the 6 week therapy group. Therefore, modified 6 3 maintenance therapy is more effective for preventing a recurrence in a superficial bladder cancer than 6 week therapy.
Bacillus ; Follow-Up Studies ; Humans ; Immunotherapy ; Mycobacterium bovis ; Recurrence ; Urinary Bladder ; Urinary Bladder Neoplasms

BACKGROUND: Laparoscopic cholecystectomy has become the standard treatment of benign gallbladder disease. It requires the skill of a trained surgeon, and its safe performance. The advantages of laparoscopy are less postoperative pain, absence of cosmetic damage, shorter recovery times, and decreased length of hospital stays compared with conventional open surgery. METHODS: We reviewed 500 consecutive laparoscopic cholecystectomies retrospectively at the department of general surgery of Maryknoll Hospital from February 1992 to May 1999. RESULTS: There were 175 males and 325 females(M:F=1:1.86) with ages ranged from 21 to 78 years (mean: 50.0 year). Preoperatively, 72 patients underwent endoscopic retrograde cholagiography and 7 patients underwent endoscopic sphincterotomy due to common bile duct stone. Mean operation time was 73.7 minutes. Operative cholangiogram was attempted in 8 patients. Conversion to open cholecystectomy during operation was done in 8 cases(1.6%) and leading causes were severe adhesion, uncontrolled bleeding, suspected malignancy, bile duct injury. Operative Complications occured in 18 patients(3.6%): bile duct injury 1, postoperative bleeding 1, bile leakage 4,subcutaneous emphysema 1, abdominal wall hematoma 3, wound infection 8. There was no operative mortality. The length of hospital stay ranged from 2 to 15 day with average of 4.7 day. CONCLUSION: Laparoscopic cholecystectomy is a safe and effective operation in patients with benign gallbladder diseases.
Abdominal Wall ; Bile ; Bile Ducts ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Common Bile Duct ; Emphysema ; Gallbladder Diseases ; Hematoma ; Hemorrhage ; Humans ; Laparoscopy ; Length of Stay ; Male ; Mortality ; Pain, Postoperative ; Retrospective Studies ; Sphincterotomy, Endoscopic ; Wound Infection

Prostate cancer can be prevented more easily than other types of cancers, thanks to the following reasons: The presence of precursor lesions, longer doulbling time of cancerous cells, high incidence and prevalence, and susceptibility to chemo-preventive agents such as 5 alpha reductase inhibitor (5ARI). The following risk factors may increase the incidence of prostate cancer: age (older than 50), family history of prostate cancer, race (African-American), hormones (testosterone, dehydrotestosterone), and diet high in dairy foods and calcium. The following protective factors may decrease the risk of prostate cancer: Lycopene, Soy, Green tea, Vit. D, and taking Finasteride or Dutasteride. The following have not been proven to prevent prostate cancer: Selenium, vitamin E, retinoid, and multivitamins. However, their effectiveness is still under investigation. Avoiding risk factors such as smoking, being overweight and lack of exercise may help prevent cancers. Increasing protective factors such as quitting smoking, eating a healthy diet and exercising may also help prevent cancers. Some clinical studies are conducted on polyphenon E for high grade PIN, Vitamin D, fish oil, green tea, and aspirin for prostate cancer prevention. Prostate cancer is an attractive and appropriate target for cancer prevention because of its incidence, prevalence and disease-related mortality. In addition to changing life style with healthy food and reducing dairy and calcium intake, taking certain drugs (5ARI) may prevent cancer development.
Aspirin ; Azasteroids ; Calcium ; Carotenoids ; Catechin ; Cholestenone 5 alpha-Reductase ; Continental Population Groups ; Diet ; Dutasteride ; Eating ; Finasteride ; Humans ; Incidence ; Life Style ; Overweight ; Prevalence ; Prostate ; Prostatic Neoplasms ; Risk Factors ; Selenium ; Smoke ; Smoking ; Tea ; Vitamin D ; Vitamin E ; Vitamins

No abstract available.
Polycystic Kidney Diseases* ; Tuberous Sclerosis*

PURPOSE: To evaluate the usefulness and effectiveness of transurethral coagulation and incision of the ejaculatory duct for hematospermia caused by ejaculatory duct cyst and obstruction. MATERIALS AND METHODS: Twenty-six patients with hematospermia were enrolled. Ejaculatory duct cyst or obstruction was diagnosed by transrectal ultrasound or MRI, revealing seminal vesicle hypertrophy and cystic dilated ejaculatory ducts. One patient had hematospermia associated with infertility. The mean age of the patients and their duration of symptoms were 42.7 years (range, 25-67 years) and 16 months (range, 1-60 months), respectively. All patients underwent transurethral management for treatment of their ejaculatory duct obstruction in the form of incision and coagulation of the ejaculatory duct. We used a 9.5 Fr rigid ureteroscope (Stortz(R), Germany) and a Bugbee electrode. Patients were followed for more than 3 months after the procedure. RESULTS: All patients reported improvement of hematospermia and disappearance of midline cysts, except for one patient. The one case, ureteroscope failed to pass through verumontanum. A ejaculatory duct cyst was found in 18 cases. Calculi were present in the seminal vesicle and ejaculatory ducts in 7 patients and were removed with endoscopic instruments. One infertile patient regained reproductive ability after the procedure. Postoperative complications, such as epididymitis, orchitis, or retrograde ejaculation were not observed. CONCLUSIONS: Transurethral incision and coagulation was a safe and effective treatment option for hematospermia caused by ejaculatory duct obstruction and is considered to be a successful treatment option for infertility secondary to ejaculatory duct obstruction.
Calculi ; Ejaculation ; Ejaculatory Ducts ; Electrodes ; Endoscopy ; Epididymitis ; Hemospermia ; Humans ; Hypertrophy ; Infertility ; Male ; Orchitis ; Postoperative Complications ; Seminal Vesicles ; Ureteroscopes

No abstract available.
Calcium* ; Humans ; Infant, Newborn*

OBJECTIVE: To show the value of rotating chair test (ROT) as an adjunct to the conventional electronystagmography (ENG) examination including caloric test for the diagnosis of vestibular lesions. BACKGROUND: Since caloric stimulatim is regarded as a very low frequency (0. 003Hz) test, it is desirable to test the function of horizontal semicircula canals by stimulating with faster frequencies. Baloh et al. (1984a) described that lesions ofdifferentiated by ROT. Leigh and Zee(1991) told that ROT can give more accurate and reproducible results than do caloric tests. METHOD: 30 patients who suffered from vertigo with either peripheral or central pathology were given computerized ENG and ROT. We discuss the representative examples of our initial experience with ROT. RESULTS: 1.In eight patients with known peripheral pathology, low-frequency phase deficits, asymmetry toward the lesim side and VOR suppression by gazefixation were seen during ROT. With bilateral peripheral vetibular disease, the ROT could identify remaining vestibular function at higher frequencies. 2. Seven patients with lesions of central vestibular structure showed abnormalities of saccades and pursuit during ENG and failure of VOR suppression by gaze fixation during ROT. 3. Out of 15 patients whose lesions could not be localized distinctly after caloric test, four patients were suggested to have central pathology. CONCLUSION: ROT can be a useful method to study the vestibular abnonnahties and an adjunct to the conventional ENG test.
Caloric Tests ; Diagnosis ; Electronystagmography ; Humans ; Pathology ; Saccades ; Vertigo* ; Vestibular Function Tests