No abstract available in English.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies

A lipomatous tumor originating in the uterus is a rare benign neoplasm, and most reported cases have been of the mixed type. Authenticated cases of pure lipomas of the uterus are extremely rare. We report one such case in which the findings of magnetic resonance imaging provided the basis for preoperative diagnosis.
Diagnosis ; Lipoma* ; Magnetic Resonance Imaging ; Uterine Neoplasms ; Uterus

BACKGROUND: Epidural morphine is usually associated with decreased bowel motility and increased transit time. Low doses of intravenous naloxone have been known to reduce morphine-induced side effects including intestinal hypomotility without reversing analgesia, but the effect of epidural naloxone has not been defined in any human study. Therefore, we evaluated bowel motility and analgesia when naloxone was administered via the epidural route. METHODS: Forty patients having epiduro-general analgesia for subtotal gastrectomy were randomly assigned to one of two study groups. As a means of postoperative pain control, all received 1.5 mg of epidural morphine bolusly 1 hour before the end of surgery, and a continuous epidural infusion was started using a two-day infusor containing 2.5 mg of morphine in 0.125% bupivacaine 100 ml with either no naloxone (control group, n=20) or 5 microgram/kg/day of naloxone (experimental group, n=20). We measured the time to the first postoperative passage of flatus and feces to evaluate the restoration of bowel function, and visual analog scales (VAS) for pain, during rest and movement. Scores were taken at 2 and 4 hours after the operation, 7 AM, 1 PM, and 7 PM of the 1st postoperative day and 7 AM and 1 PM of the 2nd postoperative day. RESULTS: The experimental group revealed less time to the first postoperative passage of flatus and feces. No significant difference was found in resting and movement VAS between two groups. CONCLUSION: This study suggests that epidural naloxone reduces epidural morphine-induced intestinal hypomotility without reversing analgesic effects.
Analgesia ; Bupivacaine ; Feces ; Flatulence ; Gastrectomy* ; Humans ; Infusion Pumps ; Morphine* ; Naloxone* ; Pain, Postoperative ; Visual Analog Scale

Actinic reticuloid as a manifestation of chronic actinic dermatitis (CAD) is a rare dermatosis whose clinical and histologic features resemble other types of pseudolymphomas including mycosis fungoides and Jessner's lymphocytic infiltration, and it is regarded as an eventual stage of various photodermatoses like photosensitive eczema or persistent light reaction or chronic photoallergic contact dermatitis and so on. Phototests in the patients with actinic reticuloid usually reveal hypersensitivity to UVB, UVA, and sometimes to visible light. We present a case of actinic reticuloid in a 65-year-old male, whose skin lesions developed as erythematous lichenified infiltrating plaques on the face at first, and then spread themselves onto the upper trunk later. Histologically those skin lesions showed the aggregation of atypical lymphocytes and photobiologically the results of phototests revealed photosensitivity to UVB and UVA.
Actins* ; Aged ; Dermatitis, Photoallergic ; Eczema ; Humans ; Hypersensitivity ; Light ; Lymphocytes ; Male ; Mycosis Fungoides ; Photosensitivity Disorders ; Pseudolymphoma ; Skin ; Skin Diseases

Lateral osteotomy has been chosen as a part of rhinoplasty for modification of the nasal bony vault, alteration of the base width of the lateral walls, establishment of a new profile line of the nasal dorsum and lateral profile line, and closure of the open roof. Various methods of lateral osteotomy may be employed, however Orientals have characteristically broad and flat noses Compared to caucasians and for an esthetically satisfactory result, it is important to correct both in rhinoplasty. In this study, the authors performed their devised method of lateral osteotomy in 12 patients for the correction of broad, flat nasal dorsum and deviated noses. The operations could be broadly categorized into two groups: 1) short lateral osteotomy in which the lateral osteotomy line was incomplete and short, extending to the infraorbital rim; and 2) green-stick transverse osteotomy which was induced by in-siturotation fracture by osteotomy and, if considered necessary, augmentation rhinoplasty and nasal tip plasty were also performed simultaneously. Our nasal osteotomy has limited mobilization, where as the previous method has total mobilization, and it has the advantages of repositioning the broad and deviated nose in a preferable direction and shape, as well as the capability of narrowing the preferable area selectively. Especially if there is a necessity to correct both broad and flat noses such as in Orientals, our osteotomy methods have a synergistic effect in esthetic outcome when performed with augmentation rhinoplasty with a silastic implant. There were no complications such as relapse or air-way obstruction during the 4.5-month follow-up period. However, a long-term follow-up period is needed to evaluate the complications considering the physiologic aspect of the nose.
Follow-Up Studies ; Humans ; Nose ; Osteotomy* ; Recurrence ; Rhinoplasty*

Zygomatic arch fracture is one of the most commonly seen facial bone fractures and there have been many methods of reduction designed so far. However, for a simple fracture, the Gillies temporal approach is most commonly used because of the easy reducibility, and also because the depressed fracture can be approached without a facial incision. The Gillies temporal approach starts in the temporal area, between the temporalis muscle and deep temporal fascia. We have developed a new route which starts in the postauricular hair margin area and then reaches to the periosteum of the temporal bone. An elevator is then inserted to penetrate the periosteum and subperiosteal dissection is performed toward the zygomatic process of the temporal bone. At the origin of the zygomatic process, the route of dissection changes to the posterior aspect of the zygomatic arch using a curved palate elevator or the authors' modified Langenbeck elevator. This method of approach has been used in 6 cases of zygomatic arch fracture with good results and we report this method along with written reports.
Elevators and Escalators ; Facial Bones ; Fascia ; Hair ; Palate ; Periosteum ; Temporal Bone ; Zygoma*

Non-salivary type adenocarcinoma of the sinonasal tract is a rare entity and includes low grade and high grade adenocarcinomas, which show somewhat different clinical and histological features. We report a case of non-salivary type adenocarcinoma occurring in a 55-year-old man. Computed tomography showed a soft tissue mass in right nasal cavity and ethmoid sinus, which extended to the nasopharynx. Removed mass showed both high grade and low grade adenocarcinomatous areas, which have different histology from usual salivary type tumor. The high grade area mimicked intestinal adenocarcinoma and low grade area was similer to adenoma because of very well differentiated tumor glands.
Adenocarcinoma* ; Adenoma ; Ethmoid Sinus ; Humans ; Middle Aged ; Nasal Cavity ; Nasopharynx

Uereterorenoscopy has become a useful diagnostic tool for the evaluation and treatment of the ureteral diseases such as the filling defect upper tract hematuria and abnormal cytology. Keeping a clear visual field in ureterorenoscopy is an essential for the reducing of complication such as ureteral perforation. We used alternative suction with 4 Fr. ureteral catheter through side hole of ureterorenoscopic sheath in 32 cases without serious complications. We believe that this method may help not only keeping clear visual field but also doing ureterorenoscopy safely, while use ureteral catheter as a safety guide wire.
Hematuria ; Suction ; Ureter* ; Ureteral Diseases ; Urinary Catheters* ; Visual Fields*

Primary renal sarcoma is a rare malignant mesenchymal tumor with a variety of histologic type. The clinical differential diagnosis with renal cell carcinoma may be impossible. The prognosis of primary renal sarcoma is extremely poor and majority of patients die within 2 years. We experienced two cases or primary renal sarcoma, which was diagnosed by immunohistochemical stains.
Carcinoma, Renal Cell ; Coloring Agents ; Diagnosis, Differential ; Humans ; Kidney ; Prognosis ; Sarcoma*

BACKGROUND: For out-patient anesthesia a safe and rapid postoperative recovery, especially, the full recovery of psychological function for "street fitness" has become increasingly important. Up to the present, the scoring system - Steward postanesthesia recovery score - has been frequently used for the decision of discharge. But this system focuses on recovery of vital signs, other objective tests are needed to investigate cognitive and psychomotor function which is suitable for estimation of "street fitness". METHODS: The propofol group(n=70) received fentanyl 0.8 ug/kg followed by propofol I mg/kg for anesthesia induction. Continuous propofol infusion was initiated upon induction. Ventilation was supported with N2 O-O2 mixture. The enflurane group(n=70) was induced with sodium thiopental 4 mg/kg. 2.0 vo1% of enflurane with N2 O-O2 mixture was initiated immediately upon induction. Both group received vecuronium 0.08 mg/kg as muscle relaxants. We measured Steward postanesthesia recovery score as scoring system and seven kinds of parameters as cognitive and psychomotor function test. The tests were performed at three measurement points; the day before the operation and 30, 60 minutes after extubation. RESULTS: By the scoring system, no difference in recovery score at postop. 60 min. could be found between two groups. But by the cognitive and psychomotor function test, propofol group showed significantly better recovery than enflurane group at all tests, reaching control values at postop. 60 min. CONCLUSIONS: The scoring system is not suitable method for decision of discharge, thus cognitive and psychomotor function test should be performed for "street fitness" after outpatient anesthesia. Propofol was associated with less impairment in cognitive and psychomotor function than enflurane.
Anesthesia* ; Enflurane* ; Fentanyl ; Humans ; Outpatients ; Propofol* ; Sodium ; Thiopental ; Vecuronium Bromide ; Ventilation ; Vital Signs