No abstract available.
Circumcision, Male* ; Female ; Male ; Sensation*

A 51-year-old man underwent laparoscopic cholecystectomy for gallbladder stones. He had developed fever, chills, and abdominal pain four days after the procedure. In the drain tube, bile was persistently observed. An endoscopic retrograde cholangiopancreatography (ERCP) showed a leakage from the small duct into the right intrahepatic duct. We determined that the bile leak was caused by an injury to the ducts of Luschka. An endoscopic sphincterotomy (ES) using a 5-F nasobiliary tube (NBT) was performed, and the leak was resolved in five days. Herein, we report a bile leak caused by an injury to the ducts of Luschka after laparoscopic cholecystectomy. The leak was treated with ES using 5-F NBT, and the resolution of the leak was confirmed without repeated endoscopy.
Abdominal Pain ; Bile Ducts ; Bile* ; Chills ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Drainage* ; Endoscopy ; Fever ; Gallbladder ; Humans ; Middle Aged ; Sphincterotomy, Endoscopic

Schwannomas are benign tumors derived from the Schwann cells of the nerve sheath. These are rare tumors that can be found in any part of the body although fewer than 4% of these tumors involve the nasal cavity and paranasal sinuses. Here, we present three cases of sinonasal schwannoma. The tumor masses were removed by endoscopic excision under general anesthesia. Pathological examination of the excised specimens confirmed schwannoma and the tumor cells were immunoreactive for S-100 protein. The patients are doing well with no evidence of recurrence.
Anesthesia, General ; Humans ; Nasal Cavity ; Neurilemmoma ; Nose ; Paranasal Sinuses ; Recurrence ; S100 Proteins ; Schwann Cells

OBJECTIVES: To investigate the effect of LH receptor in folliculogenesis, we confirm the expression level of LH receptor (LH-R) mRNA in human granulosa cells (GCs) and its expression levels were analyzed by comparison to embryo developmental rate and pregnancy rate. MATERIALS AND METHODS: GCs were obtained at the time of oocyte retrieval from the patients undergoing IVF-ET program. The patients were divided into two groups: Group I (n=20) is poor responder (retrieved oocyte(s)< or =3ea), Group II (n=80) is normal responder (retrieved oocytes>3ea). After the extraction of total RNA, semiquantitative RT-PCR was performed and the expression level of LH-R mRNA was normalized by beta-actin. Statistical analysis was performed by using Chi(2) test, Student's t-test and Pearson correlation. RESULTS: In Group II, the relative values of LH-R mRNA (0.680 vs. 0.463, p<0.005) and pregnancy rate (54.7% vs. 23.1%, p<0.05) were significantly higher than in Group I. Number of retrieved oocyte(s) was gradually increased when the expression of LH-R mRNA was increased (p<0.05). But the quality of retrieved oocyte and transferred embryo were not related with the expression of LH-R mRNA. When the pregnancy rate was compared with FSH only group and FSH combined with hMG group in the ovarian stimulation protocol, FSH combined with hMG group was significantly higher than FSH only group in Group I (37.5% vs. 0%), and the expression of LH-R mRNA was significantly higher in hMG combined group than FSH only group (p<0.05). CONCLUSION: Expression level of LH-R mRNA has important role in ovarian function related with the response to gonadotrophin in human folliculogenesis. Furthermore these data might provide the evidence that additional use of hMG is helpful to poor responders.
Actins ; Embryonic Development ; Embryonic Structures ; Female ; Granulosa Cells ; Humans ; Oocyte Retrieval ; Oocytes ; Ovulation Induction ; Pregnancy Rate ; Pregnancy* ; Receptors, LH* ; RNA ; RNA, Messenger

The most common disease process involving the frontal sinus is infection secondary to inadequate drainage through the frontal recess. Obstruction of the frontal recess may result from rhinosinusitis, allergic rhinitis, nasal polyposis, tumor and traumatic injury. The principle treatments are not only ventilation and drainage but also removal of predisposing factors. If there is no response to conservative treatment, surgical treatment is considered. To prevent closure of the frontal recess, external approach, endoscopic approach, grafts, indwelling tubes and mucoperiosteal flaps have been used. Insertion of silicone tube in frontal recess is a simple and easy method of drainage through frontal recess. We report a case of traumatic recurrent frontal sinusitis which was treated by endoscopic sinus surgery with silicone T-tube insertion.
Drainage ; Frontal Sinus ; Frontal Sinusitis ; Rhinitis ; Rhinitis, Allergic, Perennial ; Silicones ; Transplants ; Ventilation

Arteriovenous malformation (AVM) consists of an abnormal connection between artery and vein without any interposed capillary bed, and is usually congenital. However, acquired AVM is quite rare, and is usually caused by injury, which induces direct arteriovenous shunting. Acquired digital AVM is a distinct entity, which was first described by Kadono et al. in 2000, and was thought to result from shunts between an artery and a vein in a finger tip. We report a case of acquired digital AVM in a 44-year-old women. The patient showed punctate hyperketatotic ectasia on the pulp of the right thumb. Histological finding showed dilated venous and arterial vessels in upper and lower dermis, and shunts between arteriols and venules.
Adult ; Arteries ; Arteriovenous Malformations* ; Capillaries ; Dermis ; Dilatation, Pathologic ; Female ; Fingers ; Humans ; Thumb ; Veins ; Venules

Squamous papilloma is a benign epithelial tumor that can develop in any mucosal site of the upper aerodigestive tract. While this tumor is found mainly in the squamocilliary junction, its distribution does not occur randomly. However, in many cases, squamous papilloma is asymptomatic, and only a small number of cases are diagnosed. We experienced a patient presented with the complaint of snoring. This patient was diagnosed as having squamous papilloma of the soft plate on the nasopharyngeal surface. The patient might have been misdiagnosed as having merely a simple snoring problem, as nothing was found upon macroscopic examination. Nevertheless, squamous papilloma was detected through fiberoptic nasopharyngolaryngoscopy. This patient was successfully treated with laser-assisted uvulopalatoplasty, and we report this case, along with the associated literature.
Humans ; Nasopharyngeal Neoplasms ; Palate, Soft ; Papilloma ; Snoring

Unlike the small cell carcinoma of the lung, much remains to be discovered about the natural history and of optimal therapy of primary small cell carcinoma of the pancreas. We experienced a case of a primary small cell carcinoma of pancreas with both adrenal metastasis. The patient was a seventy-year old woman who had complained of right upper quadrant abdominal pain for 1 month. Chest x-ray revealed no abnormality. Abdominal CT scan showed a non-enhancing low density mass in uncinate process of pancreas, retropancreatic lymphadenopathy and well defined masses in both adrenal gland. CT-guided biopsy of pancreas showed small cell carcinoma. Herein, we report a case of primary small cell carcinoma of the pancreas with both adrenal metastasis and review the literature.
Abdominal Pain ; Adrenal Glands ; Biopsy ; Carcinoma, Small Cell* ; Female ; Humans ; Lung ; Lymphatic Diseases ; Natural History ; Neoplasm Metastasis ; Pancreas* ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. METHODS: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age,sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. RESULTS: 1) Group 1 patients had lower glucose level{63.3+/-30.8(mg/dl)} than that of the group 2{98.5+/-34.2(mg/dl), p<0.05}, and higher LDH level{776.3+/-266.0(IU/L)} than the group 2 patients{376.3 +/-123.1(IU/L), p<0.05), and also longer duration of symptom before treatment{2.0+/-1.7(month)} than the group 2{ 1.1 +/-1.2(month), p<0.05)}, respectively. 2) In group 1, FVC changed from preoperative 2.55+/-0.80(L) to postoperative 2.99+/-0.78(L)(p<0.05), and FEV1 changed from preoperative 2.19 +/- 0.70(L/sec) to postoperative 2.50+/-0.69(L/sec) (p<0.05). 3) There was no difference in pleural fluid protein level(5.05+/-1.01(gm/dL) and 5.15+/-0.77 (gm/dl), p>0.05) and WBC differential count between group 1 and group 2. CONCLUSION: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.
Biochemistry ; Cell Count ; Drug Therapy ; Dyspnea ; Glucose ; Humans ; Pleural Effusion* ; Pleurisy ; Prospective Studies ; Tuberculosis, Pleural*

An umbilical omphalomesenteric duct polyp arises from remnants of the omphalomesenteric duct, which connects the midgut to the Yolk sac of the embryo and is closed completely at 7 weeks. Persistence of the omphalomesenteric duct shows various clinical manifestations of embryologic anomalies such as umbilical enteric fistula, Meckel's diverticulum or vitelline cysts. In particular, the umbilical omphalomesenteric duct polyp should be clinically discerned from persistent granulation tissue or pyogenic granuloma and attention should be given to external openings with discharge, which can be suggestive of underlying anomalies. We herein report an case of an umbilical omphalomesenteric duct polyp in a 10-year-old male who had no underlying anomalies.
Child ; Embryonic Structures ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Meckel Diverticulum ; Polyps* ; Vitelline Duct* ; Vitellins ; Yolk Sac