Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

OBJECTIVE: To compare clinical features and surgical outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH) by the number of ports in the treatment of uterine myoma and adenomyosis. METHODS: Between 1st January 2009 and 31th March 2010, 50 patients underwent 5 mm-2 port LAVH and 10 mm-3 port LAVH respectively by same surgeon at Chosun university hospital. We compared clinical features and surgical outcomes. RESULTS: There was no difference in weight of uterus between the 5 mm-2 port LAVH group and the 10 mm-3 port LAVH group (465.2+/-206.9 g vs. 470.8+/-148.5 g) (Mean+/-S.D.), and in amounts of blood loss during procedure between the two groups (115.0+/-179.3 mL vs. 125.0+/-211.7 mL). The duration of procedure showed a difference between the two groups(55.1+/-12.0 minutes vs. 60.4+/-19.5 minutes) (p=0.03). In the 5 mm-2 port LAVH group, 2 of 50 (4%) converted to laparotomy, and 1 of 50 (2%) in the 10 mm-3 port LAVH group. There was no difference in length of postoperative hospital day between the two groups (5.8+/-1.0 days vs. 6.3+/-1.6 days). In the comparison of postoperative complications, 1 of 50 (2%) required readmission and reoperation for both of the two groups. CONCLUSION: We conclude that 5 mm-2 port LAVH could be a available method in the treatment of uterine myoma and adenomyosis.
Adenomyosis ; Female ; Humans ; Hysterectomy, Vaginal ; Laparotomy ; Myoma ; Postoperative Complications ; Reoperation ; Uterus

OBJECTIVE: To compare clinical features of minilaparoscopic radiofrequency myolysis (MLRFM) with laparoscopic-assisted vaginal hysterectomy (LAVH) in the treatment of uterine myoma. METHODS: Between 1st January 2006 and 31th March 2009, 125 patients underwent LAVH and 125 patients underwent MLRFM by same surgeon at the University of Chosun Hospital, Department of Gynecology. We compared the age of patients, indication for treatment, myoma size, major symptom, duration of procedure, amounts of blood loss and postoperative transfusion, length of hospital day, postoperative complication and satisfaction between the two groups. RESULTS: There were significant differences in duration of procedure between the LAVH group and the MLRFM group (69.0+/-31.6 minutes vs 43.5+/-19.8 minutes) and in the amounts of blood loss during procedure (215.2+/-215.0 mL vs 0.8+/-8.9 mL). The amounts of postoperative transfusion was 0.3+/-0.7 pints, 16 of the 125 (12.8%) for the LAVH group and no one underwent postoperative transfusion for the MLRFM group. There was significant difference in length of postoperative hospital day between the LAVH group and the MLRFM group (5.0+/-1.2 days vs 2.3+/-1.2 days). In the comparison of postoperative complications, there was no significant complication for the LAVH group, but there was major complications requiring readmission and reoperation for the MLRFM group. In MLRFM group, postoperative myoma size decreased compared to preoperative size. CONCLUSION: We conclude that there was no treatment of choice in uterine myoma. When considering treatment of uterine myoma, we should choose appropriate method after analyzing patient characteristics, general condition, uterine myoma characteristics case by case.
Female ; Gynecology ; Humans ; Hysterectomy, Vaginal ; Myoma ; Postoperative Complications ; Reoperation

PURPOSE: Febrile convulsions (FC) were considered to be a benign seizure syndrome that is distinct from epilepsy. But it is thought that children with complex features i.e., partial or prolonged seizures or multiple episodes of FC would bear a higher risk of developing unprovoked seizures. The aim of this study is to look into the relative significance of each criteria that define complex febrile convulsions (CFC) as a predictor of subsequent epilepsy. METHODS: All children were retrospectively identified for a febrile seizure through pediatric departments of the Konyang University Hospital. Information was collected from medical records and interviews with parents. Patients with abnormal neurological examinations at presentation were excluded. RESULTS: This study was performed from March 2000 to December 2003. Sixty-three out of 314 children (20.0%) with febrile convulsion fulfilled the criteria for CFC and forty-four children of them have been followed for 12 months or more. Ten of these (23.2%) had unprovoked seizures for 14-62 months (median 34.2+/-11.6 months). The patients with partial FC showed a trend toward a higher risk (57.1%) of developing epilepsy than the patients with multiple or prolonged febrile convulsions (26.7%, 24.1% respectively). CONCLUSION: We found that the partial feature of febrile convulsion is associated with subsequent epilepsy.
Child* ; Epilepsy ; Humans ; Medical Records ; Neurologic Examination ; Parents ; Retrospective Studies ; Seizures* ; Seizures, Febrile*

An epidermal cyst, presenting as an intrascrotal tumor, with no relation to the testicles or cord structures, is a rare benign tumor. Their etiology is unknown, but the most widely accepted theory on the histogenesis of testicular epidermal cysts is that they are the end result of a monolayer teratoma arising from germ cells; however, an extratesticular epidermoid cyst is believed to be an abnormal closure of the median raphe and urethral groove. An extratesticular epidermal cyst is normally subcutaneous, and can be localized anywhere along the median raphe, from the distal penis to the anus. To our knowledge, there has been no case reported in the Korean literature. A case of an intrascrotal epidermal cyst is reported in a 44-year-old man.
Adult ; Anal Canal ; Epidermal Cyst* ; Germ Cells ; Humans ; Male ; Penis ; Scrotum ; Teratoma ; Testis

Herein, a new left renal vein stenting procedure (expandable metallic stent placement), which provided relief for an 18-year-old man incapacitated by an intermittent gross hematuria, is reported. The placement of an expandable metallic stent is a minimally invasive therapy, and a simpler and more physiological therapy than previous approaches to Nutcracker syndrome.
Adolescent ; Hematuria ; Humans ; Renal Veins ; Stents*

BACKGROUND:Accurate and timely diagnosis of acute surgical disease in pregnant patient is chal enging. Although magnetic resonance imaging (MRI) is the most accurate modality to diagnose acute appendicitis in pregnant patients, it is often used as a last resort because of high cost and long scan time. We performed this study to analyze differential diagnoses of appendix MRI and to investigate if there are any blood tests that can predict surgical condition in pregnant patients. METHODS:A retrospective, cross-sectional study was conducted on 46 pregnant patients who underwent non-enhanced appendix MRI in suspicion of acute appendicitis from 2010 to 2016. Differential diagnoses of appendix MRI were analyzed and blood tests were compared between those who had surgical and non-surgical disease. RESULTS:Appendix MRI differentiated two surgical disease; acute appendicitis and ovarian torsion; and various non-surgical conditions such as uterine myoma, hydronephrosis, ureterolithiasis and diverticulitis among clinically suspected acute appendicitis in pregnancy. The diagnostic accuracy of MRI for acute appendicitis in this study was 93.5％. Patients who had surgical disease showed significantly higher WBC count (≥11,000/mm3), proportion of neutrophils in the WBC (≥79.9％), neutrophil-to-lymphocyte ratio (NLR≥6.4), levels of C-reactive protein (CRP≥1.82 mg/dL) and bilirubin (≥0.66 mg/dL ) than those who had non-surgical disease. CONCLUSION:MRI can reliably differentiate surgical conditions and several blood tests (WBC, proportion of neutrophils in the WBC, NLR, CRP, bilirubin) can help anticipate acute surgical condition among pregnant patients suspected to have acute appendicitis.

From June 1990 to December 1998, 792 kidney transplantations were performed at Asan Medical Center. 436 cases(55M) were from living-related donors, 139 cases(17.6%) were from living-unrelated donors and 217 cases(27.4%) were from cadaveric donors. The results of the trasnplantation were analyzed according to the various factors known to influence the outcome of transplantation. In living transplants, the overall patients survival rate was 98.2% at 1 year and 95.8% at 5 years, the corres-ponding allograft survival rate was 96.9 and 86.1N. In cadaveric transplants, the overall patients survival rate was 94.3% at 1 year and 94.3% at 5 years, the corresponding allograft survival rate was was 90.296 and 84.8%. In living transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, pretrans-plant blood transfusion, diabetic history had no effect on allograft survival rate. But HLA DR cornpa-tability, serum creatinine(2.5mg/dL) at discharge and rejection history had effect on allograft survival(p<0.05). In living-related transplants, 5 year allograft survival rate was 100% at HLA identical group and 86% at HLA haplomatched group. But the statistical significance was not found(p=0.052). In cadaveric transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, HLA DR match, diabetic history, pretransplant transfusion had no effect on allograft survival. But serum creatinine at discharge(>2.5mg/dL) and posttransplant rejection had effect on allograft survival.
Allografts ; Blood Transfusion ; Cadaver ; Chungcheongnam-do* ; Creatinine ; Humans ; Kidney Transplantation ; Survival Rate ; Tissue Donors

BACKGROUND: Arterial stiffness is an important factor in atherosclerosis. Thus we examined whether aerobic exercise could reduce arterial stiffness in obese women with type 2 diabetes without diabetic complication. METHODS: A total of 35 women with type 2 diabetes (body mass index, 26.6+/-2.8 kg/m2; age, 56.4+/-1.9 years; duration of diabetes, 4.7+/-4.8 years) were assigned to aerobic exercise group (AEG) or control group (CG). AEG completed a 12-week exercise program (3.6 to 5.2 metabolic equivalents, 3 day/week, 60 min/day), with their exercise activities monitored by accelerometers. We measured abdominal total fat area (TFA), visceral fat area (VFA), and subcutaneous fat area (SFA) by computed tomography, insulin sensitivity by insulin tolerance test (K(ITT)), and augmentation index (AIx) by SphygmoCor at baseline and at the end of the 12-week program. RESULTS: The AIx was improved in the AEG compared with the CG (P<0.001). The percent change of AIx had significant correlation with the improvement of physical activity energy expenditure (PAEE), aerobic capacity, TFA, and SFA (r=-0.416, P=0.013; r=0.560, P<0.001; r=0.489, P=0.003; r=0.531, P=0.001, respectively), but not with insulin sensitivity, energy intake, or VFA. CONCLUSION: Improvement in aortic stiffness by aerobic exercise is related with the improvement of aerobic capacity, PAEE, and total fat but not with insulin sensitivity or energy intake in obese women with type 2 diabetes.
Abdominal Fat ; Atherosclerosis ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Energy Intake ; Energy Metabolism* ; Exercise* ; Female ; Humans ; Insulin ; Insulin Resistance* ; Intra-Abdominal Fat ; Metabolic Equivalent ; Motor Activity* ; Subcutaneous Fat ; Vascular Stiffness*

OBJECTIVES: To report two cases of neuropathy due to methyl bromide intoxication. METHODS: Workers, engaged in the fumigating process, complained fatigue, general weakness, ataxia, and hypersomnia. We evaluated them with blood tests, neurophysiologic studies and MRI and investigated their occupational history. RESULTS: Increased signal intensities were found in the medulla oblongata and paraver mian of cerebellum in MRI and after 11 days, high signal intensities were reduced in the following MRI. In the other case, polyneuropathy and rlght lower brainstem lesion were observed In the NCV and BAEP studies. CONCLUSIONS: We confirmed that worker's symptoms were related to methyl bromide exposure in the fumigation. It is necessary that we should evaluate present condition of fumigating process and prepare appropriate methods to protect workers engaged in the fumigation.
Ataxia ; Brain Stem ; Cerebellum ; Disorders of Excessive Somnolence ; Fatigue ; Fumigation* ; Hematologic Tests ; Magnetic Resonance Imaging ; Medulla Oblongata ; Polyneuropathies