PURPOSE: Our aim for this study was to evaluate early and late complications and outcomes of primary sleeve gastrectomy (PSG) versus conversion sleeve gastrectomy (CSG). METHODS: From February 2013 to December 2016, a total of 180 patients underwent sleeve gastrectomy (150 PSG and 30 CSG). All patients received a metal clipping at the end of the stapling line and a continuous seromuscular suture at the resection margin, for reinforcement. RESULTS: There were no differences in the percentages among males and females or age between the 2 groups, but the body mass index (BMI) of the PSG group was higher at 36.8 ± 4.7 than that of the CSG group (32.4 ± 5.7, P < 0.001). Three early postoperative complications were noted in the PSG group; 1 patient underwent repeat laparoscopic exploration due to pancreatic injury, and 2 other patients developed pulmonary atelectasis. On the contrary, 2 early minor complications were noted in the CSG group. Thirty-eight patients (25.3%) in the PSG group developed 43 late, minor complications, while 9 patients (30.0%) developed 11 late minor and 1 major complication in the CSG group. However, there was no difference in complication rate between PSG and CSG. Percentage excess BMI loss at 3, 6, and 12 months after surgery was comparable between the groups. CONCLUSION: PSG and CSG were comparable in terms of postoperative complications and loss of weight. Therefore, CSG could be used for failed primary restrictive bariatric surgery. However, the durability of these outcomes remains unknown.
Bariatric Surgery ; Body Mass Index ; Female ; Gastrectomy ; Humans ; Male ; Postoperative Complications ; Pulmonary Atelectasis ; Reoperation ; Sutures

The eight patients of neurocysticercosis have been diagnosed from 1985 to 1987 in the department of neurosurgery at The Baptist Hospital. Six patients had parenchymal cysts, one had a racemose cyst and the other one had a mixed cyst. The blood serum and CSF ELISA on six patients had a positive reaction for cysticercosis but the follow-up ELISA titers were variable three months later on these four. The racemose and mixed cysts were removed surgically due to mass effect and followed by praziquantel therapy. The parenchymal cysts were treated with praziquantel only. Praziquantel was given daily at 50mg/kg of body weight for two weeks or 30mg/kg of body weight for three weeks. The common side effects of praziquantel were headache, dizziness, nausea, seizure and focal neurological deficits. These side effects could be prevented or minimized by corticosteroid. The result of praziquantel therapy was excellent in all the patients except the mixed cyst.
Body Weight ; Cysticercosis ; Dizziness ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Headache ; Humans ; Nausea ; Neurocysticercosis ; Neurosurgery ; Praziquantel* ; Protestantism ; Seizures ; Serum

The eight patients of neurocysticercosis have been diagnosed from 1985 to 1987 in the department of neurosurgery at The Baptist Hospital. Six patients had parenchymal cysts, one had a racemose cyst and the other one had a mixed cyst. The blood serum and CSF ELISA on six patients had a positive reaction for cysticercosis but the follow-up ELISA titers were variable three months later on these four. The racemose and mixed cysts were removed surgically due to mass effect and followed by praziquantel therapy. The parenchymal cysts were treated with praziquantel only. Praziquantel was given daily at 50mg/kg of body weight for two weeks or 30mg/kg of body weight for three weeks. The common side effects of praziquantel were headache, dizziness, nausea, seizure and focal neurological deficits. These side effects could be prevented or minimized by corticosteroid. The result of praziquantel therapy was excellent in all the patients except the mixed cyst.
Body Weight ; Cysticercosis ; Dizziness ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Headache ; Humans ; Nausea ; Neurocysticercosis ; Neurosurgery ; Praziquantel* ; Protestantism ; Seizures ; Serum

PURPOSE: This study aimed to compare amount of weight loss, serum laboratory results, and bariatric analysis and reporting outcome system (BAROS) scores obtained before surgery with those obtained 1 year after laparoscopic adjustable gastric banding (AGB). MATERIALS AND METHODS: From January 2013 to November 2014, 32 consecutive patients who underwent AGB were enrolled in this study. This study was a retrospective analysis of our prospectively collected database. The BAROS score included BAROS weight, medical condition, quality of life, and complications recorded 1 year after AGB. Demographic and post-operative data were also collected and analyzed. RESULTS: Thirty-two patients were enrolled in this study, comprising 26 women and 6 men, with an average body mass index of 39.0±6.1 kg/m². The total BAROS score 1 year post AGB was 4.6±1.7, and it was classified as excellent grade. Among them, the quality of life score was 1.8±0.6. Four minor complications were noted. The serum laboratory values improved 1 year post surgery, including hemoglobin A1c, c-peptide, insulin, Homeostatic model assessment of estimated insulin resistance (HOMA IR), Homeostatic model assessment of beta-cell function (HOMA B), triglyceride, total protein, and uric acid. CONCLUSION: AGB showed that it is acceptable in aspect of BAROS outcome as well as weight loss, and serum laboratory result in short-term period.
Bariatric Surgery ; Body Mass Index ; C-Peptide ; Female ; Humans ; Insulin ; Insulin Resistance ; Male ; Prospective Studies ; Quality of Life ; Retrospective Studies ; Triglycerides ; Uric Acid ; Weight Loss

PURPOSE: Adjustable gastric banding (AGB) and sleeve gastrectomy (SG) are restrictive bariatric surgeries that are popular in Korea. However, patients often require further conversion surgeries because weight loss failure and surgical complications tend to occur. The aim of this study was to evaluate the feasibility and safety of conversion sleeve gastrectomy (CSG) after failed primary AGB (PAGB) or primary SG (PSG). MATERIALS AND METHODS: From February 2010 to April 2016, 21 consecutive patients who underwent CSG after failed PAGB or PSG were enrolled in this study. This study was a retrospective analysis of our prospectively collected database. Demographic, intra and post-operative data were collected and analyzed. RESULTS: Twenty-one patients were enrolled in this study. This comprised 20 women and 1 man, with an average BMI of 31.8±7.8 kg/m². Eighteen patients underwent PAGB and 3 underwent PSG. The mean operative time was 243.6±76.8 minutes, and the estimated blood loss was 190.9±233.2 ml. The mean hospital stay was 4.7±1.7 days. The mean follow-up after CSG was 9.3±1.0 months. Two cases developed immediate postoperative complications: one was a stricture (Clavien-Dindo surgical complication grade II) and the other, a pleural effusion (Grade I). CONCLUSION: CSG is a feasible and safe treatment option after failed PAGB or PSG. Further prospective studies are required to establish the strategy for conversion operations after failed primary restrictive bariatric surgery.
Bariatric Surgery ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Gastrectomy* ; Humans ; Korea ; Length of Stay ; Operative Time ; Pleural Effusion ; Postoperative Complications ; Prospective Studies ; Retrospective Studies ; Weight Loss

The urethral polyp is relatively unusual lesion but recently, has been reported more frequently Polyps of the anterior urethra are less common than those of the posterior urethra. The lesion is usually encountered in the young child but has occurred in the adult. Recently, we found two cases of urethral polyp. So, we report these with a brief review of the literature.
Adult ; Child ; Humans ; Polyps* ; Urethra

PURPOSE: The purpose of this study was to evaluate the annual changes in prostate variables and style of surgical treatment of patients with benign prostatic hyperplasia (BPH) over the past 12 years. MATERIALS AND METHODS: The subjects were 918 patients (January 1999-November 2010) who were treated by either open prostatectomy or transurethral resection of prostate (TURP). Every year, the performance ratio between open prostatectomy and TURP was evaluated. Before surgery, total and transitional zone volumes of the prostate were measured by transrectal ultrasonography (TRUS). After surgery, resection weight and residual volume of the prostate were measured by TRUS. RESULTS: From 2001 through 2010, the performance ratio of TURP increased greatly from 89% to 97%. During 1999 to 2010, the total volume of the prostate increased from 40.0 cc to 55.0 cc in the TURP group and from 74.1 cc to 116.7 cc in the open prostatectomy group. During 1999 to 2010, the mean resection volume of the TURP group increased from 2.3 cc to 20.1 cc. Also, the mean resection volume of the open prostatectomy group increased from 59.3 cc to 114.3 cc. During 1999 to 2003, the resection time of the TURP group decreased from 72.9 minutes to 43.2 minutes. CONCLUSIONS: During 1999 through 2010, the performance ratio between open prostatectomy vs TURP was high for TURP. The total volume and resection volume of the prostate increased annually, and the resection time decreased annually.
Humans ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Residual Volume ; Transurethral Resection of Prostate

OBJECTIVE: The purpose of this study was to determine differential findings between Type I degenerative endplate changes and diskitis on MR images. MATERIALS AND METHODS: MR images(T1, T2 weighted or Gradient echo) of L-spine in twelve patients with a Type I degenerative endplate change and nine patients with diskitis were reviewed for the morphologic and signal intensity changes of intervertebral disc, vertebral endplate and vertebral body. RESULTS: involvement of the marrow of one side of intervertebral disk was noted in 33%(4/12) of Type I endplate changes, and 11%(1/9) of diskitis. Decreased signal intensity of intervertebral disc was seen in 92% (11/12) of Type I endplate changes, and 11%(1/9) of diskitis on T2 weighted or Gradient echo image. Loss of intranuclear cleft signal was noted in 17%(2/12) of Type I endplate changes, and 78%(7/9) of diskitis. Even disc space narrowing was seen in all cases of Type I endplate changes, but uneven narrowing was seen in 44%(4/9) of diskitis. Only partial cortical disruption was noted in 42%(5/12) of Type I endplate changes, while partial or total cortical disruption was noted in 89%(8/9) of diskitis. The extent of marrow involvement more than 2/3 was noted in 8%(1/12) of Type I endplate changes, but 56%(5/9) of diskitis. The margin of signal intensity change was well defined in 33%(4/12) of Type I endplate changes, but that of diskitis was ill defined in all cases(9/9). Gadolinium enhancement was homogeneous in all cases(5/5) of Type I endplate changes, and 63%(5/8) of diskiris. CONCLUSION: We conclude that involvement of one side of endplate, decreased signal intensity of intervertebral disc on T2 weighted or gradient echo image, even narrowing of disc space, lesser extent of marrow involvement, well defined margin and homogeneous enhancement pattern are the findings of Type I degenerative endplate changes on MR images.
Bone Marrow ; Diagnosis, Differential* ; Discitis* ; Gadolinium ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging*

Mesocolic hernia is a rare congenital anomaly caused by an error of rotation of the midgut. It may be seen as total encapsulation of the small bowel or a single loop within a hernial sac. It may be asymptomatic or cause life-threatening intestinal obstruction. Symptoms, when present, are often chronic vague abdominal pain and intermittent obstructive episodes. We have encountered a 40-year-old woman with a congenital mesocolic hernia. Abdominal CT provided the diagnosis. She successfully underwent operation and discharged with good condition. Now we present a case of congenital mesocolic hernia with a review of some articles.
Abdominal Pain ; Adult ; Diagnosis ; Female ; Hernia* ; Humans ; Intestinal Obstruction ; Tomography, X-Ray Computed

Inverted papilloma of the urinary tract is a rare benign lesion. We report, to our knowledge, the first case of inverted papilloma of the prostatic urethra arising in a juvenile. Our patient was referred for evaluation of painless, gross hematuria and voiding difficulty. Transrectal sonography demonstrated a 1.4 cm papillary lesion on the medial aspect of the prostatic urethra. Cystoscopy showed a solitary, papillary tumor on the prostatic urethra. Transurethral resection was performed and histological examination showed an inverted papilloma.
Cystoscopy ; Hematuria ; Humans ; Papilloma ; Papilloma, Inverted ; Prostate ; Urethra ; Urinary Tract