No abstract available.
Pregnancy*

Tuberculoma means a tumor-like mass resulting from enlargement of a caseous tubercle which microscopically shows infiltration of epithelioid cells, Langhans giant cells and lymphocytes. In a 57-year-old woman suffering from left renal tuberculosis, we incidentally found a large retroperitoneal tuberculoma (site: retrohepatic, above right adrenal gland, below diaphragm and outside Gerota`s fascia, size: 13X11x9cm). Generally, Mycobacteria tuberculosis invade the lung via airway, and subsequently, they can be disseminated to any organ or tissue. They are apt to establish disease in the organ or tissue of high oxygen tension level. We report a case of retroperitoneal tuberculoma with wonder that it could develop in the retroperitoneum of poor blood supply.
Adrenal Glands ; Diaphragm ; Epithelioid Cells ; Fascia ; Female ; Giant Cells, Langhans ; Humans ; Lung ; Lymphocytes ; Middle Aged ; Oxygen ; Tuberculoma* ; Tuberculosis ; Tuberculosis, Renal

This article consists of a clinical analysis of 171 cases of intussusception treated at the Department of General Surgery and Pediatrics of Pusan Adventist Hospital, during a five year period from Jan. 1991 to Dec. 1995. The results were as follows ; 1) On the age and sex distribution, the age incidence under 1 year old was the most common(73.1%), and male to female ratio was 1.48 : 1. 2) The seasonal variation was Autumn(35.1%), Spring(32.1%), Summer(19.9%), and Winter(12.9%). 3) On the hematologic laboratory finding, 68% were revealed leukocytosis above 10,000/mm3 in serum. 4) In etiology, idiopathic type was common(98.5%), and Meckel's diverticulum was rare(1.5%). 5) The frequent Symptoms and signs were abdominal pain and irritability(84.2%), bloody stool(83.6%), vomiting(80.7%), palpable abdominal mass(48.5%). 6) On comparison of barium reduction to methods of the operation in relation to duration of symptoms, within 12 hours was 81.4% : 15.7% and above 24 hours was 49% : 51% 7) The common anatomical type of intussusception was ileo-colic type (36.9%), and the common types of bowel resection were ileoileo type and ileoileocolic type(80%). 8) The methods of the operation were manual reduction(53.8%), bowel resection(30.8%), and spontaneous reduction(15.4%). 9) Postoperative complications occurred in 10 cases ; febrile convulsion 3 cases, wound infection 2 cases, and wound dehiscence, intestinal obstruction, pulmonary complication each 1 case. 10) The overall recurrence rate was 5.3% (8 cases); 6.6% (7 cases) were after barium reduction, and 1.5% (1 case) was after manual reduction.
Abdominal Pain ; Barium ; Busan ; Child* ; Female ; Humans ; Incidence ; Infant* ; Intestinal Obstruction ; Intussusception* ; Leukocytosis ; Male ; Meckel Diverticulum ; Pediatrics ; Postoperative Complications ; Recurrence ; Seasons ; Seizures ; Seizures, Febrile ; Sex Distribution ; Wound Infection ; Wounds and Injuries

Hematuria is a important clinical sign that is a consequence of significant fenal. urologic or sytemic disease. Recently the morphology of the red cell in hematuria has been used to indicate a renal or non-renal source and also the measurement of red cell volume by red cell analyzer has been used to distinguish glomerular from non-glomerular hematuria. In this study. the MCV(mean corpsular red cell voume). RDW(red cell distribution width) and HDW (hemoglobin distribution width) were measured using H-1 system in57 children with hematuria to assess the diagnostic usefulness of the urinary red cell analyzer in the differentation of glomerular and non-glomerular hematuria. The patients were divided into two groups as glomerular diseases(40cases)and non-glomerular diseases(17 cases)and the location of the bleeding was confirmed by renal biopsy, radiology and the clinical findings. The results were as follows. 1) The urinary red cell MCV waslower in patients with glomerular diseases than that in patients with non-glomerular diseases (79.89 +/- 12.0fl vs. 90.93 +/- 9.71fl vs. 90.93+/-9.71 fL; p<0.01) 2) The urinary RDW and HDW were significantly higher in glomerular diseases than those in non-glomerular diseases (RDW; 19.86 +/- 11.28% vs 11.34+/-5.88%, HDW; 3.37+/-2.07 gm vs. 1.86+/-1.43gm). 3) The urinary red cell MCV was correlated well with the RDW and HDW while there was no correlation between the urinary red cell MCV and the urinary SG or pH. 4) The sensitivity, specificity and positive predictability of the urinsary MCV were 37.8%, 94.1% and 93.7% and those of RDW were 62.5%, 82.3% and 89.2% 5) The sensitivity, specificity and positive predictability of the urinary HDW were 42.5%, 88.2% and 89.4% We concluded from above date that the measurment of the urinary MCV, RDW and HDW would be useful as a primary non-invasive screening test in differentation of glomerular and non-glomerular hematuria in children.
Biopsy ; Cell Size* ; Child* ; Diagnosis* ; Hematuria* ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Mass Screening ; Sensitivity and Specificity

PURPOSE: A diverting stoma is known to reduce the consequences of distal anastomotic failure following colorectal surgery. The aim of this study was to evaluate the efficacy of a diverting stoma after an ultra-low anterior resection (uLAR) for rectal cancer. METHODS: Between 2000 and 2007, 836 patients who underwent an uLAR were divided into two groups, depending on the fecal diversion: 246 received fecal diversion, and 590 had no diversion. Patient- and disease-related variables were compared between the two groups. RESULTS: Thirty-two of the 836 patients (3.8%) had immediate anastomosis-related complications and required reoperation. Anastomosis leakage comprised 72% of the complications (23/32). The overall immediate complication rate was significantly lower in patients with a diverting stoma (0.8%, 2/246) compared to those without a diverting stoma (5.1%, 30/590; P = 0.005). The fecal diversion group had lower tumor location, lower anastomosis level, and more preoperative chemo-radiation therapy (P < 0.001). In total, 12% of patients in the diverting stoma group had complications either in making or reversing the stoma (30/246). CONCLUSION: The diverting stoma decreased the rate of immediate anastomosis-related complications. However, the rate of complications associated with the diverting stoma was non-negligible, so strict criteria should be applied when deciding whether to use a diverting stoma.
Colorectal Surgery ; Humans ; Ileostomy ; Rectal Neoplasms ; Reoperation

The majority of the cysts developed in pancreas are inflammatory pseudocyst but neoplastic cysts are rarely encountered Especially, mucinous cystadenoma which was begun and originated from epithelial cell of pancreatic duct is difficult to differentiate from pseudocysts by preoperative clinical, laboratory and radiologic findings. Mucinous cystadenoma has a malignant potentiality, so complete excision of cystadenoma is the treatment of choice. Recently, we experienced one case of mucionus cystadenoma in 37 year-old female, we report it with a review of the literature.
Adult ; Cystadenoma ; Cystadenoma, Mucinous* ; Epithelial Cells ; Female ; Humans ; Mucins* ; Pancreas* ; Pancreatic Ducts

The brain computerized tomography, an epoch-making diagnostic procedure has caused a revolutionary change in the neurosurgical field;the correct localization of small space occupying lesion wherever it is in the brain without pain and harm to the patients. The brain CT findings of 3035 patients which were examined in this hospital during past 29 months from Oct. 1981 to March 1984 were analysed and the literature review was made. The results of analysis are as follows: 37.1% of total 3035 cases were observed abnormal, including 29% of head injured patients, 42.4% of non-trauma cases, 57.6% of emergency cases and 15.2% of non-emergency cases. 2) The rates of abnormal findings were proportional to the degree of consciousness disturbance in the head injured patients and severity of the neurological deficits in the other neurosurgical patients. 3) The follow up studies were performed for 287 patients among 1127 patients having abnormal findings in the first check and we found the improving process of various lesion and the resolving process of hematoma after operation. The follow up studies were performed for 138 patients having normal findings in the first check and 26% of these cases were observed abnormal, including 21.5% of head injured cases and 55% of the non-trauma cases. 4) 94% of patients with spontaneous subarachnoid hemorrhage showed bleedings chiefly in the basal cistern.
Brain* ; Consciousness ; Emergencies ; Follow-Up Studies ; Head ; Hematoma ; Humans ; Subarachnoid Hemorrhage

Osteopontin, a secreted, arginine-glycin-asparate (RGD)-containing phosphoprotein is up-regulated in renal cortex in many experimental models of tubu- lointerstitial fibrosis. Osteopontine gene seems to be induced predominantly in chronic and progressive glomerulosclerosis. To examine the effects of enala-pril and lovastatin alone or in combination on osteopontin, TGF- 8, endothelin- 1, procollagen a 1(I) at an early phase of chronic renal failure in 5/6 nephrectomized rats, randomly assigned 4 groups [untreated 5/6 nephrectomy(group Nx), treated with enalapril(group E) or lovastatin(group L) alone and in combination(group EL)(each group n=6)] were sacrificed at 8 weeks. Four rats were served as normal control ones. Systolic blood pressure, 24 hour urine protein excretion, serum chemistry were mea- sured. mRNA levels of renal cortical osteopontin, TGF- , endothelin-l, procollagen a 1(I) were measured by Northern hybridization. Eight week after nephrectomy untreated neph- rectomized rats had higher systemic blood pressure (157 3 vs. 140 1mmHg, p<0.05) with increasing proteinuria(32.9 11 vs. 1.2 0.2, p<0.05) than normal con- trol rats. mRNA expression of osteopontin(12.5 folds, p<0.05) and endothelin-l(1.6 folds, p<0.05) in renal cortex were elevated, but mRNA expression of TGF- 0 and procollagen a 1(I) were not. The treatment with enalapril or lovastatin alone prevented a further rise in proteinuria and significantly reduced renal cortical osteopontin mRNA expression at 8 weeks. Enalapril reversed systemic hypertension but lovastatin not. Both drugs had no effect on renal cortical endothelin-1 mRNA expression. The treatment with combined enalapril and lovastatin reduced renal cortical osteopontin mRNA expression more and showed trend to reduce proteinuria compared to treatment with each drug alone. The results of the present study indicate that the treatment with enalapril or lovastatin reduces proteinuria and renal cortical osteopontin mRNA expression which are occurred at early phase of chronic renal failure in 5/6 nephrectomized rat model and combined treatment appears to be more effective.
Animals ; Blood Pressure ; Chemistry ; Enalapril* ; Endothelin-1 ; Fibrosis ; Gene Expression* ; Hypertension ; Kidney Failure, Chronic ; Lovastatin* ; Models, Animal ; Models, Theoretical ; Nephrectomy ; Osteopontin* ; Procollagen ; Proteinuria ; Rats* ; RNA, Messenger

Traditionally, radical hysterectomy is the main surgical method for the treatment of early cervical carcinoma and always results in the loss of fertility. But, large numbers of young women are recently being diagnosed with cervical carcinoma and fertility preservation has become a concern. So, there has been a move towards more conservative approaches for the treatment of cervical carcinoma in recent years. Radical trachelectomy, which allows preservation of uterus but removes the cervix, parametrium and upper one third of the vagina, is a conservative but locally radical procedure. We performed radical abdominal trachelectomy with pelvic lymphadenectomy for two cases of invasive cervical carcinomas, which may be the first report in korea. One patient was 37 years old single women who had stage Ib cervical cancer and was disease free for 17 months after treatment. The other patient was 19 years old student who was also single and had stage IIa cervical cancer and was disease free for 14 months after treatment. We report the first two cases and review the literature on radical trachelectomy.
Adult ; Cervix Uteri ; Female ; Fertility ; Fertility Preservation ; Humans ; Hysterectomy ; Korea ; Lymph Node Excision* ; Uterine Cervical Neoplasms ; Uterus ; Vagina ; Young Adult

No abstract available.
Anesthesiology* ; Education* ; Publications*