PURPOSE: To evaluate the short-term therapeutic effectiveness of ovarian vein embolization using coils for pelvic congestion syndrome (PCS), a common cause of chronic pelvic pain, and to determine patient satisfaction. MATERIALS AND METHODS: Forty-four multiparous women aged 26-73 (mean, 39.9) years in whom chronic pelvic pain due to unknown causes had lasted for more than six months, and whose gynecologic findings and laboratory data suggested PCS, underwent transabdominal or transvaginal ultrasonography and selective ovarian venography. PSC was finally diagnosed in 21 of th 44, who underwent 22 ovarian vein embolizations (in one case, bilaterally). The simple pain rating system was used at admission, with a 'minimal' or 'moderate' grade representing discomfort in daily life, and 'severe' indicating the need for medication. Indications for coil embolization included dilatation of the ovarian vein to a diameter of more than 6 mm, reflux involving an incompetent valve, congestion of the pelvic venous plexus (involving the stasis of contrast media), and/or opacification of the ipsilateral internal iliac vein (or contralateral filling). Embolizations were undertaken using coils of optimal size and number, and the mean follow-up period was 217 (31-267) days. By means of a telephone questionnaire, the outcome was classified as a cure, pain reduction, or 'no change, or aggravation', and on the basis of whether or not they would opt for the same treatment, or recommend embolization to others, patient satisfaction was graded as 'substantial', 'moderate', or 'absent. RESULTS: Venous occlusion was confimed at postembolization venography in all 22 cases. Clinical treatment led to symptomatic relief in 76.2% of patients a cure in 33.3% (7/21), pain reduction in 42.9% (9/21) and no imchange, or aggravation, in 23.8% (5/21). Eighteen patients (85.8%) were very (9/21, 42.9%) or moderately (9/21, 42.9%) satisfied with coil embolization. In two, the coil migrated, and was successfully retrieved using a snare loop. CONCLUSION: In this study, ovarian vein embolization using coils for PCS appeared to be both safe and effective in controlling pain. If other causes of pelvic pain are absent, it is thought to be a valuable alternative to surgical procedures.
Dilatation ; Embolization, Therapeutic ; Estrogens, Conjugated (USP)* ; Female ; Follow-Up Studies ; Humans ; Iliac Vein ; Patient Satisfaction ; Pelvic Pain ; Phlebography ; Surveys and Questionnaires ; SNARE Proteins ; Telephone ; Ultrasonography ; Veins*

Cubital tunnel syndrome is the second most common nerve entrapment syndrome affecting the upper extremity. Surgical treatment is indicated for those who have motor weakness or when conservative measures have failed. Several different surgical techniques have been introduced, however, the optimal treatment for cubital tunnel syndrome is still under debate. In the recent years, well-performed prospective randomized studies show that there is no difference in outcome among various surgical techniques regardless of the severity and presence of subluxation. It is advised that in situ decompression is the preferred technique because it is simpler and less time consuming procedure. Although in situ decompression is effective in uncomplicated ulnar nerve subluxation, anterior transposition should be considered when the subluxation is painful or when the ulnar nerve actually snaps back and forth over the medial epicondyle. Anterior transposition of the ulnar nerve is still indicated for revision surgery, previous trauma around the elbow, distal humerus fractures, severe osteoarthritis needing medial spur excision, and severe valgus deformity of the elbow.
Congenital Abnormalities ; Cubital Tunnel Syndrome ; Decompression ; Elbow ; Humerus ; Nerve Compression Syndromes ; Osteoarthritis ; Ulnar Nerve ; Upper Extremity

PURPOSE: To report the clinical results of the perforated-based propeller flap for lower extremity soft tissue reconstruction. MATERIALS AND METHODS: Between January 2010 and June 2012, a total of 16 defects in the lower extremities were covered with perforator-based propeller flaps. Retrospective data for location and size of the defect, flap dimension, pedicle artery, pedicle rotation, complications were obtained. RESULTS: Peroneal artery-based perforator flap were used in eleven cases, posterior tibial artery-based perforator flap in two cases, anterior tibial artery-based perforator flap in one case and medial plantar artery-based perforator flap in two cases. The average size of the flaps was 63 cm2. The marginal skin necrosis of the flaps as a complication was developed in two cases, one of which was covered with split-thickness skin graft. There were no functional deficits from the donor site. CONCLUSION: For the reconstruction of lower extremities, the perforator-based propeller flap could be a reasonable alternative as it is a simple, safe and versatile technique.
Arteries ; Humans ; Lower Extremity ; Necrosis ; Perforator Flap ; Retrospective Studies ; Skin ; Tissue Donors ; Transplants

Pseudoaneurysms might be caused by perforation of an artery with hematoma formation between the arterial wall and the surrounding tissue after penetrating injury, intervention or operation. The frequency of radial artery pseudoaneurysm as a complication of cannulation is known for 0.048%. We report one case of radial artery pseudoaneurysm after single arterial blood gas analysis at wrist, which was managed by excision followed by vein graft.
Aneurysm, False ; Arteries ; Blood Gas Analysis ; Catheterization ; Hematoma ; Radial Artery ; Transplants ; Veins ; Wrist

No abstract available.
Hypertension*

Rupture of teratoma is rare. Ovary cystic teratoma was occurred 95% in benign ovary tumor, but chemical peritonitis arising from ruptured cystic teratoma is a scarce case. Peritoneal tuberculosis is also rare disease nowadays. It causes easily fatigue, abdominal distension, intermittent abdominal pain and ascities insidiously. We have recently experienced a case of chemical peritonits from ruptured both ovary cystic teratoma of ovary with superimposed peritoneal tuberculosis in 44 year-old woman and report our scarce case with a brief review of the literature.
Abdominal Pain ; Adult ; Fatigue ; Female ; Humans ; Ovarian Cysts* ; Ovary ; Peritonitis* ; Peritonitis, Tuberculous* ; Rare Diseases ; Rupture ; Teratoma*

PURPOSE: Although the possibility of distal radius fractures is strong in hemodialysis patients, there are many difficult problems such as the bleeding tendency, hypervascularity and injury to arteriovenous fistula. We studied the outcomes of open reduction and volar locking plate fixation of the distal radius fractures in hemodyalisis patients with ipsilateral arteriovenous fistula. METHODS: From 2007 to 2009, a retrospective chart review was performed of eleven hemodialysis patients who underwent volar locking plate fixation for treatment of distal radius fractures. Eight of them were female and three were male and mean age was 68 years (range, 57-81 years). Mean follow-up period was 19 months (range, 12-28 months). All patients had osteoporosis with mean T-score of -2.7. All operations were performed on the next day of hemodialysis. Scheduled hemodialysis was possible on the next day of surgery without splint. We analyzed radiographic results, the wrist range of motion, Mayo wrist score and disabilities of the arm, shoulder and hand (DASH) score at the last follow-up. RESULTS: All fractures achieved anatomical reduction and united at final follow-up. Complications such as hematoma or occlusion of arteriovenous fistula were not observed. Mean Mayo wrist score was 78 and mean DASH score was 22. CONCLUSION: Volar locking plate fixation for distal radius fractures provides immediate support for continuing hemodialysis and exercise. Open reduction of the fractures and the use of tourniquet don't seem to increase the vascular complications like hematoma and fistula occlusion.
Arm ; Arteriovenous Fistula ; Female ; Fistula ; Follow-Up Studies ; Hand ; Hematoma ; Hemorrhage ; Humans ; Male ; Osteoporosis ; Radius Fractures* ; Radius* ; Range of Motion, Articular ; Renal Dialysis* ; Retrospective Studies ; Shoulder ; Splints ; Tourniquets ; Wrist

Laryngeal leukoplakia is seen in a number of pathologic settings such as keratosis without atypia(KWOA), keratosis with atypia(KWA), squamous cell carcinoma in situ(CIS) and invasive squamous cell carcinoma, and it continues to be a confusing and controversial topic for both otolaryngologist and pathologist. This is largely due to the use of ambiguous and inconsistent terminology, the lack of unanimous agreement on the definition of these terms, failure of the clinician to obtain a representative biopsy, and the subjectivity of the pathologist interpreting the biopsy. To evaluate the applicability of the expression pattern of p53 and PCNA in borderline cases of histopathologic classification, we performed a histopathologic analysis of leukoplakia to includ clinical follow-up, correlation of disease progression and degree of atypia, and expression of p53 and PCNA according to the degree of atypia. Histologically, laryngeal leukoplakia included seven cases of KWOA, fourteen cases of KWA (mild-2, moderate-8, severe-4), three cases of CIS, and one case of invasive squamous cell carcinoma. Keratosis with atypia, a moderate degree or more, showed a strong tendency to progress to invasive carcinoma(p<0.05). The degree of p53 and PCNA expression correlated with the degree of atypia(p<0.05). p53-positive cases at the initial biopsy clearly tended to recur and develop into invasive carcinoma(p<0.01).
Biopsy

The diagnoses of ASCUS, AGUS and LSIL were introduced in 1988 by The Bethesda System(TBS) for reporting cervical/vaginal cytologies. However the outcomes and the appropriate managements of patients with these diagnoses are not well established. We reviewed all Papnicolaou smears which totaled 10,630 cases performed in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center from January 1995 through December 1995. The results were as follows. 1. Of the 10,630 specimens accessed during one-year period, 611(5.7%) were diagnosed as SCUS, 13(0.12%) as AGUS and 117(1.1%) as LSIL. 2. Of these, 92 cases with ASCUS and 66 with LSIL and subsequent cervical biopsies. The biopsy cases with ASCUS showed 49(53.3%) cervicitis, 13(14.1%) condyloma, 7(7.6%) CIN I, 3(3.3%) CIN II, 10(10.9%) CIN III and 3(3.3%) invasive carcinoma. Those with LSIL showed 21(31.8%) cervicitis, 5(7.6%) condyloma, 18(27.3%) CIN I, 6(9.1%) CIN II, 11(16.7%) CIN III and 3(4.5%) invasive carcinoma. 3. The repeated cytologic examination of 415 cases with ASCUS after 3~6 months revealed WNL(within normal limit) in 277(66.7%), BCC( benign cellular change) in 13(3.1 %) ASCUS again in 97(23.4%), AGUS in 2(0.1%), LSIL in 21(5.1%) and HSIL in 7(1.7 %). 4. The presence of high-risk or intermediate-risk HPV DNA was confirmed with Hybrid capture system(HCS) in 31.6%(6/19) of patients without evidence of CIN, 50%(4/8) of those with CIN I, 100%(5/5) of those with CIN II, 81.5%(22/27) of those with CIN III and 100%(6/6) of those with invasive squamous cell carcinoma. According to our result and thorough review of the recent articles, the management of ASCUS, AGUS and LSIL is reevaluated and the management guideline of our own is presented.
Biopsy ; Carcinoma, Squamous Cell ; Chungcheongnam-do ; Diagnosis ; DNA ; Gynecology ; Humans ; Obstetrics ; Ulsan ; Uterine Cervicitis

BACKGROUND: Some types of human papillomavirus (HPV) play a major role in the pathogenesis of cervical cancer. Several dozens of studies on the association of HPV with cervical neoplasm have been done since the first detection of HPV 16 and 18 directly from cervical cancer patients in 1983. Approximately 90 types of HPV have been identified so far and the number of oncogenic HPV types is still growing. In this study, we examined the occurrence of oncogenic HPV infections in patients with cervical lesions. Method : Two hundred twenty cervical swab specimens were collected during a 3 year period (1996-1999). Processed specimens were tested for HPV type 16 and 18 by polymerase chain reaction. RESULTS: HPV type 16 was detected in the cervical swab specimens as follows: 19 (51.4%) of 37 cervical cancer patients, 19 (30.2%) of 63 high-grade squamous intraepithelial lesions, 5 (9.6%) of 52 low-grade squamous intraepithelial lesion, none in 6 atypical squamous cells of undetermined significance and 3 (4.8%) of 62 normal cervices. Conclusion : The positive rate for HPV type 16 increased according to the degree of cervical malignancy.
Human papillomavirus 16 ; Humans* ; Polymerase Chain Reaction* ; Uterine Cervical Neoplasms