PURPOSE: The subconjunctival sparganosis is rare tissue helminthiasis which developed frequently in abdominal, urethral, ureteral and vertebral cases. Authors report a case of sparganosis in the subconjunctival mass. METHODS: A 51-year-old man with reddish non painful mass in his left eye on the subconjunctiva that was unresponsive to medications for 6months was evaluated and treated surgically. On surgical exploration, a white thread-like plerocercoid 0.2 x 4.7 cm in size was extracted from the subconjunctival mass and actively motile in the bottle filled with saline. It was confirmed as a typical sparganum under histologic examination. Three months after surgery, the lesion disappeared completely. RESULTS: Although rare, parasitic disease should be suspected in a palpable subconjuntival mass unresponsive to the medical treatment.
Helminthiasis ; Humans ; Middle Aged ; Parasitic Diseases ; Sparganosis* ; Sparganum ; Ureter

PURPOSE: This study was attemped to investigate the prognostic factors for the outcome of stage I renal cell carcinoma after radical nephrectomy. MATERIALS AND METHODS: Twenty nine patients treated from 1984 to 1995 at Kyung Hee University Medical Center were studied retrospectively. All of them were diagnosed with pathologic Robson stage I renal cell carcinoma after radical nephrectomy. RESULTS: Males were affected three times more frequently than females. The tumor was detected on the right kidney in 15 cases, and on the left in 14. Average follow up period was 36.6 months, average disease free interval was 29.4 months and median survival was 30 months. During the follow up, 9 patients (31.0%) expired due to liver and lung metastasis at postoperate 21.6 months on average. Eleven patients (37.9%) developed distant metastasis in the follow up. There was no local recurrence of tumor. Seventeen patients were diagnosed incidentally without clinical symptoms. In our retrospective study for stage I renal cell carcinoma, there were no predictive prognostic parameters for predicting the outcome of patients, except for the incidental diagnosis of the tumor. CONCLUSIONS: These results suggest that incidental diagnosis of the tumor may be the most important prognostic factor for the outcome of stage I renal cell carcinoma. Although the patients were confirmed as stage I renal cell carcinoma pathologically after radical nephrectomy, close follow up is very important, because of high incidence of metastasis. We recommand that chest X-ray, abdominal ultrasonogram and bone scan should be checked at 3 months interval for postoperative one year even though stage I renal cell carcinoma.
Academic Medical Centers ; Carcinoma, Renal Cell* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney ; Liver ; Lung ; Male ; Neoplasm Metastasis ; Nephrectomy ; Recurrence ; Retrospective Studies ; Thorax ; Ultrasonography

OBJECTIVES: To clarify the clinicopathologic features of borderline malignancy of the ovary and analyze the treatment and survival characteristics through the study of our cases. Study METHODS: 102 patients with borderline tumors of the ovary, aged from 14 to 79 years, treated between 1982 and 1999 at Seoul National University Hospital, were analyzed retrospectively for clinicopathologic features. Most informations about stage, treatment modality and prognosis were obtained by hospital record or contacting patient with telephone. RESULTS: There were 77 patients (75.5%) with stage Ia, 5 stage Ib, 11 stage Ic, 4 with stage II and 5 with stage III by the classification of FIGO. 72 patients (70.6%) were mucinous type and 28 (27.5%) were serous type, 1 endometrioid type, 1 mixed. Total abdominal hysterectomy, bilateral adnexectomy, and omentectomy were performed in 43 (42.2%) patients and fertility saving surgery in 43 patients(cystectomy in 11 patients, USO in 32 patients). Twenty two patients (21.6%) were treated with postoperative adjuvant chemotherapy. The median duration of follow up was 54.0 months (1-204 months) and 6 patients developed recurrence after several years from the primary operation. The ten-year eumulative survival rate was 92.2% and the only independent prognostic factors evaluated by Cox analysis in regards to corrected survival were the FIGO stage (p=0.0197). There was no difference in the ten-year survival rate between surgery types - conservative surgery versus full surgical staging. And there was no difference in the 10-year survival rate between treatment groups - surgery only versus surgery followed by adjuvant chemotherapy. CONCLUSIONS: FIGO stage is the only independent prognostic factor in the borderline ovarian tumors. There was no difference in the 10-year survival rate of barderline ovarian tumors between surgery alone versus surgery followed by adjuvant chemothearpy. The slow clinical course, low recurrence rate and good prognosis in our patients explained again the reason for therapeutic approach relying on surgery alone.
Chemotherapy, Adjuvant ; Classification ; Female ; Fertility ; Follow-Up Studies ; Hospital Records ; Humans ; Hysterectomy ; Mucins ; Ovary* ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Telephone

Osteogenic sarcoma is a malignant primary tumor of bone composed of a malignant connective tissue stroma with evidence of malignant osteoid, bone and/or cartilage formation. A 23 year old man was admitted to dental department of Yeungnam University hospital with chief complaint of swelling and pain on alveolar ridge of lower right molar region. It was certain of osteogenic sarcoma through clinical and radiographic features and biopsy. Surgical resection of the lesion was performed by partial mandibulectomy and resin plate insertion. By follow up check of the patient, we made good result of functional reconstruction without any sign of recurrence of the lesion.
Alveolar Process ; Biopsy ; Cartilage ; Connective Tissue ; Follow-Up Studies ; Humans ; Mandible* ; Molar ; Osteosarcoma* ; Recurrence

Reconstruction in the head and neck region uses a wide range of surgical flaps for defect closure. The methods range from local, mostly myocutaneous flaps, and skin grafts to free microsurgical flaps. Reconstructive surgery must conserve the appearance and mimic the original function. Moreover, the donor-site defect needs to be reduced, with no resulting functional or aesthetic impairment. To achieve these goals, a thin reliable flap that is close to the face and neck region with a good match of the skin texture and a smooth, hairless skin surface is needed. So we used a flap from the shoulder region which provides an optimum skin texture to match the neck and face. This supraclavicular flap is a fasciocutaneous island flap, which has a vascular pedicle extending from the transverse cervical artery with two accompanying veins. Moreover, the tunneling method improves the donor site by reducing scarring. We hereby introduce the anatomic characteristics and effectiveness of this method.
Arteries ; Cicatrix ; Head* ; Humans ; Myocutaneous Flap ; Neck* ; Shoulder ; Skin ; Surgical Flaps ; Tissue Donors ; Transplants ; Veins

BACKGROUNDS: Katz index of ADL and Barthel index of ADL have been used to evaluate the function of disabled elderly in Korea. But no ADL scale reflecting Korean's own language expression and culture has been developed and verified yet. METHODS: Descriptions of basic activities which needed others' help were collected from 190 Korean disabled elderly. The collected results were categorized into basic activities of daily living and instrumental activities of daily living, and then in each domain such as bathing, shopping, etc. Preliminary instrument items were selected by the judgement of the expert committee, considering the frequency of the responses and the importance of each item. A preliminary questionnaire was developed based on the selected items. The preliminary questionnaire was pretested twice, and corrected by the results. Finally a scholar on Korean literature verified the questionnaire on the grammar and context. RESULTS: A total of 408 basic activities of daily living and 242 instrumental activities of daily living were collected. The activities were categorized into 7 domains of ADL(dressing, washing face and hand, bathing, eating, transfer, toileting, continence) and 10 domains of IADL(decorating, housework, preparing meals, laundry, outgoing for a short distance, using transportation, shopping, handling money, using telephone, taking medicine) CONCLUSIONS: We developed a Korean Activities of Daily Living(K-ADL) scale and Korean Instrumental Activities of Daily Living(K-IADL) scale reflecting Korean elderly's own language expression and culture.
Activities of Daily Living ; Aged ; Baths ; Eating ; Hand ; Housekeeping ; Humans ; Korea ; Meals ; Surveys and Questionnaires ; Telephone ; Transportation

OBJECTIVE: To prospectively evaluate the feasibility, safety, and survival of laparoscopic surgical staging in patients with locally advanced cervical cancer. METHODS: From Oct 2001 to Jul 2006, a total of 83 consecutive patients were eligible for inclusion and underwent laparoscopic surgical staging. RESULTS: Three patients with intraoperative great vessel injury and 1 patient in whom the colpotomizer was unable to be inserted were excluded. Laparoscopic surgical staging was feasible in 95.2% (79/83). Immediate postoperative complications were noted in 12 (15.2%) patients. Prolonged complications directly related to operative procedures numbered 2 (2.5%), and were trocar site metastases. The mean time from surgery to the start of radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) was 11 (5-35) days. All patients tolerated the treatment well and completed scheduled RT or CCRT without disruption of treatment and additional admission. The rate of modification of the radiation field after surgical staging was 8.9% (7/79). Five-year progression-free survival and overall survival (OS) rates were 79% and 89%, respectively. The OS of patients with microscopic lymph node metastases, which were fully resected, were comparable to those of patients without lymph node metastasis. However, the OS of patients with macroscopic lymph node metastases that were fully resected were poorer compared with those of patients without lymph node metastasis. CONCLUSION: Pretreatment laparoscopic surgical staging is a feasible and safe treatment modality. However the survival benefit of debulking lymph nodes or full lymph node dissection is not clear.
Chemoradiotherapy ; Disease-Free Survival ; Glycosaminoglycans ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Postoperative Complications ; Prospective Studies ; Surgical Instruments ; Surgical Procedures, Operative ; Uterine Cervical Neoplasms

BACKGROUND AND OBJECTIVES: The ventricular pacing electrodes are customarily placed into the right ventricular muscle because there is easily accessible. However detailed physiologic studies have shown that the single stimulation of right ventricular sites causes dysynchronous ventricular contraction due to early depolarization of the right ventricle and delayed depolarization of the left ventricle. In contrast, normal human ventricular activation, which is conducted by the Purkinje system, spreads transmurally from the endocardium to multiple paraseptal epicardial regions and results in more synchronous contraction of the ventricle. Therefore, the hypothesis that producing biventricular activation by simultaneously pacing ventricles across the septum might confer hemodynamic benefits over those of conventional right ventricular pacing. The purpose of this study was to evaluate the acute hemodynamic changes of different pacing modes (right ventricular : RV, biventricular : BV, atrio-right ventricular : A-RV, and atrio-biventricular : A-BV pacing). MATERIALS AND METHOD: In 9 open chest dogs anesthetized with alpha-chloralose, sinus node crushing was done, and then hemodynamic data (QRS width, femoral arterial pressure : FAP, pulmonary arterial pressure : PAP, and Cardiac output : CO) were acquired after 5 minutes of pacing at a fixed rate during each pacing mode. RESULTS: Results were as follow : 1. BV pacing significantly increased cardiac output compared with RV pacing (P<0.01). BV pacing significantly shortened QRS width compared with RV pacing (P<0.01). 2. A-BV pacing significantly increased cardiac output compared with A-RV pacing (P<0.01). A-BV pacing significantly shortened QRS width compared with A-RV pacing (P<0.01). 3. A-RV pacing significantly increased systolic pulmonary arterial pressure and cardiac output compared with BV pacing (P<0.01). CONCULSION: These results support the use of atrio-biventricular pacing to improve acute hemodynamic performance.
Animals ; Arterial Pressure ; Cardiac Output ; Cardiac Resynchronization Therapy* ; Chloralose ; Dogs* ; Electrodes ; Endocardium ; Heart Ventricles ; Hemodynamics* ; Humans ; Sinoatrial Node ; Thorax*

Esophageal duplication (ED) is rarely diagnosed in adults and is usually asymptomatic. Especially, ED that is connected to the esophagus through a tubular communication and combined with bronchoesophageal fistula (BEF) is extremely rare and has never been reported in the English literature. This condition is very difficult to diagnose. Although some combinations of several modalities, such as upper gastrointestinal endoscopy, esophagography, computed tomography, magnetic resonance imaging, and endoscopic ultrasonography, can be used for the diagnosis, the results might be inconclusive. Here, we report on a patient with communicating tubular ED that was incidentally diagnosed on the basis of endoscopy and esophagography during the postoperational evaluation of BEF.
Adult ; Bronchial Fistula ; Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal ; Endosonography ; Esophageal Fistula ; Esophagus ; Fistula* ; Humans ; Magnetic Resonance Imaging

OBJECTIVE: To evaluate the feasibility and clinical and angiographic outcomes of stent-assisted embolization for complex middle cerebral artery (MCA) aneurysms. METHODS: The records of 23 consecutive patients with 24 MCA aneurysms, who underwent stent-assisted embolization of the aneurysm, were retrospectively evaluated. RESULTS: Fifteen aneurysms were treated with one stent and 8 were treated using more than two stents (5 a stent-within-a-stent, 1 triple stents, and two Y-stent). Angiographically, complete or near complete occlusion was achieved in 15 aneurysms (65.2%), residual neck in five (21.7%), and residual aneurysm in three (13.1%). Five aneurysms demonstrated thrombosis within the stent during the procedure and hospitalization, and were resolved by intraarterial and intravenous Tirofiban injection. Symptomatic thromboembolic complications were developed in five patients and permanent deficits demonstrated in two patients with modified Rankin Scale 1 and 2, respectively. Treatment-related permanent morbidity and mortality rates were 8.3% and 0% with relatively high complication rate. Angiographic follow-up was available in 17 aneurysms at 6-31 months (mean, 13.2 months) and showed stable or improved in 15 (88.2%) and major and minor recurrence in one, respectively. CONCLUSION: Complex MCA aneurysms could be treated by stent-assisted coiling and showed lower recanalization rate during mid-term follow-up by effective flow diversion due to various stent-assisted techniques. Our results warrant further study with a longer follow-up period in a larger sample.
Aneurysm ; Follow-Up Studies ; Hospitalization ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Neck ; Recurrence ; Retrospective Studies ; Stents ; Thrombosis ; Tyrosine