OBJECTIVE: To evaluate the complication and recurrence rates in patients undergoing trocar-guided mesh implant for pelvic organ prolapse (POP) treatment. METHODS: A retrospective study was performed based on the medical records of patients who had undergone mesh implant by one surgeon from May 2006 to August 2013 at the Presbyterian Medical Center in Korea. We evaluated perioperative complications such as bladder injury, mesh exposure, urinary symptoms, infections, and chronic pelvic pain. Recurrence was defined as a POP-quantification system stage ≥II or any symptomatic prolapse. RESULTS: Sixty-seven patients were evaluated, and the mean age of patients was 65.4±7.2 years. Stage ≥III POP-quantification Ba was noted in 61 patients (91%). Intraoperative complications included three cases of bladder injury (4.5%). The mean follow-up period was 44.1±7.9 months. Postoperative complications occurred in seven women (10.5%): four cases of urinary symptoms (6%), two cases of infections (3%), and one case of chronic pelvic pain (1.5%). Mesh exposure did not occur (0%). Prolapse recurrence was reported in five patients (7.5%). CONCLUSION: Based on our operational result, the trocar-guided mesh implant seems to provide safe and effective outcomes.
Female ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Korea ; Medical Records ; Pelvic Organ Prolapse* ; Pelvic Pain ; Postoperative Complications ; Prolapse ; Protestantism ; Recurrence ; Retrospective Studies ; Surgical Mesh ; Urinary Bladder

Prostate cancer commonly manifests with bony metastases. Visceral metastasis can also occur in the lungs and liver. However, stomach metastasis related to prostate cancer is rare. Here, we report a case of prostate cancer metastatic to the stomach. A 66-year-old male was diagnosed with prostate adenocarcinoma. He was noted as having abdominal discomfort, nausea, and vomiting 18 months after the diagnosis. A histopathologic examination and an esophagogastroduodenoscopic gastric biopsy revealed stomach-metastatic adenocarcinoma. He was also noted as having cerebellar metastatic lesions, which were identified by using a brain magnetic resonance imaging (MRI) scan. The patient died of cardiovascular complications 5 months after the diagnosis of stomach metastasis.
Adenocarcinoma ; Aged ; Biopsy ; Brain ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; Male ; Nausea ; Neoplasm Metastasis ; Prostate ; Prostatic Neoplasms ; Stomach ; Vomiting

BACKGROUND: Cigarette smoking is an important modifiable cardiovascular risk factor, which is known to acutely increase arterial stiffness. But the chronic effects of smoking on arterial stiffness are still controvertial. We studied the effects of chronic cigarette smoking on arterial stiffness in Korean subjects. METHODS: Our subjects included those >18 years of age (n=2685, 991 females) who had undergone a pulse wave velocity from July 2004 to June 2008. They were classified into two groups, smokers (n=641) and non-smokers (n=2044). In addition to the pulse wave velocity (PWV), we reviewed the highly sensitive C-reactive protein levels in a random manner when it was available. RESULTS: Males were predominant in the smokers group. Smokers had significantly higher heart-femoral PWVs than non-smokers (1083.6+/-264.1 cm/sec vs. 1041.3+/-257.3 cm/sec; p<0.001). There was no linear relationship between smoking duration and PWV (r= -0.225, p=0.506) even after adjusting for age, sex, and body mass index. Furthermore, there was no difference in the ankle-brachial index between the two groups. On the multivariate regression analysis, age, male gender, hypertension, and diabetes were independent predictors of increased arterial stiffness. CONCLUSION: In this study, chronic cigarette smoking increased central arterial stiffness in Korean subjects.
Ankle Brachial Index ; Body Mass Index ; C-Reactive Protein ; Humans ; Hypertension ; Korea ; Male ; Pulse Wave Analysis ; Risk Factors ; Smoke ; Smoking ; Tobacco Products ; Vascular Stiffness

OBJECTIVE: The aim of this study is to determine prognostic factor affecting the mode of delivery in women with one previous low transverse cesarean section by comparing success group with failure group in Vaginal birth after cesarean (VBAC). METHODS: In this retrospective study, 79 patients with one previous low transverse cesarean section who attempted vaginal birth at Jeon-Ju Jesus Presbyterian hospital from January 1, 1997 to December 31, 2007. Information was collected and analyzed to see if there is significant difference between success group and failure group in VBAC. and the significance was set at P<0.05. RESULTS: The VBAC success rate turned out to 88.6%. There was one case of uterine rupture which was associated with hypoxic -ischemic encephalopathy in neonate. But, there was no case of the fetal death or mother death. There were significant difference between two groups in gestational age, expected fetal body weight, cervical dilation, Bishop score, thickness of lower uterine segment. CONCLUSION: The prognostic factors on success of VBAC can be aid in deciding the mode of delivery after cesarean section. Patient being chosen under strict indication, can enhance the VBAC trial and success rate.
Cesarean Section ; Female ; Fetal Death ; Fetal Weight ; Gestational Age ; Humans ; Infant, Newborn ; Lipids ; Mothers ; Parturition ; Pregnancy ; Protestantism ; Quaternary Ammonium Compounds ; Retrospective Studies ; Uterine Rupture ; Vaginal Birth after Cesarean

This study is designed to evaluate the effect of low-dose whole body irradiation (WBI) for treatment of myasthenia gravis(MG) and changes of immunological parameters. According to MG protocol of low dose WBI, eleven patients were selected and followed up for at least one year. Clinical status and immunological parameters were assessed at the time of pretreatment (baseline) and 1, 2, 3, 6, 12 months after initial dose irradiation. The improvement began five weeks after WBI and lasted for 12-month follow-up in 7 patients (good responders) Clinical improvement and immunological changes were more pronounced in good responders. So, it is suggested that low dose WBI may have the role in the treatment of the MG as an another therapeutic modality.
Follow-Up Studies ; Humans ; Myasthenia Gravis* ; Whole-Body Irradiation*

The pregnancy-associated breast cancer is one of the most common malignancy developed during pregnant period and occupies 1-2% of the all breast cancer patients. There is no evidence to implicate pregnancy or lactation in either the etiology and the progression of breast cancer. Careful breast examination early in the pregnancy is very important to find solid masses before breast engorgement hides them. But unfortunately, delay in the diagnosis is common and most of patients with operable primary lesions have positive axillary lymph nodes. The treatment of choice is the modified radical mastectomy and adjuvant chemotherapy. The authors report a patient of breast cancer diagnosed and treated during pregnancy with review of literature.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Diagnosis ; Female ; Humans ; Lactation ; Lymph Nodes ; Mastectomy, Modified Radical ; Pregnancy*

No abstract available.
Lung Neoplasms* ; Lung*

BACKGROUND: Coronary stenting is one of effective and well-accepted treatments for coronary artery disease. On the other hand, side branch occlusion (SBO) is a known complication of percutaneous transluminal coronary angioplasty (PTCA) and coronary stenting. Accordingly, this study was designed to determine the incidence, predictors and acute clinical outcomes of SBO. METHODS: Coronary angiographic findings of 45 patients who had total 98 side branches originating from the stented segments were analized before and just after coronary stenting. Bifurcation lesions were divided into 3 types : type 1, type 2, type 3 and each type was subdivided into type A with significant ostial narrowing (diameter stenosis >or=50%) and type B without significant ostial narrowing of side branches. Side branch occlusion was defined as development of total occlusion or morphologic changes from type B to type A or reduction of TIMI flow more than grade 1 compared with pre-stenting flow of side branches. RESULTS: After coronary stenting, SBO occurred in 20 of 98 side branches (20.4%). SBO was significantly related with history of previous myocardial infarction (p=0.02), threatened side branch morphology (p=0.016) and poor pre-stenting flow of side branches (p=0.014). There were no serious clinical events such as myocardial infaction and death associated with acute SBO. CONCLUSION: Acute SBO can be developed in a few stented patients. Signifiant clinical and angiographic predictors of SBO just after coronary stenting were the history of previous myocardial infarction, threatened side branch morphology and poor pre-stenting flow of side branches.
Angioplasty, Balloon, Coronary ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Stenosis ; Hand ; Humans ; Incidence ; Myocardial Infarction ; Stents*

No abstract available.
Adult ; Diagnosis, Differential ; Female ; Humans ; Liver/pathology/radiography/ultrasonography ; Peliosis Hepatis/pathology/*radiography ; Tomography, X-Ray Computed

Emery-Dreifuss muscular dystrophy (EDMD) is a degenerative myopathy characterized by mild, slowly progressing weakness, muscle atrophy, and early contracture of the neck, ankle and elbow. Heart involvement becomes apparent during the teenage years and is characterized by cardiac conduction defects and the infiltration of the myocardium by fibrous and adipose tissues. Heart block can eventually lead to sudden death, and therefore, early treatment with a cardiac pacemaker may improve symptoms and be lifesaving in patients with heart block. We describe our experience of pacemaker implantation in a 14-year old boy with X-linked recessive EDMD and emerin gene mutation. His electrocardiogram findings showed junctional escape beats, and his clinical features, i.e., ECG, nerve conduction test, electromyography and muscle biopsy findings were compatible with EDMD. He was implanted with a VVI type permanent pacemaker following an electrophysiologic study.
Adolescent ; Ankle ; Atrophy ; Biopsy ; Contracture ; Death, Sudden ; Elbow ; Electrocardiography ; Electromyography ; Heart ; Heart Block ; Humans ; Male ; Muscle Weakness ; Muscular Diseases ; Muscular Dystrophy, Emery-Dreifuss* ; Myocardium ; Neck ; Neural Conduction ; Pacemaker, Artificial ; United Nations