Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

PURPOSE: Variable modalities, with more comfortable and less incidence of post-operative complications over TURP, have been used for the treatment of benign prostatic hyperplasia(BPH) with bladder outlet obstruction. Recently, we performed Interstitial Laser Coagulation(ILC) with the 830nm diode laser, which is considered as a method of minimally invasive treatments for BPH, to assess the efficacy and safety of the device, and to evaluate its capability of replacing TURP for managing BPH. MATERIALS AND METHODS: We analysed 16 patients, who had suffered from symptomatic BPH, treated with ILC using diode laser retrospectively from April 1996 to January 1997. Mean age of the patients was 71.7(52-84) years old and mean size of prostates before the treatments was 52.2(26.8-100.7)gm. Treatment outcome was estimated by comparing IPSS, QOL, Qmax, Qave and residual urine before the operations with them of first and second month after the operations. Post-operative transrectal ultrasonography was able to several cooperative cases and they were compared with them of pre-operative volumes, too, although it was unavailable to evaluate statistically. RESULTS: The operation were performed under epidural or spinal anesthesia with average time of 62 minutes and with 10 days of post-operative catheterization. IPSS reduced from 22.25(+/-4.82), mean value before the operation, to 11.00(+/-5.58) and 5.00(+/-3.10) at first and second month after ILC. QOL was gradually decreased from 4.44(+/-0.51) to 2.31(+/-1.20) and 1.19(+/-0.91), too. In terms of Qmax, mean was 12.29(+/-5.55)ml/sec before the operation and it was increased to 15.94(+/-7.38)ml/sec and 20.75(+/-8.48)ml/sec. Average flow rate was also increased from 6.98(+/-2.05)ml/sec to 10.38(+/-3.72)ml/sec and 14.93(+/-4.37)ml/sec. Significant reduction was observed in residual urine volume from 98.13(+/-91.72)ml to 33.19(+/-36.58)ml and 9.56(+/-11.24)ml respectively. Minimal hematuria and mild bladder irritations were common symptoms after the procedure, and possible significant complications as like anemia, electrolyte imbalance(post-TUR syndrome), epididymoorchitis, erectile dysfunction, urethral stricture, retrograde ejaculation had not found in our experience, but 1 patient was retreated with TURP because of continued bladder outlet obstruction. CONCLUSIONS: Our initial results with ILC showed that it is a relatively simple and minimally invasive method with minimal occurrence of bleeding and no electrolyte imbalance. We concluded that ILC is a safe and efficacious treatment modality, and it can be used even for elder patients with co-morbidity illness as well as patients with too large prostate to perform TURP.
Anemia ; Anesthesia, Spinal ; Catheterization ; Catheters ; Ejaculation ; Erectile Dysfunction ; Hematuria ; Hemorrhage ; Humans ; Incidence ; Lasers, Semiconductor ; Male ; Prostate ; Prostatic Hyperplasia* ; Retrospective Studies ; Transurethral Resection of Prostate ; Treatment Outcome ; Ultrasonography ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder Neck Obstruction

Acupuncture with gold needle insertion is utilized in Oriental medicine, and the effect of therapy is represented by anti-inflammatory and analgesic function, But sometimes the needle is erroneously inserted into abdominal organs, and then it may cause dangerous complications. We report a case of multiple gold needles in the abdominal organs without having definete clinical symptoms.
Acupuncture* ; Medicine, East Asian Traditional ; Needles* ; Radiography*

No abstract available in English.
Neoplasm Metastasis* ; Stomach* ; Ureter*

No abstract available.
Insulinoma*

PURPOSE: The aim of this study was to assess the mid-term results of primary cementless total hip arthroplasty (THA) using Summit® stems. MATERIALS AND METHODS: One hundred twenty-eight arthroplasties in 121 patients who were performed THA from December 2004 to March 2013, were reviewed retrospectively a minimum of 4 years follow-up (mean age, 60.3 years; mean postoperative follow up period, 86.3 months). For a clinical evaluation, the Harris hip score (HHS) was used to assess outcome. Radiographic evaluation was done through spot welds, subsidence, stress shielding, canal filling. RESULTS: The mean HHS was 69.8 points preoperatively, and it improved significantly to 96.3 points at the final follow-up. Postoperatively, 10 patients experienced thigh pain and 7 patients showed a moderate limping gait. There was not only early stem subsidence but there was no more subsidence at last follow up. One hundred eighteen hips showed radiographic signs of stem bone ingrowth, and 10 hips showed fibrous ingrowth at the last follow-up. Stress shielding occurred in 85 hips and third degree stress shielding was observed in 6 hips. Complication arose in 10 hips due to dislocation. Although revisions due to recurrent dislocations led to acetabular component revision in one hip, no revisions arose due to isolated aseptic loosening of the femoral component. CONCLUSION: The clinical and radiological mid-term results of primary THA using Summit® stems revealed solid initial fixation and bone ingrowth stable fixation. Considering the satisfactory clinical results, Summit® stems may be a good treatment option in Korean patients who were required hip arthroplasty
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Dislocations ; Femur ; Follow-Up Studies* ; Gait ; Hip ; Humans ; Retrospective Studies ; Thigh

PURPOSE: This study was aimed to review findings of gray-scale ultrasonography and to assess the diagnostic value of the resistive index (RI) in patients with acute epididymitis by comparing with that in normal volunteers. MATERIALS & METHODS: Gray-scale ultrasonogram was reviewed in nine patients with acute epididymitis for echogenicity, size and reactive hydrocele. Normal values of resistive index (RI) were obtained in 20 epididymides from 10 volunteers (aged 20-28, mean 23.7). Nine patients of epididymitis (aged 18-67, mean 37.2) were examinated with color Doppler sonography and RI was measured at 11 sites on epididymal arteries. For the prediction of acute epididymitis, accuracy, sensitivity and specificity were calculated at the cut-off value of RI in 0.65 and 0.70. RESULTS: Gray-scale ultrasonography showed echogenicity that was variable among the 9 cases (hype- rechoic 2 cases, isoechoic 2, hypoechoic 5), enlargement of epididymis in 8, and reactive hydrocele in 8 cases. Normal volunteers displayed color Doppler signals in 14 out of 20. The range of RI in normal volunteers were between 0.64 and 1.00 (mean, 0.79 +/- SD 0.10). In patients with acute epididymitis, color Doppler signals were detected in all patients. The range of RI in epididymitis were 0.40-0.68 (mean, 0.56 +/- SD 0.10). At cut-off RI value of 0.65, accuracy was 88%, sensitivity 81.8%, and specificity 92.7%. At cut-off value of 0.70, accuracy was 92%, sensitivity 100%, and specificity 85.7%. CONCLUSION: In addition to the findings of gray-scale ultrasonography, resistive index and color flow changes are valuable in diagnosing acute epididymitis.
Arteries ; Epididymis ; Epididymitis* ; Healthy Volunteers ; Humans ; Male ; Reference Values ; Sensitivity and Specificity ; Ultrasonography ; Volunteers

OBJECTIVE: The aim of this study is to evaluate the effects of intracranial-extracranial arterial bypass(EIAB) surgery on cerebrovascular reserve capacity(CRC) in patients with hemodynamic cerebral ischemia and to assess the significance of transcranial doppler(TCD) examination before and after EIAB surgery. METHODS: In 29 consecutive patients who underwent EIAB surgery due to symptomatic internal carotid artery or middle cerebral artery(MCA) occlusion, 21 patients were studied using preoperative and postoperative digital subtraction angiogram(DSA), SPECT, and TCD examination. After measuring mean radioactivity count of a region of interest, relative regional cerebral blood flow(rrCBF) was quantitated by the following formula: lesional radioactivity count/contralateral radioactivity count x 100%. CRC was calculated as the percentage change from baseline flow after a vasodilatory challenge. RESULTS: Postoperative DSA showed good collateral circulation through the bypass except 4 patients. Preoperative mean value of rCRC improved significantly after EIAB surgery from -14.8+/-2.6% to 6.9+/-2.7%(p<0.01). Intraoperatively, flow velocity of superficial temporal artery(STA) and MCA just after anastomoses increased remarkably in comparison with the values just before anastomoses(p<0.01). There was no correlation between the change of pre- and postoperative flow velocity and the change of rrCBF. In patients with the increase of flow velocity after surgery manifested good collateral circulation through the bypass. The difference was statistically significant(repeated measures ANOVA, p<0.05). Over a mean follow-up period of almost 3 years, no patient had another episode of brain ischemia. CONCLUSION: We believe that the measurement of flow velocity is expected a good method to evaluate the degree of collateral circulation through the bypass.
Brain Ischemia* ; Carotid Artery, Internal ; Collateral Circulation ; Follow-Up Studies ; Hemodynamics* ; Humans ; Radioactivity ; Tomography, Emission-Computed, Single-Photon

Foreign bodies in the genitourinary tract are relatively common, and almost of them are discovered within the bladder. We had experienced a patient and report herein, who had a plastic tube in the bladder, introduced through urethra during masturbation. The size of the tube was 110cm in length and 0.5cm in diameter, and it was easily diagnosed by history, symptoms, simple KUB, cystoscopy, and was removed by foreign body forceps under the cystoscopy.
Cystoscopy ; Foreign Bodies* ; Humans ; Masturbation ; Plastics ; Surgical Instruments ; Urethra ; Urinary Bladder*

PURPOSE: It may be difficult to differentiate renal cell carcinoma involving collecting system from renal urothelial tumor invading into renal parenchyma. The purpose of this study was to assess the differences of CT findings between two conditions. MATERIALS AND METHODS: CT findings of 5 cases of renal cell carcinoma involving the renal collecting systems and 10 cases of renal urothelial tumors invading the renal parenchyma were compared, and analyzed about the presence or absence of hydronephrosis, normal or abnormal CT nephrogram, renal contour changes due to mass and tentative diagnosis. The diagnoses were confirmed at surgery. RESULTS: Renal cell carcinoma showed hydronephrosis in only 20% and normal CT nephrogram and outward contour bulging in all cases. In contrast, renal urothelial tumor showed hydronephrosis(70%), abnormal CT nephrogram(60%), and preservation of reniform shape(100%). CONCLUSION: Renal contour changes and CT nephrogram may be useful in distinguishing both disease entities.
Carcinoma, Renal Cell* ; Diagnosis ; Hydronephrosis