No abstract available.

BACKGROUND AND PURPOSE: Laser induced prostatectomy(LIP) has recently been considered as safe alternative to conventional transurethral resection of the prostate(TURP) in the surgical treatment of BPH. However, the value of LIP remains incompletely defined. We herein have performed a prospective study to compare TURP and LIP in treatment efficacy, safety and costs to define the value of LIP. MATERIALS AND METHODS: 113 patients with BPH who were candidates of TURP were randomized to undergo TURP or LIP and were adequately followed up for more than 1 year. There were no significant differences in preoperative clinical characteristics between 55 patients who underwent TURP and 58 patients who underwent LIP. For the LIP procedure, Nd:YAG was used in 42 patients and diode laser in 16 patients, respectively. 37 patients were treated by contact LIP only, and 21 with hybrid procedures of contact LIP and noncontact LIP using side firing laser fiber or interstitial laser fiber. Seven patients underwent LIP under local anesthesia at the outpatient department. RESULTS: International prostate symptom score(IPSS) and peak urinary flow rate(Qmax) were significantly improved at 3 months, 6 months, and 1 year after LIP as well as after TURP. There were no significant difference between TURP group(85.4%) and LIP group(87.9%) in treatment success rate as defined by improvement of IPSS and Qmax as well as patient's content for the surgical outcome. Nine(16.4%) and two(3.6%) of the patients who underwent TURP and none of the patients who LIP underwent developed ignificant bleeding and electrolyte imbalance, respectively. There were no significant difference in postoperative incidence of retrograde ejaculation, infection and urethral stricture between the two groups. Compared to TURP, the LIP procedure required significantly shorter hospitalization(6.8 vs 4.5 days) and catheterization(4.1 vs 2.6 days, all p<0.0l). There was no significant difference in total treatment cost between the two groups. CONCLUSIONS: LIP may be comparable to TURP in terms of short term treatment efficacy and cost effectiveness. LIP may be better than TURP in terms of safety and shortened hospitalization and catheterization. Further studies are necessary on long-term outcomes of LIP."
Anesthesia, Local ; Catheterization ; Catheters ; Cost-Benefit Analysis ; Ejaculation ; Fires ; Health Care Costs ; Hemorrhage ; Hospitalization ; Humans ; Incidence ; Lasers, Semiconductor ; Lip ; Male ; Outpatients ; Prospective Studies ; Prostate* ; Prostatectomy* ; Transurethral Resection of Prostate ; Treatment Outcome ; Urethral Stricture

A 45-year-old female visited our clinic due to sudden right leg weakness and sensory loss. Brain and spinal cord magnetic resonance imaging showed widespread cavernous malformations. Cavernous malformation in L1 spine area was accompanied by a subacute stage hematoma with perilesional edema. Sensory loss subsided after corticosteroid therapy. Usually, neurologic deficit by spinal cavernous malformation appears more chronically in the adults compared to children. Treatment options are difficult to establish in a case with multiple cavernous malformations. Identifying hemorrhagic lesions by extensive neuroimaging evaluation could be helpful to select the treatment target for cavernous malformation.
Adult ; Brain ; Central Nervous System* ; Child ; Edema ; Female ; Hematoma ; Hemorrhage ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Neuroimaging ; Neurologic Manifestations* ; Spinal Cord ; Spine

Esophageal duplication is the congenital developmental anomaly manifestated as cystic or tubular type. The tubular esophageal duplication found at adult is extremely rare. A patient with tubular esophageal duplication is reported. A 37 years old male developed epigastric pain aggravated at hunger state from 2 monthes before administration. Gastrofiberscopy was done, and we could found the tubular esophageal duplication at 25 cm from incisiors. Esophagogram exposed the tunnel communicated with right anterior side of normal esophagus at upper and lower part of the tubular pathway with the length of 6 cm at T4-5 level. The microscopic finding of the tubular lumen revealed normal esophageal wall structure involving the outer part of muscle layer. Surgical resection was not done for the lesion was small and no symptom due to esophageal duplication was present. And so, the authors report this case as a tubular esophageal duplication with a literature review.
Adult ; Esophagus ; Humans ; Hunger ; Male

PURPOSE: In spite of many published reports about the primary gastrointcstinal lymphoma in Korea, the majority of them unfortunately involved a small number of patients with diverse results conceming treatment, patient survival, and prognostic factors. There also were few reports mainly focusing on primary intestinal lymphoma alone. Therefore we studied the patient-survival and prognostic factors in 52 cases of intestinal lymphomas. MATERIALS AND METHODS: We reviewed fifty two patients who received treatment due to primary intestinal lymphoma at Severance hospital, from January 1980 to June 1995. RESULTS: The intestinal lymphomas were located in descending order of frequency at the terminal ileum, i1eocecal region, right colon, and the jejunum. The most common histologic type was diffuse large cell type and the majority showed an intermediate grade of differentiation. The average survival time was 40.7 months with a 5 year survival rate of 41.4%. The overall and complete remission rate of the intestinal lymphoma were 76.2%, 64.3%, respectively. Additional chemotherapy or radiotherapy to surgery improved remission rate. The overall 5 year survival rates were 50.4%, 47.3%, 33.3%, and 25.0% in stage I, II1, II2 and III~IV, respectively. The 5 year survival rate after curative resection was 57.0% and 16.6% after incomplete resection. The significant prognostic factors were residual tumor, site of the lesion, multiplicity, and adjacent organ invasion. However, the site of the lesion alone (worst in the jejunum) was the sole independent variable on multivariate analysis. CONCLUSION: We concluded that early diagnosis and curative resection were important to improve survival rates in the primary intestinal lymphoma. More number of such cases are needed for further comparison of various treatment methods and results.
Colon ; Drug Therapy ; Early Diagnosis ; Humans ; Ileum ; Jejunum ; Korea ; Lymphoma* ; Multivariate Analysis ; Neoplasm, Residual ; Radiotherapy ; Survival Rate

PURPOSE: This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. METHODS: This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. RESULTS: Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. CONCLUSION: To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.
Animals ; Animals, Wild ; Bites and Stings ; Child ; Child Health ; Health Personnel ; Humans ; Isothiocyanates ; Medical Records ; Post-Exposure Prophylaxis ; Rabies ; Vaccination

No abstract available.
Amnion* ; Amniotic Fluid* ; Female ; Prolactin* ; Rabbits* ; Vasopressins*

PURPOSE: Recently Tc99m MIBI (methoxyisobutylisonitrile) has been described as an alternative to thallium for localizing parathyroid lesions. The purpose of this study was to compare the efficacy of a Tc99m MIBI scan with a Tl201/Tc99m subtraction scan for localizing parathyroid lesions in patients with primary hyperparathyroidism. METHODS: Among 31 cases of primary hyperparathyroidism operated on at the Department of Surgery, Seoul National University Hospital from January 1997 to June 2001, a Tl201/Tc99m subtraction scan was performed on 16 patients and a Tc99m MIBI scan on 22 patients. Seven patients underwent both. RESULTS: The pathology was a single adenoma in 28 patients, a hyperplasia in 1 patient and a carcinoma in 2 patients. Hypercalcemia was controlled postoperatively in all cases. The sensitivities of the Tl201/Tc99m subtraction scan and Tc99m MIBI scan were 53.3% and 86.4%, respectively. The positive predictive values were 100% of the two study groups. CONCLUSION: We concluded that the better accuracy, superior image quality and lower cost of Tc99m MIBI scan will make it the new radiopharmaceutical parathyroid scan of choice. A unilateral approach can be used with a high degree of success, as in case of a preoperatively localized single parathyroid adenoma, which was confirmed when surgical exploration identified of a normal ipsilateral gland.
Adenoma ; Humans ; Hypercalcemia ; Hyperparathyroidism, Primary* ; Hyperplasia ; Parathyroid Neoplasms ; Pathology ; Seoul ; Thallium

BACKGROUND: Small deep cerebral infarct can be associated with small-vessel occlusive disease, largevessel disease, low-flow or thrombo-embolic mechanism. This study is designed to investigate ralationship between symptomatic single small deep infarcts ahd vascular diseases. METHODS: We studied 154 patients who had symptomatic, small-sized(<20 mm), single, subcortical infarction(basal ganglia, corona rediata, centrum semiovale) who were admitted to our hospital from jund, 1996 to September, 1999. They were evaluated about the lesion site and vascular status of the carotid system and middle cerebral artery, using MRI, MRA and cervical duplex sonography or conventional angiography. RESULTS: Among 154 patients with single small deep infarction, 100 were related with small artery disease(64.9%), 38 with middle cerebral artery disease(26.7%) and 16 with carotid artery disease(10.4%). The basal ganglia or basal ganglia with corona radiata area were more frequently responsible lesion sites in both small artery disease(n=59, 59%) and middle cerebral artery disese(n=28, 73.7%) than in carotid artery disease(n=1, 6.3%). The centrum ovale or centrum ovale with corona radiata area were frequently involved lesion sites in carotid artery disease (n=10, 67.5%). CONCLUSION: Single small deep infarcts of th basal ganglia with corona radiata were mostly seen in the middle cerebral artery disease or small artery disease, and small deep infarcts of the centrum semiovale with corona radiata were usually assoicated with internal carotid artery disease. In occurrence of single small deep infarcts, middle cerebral artery disease was more frequent than carotid artery disease, which might be associated with intracranial occlusive disease known to be more common in Asians than in Caucasians.
Angiography ; Arteries ; Asian Continental Ancestry Group ; Basal Ganglia ; Carotid Arteries ; Carotid Artery Diseases ; Carotid Artery, Internal ; Cerebral Infarction* ; Ganglia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Vascular Diseases

STUDY DESIGN: This is a retrospective study analysing the results of Buck's operation for spondylolysis. PURPOSE: To analyze the results of Buck`s methods as a treatment for symptomatic spondylolysis clinically and radiographically. MATERIALS AND METHODS: Between March 1992 and March 1999, 12 patients with symptomatic spondylolysis were treated with Buck`s method. Surgical indication was 1)under 30 years of age, 2) patients with intractable low back pain without sciatica who did not response to conservative treatment for over 6 months, 3) without disc degeneration in lumbar MRI, 4) without instability in lateral flexion-extension view. The average age was 23 years and the follow-up periods ranged from 12 months to 54 months, mean 25 months. We confirmed union of defect and loosening or breakage of screws in preoperative, postoperative and the final radiographs, and in bone SPECT. And we analyzed symptomatic improvement by subjective assessment guidelines of Henderson clinically. RESULTS: Radiologically, union of defect by trabeculation was seen in 8 patients, in 2 patients unilaterally. In bone SPECT, union of defect was seen in 5 cases among 7 cases postoperatively. Average periods of union were 3.1 months(2.5-6.2 months). There was no loosening of screws, but in 1 patient breakage of screws and nonunion was seen 8 months postoperatively. Clinically, 10 patients(83.3%) were rated as excellent or good-5 patients excellent, 5 patients good-according to subjective assessment guidelines of Henderson. CONCLUSION: It is suggested that Buck's operation, one of the method of treatment of spondylolysis is simple and has low complication rate. We concluded that it is satisfactory to use Buck's operation in young patients with symptomatic spondylolysis.
Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Low Back Pain ; Magnetic Resonance Imaging ; Retrospective Studies ; Sciatica ; Spondylolysis* ; Tomography, Emission-Computed, Single-Photon