Omphalocele-exstrophy-imperforate anus-spinal defects(OEIS Syndrome) is a single defect in early mesoderm, and its incidence is about one in 250,000. If was first described by Littre in 1709. The characteristics of this disorder is omphalocele, extrpohy of bladder, imperforate anus and spina bifida. There have been reports of longtime survival made possible by several operations, but for most cases normal life is impossible due to the deformities. We report a case of OEIS complex who had omphalocele, exstrophy of bladder, imperforate anus and spina bifida from birth.
Anus, Imperforate ; Bladder Exstrophy ; Congenital Abnormalities ; Hernia, Umbilical ; Incidence ; Mesoderm ; Parturition ; Spinal Dysraphism ; Urinary Bladder

Omphalocele-exstrophy-imperforate anus-spinal defects(OEIS Syndrome) is a single defect in early mesoderm, and its incidence is about one in 250,000. If was first described by Littre in 1709. The characteristics of this disorder is omphalocele, extrpohy of bladder, imperforate anus and spina bifida. There have been reports of longtime survival made possible by several operations, but for most cases normal life is impossible due to the deformities. We report a case of OEIS complex who had omphalocele, exstrophy of bladder, imperforate anus and spina bifida from birth.
Anus, Imperforate ; Bladder Exstrophy ; Congenital Abnormalities ; Hernia, Umbilical ; Incidence ; Mesoderm ; Parturition ; Spinal Dysraphism ; Urinary Bladder

OBJECTIVE: The objective of the study was to estimate socioeconomic burden of polycystic ovary syndrome (PCOS) during the reproductive life span using current definitions and prevalence or incidence data. METHODS: Questionnaires were given to 8,588 reproductive women reviewed at Ewha Womans University Mokdong hospital. The PCOS affected approximately 10.4% of reproductive-aged women (11 million women in Korea, prevalence rate according to 1990 National Institutes of Health PCOS diagnosis criteria). We tied general societal cost data for the different health consequences to reproductive-age PCOS costs, using prevalence data. RESULTS: We estimated the mean annual cost of the initial evaluation to be 76 hundred million won, that of hormonally treating menstrual dysfunction, providing infertility care, diagnosis/treatment of endometrial hyperplasia, GDM, type 2 DM, and hypertension to be 280 billion won. The total annual socioeconomic cost of evaluating and providing care to reproductive-aged PCOS women in Korea is 350 billion won. CONCLUSION: Because the cost of the diagnostic evaluation accounted for a relatively minor part of the total socioeconomic costs, more widespread screening for PCOS appears be a cost-effective strategy, leading to earlier diagnosis and intervention and possibly the amelioration and prevention of serious sequelae.
Endometrial Hyperplasia ; Female ; Humans ; Hypertension ; Incidence ; Infertility ; Korea ; Mass Screening ; National Institutes of Health (U.S.) ; Polycystic Ovary Syndrome ; Prevalence ; Surveys and Questionnaire

PURPOSE: We compared renal function outcomes in patients undergoing open or laparoscopic radical nephrectomy. MATERIALS AND METHODS: Seventy-one patients undergoing open or laparoscopic radical nephrectomy for kidney disease with a normal contralateral kidney were identified between January 2004 and December 2007. Renal function was calculated by using the Cockcroft-Gault formula. Serial renal functions were checked from the day before surgery to 1 year after surgery. Exclusion criteria were preexisting renal insufficiency, urinary stone disease, and pancreatic and liver disorders. RESULTS: Forty-one and 30 patients were treated with open radical nephrectomy or laparoscopic radical nephrectomy, respectively. The operative time and urine output of patients who underwent open and laparoscopic radical nephrectomy were 211.7+/-5.8 and 330.8+/-15.6 and 196.4+/-19.6 and 130.7+/-12.1, respectively (p=0.001, p=0.013). The glomerular filtration rates of patients who underwent open or laparoscopic radical nephrectomy were insignificant from baseline to postoperative day 360 (p>0.05). CONCLUSIONS: No significant differences in renal function were detected in the groups of patients who underwent open or laparoscopic radical nephrectomy from baseline to long-term follow-up.
Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kidney ; Kidney Diseases ; Laparoscopy ; Liver ; Nephrectomy ; Operative Time ; Renal Insufficiency ; Urinary Calculi

PURPOSE: To compare the efficacy of the split-bolus contrast media injection technique in helical CTangiography(CTA) of the whole aorta and iliac arteries with that of the single-bolus technique. MATERIALS AND METHODS: Using the split bolus technique in 23 patients, 90 ml of contrast medium (Ultravist 300) was injected ata rate of 3ml/sec;this was followed by an 8-sec pause and the subsequent injection of 30ml. Using the single bolustechnique in another 23 patients, 120ml of contrast medium was injected for 40sec. continuously. CT angiography ofthe thoracic aorta (slice thickness/pitch=3mm/2:1) was performed, first followed by an interscan delay of 8sec,and the abdominal aorta and iliac arteries were then scanned(slice thickness/pitch=3mm/2:1 or 5mm/1.5:1). In allpatients, CT density was measured in the aortic lumen at eight levels, from the origin of the aorta to the iliacbifurcation. RESULTS: Using the split bolus technique, visual assessment revealed second density peak in theaortic lumen of the upper abdomen in 15 of 23 patients(65%), while the use of the single bolus technique revealedno second density peak in any patient. CT density in the aortic lumen at the level of the esophagogastricjunction, and at all levels below this except the abdominal aortic bifurcation, was significantly higher using thesplit bolus technique than with the single bolus technique (t-test, p<0.05). CONCLUSION: For CTA of the wholeaorta and iliac arteries, the split bolus technique is more effective than the single bolus technique.
Abdomen ; Angiography* ; Aorta* ; Aorta, Abdominal ; Aorta, Thoracic ; Contrast Media* ; Humans ; Iliac Artery* ; Tomography, Spiral Computed*

A laparoscopicradical nephrectomy or nephrouretectomy with bladder cuff excision are acceptable treatments for renal or upper urinary tract malignancies, respectively. However, laparoscopic surgery in dialysis patients is associated with high morbidity due to the long operation time and intraabdominal insufflation of carbon dioxide. Herein, two cases of a renal cell carcinoma and an urothelial carcinoma in dialysis patients are reported.
Carbon Dioxide ; Carcinoma, Renal Cell ; Dialysis* ; Humans ; Insufflation ; Kidney Failure, Chronic ; Laparoscopy ; Nephrectomy* ; Urinary Bladder ; Urinary Tract

No abstract available.
Female ; Hysterectomy, Vaginal* ; Uterine Prolapse*

PURPOSE: There are numerous prostate cancer-related genes that involve in carcinogenesis and tumor progression. Among the genes, DNA mismatch repair genes recognize and repair misincorporated nucleotides during DNA replication. In this analysis, we evaluated the association of hMSH2 which is one of the mismatch repair genes, with risk of aggressive prostate cancer and prostate cancer recurrence. MATERIALS AND METHODS: Immunohistochemistry was performed in 46 patients who diagnosed prostate cancer and underwent radical prostatectomy between January 2006 and December 2012 at Kyung Hee University Hospital at Gangdong. We evaluated an association between the degree of hMSH2 immunohistochemical staining and various clinical variables including prostate-specific antigen (PSA), Gleason score, pathological stage, and biochemical recurrence. The intensity of immunostaining for hMSH2 was divided into 2 groups: low expression group (immunostaining score < 2) and high expression group (immunostaining score ≥2). RESULTS: Although seminal vesicle invasion was marginally associated with the degree of hMSH2 immunohistochemical staining, PSA, Gleason score, lymph node metastasis, presence of lymphatic, perineural, vascular invasion, and extracapsular extension were not associated with the degree of hMSH2 immunohistochemical staining. Furthermore, the association of biochemical recurrence free survival with hMSH2 expression was not statistically significant. CONCLUSIONS: The hMSH2 expression was marginally associated with risk of aggressive prostate cancer such as seminal vesicle invasion. Further evaluation with a larger number of cases is needed to verify these results.
Base Pair Mismatch ; Carcinogenesis ; DNA Mismatch Repair ; DNA Repair ; DNA Replication ; Gene Expression ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Nucleotides ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Seminal Vesicles

PURPOSE: The aim of our study was to evaluate the association of several factors with spontaneous stone expulsion, including ureteral stone characteristics (size, location, hydronephrosis, perinephric stranding), types of medications prescribed (alpha-blocker, low-dose steroid), and other possible demographic and health-history factors (gender, age, serum creatinine, underlying diabetes mellitus [DM], and hypertension). MATERIALS AND METHODS: A total of 366 patients with ureteral stones were enrolled. All patients underwent watchful waiting without any invasive procedures. Initial diagnoses of ureteral stones were confirmed by computed tomography scans, which were taken at approximately 1-month intervals to check for stone expulsion. Univariate and multivariate analyses were conducted to identify significant factors that contributed to stone expulsion. RESULTS: Among 366 patients, 335 patients (91.5%) experienced spontaneous stone passage during a mean follow-up period of 2.95+/-2.62 weeks. The patients were divided into two groups depending on the success of spontaneous stone passage. Univariate analyses revealed that stone location (p=0.003), stone size (p=0.021), and underlying DM (p<0.001) were significant predictors of stone passage. Multivariate analyses confirmed that stone size (p=0.010), stone location (p=0.008), and underlying DM (p=0.003) were independent predictive factors affecting stone passage. CONCLUSIONS: Stone size, location, and underlying DM were confirmed to be significant predictive factors for spontaneous passage of ureteral stones. Urologists should consider active procedures, such as shock wave lithotripsy or ureteroscopy, rather than conservative management in patients presenting with proximally located stones, large ureteral stones, or underlying DM.
Adult ; Aged ; Diabetes Complications/*therapy ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Remission, Spontaneous ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Ureteral Calculi/pathology/radiography/*therapy ; *Watchful Waiting

Most submucosal tumors of the stomach are of mesenchymal origin. According to the advances of immunohistochemical staining and electron microscopy, spindle cell tumors which were considered as leiomyoma or leiomyosarcoma appeared to be heterogeneous group; from smooth muscle cell, neural, bidirectionally differentiated cells of smooth muscle cell and neural cell, or immature mesenchymal cell. Therefore, the gastrointestinal mesenchymal tumors are referred to as gastrointestinal stromal tumors. The biologic behavior of gastrointestinal stromal tumors is difficult to predict, except benign leiomyoma and schwannoma. Recently, we experienced a case of 5 cm-diameter submucosal tumor with a central ulcer on body of the stomach, endoscopically. The tumor was a well cir- cumscribed submucosal mass located in the midbody along greater curvature. Micros- copically, the tumor was composed of fasciculating bundles of spindle cells with benign nuclear atypia and peripheral lymphoid cell cuffing. The tumor cells revealed a diffuse strong immunoreactivity to S-100 protein and vimentin, but were negative to desmin and smooth muscle actin. Ultrastructurally, many tumor cells showed a number of thin elon-gated and interdigitating dendritic-like cell processes, distinct uniform basal laminae, frequent cellular attachments and microfilaments. The findings supported the schwannian nature of the tumor.
Actin Cytoskeleton ; Actins ; Basement Membrane ; Desmin ; Gastrointestinal Stromal Tumors ; Leiomyoma ; Leiomyosarcoma ; Lymphocytes ; Microscopy, Electron ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Neurilemmoma* ; S100 Proteins ; Stomach ; Ulcer ; Vimentin