No abstract available.
Nursing Homes* ; Nursing* ; Nutritional Status*

Eosinophilic granuloma of bone is a self-limited condition, characteristically a disease of children and young adults. It is the most benign variant of histiocytosis X. It is most common in skull, but any bone may be affected. Vertebral involvement occurs in about 10 to 15%. This benign bone destructive lesion is characterized by the presence of Langerhans cells contain Birbeck granules, infilitration of histiocytes and eosinophilic leukocytes unknown origin. We report a eosinophilic granuloma in lumbar spine of old patient.
Child ; Eosinophilic Granuloma* ; Eosinophils* ; Histiocytes ; Histiocytosis, Langerhans-Cell ; Humans ; Langerhans Cells ; Leukocytes ; Skull ; Spine* ; Young Adult

PURPOSE: Endoscopic holmium:yttrium-aluminum-garnet (Ho:YAG) laser urethrotomy is an alternative method in the management of urethral strictures. We report our initial experience in 15 cases of evaluating the therapeutic efficacy of the holmium laser for treating incomplete urethral strictures. MATERIALS AND METHODS: Endoscopic holmium laser urethrotomy was primarily performed on 15 patients with incomplete urethral stricture. Exclusion criteria were complete urethral stricture and previous treatment of urethral stricture. Retrograde urethrography and uroflowmetry were performed preoperatively and were carried out as follow-up studies postoperatively. RESULTS: Successful results without recurrence were achieved in 8 of 15 patients. When we classified the results by stricture length, the success rate was 80% in strictures less than 2 cm, whereas there was no therapeutic effect in strictures over 2 cm. When we classified the results by etiology, the number of successful results in strictures with an inflammatory, trauma, iatrogenic, or unknown cause was 2 (2/8), 3 (3/4), 2 (2/2), and 1 (1/1), respectively. In 7 patients who failed treatment, we repeated holmium laser urethrotomy in 5 patients and urethroplasty in 2 patients. No operative complications occurred in any patients. CONCLUSIONS: Endoscopic holmium laser urethrotomy is a safe and effective minimally invasive therapeutic modality in cases of stricture less than 2 cm. Further data from long-term follow-up are necessary to compare the success rate with that of conventional urethrotomy and urethroplasty.
Constriction, Pathologic ; Follow-Up Studies ; Holmium ; Humans ; Lasers, Solid-State ; Recurrence ; Urethral Stricture

STUDY DESIGN: Retrospective study. PURPOSE: The objective of the study is to evaluate the relationship between the detection rate of lumbar disc herniation and socioeconomic status. OVERVIEW OF LITERATURE: Income is one important determinant of public health. Yet, there are no reports about the relationship between socioeconomic status and the detective rate of disc herniation. METHODS: In this study, 443 cases were checked for lumbar computed tomography for lumbar disc herniation, and they reviewed questionnaires about their socioeconomic status, the presence of back pain or radiating pain and the presence of a medical certificate (to check the medical or surgical treatment for the pain) during the Korean conscription. RESULTS: Without the consideration for the presence of a medical certificate, there was no difference in spinal physical grade according to socioeconomic status (p=0.290). But, with the consideration of the presence of a medical certificate, the significant statistical differences were observed according to socioeconomic status in 249 cases in the presence of a medical certificate (p=0.028). There was a lower detection rate in low economic status individuals than those in the high economic class. The common reason for not submitting a medical certificate is that it is neither necessary for the people of lower socioeconomic status nor is it financially affordable. CONCLUSIONS: The prevalence of lumbar disc herniation is not different according to socioeconomic status, but the detective rate was affected by socioeconomic status. Socioeconomic status is an important factor for detecting lumbar disc herniation.
Back Pain ; Intervertebral Disc Displacement ; Prevalence ; Public Health ; Retrospective Studies ; Social Class ; Surveys and Questionnaires

We report a case of nutcracker syndrome diagnosed with 3-dimensional computed tomography angiography (3-D CTA). Nutcracker syndrome had been confirmed by conventional venography until recent years. Nowadays, with the development of imaging techniques, color Doppler sonogram and 3-D CTA are replacing venography for the diagnosis of nutcracker syndrome. The patient, a 20-year-old male, had abrupt gross hematuria and left abdominal pain 6 months previously and intermittent microscopic hematuria thereafter. Including renal biopsy, the results of conventional hematuria study showed no abnormalities. 3-D CTA showed left renal vein compression between the abdominal aorta and superior mesenteric artery and collateral veins. The angle and distance between the superior mesenteric artery and aorta at the level of the left renal vein were 35degrees and 3.0 mm, respectively. We diagnosed nutcracker syndrome and later confirmed the diagnosis with venography.
Abdominal Pain ; Angiography ; Aorta ; Aorta, Abdominal ; Biopsy ; Hematuria ; Humans ; Male ; Mesenteric Artery, Superior ; Phlebography ; Renal Veins ; Veins ; Young Adult

PURPOSE: To determine which CT findings are useful for differentiating cholangiocarcinomas (CC) from hepatic abscesses and also to determine whether artificial neural networks (ANNs) improve radiologists' performance. MATERIALS AND METHODS: CT findings of 51 patients with mass-forming type CC and 70 patients with hepatic abscesses were analyzed with morphologic, enhancing and other ancillary findings by three radiologists with differing levels of expertise independently. ANNs were constructed using statistically significant CT findings derived from the analyses. The performances of the ANNs and the radiologists were evaluated using receiver operating characteristic analysis. RESULTS: CT findings of rim-like enhancement, lymphadenopathy, capsular retraction, focal bile duct dilatation and a solid component were significant features of CC (p< 0.05). Findings of a clustered sign, multilayered enhancement, sharp margin, round shape, and air-biliary gram were significant features of hepatic abscesses. The ANNs showed better performance (AZ=0.9673, 98.0%, 97.1%, and 97.5%, respectively) than the resident (AZ=0.898, 78.4%, 81.4%, 80.2%) (p<0.05) in differentiating between the two diseases: (AZ, sensitivities, specificities, and overall accuracies). However, there were no significant differences in the diagnostic performance of the ANNs and the two board-certified radiologists. CONCLUSION: Several CT findings are useful in differentiating CC from hepatic abscesses and ANNs may improve the performance of a radiologist with little experience.
Bile Ducts ; Cholangiocarcinoma* ; Dilatation ; Humans ; Liver Abscess* ; Lymphatic Diseases ; ROC Curve

OBJECTIVE: To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage. MATERIALS AND METHODS: We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted. RESULTS: The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients. CONCLUSION: Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.
Adult ; Female ; Humans ; Hysterectomy ; Leiomyoma/blood supply/*surgery ; Middle Aged ; Postoperative Hemorrhage/*therapy ; Retrospective Studies ; Treatment Outcome ; Uterine Artery Embolization/adverse effects/*methods ; Uterine Neoplasms/blood supply/*surgery ; Uterus/blood supply/surgery

A bartholin gland cysts and abscesses are common problems in women of reproductive age. Although the cysts are usually asymptomatic, they may become enlarged or infected and cause significant pain. Bartholin gland abscesses usually develop over two to four days and can become larger than 8 cm by literature but huge bartholin abscess is very rare. A number of vulvar and vaginal lesions can mimic bartholin gland cysts or abscesses and should be included in the differential diagnosis. So we report a case of hemorrhagic huge bartholin abscess with a brief review of the literatures.
Abscess* ; Diagnosis, Differential ; Female ; Humans

Objective: This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment. Methods: Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses. Results: Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load (P<0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment (P<0.01; OR, 2.732), and multiple hrHPV infections (P<0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types (P<0.05). Menopause (P<0.001; OR, 3.969), preoperative and postoperative hrHPV load (P<0.05; OR, 2.430; P<0.05; OR, 5.351), and infection with multiple hrHPV types (P<0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment. Conclusion HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.

Objective: This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment. Methods: Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses. Results: Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load (P<0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment (P<0.01; OR, 2.732), and multiple hrHPV infections (P<0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types (P<0.05). Menopause (P<0.001; OR, 3.969), preoperative and postoperative hrHPV load (P<0.05; OR, 2.430; P<0.05; OR, 5.351), and infection with multiple hrHPV types (P<0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment. Conclusion HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.