No abstract available.
Urinary Tract Infections* ; Urinary Tract*

We performed this study to evaluate the therapeutic responses of bone marrow transplantation and immunosuppressive therapy for aplastic anemia in 103 cases (68 severe and 35 moderate). Among them, 15 cases with severe aplastic anemia having HLA-identical sibling donor underwent bone marrow transplantation, and cases(53 severe and 35 moderate cases)without available HLA-identical sibling donor had received immunosuppressive therapy using antilymphocye globulin and cyclosporin-A. The results were as follows; 1) For cases given bone marrow transplantation, successful engraftment was accomplished in all cases, but 2 cases showed rejection and 1 case died of thrombotic thrombocytopenic purpura (TTP), resulting 80% disease-free survival rate. acute graft-versus-host disease above grade II was noted in 2 cases and chronic graft-versus host disease was seen in other 2 cases. The most common pathogenic organism in post-transplantation infection was Herpes zoster (6 cases), and one each cases of Herpes simplex, candidiasis, measles and hemorrhagic cystitis developed. 2) Among 88 cases of receiving immunsouppressive therapy, complete response was seen in 26 cases (29.5%) and partial respones in 37 cases (42.0%), resulting 71.6% of overall response rate and recurrence rate was 19.5% (12 cases). In 53 severe cases, complete response was seen in 9 cases (17.0%) and partial response in 25 cases (47.2%), resulting 64.2% of overall response rate. In 35 moderate cases, complete response was seen in 17 cases (48.6%) and partial response in 12 cases(34.3%), overall response rate was 82.9%. All initial responses were seen within 6 months post-treatment period, and the time interval to initial response was 8 to 162 days (median; 53 days). There was no sex difference concerning response rate, however, partial response was predominant in male and more complete response in female. The complications of immunosuppressive therapy were thrombocytopenia (93.2%), fever (67.7%), hypertension (50.0%), skin eruption (45.8%), gingivitis (17.0%). In conclusion, our date suggest that bone marrow transplantation is preferred initial treatment modality to immunosuppressive therapy in severe aplastic anemia patient with HLA-identical sibling donor, and immunosuppression is a satisfactory alternative therapy for children with severe aplastic anemia in the absence of HLA-identical sibling and for whom with moderate aplastic anemia.
Anemia, Aplastic* ; Bone Marrow Transplantation ; Candidiasis ; Child ; Cystitis ; Disease-Free Survival ; Female ; Fever ; Gingivitis ; Graft vs Host Disease ; Herpes Simplex ; Herpes Zoster ; Humans ; Hypertension ; Immunosuppression ; Male ; Measles ; Purpura, Thrombotic Thrombocytopenic ; Recurrence ; Sex Characteristics ; Siblings ; Skin ; Thrombocytopenia ; Tissue Donors

Two cases of spontaneous kidney rupture with literatural review was presented at first in Korea. 1) 56 years male patient and 25 years male patient admitted to our department of Urology through Emergency Room after onset of 2 and 1 day. after treatment at local clinic. 2) Chief complaints were one side flank pain which was followed by total gross hematuria. 3) Preoperative diagnoses were kidney rupture due to necrotic pelvic tumor in 56 years male and hypernephroma in 25 years male patient. 4) Operation was procedured at 8 days and 4 days after admission respectively. 5) The operative procedure were nephrectomy in both cases. 6) The pathological diagnoses were pelvis rupture due to renal stone and parenchymal rupture due to renal infarction in each case.
Carcinoma, Renal Cell ; Diagnosis ; Emergency Service, Hospital ; Flank Pain ; Hematuria ; Humans ; Infarction ; Kidney* ; Korea ; Male ; Nephrectomy ; Pelvis ; Rupture ; Rupture, Spontaneous* ; Surgical Procedures, Operative ; Urology

Between 1986 and 1990, four children with recurrent CNS leukemia who had previous CNS prophylaxis therapy were treated with intermittent central nervous system irradiation and intrathecal chemotherapy (IIIC). There was no isolated CNS recurrence. One patient died form bone marrow relapse. Three patients are alive without evidence of disease for 3E3/12 year to 3E6/12 year after the diagnosis of recurrence of CNS leukemia. This experience suggests that IIIC may be an effective treatment for preventing the recurrence of CNS leukemia without any serious side effects.
Bone Marrow ; Central Nervous System* ; Child* ; Diagnosis ; Drug Therapy* ; Humans ; Leukemia* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence

A 5-month-old male infant was referred by the pediatrician for nontender, left testicular enlarged mass. It was intratesticular round cyst 1.7 cm in diameter without internal echoes on ultrasonogram. After inguinal orchiectomy, pathologic report was intratesticular simple cyst. We report a rare case of intratesticularsimple cyst with a brief review of the literature.
Humans ; Infant ; Male ; Orchiectomy ; Testis ; Ultrasonography

A 13-year old boy was seen for progressive enlargement of a right scrotal mass that had been present since early childhood. Scrotal mass was excised and consisted of a well demarcated multinodular cystic soft mass. Pathology was characteristic of cavernous lymphangioma. Lymphangiomas are benign tumors of congenital origin, occurring about 95% of the lesion at neck and axilla. Their scrotal location is quite uncommon. Treatment consists of surgical excision. Unless completely removed, recurrences are common.
Adolescent ; Axilla ; Humans ; Lymphangioma* ; Male ; Neck ; Pathology ; Recurrence ; Scrotum*

Disturbances of the surrounding vascular system and the severe cicatrical entrapment of the injured plexus should be considered, with its neural damage, in brachial plexus injury by Gun-Shot. Therefore, Subclavian arteriography and Subclavian venography before operation should be essential and the correction of the deficit of the vascular system may be a factor in the determination of prognosis in relation to pain control. We have reported 2 cases of the brachial plexus injury by Gun-shot and discussed the importance of Subcalvian arteriography and Subclavian venography. External neurolysis seems to be beneficial in Causalgia caused by brachial plexus injury.
Angiography ; Brachial Plexus* ; Causalgia ; Phlebography ; Prognosis

Hemimegalencephaly is a rare brain malformation characterized by congenital hypertrophy of one cerebral hemisphere, ipsilateral ventriculomegaly, hemiparesis, intractable epilepsy, and mental retardation, which often results in early death. We reported a case of hemimegalencephaly in a 1-month-old male with the chief complaint of intractable focal seizure.
Brain ; Cerebrum ; Epilepsy ; Humans ; Hypertrophy ; Infant, Newborn ; Intellectual Disability ; Male ; Malformations of Cortical Development* ; Paresis ; Seizures*

PURPOSE: Single incision laparoscopic cholecystectomy (SILC) is increasingly performed worldwide. Accordingly, the Konyang Standard Method (KSM) for SILC has been developed over the past 6 years. We report the outcomes of our procedures. METHODS: Between April 2010 and December 2016, 1,005 patients underwent SILC at Konyang University Hospital. Initially 3-channel SILC with KSM was changed to 4-channel SILC using a modified technique with a snake retractor for exposure of Calot triangle; we called this a modified KSM (mKSM). Recently, we have used a commercial 4-channel (Glove) port for simplicity. RESULTS: SILC was performed in 323 patients with the KSM, in 645 with the mKSM, and in 37 with the commercial 4-channel port. Age was not significantly different between the 3 groups (P = 0.942). The postoperative hospital days (P = 0.051), operative time (P < 0.001) and intraoperative bleeding volume (P < 0.001) were significantly improved in the 3 groups. Drain insertion (P = 0.214), additional port insertion (P = 0.639), and postoperative complications (P = 0.608) were not significantly different in all groups. Postoperative complications were evaluated with the Clavien-Dindo classification. There were 3 cases (0.9%) over grade IIIb (bile duct injury, incisional hernia, duodenal perforation, or small bowel injury) with KSM and 3 (0.5%) with mKSM. CONCLUSION: We evaluated the evolution of the KSM for SILC. The use of the mKSM with a commercial 4-channel port may be the safest and most effective method for SILC.
Cholecystectomy, Laparoscopic* ; Classification ; Hemorrhage ; Humans ; Incisional Hernia ; Laparoscopy ; Methods* ; Operative Time ; Postoperative Complications ; Snakes

PURPOSE: The purpose of this study was to assess the efficacy of a polytetrafluoroethylene (PTFE) stent graft for preventing potential complications related to a transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: Between January 2002 and March 2003, seven patients (males: 5, females: 2, mean age: 44) underwent TIPS stent placement using the PTFE stent graft (Nitis, Taewoong, Seoul, Korea) to prevent potential complications such as life threatening hemoperitoneum, hemobilia and early stent occlusion. Three patients were admitted for esophageal varix bleeding, three patients were admitted for gastric varix bleeding and one patient was admitted for umbilical bleeding. The extrahepatic portal vein was punctured inadvertently in four patients (main portal vein: 1 case, portal vein bifurcation: 3 cases), but contrast media extravasation into the peritoneal cavity on the tractogram was noted only in two patients. Two of four patients had chronic portal vein occlusion with intra- and extrahepatic cavernous transformation. The bile duct was inadvertently punctured and visualized on the tractogram in three patients. RESULTS:All the identified biliary trees or contrast media extravasations observed on the tractograms were successfully sealed off on the post-procedure portograms. The immediate post-procedure clinical recovery courses were uneventful in all patients (no hemobilia or hemoperitoneum was noted). Bleeding control was successful in all patients. The one patient who had Child-Pugh class C disease died of hepatic encephalopathy 3 days after TIPS placement. Five of the six living patients have not shown any complications or rebleeding during the follow up periods (9-23 months). The one patient who had biliary communication on the tractogram re-bled due to TIPS stent stenosis 25 days after TIPS, and this patient was successfully treated by TIPS revision. CONCLUSION: Potential complications related to TIPS procedure can be successfully prevented with PTFE stent-graft placement.
Bile Ducts ; Blood Vessel Prosthesis ; Constriction, Pathologic ; Contrast Media ; Esophageal and Gastric Varices ; Extravasation of Diagnostic and Therapeutic Materials ; Female ; Follow-Up Studies ; Hemobilia ; Hemoperitoneum ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Peritoneal Cavity ; Polytetrafluoroethylene* ; Portal Vein ; Portasystemic Shunt, Surgical* ; Seoul ; Stents*