No abstract available.
Drainage* ; Humans ; Jaundice, Obstructive*

No abstract available.

Sixty patients with hilar bile duct cancer were operated on during a period of nine years. The tumor was resected in 45 patients (resection rate:75.0%). A hilar resection with regional lymph-node dissection was performed in 27 patients, and various types of hepatic resections were added in 18 patients. A potentially curative resection was achieved in 20 patients (curative resection rate:44.4%). There were two operative deaths (operative mortality:4.4%). The overall cumulative five-year survival rate was 25.6%. Six patients survived for more than five years. The survival was superior in patients with a curative resection and in those with a combined hepatic resection, but this result was statistically insignificant. Regional lymph-node metastasis, gross type, histologic grade, and perineural invasion were significant prognostic factors. We conclud that improved survival in hilar bile duct cancers can be achieved by a radical resection with acceptable morbidity and mortality.
Bile Duct Neoplasms* ; Bile Ducts* ; Bile* ; Humans ; Mortality ; Neoplasm Metastasis ; Survival Rate

Klebsiella pneumoniae(K. pneumoniae) infection has a tendency of abscess formation and it is known to be associated with diabetes mellitus. Metastatic infection was an important feature of K. pneumoniae liver abscess and bacteremia, metastatic prostate abscess was rare. We present a case of a 81-year-old man with K. pneumoniae liver abscess and metastatic prostate abscess, This patient was successfully treated with percutaneous abscess drainage of liver abscess and transurethral incisional drainage of prostate abscess.
Abscess* ; Aged, 80 and over ; Bacteremia ; Diabetes Mellitus ; Drainage ; Humans ; Klebsiella ; Klebsiella pneumoniae ; Liver Abscess* ; Liver* ; Pneumonia ; Prostate* ; Transurethral Resection of Prostate

Single anomalous coronary artery is a rare congenital anomaly of the coronary circulation. Right coronary artery (RCA) arising from the left anterior descending artery is an extermely rare variety of single coronary artery. We report a 68-year-old patient with a single coronary artery system, in whom the right coronary artery originated from the mid left anterior descending artery.
Aged ; Arteries* ; Coronary Circulation ; Coronary Vessel Anomalies ; Coronary Vessels* ; Humans

The involvement of subaortic structures in the aortic valve endocarditis appears more common than previously recognized. The most common location of the subaortic complications is mitral-aortic intervalvular fibrosa(MAIVF) and the complications may be presented as abscess or pseudoaneurysm. We describe a case of infectious pseudoaneurysm of mitral-aortic intervalvular fibrosa mimicking abscess. In our case, complete AV block was revealed on ECG after aortic valve replacement (AVR). Several days after the first operation, re-do AVR and reconstruction of the MAIVF was performed because of complete AV block and dual fistula complicated by pseudoaneurysm in MAIVF.
Abscess ; Aneurysm, False* ; Aortic Valve* ; Atrioventricular Block* ; Echocardiography ; Electrocardiography ; Endocarditis* ; Fistula* ; Humans

Vascular catheters are associated with complications such as infection, thrombosis and stenosis. The embolization of a venous catheter fragment is a rare complication. A 39-year-old woman underwent placement of a totally implantable venous access device for chemotherapy to treat a recurrent liposarcoma of the left thigh. The "pinch-off sign" was noted on a routine chest X-ray but that was ignored. Three-months after implantation of the intravenous access device, the indwelling central catheter was fractured and embolized to the pulmonary trunk. The catheter in the pulmonary trunk was successfully removed through a percutaneous femoral vein approach using a pigtail catheter and goose neck snare.
Thigh/pathology ; Pulmonary Artery/*injuries/surgery ; Liposarcoma/drug therapy ; Humans ; Foreign-Body Migration/*complications/surgery ; Female ; *Equipment Failure ; Embolism/*etiology/surgery ; Catheters, Indwelling/*adverse effects ; Catheterization, Central Venous/*adverse effects/instrumentation ; Adult

PURPOSE: Circular stapled hemorrhoidopexy (CSH) is widely used to treat patients with grades III–IV hemorrhoids because of less pain and short hospital stay. However, this procedure is associated with some complications, such as urge to defecate, anal stenosis, staple line dehiscence, abscess and sepsis. To avoid these complications, surgeons perform a partial stapled hemorrhoidopexy (PSH). The aim of this study is to present our early experience with the PSH. METHODS: We retrospectively reviewed the medical records of 58 patients with hemorrhoids who were treated with a PSH at Busan Hang-Un Hospital from January 2016 to June 2016. A specially designed tri-window anoscope was used, and a purse string suture was made at the mucosae of the protruding hemorrhoids through the window of the anoscope. The hemorrhoidopexy was done by using a circular stapler. RESULTS: Of the 58 patients included in this study, 34 were male and 24 were female patients (mean age, 50.4 years). The mean operation time was 12.4 minutes, and the mean postoperative hospital stay was 3.8 days. Three patients experienced bleeding (5.1%) 5 urinary retention (8.6%) and 5 skin tags (8.6%). Urge to defecate, tenesmus, abscess, rectovaginal fistula, anal stricture, incontinence, and recurrence did not occur. CONCLUSION: PSH is a minimally invasive, feasible, and safe technique for treating patients with grades III–IV hemorrhoids. A PSH, instead of a CSH, can be used to treat certain patients with hemorrhoids.
Abscess ; Busan ; Constriction, Pathologic ; Female ; Hemorrhage ; Hemorrhoids* ; Humans ; Length of Stay ; Male ; Medical Records ; Mucous Membrane ; Rectovaginal Fistula ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Surgeons ; Sutures ; Urinary Retention

Cardiac myxoma is the most common benign cardiac tumor and it presents various clinical symptoms and signs. Although two-thirds of patients have abnormal electrocardiographic findings, atrial flutter or conduction abnormalities are known to be rare. We report on a case of a large left atrial myxoma which was diagnosed by trans-thoracic, trans-esophageal echocardiography, chest computerized tomography, and histological examination. The myxoma was presented as atrial flutter in a 41-year old man who was complaining palpitation and dyspnea on exertion. After surgical excision of the mass, atrial flutter converted to normal sinus rhythm. We report this case with review of literatures on left atrial myxoma associated with arrhythmia.
Arrhythmias, Cardiac ; Atrial Flutter ; Dyspnea ; Echocardiography ; Electrocardiography ; Heart Neoplasms ; Humans ; Myxoma ; Thorax

BACKGROUND AND OBJECTIVES: Certain types of arrhythmias have gender differences. Women have a higher incidence of drug-induced QT prolongation than in men. However, there are no reports regarding gender-related differences of the P wave signal averaged electrocardiogram (PWSAE), based on the risk of atrial fibrillation (AF). PWSAE has been recognized as a diagnostic tool for identifying the risk of paroxysmal atrial fibrillation (PAF). We therefore investigated the influence of gender in the parameters of PWSAE and in the risk of AF. SUBJECTS AND METHODS: We recorded 100 PWSAEs in apparently healthy Korean subjects (53 men and 47 women), aged 20 to 79 years. RESULTS: The mean age of the male subjects was 38.2 years and the mean age of the female subjects was 43.2 years (p=0.19). The body surface area (BSA) were larger in men (1.83 m2 vs. 1.53 m2, p<0.05). In men, the filtered P wave duration (fPD) was longer than in women (136.8 msec vs. 125.2 msec, p<0.05). The root mean square voltage in the terminal 20 ms of the filtered P wave (RMS20) was 5.9 micron V in women and 4.5 micron V in men (p<0.05). CONCLUSION: Men have a longer fPD and lower RMS20 than women. The BSA showed a positive correlation with fPD and a negative correlation with RMS20. This study suggests that BSA is an important factor for fPD and RMS20. In addition, as men have a larger BSA as compared with women, we suspect that men have a higher risk of AF as compared with women.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Body Surface Area ; Electrocardiography* ; Female ; Humans ; Incidence ; Male