We report a 72-year-old female patient with spontaneous rupture of the left external iliac vein. She visited our hospital for abdominal and back pain. She had the abnormal finding of hemoperitoneum. We performed an emergency operation with diagnosis of left ovarian cyst rupture though she suffered from spontaneous rupture of the left external iliac vein. This case provides insight to the experience of spontaneous rupture of the left external iliac vein.
Aged ; Back Pain ; Emergencies ; Female ; Hemoperitoneum ; Humans ; Iliac Vein ; Ovarian Cysts ; Rupture ; Rupture, Spontaneous

PURPOSE: We report here on the safety and efficacy of nephron-sparing radiofrequency ablation(RFA) for treating renal tumor. MATERIALS AND METHODS: Starting June 2004, a total of 14 patients underwent RFA for renal tumor during the following 3 years. Of these, 12 cases were followed up for at least 6 months postoperatively. Eight cases of combined computed tomography(CT) and ultrasonogram-guided percutaneous RFA, and four cases of intraoperative ultrasonography-guided laparoscopic RFA were performed with mean follow-up of 18.2 months(range: 4-27 months). The treatment indications were a localized, small(<4cm), solid renal mass in the elderly patients and those patients with co-morbid conditions. Physical examination, CBC, determining the serum creatinine levels and urine analysis were performed for the follow-up laboratory study and kidney CT was performed at day 1, 1 week, 1 month, 3 months, 6 months and 1 year after ablation and thereafter semi-annually. The mean follow-up duration was 18.2 months(range: 4-27 months). RESULTS: All the patients underwent successful RFA without any serious events. Four patients had mild perinephric hematoma on the follow-up CT scan and there was one case of mild gross hematuria postoperatively. With a mean follow-up of 18.2 months, two patients showed residual tumor at 3 months & 22 months, respectively, on the follow-up contrast- enhanced CT after the first tumor ablation. One patient underwent a second RFA and another patient underwent laparoscopic radical nephrectomy, and no residual tumor was seen on the follow-up CT. Distant metastasis was not found in any cases and all the patients are alive on serial follow-up. CONCLUSIONS: Percutaneous or laparoscopic RFA is considered a useful treatment for selected patients who have a small renal mass, and to spare the nephrons. The ultimate role of this modality will continue to evolve and this warrants further studies.
Aged ; Creatinine ; Follow-Up Studies ; Hematoma ; Hematuria ; Humans ; Kidney ; Laparoscopy ; Neoplasm Metastasis ; Neoplasm, Residual ; Nephrectomy ; Nephrons ; Physical Examination

A Case of the epidermoid cyst with highly unusual location which is occurred in the interhemispheric fissure is reported. Intracranial epidermoid tumor develops predominantly in the cerebellopontine angle and parasellar regions. There has been no literally reported case the epidermoid developed in the interhemispheric fissure. The patient was 31-year-old man with the chief complaint of generalized seizure which was the first attack occurred one day before admission. The lesion with the size of about 3cm in diameter demonstrated by MRI was completely removed through posterior interhemispheric approach. The patient's postoperative recovery was unremarkable and without neurological deficit.
Adult ; Cerebellopontine Angle ; Epidermal Cyst* ; Humans ; Magnetic Resonance Imaging ; Seizures

PURPOSE: To evaluate the safety and efficacy of a laparoscopic nephroureterectomy in patients with a transitional cell carcinoma of the renal pelvis and ureter. MATERIALS AND METHODS: All patients underwent a nephroureterectomy for an upper tract transitional cell carcinoma. Of these, 23 and 22 underwent a laparoscopic nephroureterectomy (LNU) and open nephroureterectomy (ONU), respectively, between January 2002 and June 2006. After the nephrectomy had been performed, a 5-6cm modified Gibson incision was created to allow dissection of the lower ureter and bladder cuff, and extraction of the intact specimen. A retrospective analysis was performed on the operating time, blood loss, analgesic requirement, ambulation time, interval to resume oral intake, hospital stay, complications and follow-up results for both groups. RESULTS: The LNU was superior to the ONU with regard to the mean operation time; 275 (190-390) versus 258 (180-400) (p=0.259), blood loss; 188 (130-250) versus 488ml (350-750) (p<0.05), ambulation time; 2.5 versus 3.3 days (p<0.05), interval to resume oral intake 2.1 versus 2.8 days (p<0.05), and hospital stay; 8.3 versus 11.1 days (p<0.05). Complications developed in 4 and 5 of the LNU and ONU patients, respectively, but all were resolved with conservative management. The mean follow-up duration of the LNU and ONU groups were 29 versus 14 months, respectively. CONCLUSIONS: Based on our experience, a laparoscopic nephroureterectomy is better tolerated with respect to pain, has less blood loss, shorter hospital stays, ambulation time and time to oral intake. LNU is safe for an upper tract transitional cell carcinoma, and is also an efficacious alternative to open surgery. However, a long-term follow-up will be warranted to ascertain accurate oncologic data.
Carcinoma, Transitional Cell* ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Length of Stay ; Nephrectomy ; Retrospective Studies ; Ureter ; Urinary Bladder ; Urinary Tract* ; Walking

Ankylosing spondylitis(AS) and diffuse idiopathic skeletal hyperostosis(DISH) increase the risk of spinal fracture after minor trauma in an ankylosed spine. There are few reports on a spinal fracture in people with both conditions. A 67-year-old man visited our emergency room with moderate back pain developed after slipping. No neurological deficit was noted. On physical examination, direct tenderness was noted in the back at the level of the thoracolumbar(TL) junction. Radiological evaluations showed the compression fracture of ankylosed spine and the coexistence of AS and DISH. Vertebroplasty was performed in fractured spine due to persistent back pain. Several weeks later, neurological deficits were developed. Finally, decompressive laminectomy and posterior screw fixations were performed. After operation, neurological deficits were fully recovered and patient was discharged. Patient who had a fracture of an ankylosed spine in association with coexisting AS and DISH could be considered the early surgical treatment.
Aged ; Back Pain ; Emergencies ; Fractures, Compression ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; Laminectomy ; Physical Examination ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing ; Vertebroplasty

PURPOSE: The objective of the present study was to evaluate the efficacy of a sclerosing solution for inducing epididymal occlusion in male rats. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into two groups: an injection group (n=20) and control group (n=20). Before injecting the sclerosing agent, seminal vesiculectomy and sperm identification using electrostimulation were performed in all of the rats. In the injection group, 0.2 mL of 0.1% sodium tetradecyl sulfate solution was injected into the epididymis. In the sham group, only the identification of the epididymis was performed. At 4 and 12 weeks after the injection, semen was collected by electrostimulation and evaluated to assess the contraceptive effect. Epididymis was evaluated by hematoxylin and eosin (H&E) staining. RESULTS: After 4 and 12 weeks, semen collection was performed in the two groups. Sperms were not observed in the injection group, while there was no change in the sperms in the sham group. H&E staining showed the obstruction of epididymal tubules and an accumulation of inflammatory cells in the injection group. CONCLUSIONS: This study showed that the sclerosing agent induced sterilization in male rats. This result suggests that the injection method can replace vasectomy as a contraceptive method. However, a further study of large animals and a clinical study are needed. Further, the long-term effectiveness of this method needs to be studied.
Animals ; Contraception* ; Contraceptive Agents ; Eosine Yellowish-(YS) ; Epididymis ; Hematoxylin ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Sclerotherapy* ; Semen ; Sodium Tetradecyl Sulfate ; Spermatozoa ; Sterilization ; Vasectomy

PURPOSE: The objective of the present study was to evaluate the efficacy of a sclerosing solution for inducing epididymal occlusion in male rats. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into two groups: an injection group (n=20) and control group (n=20). Before injecting the sclerosing agent, seminal vesiculectomy and sperm identification using electrostimulation were performed in all of the rats. In the injection group, 0.2 mL of 0.1% sodium tetradecyl sulfate solution was injected into the epididymis. In the sham group, only the identification of the epididymis was performed. At 4 and 12 weeks after the injection, semen was collected by electrostimulation and evaluated to assess the contraceptive effect. Epididymis was evaluated by hematoxylin and eosin (H&E) staining. RESULTS: After 4 and 12 weeks, semen collection was performed in the two groups. Sperms were not observed in the injection group, while there was no change in the sperms in the sham group. H&E staining showed the obstruction of epididymal tubules and an accumulation of inflammatory cells in the injection group. CONCLUSIONS: This study showed that the sclerosing agent induced sterilization in male rats. This result suggests that the injection method can replace vasectomy as a contraceptive method. However, a further study of large animals and a clinical study are needed. Further, the long-term effectiveness of this method needs to be studied.
Animals ; Contraception* ; Contraceptive Agents ; Eosine Yellowish-(YS) ; Epididymis ; Hematoxylin ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Sclerotherapy* ; Semen ; Sodium Tetradecyl Sulfate ; Spermatozoa ; Sterilization ; Vasectomy

An outbreak of Salmonella enteritidis epidemic involving about 200 inpatients of gastroenteritis and 1 death occurred among about 750 participants from Hamyang County who attended 4 wedding lunch parties at one buffet restaurant on April 25, 1999. There were also many patients including 1 death among about 500 participants outside Hamyang County who attended same parties. Person to person interviews made to 155 inpatients revealed that distribution of incubation periods was between 1 to 34 hours with median time, 13-14 hours. A retrospective cohort study was conducted to investigate the mode of transmission. Telephone interviews were made to party participants (except 61 inpatients who already had been interviewed personally) on symptoms and on which they had eaten among 40 served foods including water at the parties and data among 288 persons were available for the analyses. One hundred and ninety one interviewees had more than two symptoms among symptoms of diarrhea(more than 3 times), abdominal pain, and fever, which gave an attack rate of 66.3%(191/288). The relative short incubation period and high attack rate suggested the presence of higher infecting dose in this epidemic. Logistic regression analysis revealed that the probable infective foods were boiled cockle, gamju, boiled midodok, fried rices, eomook, and boiled pig's trotter. Salmonella enteritidis were identified in the specimens of boiled cockle, cooked beef, and uncooked beef. Only boiled cockle was both an epidemiological and microbiological infective food. There might be cross-contaminations between several served foods, which meant presence of many contaminated foods by Salmonella enteritidis with different stage of their multiplications. Efforts to inspect food service areas and educate foodhandlers in good personal hygiene and proper foodhandling practices should be strengthened to reduce the incidences of salmonellosis in Korea.
Abdominal Pain ; Cardiidae ; Cohort Studies ; Fever ; Food Services ; Gastroenteritis ; Humans ; Hygiene ; Incidence ; Inpatients ; Interviews as Topic ; Korea ; Logistic Models ; Lunch ; Restaurants ; Retrospective Studies ; Salmonella enteritidis ; Salmonella Infections* ; Water

Coronary artery fistula (CAF) is an abnormal communication between an epicardial coronary artery and a cardiac chamber, major vessel or other vascular structures. This report presents a rare case of CAF in which a dilated left main trunk and proximal circumflex coronary artery are connected to a dilated coronary sinus. There were also two other fistulae and persistent left superior vena cava. The coronary fistula was managed conservatively.
Arteriovenous Fistula ; Coronary Sinus ; Coronary Vessel Anomalies ; Coronary Vessels ; Fistula ; Glycosaminoglycans ; Vena Cava, Superior

Emphysematous gastritis is a subtype of phlegmonous gastritis characterized by emphysematous change of the gastric wall. It is associated with infection of gas forming organism and is often fatal because of suppurative bacterial infection. Streptococci is the most commonly involved microorganism of emphysematous gastritis. Aspergillus is a very rare pathogen of this disease, because invasive aspergillosis often presents as pulmonary infections and rarely involves the gastro-intestinal tract. Treatment should be aimed to cover various organism using broad spectrum antibiotics, and sometimes aggressive surgical management may be needed to enhance survival. We report a case of severe emphysematous gastritis caused by invasive aspergillosis with a review of the literature.
Anti-Bacterial Agents ; Aspergillosis ; Aspergillus ; Bacterial Infections ; Cellulitis ; Gastritis