A case of a ruptured aneurysm originating at the proximal portion of the left posterior inferior cerebellar artery and an arteriovenous malformation in the left cerebellar hemisphere fed by the same artery is reported. The coincidental occurrence of these two vascular anomalies within the posterior fossa is uncommon. Aneurysms of the posterior inferior cerebellar artery require special consideration during surgical planning and operation because of the proximity of the posterior inferior cerebellar artery to the brain stem and to the origin of the lower cranial nerves. In our reported case, the aeurysm was located 2.7mm from the midline and 4.7mm from the clivus when measured radiometrically. The operation was carried out with the patient in a three quarter prone position through a left lateral suboccipital approach. Clipping of the neck of the aneurysm and total removal of the arteriovenous malformation were performed successfully in a one-stage operation.
Aneurysm* ; Aneurysm, Ruptured ; Arteries* ; Arteriovenous Malformations* ; Brain Stem ; Cranial Fossa, Posterior ; Cranial Nerves ; Humans ; Intracranial Aneurysm ; Neck ; Prone Position

No abstract available.
Mucous Membrane* ; Muramidase* ; Turbinates*

PURPOSE: To evaluate the prevalence and type distribution of high-risk human papillomavirus (HPV) infection in genital warts of Korean men, and for the first time, to describe the risk factors associated with high-risk HPV infection in male genital warts. MATERIALS AND METHODS: In a single private clinic, 150 consecutive male patients with histopathologic-confirmed genital warts who underwent HPV genotyping by use of polymerase chain reaction (PCR) were included in this study. We detected HPV DNA in male genital warts and evaluated HPV type distribution, especially high-risk HPV types, by use of PCR. The associations between HPV prevalence and various characteristics, such as age, circumcision status, type of genital warts diagnosis (new vs. recurrent), number of lesions, site of lesions, and gross morphology, were assessed by use of unconditional multiple logistic regression. RESULTS: High-risk HPV types were detected in 31 cases (23.5%), and of these, 27 cases (20.5%) contained both high-risk and low-risk HPV types. The most frequently detected high-risk HPV types were HPV16 (6.8%), HPV33 (4.5%), HPV18 (2.3%), and HPV68 (2.3%). In particular, the prevalence of infection with HPV16 and/or HPV18 was 8.3% (11 of 132). In the multivariate analysis, lesions located at sites including the base of the penis or the pubic area, papular or mixed genital warts, and lack of circumcision significantly increased the association with high-risk HPV infection in male genital warts. CONCLUSIONS: The prevalence of high-risk HPV infection was substantial in male genital warts. The site and morphology of lesions and circumcision status were significantly associated with the prevalence of high-risk HPV infection.
Circumcision, Male ; Condylomata Acuminata* ; Diagnosis ; DNA ; Female ; Human papillomavirus 16 ; Humans* ; Logistic Models ; Male* ; Multivariate Analysis ; Papillomavirus Infections* ; Penis ; Polymerase Chain Reaction ; Prevalence* ; Risk Factors

Neurilemmoma is well-encapsulated tumor of Schwann cell origin. The majority arise in peripheral nerve or cranial nerve, and rare in retroperitoneum. Although it is incidentally detected by the advances in diagnostic procedures, especially in ultrasound and computed tomography, it is confirmed by pathologic findings. The treatment is surgical excision. We report a case of retroperitoneal neurilemmoma arising from adjacent to adrenal gland, in 45 years old female.
Adrenal Glands* ; Cranial Nerves ; Female ; Humans ; Middle Aged ; Neurilemmoma* ; Peripheral Nerves ; Ultrasonography

Tuberculous bronchoesophageal fistula is a rare disease. We experienced a case of the tuberculous bronchoesophageal fistula, which was found by endoscopy and surgically confirmed. A sixty seven years old female patient complained of foreign body sensation in the throat and frequent aspiration, especially after liquid meal. Esophagoscopic ex- aminatian showed the orifice of the fistula in the midesophagus at the level of 28 cm from the incisors. Esophagogram showed bronchoesophageal fistula between midesophagus and the right intermediate bronchus. A bronchoscopy visualized fistulous tract with granulation in the right intermediate bronchus. Biopsy specimens obtained from the bronchus revealed the esophageal tissue with granulation and multinucleated giant cells. Fistulectomy with wrapping procedure was performed successfully. Surgical pathologic findings confirmed a small focal granuloma and chronic inflammations, compatible with tuberculosis. There was no evidence of malignancy at the specimens. She was treated with anti-tuberculous agents and became well.
Biopsy ; Bronchi ; Bronchoscopy ; Endoscopy ; Female ; Fistula* ; Foreign Bodies ; Giant Cells ; Granuloma ; Humans ; Incisor ; Inflammation ; Meals ; Pharynx ; Rare Diseases ; Sensation ; Tuberculosis

Anisakiasis refers to the infestation of humans by species of marine nematode larvae belonging to the subfamily Anisakiae. An acute abdominal symptom may occur after ingestion of raw marine fish containing nematode larvae of the genus Anisakis. Migration of the parasite into the wall of gtomach, small intestine or, less commomly, the colon elicits a striking eosinophilic granulomatous tissue response. A 39 year old man was visited St. Vincent Hospital because of abdominal distension and tenderness. The plain abdominal X-ray showed ileus pattern suggesting intestinal obstruction. Hence we presented a case of intestinal Anisakiasis combined with intstinal obstruction.
Adult ; Anisakiasis* ; Anisakis ; Colon ; Eating ; Eosinophils ; Humans ; Ileus ; Intestinal Obstruction ; Intestine, Small ; Larva ; Parasites ; Strikes, Employee

Fifty-two patients with unstable cervical spine injuries underwent operations between January 1, 1990 to June 30, 1997 in our institution and this is retrospective study on clinical results about these patients. Patients with cervical instability resulted from injury posterior column, being included in White's criteria, were treated with Hafifax interlaminar clamps for cervical instability. We followed up forty-two cases for more than one year. All of the forty- two cervical fixations showed immediate and long term stability and there were no neurological complication. Neu rologic improvements were seen in thirty three, but thirteen cases were unchanged. These results indicate that Halifax interlaminar clamps are consider to be a safe and effective method for posterior stabilization of va rious causes of cervical spine instability.
Humans ; Retrospective Studies ; Spine*

Nasal lymphoma is an uncommon neoplasm in the sinonasal tract. The NK/T-cell type of lymphoma is more commonly found in Asian populations. However, B-cell lymphoma is more common in the western countries whereas it is rare in Asia. Recently, we experienced two cases of sinonasal B-cell lymphoma, which are rare cases in Korea, one in an advanced stage and one in an early stage. Both patients had no specific nasal symptoms or systemic B symptoms (fever, night sweat, weight loss). As our cases demonstrate, diagnosis of B cell lymphoma is often delayed in many cases because B-cell lymphoma does not show any specific symptoms. Thus, careful physical examination and biopsy under suspicion of malignancy are important for early diagnosis of nasal lymphoma.
Asia ; Asian Continental Ancestry Group ; B-Lymphocytes ; Biopsy ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Physical Examination ; Sweat

PURPOSE: A sling operation using tension-free vaginal tape (TVT) has been recently developed and popularized. In order to overcome the problem that the location of the TVT procedure is limited to the mid-urethra, the therapeutic effectiveness of the TVT sling through bladder neck approach was investigated and compared with that through the mid-urethra approach. MATERIALS AND METHODS: Out of 127 stress urinary incontinence patients, 78 patients were assigned to Group A (the mid-urethra approach) and 49 patients were assigned to Group B (the bladder neck approach). The data was analyzed according to age, grade, time of operation, postvoiding residual urine volume, postoperative complications, success rate and the patient's satisfaction. RESULTS: Both groups were mainly Grade I in Stamey grade. There was no significant difference in the surgery time between the two groups, with an average of 23 minutes and 24 minutes, respectively. Of the total number of SUI patients, 12% of Group B patients had a postvoiding residual urine volume larger than 100ml while 6% of Group A patients had a similar residual urine volume. In both groups, severe complications and discomfort were very rare. The success rates of the two groups were similar, 95% versus 96% respectively, and similar results were shown in the patients' satisfaction. Overall, there was no significant difference between two groups. CONCLUSIONS: In the TVT sling operation, the mid-urethra approach is the standard for SUI treatment. However, bladder neck approach has an equivalent effect. Therefore, it is believed that this site for the TVT will lead to more surgical approaches.
Female* ; Humans ; Neck ; Postoperative Complications ; Suburethral Slings* ; Urinary Bladder ; Urinary Incontinence*

The perinephric cyst in which cystic structures are in close relation to the kidney and renal pelvis is rare in occurrence. The causes may be obscure but most perinephric cysts around the kidney are a result of trauma, either accidental or an operative complication and doubtful origin, in which there is an encysted collection of urine or serous fluid lying beside and sometimes compressingthe kidney, and sometimes communicating with the pelvis. Clinical presentation is characterized by palpable flank mass and history of trauma. The diagnosis is made by excretory urography, ultrasonogram and CT scan. The treatment is aspiration or encleation of the cyst, or rarely nephrectomy. We report a case of perinephric cyst with hypertension developed in a 58-year-old woman presented with a child-fist sized palpable mass on right upper abdomen.
Abdomen ; Deception ; Diagnosis ; Female ; Humans ; Hypertension ; Kidney ; Kidney Pelvis ; Middle Aged ; Nephrectomy ; Pelvis ; Tomography, X-Ray Computed ; Ultrasonography ; Urography