No Abstract Available.
Endothelial Cells* ; Vitrectomy*

Purpose: Compressive hip dressings have been used to decrease the amount of postoperative bleeding after total hiparthroplasty. However, there is no data showing that a compressive dressing is effective. This study evaluated the effect of compressive dressings on the level of postoperative bleeding after total replacement arthroplasty. Materials and Methods: This prospective randomized clinical trail included 80 consecutive primary total hip arthroplasties in 72 patients. The 80 hips were randomly assigned to a compressive dressing group or a non-compressive dressing group using a table of random numbers. Forty-two hips in 37 patients were treated using the compressive dressing and the remaining 38 hips in 35 patients were treated using a non-compressive dressing. The patients were followed up for an average of 10.3 months. In all patients, a hemovac suction drain was inserted postoperatively. Results: The mean level of bleeding was 626.6 mL in the compressive group and 693.8 mL in the non-compressive group. There was no statistical difference between the two groups (P=0.416). Moreover, the incidence of postoperative complications including dislocation, nerve injury, symptomatic deep vein thrombosis and heterotopic ossification was similar in both groups. Conclusion: These results suggest that the compressive dressing has no significant effect on the amount of postoperative bleeding and clinical results after total hip arthroplasty.
Arthroplasty* ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip* ; Bandages ; Dislocations ; Hemorrhage* ; Hip ; Humans ; Incidence ; Ossification, Heterotopic ; Postoperative Complications ; Prospective Studies ; Suction ; Venous Thrombosis

PURPOSE: The common features of brain metastases from gastric cancer are unknown because brain metastasis is an uncommon pattern of metastasis. The purpose of this study was to investigate the clinical features of and the prognosis for patients with brain metastases after a curative resection for gastric cancer. MATERIALS AND METHODS: Twenty-one (21) cases of patients with brain metastases of gastric cancer, who had been treated at the Department of Surgery, Yonsei University College of Medicine, were assessed retrospectively. RESULTS: The mean age was 55.8+/-9.6 years (range: 34~70 years), and the male-to-female ratio was 2.5:1. The most common neurologic symptom was headache (38.5%), and no patient was free from the neurologic symptoms. The incidence of parenchymal metastasis (PM: 76.2%) was higher than that of leptomeningeal metastasis (LM: 19.0%). Patients with gastric cancer and brain metastasis showed high rates of blood and lymphatic vessel invasion (lymphatic vessel invasion: 85.7%; blood vessel invasion: 80.9%). According to Lauren's classification, the incidence of intestinal types was 14/21 (66.7%), that of diffuse types was 3/21 (14.3%) and that of mixed types was 4/21 (19.0%). The mean interval between the gastrectomy and the diagnosis of brain metastasis was 24.7+/-4.0 months (PM: 26.8 months; LM: 20.3 months). The median period of survival after diagnosis of brain metastasis was 2 months for paren chymal metastasis and 0 months for leptomeningeal metastasis. CONCLUSION: During a follow-up period, patients with neurologic symptoms should be suspected of having brain metastasis. Early diagnosis and treatment is the only hope to prolong survival in such patients.
Blood Vessels ; Brain* ; Classification ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Gastrectomy* ; Headache ; Hope ; Humans ; Incidence ; Lymphatic Vessels ; Neoplasm Metastasis* ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: Recently, the change to a more complex social structure has led to an increased frequency of traumas due to violence, accident and so on. In addition, the severity of the traumas and the frequency of penetrating injuries have also increased. Traumas to cervical and abdominal areas, what are commonly seen by general surgeons, can have mild to fatal consequences because in these areas, various organs that are vital to sustaining life are located. The exact location and characteristics of the injury are vital to treating patients with the trauma to these areas. Thus, with this background in mind, we studied, compared, and analyzed clinical manifestations of patients who were admitted to Wonju Christian hospital for penetrating injuries inflicted by themselves or others. METHODS: We selected and performed a retrospective study of 64 patients who had been admitted to Wonju Christian Hospital from January 2005 to December 2009 and who had cervical or abdominal penetrating injuries clearly inflicted by themselves or others. RESULTS: There were 51 male (79.7%) and 13 female (20.3%) patients, and the number of male patients was more dominant in this study, having a sex ratio of 3.9 to 1. The range of ages was between 20 and 86 years, and mean age was 43.2 years. There were 5 self-inflicted cervical injuries, and 19 self-inflicted abdominal injuries, making the total number of self-inflicted injury 24. Cervical and abdominal injuries caused by others were found in 11 and 29 patients, respectively. The most common area involved in self-inflicted injuries to the abdomen was the epigastric area, nine cases, and the right-side zone II was the most commonly involved area. On the other hand, in injuries inflicted by others, the left upper quadrant of the abdomen was the most common site of the injury, 14 cases. In the neck, the left-side zone II was the most injured site. In cases of self-inflicted neck injury, jugular vein damage and cervical muscle damage without deep organ injury were observed in two cases each, making them the most common. In cases with abdominal injuries, seven cases had limited abdominal wall injury, making it the most common injury. The most common deep organ injury was small bowel wounds, five cases. In patients with injuries caused by others, six had cervical muscle damage, making it the most common injury found in that area. In the abdomen, small bowel injury was found to be the most common injury, being evidenced in 13 cases. In self-inflicted injuries, a statistical analysis discovered that the total duration of admission and the number of patients admitted to the intensive care unit were significantly shorter and smaller, retrospectively, than in the patient group that had injuries caused by others. No statistically significant difference was found when the injury sequels were compared between the self-inflicted-injury and the injury-inflicted-by-others groups. CONCLUSION: This study revealed that, in self-inflicted abdominal injuries, injuries limited to the abdominal wall were found to be the most common, and in injuries to the cervical area inflicted by others, injuries restricted to the cervical muscle were found to be the most common. As a whole, the total duration of admission and the ICU admission time were significantly shorter in cases of self-inflicted injury. Especially, in cases of self inflicted injuries, abdominal injuries generally had a limited degree of injury. Thus, in our consideration, accurate injury assessment and an ideal treatment plan are necessary to treat these patients, and minimally invasive equipment, such as laparoscope, should be used. Also, further studies that persistently utilize aggressive surgical observations, such as abdominal ultrasound and computed tomography, for patients with penetrating injuries are needed.
Abdomen ; Abdominal Injuries ; Abdominal Wall ; Female ; Hand ; Humans ; Intensive Care Units ; Jugular Veins ; Laparoscopes ; Male ; Muscles ; Neck ; Neck Injuries ; Retrospective Studies ; Sex Ratio ; Violence

PURPOSE: The increasing use of ultrasonography has allowed for an increase in the of the detection of congenital hydronephrosis, and the clinical outcomes of congenital hydronephrosis are widely varied. In this study, the necessity of voiding cystourethrography in neonate with hydronephrosis to rule out vesicoureteral reflux (VUR) was evaluated. METHODS: Between January 2004 and December 2007, we reviewed the medical record of 157 childrens with congenital hydronephrosis detected within 1 month of age. The severity of hydronephrosis was graded by SFU (Society of Fetal Urology) system, and anterior posterior pelvic diameter (APPD). We evaluated the relationship between severity of hydronephrosis and incidence of VUR by using SPSS windows version 16.0. A P-value<0.05 is considered to be statistically significant. RESULTS: Total renal unit number was 254, and 20(7.8%) renal units had VUR. We did not find any relationship between hydronephrosis grade the presence of VUR grade (P>0.05). In addition, there was no statistical significance between APPD, laterality of hydronephrosis and VUR incidence. However, renal units with VUR had lower spontaneous resolution rate (P<0.05), compared to renal units without VUR. CONCLUSION: In this study, there was no statistical significance between the severity of hydronephrosis and presence of VUR. Therefore, voiding cystourethrogram is recommended for all children with hydronephrosis to rule out VUR, regardless of the severity of hydronephrosis.
Child ; Humans ; Hydronephrosis ; Incidence ; Infant, Newborn ; Medical Records ; Vesico-Ureteral Reflux

PURPOSE: The purpose of current study is to evaluate the midterm results of cementless primary total hip arthroplasty (THA) using a dual offset titanium tapered stem. MATERIALS AND METHODS: A retrospective analysis of 102 cases (84 patients), with a minimum of 7-year clinical follow-up, was performed. All of the cases consisted of patients who underwent primary cementless THA, using a dual offset titanium tapered stem in The Catholic University of Korea, Bucheon St. Mary's Hospital between July 2004 and May 2009. Clinical results were analyzed via the Harris hip score, level of thigh pain, squeaking around hip joint, and complication rate. Radiologic results were examined with stability and location of inserted prosthesis, hypertrophy of femoral cortex, and osteolysis. RESULTS: Out of the 102 cases (84 patients; 47 males and 37 females), with the mean age of 55.9 years (range, 27–79 years) and mean follow-up period of 99.2 months (range, 84–132 months). The mean Harris hip score was 53.8 preoperatively (range, 26–75) and improved to 93.5 postoperatively (range, 74–100) (p=0.000). All of the cases gained stable bony fixation on the final follow-up, including 2 cases of intra-operative proximal femur fracture. Calcar remodeling was observed in 94 cases, however, they were irrelevant with stem stability. Cortical hypertrophy of femur was seen in 12 cases and thigh pain in 4 cases; nonetheless, they were not relevant (p=0.067). There was 1 case of squeaking sound during joint movement. Hip dislocation occurred in 1 case early after the procedure, but the event was due to excessive anteversion of the acetabular cup, in which a revisional replacement procedure of the acetabular cup was conducted. No sign of ceramic breakage was observed. There were 2 cases of heterotrophic ossification. CONCLUSION: Results from a 7-year follow-up of cementless THA using dual offset titanium tapered stem were encouraging in both clinical and radiologic evaluations.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Ceramics ; Femur ; Follow-Up Studies* ; Gyeonggi-do ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Hypertrophy ; Joints ; Korea ; Male ; Osteolysis ; Prostheses and Implants ; Retrospective Studies ; Thigh ; Titanium*

OBJECTIVE: The purpose of this study was to establish reference ranges for the fetal orbital diameters (OD) and outer orbital diameters at 16 to 38 weeks' gestation. METHODS: This prospective longitudinal study enrolled 41 consecutive women with uncomplicated singleton gestations during their first trimester of pregnancy. Serial measurements of the fetal orbits by ultrasound examination were performed at intervals of 4 weeks until 28 weeks, and then every 2 weeks until 36 weeks, and weekly thereafter. Linear regression was used for statistical analysis. RESULTS: A total of 331 fetal orbital diameters and 298 outer orbital diameters were measured. The reference ranges for orbital diameters and outer orbital diameters were presented as mean, 95% confidence interval of the mean and percentiles. A linear growth function was observed between gestational age (GA), orbital diameter (Y=0.654 x GA - 0.856; r2=0.948; p<0.0001) and outer orbital diameter (Y=1.679 x GA+0.510; r2=0.942; p<0.0001). Significant correlation was also found between orbital diameter and outer orbital diameter (Y=2.451 x OD+4.840; r2=0.906; p<0.0001). CONCLUSION: We have presented percentile tables and regression formulas for fetal orbital diameters and outer orbital diameters. These results provide normative data of the growth of the fetal orbit and may be useful in assessing fetal orbital architecture in patients at risk of ocular abnormalities.
Female ; Gestational Age ; Humans ; Linear Models ; Longitudinal Studies* ; Orbit* ; Pregnancy ; Pregnancy Trimester, First ; Prospective Studies* ; Reference Values* ; Ultrasonography

We report the case of a patient with a recurrent squamous cell carcinoma of the cervix, FIGO stage IIa, that metastasized to both lung fields 5 years after primary radical hysterectomy and adjuvant pelvic irradiation. The tumor was resistant to UFT-cisplatin regimen. We used a combination of paclitaxel (175mg/m2 intravenous infusion over 3 hours) and carboplatin with a target area under the curve of 4.5 microgram-h/ml and repeated every 3 weeks. The patient well tolerated the chemotherapy with minor neurologic side effect and myelosuppression controlled by granulocyte colony-stimulating factor. The disease went into remission. Thus, the combination of paclitaxel and carboplatin may be a good combination in recurrent or advanced squamous cell carcinoma of the cervix.
Carboplatin* ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Female ; Granulocyte Colony-Stimulating Factor ; Humans ; Hysterectomy ; Infusions, Intravenous ; Lung ; Paclitaxel* ; Uterine Cervical Neoplasms*

PURPOSE: It is very important to remove or to reduce the effect of organ motion due to respiration in stereotatic radiosurgery of lung. This study reports the effectiveness of the breath hold technique with a ABC for reducing the breathing effect. MATERIALS AND METHODS: Whole body stereotactic frame (Elekta, Sweden) was used for lung SRS. Patients who have tumor motion range larger than 10 mm from fluoroscopic observation were selected to apply a ABC. Seventeen patients were enrolled in this study. Passive breath hold is possible with our ABC. Automatic breath hold was set at 80% of deep inspiration. Breath hold time was 25~30 seconds depending on the patients. Three consecutive CT scans were performed as indicated in Asan Medical Center SRS procedure for each patients. Lung volume and PTV differences between with breath hold and free breath were examined for 5 patients. RESULTS: The breath hold technique with ABC could be applied for 15 patients. Inter-, intra-treatment organ motion with ABC showed 1.5 mm, while it was 2.3 mm with abdomen compress. When with breath hold technique, PTV and CTV was reduced 33.7% and 45.4%, respectively, and lung volume was increased 32.3 % compared to conventional SRS method. CONCLUSION: Better target localization could be achieved with breath hold technique in lung SRS. Tumor motion could be minimized and relative lung volume irradiation could be reduced
Abdomen ; Chungcheongnam-do ; Humans ; Lung Neoplasms* ; Lung* ; Radiosurgery ; Respiration ; Tomography, X-Ray Computed

Associated congenital anomalies of both reproductive and urinary tracts are frequent, because wolffian and mullerian developments are closely related. The combination of uterus didelphys, obstructive hemivagina, ana ipsilateral renal agenesis is a rare but specific syndrome. The most common clinical presentation is pelvic pain and/or dysmenorrhea shortly after menarche, in association with the finding of a vaginal or pelvic mass. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patients. The simple and curative treatment of the condition is incision of the obstructing vaginal septum providing adequate drainage of the retained blood. We report three cases of uterus didelphys with an obstructed bemivagina and ipsilateral renal agenesis with a brief review of concerned literatures.
Diagnosis ; Drainage ; Dysmenorrhea ; Female ; Fertility ; Humans ; Menarche ; Pelvic Pain ; Urinary Tract ; Uterus*