No abstract available.
Leg* ; Myocutaneous Flap*

Angiolymphoid hyperplasia with eosinophilia(ALHE) is a benign angiomatous neoplasm which usually arises from skin, blood vessel, soft tissue, heart and rarely from bone. The authors experienced a case of ALHE which involved the distal femur of 35-years old male and treated by marginal excision and autogenous cancellous bone graft with plate fixation.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Femur ; Heart ; Humans ; Hyperplasia ; Male ; Skin ; Transplants

Authors experienced an unusual case of malunited trans-epiphyseal fracture of the proximal femur in a 2 year-old girl. She was treated at a private clinic by closed reduction and cast immobilization, which subsequently resulted in malunion and capital subluxation. Because of subsequent failure of remodelling of the subluxated malunited fracture for two years, corrective femoral varisation and internal rotation osteotomy was done to reduce the subluxated femoral head. Postoperatively congrous reduction was obtained and gradual remodelling of the malunited fracture took place during 5 and a half years follow-up period.
Child ; Female ; Femur ; Follow-Up Studies ; Fractures, Malunited ; Head ; Hip ; Humans ; Immobilization ; Osteotomy

BACKGROUND: The Ivor-Lewis operation has been widely applied for treating thoracic esophageal cancer, but more acceptable results from three-field lymph node dissection have recently been reported. In this study the efficacy of the Ivor-Lewis operation was evaluated. MATERIAL AND METHOD: Among the 273 patients, who underwent operation for esophageal cancer between September 1994 and August 2004, we retrospectively studied 172 patients with esophageal squamous cell carcinoma and who had no other primary cancer and who underwent complete resection with an Ivor-Lewis operation. The postoperative complications, the short and long-term survival and the recurrence patterns were analyzed. RESULT: The postoperative staging was as follows: stage I in 40 cases, IIA in 48 cases, IIB in 18 cases, III in 55 cases, IVA in 5 cases and IVB in 6 cases. The operative mortality rate was 4% (7 of 172 pts). Postoperative complication occurred in 32 patients (18%) and tumor recurred in 55 patients (32%). The overall 5-year survival rate was 48%; it was 85.6% in stage I patients, 47.6% in IIA patients, 65% in IIB patients, 22.8% in III patients and 0% for those in IV (p<0.05). The 5-year survival rate according to the location of esophageal cancer was 26.5% for patients with tumor in the upper 1/3 of the esophagus and 52.4% for patients with tumor in the mid and lower 1/3 (p>0.05). CONCLUSION: The Ivor-Lewis operation is an acceptable surgical procedure for thoracic esophageal squamous cell carcinoma. Yet it is necessary to consider other surgical procedures, and especially three-field lymph node dissection for treating upper 1/3 esophageal cancer.
Carcinoma, Squamous Cell* ; Esophageal Neoplasms ; Esophagus ; Humans ; Lymph Node Excision ; Mortality ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: Holmium: YAG laser (Ho: YAG laser) lithotripsy represents an additional option in the management of urinary tract calculi. We report here on the results for the success and complications of Ho: YAG laser lithotripsy on the management of ureteric calculi. MATERIALS AND METHODS: 132 patients (72 males and 60 females, mean age: 46 years (range: 26-75)) underwent 137 ureteroscopic procedures using a 6/7.5Fr semi-rigid ureterocope (Wolf, Germany). A Ho: YAG laser (Trimedyne Inc., Irvine, USA) was used for laser lithotripsy at a maximum energy of 1.0J/pulse at 10Hz. The calculi were located in the lower ureter in 93 cases, the middle ureter in 20 cases and the upper ureter in 24 cases. The patients were assessed with plain x-ray within 4 weeks postoperatively. RESULTS: The overall stone-free rate was 98%. Stratifying the results by location, the stone-free rate was 99% in the lower ureter, 95% in the middle ureter and 96% in the upper ureter. Fragmentation failed in three cases (2%). Ureteral stricture developed in one case postoperatively. CONCLUSIONS: Ho: YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.
Calculi ; Constriction, Pathologic ; Female ; Holmium* ; Humans ; Lasers, Solid-State* ; Lithotripsy* ; Lithotripsy, Laser ; Male ; Ureter ; Ureteral Calculi ; Ureteroscopy ; Urinary Tract

PURPOSE: Holmium: YAG laser (Ho: YAG laser) lithotripsy represents an additional option in the management of urinary tract calculi. We report here on the results for the success and complications of Ho: YAG laser lithotripsy on the management of ureteric calculi. MATERIALS AND METHODS: 132 patients (72 males and 60 females, mean age: 46 years (range: 26-75)) underwent 137 ureteroscopic procedures using a 6/7.5Fr semi-rigid ureterocope (Wolf, Germany). A Ho: YAG laser (Trimedyne Inc., Irvine, USA) was used for laser lithotripsy at a maximum energy of 1.0J/pulse at 10Hz. The calculi were located in the lower ureter in 93 cases, the middle ureter in 20 cases and the upper ureter in 24 cases. The patients were assessed with plain x-ray within 4 weeks postoperatively. RESULTS: The overall stone-free rate was 98%. Stratifying the results by location, the stone-free rate was 99% in the lower ureter, 95% in the middle ureter and 96% in the upper ureter. Fragmentation failed in three cases (2%). Ureteral stricture developed in one case postoperatively. CONCLUSIONS: Ho: YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.
Calculi ; Constriction, Pathologic ; Female ; Holmium* ; Humans ; Lasers, Solid-State* ; Lithotripsy* ; Lithotripsy, Laser ; Male ; Ureter ; Ureteral Calculi ; Ureteroscopy ; Urinary Tract

BACKGROUND: Hepatocyte growth factor (HGF) is a potent mitogenic cytokine. C-met protein, which is known to be the HGF receptor has transmembrane tyrosine kinase activity and is encoded by the c-met oncogene. The HGF/c-met signaling pathway may play various roles in the carcinogenesis of various organs. METHODS: We examined HGF and c-met mRNA expression by utilizing reverse transcription polymerase chain reaction on 40 surgically resected intracranial meningiomas (25 benign, 10 atypical, and 5 anaplastic cases). RESULTS: An HGF overexpression was detected in 28%, 50%, and 80% of the benign, atypical and anaplastic meningiomas, respectively; a high expression of HGF or the coexpression of HGF/c-met was detected in the high grade meningiomas (the atypical and anaplastic cases, p=0.046, p=0.014). An HGF expression was statistically significant in the recurrent meningiomas (p=0.003), and HGF expression was significantly lower than c-met mRNA expression in benign meningiomas (p=0.034). CONCLUSIONS: There was no correlation between histologic subtypes and HGF/c-met expression. Determination of HGF expression can be used as a molecular predictor for recurrence of meningioimas. These results suggest that HGF and c-met expression in meningiomas may be associated with anaplastic progression.
Hepatocyte Growth Factor ; Hepatocytes ; Meningioma ; Neoplasm Recurrence, Local ; Oncogenes ; Polymerase Chain Reaction ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins c-met ; Recurrence ; Reverse Transcription ; RNA, Messenger

PURPOSE: We evaluated the correlation of the pathologic diagnosis, including the grade or location of the inflammation on a prostate biopsy specimen, to the serum prostate-specific antigen(PSA) level. MATERIALS AND METHODS: 172 patients(the patients' PSA was> or=4ng/ml) who received prostate biopsy at our department from January 2000 to August 2003 were retrospectively studied. The pre-biopsy PSA and pathology, including the diagnoses and inflammatory patterns, were analyzed. The pathologic patterns of inflammation were divided as acute or chronic by the predominant inflammatory cell type; especially, the chronic inflammation was divided by grade or location, and then this was reviewed by 1 pathologist. Chronic Inflammation was graded as I, II or III according to the severity of inflammation. The PSA levels were compared among the grades. The presence or absence of chronic inflammation was checked in the periglandular, stromal and perivascular areas, respectively. The PSA levels were compared between the presence and absence of inflammation at each location. RESULTS: Among 172 patients, the number of patients with prostate cancer was 37(21.5%), and 68 patients had only BPH(39.5%), 27 had only prostatitis(15.7%) and 40 patients had benign prostatic hyperplasia(BPH) with prostatitis(23.3%). The number of patients with any prostatitis was 67(39.0%). The age of the patients was 68.4+/-8.7 years(45-91), the serum PSA was 13.30+/-14.38ng/ml(4.30-102.48), and the prostate size was 49.5+/-21.1ml(20-126). One case of BPH with prostatitis had a PSA level above 100ng/ml. Among the 67 specimens that showed prostatitis, 16 patients had histologically acute inflammation(23.9%) and 51 patients had chronic inflammation(76.1%). The PSA levels of the acute or chronic inflammation patients were 24.04+/-25.95ng/ml(4.46-102.48) and 9.93+/-4.73ng/ml(4.3-21.12, p=0.047), respectively. The PSA levels were not different among the 3 grades of chronic inflammation. In periglandular, stromal and perivascular locations, the PSA levels were not different between the presence and absence of chronic inflammation. CONCLUSIONS: About 39% of the prostate biopsy specimens showed prostatitis. The PSA level was higher for the acute inflammation than for the chronic inflammation. However, there was no difference in PSA levels among the each of the grades or locations of chronic prostatic inflammation.
Biopsy ; Diagnosis ; Humans ; Inflammation* ; Pathology* ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Prostatitis* ; Retrospective Studies

PURPOSE: Pseudomembranous trigonitis is a common cystoscopic finding in the female patients with voiding symptoms. We evaluated the changes in voiding symptoms of the patients after coagulating this lesion with Holmium:YAG laser. MATERIALS AND METHODS: Six female patients with voiding symptoms including frequency, dysuria, lower abdominal pain who were refractory to the conservative treatment for more than 1 month were enrolled in this study. The mean age was 35(range: 26~43) years. The patients were treated with cystoscopic evaluation and Holmium:YAG laser with 365 and 500 micrometer probe fibers. Power setting was between 6 and 11 watts. Only the lesions at the trigone and bladder neck were coagulated. No indwelling urethral catheter was used postoperatively. We evaluated patient's symptoms with out-patient follow-up or telephone up to 16 months. RESULTS: The mean duration of symptoms were 3.8(range: 6 months~13 years) years, and the mean follow-up was 13.3(range: 8~16) months. In all cystoscopic evaluations, pseudomembranous trigonitis was seen. After treatment, 3 of the 6 patients showed symptomatic improvements within 3 months and retained the improved state up to the last follow-up period. However, in the other 3 patients, no change in symptoms or initial response with following recurrence was seen. In the 3 patients who showed good response, transient worsening period of 1~3 months preceded the improvement. Follow-up cystoscopy at 3 months showed complete regeneration of the trigone and bladder neck mucosa. CONCLUSION: In the patients of pseudomembranous trigonitis with voiding symptoms refractory to conservative therapy, laser coaulation of the trigonal lesion was not so satisfactory but may be one of therapeutic options. Further investigation is needed.
Abdominal Pain ; Cystoscopy ; Dysuria ; Female* ; Follow-Up Studies ; Humans ; Laser Coagulation* ; Laser Therapy ; Mucous Membrane ; Neck ; Outpatients ; Recurrence ; Regeneration ; Telephone ; Urinary Bladder ; Urinary Catheters

PURPOSE: Chronic prostatitis/chronic pelvic pain syndrome (CPPS) presents various symptoms, such as various pains, voiding and sex-related symptoms. To elucidate the characteristic symptoms of CPPS we compared BPH patients with healthy men. MATERIALS AND METHODS: We obtained questionnaires from 530 men, consisting of three groups: 243 CPPS patients aged 40 or below with small sized prostate (<25ml); 115 BPH patients aged 45 or older with non-small sized prostate (> OR =25ml); and 172 healthy men aged below and equal 40 years without pyuria. We compared various pains and voiding symptoms among the three groups, and the sex-related symptoms between 145 CPPS patients and 64 healthy men who had been married at least 6 months, and had regular sexual intercourse with their wife. RESULTS: In comparison with healthy men, the CPPS patients had a higher prevalence of the various pains and most of the voiding symptoms. The CPPS patients had a higher prevalence of pain over the penis, urethra, perineum and prostate gland compared to the BPH patients (p<0.05). There was no statistical significance in voiding symptoms between the CPPS and BPH patients. In respect to the sex-related symptoms, the CPPS patients had a higher prevalence of decreased maintenance time, rigidity at erection, libido, orgasmic feeling and a more painful ejaculation than the healthy men (p<0.01). The frequencies of sexual intercourse and orgasmic sensation following ejaculation were slightly decreased, bur with no statistical significance (p>0.05). CONCLUSIONS: The CPPS patients showed a higher prevalence of various pains and voiding symptoms than the healthy men. Pains over the penis, urethra, perineum and prostate gland are characteristic in CPPS patients. Both the CPPS and BPH patients felt trouble due to the voiding symptoms. The CPPS patients had a higher prevalence of most of sex-related symptoms, but had similar frequencies of sexual intercourse and orgasmic sensation following ejaculation compared to the healthy men.
Coitus ; Ejaculation ; Humans ; Libido ; Male ; Orgasm ; Pelvic Pain* ; Penis ; Perineum ; Prevalence ; Prostate ; Pyuria ; Surveys and Questionnaires ; Sensation ; Spouses ; Urethra