PURPOSE: To evaluate the outcome of transurethral microwave thermotherapy(TUMT) for the treatment of urinary retention due to benign prostatic hyperplasia(BPH) in the high-risk surgical patients. MATERIALS AND METHODS: From November, 1992 to March, 1997, a total of 26 patients with urinary retention due to BPH underwent TUMT with PRIMUS U+R because of poor physical and medical status at the department of urology, Red Cross hospital in Seoul. Mean patient age was 73years(range 58 to 97years), mean prostatic weight was 35gm(range 14gm to 68gm) and mean duration of retention was 1.7 months(range 1 day to 36months). The once or twice 1-hour TUMT session was well tolerated and without significant adverse effect. Patients were divided into responder and non-responder. In responder group who were catheter free after TUMT, peak flow rate and post-void residual urine(PVR) were assessed at 3, or 6, or 12months of follow-up. RESULTS: Of 26 patients, 16 patients were responders(61.5%) after TUMT for the duration of follow-up. The mean peak flow rate and post-voiding residual urine during 12months of follow-up period were 10.4m1/sec(range 3 to 22m1/sec) and 62.8ml(range 0 to 269m1), respectively. There was no major complication. CONCLUSIONS: From these results TUMT appears to be safe and erective treatment modality in the high-risk surgical patients.
Catheters ; Follow-Up Studies ; Humans ; Microwaves ; Prostatic Hyperplasia* ; Red Cross ; Seoul ; Transurethral Resection of Prostate* ; Urinary Retention* ; Urology

BACKGROUND: A stenosis of left main coronary artery has critical prognostic importance. Recent reports on successful left main stenting are now challenging traditional treatment patterns for this lesion. We evaluated recent four-year trends in incidence, clinical, angiographic findings and treatment modalities in patients with left main coronary artery stenosis(LMS). METHODS: Patients who were diagnosed as a significant LMS at Yonsei cardiovascular hospital between 1996 and 1999 were analyzed retrospectively. RESULTS: The incidence of LMS during the period of 1996 to 1999 was 3.3%(n=24) and it was significantly higher than that of previous 15 years before 1996(p<0.01). The incidence of isolated ostial lesion was 0.28% and this lesion was more prevalent in young female patients with less risk factors compared with other types of LMS(p<0.01). After exclusion of the patients with an isolated ostial lesion, patients were grouped according to the lesion site: ostium, shaft, and shaft lesion extended to distal vessels. There were no differences in clinical and hemodynamic findings among these groups. Coronary artery bypass graft was performed in 141 patients(63%) and stent implantation in 16 patients(14%). CONCLUSION: The incidence of LMS has been increased. There was no difference in clinical and hemodynamic findings according to the types of LMS. Surgery is still a standard treatment, but in selected patients percutaneous coronary intervention can be another treatment option.
Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Hemodynamics ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Stents ; Transplants

Discrete subvalvular aortic stenosis is a relatively uncommon cause of the left ventricular outflow obstruction, requiring early intervention. Conventional transthoracic echocardiography may fail in some patients due to insufficient imaging quality. In particular, in patients with a discrete fibrous membrane close to the aortic valve without narrowing of the left ventricular outflow tract, the echocardiographic detection of the membrane may be difficult. Transesophageal echocardiography allows a clear visualization of the aortic valve and the left ventricular outflow tract in virtually all patients, it can be performed rapidly with almost no risk, and it may therfore be helpful in establishing the diagnosis of discrete subaortic stenosis, in particular in patients where the conventional transthoracic approach fails. We have experienced two cases of discrete subaortic stenosis. One case of them was combined with hypertrophic obstructive cardiomyopathy in this report we discussed the utility of multiplane transesophageal echocardiography in patients with discrete subvalvular aortic stenosis.
Aortic Stenosis, Subvalvular* ; Aortic Valve ; Cardiomyopathy, Hypertrophic ; Diagnosis ; Discrete Subaortic Stenosis ; Early Intervention (Education) ; Echocardiography* ; Echocardiography, Transesophageal ; Humans ; Membranes ; Ventricular Outflow Obstruction

Renal Infarction is a rare disease and in 90% of patients with renal infarction, underlying cardiac disease is presented. Most often this includes valvular heart disease, cardiac arrhythmias, rheumatic heart disease with fibrillation, or subacute bacterial endocarditis. The correct clinical diagnosis and appropriate treatment of renal infarction are often delayed. Three cases of renal infarction were presented with review of literature.
Arrhythmias, Cardiac ; Diagnosis ; Endocarditis, Subacute Bacterial ; Heart Diseases ; Heart Valve Diseases ; Humans ; Infarction* ; Rare Diseases ; Rheumatic Heart Disease

Myoepithelioma is a rare benign tumor of salivary gland myoepithelial cells, most commonly as a spindle subtype. Here, we present two cases of fine needle aspiration cytology of plasmacytoid myoepithelioma arising from a parotid gland and a hard palate. Aspirates showed plasmacytoid cells with pink-staining, homogeneous, abundant eosinophilic cytoplasm eccentrically displacing the nucleus in cohesive and dissociated forms. Rarely, nuclear grooves and intranuclear cytoplasmic inclusions were evident. These unfamiliar cytologic findings of uncommon myoepithelioma often cause diagnostic difficulties in preoperative aspiration cytology. Recognition of those rare findings provides a reliable diagnostic clue.
Biopsy, Fine-Needle ; Cytoplasm ; Eosinophils ; Inclusion Bodies ; Myoepithelioma ; Palate, Hard ; Parotid Gland ; Salivary Gland Neoplasms ; Salivary Glands

Small round cell tumors (SRCTs) are a heterogeneous group of neoplasms composed of small, primitive, and undifferentiated cells sharing similar histology under light microscopy. SRCTs include Ewing sarcoma/peripheral neuroectodermal tumor family tumors, neuroblastoma, desmoplastic SRCT, rhabdomyosarcoma, poorly differentiated round cell synovial sarcoma, mesenchymal chondrosarcoma, small cell osteosarcoma, small cell malignant peripheral nerve sheath tumor, and small cell schwannoma. Non-Hodgkin\'s malignant lymphoma, myeloid sarcoma, malignant melanoma, and gastrointestinal stromal tumor may also present as SRCT. The current shift towards immunohistochemistry and cytogenetic molecular techniques for SRCT may be inappropriate because of antigenic overlapping or inconclusive molecular results due to the lack of differentiation of primitive cells and unavailable genetic service or limited moleculocytogenetic experience. Although usage has declined, electron microscopy (EM) remains very useful and shows salient features for the diagnosis of SRCTs. Although EM is not always required, it provides reliability and validity in the diagnosis of SRCT. Here, the ultrastructural characteristics of SRCTs are reviewed and we suggest that EM would be utilized as one of the reliable modalities for the diagnosis of undifferentiated and poorly differentiated SRCTs.
Chondrosarcoma, Mesenchymal ; Cytogenetics ; Diagnosis ; Gastrointestinal Stromal Tumors ; Genetic Services ; Humans ; Immunohistochemistry ; Lymphoma ; Melanoma ; Microscopy ; Microscopy, Electron ; Microscopy, Electron, Transmission* ; Neurilemmoma ; Neuroblastoma ; Neuroectodermal Tumors ; Osteosarcoma ; Pathology ; Peripheral Nerves ; Reproducibility of Results ; Rhabdomyosarcoma ; Sarcoma, Myeloid ; Sarcoma, Synovial

PURPOSE: To study the early follow-up results of total hip arthroplasty using a 36 mm large femoral head MATERIALS AND METHODS: Sixteen of primary case and two of revision, who underwent total hip arthroplasty using a 36 mm Cobalt-Chrome femoral head with Longevity(R) (Zimmer , Warsaw, Indiana) as a polyethylene liner from August 2004 to April 2005, were evaluated. The average age was 53 years, and the mean follow-up period was 28.3 months(range, 24 to 32 months). The clinical outcome was analyzed, and the latest follow-up radiographs were assessed to determine the complications such as osteolysis, loosening, fracture, dislocation, etc. RESULTS: There were no complications such as infection and dislocation during the follow-up period. The Modified Harris Hip Scores was more than 'Good'in all cases with a mean score of 93. The Merle d' Aubigne and Postel scores was more than 'Good'in 78%. The radiographic examinations showed satisfactory fixation in all patients with uncemented and uncemented femoral components. There were no cases of osteolysis, loosening, dislocation, and fracture in the pelvis or proximal femur. CONCLUSION: No dislocation was encountered despite there being no limitation in the range of motion in the early post-operative period. Total hip arthroplasty using a large femoral head gave a higher satisfaction to the patients.
Arthroplasty, Replacement, Hip* ; Dislocations ; Femur ; Follow-Up Studies* ; Head* ; Hip ; Humans ; Osteolysis ; Pelvis ; Polyethylene ; Range of Motion, Articular

It has been known the highly cross linked polyethylene (HXLPE) has an advantage of improved wear rate. However, the alteration in mechanical properties such as decreased tensile yield and fatigue strength make concerns about fragility of HXLPE. We experienced a case of HXLPE breakage. But, this case of liner breakage happened although patient belonged to normal BMI and proper acetabular cup position so called "safe zone" on radiographs. So, we report this case with reference review.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Fatigue ; Head* ; Humans ; Polyethylene*

BACKGROUND: Coughing during emergence from general anesthesia is a common clinical problem and results in a number of undesirable side effects. Remifentanil stimulate micron-opioid peptide receptor known to be related to antitussive effect. The goal of this study was to evaluate the effect of remifentanil on coughing after general anesthesia with desflurane. METHODS: Fifty one ASA physical status I and II patients undergoing elective oral and maxillofacial surgery were randomly assigned to receive either remifentanil with 1 ng/ml effect site concentration or normal saline until extubation. The number and intensity of coughs were monitored during emergence and the recovery time was recorded. RESULTS: The incidence and number of coughing during emergence was significant less frequent in the remifentanil group (P < 0.05). The intensity of coughing was significant milder in the remifentanil group (P < 0.05). There was no significant difference between two groups in the recovery time. CONCLUSIONS: Continuous remifentanil infusion with 1 ng/ml effect site concentration during emergence from general anesthesia with desflurane decrease the incidence of coughing without delaying the recovery time.
Anesthesia, General ; Cough ; Humans ; Incidence ; Isoflurane ; Piperidines ; Receptors, Peptide ; Surgery, Oral

BACKGROUND: There are few studies of how to diagnose small cell lung cancer in cytological tests through morphometric analysis. We tried to measure and analyze characteristics of small cell carcinoma in lung by image analysis. METHODS: We studied three types of cytologic specimens from 89 patients who were diagnosed with small cell lung cancer by immunohistochemistry. We measured area, perimeter, maximal length and maximal width of cells from small cell carcinoma using image analysis. RESULTS: In lung aspirates, the nuclear mean area, perimeter, maximal length and maximal width of small cell lung cancer were 218.69 microm2, 55 microm, 18.48 microm and 14.65 microm. In bronchial washings, nuclear measurements were 194.66 microm2, 50.07 microm, 16.27 microm and 14.1 microm. In pleural fluid, values were 177.85 microm2, 48.09 microm, 15.7 microm and 13.37 microm. CONCLUSIONS: Nuclear size of small cell lung carcinoma is variable and depends on the cytology method. Nuclei are spindle-shaped and larger in small cell carcinoma from lung aspirates than in bronchial washings or pleural fluid. The cytoplasms of the cells in bronchial washings and pleural fluid were swollen. Therefore, one should consider morphologic changes when trying to diagnose small cell lung cancer through cytological tests.
Bronchoalveolar Lavage ; Carcinoma, Small Cell ; Cytoplasm ; Humans ; Immunohistochemistry ; Lung ; Respiratory Aspiration ; Small Cell Lung Carcinoma