No abstract available.
Humans

Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistula formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelialized (5 mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejuna transfer.
Constriction, Pathologic ; Fistula ; Forearm ; Free Tissue Flaps ; Head ; Humans ; Neck

No abstract available.
Cystadenoma*

No abstract available.
Cystadenoma*

Penile metastases are rare, and usually secondary to other genitourinary primary tumors. Bladder, prostate and renal tumors are the main sources of penile metastasis. Rectal and respiratory neoplasms also metastasize to the penis. However, metastatic penile cancer originating from the pancreas is extremely rare. Here, a case of pancreatic cancer, with penile metastasis, is reported.
Male ; Neoplasm Metastasis ; Pancreas* ; Pancreatic Neoplasms ; Penile Neoplasms* ; Penis ; Prostate ; Urinary Bladder

A lymphoma of the prostate is very rare, and is usually incidentally discovered. Malignant lymphomas can be divided into either primary or secondary according to their origin. Secondary involvement of the gland is the most common presentation. Most non-Hodgkin's lymphomas that affect the prostate are of the B-cell type, and present with non-specific obstructive symptoms. A variety of methods have been used for their, including prostatectomy, radiotherapy or combinations of chemotherapy and radiotherapy. However, the prognosis remains poor, regardless of the patient's age, histological type, treatment or clinical stage at presentation. Here, the case of a patient with a B-cell lymphoma, who presented with symptoms of a bladder outlet obstruction, is reported. The patient has been in complete remission following the completion of 6 cycles of doxorubicin-based chemotherapy and accompanying radiotherapy.
B-Lymphocytes* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Prognosis ; Prostate* ; Prostatectomy ; Radiotherapy* ; Urinary Bladder Neck Obstruction

PURPOSE: To evaluate long-term efficacy and safety of intravitreal ranibizumab on choroidal neovascularization (CNV) in age-related macular degeneration (AMD) in Korean patients over a 2-year period. METHODS: Twenty-three eyes of 23 patients who underwent intravitreal ranibizumab injection for secondary CNV in AMD were followed up more than 2 years, and their records were retrospectively investigated. The best corrected visual acuity (BCVA), central macular thickness (CRT) were compared at baseline and at 6, 12, 18 and 24 months after injection. RESULTS: The mean BCVA (log MAR) was 0.58 +/- 0.36, 0.54 +/- 0.49, 0.59 +/- 0.49, 0.64 +/- 0.51, and 0.61 +/- 0.51 at baseline, 6, 12, 18 and 24 months, respectively (p = 0.332, p = 1.000, p = 0.670, p = 0.697). The mean CRT was 283.75 +/- 61.41 microm, 239.93 +/- 53.12 microm, 244.89 +/- 47.44 microm, 246.36 +/- 55.78, and 244.70 +/- 54.86 at baseline, 6, 12, 18 and 24 months, respectively (p = 0.009, p = 0.036, p = 0.01, p = 0.015). The mean number of injection was 5.96 +/- 2.93 over a 2-year period. CONCLUSIONS: In Korean patients who underwent intravitreal ranibizumab injection for secondary CNV in AMD, long-term efficacy in diminishing CRT was evident. However, long-term efficacy in increasing visual acuity was not observed.
Antibodies, Monoclonal, Humanized ; Choroid ; Choroidal Neovascularization ; Eye ; Humans ; Macular Degeneration ; Retrospective Studies ; Visual Acuity ; Ranibizumab

The relationship between functional abdominal pain (FAP) and occult constipation (OC) in children who did not meet the Rome III criteria for constipation has rarely been reported. This study aimed to estimate the prevalence of OC in patients with FAP and to compare the effectiveness of prokinetic drugs and laxatives for FAP and OC. Pediatric outpatients (n = 212; aged 4–15 years) who satisfied the Rome III criteria for childhood FAP were divided into 2 groups based on Leech scores: group 1 < 8; group 2 ≥ 8. Group 2 received either prokinetic drugs or laxatives and pain severity was assessed after 2 weeks, 1 month, and 3 months. A total 52.4% (111/212) of patients had OC in this study. More patients who received laxatives had reduced pain scores compared with those who received prokinetic drugs. Those treated with laxatives in group 2 had a better response than those treated with prokinetic drugs throughout the study period (P < 0.001, P < 0.001, and P = 0.002 after 2 weeks, 1 month, and 3 months, respectively). OC was frequently encountered in children with FAP. Laxatives can be more effective than prokinetic drugs for relieving symptoms of FAP in children with a Leech score ≥ 8 and suspected OC.
Abdominal Pain* ; Child* ; Constipation* ; Gastrointestinal Diseases ; Humans ; Laxatives* ; Outpatients ; Pediatrics ; Prevalence

BACKGROUND: Endobroncheal intubation or extubation may occur accidentally when the patient's neck is flexed or extended even in the appropriate endotracheal intubation. The purpose of this study is to examine the effect of fixation or unfixation of the endotracheal tube at the teeth level on the displacement of its distal end when the patient's neck is extended or flexed. METHODS: This study was conducted in 37 patients who underwent endotracheal general anesthesia. The patients with the evidence of pathology in head, neck and chest were excluded from the study. Individual patient's displacement in endotracheal tube tip compared unfixed cases with fixed cases when the change of neck position. The moved distance was measured by fiberoptic bronchoscope. The data were statistically analyzed by Student's paired t-test. RESULTS: The endotracheal tube moved away from the carina when the patient's neck was extended, while it moved toward the carina when flexed in all cases. When the patient's neck was extended the average distance displaced 1.2 0.7 cm in fixed cases and 1.1 0.9 cm in unfixed cases. when the neck was flexed, they were 1.2 0.5 cm and 1.0 0.8 cm respectively. There were not statistically significant between the fixed and the unfixed cases. CONCLUSIONS: It is concluded that the displacement of the endotracheal tube is not related to its fixation or unfixation at the teeth level and therefore, unfixation does not provide any benefits in terms of the displacement of the distal end of the tube in adult trachea.
Adult ; Anesthesia, General ; Bronchoscopes ; Head ; Humans ; Intubation ; Intubation, Intratracheal ; Neck* ; Pathology ; Thorax ; Tooth ; Trachea

Isolated ACTH deficiency is a uncommon disorder causing secondary adrenocortical insufficiency. Less than 200 cases have been reported in the world. The major clinical manifestations are hypoglycemia, weight loss, hypotension, anemia, weakness, nausea, inability to excrete water load, and hyponatremia. A 56-year-old male was admitted because of weakness, fatigue, nausea and vomiting. He was pallor and not associated with hyperpigmentation. The basal plasma ACTH and cortisol levels were 8.30 pg/ml and 0.6 ug/dl. The serum cortisol did not response to rapid ACTH stimulation test. On combined pituitary stimulation test, the cortisol did not response to insulin-induced hypoglycemia. Other anterior pituitary hormones showed normal responses except elevated prolactin level. Six months after glucocorticoid replacement therapy, the elevated basal prolactin level returned to normal. Brain MRI did not show any anatomic abnormalities of the sellar and suprasella area. We report a case of isolated ACTH deficiency accompanied by hyperprolactineia, which respond to glucocorticoid replacement therapy.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Anemia ; Brain ; Fatigue ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hyperprolactinemia* ; Hypoglycemia ; Hyponatremia ; Hypotension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nausea ; Pallor ; Pituitary Hormones, Anterior ; Plasma ; Prolactin ; Vomiting ; Water ; Weight Loss