Unruptured cerebral aneurysms sometimes present with visual symptomsdue to compression of the visual pathways. However, until now, unruptured anterior communicating artery (ACoA) aneurysms presenting visual field defects have been extremely rare. The authors report the case of a 51-year-old woman who presented with left homonymous hemianopsia. Radiological findings demonstrated an ACoA aneurysm filled with thrombus, that was compressing the optic chiasm and post-chiasmal tract. The patient underwent clipping of the aneurysm, which resolved the visual field defect. In cases of visual field defects, an ACoA aneurysm should be included in the differential diagnosis.
Aneurysm ; Arteries ; Diagnosis, Differential ; Female ; Hemianopsia* ; Humans ; Intracranial Aneurysm* ; Middle Aged ; Optic Chiasm ; Thrombosis ; Visual Fields ; Visual Pathways

PURPOSE: This study was conducted in order to evaluate effect and efficiency of selective spinal nerve root block for neuropathic pain patients with lower leg radiating pain. MATERIALS AND METHODS: A total of 113 patients were evaluated and follow-up periods were a minimum of 12 months. They were divided into two groups: group A included 41 patients with neuropathic pain and group B included 72 patients with simple lower leg radiating pain. RESULTS: Fourteen (34.1%) patients in group A and 45 (62.5%) patients in group B had favorable results for selective spinal nerve block (p<0.05). Visual analog scale (VAS) was improved from 7.57 to 5.23 at 12 months in group A and from 7.11 to 3.49 at 12 months in group B. CONCLUSION: The initial treatment period for group A was significantly later than in group B. For patients with neuropathic pain and radiculopathy, early assessment was recommended and early selective spinal nerve block could be a good treatment option for neuropathic pain patients.
Follow-Up Studies ; Humans ; Leg ; Neuralgia* ; Radiculopathy* ; Spinal Nerve Roots* ; Spinal Nerves ; Visual Analog Scale

Occipitocervical posterior fusion itself is an uncommon cause of severe dysphagia. But occipitocervical malalignment after posterior fusion can be a cause of severe dysphagia. A 46-year-old man was referred to the department of rehabilitation medicine because of swallowing difficulty. He complained of severe dysphagia immediately after the occipitocervical posterior fusion. From the lateral view of video-fluoroscopic swallowing study (VFSS), we could conclude that the mechanical cricopharyngeal relaxation failure was a direct cause of his dysphagia and this was due to malalignment of the occipitocervical fixation. His occipitoaxial angle was fixed in hyperflexed position and this lead to the severe dysphagia and even dyspnea. After the revision operation, his dysphagia and dyspnea symptom was dramatically resolved. The occipitoaxial angle can be a useful index, which measure the anatomic relation of the occiput and the cervical vertebrae on sagittal plane, on evaluation of the swallowing function in the patient who had occipitocervical posterior fusion.
Cervical Vertebrae ; Deglutition ; Deglutition Disorders ; Dyspnea ; Female ; Humans ; Middle Aged ; Relaxation

PURPOSE: Laparoscopic appendectomy is a common procedure for treatment of appendicitis. However, in some complicated cases, like periappendiceal abscess, deciding on treatment options is very challenging. Early appendectomy or interval appendectomy may be possible, but remains controversial. METHODS: We prospectively studied the advantages of interval appendectomy in 21 patients with periappendiceal abscess using a laparoscopic method versus 14 patients with immediate initial laparotomy. RESULTS: In the interval appendectomy group (INT group), in periappendiceal abscess, use of a laparoscopic method was advantageous in terms of operation time (p<0.001), less fasting time (p<0.001), and fewer postoperative complications (p=0.032). However, the total cost in the INT group was 1,686,000+/-940,000 South Korean won (KRW) compared with 1,506,000+/-322,000 KRW in the early appendectomy group (EAR group) (p=0.007) because patients in the INT group required two hospital visits. The total length of hospital stay postoperatively, was 7.31+/-2.726 days in the INT group, compared with 9.21+/-3.378 days in the EAR group (p=0.537). CONCLUSION: We recommend interval appendectomy as the preferable approach for the periappendiceal abscess, as it can result in more favorable postoperative surgical outcomes, fewer complications, and less antibiotic usage.
Abscess* ; Appendectomy* ; Appendicitis ; Cost-Benefit Analysis ; Ear ; Fasting ; Humans ; Laparotomy ; Length of Stay ; Postoperative Complications ; Prospective Studies

PURPOSE: Laparoscopic appendectomy is a common procedure for treatment of appendicitis. However, in some complicated cases, like periappendiceal abscess, deciding on treatment options is very challenging. Early appendectomy or interval appendectomy may be possible, but remains controversial. METHODS: We prospectively studied the advantages of interval appendectomy in 21 patients with periappendiceal abscess using a laparoscopic method versus 14 patients with immediate initial laparotomy. RESULTS: In the interval appendectomy group (INT group), in periappendiceal abscess, use of a laparoscopic method was advantageous in terms of operation time (p<0.001), less fasting time (p<0.001), and fewer postoperative complications (p=0.032). However, the total cost in the INT group was 1,686,000+/-940,000 South Korean won (KRW) compared with 1,506,000+/-322,000 KRW in the early appendectomy group (EAR group) (p=0.007) because patients in the INT group required two hospital visits. The total length of hospital stay postoperatively, was 7.31+/-2.726 days in the INT group, compared with 9.21+/-3.378 days in the EAR group (p=0.537). CONCLUSION: We recommend interval appendectomy as the preferable approach for the periappendiceal abscess, as it can result in more favorable postoperative surgical outcomes, fewer complications, and less antibiotic usage.
Abscess* ; Appendectomy* ; Appendicitis ; Cost-Benefit Analysis ; Ear ; Fasting ; Humans ; Laparotomy ; Length of Stay ; Postoperative Complications ; Prospective Studies

Saccular aneurysm of the external jugular vein presenting as a neck mass is very rare. We report the surgical treatment of an external jugular venous aneurysm in a 48-year-old female patient due to the cosmetic problem of neck engorgement, concomitant with thyroidectomy for cancer.
Aneurysm* ; Female ; Humans ; Jugular Veins* ; Middle Aged ; Neck ; Thyroidectomy ; Vascular Diseases

Using lactoferrin as the specific ligand, we developed a simplified method for preparation of molecular conjugate for gene delivery. Replacement of column chromatography and dialysis by one step centrifugal filtration (Centricon, cut off size : 30,000), resulted in the rapid purification of bovine lactoferrin/polylysine (bLf/pL) and human lactoferrin/polylysine (hLf/pL) conjugates and easy separation of unconjugated polylysine. The Lf/pL conjugates prepared by this method efficiently transferred the reporter genes, CAT and LacZ gene, to HeLa and hepatic cells. The bLf/pL and hLf/pL conjugates could transfer the reporter genes to various hepatocytes including primary mouse hepatocyte, Hepa 1-6, SK-Hep1 and Chang liver, but not to NIH 3T3 mouse fibroblast cells, indicating that the Lf/pL conjugates conferred hepatocyte-specific gene transfer. The bLf/pL and hLf/pL conjugates prepared in the present study exhibited higher transfection efficiencies for mouse and human hepatocytes than the commercially available transferrin/polylysine (Tf/pL) conjugate.
Animals ; Cats ; Chromatography ; Dialysis ; Fibroblasts ; Filtration ; Genes, Reporter ; Genes, vif* ; Hepatocytes* ; Humans ; Lac Operon ; Lactoferrin* ; Liver ; Mice ; Polylysine ; Transfection

PURPOSE: This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. MATERIALS AND METHODS: The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range 35~76). The distribution by surgical FIGO stages were 63.0% for 0Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to 41.4~54 Gy (median: 50.4 Gy). Additional intravaginal brachytherapy was applied to 20 patients (37.0% of all). Median follow-up time was 35 months (5~115 months). Significant factors of this study: histologic grade, lymphovascular space invasion and myometrial invasion depth were scored (GLM score) and analyzed. Survival analysis was performed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. RESULTS: 5-year overall and disease-free survival rates were 87.7% and 87.1%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, lymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, lymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival (p=0.0090, p=0.0073, respectively) and distant recurrence (p=0.0132), which was the sum of points of histologic grade, lymphovascular space invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic lymph nodes, 2 lungs, a supraclavicular lymph node and a vagina. CONCLUSION: The prognosis in patients with endometrial carcinoma treated by postoperative radiotherapy was closely related with surgical histopathology. If further explorations confirm the system of prognostic factors in endometrial carcinoma, it will help us to predict the progression pattern and to manage.
Adenocarcinoma ; Brachytherapy ; Busan ; Disease-Free Survival ; Endometrial Neoplasms* ; Female ; Follow-Up Studies ; Humans ; Lung ; Lymph Nodes ; Multivariate Analysis ; Prognosis ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Vagina

The absence or disfigurement of the umbilicus is both cosmetically and psychologically distressing to patients. The goal of aesthetically pleasing umbilical reconstruction is to create a neoumbilicus with sufficient depth and good morphology, with natural-looking superior hooding and minimal scarring. Although many reports have presented techniques for creating new and attractive umbilici, we developed a technique that we term the "four flaps technique" for creating a neoumbilicus in circumstances such as the congenital absence of the umbilicus or the lack of remaining umbilical tissue following the excision of a hypertrophic or scarred umbilicus. This method uses the neighboring tissue by simply elevating four flaps and can yield sufficient depth and an aesthetically pleasing shape with appropriate superior hooding.
Abdominal Wall ; Abdominoplasty ; Cicatrix ; Humans ; Umbilicus

BACKGROUND/AIMS: Recently, it has been well known that the incidence of colonic diverticulosis is increasing in Korea. However, cases of right-sided colonic diverticulitis are rare although diverticula are located in right-sided colon more than left-side. The major clinical symptom of right-sided colonic diverticulitis is acute right lower quadrant pain which may mimic acute appendicitis. Therefore, we evaluated the clinical characteristics of the patients with right-sided colonic diverticulitis and safety of the colonoscopic examinations in these patients. METHODS: The evidence of diverticulitis was confirmed by the presence of pus at the diverticular lesions on colonoscopy. We retrospectively analyzed clinical menifestations, laboratory findings, colonoscopic findings and the presence of complications after colonoscopy, and radiologic findings of the patients with right-sided colonic diverticulitis. RESULTS: All the patients with right-sided colonic diverticulitis had abdominal pain. Physical examinations showed abdominal tenderness in all patients and leukocytosis was noticed in 8 out of 12 patients (66%). There was no complication during and after colonoscopy. All the patients were managed with conservative treatment including broad-spectrum antibiotics and improved without clinical aggravation. CONCLUSIONS: The colonoscopic examination may be helpful to diagnose right-sided colonic diverticulitis.
Abdominal Pain ; Anti-Bacterial Agents ; Appendicitis ; Colon* ; Colonoscopy ; Diagnosis* ; Diverticulitis ; Diverticulitis, Colonic* ; Diverticulosis, Colonic ; Diverticulum ; Humans ; Incidence ; Korea ; Leukocytosis ; Physical Examination ; Retrospective Studies ; Suppuration