One hundred and two patients with benign prostatic hyperplasia were treated by transurethral radio-frequency thermotherapy (TURT) device (Thermex-II, Direx, Israel) with 47.5 degrees C in single session for 2 hours and 30 minutes from November 1992 to October 1993. Among them, 83 patients, who were followed up for more than 3 months were included in this study. Twenty-seven (32.5%) patients had a history of acute retention. Pretreated values of the mean Madsen-Iversen symptom score, maximum urine flow rate, postvoiding residual urine volume, prostate volume and prostate specific antigen (PSA) were 15.4, 6.5 ml/sec, 61.3ml, 43.2ml and 0.77 ng/ml respectively. Madsen-Iversen symptom score, maximum urine flow rate were measured at 2 weeks, 1, 3 and 6 months after TURT. The residual urine volume, prostate volume and PSA level were measured at 3 and 6 months after TURT. During the follow up, the symptom score started to decrease significantly at 1 month (9.9, p< 0.01) after TURT, and gradually decreased up to 6.9 at 3 months. The maximum flow rate showed initial significant improvement at 2 weeks (8.1 ml/sec., p< 0.01), but no significant interval change was observed thereafter. The residual volume decreased significantly at 3 months (41.3 ml, p< 0.01) and no decrement was noted until 6 months. Neither the prostate volume nor PSA value changed significantly at 3 or 6 months after TURT. The improvement, which was defined as a change of 50% or more in at least one of subjective or objective symptoms showed in 63.9% (53/83) at 3 months and 57.1% (32/56) at 6 months. Both subjective and objective improvements at 3 and 6 months after treatment showed in 24.1% and 19.6%, respectively.
Aged ; Follow-Up Studies ; Human ; *Hyperthermia, Induced/methods ; Male ; Middle Age ; Prognosis ; Prostatic Hyperplasia/*therapy ; Radio Waves/therapeutic use

PURPOSE: This study was designed to evaluate diagnostic accuracy of serial electrocardiograms(ECG), myocardial band of creatinine phosphokinase(CK)(CK-MB/CK ratio) and two dimensional echocardiography(ECHO) for myocardial injury in patients with blunt chest trauma. METHODS: We prospectively investigated 54 patients(male : 38, female : 16, mean age : 41) with severe blunt chest trauma. Presence of myocardial injury was determined by increase(>0.1ug/L) of peak serum troponin T(TnT) concentration from serial mesurements. RESULTS: Among 54 patients with blunt chest trauma, 23 patients(43%) had increased peak TnT level which suggested of myocardial injury. Among 23 patients with increased TnT, abnormal ECG findings were found in 18(78%) and echocardiographic abnormalities were observed in 17(74%). Cardiovascular events in 9(39%) of 23 patients with increase Tnt. There was no cardiovascular events in patients with normal TnT. CONCLUSION: Significant proprotion of patients with blunt chest trauma had elevated TnT value which suggested of myocardial injury. We recommend echocardiagraphy and serial tracing of ECG to verify the clinical significance of elevated TnT in patients with blunt chest trauma.
Creatinine ; Diagnosis* ; Echocardiography ; Electrocardiography ; Female ; Humans ; Prospective Studies ; Thorax* ; Trinitrotoluene ; Troponin ; Troponin T

Fibrolipoma is a rare histological variant of lipoma characterized by proliferation of mature fat and fibrous tissue. Most of the benign lipomatous tumors in the palm reported in the literature developed in the nervous tissue, especially the median nerve sheath. We report an unusual form of fibrolipoma on the palm which arose from the subcutaneous tissue or superficial palmar fascia in the palm, not the nerve or tendon sheath. There was no recurrence 3 years after surgical removal was performed.
Fascia ; Lipoma ; Median Nerve ; Recurrence ; Subcutaneous Tissue ; Tendons

BACKGROUND: The maximum surgical blood order schedule (MSBOS) is a viable option for reducing unnecessary crossmatching and achieving significant cost savings in the blood bank. In this study, we showed the process establishing MSBOS and through a prospective study, we evaluated the efficacy of MSBOS. METHODS: We organized task force team for transfusion management improvement composed of a director of the blood bank, surgeons and anesthesiologists in the Committee for Quality Improvement (CQI) of Asan Medical Center. In this team, we established MSBOS for most elective surgeries through the review of the previous transfusion and crossmatching data. We introduced MSBOS in April 1998 and prospectively analyzed surgeon's acceptance rate of MSBOS, crossmatch-to-transfusion ratio (C/T ratio), blood wastage rate, and cost savings. RESULTS: During the first 19 months after introducing MSBOS at our hospital, there was gradual increase in the surgeon's compliance rate of MSBOS from 30% to 94.0% through continuous education. The C/T ratio was changed from 3.5 to 1.6 and blood wastage rate was decreased from 4.0% to 1.9%. And also we could save more than 38,400,000 won through not performing the unnecessary crossmatches of 7,680 cases per year. CONCLUSION: Introduction of MSBOS can have a significant impact in reducing C/T ratio, blood wastage rate, and unnecessary crossmatches for the unused blood units. For successful application of MSBOS, cooperation with surgeons and anesthesiologists and continuous education is essential.
Advisory Committees ; Appointments and Schedules* ; Blood Banks ; Chungcheongnam-do ; Compliance ; Cost Savings ; Education ; Prospective Studies ; Quality Improvement

No abstract available.
46, XY Disorders of Sex Development* ; Humans ; Male*

Teratoma is one of germ cell tumor, common neoplasm in women of reproductive age, but it can arise at any age. Its malignant transformation is rare, less than 2%, frequently at older age. Nearly all the cases are squamous, sarcomatous and adenomatous transformation. Here we present a case of mixed transformation, adeno-squamous cell carcinoma with brief review of the concerned literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Teratoma*

It is often difficult, on the basis of clinical examination and conventional investigations, to evaluate the functional impairment of brain in children with cerebral palsy in which early detection remains a challenge. This study was designed to know the usefulness of single photon emission tomography(SPECT) of the brain with technetium-99 m hexamethylpropyleneamineoxime (99mTc-HMPAO) as a semiquantitative method of determination of right-left asymmetries in tracer uptake and a change in antero-posterior regional cerebral blood flow(rCBF) distribution. We investigated 33 children with cerebral palsy aged from 4 months to 48 months(mean 19.3 months). The results were as follows: right to left ratio and regional index of a transverse view were useful to quantify the decrease of tracer uptake in left hemiplegia, but not in right hemiplegia who were all mild in severity, and in tetra- and diplegia in which cerebral lesions were found bilaterally; cortico-cerebellar ratios of a sagittal view were found useful to detect a decrease of rCBF distribution in tetra- and diplegia ,which was not distinct by means of right to left ratio and regional index on transverse view. The results suggest that semiquantitative analysis of 99mTc-HMPAO Brain SPECT would be a valuable complementary tool for determination of topographical involvement in cerebral palsy.
Brain* ; Cerebral Palsy* ; Child ; Hemiplegia ; Humans ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

Clinical manifestations caused by vascular complications including stenosis, occlusion, aneurysm and arteriovenous malformation were rarely developed in patients with neurofibromatosis. We reviewed 23 cases of neurofibromatosis type I to identify the histopathologic features of vessels in neurofibromatosis associated with clinical features. The results were as follows: 1. The age of patients ranged from 4 to 61 years(mean: 23 years) at diagnosis and sex ratio of male to female was 1.3 : 1. The family history was present in 52%(12/23) of the patients. Angiographically, 3 cases of atherosclerosis, 1 case of arteriovenous malformation, and 1 case of aneurysm were seen. 2. peculiar vascular alternations were found in 7 of 23 cases of neurofibromatosis, which were classified as 4 types: 6 cases of pure intimal; 3 cases of advanced intimal; 1 case of intimal-aneurysmal; 3 cases of nodular type. The most frequent type of vascular lesions was observed in the patients with neurofibromatosis was Pure intimal, and the most uncommon one was intimal-aneurysmal. 3. Immunohistochemically, the positivity to S-100 protein was noted in the tumor cells arranged in the periphery of vessels, but no reaction was seen in the spindle or epithelioid cells within the vascular wall. In conclusion, the vascular lesions associated with neurofibromatosis may result from abnormal proliferation of cells in the vascular wall, possibly smooth muscle cells, not Schwann cells in origin. The various types of lesions described previously appear to be of stage of development.
Aneurysm ; Arteriovenous Malformations ; Atherosclerosis ; Constriction, Pathologic ; Diagnosis ; Epithelioid Cells ; Female ; Humans ; Male ; Myocytes, Smooth Muscle ; Neurofibromatoses* ; Neurofibromatosis 1 ; S100 Proteins ; Schwann Cells ; Sex Ratio

A 65-year-old woman complained of a pedunculated, huge mass on the anterior chest associated with neurofibromatosis type 1. The clinical and histological data showed the possibility of a malignant peripheral nerve sheath tumor. On electron microscopy, we found the characteristic findings of a malignant peripheral nerve sheath tumor, such as the foci of en-tangled cytoplasmic processes, undifferentiated spindle cells having large pleomorphic nuclei with prominent nucleoli, distinct basal cell lamina, rudimentary cell junctions, intermediate filaments and clumps of glycogen in the tumor cells. We, herein, report a case of malignant peripheral nerve sheath tumor arising from neurofibromatosis, studied by electron microscopy.
Aged ; Cytoplasm ; Female ; Glycogen ; Humans ; Intercellular Junctions ; Intermediate Filaments ; Microscopy, Electron ; Neurofibromatoses* ; Neurofibromatosis 1 ; Peripheral Nerves* ; Thorax

OBJECTIVE: To evaluate the usefulness of percutaneous umbilical blood sampling (PUBS) and prevalence of fetal infection in the pregnant women with suspicious fetal rubella infection. METHODS: Between June 1996 and May 2002 in Chonnam National University Hospital, the rubella specific IgG, IgM antibody and RT-PCR were checked in fetal blood obtained from 31 pregnant women with high risk of rubella infection. Eighteen women (58.1%) had rubella specific IgM, 11 women (35.5%) high titer of rubella specific IgG, and 2 women had a history of recent rubella vaccination within 3 months. RESULTS: PUBS was performed in all cases, successful in 27 cases (87.1%) and failed in 4 cases (12.9%). Cardiocentesis was performed in failed cases. Performing the PUBS, fetal bradycardia was observed in 7 cases (25.9%), fetal tachycardia in 1 case (14.8%), and preterm labor in 2 cases (7.4%). Performing cardiocentesis, fetal bradycardia was observed in 1 case (25.0%), fetal tachycardia in 2 cases (50.0%), and preterm labor in 1 case (25.0%). There was no fetal death. All samples of fetal blood were positive for rubella specific IgG but rubella specific IgM was detected in only 1 case. RT-PCR was negative in all cases. CONCLUSION: Fetal blood sampling is relatively safe and a great precaution is necessary before termination of pregnancy with suspicious fetal rubella infection and without typical maternal rash to reduce unnecessary termination of pregnancy. Several tests such as rubella specific IgM and PCR from placental villi, amniotic fluid, and fetal blood should be considered before termination of pregnancy.
Amniotic Fluid ; Bradycardia ; Chorionic Villi ; Cordocentesis* ; Exanthema ; Female ; Fetal Blood ; Fetal Death ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Jeollanam-do ; Obstetric Labor, Premature ; Polymerase Chain Reaction ; Pregnancy ; Pregnant Women* ; Prenatal Diagnosis* ; Prevalence ; Rubella* ; Tachycardia ; Vaccination