Purpose: This retrospective study aimed to compare the clinical outcomes between hybrid surgical thrombectomy (ST) and AngioJet pharmacomechanical thrombectomy (PMT) for thrombotic occlusion of arteriovenous graft. Materials and Methods: This study enrolled patients who underwent either hybrid ST or AngioJet PMT in Presbyterian Medical Center from July 2018 to December 2018. We primarily compared the technical and clinical success rates between the two groups immediately after the procedures. Subsequently, the postprocedure clinical outcomes, including the primary and secondary patency rates and complications, were also compared. Results: The hybrid ST group had a significantly higher bleeding amount than the AngioJet PMT group (P=0.02). The technical and clinical success rates were 96.7% and 93.3% in the AngioJet PMT group and 100% and 100% in the hybrid ST group, respectively. There was no significant difference in complications between the groups. The primary and secondary patencies at 12 months were not statistically different between the groups. Conclusion Comparable clinical outcomes were observed between the AngioJet PMT and hybrid ST groups, highlighting an equivalent efficacy of these two methods. Although the cost is more expensive, AngioJet PMT lowered the bleeding amount. Therefore, it can be considered in selected patients who are at risk of bleeding or reluctant to surgery.

Purpose: This retrospective study aimed to compare the clinical outcomes between hybrid surgical thrombectomy (ST) and AngioJet pharmacomechanical thrombectomy (PMT) for thrombotic occlusion of arteriovenous graft. Materials and Methods: This study enrolled patients who underwent either hybrid ST or AngioJet PMT in Presbyterian Medical Center from July 2018 to December 2018. We primarily compared the technical and clinical success rates between the two groups immediately after the procedures. Subsequently, the postprocedure clinical outcomes, including the primary and secondary patency rates and complications, were also compared. Results: The hybrid ST group had a significantly higher bleeding amount than the AngioJet PMT group (P=0.02). The technical and clinical success rates were 96.7% and 93.3% in the AngioJet PMT group and 100% and 100% in the hybrid ST group, respectively. There was no significant difference in complications between the groups. The primary and secondary patencies at 12 months were not statistically different between the groups. Conclusion Comparable clinical outcomes were observed between the AngioJet PMT and hybrid ST groups, highlighting an equivalent efficacy of these two methods. Although the cost is more expensive, AngioJet PMT lowered the bleeding amount. Therefore, it can be considered in selected patients who are at risk of bleeding or reluctant to surgery.

Ceruminous glands are specialized apocrine glands located in the external auditory canal (EAC). Pleomorphic adenoma (PA) of the EAC is derived from these ceruminous glands. Tumors arising from these ceruminous glands are rare. Furthermore, ceruminous PA of the EAC is extremely rare. About 35 cases have been reported to date in the English literature, and only 4 cases have been reported in Korea. There are several controversial issues about these rare tumors such as nomenclature, histogenesis and classification. We report here on two cases of ceruminous PA and review the cases in the Korean literature.
Adenoma ; Adenoma, Pleomorphic* ; Apocrine Glands ; Classification ; Ear Canal* ; Korea

Entecavir (Baraclude®) is an oral antiviral drug used for the treatment of HBV. Entecavir is a reverse transcriptase inhibitor which prevents the HBV from multiplying. Most common adverse reactions caused by entecavir are headache, fatigue, dizziness, and nausea. Until now, there has been no report of peripheral neuropathy as a side effect associated with entecavir treatment. Herein, we report a case of peripheral neuropathy which probably occurred after treatment with entecavir in a hepatitis B patient. The possibility of the occurrence of this side effect should be carefully taken into consideration when a patient takes a high dose of entecavir for a long period of time or has risk factors for neuropathy at the time of initiating entecavir therapy.
Administration, Oral ; Antiviral Agents/*adverse effects/therapeutic use ; Brain/diagnostic imaging ; Drug Therapy, Combination ; Duloxetine Hydrochloride/therapeutic use ; Glucocorticoids/therapeutic use ; Guanine/adverse effects/*analogs & derivatives/therapeutic use ; Hepatitis B, Chronic/drug therapy ; Humans ; Male ; Middle Aged ; Polyneuropathies/*diagnosis/drug therapy/etiology ; Prednisolone/therapeutic use ; Pregabalin/therapeutic use ; Tomography, X-Ray Computed

Paranasal sinus mucoceles are benign non-neoplastic condition characterized by cystic expansion. They are classified into primary and secondary mucoceles by known causes. Most mucoceles are located in the frontal and anterior ethmoid sinuses and they involve the frontoethmoial region, expanding to the region of the orbit, leading to the ocular symptoms. The primary maxillary sinus mucoceles are not common, whereas secondary ones such as postoperative maxillary sinus mucoceles (POMMs) developing after Caldwell-Luc operation are pretty common. POMMs have often multiple septated mucoceles. However, most of the primary maxillary sinus mucoceles are an expansile and cystic mass of maxillary sinus with medial bulging. We present a case of primary septated mucocele in the maxillary sinus of a 36-year-old male who underwent revision surgery.
Adult ; Ethmoid Sinus ; Humans ; Male ; Maxillary Sinus* ; Mucocele* ; Orbit

OBJECTIVE: To compare perioperative outcome of robot-assisted radical hysterectomy with abdominal radical hysterectomy for early-stage cervical cancer and endometrial cancer and to evaluate the feasibility of robotic-assisted radical hysterectomy. METHODS: We reviewed medical record of 37 patients who had radical hysterectomy at Hallym university for cervical cancer stage Ia1 to IIa and endometrial cancer stage Ia to Ib. Abdominal radical hysterectomy was carried out in 27 (Abdominal group) patients and robot-assisted radical hysterectomy carried out in 10 patients (Robotic group). We compared patient's characteristics between two groups. Perioperative characteristics compared included cancer stage, operative time, number of nodes, estimated blood loss, length of hospital stay and complications. RESULTS: There were no differences in age, parity, history of medical disease, body mass index between two groups (p>0.05). Robotic operative times were significantly longer than for abdominal (480.0+/-117.8 vs. 286.9+/-65.6 min, p<0.0001). Blood loss (660.0+/-245.9 vs. 1,137.0+/-608.4 mL. p<0.0001) and length of hospital stay (7.2 versus 17.1 days, p<0.0001) were significantly lower for the robotic group. Lymph node yield in the robotic group was equivalent to that for the abdominal group (30.1+/-8.7 vs. 35.4+/-16.9, p=0.356). No major operative complications occurred with both groups. CONCLUSION: Robot-assisted radical hysterectomy appears safe and feasible in early-stage cervical and endometrial cancer.
Body Mass Index ; Endometrial Neoplasms ; Female ; Humans ; Hysterectomy ; Length of Stay ; Lymph Nodes ; Medical Records ; Operative Time ; Parity ; Uterine Cervical Neoplasms

BACKGROUND: The clinical presentation and course of Langerhans cell histiocytosis (LCH) are variable, ranging from an isolated, spontaneously remitting bone lesion to multisystem disease with risk organ involvement. Treatment of LCH ranges from a wait-and-see attitude to intensive multidrug therapy and, in some cases, bone marrow transplantation. It is necessary to develop an objective score for assessing disease activity in patients with LCH. We propose a new clinical scoring system to evaluate disease activity at diagnosis that can predict the clinical outcomes of LCH and correlate it with clinical courses. METHODS: Clinical data, obtained from children diagnosed with LCH at Asan Medical Center and Hanyang University Hospital between March 1998 and February 2009, were studied retrospectively. The scoring system was developed according to the basic biological data, radiological findings, and physical findings and applied to a database containing information on 133 patients. RESULTS: The median age of the 133 patients (74 male, 59 female) was 52 months (range, 0.6-178 months), and LCH was diagnosed based on CD1a positivity. At diagnosis, the score distributions were highly asymmetrical: the score was between 1 and 2 in 75.9% of cases, 3-6 in 15.8%, and greater than 6 in 8.3%. Initial scores above 6 were highly predictive of reactivation and late complications. CONCLUSION: This new LCH disease activity score provides an objective tool for assessing disease severity, both at diagnosis and during follow-up.
Bone Marrow Transplantation ; Child ; Follow-Up Studies ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Langerhans Cells ; Male ; Retrospective Studies

No abstract available.
Foreign Bodies

PURPOSE: Nocturia has been one of the most bothersome symptoms in benign prostatic hyperplasia (BPH) patients. Therefore, the authors evaluated the effect of tolterodine and oxybutyninin on nocturia in BPH patients. MATERIALS AND METHODS: From September 2006 to March 2007, 82 patients who presented over than 2 in nocturnal bladder capacity index (NCBI) in spite of having alpha blockers for 6 months were enrolled. Group I (n=38) took alpha blocker with tolterodine, group II (n=44) took alpha blocker with oxybutynin. The number of their nocturia episodes was separately evaluated by the time before and after the medication. The complications were assessed using a questionnaire. RESULTS: The number of nocturia episodes decreased by at least 1 in 68.4% (26/38), 84.1% (37/44) of patients in group I, II, respectively, and decreased by 2 or more, 1 and were unchanged or increased were 36.8, 31.6, 31.6% in group I patients and 45.5, 38.6, 15.9% in group II patients, respectively. In baseline nocturia > or =6 group, the nocturia decreased by 1 or more in 66.7%, 77.8% in group I, II, respectively. Adverse events, including dry mouth, dizziness, headache, etc, occurred in 21.1% (8/38) in group I and 27.3% (12/44) in group II patients. The complications between two groups showed no significant differences. CONCLUSIONS: Alpha blockers with tolterodine or oxybutynin can be effectively combined as a treatment option for patients with BPH complaining of unresolved nocturia.
Dizziness ; Headache ; Humans ; Mouth ; Nocturia* ; Prostatic Hyperplasia* ; Surveys and Questionnaires ; Urinary Bladder ; Tolterodine Tartrate

PURPOSE: In bladder cancer screening, many methods such as urinary cytology, bladder tumor antigen, and nuclear matrix protein-22 are well known. To learn the value of urinary melanoma antigen gene expression (MAGE) in bladder cancer screening, we compared the urinary MAGE test with irrigated urinary cytology. MATERIALS AND METHODS: From July 2000 to July 2007, a total of 142 patients were enrolled in this study. We divided these patients into 2 groups. Eighty-eight patients with bladder cancer were included in group I. Group II consisted of 54 patients who had been treated for bladder cancer and had no evidence of tumor by cystoscopy and irrigated urinary cytology. Urinary cytology, urinary MAGE test, and cystoscopy were performed in all patients. The urinary MAGE test was done by reverse transcriptase polymerase chain reaction (RT-PCR). Sensitivity and specificity were investigated according to cancer grade and stage. RESULTS: The overall sensitivity of the urinary MAGE test and urinary cytology was 69.3% (61/88) and 53.4% (47/88), respectively (p=0.03). The specificity of the urinary MAGE test and urinary cytology was 75.9% (41/54) and 83.3% (45/54), respectively (p=0.34). The sensitivity of each test in superficial tumors (Ta, T1) was 65.5% (38/58) and 46.6% (27/58), respectively (p=0.04). In advanced disease (> or =T2), the sensitivity of the tests was 76.7% (23/30) and 66.7% (20/30), respectively (p=0.39). The sensitivity of the urinary MAGE test in grade 1 tumors (60.5%, 23/38) was significantly higher (p=0.01) than that of urinary cytology (31.6%, 12/38). CONCLUSIONS: The urinary MAGE test was more sensitive than urinary cytology in bladder cancer screening. We consider the urinary MAGE test to possibly be a valuable test together with urinary cytology, especially for Grade 1 and Ta, T1 bladder cancer.
Cystoscopy ; Gene Expression ; Humans ; Mass Screening ; Melanoma ; Nuclear Matrix ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder Neoplasms