Anastomosing hemangioma (AH), a rare benign vascular tumor, is a newly recognized variant of capillary hemangioma. In the microscopic examination, this tumor has characteristic feature of the unique anastomosing sinusoidal capillary sized vessels. It can be misdiagnosed as a malignancy such as renal cell carcinoma or angiosarcoma. Herein, we report a case of AH originating in the right kidney of a 43-year-old man, which was initially considered as cystic renal cell carcinoma on computed tomography (CT). The patient underwent laparoscopic radical nephrectomy, but pathologic result was AH of the kidney. There was no evidence of recurrence or metastasis 5 months after the surgery.
Adult ; Capillaries ; Carcinoma, Renal Cell* ; Hemangioma* ; Hemangioma, Capillary ; Hemangiosarcoma ; Humans ; Kidney ; Neoplasm Metastasis ; Nephrectomy ; Recurrence

Hem-o-Lok clips (Weck Surgical Instruments, Teleflex Medical, Durham, NC, USA) are widely used in robot-assisted laparoscopic radical prostatectomy because of their easy application and secure clamping. To date, there have been some reports of intravesical migration of these clips causing urethral erosion, bladder neck contractures, and subsequent calculus formation. We report the first case of bladder migration of Hem-o-Lok clips without stone formation after robot-assisted laparoscopic radical prostatectomy. The Hem-o-Lok clips were found during urethral dilation with a guide wire for bladder neck contracture under cystourethroscopy. The Hem-o-Lok clips were floating in the bladder without stone formation and were removed by a cystoscopic procedure.
Calculi ; Constriction ; Contracture ; Neck ; Prostatectomy ; Robotics ; Surgical Instruments ; Urinary Bladder

BACKGROUND: Although tetanus infections have diminished dramatically since the advent of tetanus vaccination, this disease has not disappeared. Those 60 years and older are still very much at risk for this infection. Thus, we investigated the tetanus antibody titers in people 60 years and older in Korea. METHODS: Our subjects included those visiting eight emergency departments from March 2009 to February 2010 after an injury with stable vital signs and without acute disease. Samples obtained were tested using the tetanus immunoglobulin enzyme-linked immunosorbent assay method. The resultant tetanus antibody titers were analyzed. RESULTS: The number of subjects enrolled was 462. The mean titer was 0.09+/-0.14 IU/mL. Twenty-two percent of the subjects had a safe titer level (>0.1 IU/mL). Males and urban subjects had higher tetanus antibody titers than did females and suburban subjects. Subjects living in Incheon, Gangwon-do, Chungcheong-do, and Jeju-do had lower titers. CONCLUSION: The results of this study showed that Koreans 60 years and older did not have a protective mean level of tetanus antibody titer and that 78% of the subjects did not have a seroprotective level after tetanus exposure. Therefore, a national effort to administer tetanus vaccination to elderly Koreans is needed.
Acute Disease ; Aged ; Emergencies ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulins ; Korea ; Male ; Tetanus ; Vaccination ; Vital Signs

PURPOSE: As recently reported, the short-term results of the tension-free vaginal tape SECUR(R) (TVT-S) procedure seem to be similar to those of the conventional transobturator tape (TOT) procedure. However, results of efficacy and satisfaction with TVT-S are insufficient in patients with more than 1 year of follow-up. Therefore, we evaluated the results of the TVT-S procedure in women with stress urinary incontinence (SUI) during 2 years. MATERIALS AND METHODS: We evaluated 51 patients with clinical and urodynamic diagnoses of SUI who underwent the TVT-S procedure from March 2008 to February 2009. Preoperative evaluation included a history, cough stress test with full bladder, urodynamic study, and incontinence quality of life (I-QoL) questionnaire. Following the postoperative period, urinary incontinence status was examined through a physical examination and the I-QoL questionnaire was completed in an outpatient setting or by telephone. RESULTS: Data from 2 years of follow-up were available for 46 of 51 patients. The cure rate was 80.4% at 1 month after TVT-S and 76.0% at 2 years after TVT-S. The cure or improvement rate was 93.5% at 1 month after TVT-S and 86.8% at 2 years after TVT-S. The mean total I-QoL score increased by 42 points at 1 month after TVT-S (p<0.026) and by 32 points at 2 years after TVT-S (p<0.013). Most patients reported significant improvements in quality of life. At the 2-year follow-up, there were no significant complications related to TVT-S. CONCLUSIONS: The results of this study suggest that TVT-S is an efficient and safe procedure for the improvement of both the quality of life of the patients and the SUI itself.
Cough ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Outpatients ; Physical Examination ; Postoperative Period ; Quality of Life ; Suburethral Slings ; Surgical Procedures, Minimally Invasive ; Treatment Outcome ; Urinary Bladder ; Urinary Incontinence ; Urinary Incontinence, Stress ; Urodynamics

A 75-year-old female visited our hospital with bilateral adrenal masses that were detected incidentally during lumbar spine magnetic resonance imaging (MRI) for the evaluation of radiating flank pain. Consecutive computed tomography and MRI revealed bilateral adrenal masses with no evidence of lymph node enlargement or local invasion; 2[(18)F]fluoro-2-deoxyglucose (FDG)-positron emission tomography showed an intense FDG accumulation in both adrenal glands without abnormal FDG uptake in extra-adrenal regions. The laboratory test results were within normal ranges. We performed a bilateral adrenalectomy. The pathologic diagnosis of both adrenal masses was consistent with adrenocortical carcinoma. The patient recovered well with no complications.
Adrenal Glands ; Adrenalectomy ; Adrenocortical Carcinoma ; Aged ; Female ; Flank Pain ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Reference Values ; Spine

Adrenal myelolipoma is a rare, nonfunctional benign tumor that is composed of mature adipose tissue and hematopoietic elements. In the past, these tumors were accidentally discovered at autopsy. Today, they are found much more frequently and incidentally, mainly because of the widespread use of noninvasive imaging with ultrasonography, computed tomography, and magnetic resonance imaging. Most lesions are asymptomatic, small, and unilateral, but a number of bilateral tumors have been reported. We report here on a case of a 48-year-old man with incidentally found myelolipomas of both adrenal glands. In particular, a giant myelolipoma of the left adrenal gland was treated by transperitoneal laparoscopic adrenalectomy.
Adipose Tissue ; Adrenal Glands ; Adrenalectomy ; Autopsy ; Humans ; Laparoscopy ; Magnetic Resonance Imaging ; Middle Aged ; Myelolipoma

Adrenal myelolipoma is a rare, nonfunctional benign tumor that is composed of mature adipose tissue and hematopoietic elements. In the past, these tumors were accidentally discovered at autopsy. Today, they are found much more frequently and incidentally, mainly because of the widespread use of noninvasive imaging with ultrasonography, computed tomography, and magnetic resonance imaging. Most lesions are asymptomatic, small, and unilateral, but a number of bilateral tumors have been reported. We report here on a case of a 48-year-old man with incidentally found myelolipomas of both adrenal glands. In particular, a giant myelolipoma of the left adrenal gland was treated by transperitoneal laparoscopic adrenalectomy.
Adipose Tissue ; Adrenal Glands ; Adrenalectomy ; Autopsy ; Humans ; Laparoscopy ; Magnetic Resonance Imaging ; Middle Aged ; Myelolipoma

The followings are the results for external quality assessment (EQA) in immunoserology for 2009: Evaluation of EQA was done in 2 trials in April and November, about 99% of laboratories participating average 7.4 items. The results were collected via internet and about 98% of laboratories have sent their results via internet. Control materials used in EQA were pooled sera including commercial controls, MASR Immunology Control from Medical Analysis Systems (Camarillo, CA, USA), which were delivered refrigerated for stability of control materials, being received within 48 hours after sending. Latex agglutination tests for rheumatoid factor (RF) showed frequently false positive or false negative results especially in commercial controls, possibly due to matrix effect. False negative and positive results were frequently found in the laboratories using immunochromatography assay (ICA) for anti-HCV and anti-HIV. More careful quality control should be required for ICA tests. New tests measuring non-treponemal and trponemal antibody such as turbidoimmunoassay (TIA) and chemiluminescence immunoassay (CLIA) were introduced. Standardization of instruments and reagents including calibrators for quantitative results should be required for the harmonization of results.
Hepatitis B Surface Antigens ; Immunoassay ; Immunochromatography ; Indicators and Reagents ; Internet ; Korea ; Latex Fixation Tests ; Luminescence ; Nephelometry and Turbidimetry ; Quality Control ; Rheumatoid Factor

OBJECTIVE: We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. MATERIALS AND METHODS: Five cadavers were subjected to whole-body, 16-channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. RESULTS: Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. CONCLUSION: A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations.
Adult ; Aged ; Autopsy/*methods ; Cadaver ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Prospective Studies ; Tomography, X-Ray Computed/*methods ; *Whole Body Imaging

BACKGROUNDS/AIMS: Negative hepatitis B core antigen (HBcAg) staining in hepatocytes is indicative of viral replication by an active immune response. HBcAg is expressed mainly in the cytoplasm in patients with active hepatitis and hepatocyte regeneration, and mainly in the nuclei of hepatocytes in patients with minimal liver injury in the absence of hepatocyte regeneration. The aim of this study was to elucidate whether the existence and expression pattern of HBcAg predicts the response to antiviral treatment. METHODS: The study involved 58 patients with biopsy-proven chronic hepatitis B who were treated with lamivudine. Hepatitis B e antigen (HBeAg), antibody to HBeAg, hepatitis B virus DNA, and alanine aminotransferase in serum were recorded every 3 months. The inflammation grade and the fibrosis stage of chronic hepatitis were scored from 0 to 4 according to lobular inflammation, portal inflammation, periportal inflammation, and fibrosis. RESULTS: The 58 patients included 49(84%) HBcAg-positive patients, with HBcAg staining confined to the cytoplasm in 15(31%) and in both cytoplasm and nuclei in 34(69%). The grade of lobular inflammation and the total histology score were significantly higher in patients with cytoplasmic expression of HBcAg than in HBcAg-negative patients (lobular inflammation: 2.9 vs 2.1, P=0.02; total histology score: 12.2 vs 10.3, P=0.04). The virologic responses at 3, 6, 9, and 12 months differed significantly between the cytoplasmic and mixed expression groups (P<0.01). CONCLUSIONS: The expression pattern of HBcAg (including its possible absence) before initial therapy appears to predict the response to antiviral treatment.
Adult ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Female ; Hepatitis B Core Antigens/*analysis/metabolism ; Hepatitis B e Antigens/metabolism ; Hepatitis B virus/isolation & purification ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies