Voiding and Sexual Dysfunction following Total Mesorectal Excision and Autonomic Nerve Preservation for Rectal Cancer in Males:A Prospective Study / 대한비뇨기과학회지

PURPOSE: We designed a prospective study to evaluate the effects of total mesorectal excision and autonomic nerve preservation(TME-ANP) on postoperative genitourinary function in the course of time and the quantitative effects of various peri-operative risk factors on the postoperative genitourinary dysfunction. MATERIALS AND METHODS: Forty-five patients who underwent TME-ANP with rectal cancer were prospectively examined before and after operation, as well after the first, third and sixth postoperative month. The preoperative urological evaluation consisted of International Prostate Symptom Score(IPSS), Erectile Function Domain score in International Index of Erectile Function(IIEF-EFD), Ejaculation domain in Male Sexual Health Questionnaire(MSHQ-EjD) and urodynamic study. RESULTS: Preoperative IPSS decreased significantly in postoperative 1 month. But there was no difference between preoperative IPSS and postoperative IPSS after 3 month of operation. Erectile function significantly decreased in the course of time(p-trend<0.05). Ejaculation function also significantly decreased after 1 month of operation, however no significant change of MSHQ-EjD was observed thereafter. Multivariate analysis revealed history of abdominoperineal resection and baseline mild erectile dysfunction were found to be the risk factors of decreasing erectile function. Diabetes was associated with diminishing ejaculatory function. CONCLUSIONS: While the voiding dysfuncion was no longer problematic following TME-ANP, substantial number of sexual dysfunction persisted despite TME-ANP.

Analysis of c-Kit Gene Polymorphism in NK/T Cell Lymphoma in Korean Population / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The proto-oncogene c-KIT encodes a receptor tyrosine kinase (KIT) whose ligand is a stem cell factor. KIT is expressed and critical for the development and growth of mast cells, melanocytes, hematopoetic stem cells, and the interstitial cells of Cajal. In this study, c-kit gene mutations were analyzed in 27 cases of NK/T cell lymphoma. SUBJECTS AND METHODS: During 1995 to 2002, 27 patients with NK/T cell lymphoma in the head and neck area were selected for this study. The nasal cavity were predominant sites (15 cases), followed by 6 nasopharynx cases, 4 tonsil 4 cases, and 2 hard palate cases. Gene mutation was analyzed by PCR-SSCP and direct sequencing. RESULTS: c-kit gene mutation was found in 5 of 27 cases by the PCR-SSCP method. Among the 5 cases, 2 cases exhibited no mutation by direct sequencing. Consequently, the mutation of c-kit gene was detected in 3 of 27 cases. CONCLUSION: The frequency of c-kit gene mutation (11%) indicated in the present cases is lower than that reported in north China but higher than that in Japan.

Thyrotracheal Anastomosis for Combined Laryngotracheal Stenosis: Experience in 11 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The combined Laryngotracheal stenosis produces cripling complications of respiratory and phonation difficulty. The area between cricoid cartilage and first tracheal ring is the most common site of stenosis and is the most difficult area to manage, therefore, appropriate selection of surgical method is the important factor determining the success of treatment. The authors treated laryngotracheal stenosis with thyrotracheal anastomosis and here we report the results and problems of thyrotracheal anastomosis to provide aid in the management of laryngotracheal stenosis. MATERIALS AND METHODS: Authors retrospectively studied 11 cases of laryngotracheal resection with thyrotracheal anastomosis patients for clinical characteristics, site and degree of stenosis, operation technique such as granulation tissue removal under bronchoscopy, CO2 laser excision, insertion of T-tube, insertion of laryngeal stent, and its results. RESULTS: 1) Decannulation was possible in seven cases (63.6%). 2) The success rates of patients under the ages of 20years was 80%, patients with normal vocal cord movement was 85.7%. 3) The patients with residual neurologic symptom, or with decreased coughing reflex failed in decannulation. CONCLUSION: Treatment of combined laryngotracheal stenosis is very difficult and our study showed a success rate of 63.6%. Laryngotracheal resection and end to end thyrotracheal anastomosis showed to be the most effective treatment method and in general the patients under the ages of 20 years, or with normal vocal cord movement showed better prognosis. Therefore, a radical treatment planning with efforts to reduce complication at this group may produce satisfactory results in the management of laryngotracheal stenosis.

Selection of Surgical Treatment for Warthin's Tumors of Parotid: Experience in 20 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Warthin's tumor is characterized by its frequent occurrence in the parotid tail and multifocal presentation. Superficial or total parotidectomy was advocated by many surgeons due to its multifocal nature. Recently, with the advancement of various radiologic diagnostic methods, more conservative surgical management with low morbidities can be considered since an accurate pattern and site of the tumor can be determined. MATERIALS AND METHODS: Authors retrospectively studied 20 cases of pathologically diagnosed Warthin's tumor for clinical pattern, tumor site in parotid gland, recurrence and complication rate according to different surgical methods. Patients were divided into two groups: Group II received enucleation and Group II received either superficial parotidectomy or total parotidectomy. RESULTS: Post operative complication rate was low in enucleation group, compared with parotidectomy. There was no difference in the recurrence between the two groups. CONCLUSION: Enucleation is an effective method in treatment of solitary or multifocal Warthin's tumors.

Transarterial Embolization of a Carotid Cavernous Fistula with Guglielmi Detachable Coils: A Case Report

In the management of carotid cavernous fistula, detachable balloon has become the treatment of choice.However, technical difficulties are not uncommon, and transarterial balloon embolization fail in 5% to 10% ofcases. Failure occurs because in some patients, the fistula orifice may be too small to allow entry. Using atracker catheter system with Guglielmi detachable coils, we achieved successful transarterial occlusion of acarotid cavernous fistula with a small fistula.

Well-Differentiated Papillary Mesothelioma of the Peritoneum: Report of a case

We described a case of well differentiated papillary mesothelioma (WDPM) of the peritoneum in a 68-year-old man because of its rarity. It was incidentally found during operation for renal cell carcinoma. Grossly, the tumor appeared as multiple small granules or nodules on the entire peritoneal surface, including serosa of the intestine, omentum and mesentery. Microscopically, characteristic features are papillary, tubulopapillary or solid architecture lined by single layer of uniform, cytologically bland, cuboidal or polygonal mesothelial cells. The tumor cells were positive for EMA, cytokeratin and vimentin, but negative for CEA on immunohistochemical staining. Ultrastructural study showed characteristic long slender microvilli on the surface and intercellular junctions.

Tuberculous Pneumonia: CT Findings in 20 Patients

PURPOSE: To evaluate CT findings of tuberculous pneumonia mainly presenting as parenchymal consolidation. MATERIALS & METHODS: CT scans of twenty patients with tuberculous pneumonia were retrospectively reviewed. Analyses included the location, extent, and homogeneity of consolidation, presence of volume loss of involved lung and air-bronchogram, associated lesions suggesting previous tuberculous infection and evidence of bronchogenic spread. RESULTS: The location of consolidation revealed relatively even distribution without any specific predilection site. The areas of consolidation were irregular in margin (95%), inhomogeneous in attenuation (75%) including focal areas of low attenuation and multiple cavities within it. Volume loss (70%) of the involved lobe was associated. There were lesions suggesting previous tuberculous infection (95%) in the surrounding area and evidences of bronchogenic spread (100%) such as poorly-defined nodules and Iobular consolidations in the remote site from main consolidation. CONCLUSION: In tuberculous pneumonia, the areas of consolidation are irregular in margin and inhomogeneous in attenuation on CT scan. The evidences of bronchogenic spread and lesions suggesting previous tuberculous infection are almost always associated in the surrounding or remote site from main consolidation.

Tuberculous Pleural Effusion vs Empyema: It is Possible to Differentiate Based on CT Findings?

PURPOSE: To describe radiologic differences between tuberculous pleural effusion and empyema on the basis of computed tomography(CT). MATERIALS AND METHODS: We reviewed retrosepectively CT findings of 50 patients with pathologically and grossly proved empyema. Twenty-two patients had empyema, and 28 patients had tuberculous pleurisy. RESULTS: CT findings known to be useful in differentiating tuberculous pleural effusion from empyema (1) contour and extent of pleural thickening, (2) mediastinal pleural involvement, (3)accumulation of extrapleural tissue and (4) change of ipsilateral thoraic volume of empyema. However, none of the above findings were helpful in the differential diagnosis of empyema. CONCLUSION: The differentation of tubrculous pleurisy from pyogenic empyema may be not possible with CT findings only.