ABSTRACT
Lymphedema is one of the most common complications of mastectomy. It decreases quality of life and causes functional or aesthetical problems in post-mastectomy patients. Axillary lymph needs dissection (ALND), and radiation therapy(RTx) is known as the representative factor of lymphedema. Authors discovered that breast reconstructions using latissimus dorsi(LD) myocutaneous flap decrease the incidence of lymphedema in spite of these risk factors. Therefore we compared the incidence of lymphedema between the patients who underwent breast reconstructoins by LD pedicled flap, and the patients who did not undergo breast reconstructions from January 2002 to December 2004. Lymphedema was diagnosed when difference of arm circumference was over 2cm or limitation of joint movement was greater than 20 degrees. Overall incidence of lymphedema was 14.0%, and it was 18.9% in case of ALND, and 21.1% in case of RTx, respectively. But the incidence of breast-reconstructed patients using LD pedicled flap was 3.3%. This result reveals that LD pedicled flap decreases incidence of lymphedema significantly. In the future, it is recommended to identify the causes of decrease in the incidence of lymphedema in case of breast reconstructed by LD myocutaneous pedicled flap, for example lymphoscintigraphy and so on.
Subject(s)
Female , Humans , Arm , Breast , Incidence , Joints , Lymphedema , Lymphoscintigraphy , Mammaplasty , Mastectomy , Myocutaneous Flap , Quality of Life , Risk Factors , Superficial Back Muscles , Surgical FlapsABSTRACT
Neurilemoma(schwannoma, neurinoma, Schwann's cell tumor) is a relatively uncommon, slowly growing lesion that usually has been present for a considerable time before diagnosis and treatment are requested. The site of origin is believed to be the ectodermal Schwann cells of the nerve sheath. An interesting variant, known as the ancient neurilemoma, has been reported by Eversole and others. They suggest that the histologic feature that typify this tumor result from degenerative changes which occur as a classic neurilemoma ages. We have experienced a case of schwannoma arising on the nasal tip of a 27 years old man and discussed with brief current literatures review.
Subject(s)
Adult , Humans , Diagnosis , Ectoderm , Neurilemmoma , Schwann CellsABSTRACT
PURPOSE: The National Institute of Health (NIH) category III Chronic Nonbacterial Prostatitis/Chronic Pelvic Pain Syndromes (CPPS) are common disorders. However, there has been no consensus on how treatment should be planned for these patients. The purpose of this trial was to compare the efficacy of tamsulosin and ibuprofen in the treatment of CPPS patients. MATERIALS AND METHODS: Between June 2001 and May 2002, 117 patients were diagnosed, in our department, as noninflammatory CPPS (Category IIIb). The study comprised of 63 patients who were randomly placed into three groups as follows: group 1 tamsulosin, group 2 ibuprofen and group 3, both tamsulosin and ibuprofen. The tamsulosin and ibuprofen, or both, were given to the respective groups for 12 weeks. The NIH chronic prostatitis symptom index (NIH-CPSI) and uroflowmetry were evaluated both before and after the treatment. RESULTS: Before the treatment, the CPSI of the 40 patients who received tamsulosin was 18.43+/-6.60, and after was 13.00+/-6.07. For the ibuprofen group, the CPSI value before the treatment was 18.00+/-5.81, and after was 17.07+/-5.36. In the tamsulosin group, the difference between the pre- and post treatment CPSI values was statistically significant (p<0.001). Conversely, in the ibuprofen group, the difference was insignificant (p=0.106). After the treatment, the difference between the tamsulosin and ibuprofen groups was also statistically significant (p=0.039). The mean maximal urinary flow rate (Qmax) before the treatment in all patients was 15.49+/-4.82ml/sec. A significant increase in the Qmax was obtained in the tamsulosin group. CONCLUSIONS: Tamsulosin appeared effective for treating patients with noninflammatory CPPS. However, it was concluded that a 12 week treatment period was insufficient.
Subject(s)
Humans , Consensus , Ibuprofen , Pelvic Pain , ProstatitisABSTRACT
We report a rare case of an epididymal adenomatoid tumor in a 31-year-old man who had a slowly growing painless left scrotal mass for approximately two years. Physical examination revealed a rubbery, non-tender, 2x2cm sized mass located in the tail of the epididymis. Scrotal ultrasonography showed a 1.7x1.7cm sized isoechogenic mass inferior to the left testicle. Left epididymectomy done. The diagnosis was confirmed by a surgical excision and a subsequent histological analysis.
Subject(s)
Adult , Humans , Male , Adenomatoid Tumor , Diagnosis , Epididymis , Physical Examination , Testis , UltrasonographyABSTRACT
PURPOSE: The prognostic factors influencing the survival rate in patients with renal cell carcinoma were evaluated. MATERIALS AND METHODS: An analysis was performed on 102 patients with renal cell carcinoma who underwent a radical nephrectomy from January 1995 to June 1999. The survival rate according to each prognostic factor such as the 1997 TNM stage, the size, cell type and nuclear grade of the tumor and the presence of symptoms at the point of diagnosis, age and gender, and tumor location was analyzed using the Kaplan-Meier method. The statistics was determined by the log-rank test of a univariate analysis and the Cox proportional hazards model of multivariate analysis. RESULTS: Univariate analysis showed that the TNM stage, size and nuclear grade of tumor, and the presence of symptoms at the point of diagnosis had a significant influence on survival rate of patients with renal cell carcinoma. The tumor cell type, age and gender, the location of the tumors had little statistical significance. Multivariate analysis showed that a distant metastasis was the most significant prognostic factor followed by nuclear grade of the tumor cell, T stage, the presence of symptoms at the point of diagnosis, and lymph node metastasis in this order. CONCLUSIONS: The TNM stage, nuclear grade of the tumor and the presence of symptoms at diagnosis are important prognostic factors in renal cell carcinoma. Analyzing these prognostic factors will be useful as a treatment modality, follow up and prognosis of patients with renal cell carcinoma.
Subject(s)
Humans , Carcinoma, Renal Cell , Cell Size , Diagnosis , Follow-Up Studies , Lymph Nodes , Multivariate Analysis , Neoplasm Metastasis , Nephrectomy , Prognosis , Proportional Hazards Models , Survival RateABSTRACT
PURPOSE: This study was undertaken to evaluate the usefulness, and significance, of polymerase chain reaction (PCR) in the diagnosis of chronic pelvic pain syndrome (CPPS), analyzing Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum as the main causative organisms of CPPS. MATERIAL AND METHODS: We used a PCR assay designed to detect C. trachomatis, T. vaginalis, M. hominis, M. genitalium and U. urealyticum in expressed prostatic secretions (EPS), or third voided urine specimens (VB3), of 359 patients diagnosed with CPPS. RESULTS: Among 359 patients, 125 patients (34.8%) were category IIIa and 234 patients (65.2%) were category IIIb. With the use of PCR, Ttwenty-one (16.8%) of the 125 category IIIa, and nineteen (8.1%) of the 234 category IIIb, patients were found to have positive PCRs for the causative organisms of CPPS. In total 43 isolates, of presenting positive PCR, the common causative microorganisms were C. trachomatis in 15 cases (34.9%), U. urealyticum in 14 cases (32.6%), M. genitalium in 13 cases (30.2%) and M. hominis in 1 case (2.3%). CONCLUSIONS: With the invention of PCR, the inconvenience to patients in the process of extracting causative microorganisms is reduced, and it has become possible to get a result within 2-4 hours in a technically less difficult way. Moreover, PCR shows nearly 100% accuracy in terms of sensitivity and specificity. PCR is expected to play an important role in way of diagnosis, and treatment, for chronic pelvic pain syndrome in urology.