Surgical Removal of a Left Ventricular Thrombus Which Showed Morphologic Changes Over Time in a Patient with Stress-Induced Cardiomyopathy

Although stress-induced cardiomyopathy (SCMP) is a reversible disease and the prognosis is usually excellent, several complications can occur and can result in fatal adverse events. The formation of left ventricular (LV) thrombus is one of these critical complications of SCMP. This report describes a case of SCMP complicated by formation of a LV thrombus that became increasingly mobile as LV contractility recovered, and for which surgical removal was performed. Here, we report a case of SCMP complicated by LV thrombus and review the literature regarding this topic.

Three-Dimensional Angiography-Guided Percutaneous Transluminal Angioplasty for Distal Aorta and Bi-Iliac Chronic Total Occlusion

Percutaneous recanalization of chronic total occlusions (CTOs) in peripheral arteries, especially TASC D classification including the distal aorta and both iliac arteries is still technically challenging. The conventional technique using standard guidewires and catheters guided by computed tomography and angiography can achieve a limited initial success, depending on lesion characteristics and operator's experience. A special imaging technique using 3-dimensional rotational angiography and spatio-temporal reconstruction with endoview for a better examination of the proximal stump, exact obstruction location, and distal stump direction in a stumpless lesion can be indispensable for successful intervention. We report a successful revascularization case of stumpless distal aorta and bi-iliac CTO guided by this specialized imaging technique.

Comparison between Laparoscopic Unroofing and Open Surgery for Nonparasitic Hepatic Cyst

PURPOSE: Nonparasitic hepatic cyst is being increasingly found due to the frequent application of diagnostic imaging. The treatment for nonparasitic hepatic cysts varies according to the nature of the lesion. Many authors have recently reported the benefit of performing laparoscopic unroofing for nonparasitic hepatic cyst. In this study, we reviewed the indications and the results of open surgery and laparoscopic unroofing for nonparasitic hepatic cyst. METHODS: From May 1992 until May 2005, 28 patients underwent an operation for nonparasitic hepatic cyst in our hospital. 12 patients had open surgery and 16 patients had laparoscopic unroofing. The indications and outcomes for open surgery and laparoscopic unroofing were compared. RESULTS: 25 patients were female and 3 patients were male, and the mean age was 59.7 (range: 35~80) years. Non- specific abdominal pain was the most common symptom in 74.4% (20/28) of the patients. The indications for open surgery included suspicious neoplastic cyst (3), hemorrhagic cyst (1), infected cysts (2), a huge cyst involving one lobe (1), cysts in segment 7 (2), and simple cysts that had been operated on before 1996 (2). Three suspicious neoplastic hepatic cysts turned out to be simple cysts on the pathology report. Laparoscopic unroofing was performed for 15 simple nonparasitic hepatic cysts and for one infected cyst. The mean hospital stay was 4.7 days (mean stay: 2~11) for the laparoscopic surgery patients compared to 16.2 days (mean tay: 7~38) for the open surgery patients (p< 0.0005). No morbidity or mortality was present in both groups. CONCLUSION: Laparoscopic unroofing for nonparasitic hepatic cyst is less invasive and it required a shorter hospital stay. Thus, laparoscopic unroofing is favored for the nonparasitic hepatic cyst unless it is complicated by neoplastic cysts.

A Case of Congenital Dislocation of the Knee / 대한주산의학회잡지

Congenital dislocation of the knee is very rare skeletal deformity and was firstly described by Chatelaine in 1822. Since then there have been a few number of case reports and some series discussing the etiology and treatment. The tibia is displaced anteriorly in relation to the femur. It is generally subdassified as simple hyperextention, subluxation, and dislocation depending on the degree of the joint displacement and the severity of disease. Early gentle manipulation and serial splintage or plaster cast are recommended for treatment and were successful in the majority except the case of quadriceps contrarture or late correction. The authors experienced one case of congenital dislocation of the right knee and brief review of the related literatures was made.

A Case of Diverticulum of Female Urethra / 대한비뇨기과학회지

Diverticulum of the female urethra is rather unusual disease which is relatively frequent in older women in whom it occurs more often than males; it is most rare in the young. A case of urethral diverticulum that occurred in a 50 years old women was presented. This patient was performed physical examination, cystoscopy, cystourethrogram and urethral soundation in order to know accurate size, location, extension and contents of the diverticulum. The transvaginal resection of the urethral diverticulum was performed, and the postoperative complication was not occurred.

Clinical Observation on Urolithiasis / 대한비뇨기과학회지

Clinical observation was made on 272 cases of urolithiasis who admitted in the department of Urology, Seoul Adventist Hospita1, during the period from Jan. 1976 to Dec. 1980. The results of this observation may be summarized as follows: 1. Among total admissions (969 cases), those with urolithiasis were 272 cases (28.2%) and the sex ratio of male and female was about 9.2 : 5.9. 2. The highest incidence on age distribution showed in 20 to 40 years (61.0%). 3. On seasonal distribution, occurence was prevalent in summer (3O.8%). 4. The ureter was he most favored predilection site of urinary stone (84.9%) and upper urinary stones were almost noted (95.6%). The most common location of ureteral stones was lower third of ureter (60.2%). 5. In the aspect of number of urinary calculi, the single was in 257 cases (91.8%) and the most common size was below 1.0cm in diameter (64.8%), weight in 0.6-1.0gm (38.4%). In shape, round or oval stones were more prevalent (38.9%) and the 2 cases of staghorn calculi were noted in renal region. 6. The clinical symptoms of upper urinary tact showed flank pain in 91.8%, nausea & vomiting: etc. in 57.8%. hematuria in 47.8% but in lower urinary tract, hematuria was in 83.3%, vesica1 irritability in some cases. 7. Microscopic hematuria showed in 88.8% and pyuria in 65.3% Positive urine cultures above ever 100,000 colony/ml were obtained in 158 cases (58.O%) and most common organisms were E. coli (56.8%), staphylococcus aureus (21.5%), Proteus mirabilis (8. 2%). 8. It upper urinary stones, hydronephrosis with or without functional deterioration were detected in 91% on excretory urogram or other X-ray films, Among them, moderate hydronephrosis showed in 34.9% 9. The 142 cases of urolithiasis (58.0%) were treated with surgical intervention. Among them, ureterolithotormy was made in 40.7%. 10. On chemical analysis of urinary calculi (107 cases), calcium phosphate and calcium oxalate in mixed type was most common (39.8%). On the chemical component of urinary calculi, most prevalent types were phosphate stone (72.2%). oxalate stone (61.7%), etc.

Clinical Observation on Pyelonephritis / 대한비뇨기과학회지

The clinical observation was made on 233 cases of pyelonephritis in the Department of Urology, Seoul Adventist Hospital, during the period from 1978 to 1980. The following results were obtained: 1. The incidence of pyelonephritis was 36.7% of the total number of in-patient admitted to the Department of Urology during this period. 2. The age ranged from 10 to 70 years and most favorable age was from 31 to 40 years for 45.3%. 3. The sex ratio of male and female was about 1 : 4. 4. The most common symptoms were flank pain (89. 0%) fever, chill (81. 1%), abdominal pain (34. 0%), lumbago (29. 2%), hematuria (76.4%) and others. 5. In urine culture. The most common organisms were E. Coli (72.9%). Staphylococcus aureus (19. 6%). Pseudomonas aeruguinosa (46%) In urine A.F.B. Stain, 26 cases (11. 0%) were positive. 6. On the I.V.P. findings of pyelonephritis, 83 (35.6%) cases were normal and 150 cases (64.4%) abnormal. 7. The underlying diseases associated with pyelonephritis were cystitis (31. 3%), diabetes or debilitating illness (6.9%), tuberculosis of urinary tract (11%), calculi of urinary tract (29%), congenital anomaly of urinary tract (4. 7%), instrumentation (1.9%), pregnancy (1%), etc. (7. 2%). 8. On treatment of pyelonephritis, 143 cases were performed with conservative, medical treatment, and other cases ware performed with operation, for examples: ureterolithotomy in 51 cases, nephrectomy 26 cases, nephrolithotomy, pyelolithotomy in 6 cases, T.U.R., partial nephrectomy in each 2 cases, etc. or with combined treatment.

Two Cases of Vesicovaginal Fistula / 대한비뇨기과학회지

We experienced 2 cases of vesicovaginal fistula and obtained good results in the Department of Urology, Seoul Adventist Hospital, Seoul, Korea. The causes of vesicovaginal fistula were corrosive agent and prolonged labor, the ages were 42 and 52 years old, the locations were in the trigonal area in both cases and the sizes were 3cm and 1.5cm respectively. Both cases were treated successfully with suprapubic transvesical approach.

A Case of Sparganosis in the Left Flank and the Left Scrotum / 대한비뇨기과학회지

The human sparganum mansoni infestation was reported 63 cases in Korea until 1974, but urogenital infestation of sparganum is relatively rare. We experienced a case of sparganosis in which one parasite migrated from the Left flank to the left scrotum and the other remained in the left flank. The white ribbon worm-like structure was crawling in the subcutaneous tissue of the left scrotum. This 51 year lod male patient had an episode of intake of raw snake as a tonic 2 year ago in Kyungki-do, Korea.