A Tension-free Herniorrhaphy Using the Prolene Hernia System: Clinical Experiences

PURPOSE: The aim of this study was to detail clinical experiences with a new type of tension-free herniorrhaphy using the Prolene Hernia System (PHS) and analyze the system' usefulness. METHODS: We reviewed 48 cases of herniorrhaphy using PHS and 45 cases of conventional herniorrhaphy retrospectively by reviewing the medical records of patients undergoing either procedure between January 2000 and February 2005. RESULTS: There was no significant difference in the operation time (P=0.054) or the length of hospital stay (P=0.138) between the groups. However, the need for analgesic therapy in the PHS group was less than in the control group (P= 0.008). There were no serious postoperative complications, but wound complications occurred more often in the PHS group (6 seromas and 2 hematomas), and urinary retention occurred more frequently in the control group. The recurrence rate in the control group was 2.2% (1/45), but there were no recurrences in the PHS group for 46 months. CONCLUSION: Herniorrhaphy using the PHS is safe and effective as conventional surgery. It can be carried out under local anesthesia more easily, and it is less painful than the conventional surgery. We suggest that the PHS be widely adopted as a method of tension-free herniorrhaphy.

Solid and Papillary Epithelial Neoplasm of the Pancreas in a Child: A case Report

Solid and papillary epithelial neoplasm (SPEN) of the pancreas is a rare tumor with low malignant potentiality that usually occurs in young females. Preoperative evaluation, especially radiologic tests, including ultrasonography and CT scan, is helpful in the diagnosis. These studies demonstrate a well-demarcated large mass with solid and cystic portions, frequently in the tail or body of the pancreas. Complete resection is usually curative, however local invasion and/or metastasis may occur. The authors report a case of a solid and papillary epithelial neoplasm of the pancreatic body in a 14-year old child at St. Benedict Hospital and review the literature.

Induction of Apoptosis in Head and Neck Cancer Cells by Dominant Negative C-myb Gene Therapy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although the role of c-myb in head and neck tumor has not been studied, aberrant expression of c-myb in various cancer has been demonstrated recently, suggesting that c-myb may play a role in tumorigenesis. Consequently, disrupting c-myb function might prove a possible stratergy for controlling cancer cell growth. The purpose of this study is to investigate the possibility of clinical application of adenovirus-mediated dominant negative c-myb (DN-myb) gene therapy in head and neck cancer. MATERIALS AND METHOD: All tissues were obtained from patients undergoing therapeutic operation for head and neck tumors and were assayed the expression of c-myb and bcl-2 in tumor and normal tissue by RT-PCR. We have generated a replication-deficient recombinant adenovirus encoding the dominant negative c-myb (Ad/DN-myb) or control adenovirus encoding no transgene (Ad/GFP) and infected adenovirus to SNU-1076, head and neck tumor cell line. We examined cell proliferation by 3H-thymidine assay, apoptosis by DNA fragmentation, bcl-2 expression and Akt/PKB phosphorylation by Western immunoblot, and IGF-II, VEGF mRNA expression by RT-PCR. RESULTS: c-myb expression of head and neck tumor tissues was significantly higher than that of normal tissue, indicating that these genes may play an important role in carcinogenesis of head and neck tumor. Ad/DN-myb infected SNU-1076 cells decreased cell proliferation, IGF-1I and VEGF expression, and remarkably increased their apoptosis through the down-regulation of bcl-2 expression and the inhibition of Akt/PKB pathway activation. CONCLUSION: Results obtains from these study suggest that DN-myb induced apoptosis of head and neck tumor cells and the adenovirusmediated DN-myb gene therapy may be a potential molecular therapy for the treatment of head and neck tumor.

A Case of High Jugular Bulb Associated with Conductive Hearing Loss / 대한이비인후과학회지

A high jugular bulb is often discovered as an incidental finding that is asymptomatic. The incidence of high jugular bulb protruding into the level of oval window is rare. Conductive hearing loss in association with this anomaly may occur, but has been reported infrequently in the literature. We report one case of high jugular bulb and the associated conductive hearing loss. Mechanisms to explain the conductive hearing loss include contact of the jugular bulb with tympanic membrane, interference with the ossicular chain, and obstruction of the round and oval window niche. The operative findings, radiographic and audiometric data that support these mechanisms of couductive hearing loss are presented.

A Clinical Review of 1000 Cases of Surgical Biliary Tract Diseases

There have been some differences between the manifestations of biliary tract diseases in the Korean population and those in the populations of western countries, and these differences have been varying recently. A clinical analysis of 1000 patients who had been treated surgically for biliary diseases at the Department of General Surgery, St. Benedict Hospital, during the period of 10 years from January 1986 to December 1995 was done, and the results were compared with those of previous reports. The following subjects emerged as points of variance : 1) The incidence of the each biliary tract disease, 2) In calculous biliary disease, the location of the stone and the chemical composition of the stone, 3) Parasitic biliary disease, 4) The sex ratio and the age distribution, 5) The duration of illness, 6) Common symptoms and signs and their frequency, 7) Positive laboratory findings and the availability of radiologic diagnoses, 8) Common organisms in the bacterial culture, 9) The management of biliary diseases, and 10) Postoperative complications and the mortality rate. The clinical manifestations of biliary diseases have changed gradually and have been influenced by multiple factors: improvements inf living, education, and the environment, advances in diagnostic and therapeutic methods, etc.. Although these changes are due to the influences of westernization, they should also exhibit Korean-unique charecteristics. Also, we l expect further improvements in the future, and keep in mind those different points, there should be further suitable management, depending on changing features.