Ultrasonography of intrascrotal torsed appendages: size and interval between symptom onset and the ultrasonographic examination according to echogenicity

Purpose@#This study investigated the size of torsed appendages and the interval between symptom onset and the ultrasonographic examination according to the echogenicity of the torsed appendages. @*Methods@#This was a retrospective analysis of 54 cases in 46 patients with torsion of the testicular appendages between December 2008 and July 2021. Eight patients received follow-up ultrasonography 7-48 days after initial ultrasonography. The echogenicity of torsed appendages was classified into three groups: hypoechoic, hyperechoic, or isoechoic. @*Results@#The 54 torsed appendages were hypoechoic (n=40), hyperechoic (n=9), or isoechoic (n=5). The size of the torsed appendages ranged from 4 to 14 mm (8.0±3.1 mm) in hypoechoic torsed appendages and from 2.6 to 5.0 mm (3.7±0.9 mm) in hyperechoic torsed appendages. The interval between symptom onset and the ultrasonographic examination ranged from 0 to 17 days (4.2±4.4 days) in hypoechoic torsed appendages and from 8 to 48 days (29.8±16.0 days) in hyperechoic torsed appendages. The hyperechoic torsed appendages were smaller and had longer intervals between symptom onset and the ultrasonographic examination than the hypoechoic torsed appendages (P<0.05). Three hypoechoic torsed appendages and a single isoechoic torsed appendage on initial ultrasonography became hyperechoic on follow-up ultrasonography. @*Conclusion@#The size of the torsed appendages and the interval between symptom onset and the ultrasonographic examination varied according to the echogenicity of the torsed appendages. The hyperechoic torsed appendages were smaller and had longer intervals until the examination than the hypoechoic torsed appendages.

Laparoscopic Appendectomy: Is There a Learning Curve after Completion of Colorectal Fellowships Training?

PURPOSE: Recent studies have shown that the procedure of laparoscopic appendectomy requires a learning curve before mastering. The aim of this study was to investigate the question of whether a surgeon who has been working as a first assistant for training in laparoscopic colorectal surgery can perform laparoscopic appendectomy without previous experience as an operator in laparoscopic appendectomy. METHODS: Ninety consecutive patients who underwent laparoscopic appendectomy by a single surgeon were retrospectively enrolled in this study. The operating surgeon completed fellowship training of the colorectal cancer division as a first assistant for two years. The patients were divided into two groups by consecutive order: Group (A) included the initial 45 patients and Group (B) included the next 45 patients. The clinical patient demographics, histological diagnosis, and outcome variables including operation time, conversion to open surgery, complications, and length of hospital stay were compared between the two groups. RESULTS: No difference in operation time was observed between the groups (mean: 58.22 min vs 66.6 min, p=0.097). Open conversion rate and drain insertion rate were similar between the two groups. There was no difference in length of hospital stay. Overall complication rate did not differ between the two groups. Moving average curve showed no specific time shortening point within these 90 enrolled patients. CONCLUSION: This study demonstrates that laparoscopic appendectomies performed by a surgeon who had achieved a training course as an assistant in laparoscopic colorectal surgery were performed safely without any difficulties during the learning period. This finding needs further validation in additional large-scale studies.

A Clinical Study of Uterine Sarcoma / 대한산부인과학회잡지

OBJECTIVE: Uterine sarcomas are rare and characterized by rapid clinical progression and poor prognosis. The manegement of uterine sarcoma has been challenged. The purpose of this study was to investigate the clinicopathologic findings and outcome of patients with uterine sarcoma METHODS: From Sep. 1990 to July. 1999, 8 patients with histologically proven uterine sarcoma at department of obstetrics and gynecology of Chonbuk University Hospital were evaluated for their clinical profiles and survival retrospectively RESULTS: The age of patients with uterine sarcoma ranged 31 to 60, and the mean age was 46 years. The most common pathologic type of uterine sarcoma was leiomyosarcoma. The common presenting symptom were irregular uterine bleeding, hypermenorrhea and lower abdominal palpable mass. The patients with uterine sarcoma were treated by surgery, post-operative radiotherapy and adjuvant chemotherapy. The mean follow up duration was 34.1 months. The 2 year survival rate was 50%. Distant metastasis were reveled at two patients, and the sites are lung and brain. CONCLUSIONS: Uterine sarcomas are aggressive tumor with a poor prognosis. The Major treatment is surgery and the effect of chemotherapy and radiotherapy were undetermined.

One Case of Xanthogranulomatous Pyelonephritis / 대한비뇨기과학회지

Xanthogranulnmatous pyelonephritis is an unusual chronic renal infection associated with renal calculi, urinary tract infection or obstruction in many cases. It is characterized by orange-yellow nodules of inflamed parenchymal tissue macroscopically and foamy lipid-laden histiocyte microscopically. We report a case of Xanthogranulomatous pyelonephritis in a 74 years old male.