A Case of Sigmoid Volvulus Treated by Emergency Endoscopic Reduction and Surgical Colonic Resection / 대한소화기내시경학회지

An intestinal obstruction is a common cause of acute abdominal diseases which need emergency measures. Sigmoid volvulus is one of rare causes of colonic obstruction and occupies 2~3% of its causes in Korea. Volvulus requires a prompt diagnosis and decompression in order to prevent its progression to strangulation and gangrene. Although 90% of sigmoid volvulus can be diagnosed just by plain abdominal x-ray, computed tomography or barium enema can be done for more accurate diagnoses. For the successful treatment, accurate early examination, endoscopic reduction and surgical colonic resection are required. Endoscopic reduction has low mortality but is liable to recur, whereas emergency colonic resection has little recurrence rate but a high mortality. We experienced a case of a sigmoid volvulus in a 55-year-old male who companied of sudden abdominal pain. After diagnosed as sigmoid volvulus through plain abdominal x-ray and abdominal computed tomography, endoscopic reduction was done in the early period of development, and the sigmoid resection was performed after 7 days. We report our experience with a review of the literature regarding the diagnosis and treatment of sigmoid volvulus.

Serum lipid profile in patients with fibromyalgia / 대한내과학회지

BACKGROUND: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal disorder that's characterized by widespread bodily pain, chronic fatigue, irritable bowel syndrome and increased tenderness at specific anatomic sites. This study was undertaken to compare the serum lipid profiles in patients with FMS and the healthy controls, and we also wanted to investigate relationship between the serum lipid levels and the symptoms in FMS patients. METHODS: Fifty three patients who visited Maryknoll Hospital between March 2001 and March 2005 were included; they were compared with 53 age & gender matched healthy adults. We assessed the serum lipid profile of the FMS patients in terms of the tender points, the Korean Fibromyalgia Impact Questionnaire (KFIQ) scores and the Korean Center for Epidemiologic Studies Depression (KCES-D) scores. RESULTS: Total cholesterol (208.9+/-38.5 vs 194.2+/-37.1, respectively, p=0.047) and LDL cholesterol (low density lipoprotein cholesterol, 121.9+/-31.0 vs 109.3+/-32.2, respectively, p=0.043) were significantly higher in the FMS patients than in the controls. The tender points and KCES D scores were inversely influenced by the total cholesterol, and there was a statistically significant difference. The KFIQ score was inversely influenced with the lipid profile, but there was no statistically significant difference. CONCLUSIONS: The results showed significant differences in the lipid levels of FMS patients and the controls. More extensive investigation of the lipid levels is required to determine whether the lipid levels are associated with FMS.

Isolated and Combined Influences of Diabetes and Hypertension on the Myocardial Function and Geometry

BACKGROUND AND OBJECTIVES: Because hypertension and left ventricular hypertrophy (LVH) frequently coexist with diabetes, in this study we sought to compare the myocardial functional and structural changes in diabetic patients who were with or without hypertension with those myocardial functional and structural changes in non-diabetic subjects with hypertension (essential hypertension), in order to identify the role of diabetes alone, in relation to the myocardial dysfunction. SUBJECTS AND METHODS: We studied 50 patients with essential hypertension (HTN, 20 men and 30 women; mean age: 59+/-12 years), 54 diabetes mellitus patients without hypertension (DM, 24 men and 30 women; mean age: 60+/-9 years), 53 diabetes mellitus patients with hypertension (DM+HTN, 23 men and 30 women; mean age: 61+/-7 years), and 49 normal subjects (22 men and 27 women; mean age: 56+/-13 years). We used echocardiography that was comprised of the standard 2-dimensional and conventional Doppler imaging for estimating the left ventricular mass index (LVMI), the relative wall thickness (RWT) and the Doppler-derived myocardial performance index (MPI, Tei index). Subjects were considered to have normal geometry (NG) if both the LVMI and RWT were normal (LVMI < or = 104 g/m2 in females, LVMI < or = 116 g/m2 in males, RWT < or = 0.43), concentric hypertrophy (CH) if both were elevated, eccentric hypertrophy (EH) if the LVMI was elevated and the RWT was normal, and concentric remodeling (CR) if the LVMI was normal and the RWT was elevated. RESULTS: The Tei index was significantly higher in the patients with essential hypertension and diabetes, especially in the DM+HTN group (HTN=0.48+/-0.13; DM=0.41+/-0.09; DM+HTN=0.53+/-0.11), as compared to the controls (0.31+/-0.11, p<0.05). The LVMI and RWT were significantly higher in the patients with essential hypertension and diabetes, and especially in the DM+HTN group (HTN=132.2+/-44.4 g/m2 and 0.45+/-0.11; DM=125.9+/-34.4 g/m2 and 0.44+/-0.07; DM+HTN=153.9+/-42.9 g/m2 and 0.48+/-0.07), as compared to the controls (108.9+/-22.2 g/m2 and 0.39+/-0.05, p<0.05). CONCLUSION: Our study demonstrated the early appearance of adverse myocardial functional and geometric changes in the diabetic patients, and the study also showed that the contributory effects of diabetes to the myocardial impairment and LV hypertrophy were produced by the presence of hypertension. The Tei index is a very sensitive method for the detection and evaluation of myocardial impairment in diabetic patients.

A case of low grade endometrial stromal sarcoma / 대한산부인과학회잡지

Uterine sarcoma is a rare female neoplasm that accounts for about 2-4% of all uterine malignancies. According to the classification of Norris and Taylor, the subgroup of endometrial stromal sarcoma (ESS), comprising approximately 7-15% of all uterine sarcomas, can be divided into low-grade ESS and high-grade ESS and is characterized by proliferations composed of cells with endometrial stromal cell differentiation. We experienced this infrequent malignant tumor in a 52-year old woman and was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adriamycin chemotherapy. We present a case of low-grade ESS with a brief review of the literature.

A case of low grade endometrial stromal sarcoma / 대한산부인과학회잡지

Uterine sarcoma is a rare female neoplasm that accounts for about 2-4% of all uterine malignancies. According to the classification of Norris and Taylor, the subgroup of endometrial stromal sarcoma (ESS), comprising approximately 7-15% of all uterine sarcomas, can be divided into low-grade ESS and high-grade ESS and is characterized by proliferations composed of cells with endometrial stromal cell differentiation. We experienced this infrequent malignant tumor in a 52-year old woman and was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adriamycin chemotherapy. We present a case of low-grade ESS with a brief review of the literature.

The Effects of Nifedipine and Allopurinol on Shock Wave Induced Acute changes of Rabbit Ureter / 대한비뇨기과학회지

PURPOSE: Introduction of shock wave lithotripsy has provided an avenue for dealing with many urinary stones noninvasively. Although shock wave is known to cause pathologic changes in various organ, little is k nown about its effect on the ureter and recovery after shock wave, the target organ in SWL of injury induced by shock wave and the potential protective effect of allopurinol and nifedipine against shock wave. MATERIALS AND METHODS: A total 24 rabbits were assigned to 2 groups. 12 rabbits received allopurinol(10mg.each) and nifedipine (1mg.each) that were given orally 3 times a day for 5 days starting the night before SWL. The other 12 rabbits reseived no medication. The left lower Ureter segments of 24 rabbits were removed ureter. Groups of 8 rabbits(4were medication group and 4, no medication group) were sacrificed 1, 3 and 5 days after shock wave exposure. The histomorphological alterations were examined under light and transmission electron microscopy. RESULTS: The epithelial cells disclosed no change after shock wave application. Histologically the muscular layer was the most affected part of ureter. There was interstitial and intracellular edema on light microscopy and made chromatin and mitochondrial changes at the subcellular level. The adventitial layer wes also edematous. This chanfes were prominent on day 1and 3 and returned to normal on day 5. The medication group showed less severe features of injury, compared with the no medication group. CONCLUSIONS: Electromagnetic shock waves produce reversible morphological changes in rabbit ureteric muscle and allopurinol and nifedipine may have its role in protecting the tissue injury produced by high energy shock waves.

A case of Malignant Peripheral Nerve Sheath Tumor Near Left Inguinal Region / 대한비뇨기과학회지

No abstract available.

The Usefulness of New Diagnostic Criteria on Color Doppler Ultrasound for Varicocele Diagnosis / 대한비뇨기과학회지

No abstract available.

The Clinical Observation on 67 Cases of Renal Injury by Blunt Trauma with Conservative Treatment / 대한비뇨기과학회지

No abstract available.

A case of Renal Angiomyolipoma in a Child without Evidence of Tuberous Sclerosis / 대한비뇨기과학회지

Angiomyolipoma is a rare benign tumor and approximately 20 to 50% of patients with the diagnosis of angiomyolipoma have some or all of the other stigma of tuberous sclerosis. Patients with tuberous sclerosis tend to be younger, more likely to have multifocal and bilateral disease. Angiomyolipoma which is not associated with tuberous sclerosis mostly affects middle aged women. According to literature data, angiomyolipoma is very rare in child and almost exclusively associated with tuberous sclerosis. We report a case of 14 year-old girl who has a renal angiomyolipoma without clinical evidence of tuberous sclerosis.