Glans Approximation Procedure (GAP) for Distal Hypospadias Repair / 대한비뇨기과학회지

PURPOSE: There are various methods for distal hypospadias repair. Although meatal advancement-glanuloplasty (MAGPI) has been popularly used, it is not suitable in cases of megameatus intact prepuce (MIP) or hypospadias with a wide, deep, glanular groove. We assessed the reliability, cosmesis and complication rates of the glans approximation procedure (GAP). MATERIALS AND METHODS: 22 patients with distal hypospadias, who had undergone a GAP, were evaluated based on their charts. The cases of MIP, glanular hypospadias and coronal hypospadias were 10, 10 and 2, respectively. All the patients had wide, deep, glanular grooves or wide fish-mouth meatus. Two patients had mild ventral skin chordee. The mean age of the patients was 13 years old, ranging from 1 to 40 years, and the mean follow up period was 26 months ranging from 3 to 48 months. A Foley catheter was inserted in 18 cases, for a mean of 4.2 days. The surgical outcomes were retrospectively evaluated. RESULTS: In the 22 patients, there was one urethro-cutaneous fistula, which was repaired, with a good result. There were 2 temporarily weak streams, 2 urine retentions and one wound infection, which were all resolved with appropriate treatments. All patients were pleased with the cosmetic results, and had good straight urinary streams. CONCLUSIONS: The GAP was technically easy and reliable, and showed low complication rates in selected patients with MIP hypospadias and hypospadias, with a deep glanular groove.

The study of the predictors in arthrocentesis and lavage of temporomandibular joint disorder : retrospective evaluation of anterior disc displacement without reduction

PURPOSE: The purpose of this study was to find the predictors for successful arthrocentesis for anterior disc displacement without reduction(ADD without Reduction) of the temporomandibular joint (TMJ). PATIENTS AND METHODS: Arthrocentesis and lavage was carried out in 25TMJs of 22patients whose MRI findings were all anterior disc displacement without reduction. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predectors which was analyzed were age, duration of painful locking, MMO, the degree of pain, perioperative clicking and the amounts of irrigation fluid. RESULTS: 18cases (72%) was included to criteria for success. There were no significant differences in age, duration of locking, MMO and the degree of pain statistically. But In 15cases(83%) of successful cases, amouts of irrigated solution recovered to normal MMO were less than 150ml. And In 8cases (44%) of successful cases, perioperative clicking was appeared. CONCULSION: Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.

Reconstruction of palatal defect using palatal flap

The Reconstructive techniques of palatal defect are palatal island flap, palatal mucoperiosteal expansion, buccal flap, tongue flap, pushback palatoplasty, free flap and so on. We report a reconstruction of palatal defect using palatal flap. Excellent results were obtained by palatal connective tissue island flap and split thickness pedicle flap. Healing of defect occured rapidly. There were no postoperative complications except dull pain.

A Case of Torsed Voluminous Parovarian Cyst / 대한산부인과학회잡지

Parovarian cysts constitute 10% of adnexal masses. They were found in broad ligament and mostly arise from mesothelium and less commonly from paramesonephric element and rarely from mesonephric element. In most cases parovarian cysts were asymptomatic. So, they were found incidentally at surgery for other conditions. Torsion is infrequent and it is difficult to distinguish it from torsion of other adnexal masses, appendicitis, etc. Recently, we experienced a voluminous parovarian cyst undergoing torsion, 25 cm in diameter. The case is presented with a review of literature.