BACKGROUND AND OBJECTIVES: The majority of laryngeal tumors are known to be SCC (squamous cell carcinoma). Non-SCC (non-squamous cell cancers) of the larynx represent a diverse spectrum of diseases with different prognosis and ratio-nales of management from SCC. Therapeutic options to these tumors depend on their histopathological characteristics and clinical behaviors. The purpose of this study was to assess the unique aspects of the non-SCC and to draw diagnosis and provide management options and prognostic variables. MATERIALS AND METHOD: Eleven non-SCC of the larynx from the 212 patients who were diagnosed with larynx cancer during their 3-year visits from 1997 to 2000 were reviewed retrospectively. RESULTS: The incidence of non-SCC was 5.2%. Pathology of non-SCC revealed 3 cases of malignant lymphoma, 2 cases of verrucous cell carcinoma and neuroendocrine carcinoma one case each of basaloid squamous cell carninoma, salivary duct carcinoma, adenocarcinoma, and spindle cell carcinoma. The most common site of origin was supraglottis (6 case, 56.5%), followed by glottis (4 cases, 36.4%) and subglottis (2 cases, 17.2%). Non-Hodgkin's lymphomas and basaloid squamous cell carninoma were treated by chemotherapy. The remaining cases were treated with surgery followed by postoperative radio-therapy or postoperative chemotherapy. The mean follow-up period was 26.8 months (12-43 months). CONCLUSION: Non-SCC accounts for approximately 5.2% of all malignancies of the larynx. Tissue biopsy is the most important diagnostic tool for the non-SCC of the larynx and the tissue sample must be obtained from the deep portion of the submucosal layer. Except for malignant lymphomas, the combined therapy that includes surgery would be the best method of treatment for non-SCC.
Adenocarcinoma ; Biopsy ; Carcinoma, Neuroendocrine ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Glottis ; Humans ; Incidence ; Laryngeal Neoplasms ; Larynx* ; Lymphoma ; Lymphoma, Non-Hodgkin ; Pathology ; Prognosis ; Retrospective Studies ; Salivary Ducts

PURPOSE: Cancer is a genetic disease caused by alterations in key regulators of cell growth and cell turnover. We investigated apoptotic cell death and cell proliferation in gastric adenomas and adenocarcinomas. MATERIALS AND METHODS: The TdT-mediated dUTP-biotin nick end labelling (TUNEL) method and immunohistochemistry for Ki-67 were performed, using paraffin-embedded tissues of 41 gastric adenomas and 100 gastric adenocarcinomas. These results were compared with histopathologic parameters. RESULTS: The Ki-67 labelling index was higher in adenocarcinomas than in adenomas and the apoptotic index was higher in adenomas than in adenocarcinomas. There were no significant difference between the apoptotic index/Ki-67 labelling index and clinicopathological parameters. CONCLUSION: We propose that cell proliferation is more closely associated with gastric adenocarcinomas than apoptosis is, but that neither has any clinical significance as a prognostic factor in gastric adenocarcinomas.
Adenocarcinoma* ; Adenoma* ; Apoptosis* ; Cell Death ; Cell Proliferation* ; Immunohistochemistry

PURPOSE: To compare the diagnostic accuracy of US/CT with US/CT/¹⁸F-FDG PET-CT in the diagnosis of cervical lymph nodes metastasis in papillary thyroid carcinoma. METHODS: From July 2008 to May 2010, 36 patients with papillary thyroid carcinoma, confirmed by aspiration cytology analysis, underwent neck US, neck CT and ¹⁸F-FDG PET-CT preoperatively. The sensitivity, specificity and diagnostic accuracy of the US/CT, US/CT/PET-CT was analyzed according to lymph node level (all: levels I~VI, central: level VI, lateral: levels I~V). RESULTS: At all lymph nodes group (level I~VI), US/CT/ PET-CT showed a sensitivity of 66.6%, a specificity of 61.9% and a diagnostic accuracy of 63.8%. The corresponding values for US/CT were 60.0%, 85.7%, 75.0% respectively. Considering the central cervical nodes group (level VI), US/CT/PET-CT showed a sensitivity of 57.1%, a specificity of 68.1%, and a diagnostic accuracy of 63.8%. The corresponding values of US/CT were 57.1%, 90.9%, 77.7% respectively. Considering the lateral cervical nodes group (level I~V), US/CT/PET-CT showed a sensitivity of 100%, a specificity of 84.3%, and a diagnostic accuracy of 86.1%. The corresponding values of US/CT were 75.0%, 84.3%, 83.3% respectively. The diagnostic results of US/ CT, US/CT/PET-CT in initial evaluation of the cervical nodes metastasis did not differ significantly. CONCLUSION: Our preliminary results suggest that additional PET-CT evaluation in US/CT does not provide statistically significant benefit for initial diagnosis of cervical lymph nodes metastasis in papillary thyroid carcinoma.
Diagnosis* ; Humans ; Lymph Nodes* ; Neck ; Neoplasm Metastasis* ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms

Software modules for interactive display, manipulation and retrieval of medical images have been designed for a Picture Archiving and Communications System (PACS). The target of these modules is not for a high-end diagnostic workstation for radiologists, but for a PC-based low cost clinical workstation for a referring physician. This software is constructed based on a concept of an object-oriented language which is designed to be modular and expandable. It consists of several functional modules: (a) a communication module for image retrieval, (b) a standard module for the interpretation of the DICOM images, (c) a user interface module for the non-computer oriented clinicians and (d) a tool module for viewing and manipulating images as well as editing the annotation.
Image Processing, Computer-Assisted/instrumentation* ; Radiology Information Systems* ; Software*

BACKGROUND: Vasoconstricting drugs such as dopamine, phenylephrine (PE) and epinephrine constrict normoxic lung vessels preferentially, thereby disproportionately increasing normoxic lung pulmonary vascular resistance (PVR) and inhibit hypoxic pulmonary vasoconstriction (HPV). In this study, we evaluated the effect of PE on HPV and arterial oxygenation. METHODS: This study was performed on 21 patients undergoing thoracotomy. After induction of anesthesia, Swan-Ganz catheter was inserted. After one lung ventilation was started, systolic blood pressure (SBP) of the patient was reduced to 100 mmHg using inhalation anesthetic agent and then the blood pressure was raised up to 140 mmHg by PE infusion. Hemodynamic variables were measured and arterial blood gas was analyzed at the start of one lung ventilation (control), SBP of 100 mmHg and SBP of 140 mmHg. RESULTS: The mean dose of PE infused was 5.9 +/- 3.8 microgram/kg. Infusion of PE did not increase pulmonary vascular resistant index (PVRI) significantly and did not reduce arterial PO2. There was no statistically significant difference in intrapulmonary shunt fraction (Qs/Qt) between the time of low and high blood pressures. CONCLUSION: Pulmonary vasomotor changes induced by PE are minimal and so should not affect the distribution of blood flow during one lung ventilation. On the basis of this result, PE appears to a reasonable vasoconstrictor to be used in patients undergoing thoracotomy.
Anesthesia ; Blood Pressure ; Catheters ; Dopamine ; Epinephrine ; Hemodynamics ; Humans ; Hypertension ; Inhalation ; Lung ; One-Lung Ventilation* ; Oxygen* ; Phenylephrine* ; Thoracotomy ; Vascular Resistance ; Vasoconstriction*

PURPOSE: Prognosis of papillary thyroid carcinoma (PTC) is very favorable, but PTC frequently invade adjacent soft tissue and metastases to cervical lymph node. We evaluated the pattern of cervical neck lymph node metastasis in PTC according to tumor size. METHODS: From August 2005 to January 2009, 353 patients were underwent surgery for PTC. Among these patients, total thyroidectomy with cervical neck lymph node dissection were done in 266 patients. We subdivided patients into four groups according to size and compared the clinicopathologic characters between groups. And we confirmed the factors affecting central neck node metastasis. RESULTS: The mean age of patients of diagnosis was 49.1 years and female to male ratio was 5.8:1. Cervical lymph node metastasis were in 47.0% of the total cases. Cervical lymph node metastases and invasion to adjacent structure increased with tumor size. But, there were no significant differences in tumor size, invasion to adjacent structure, multifocality or bilaterality according to cervical lymph node metastasis. Early diagnostic age and sexuality were significantly related to cervical lymph node metastasis of PTC. CONCLUSION: PTC showed the aggressiveness with increasing tumor size. Tumor size was not related to cervical lymph node metastasis. These findings suggest that tumor size can help treat PTC, can`t be used by prediction factor of cervical lymph node metastasis.
Diagnosis ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Male ; Neck* ; Neoplasm Metastasis* ; Prognosis ; Sexuality ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

No abstract available.
Allografts*

OBJECTIVES: To assess the relationship between ST segment elevation during exercise testing and coronary artery disease. METHODS: Treadmill exercise electrocardiography and coronary angiography were performed in 137 patients with angina with no Q waves. The J point elevation of > 0.03mV(0.3mm) measured from baseline, the elevation of ST segment at 80msec. from J point(ST80) measured larger in lead V1than in aV1, or both the elevation of ST segment at J point and at ST80 developed earlier than or concomitantly with ST depression were considered as abnormal responses. RESULTS: 1) There was no clinical significance of ST elevation in lead aV1. 2) Exercise-induced ST elevation in lead V1occurred in 29 of 137 patients with angina. 3) Abnormal St elevation in V1was detected in 26 of 86 patients with coronary artery disease, for a specificity of 98%. The patients with left anterior descending coronary artery or left main coronary artery stenosis were observed in 3 of 5(60%) patients with single-vessel disease, in 7 of 9(79%) with two-vessel disease, and in 9 of 10(90%) with three-vessel disease. 4) The standard ST depression yielded a specificity of 55% in the patients with isolated or predominant ST depression in inferior leads(II. III, and aVF) and of 81% in the patients with isolated or predominat ST depressin in precordial leads(p<0.001). 5) Abnormal exercise-induced ST elevation in V1was detected in 13 of 39(33%) patients with isolated or predominat ST depression in inferior leads and yielded a specificity of 94% for coronary artery disease. CONCLUSION: Abnormal ST segment elevation in V1may increase the specificity in isolated or predominat ST segment depression in inferior leads and may predict left anterior descending or left main coronary artery disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Electrocardiography ; Exercise Test* ; Hexamethonium ; Humans ; Sensitivity and Specificity

PURPOSE: Current study was designed to understand the personality and emotional composition of patients with chronic constipation. Specifically, the personality differences were evaluated in the ramified subgroups based on the physiologic characteristics. METHODS: Forty patients (31 females and 9 males) of a mean age of 48 (range, 16~86) years underwent the MMPI among 310 patients with chronic constipation. MMPI (Minnesota Multiphasic Personality Inventory) profiles were utilized for psychologic assessment for all patients prior to making diagnosis. Three validity scales of MMPI included L (Lie scale), F (Infrequency scale), K (Suppressor scale). Ten clinical scales included HS (hypochondriasis), DP (depression), HY (hysteria), PD (psychopathic deviant), MF (masculinity- feminity), PA (paranoia), PT (psychasthenia), SC (schizophrenia), MA (mania), SI (social introversion). On the basis of findings with use of anorectal physiologic studies, subgroups were categorized as patients with rectocele (A1, n=22), patient without rectocele (A2, n=18), patients with nonrelaxing puborectalis syndrome (B1, n=10), patients without nonrelaxing puborectalis syndrome (B2, n=30). The MMPI profiles were compared between subgroup patients. RESULTS: In overall patients, mean scores for scales HS, DP were elevated as compared with mean profiles (60~65 and 45~55, respectively). Male patients showed higher mean scores for scale SI than those of female patients (male vs. female; 63.5 vs. 53.9, P<0.05). A1 group showed higher mean scores for PD scale than those of A2 group (A1 vs. A2; 57.4 vs. 49.8, P=0.01). B1 group showed higher mean scores for DP scale than those of B2 group (B1 vs. B2; 67.5 vs. 59.8, P<0.05). CONCLUSIONS: Present series provided that the MMPI is a valuable tool for assessing the psychologic functioning of patients with chronic constipation. It has revealed a different personality and emotional composition in the subgroup patients based on the anorectal physiologic studies. An aspect of social introversion, psychopathic deviant and depression should be emphasized. These findings can provide the fundamental information for guideline of future diagnostic evaluation and therapy in the patients with chronic constipation.
Constipation* ; Depression ; Diagnosis ; Female ; Humans ; Introversion (Psychology) ; Male ; Minnesota* ; MMPI* ; Psychology ; Rectocele ; Weights and Measures

No abstract available.
Colorectal Neoplasms* ; Exons*