No abstract available.

This study has been examined different morphologic measurements in the evaluation of patients with lumbar spinal stenosis. Preoperative CT-Myelography from 30 patients who underwent surgery for central lumbar stenosis were analyzed. Based on this, we concluded as follows : 1) Bony measurement alone did not reliably identify patients with spinal stenosis. 2) Measurement of the transverse area of the dural sac on CT-Myelography was the most accurate method for identifying stenosis. 3) Lumbar myelography was still considered to have an important role in the valuation of a patient with stenosis because of correlation between the cross-sectional area of the dural sac and the anteroposterior diameter of the dural sac was excellent. 4) We identified soft-tissue problems as the main cause of stenosis. 5) The most common level of maximum stenosis was L4-5.
Constriction, Pathologic ; Humans ; Myelography* ; Spinal Stenosis*

OBJECTIVES: Advance directives (AD) are designed to protect patients’ autonomy and self-determination, which mean the end of life care planning should precede before loss of their decision ability. We aimed to analyze our experience of AD at field of oncology, focusing on preference of end-of-life care and outcome in advanced cancer patients. METHODS: A retrospective review was conducted on advanced cancer patients who underwent AD at the department of Oncology of Hanil General Hospital, between April 2013 and January 2014. AD are composed of decision about end of life care (resuscitation, ventilator, artificial tube feeding) and determination of proxy. RESULTS: Among 23 patients who were recommended AD during study period, 19 patients (83%) successfully underwent AD. The median age was 67 years (range, 50 to 95 years) and male was predominance (84%) was observed. Most of them (90%) have not heard of AD in the past. With regard to decision of end-of-life care, decision for resuscitation and ventilator were selected only by 1 patient (5%), respectively, while 10 patients (52%) decided to receive tube feeding. Among 5 patients who underwent AD during chemotherapy, there was neither transfer to other hospital for anti-cancer treatment nor follow up loss. CONCLUSION: AD might be applicable in advanced cancer patients at field of oncology, including also patients treated with palliative chemotherapy.
Advance Directives* ; Drug Therapy ; Enteral Nutrition ; Follow-Up Studies ; Hospitals, General ; Humans ; Male ; Proxy ; Resuscitation ; Retrospective Studies ; Terminal Care ; Ventilators, Mechanical

PURPOSE: Postoperative hypocalcemia is a common complication compared with the other complications following total thyroidectomy due to thyroid carcinoma. We evaluated the incidence of transient and permanent hypocalcemia and the preservation status of the parathyroid glands following total thyroidectomy due to thyroid carcinoma. METHODS: We analyzed a total of 145 cases of total thyroidectomy due to thyroid carcinoma. The preservation status of the prarathyroid glands after total thyroidectomy was classified as intact preservation or ischemic change, according to the number of intact preserved parathyroid glands in group 1 (more than 2), group 2 (1) or group 3 (0). RESULTS: Permanent hypocalcemia was not found in group 1. The rate of transient or permanent hypocalcemia was significantly lower in group 2 than that in group 3 (P< 0.05). CONCLUSION: The parathyroid glands should be preserved to minimize the occurrence of hypocalemia after performing total thyroidectomy. The number of intact preserved parathyroid glands can be a good indicator for predicting the occurrence of post-total thyroidectomy hypocalcemia.
Humans ; Hypocalcemia* ; Incidence ; Parathyroid Glands ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*

PURPOSE: It is not common to evaluate the response of the fractionated stereotactic radiotherapy (SRT) to primary hepatoma as compared with conventional radiotherapy. The purpose of the study was to take the preliminary result on the clinical trial of primary hepatoma by SRT. MATERIALS AND METHODS: From July 1999 to March 2000, thirty three patients were hospitalized in the St. Mary's Hospital, and treated with SRT for extracranial tumors. Among them, 13 patients were diagnosed to primary hepatoma and then applied by frameless SRT using 6 MV linac accelerator. There were 12 male and 1 female patients. They had the age of 44~66 year old (median : 59) and the tumor size of 10~825 cc (median : 185 cc). SRT was given to them 3~5 fractions a week (5 Gy/fraction, 90% isodose line) for 2~3 weeks. Median dose of SRT was 50 Gy and the range was 30~50 Gy. RESULTS: Follow-up period ranged from 3 months to 13 months with median of 8 months. After treating SRT to thirteen patients with primary hepatoma, the response of the tumor was examined by abdominal CT : they are classified by 1 complete regression (7.7%), 7 partial regression (53.8%), 4 minimal regression (30.8%), 1 stable disease (7.7%). The positive responses more than partial remission were 8 patients (61.5%) after the treatment. The level of serum alpha-fetoprotein (AFP) after the treatment as compared with pretreatment had been 92.3% decreased. There was no severe complication except dyspepsia 84.6%, mild nausea 69.2%, transient decreased of hepatic function 15.4% and fever 7.7%. CONCLUSION: SRT to the patients with primary hepatoma was potentially suggested to become the safe and more effective tool than the conventional radiotherapy even though there were relatively short duration of follow-up and small numbers to be tested.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Dyspepsia ; Female ; Fever ; Follow-Up Studies ; Humans ; Male ; Nausea ; Radiotherapy* ; Tomography, X-Ray Computed

Differential diagnosis of invasive aspergillosis from other pulmonary fungal infections including mucormycosis is important because the treatment is pathogen-dependent. Clinically, invasive aspergillosis is often discriminated from other mold infections on the basis of typical histopathologic features in the biopsy specimen. However, biopsy alone is not always complete because different fungal species can display similar histopathologic features. Surrogate markers or molecular-based assays can be useful when the results of conventional diagnostic modalities are conflicting. Here, we present a case of invasive pulmonary aspergillosis histologically mimicking mucormycosis, which was confirmed by fungal polymerase chain reaction.
Aspergillosis ; Biomarkers ; Biopsy ; Diagnosis, Differential ; Fungi ; Invasive Pulmonary Aspergillosis* ; Lung Diseases, Fungal ; Mucormycosis* ; Polymerase Chain Reaction

Primary rectal lymphoma is a rare disease among the gastrointestinal (GI) lymphoma. In particular, diffuse large B-cell lymphoma (DLBCL) transformed from mucosa-associated lymphoid tissue (MALT) lymphoma is often the primary type of GI lymphoma, mostly in stomach or duodenum, but has never been reported in rectum. Here we report an unusual case in which a 75-year-old male patient diagnosed with DLBCL transformed from MALT lymphoma in the rectum. The patient was diagnosed as rectal DLBCL transformed from MALT lymphoma as Lugano stage II2 and was treated with chemotherapy (R-CHOP) with CD-20 monoclonal antibody (rituxaimb). Complete remission of multiple lymphadenopathy and mass forming ulcer of the rectum was achieved after 6 cycles of R-CHOP. He has been free from disease for 12 months.
Aged ; B-Lymphocytes* ; Drug Therapy ; Duodenum ; Humans ; Lymphatic Diseases ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone* ; Male ; Rare Diseases ; Rectum ; Stomach ; Ulcer

We present a case of subacute cutaneous lupus erythematosus which fulfilled the criteria of systemic lupus erythematosus in a 52-year-old woman with annular and polycyclic erythematous patches on the neck and upper part of the anterior chest. She complained malar of resh, arthralgia, general weakness, and severe headache. Laboratory findings showed hematologic, serologic, central nervous system, and nephrologic abnormalities. Serologic abnormalities of this patient were positive anti-nuclear antibody, anti-La antibody, rhematoid factor, anti-RNP antibody and anti-platelet antibody, but anti-dsDNA and anti-Ro antibody test were negative. She was treated with oral prednisolone and intravenous cyclophosphamide. In the course of treatment, sepsis developed and she died from multi-organ system failure.
Arthralgia ; Central Nervous System ; Cyclophosphamide ; Female ; Headache ; Humans ; Lupus Erythematosus, Cutaneous* ; Lupus Erythematosus, Systemic ; Middle Aged ; Neck ; Prednisolone ; Sepsis ; Thorax

PURPOSE: This study was aimed to compare skin entrance dose of digital radiography with that of film radiography and to show the dose reduction achievement with digital systems at 11 dental schools in Korea. MATERIALS AND METHODS: Forty six intraoral radiographic systems in 11 dental schools were included in this study. Digital sensors were used in 33 systems and film was used in 13 systems. Researchers and the volunteer visited 11 dental schools in Korea. Researchers asked the radiologic technician (s) at each school to set the exposure parameters and aiming the x-ray tube for the periapical view of the mandibular molar of the volunteer. The skin entrance doses were measured at the same exposure parameters and distance by the technician for each system with a dosimeter (Multi-O-Meter : Unfors instruments, Billdal, Sweden). RESULTS: The median dose was 491.2micronGy for digital radiography and 1, 205.0 microGy for film radiography. The skin entrance dose in digital radiography was significantly lower than that of film radiography (p< 0.05). CONCLUSIONS: Fifty-nine percent skin entrance dose reduction with digital periapical radiography was achieved over the film radiography in Korean dental schools.
Humans ; Korea ; Molar ; Radiographic Image Enhancement ; Radiography* ; Schools, Dental* ; Skin* ; Volunteers

We report a case of meningeal hemangiopericytoma presenting as metastasis in the vertebral body and pedicle of the thoracic spine. Hemangiopericytoma is a rare vascular neoplasm. Although the tumor has a strong propensity for both local recurrence and extracranial metastasis, metastasis to thoracic spine is very rare and only two cases were found in the literature. A 44-year-old woman with paraparesis and pain in the thoracic and lower legs was examined by plain radiographs and magnetic resonance imaging. The intracranial hemangiopericytoma was operated 3 years ago. Magnetic resonance imaging demonstrated a tumor invading the left vertebral body and pedicle of the 11th thoracic spine, and compressing the dural sac. The patient was gradually improved after surgical removal of the lesions and the histologic findings were characteristics of hemangiopericytoma.
Adult ; Female ; Hemangiopericytoma* ; Humans ; Leg ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Paraparesis ; Recurrence ; Spine* ; Vascular Neoplasms