No abstract available.
Atrial Fibrillation* ; Heart* ; Thoracic Surgery*

PURPOSE: Docetaxel-based chemotherapy (DTX) improves overall survival (OS) of men with metastatic castration-resistant prostate cancer (mCRPC). Considering the potential existence of androgen receptors that remain active at this stage, we aimed to assess the impact of the combined use of androgen deprivation therapy (ADT) with DTX for mCRPC. MATERIALS AND METHODS: We performed a single-institutional retrospective analysis of patients with mCRPC who received either DTX alone (DTX group, n=21) or concurrent DTX and ADT (DTX+ADT group, n=26) between August 2006 and February 2014. All patients received DTX doses of 75 mg/m2 every three weeks for at least three cycles. In the DTX+ADT group, all patients used luteinizing hormone releasing hormone agonist continuously as a concurrent ADT. RESULTS: The median follow-up period was 24.0 months (interquartile range 12.0-37.0) for the entire cohort. The median radiographic progression-free survival (rPFS) was 9.0 months and 6.0 months in the DTX+ADT and DTX groups, respectively (log-rank p=0.036). On multivariable Cox regression analysis, concurrent administration of ADT was the only significant predictor of rPFS [hazard ratio (HR)=0.525, 95% confidence intervals (CI) 0.284-0.970, p=0.040]. The median OS was 42.0 and 38.0 months in the DTX+ADT and DTX groups, respectively (log-rank p=0.796). On multivariable analysis, hemoglobin level at the time of DTX initiation was associated with OS (HR=0.532, 95% CI 0.381-0.744, p<0.001). CONCLUSION: In chemotherapy-naive patients with mCRPC, the combined use of ADT with DTX improved rPFS. Our result suggests that the concurrent administration of ADT and DTX is superior to DTX alone.
Adenocarcinoma/blood/*drug therapy/secondary ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Disease-Free Survival ; Gonadotropin-Releasing Hormone/administration & dosage/agonists ; Hemoglobins/metabolism ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms, Castration-Resistant/blood/*drug therapy/pathology ; Retrospective Studies ; Survival Rate ; Taxoids/administration & dosage

No abstract available.
Arrhythmias, Cardiac* ; Heart* ; Thoracic Surgery*

Fluorescein retinal angography has been used in order to make differential diagnosis between true papilledema and pseudopapilledema, and to make early confirmation of the incipient papilledema. After injection of 5 cc of 10% fluorescein sodium into antecubital vein, the fluorescein retinal angiographic findings of 6 normal adults and 17 papilledematous patients of the brain tumor were obtained by Zeiss fundus camera(exciter filter:Kodak Wratten 47 A, barrier filter:Schott GG 14). 1. The characteristic findings of papilledema in the disc are: a. Leakage of fluorescein from capillaries and persistence of the fluorescence till late stage. b. Capillary dilatation. c. Microaneurysm. 2. The massive leakage of the fluorescen is seen in the patients of the 3 rd ventricular or posterior fossa tumors. 3. The decreased visual acuity is prominent in the patients showing marked capillary dilatation and microaneurysm.
Adult ; Brain Neoplasms* ; Brain* ; Capillaries ; Diagnosis, Differential ; Dilatation ; Fluorescein* ; Fluorescence ; Humans ; Infratentorial Neoplasms ; Papilledema* ; Retinaldehyde ; Veins ; Visual Acuity

Conray ventriculography is a method for the roentgenographic visualization of the cerebral ventricular system with meglumine iothalamate 60%(Conray). Although it has been known that ventriculography using Conray 60% offers definite advantages compared to that with other contrast media and untoward reactions have been reported as mild and transitory ones, a significant disadvantage is the possible development of seizures. Recently we had performed Conray ventriculogrqaphy and analized their untoward reactions in 25 cases which were previously proved hydrocephalic by cerebral angiographies, from march, 1973 to August, 1974. They included twenty cases of brain tumor and five cases of hydrocephalus. Untoward reactions were analized with respect to the different concentration of the contrast media used, communicating or noncommunicating pathway of the cerebrospinal fluid and the different sites of obstruction in the cerebrospinal fluid pathway. The results were as follows: 1. Headache and convulsion were more frequently observed in cases of ventriculography using undiluted Conray. 2. High frequency of vomiting was observed in cases with communicating pathway of the cerebrospinal fluid. 3. There seemed to be no difference in untoward reactions between the levels of obstruction in the cerebrospinal fluid pathway.
Brain Neoplasms ; Cerebral Angiography ; Cerebrospinal Fluid ; Contrast Media ; Headache ; Hydrocephalus ; Iothalamate Meglumine ; Seizures ; Vomiting

Presented below are the author's report of the result of surgical treatment of 53 intramedullary gliomas. In the analysis of survival data, twenty patients with low grade glioma(except the ependymoma) were followed for a period of mean 54 months, from 1 to 103 months. Five of these patients had died from progression of the disease and the 5 year survival rate was 75%. Nine patients from the above group received postoperative radiation therapy, 6 with no apparent benefit in terms of survival rate. The median survival of thirteen patients with high grade glioma patients were 11 months and there were significant increase of median survival time in patients receiving radiation therapy, from 4 to 17 months(P=0.04). The histological grade is the important factor in determining the survival of glioma patients(P=0.01). In sixteen, out of 20 ependymoma patients, 'radical removal(>95%)' was achieved and the patients showed no signs of recurrence until the mean follow-up period of 42 months. Two of the 4 ependymoma patie nts, whose tumors were partially removed, suffered recurrence and had to be re-operated. We concluded that the 'radical removal' in ependymomas is a significant factor in determining recurrence(P=0.009). The effect of radical removal on survival is not verified statistically. Total removal is more frequently performed in ependymomas than in gliomas(p=0.03). As to functional outcome, better outcome is expected in radical removal on long-term follow-up(p=0.00506), more so in ependymoma than in glioma. Intramedullary gliomas are extremely rare. Therefore sufficient data is unavailable for the determination of efficient treatment plan. However, recently aggressive surgical treatment with the aid of microsurgical techniques has become a trial option.
Ependymoma ; Follow-Up Studies ; Glioma ; Humans ; Recurrence ; Survival Rate

PURPOSE: To determine the findings of diffusion-weighted magnetic resonance (MR) imaging of acute and chronic benign compression fracture, metastatic compression fracture, and spondylitis, and to differentiate between them. MATERIALS AND METHODS: Forty-nine cases with vertebral compression fractures (17 metastatic, 16 acute osteo-porotic, 11 old osteoporotic, 5 acute traumatic) and seven with spondylitis (4 tuberculous, 3 pyogenic) underwent MR imaging. All cases were classified as belonging to one of four groups: A: acute osteoporotic and traumatic, B: metastatic, C: old osteoporotic, or D: spondylitic. For MR imaging, a 1.5-T scanner (Magnetom Vision, Siemens, Erlangen, Germany) was used, and the diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF) and a relatively low b value of about 150 sec/mm 2. Signal intensity characteristics were evaluated in terms of the contrast ratio (CR) and signal-to-noise ratio (SNR) of bone marrow. RESULTS: Diffusion-weighted MR imaging showed that signal intensity in group A was hypointense to adjacent normal vertebral bodies, but in group B, hyperintensity was noted. In group C, signal intensity was variable, while in group D, hyperintensity was again noted. Diffusion-weighted imaging revealed that in group A, bone marrow CR had a negative value, while in groups B and D, this value was positive (p < .01). The SNR of group D was lower than that of group B, but the difference was not statistically significant (p > .01). CONCLUSION: Diffusion-weighted MR imaging revealed that the signal intensity of metastatic compression fracture and spondylitis was hyperintense to adjacent normal vertebral bodies, that of acute benign compression fracture was hypointense, and that of chronic benign compression fracture was variable. This modality is therefore useful for differentiating between metastatic compression fracture, spondylitis and acute benign compression fracture.
Bone Marrow* ; Fractures, Compression* ; Magnetic Resonance Imaging* ; Signal-To-Noise Ratio ; Spine* ; Spondylitis*

The surgical management of patients with unruptured intracranial aneurysm continues to be controversial. To provide current data about surgical outcome of patients with unruptured intracranial aneurysm, we retrospectively reviewed 494 consecutive intracranial aneurysm patients who underwent surgery between January 1990 and May 1995. Among these 494, 16 patients with unruptured aneurysms were evaluated; those with unruptured aneurysm associated with ruptured aneurysm or arteriovenous malformation were excluded. Mode of presentation, location and size of aneurysm, surgical method and complications, and surgical result were analyzed. Evaluation revealed four patients with asymptomatic and 12 with symptomatic unruptured aneurysm. Of these 12, seven presented with mass effect, four with headache, and one with cerebral infarction. The aneurysms were located in the internal carotid artery(n=8), the middle cerebral artery(n=3), the vertebral artery(n=3), the anterior communicating artery(n=2), and the basilar artery(n=2). They ranged in size from smaller than 10mm to larger than 25mm(<10mm: 10 cases, 10-25mm: 5 cases, >25mm: 1 case). An excellent or good outcome was achieved in 12 patients, including four with asymptomatic intracranial aneurysm. In three patients there were complications or sequelae and one died due to premature rupture of the aneurysm. We concluded that in patients harboring an unruptured intracranial aneurysm, aggressive early detection and surgical treatment may improve the outcome by preventing the devastating effects of subarachnoid hemorrhage.
Aneurysm* ; Aneurysm, Ruptured ; Arteriovenous Malformations ; Cerebral Infarction ; Headache ; Humans ; Intracranial Aneurysm ; Natural History ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage

OBJECTIVES: Decreased renal function is associated with increased cardiovascular risk. Our study was planned to verify the association of decreased renal function and subclinical coronary atherosclerosis in postmenopausal women. METHODS: We performed a retrospective review of 251 Korean postmenopausal women who visited the health promotion center for a routine health checkup. Estimated glomerular filtration rate (eGFR) was used to show renal function, which was estimated by calculated using the Cockcroft-Gault (CG) and the modification of diet in renal disease (MDRD) formulas. Coronary atherosclerosis was assessed by 64-row multidetector computed tomography. RESULTS: Women with reduced eGFR (< 60 mL/minute/1.73 m²) had significantly higher brachial-ankle pulse wave velocity (baPWV) than women with normal eGFR (≥ 60 mL/minute/1.73 m²). The eGFR was negatively correlated with baPWV (r = -0.352, P < 0.001), significantly. The eGFR was lower in women with coronary atherosclerosis than in normal control women, markedly. Reduced eGFR was significantly associated with the presence of coronary atherosclerosis (odds ratio [OR] = 7.528, 95% confidence interval [CI] = 2.728-20.772, P < 0.001). CONCLUSIONS: Decreased eGFR was closely associated with increased arterial stiffness and coronary atherosclerosis in postmenopausal women. Evaluating subclinical atherosclerosis by screening the renal function in postmenopausal women may be helpful screening high risk group and considering starting menopausal hormone therapy before atherosclerosis development.
Atherosclerosis ; Coronary Artery Disease* ; Diet ; Female ; Glomerular Filtration Rate ; Health Promotion ; Humans ; Kidney Function Tests ; Mass Screening ; Multidetector Computed Tomography ; Postmenopause ; Pulse Wave Analysis ; Retrospective Studies ; Risk Factors* ; Vascular Stiffness

OBJECTIVE: To identify the prognostic factors for predicting spontaneous pregnancy after laparoscopic surgical treatment of endometriosis. METHODS: Retrospective analysis was performed in 82 patients who underwent elective laparoscopic surgery with subsequent pathological confirmation of the endometriosis at Gangnam Severance Hospital from January 2003 to March 2008. We investigated the spontaneous pregnancy rate during the 12 months following surgical treatment and administration of Gonadotropin-Releasing Hormone agonist (GnRH agonist). Factors associated with clinical characteristics, blood tests and operative findings were compared with pregnant and non-pregnant women. RESULTS: The number of patients succeed to spontaneous pregnancy was 32 and failed to pregnancy was 50. Cumulative pregnancy rate was 39.02%. Mean pregnancy duration after surgical treatment was 5.96+/-3.43 months. r-AFS stage or grouping into two stages (mild/severe) (P=0.018), r-AFS score (P=0.008) and cul-de-sac obliteration (P=0.038) was significantly different between pregnant and non-pregnant group. Complete cul-de-sac obliteration was the independent factor of pregnancy failure in women with endometriosis after laparoscopic surgery. CONCLUSION: Complete cul-de-sac obliteration may be the important factors for predicting spontaneous pregnancy outcome in women with endometriosis after laparoscopic surgical treatment.
Endometriosis ; Female ; Gonadotropin-Releasing Hormone ; Hematologic Tests ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies