PURPOSE: We performed a retrospective study to compare the accuracy between conventional CT staging and intraoperative staging for advanced gastric cancer. MATERIALS AND METHODS: Sixty patients with advanced gastric cancer were included in this study during the recent 2 year-period. All were pre- and posto- peratively diagnosed as advanced gastric cancer. CTwas performed with G E 9800 and Somatom DR3 under conventional technique in 50 and with others in 10 referred patients. The CT staging for T and N category with emphasis on incurable factor, if not resacted, were performed. And we compared the accuracy between conventional CT and intraoperative staging. The final histo-pathologic staging was used as a gold standard. RESULTS: Accuracy of CT and operation for T4(n=l7) factor is 76.9 % and 86.2 % respectively. Overestimation rate for T4 was 9.3 % by CT and 6.1% by operation, and underestimation rate for was 13.8 % and 7.7 % respectively. Accuracy of CT and operation for N (n=60) factor was 50 % and 60 % respectively. Overestimation rate for N factor was 18.3 % by CT and 18.3 % by operation, and underestimation rate for N factor was 31.7 % and 21.7 % respectively. Correct Tand IM staging was possible only in 33% by CT and 38% by intraoperative assessment. CONCLUSION: Conventional CT and intraoperative staging for incurable T/N factor in advanced gastric cancer have a potential limitations, especially for N factor. Therefore, more reliable modality or technique such as dynamic scanning by spiral CT, transabdominal or endoscopic ultrasonography should be preoperatively performed to complement infrequent errors in intraoperative staging. Furthermore, a histology-oriented surgical approach seems essential in selecting the most appropriate surgical procedure.
Complement System Proteins ; Endosonography ; Fibrinogen ; Humans ; Retrospective Studies ; Stomach Neoplasms* ; Tomography, Spiral Computed

Cystic mesothelioma of the peritoneum is a very rare tumor which has a clinically and histologically benign nature. It occurs predominantly in young to middle-ged women and tends to recur locally. It affects chiefly the pelvic peritoneum-articularly the cul-e-ac, uterus, and rectum. We report a case of cystic mesothelioma of the visceral peritoneum which was located anterior to the ascending colon. A 54-ear-ld female patient visited our hospital with a palpable tender mass in the right flank. A computed tomographic scan of the abdomen showed a multicystic mass with an enhancing wall and septum in front of the ascending colon. The patient underwent a right hemicolectomy, and the mass was completely removed. Grossly, the tumor consisted of a multilocular cyst containing clear, serous, or gelatinous fluid and partially solid areas. Microscopically, the solid areas were composed of fibrous tissue, and the lining cells varied from flattened to cuboidal cells with a strong positive reactivity for cytokeratin and mild positive reactivity for epithelial membrane antigen on immunohistochemical staining. These findings suggest that the tumor was mesothelial in origin.
Abdomen ; Colon* ; Colon, Ascending ; Female ; Gelatin ; Humans ; Keratins ; Mesothelioma, Cystic* ; Mucin-1 ; Peritoneal Neoplasms ; Peritoneum ; Rectum ; Uterus

An anomalous left coronary artery from the pulmonary artery(Bland-White-Garland syndrome) is a rare congenital malformation and sometimes fatal. It is caused by an abberant endothelial budding from or an anomalous division of the truncus arteriosus. Echocardiography (transthoracic and transesophageal) and angiographical imaging are essential for the diagnosis of this anomaly. Corrective Surgery is recommended due to its fatal natural course. A case was diagnosed in a 45-year-old man who presented with intermittent palpitation. This patient was successfully treated with closure of anomalous left coronary artery orifice combined with right saphenous vein graft anastomosis.
Bland White Garland Syndrome ; Coronary Vessels* ; Diagnosis ; Echocardiography ; Humans ; Middle Aged ; Pulmonary Artery* ; Saphenous Vein ; Transplants ; Truncus Arteriosus

STUDY DESIGN: A review of all presentations at the Korean Society of Spine Surgery(KSSS) congress from 2001 to 2005. OBJECTIVES: To determine the presentation to publication rate in peer-reviewed journals of abstracts presented at the KSSS congress and evaluate the consistency between the presented abstract and published full-text counterpart. SUMMARY OF LITERATURE REVIEW: The rate of publication for presentation at international meetings has been determined but there has been no study for the KSSS. MATERIAL AND METHODS: This study reviewed all podium presentations of the past KSSS Spring and Fall meetings from 2001 to 2005. A computer search for each abstract was performed. The final published journal, time to publication and publication rate were evaluated according to subspecialty. The published full-text article was compared with the original abstract and evaluated for consistency with respect to the author, material and method, and result. RESULTS: A total of 288 free-papers were identified, of which 167 of them were published as full-text articles. The mean time to publication was 12.15 months. The publication rates according to the subspecialty were basic 67%, lumbar 68%, cervical 64%, deformity 50%, trauma 53%, minimal 14% and others 51%, respectively. CONCLUSION: The presentation to publication rate of the Korean society of spine surgery podium presentations was lower than other international meetings but the articles showed a high consistency rate.
Congenital Abnormalities ; Publications ; Spine

BACKGROUNDS AND OBJECTIVES: The direction of caloric nystagmus depends on the head position as long as vestibular function is remaining but the it does not depend on head position change in the lateral semicircular canal (SCC) plugged ear, which is attributed to thermoconvection in the lateral SCC. So determination of head position dependency using ice water test is recommended in the evaluation of peripheral vestibulopathy in which dead labyrinth is suspected. Since ice water test in prone position is frequently skipped and neglected in many vestibular laboratories, we investigated the importance and necessity of evaluating head position dependency for the candidates of ice water test and estimated the amount of head position non-dependent component in discussion. MATERIALS AND METHOD: From January through September 2003, 25 patients, who showed no nystagmus during warm irrigation, were included in this study. Following forty milliliter of ice water irrigation in supine & prone position, the maximum slow phase eye velocity (SPEV) and direction of nystagmus were assessed using video nystagmography system. RESULT: Eleven cases showed head-position dependency and were interpreted as hypofunction of lateral SCC. Fourteen cases did not show head position dependency suggesting the absence of end organ function. However, in the latter group, 6 patients, who showed definite nystagmus to ice water irrigation in supine position, can be midinterpreted as hypofunction if ice water test in prone position is not performed. CONCLUSION: Evaluation of head position dependency in ice water irrigation is an important procedure in the determination of lateral SCC function and can provide valuable information when vestibular ablative procedures are considered.
Caloric Tests ; Convection ; Ear ; Ear, Inner ; Head* ; Humans ; Ice* ; Nystagmus, Physiologic ; Prone Position ; Semicircular Canals ; Supine Position ; Water*

BACKGROUND AND OBJECTIVES: The purposes of this study was to investigate the characteristics of gentamicin-induced vestibulotoxicity of s otolith organs by assessing the results of earth vertical and the off-vertical axis rotation tests with a morphologic study. MATERIALS AND METHODS: Rabbits were grouped into two groups, ototoxic and ototoxic prevention group. Vestibulotoxicity was induced by injecting gentamicin (GM) into the peritoneum. Prevention of the vestibulotoxicity was studied by injecting NMDA receptor inhibitors (MK-801), iron chelating agents (deferoxamine) peritonially, and osmotic pumps filled with neurotrophic factors (GDNF, BDNF), respectively. The animal rotation system was designed to rotate the animal sinusoidally or in velocity step (constant velocity) rotation. Off-vertical rotation was applied to evaluate the otolithic function. Scanning electron microscopy were examined for the structural changes of the otolithic organs. RESULTS AND CONCLUSIONS: GM-induced vestibulotoxicity was confirmed by gain decreasing in the earth vertical SHA rotation test and bias decreasing in the off-vertical rotation test. However, changes in modulation was not definite. Bilateral prevention of GM-induced vestibulotoxicity was confirmed by systemic injection of deferoxamine and MK-801, and characteristics of unilateral prevention was confirmed by local application of the neurotrophic factors using osmotic pumps. In the SEM study, the GM-induced hair cell damages of the vestibule were identified, which was prevented by the preventive drugs. The reduction of bias value without change of modulation was comparable with the reduction of gain in the earth vertical axis rotation after GM-induced vestibulotoxicity.
Rabbits ; Animals ; Drug Toxicity

Salivary gland choristoma (ectopic or heterotopic salivary gland tissue) is a rare condition that occurs in various locations within the head and neck regions. A choristoma is a non-neoplastic proliferation of histologically normal tissue that forms at an abnormal site. It appears to be a developmental abnormality and may be associated with abnormalities of adjacent structures. Salivary gland choristoma in the middle ear usually occurs with unilateral conductive hearing loss and requires a differential diagnosis from other mass lesions in the middle ear cavity. Because the lesions commonly involve the facial nerve, intraoperative facial nerve monitoring is helpful for allowing safe biopsy without facial nerve damage. We present two cases of salivary gland choristoma in the middle ear with a review of the literature.
Biopsy ; Choristoma* ; Diagnosis, Differential ; Ear, Middle* ; Facial Nerve ; Head ; Hearing Loss, Conductive ; Neck ; Salivary Glands*

About one-third of radiologically indeterminate solitary pulmonary nodules (SPN) are eventually turned out to be malignant. It is very important to noninvasively determine whether the SPN is malignant or not for the decision of its way of management. PET imaging is highlighted by its unique ability of imaging the function and metabolism of cells. Glucose metabolism is increased in malignant transformed cells. We performed FDG-PET studies in patients who ha radiologi- cally indeterminate SPN and compared the findings with histologic diagnoses to assess the diagnostic accuracy in the detection of malignancy and to decide which parameter is the most suitable for clinical practice among peak SUV (pSUV), average SUV (aSUV), 50/10 ratio, and time-activity curve (TAC). Thirty patients were included in this study and the most useful parameter was pSUV. The sensitivity and specificity in the detection of malignant SPN using 3.5 as a cut off pSUV were both 87%. Interestingly, all 2 false-negative cases were bronch- ioloalveolar carcinoma on histologic examination. If these cases, which could be strongly suspected by CT findings, were excluded, the sensitivity of pSUV was 100%. In conclusion, PET imaging is very helpful for determining malignancy in indeterminate SPN and pSUV is a conveniently measurable parameter which is valuable for interpretation.
Diagnosis ; Glucose ; Humans ; Metabolism ; Positron-Emission Tomography ; Sensitivity and Specificity ; Solitary Pulmonary Nodule*

A 14-year old boy was admitted with stuporous mentality. CT scan, MRI and cerebral angiogram revealed SAH and a giant aneurysm of right middle cerebral artery(4x5x5.3cm). To minimize surgical risk, endovascular treatment was done with MDS(mechanical detachable system)-spiral coil. Follow up MRI showed intraluminal thrombus formation of the aneurysm.

BACKGROUND/AIMS: Chronic hepatitis B infection is a common cause of secondary membranous nephropathy (MN) in endemic areas. Lamivudine treatment improves renal outcome in patients with hepatitis B virus-associated MN (HBV-MN), but prolonged use leads to the emergence of lamivudine-resistant variants. We describe our experience treating lamivudine-resistant and other strains of HBV-MN with new antiviral drugs. METHODS: Of the 89 patients biopsied and diagnosed with MN from 1996 to 2011, 10 positive for hepatitis B surface antigen were recruited for this study. We investigated the clinical courses, therapeutic responses, and prognoses of patients with HBV-MN. RESULTS: The incidence of HBV-MN among the original 89 patients was 11.2%. Of these patients, four were treated with supportive care and six with antiviral drugs. One of the four patients treated with supportive care had a spontaneous remission. Four of the six patients treated with antiviral drugs were given lamivudine, and the other two were given entecavir. Two of the four patients treated with lamivudine achieved complete remission with seroconversion (i.e., development of anti-hepatitis B e antigen antibodies), whereas the other two had lamivudine-resistant strains, which were detected at 22 and 23 months after lamivudine treatment, respectively. We added adefovir to the treatment regimen for one of these patients, and for the other patient we substituted clevudine for lamivudine. Both of these patients experienced complete remission, as did the two patients initially treated with entecavir, neither of whom showed resistance to the drug. CONCLUSIONS: New nucleoside analogues, such as entecavir, adefovir, and clevudine, can be effective for treatment of HBV-MN, including lamivudine-resistant strains.
Adenine/analogs & derivatives/therapeutic use ; Adult ; Antiviral Agents/*therapeutic use ; Arabinofuranosyluracil/analogs & derivatives/therapeutic use ; Drug Resistance, Viral ; Female ; Glomerulonephritis, Membranous/*drug therapy/*etiology ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B, Chronic/*complications/*drug therapy ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Organophosphonates/therapeutic use ; Young Adult