No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Diabetic Foot*

We report a case of thoracic post-herpetic neuralgia which was improved by dorsal root ganglionectomy. The patient had failed to obtain adequate pain relief from conservative therapy such as carbamazepine, amitriptyline, thioridazine, gabapentin, and transcutaneous lidocaine infiltration. Thoracic dorsal root ganglionectomy from T5 to T7 on left side was performed and satisfactory pain relief without significant postoperative neurologic deficit was achieved. Although dorsal root entry zone operation for refractory pain was the most commonly performed procedure in past, dorsal root ganglionectomy is an alternative anatomically and technically safe procedure for the pain in the thoracic lesion. The clinical feature, operative technique and clinical result are presented with review of the literatures.
Amitriptyline ; Carbamazepine ; Ganglionectomy* ; Humans ; Lidocaine ; Neuralgia* ; Neurologic Manifestations ; Pain, Intractable ; Spinal Nerve Roots ; Thioridazine

A 51-year-old Korean woman presented with a non-tender, well-demarcated, reddish, edematous patch on the right anterior chest where a previous mastectomy and radiation therapy had been performed. She had been diagnosed as having infiltrating ductal carcinoma of the right breast about 1 year ago. Histopathological findings of the skin lesions were consistent with inflammatory metastatic carcinoma of the breast. Inflammatory carcinoma or carcinoma erysipeloides is a well-established entity most frequently associated with carcinoma of the breast. It is characterized by dermal lymphatic invasion by malignancy and clinically should be distinguished from erysipelas or cellulitis. We describe a case of inflammatory metastatic carcinoma derived from an infiltrating ductal carcinoma of the breast which can be clinically confused with radiation dermatitis.
Breast* ; Carcinoma, Ductal ; Cellulitis ; Dermatitis ; Erysipelas ; Erysipeloid ; Female ; Humans ; Mastectomy ; Middle Aged ; Skin ; Thorax

PURPOSE: The objective of this study was to determine the factors affecting the time to recurrence after radical nephrectomy for localized renal cell carcinoma. MATERIALS AND METHODS: We retrospectively evaluated 321 patients who received radical nephrectomies for localized renal cell carcinoma (pT1a-pT2b N0M0). Of 29 patients with disease recurrence, 9 had recurrence more than 5 years after radical nephrectomy. We evaluated the clinicopathological factors, with the use of a retrospective study design. RESULTS: Tumor necrosis was statistically different between the late recurrence group and the recurrence free group (Fisher exact test, p=0.046). Hematuria at diagnosis (chi-square test, p=0.045) was statistically significant in early recurrence. In the univariate logistic regression analysis, tumor necrosis (odds ratio [OR], 4.629; 95% confidence interval [CI], 1.106 to 19.379; p=0.036) and pT stage>1 (OR, 7.232; 95% CI, 1.727 to 30.280; p=0.007) were risk factors of late recurrence. In the multivariable logistic regression analysis, pT stage>1 (OR, 7.143; 5% CI 1.706 to 29.912, p=0.007) was associated with late recurrence. Regarding early recurrence, initial symptoms at diagnosis and pathologic T stage>1 were statistically significant in both univariate and multivariable logistic regression analysis. In terms of recurrence site, patients with late recurrence tended to have unusual metastasis sites other than lung, liver or bone (chi-square test, p=0.012). CONCLUSIONS: These data suggest that tumor necrosis may affect late disease recurrence. Patients with initial symptoms and hematuria at diagnosis are vulnerable to recurrence in a shorter period after nephrectomy. Patients with late recurrence showed a tendency to have unusual metastasis site other than lung, liver or bone.
Carcinoma, Renal Cell* ; Disease-Free Survival ; Hematuria ; Humans ; Liver ; Logistic Models ; Lung ; Necrosis ; Neoplasm Metastasis ; Nephrectomy* ; Recurrence* ; Retrospective Studies ; Risk Factors

PURPOSE: To determine the usefulness of fluid attenuated inversion recovery(FLAIR) imaging for the in detection of high signal intensity of hippocampus or amygdala in mesial temporal sclerosis (MTS), compared with that of turbo spin-echo T2-weighted imaging. MATERIALS AND METHODS: Two neuroradiologists independently analyzed randomly mixed MR images of 20 lesions of 17 patients in whom MTS had been diagnosed, and ten normal controls. All subjects underwent both who performed both FLAIR and turbo spin-echo T2-weighted imaging, in a blind fashion. In order to determine hippocampal morphology, oblique coronal images perpendicular to the long axis of the hippocampus were obtained. The detection rate of high signal intensity in hippocampus or amygdala, the radiologists 'preferred imaging sequence, and intersubject consistency of detection were evaluated. Signal intensity in hippocampus or amygdala was considered high if substantially higher than signal intensity in the cortex of adjacent temporo-parietal lobe. RESULTS: In all normal controls, FLAIR and spin-echo T2-weighted images showed normal signal intensity in hippocampus or amygdala. In MTS, the mean detection rate of high signal intensity in hippocampus or amyg-dala, as seen on FLAIR images was 93%, compared with 43% on spin-echo T2-weighted images. In all cases in which signal intensity on FLAIR images was normal, signal intensity on spin-echo T2-weighted images was also normal. The radiologists preferred the contrast properties of FLAIR to those of spin-echo T2-weighted images. CONCLUSION: In the diagnosis of MTS using MRI, FLAIR images are more useful for the detection of high signal intensity of hippocampus or amygdala than are spin-echo T2-weighted images. In the diagnosis of MTS, FLAIR imaging is therefore a suitable alternative to spin-echo T2-weighted imaging.
Amygdala ; Axis, Cervical Vertebra ; Diagnosis ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Sclerosis

Although the incidence of the skeletal tuberculosis is being decreased with improvement of the socioeconomic status, tuberculous arthritis of the hip in children has many problems in fact that there is a relatively high incidence comparing to that of adult, that it is difficult to early detection for its variable clinical feature, and that there are many controversies in its treatment. From Aug. 1981 to Apr, 1988, 14 cases treated at Busan Paik Hospital were analyzed, and the following conclusions were obtained. 1. Surgical treatment of tuberculous arthritis of the hip with early lesion was better than conservative treatment in that it could be made early diagnosis, removed the infected focus, lessened the recurrence rate, and preserved the hip function. 2. A relatively good result in preserving the hip function was obtained with surgical treatment in tuberculous arthritis of the hip with late lesion.
Adult ; Arthritis ; Busan ; Child ; Early Diagnosis ; Hip ; Humans ; Incidence ; Recurrence ; Social Class ; Tuberculosis

Treating diseases in the field of neurosurgery has progressed concomitantly with technical advances. Here, as a surgical armamentarium for the treatment of cerebral aneurysms, the history and present status of the keyhole approach and the use of neuroendoscopy are reviewed, including our clinical data. The major significance of keyhole approach is to expose an essential space toward a target, and to minimize brain exposure and retraction. Among several kinds of keyhole approaches, representative keyhole approaches for anterior circulation aneurysms include superciliary and lateral supraorbital, frontolateral, mini-pterional and mini-interhemispheric approaches. Because only a fixed and limited approach angle toward a target is permitted via the keyhole, however, specialized surgical devices and preoperative planning are very important. Neuroendoscopy has helped to widen the indications of keyhole approaches because it can supply illumination and visualization of structures beyond the straight line of microscopic view. In addition, endoscopic indocyanine green fluorescence angiography is useful to detect and correct any compromise of the perforators and parent arteries, and incomplete clipping. The authors think that keyhole approach and neuroendoscopy are just an intermediate step and robotic neurosurgery would be realized in the near future.
Aneurysm ; Arteries ; Brain ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Intracranial Aneurysm* ; Lighting ; Neuroendoscopy* ; Neurosurgery ; Parents

Uterine papillary serous carcinoma (UPSC) behave more aggressively than other endometrial carcinomas and have a propensity for intraabdominal spread, simulating the behavior of ovarian carcinoma. Because of high relapsing rate, and high mortality rate of UPSC, many gynecologist studied about its treatment regimen and recommended many treatment method. Many investigators recommended that patients with UPSC should undergo a staging laparotomy and they suggested the surgery should include at least total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic lymphadenectomy, paraaortic lymphadenectomy, peritoneal washing and peritoneal cytology, By and large, adjuvant systemic Platinum based chemotherapy or, paclitaxel based chemotherapy and adjuvant whole abdominal irradiation or pelvic irradiation was prescribed. We experienced two cases of the UPSC stage IIIc and stage IV diagnosed after explolaparotomy. We present these cases and review the literatures about the optimal treatment regimen of UPSC.
Drug Therapy ; Endometrial Neoplasms ; Female ; Humans ; Hysterectomy ; Laparotomy ; Lymph Node Excision ; Mortality ; Paclitaxel ; Platinum ; Research Personnel

BACKGROUND AND OBJECTIVES: It is important to understand the frequency region of cues used, and not used, by cochlear implant (CI) recipients. Speech and environmental sound recognition by individuals with CI and normal-hearing (NH) was measured. Gradients were also computed to evaluate the pattern of change in identification performance with respect to the low-pass filtering or high-pass filtering cutoff frequencies. SUBJECTS AND METHODS: Frequency-limiting effects were implemented in the acoustic waveforms by passing the signals through low-pass filters (LPFs) or high-pass filters (HPFs) with seven different cutoff frequencies. Identification of Korean vowels and consonants produced by a male and female speaker and environmental sounds was measured. Crossover frequencies were determined for each identification test, where the LPF and HPF conditions show the identical identification scores. RESULTS: CI and NH subjects showed changes in identification performance in a similar manner as a function of cutoff frequency for the LPF and HPF conditions, suggesting that the degraded spectral information in the acoustic signals may similarly constraint the identification performance for both subject groups. However, CI subjects were generally less efficient than NH subjects in using the limited spectral information for speech and environmental sound identification due to the inefficient coding of acoustic cues through the CI sound processors. CONCLUSIONS: This finding will provide vital information in Korean for understanding how different the frequency information is in receiving speech and environmental sounds by CI processor from normal hearing.
Acoustics ; Clinical Coding ; Cochlear Implants ; Cues ; Female ; Hearing ; Humans ; Male