Angiographic findings were analysed in 11 cases of Behcet'sdisease which was diagnosed clinically in Seoul national University Hospital from July 1982 to June 1983. Arterial involvement was noted in 5 cases and venous involvement in 6 cases respectively. Arterial aneurysm and occlusion were arteriographic findings. Arterial aneurysm was noted at large arteries in all 5 cases and multifocal involvement was noted in 4 cases. Characteristic finding of arterial involvement was protruding saccular aneurysm. Venous involvement was thrombotic occlusion of deep veins in iliac, femoral and tibial areas in all 6 cases. Behcet's disease should be differentiated whenever these arterial or venous angiographic findings are revealed in a young adult.
Aneurysm ; Arteries ; Humans ; Seoul ; Veins ; Young Adult

BACKGROUND: The clinical and radiologic features of radial tears of the medial meniscus posterior horn were compared with those of horizontal tears. METHODS: From January 2007 to December 2008, 387 consecutive cases of medial meniscal tears were treated arthroscopically. Among these, 91 were radial tears in the medial meniscus posterior horn, and 95 were horizontal tears in the posterior segment of the medial meniscus. The patients' data (age, gender, duration of symptom, body mass index, and injury history), radiographic findings (Kellgren and Lawrence score, posterior tibial slope, and femorotibial angle), and chondral lesions were recorded. RESULTS: The patient factors of age, gender, and body mass index were related to radial tears of the medial meniscus posterior horn. Radial tears were significantly correlated with Kellgren and Lawrence score, varus alignment, posterior tibial slope, and severity of the chondral lesion. CONCLUSIONS: Radial tears of the medial meniscus posterior horn are a unique clinical entity that are associated with older age, females and obesity, and are strongly associated with an increased incidence and severity of cartilage degeneration compared to horizontal tears.
Adult ; Age Factors ; Aged ; Arthroscopy ; Body Mass Index ; Female ; Humans ; Knee Injuries/*pathology/radiography/surgery ; Male ; Menisci, Tibial/*injuries/*pathology/radiography/surgery ; Middle Aged ; Retrospective Studies ; Sex Factors

Myxofibrosarcoma represents one of the most common soft tissue sarcomas of the extremities in adult and elderly patients. However, it only rarely occurs in the chest wall. A 58 years old woman presented with a huge painless lump (8x6.5 cm) in the right lower parasternal area which recurred a few months following excision from General surgery of our hospital. Histology showed an infiltrative deep seated dermal and subcutaneous tumor. It had a distinctive lobular growth pattern with prominent myxoid change and moderate cellularity. Tumor cells were spindle-shaped with varying degrees of pleomorphism and frequent mitotic figures. Numerous blood vessels with curvilinear growth pattern were also seen. Immunostains for S-100, CD68, Mac 387, and FX IIIa were all negative, but positive for Vimentin. The histologic feature was of an intermediate grade myxofibrosarcoma. Wide excision was performed and recovered in good condition without any physical disabilities and was discharged at one month later. Currently she is waiting for the skin graft without chemotherapy and radiotherapy.
Adult ; Aged ; Blood Vessels ; Drug Therapy ; Extremities ; Female ; Fibrosarcoma ; Humans ; Middle Aged ; Radiotherapy ; Sarcoma ; Skin ; Thoracic Wall* ; Thorax* ; Transplants ; Vimentin

PURPOSE: Under the rising demand of health services, the critical pathway (CP) which standardizes the practice guideline was introduced as a means to provide quality healthcare service. CP may increase the patient's satisfaction rate by providing systematic and consistent service. We aimed to evaluate the significance of CP by development and application of CP to patients undergoing laparoscopic cholecystectomy. METHODS: From June 2010 to July 2011, 148 patients underwent elective laparoscopic cholecystectomy. Patients were divided into two groups, including 57 patients in the CP group and 91 patients in the non-CP group. In a retrospective review, related hospital costs were analyzed and compared for both groups. Survey results on satisfaction for the CP group were also analyzed. RESULTS: The mean age was 22.7 years in the CP group and 37.9 years in the non-CP group. Number of hospitalized days was one day for the CP group and 2.51 days for the Non-CP group with p<0.001. In cost analysis all variables showed a significant reduction in the CP group compared to the Non-CP group. The satisfaction rate in the CP group scored 8 points out of 10. CONCLUSION: Results have shown benefit from the financial point of the view for the CP group. Current inclusion criteria for CP are limited and still in development for a solid protocol. Further efforts with a large-scale comparative study to broaden the indication for CP are desired.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Costs and Cost Analysis ; Critical Pathways* ; Delivery of Health Care ; Health Services ; Hospital Costs ; Humans ; Retrospective Studies

No abstract available.
Breast Neoplasms* ; Breast* ; Codon* ; Genes, p53* ; Point Mutation* ; Polymerase Chain Reaction*

To examine the relationship between gastric ulcer and gastric cancer, we investigated petients with gastric ulcer diagnosed from 1986 to l993. We reviewed the endoscopic reports and films of patients with gastric ulcer retrospectively. We excluded the patients who was diagnosed as gastric cancer in two years follow-up. The results were as follaws; 1) During follow-up of the original cohort, there were 5 patients(0.5~%) in whom gastric cancer developed at the same site initially diagnosed as gastric ulcer. The gross type of the lesion was early gastric cancer in two and advanced gastric cancer in three patients 2) The time interval between the initial diagnosis of gastric ulcer and cancer development was from 31 months to 70 months (average 51 months). 3) At the initial examination of 5 gastric cancer patients, the diagnosis was active gastric ulcer in four, multiple gastric ulcer in one, and linear gastrie ulcer in one patient. Characteristic endoscopic findjngs were gastric ulcer with clubbing mucosal folds in three and gastric ulcer with bleeding in one patient. 4) During the follow-up period, endoscopicailly and histologically healing of gastric uleer was observed in one patient and histologic finding showed chronic superficial gastritits with intestinal metaplasia. These results suggest that gastric ulcers rarely progress to gastric cancer. However if the endoscopic findings are suspicious for malignancy, then follow-up endoscopy until complete healing should be done.
Cohort Studies ; Diagnosis ; Endoscopy ; Follow-Up Studies* ; Hemorrhage ; Humans ; Metaplasia ; Stomach Neoplasms* ; Stomach Ulcer* ; Ulcer

Authors requested to change the name of the hospital to proper name.

This study was designed to investigate effectiveness of fragmentation during lithotripsy using 103 intrahepatic stones collected from 10 patients. Who had previously undergone biliary surgery. The size of each stones was measured and sonography was performed for the evaluation of the sonographic type of the stones. In vitro lithotripsy was performed on individual stones using piezoelectric lithotriptor to evaluate the fragmentation rate and average number of shock waves for fragmentation. Chemical analysis of each stone was done to determine chemical composition including calcium, bilirubin, and cholesterol. The size of the stones was from 5mm to 20 mm in diameter. Sonographic type I(echo of whole stone with posterior acoustic shadow) was 68, and type II(are-like strong surface echo of stone with clear posterior acoustic shadow) was 35 in number. The majority(78%) of stones I group 1 (5-9mm in diameter) showed sonographic type I characteristics, and 62% of stones in group 3(larger than 15mm in diameter) showed sonographic type Ii characteristics. There was a positive correlation between the size and sonographic type of stones. Fragmentation rates of stones were 100% in group 1. 71.9% in group 2 (10-15 mm in diameter), 43.8% in group 3. Respectively. Fragmentation rates of stones with sonographic type I and II were 91.2%, 65.7%. respectively. The average number of shock waves for partial and complete fragmentation was 2753±4937 and 6219±10133. Respectively. There was a positive correlation between the number of shock waves for fragmentation and diameter of stones (r=0.618. p<0.05). There was no correlation between the number of shock waves for fragmentation and chemical composition of stones. In conclusion, the most important variable determining the degree of fragmentation of intrahepatic stones using ESWL is not their chemical composition but their size and sonographic characteristics.
Acoustics ; Bilirubin ; Calcium ; Cholesterol ; Humans ; In Vitro Techniques* ; Lithotripsy* ; Shock* ; Ultrasonography

PURPOSE: To examined the level of patient knowledge and their perspectives about the controversial issues in total knee arthroplasty (TKA), and to evaluate the effect of a relevant explanation about the issues on the patient preferences for their particular option. MATERIALS AND METHODS: One hundred patients who visited our clinic and decided to undergo TKA were asked to complete a questionnaire asking about their knowledge and preference for 4 controversial issues: 1) surgical timing of the bilateral TKAs, 2) use of computer assisted surgery, 3) use of minimal invasive surgery, and 4) use of ceramic femoral component. The patients completed the same questionnaire after the advantages and disadvantages of each option had been explained using an explanatory document designed based upon what was documented in the literature. RESULTS: The patients were not well-informed about the issues and received their information through a non-professional source. The patients tended to prefer new options with claimed promises before an explanation. The patients preferred the options with safety, accuracy, and proven evidence after an explanation. Male patients tended to prefer simultaneous TKAs more than female patients. Younger patients preferred ceramic femoral component claimed to have better longevity more than older patients did. CONCLUSION: This study demonstrates that patients' knowledge of the current controversial issues is very limited, and that patient preferences would be significantly changed if they were given an explanation from a physician. Balanced information should be given to patients in order for them to reach a fair decision.
Female ; Male ; Humans

PURPOSE: To compare the fixation power of the newly devised RSP (rigid stepped plate) with the L-plate by mechanical study and to prove the efficacy of the RSP. MATERIALS AND METHODS: Lateral closing wedge proximal tibial osteotomy was performed on the 10-monthsold porcine tibiae, which were fixed by 15 L-plates and 15 RSP's. Each group of 5 pairs of the specimen were applied to the Instron apparatus and loaded by compression, valgus, and varus bending. The fixation power was compared by the stiffness of each construct. RESULTS: Specimen fixed by the RSP's showed larger stiffness than those fixed by the L-plate. Even though the difference was not statistically significant in compression (p=0.465), it was statistically significant in valgus (p=0.047) and varus (p=0.009) bending. CONCLUSION: The RSP can be applied with minimal skin incision, will provide firm initial fixation to the osteotomy site, and seems to enable early range of motion exercise. It will improve the outcome of proximal tibial osteotomy by preventing excessive soft tissue dissection and complications resulting from long-term immobilization of the knee joint.
Immobilization ; Knee Joint ; Osteotomy* ; Range of Motion, Articular ; Skin ; Tibia