BACKGROUND: This study was performed to characterize the long term observations after the use of a round needle for the management of chronic musculoskeletal pain. METHODS: The study subjects were 71 patients with musculoskeletal pain who had failed at least two previous treatments. They received interventional muscle and nerve stimulation (IMNS) using a 0.8 to 1.2 mm diameter dry needle with a streamlined shaped and a round tip from March, 2002 to July, 2002. Patients received IMNS as a bilateral segmental treatment mainly in the paraspinal, sometimes in the radicular region at 2 week intervals. The follow-up rate was 97%. Follow-up occurred at 6 months after the last IMNS treatment. Main outcomes were measured using a pain relief scale and a visual analog scale. RESULTS: Spinal stenosis, Herniated Nucleus Pulposus and an unclassified group (radicular symptoms existed, but no correlatable radiographic findings of radiculopathy were found) produced positive responses whereas fibromyalgia and failed back surgery syndrome did not. CONCLUSIONS: These results reveal that IMNS has a potential value in musculoskeletal pain originating from a spinal nerve root.
Failed Back Surgery Syndrome ; Fibromyalgia ; Fluoroscopy* ; Follow-Up Studies ; Humans ; Musculoskeletal Pain ; Needles ; Radiculopathy ; Spinal Nerve Roots ; Spinal Stenosis ; Visual Analog Scale

The vast majority of malignant tumors involving the vagina are secondary spread from primary malignant lesion of the cervix uteri, the sigmoid colon, the bladder and the vulva. Primary invasive carcinoma of the vagina remains among the rare gynecologic malignant tumor. The diagnosis of primary carcinoma of the vagina requires that the cervix and the vulva be intact and no clinical evidence of other primary tumors exist. Greater than 80-90% of all vaginal tumors are squamous cell type. We experienced two cases of primary vaginal cancer of 68 years old woman without any other gynecologic disease and 67 years old woman after hysterectomy for benign desease. We presented these cases with a brief review of related literatures.
Aged ; Cervix Uteri ; Colon, Sigmoid ; Diagnosis ; Female ; Genital Diseases, Female ; Humans ; Hysterectomy ; Neoplasms, Squamous Cell ; Urinary Bladder ; Vagina ; Vaginal Neoplasms* ; Vulva

PURPOSE: Non-Hodgkins lymphoma (NHL) is recognized as not a single disease but a group of diseases heterogeneous in biology and clinical characteristics. Recently, a new pathologic classification system, the REAL classification, has been introduced into the clinic. Although REAL classification has tried to define the subtypes biologically more correctly, its clinical usefulness has not been established yet. A retrospective study was performed to define the clinical characteristics of Korean NHLs according to the REAL classification and to determine its clinical usefulness. MATERIALS AND METHODS: Pathologies of NHLs managed at 3 major hospitals in Korea between 1989 and 1995 were reviewed with immunophenotyping to determine the pathologic subtypes according to REAL classification. Clinical characteristics at the presentation and treatment outcomes of the eligible patients were analyzed. To determine the differences from the NHLs in the western countries, data of Non-Hodgkins Lymphoma Classification Project (NHLCP) were also compared. RESULTS: Total 802 cases were eligible for this study. Although it was similar to NHLCP study that B-cell subtypes were the majority and diffuse large B-cell lymphoma was the most common subtype, the proportion of T-cell subtypes were much higher in our patient population than in the western population. It was because peripheral T-cell lymphomas, angiocentric lymphoma in particular, were more common and follicular lymphomas were less common in our patients. Eleven common pathologic subtypes could be classified into 3 prognostic groups. Marginal zone B-cell lymphoma and lymphoplasmacytoid lymphoma of which 5-year overall survival rate (5-yOSR) were > 80% were classified in the good prognostic group. Precursor T-lymphoblastic lymphoma was classified in the poor prognostic group because its 5-yOSR was less than 30%. The other 9 subtypes were classified in the intermediate prognostic group with S-yOSR of 30-79%. CONCLUSION: The clinical. character' tics and prognoses of Korean NHLs could be defined according to REAL classification. These information would be helpful for the clinicians in formulating treatment strategies of Korean NHLs according to REAL classification.
B-Lymphocytes ; Biology ; Classification* ; Hodgkin Disease* ; Humans ; Immunophenotyping ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Follicular ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell, Peripheral ; Pathology ; Prognosis ; Retrospective Studies ; Survival Rate ; T-Lymphocytes ; Tics ; Waldenstrom Macroglobulinemia

BACKGROUND: Diffuse large B-cell lymphoma (DLBL) category in the REAL classification includes histologically heterogeneous subtypes in Working Formulation or Kiel classification. Some investigators insist that the prognosis of B-cell immunoblastic lymphoma (IBL) is worse than other types of DLBL. This study was performed to determine the clinical significance of histological subclassification of DLBL. METHODS: All non-Hodgkin's lymphomas diagnosed at 3 hospitals in Korea between 1989 and 1995 were reclassified according to the REAL classification. Medical records of 404 patients with DLBL were reviewed. Their pathologies were categorized into IBL or non-IBL according to Working Formulation. We compared clinical characteristics and treatment outcomes of IBL with those of non-IBL. RESULTS: Of 404 DLBL patients, 341 cases (84%) were classified as non-IBL and 63 cases (16%) as IBL. Male patients were more common in IBL than in non-IBL (76% vs. 62%). IBL presented more often with advanced stage (III or IV) and B-symptoms than non-IBL (57% vs. 42%, 40% vs. 27%, respectively). In other clinical characteristics, no significant differences were found between the two groups. Complete response rates were 59% in IBL and 68% in non-IBL (p=0.137). With a median follow-up of 52 months (range 1-108 months), the median progression-free survival was 11 (95% confidence interval [95% CI] 8-14) months for IBL and 41 (95% CI 18-64) months for non-IBL (p=0.004). The median overall survival was 21 (95% CI 13-29) months for IBL and 72 months for non-IBL (p=0.002). A multivariate analysis for progression-free survival and overall survival showed that histological subtype (non-IBL vs. IBL) was a significant prognostic factor independent of International Prognostic Index (p=0.013 for progression-free survival, p=0.003 for overall survival). CONCLSUION: DLBL includes heterogeneous subtypes with different prognosis. Subclassification of DLBL into IBL and non-IBL has prognostic significance. IBL needs to be separated from other types of DLBL.
B-Lymphocytes* ; Classification* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Male ; Medical Records ; Multivariate Analysis ; Pathology ; Prognosis ; Research Personnel