No abstract available.
Carcinoma, Endometrioid*

No abstract available.
Stents*

Postrenal segment anomalies of inferior vena cava such as bilateral inferior vena cava and left-sided inferiorvena cava can simulate lymphadenopathy on CT scan and these anomalous veins need consideration in retroperitonealoperations such as procedures for prevenetion of venous embolism, splenorenal shunt operation and aorticprosthetic repalcement. Retrocaval ureter is a rare cause of obstructive uropathy or medical deviation of ureter.We analysed 16 cases of postrenal segment anomalies daignosed by CT, vena cavography, retrograde pyelography andultrasonography including six rare positional anomalies at hepatic segment of inferior vena cava diagnosed bycardiac angiography. The results were as follows. 1. Postrenal segment anomalies were 6 cases of bilateral IVC, 8cases of left-sided IVC and 2 cases of retrocaval ureters. On CT scan, 3 cases of bilateral IVC and 4 cases ofleft-sided IVC were accompained by malignant tumors, but caval veins could be discriminated from enlarged nodesbecause of continuous tubular nature of vein on consecutive sections with homogeneous strong enhancement. Twocases of retrocaval ureters showed hydroureteronephrosis due to ureteral compression by IVC. 2. Hepatic segmentanomalies were 6 cases. Five cases of IVC on left side of vertebral crossed midline at live to enter right-sidedright atrium and one case of IVC on right side crossed midline to enter left-sided right atrium. Four cases ofcomplex cardiac anomalies, 4 cases of asplenia and 2 cases of situs ambigus were associates with these anomalies.
Angiography ; Embolism ; Heart Atria ; Lymphatic Diseases ; Retrocaval Ureter ; Splenorenal Shunt, Surgical ; Tomography, X-Ray Computed ; Ureter ; Urography ; Veins ; Vena Cava, Inferior

Congenital anomaly of IVC is rare, but understanding of this anomaly is important in radiological diagnosis,angiographic procedures and major retroperitoneal and thoracic surgery. We analysed 23 cases of IVC interruptiondiagnosed by cardiac angiography at Seoul National University Hospital. The results were as follows: 1. Theincidence of infrahepatic interruption of IVC was 0.45% of the patients having cardiac angiography and mostpatients showed cyanosis(91%). 2. The most common associated cardiac anomaly was right ventricular outflow tractobstruction (60%). Other associated cardiac defects were VSD, ASD, valvular anomaliesin 9 cases(39%) respectively;double outlet right bentricle, bilateral superior vena cava, single ventricle in 6 cases(26%) respectively; singleatrim, PDA in 5 cases(22%) respectively. 6 cases of situs inversus, 3 cases of situs ambiguus,2 cases of visceralheterotaxia and one case of asplenia were observed also. 7 cases of left-sided IVC were associated with IVCinterruption in normal situs.
Angiography ; Humans ; Seoul ; Situs Inversus ; Thoracic Surgery ; Vena Cava, Inferior ; Vena Cava, Superior

PURPOSE: To evaluate the efficacy of stereotaxic breast core biopsy using a prone table system, and theeffects of operator experience, lesion characteristics and number of samples on biopsy results in cases involvingnonpalpable breast lesions. MATERIALS AND METHODS: We performed stereotaxic core biopsies of 62 nonpalpablemammographic lesions in 61 patients. Subsequent surgical excision was performed in 11 cases with micro calcifications and one case with a mass. We equally divided patients with micro calcifications into two groups(early and late periods) and analyzed the mammographic findings. Correlation of the pathologic results of corebiopsy with those of surgical excision were investigated. RESULTS: In two patients, stereotaxic biopsy wasimpossible due to poor visibility of micro calcifications and thinness of the compressed breast. In 59 patients,core biopsy was successfully performed and specimens were adequate for pathologic examination. The average numberof micro calcifications seen on specimen mammography in the two groups was 1.8 (range: 0~8) and 2.5 (range:0~4)respectively. In patients from whom less than five and five or more samples were taken, the average number of micro calcifications seen on specimen mammography was 1.5 (range: 0~6) and 2.6 (range: 0~8), respectively,throughout the whole period. The pathologic findings were fibrocystic change in 50 cases, fibroadenoma in four,ductal carcinoma in situ in four, invasive ductal carcinoma in one, and atypical ductal hyperplasia in one. Theagreement rate of pathologic results between core biopsy and surgical excision was 83% (10/12) for malignancy and75% for histology. In three cases with disagreement between core and surgical pathologic results, the samplingnumber was small (3~4 times) and in two of the three cases, micro calcifications were not visible on mammography. CONCLUSION: Operator experience and sampling numbers larger than five results in an increased number of micro calcifications in specimens and more reliable core biopsy.
Biopsy* ; Breast* ; Carcinoma in Situ ; Carcinoma, Ductal ; Fibroadenoma ; Humans ; Hyperplasia ; Mammography ; Thinness

BACKGROUND: Cytomegalovirus (CMV) infection is one of the important opportunistic infections in immuno-compromised patients. In Korea, seroprevalence of IgG against CMV is over 95%. Therefore, CMV diseases are expected to be a prevalent opportunistic infection in AIDS patients in Korea. METHODS: We reviewed the medical records of 128 patients with HIV infection who visited the Seoul Na-tional University Hospital during the period from Nov. 1987 to Sep. 1996. All the patients were examined by one ophthalmologist and the diagnosis of CMV retinitis were made by funduscopic findings. Other CMV dise-ases were diagnosed when histopathologic examinations showed the characteristic cytomegalic cells. RESULTS: Median duration of follow-up was 8 (0 ~ 59) months. Eleven CMV diseases were found in 7 patients (5.4%) : 6 patients had retinitis, 2 esophagitis, 1 colitis, 1 pneumonitis, and one patient developed disse-minated infection. Fifteen percent (6/33) of the patients whose CD4 + lymphocyte counts were less than 200/ mm 3 at baseline developed CMV diseases. Out of the 9 cases treated with ganciclovir, 7 improved or were stabi-lized. No patient received maintenance treatment and 3 had relapsed. CONCLUSION: CMV diseases are common opportuni-stic infections in AIDS patients in Korea.
Colitis ; Cytomegalovirus* ; Diagnosis ; Esophagitis ; Follow-Up Studies ; Ganciclovir ; HIV ; HIV Infections ; Humans ; Immunoglobulin G ; Korea ; Lymphocyte Count ; Medical Records ; Opportunistic Infections ; Pneumonia ; Retinitis ; Seoul ; Seroepidemiologic Studies

PURPOSE: For curative resection of recurrent gastric cancer, it is imperative that there be no unrecognized foci of tumoral disease outside the operation field. PET (positron emission tomography) with FDG (18 fluoro-2 deoxy-D-glucose) is a whole-body imaging technique that exploits the increased rate of glycolysis in tumor cells to detect disease. The authors evaluated the usefulness of FDG-PET in assessing resectability of recurrent gastric cancer. MATENRIALS AND METHODS: Seven patients with recurrent gastric cancer were studied with FDG-PET from December 1998 to October 2000. All FDG-PET images were interpreted in conjunction with conventional diagnostic methods. All imaging results were correlated with the pathological diagnosis and clinical outcome. Results: A final diagnosis of recurrence was obtained at 14 sites in all 7 patients by histology or clinical follow up. Locoregional recurrence, including distant metastasis, developed in 6 of 7 patients and distant recurrence in only one. FDG-PET detected all recurrent sites (5 locoregional and 5 distant) in 5 patients without peritoneal recurrence, but did not detect peritoneal seeding in 2 patients with peritoneal recurrence. The accuracy of FDG-PET in estimating resectability was 71.4% (5/7), and that of CT and PET together was 85.7% (6/7). A curative resection could be performed in three of the recurrent patients (2 locoregional and 1 distant recurrence). CONCLUSION: Our results suggest that FDG-PET may be useful for detecting locoregional and distant recurrence of gastric cancer and for selecting appropriate treatment. However, considering that FDG-PET was limited in detecting peritoneal seeding and determining the exact anatomical extension of tumor, it should be used in conjunction with other anatomical images.
Diagnosis ; Follow-Up Studies ; Glycolysis ; Humans ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms*

PURPOSE: This study was designed to investigate the clinicopathologic factors related to peritoneal recurrence and to predict peritoneal recurrence based on clinicopathologic factors. METHODS: A retrospective analysis of 383 patients with peritoneal recurrence, out of 4184 patients who had undergone curative gastric resection at SNUH from 1986 through 1996 was done. RESULTS: Of the patients with peritoneal recurrence, 275 (71.8%), 97 (25.3%), and 11 (2.9%) were early (0~24 months), intermediate (24~60), and late (more than 60) recurrence, respectively. In multivariate analysis, serosal invasion, lymph node metastasis, size of tumor, Borrmann type, perineural invasion and sex were independent prognostic factors for peritoneal recurrence. After classifying all patients into 16 groups on the basis of 4 factors, serosal invasion, lymph node metastasis, Borrmann type, and size, the number and proportion of a patients with peritoneal recurrence was obtained. There was 4.2% peritoneal recurrence in the most favorable group (n = 71), which had a Borrmann type 1 or 2 lesion less than 5 cm in maximal diameter with neither serosal invasion nor lymph node metastasis. There was a 25.4% peritoneal recurrence in the most unfavorable group (n = 331), which had a Borrmann type 3 or 4 lesion more than 5 cm with serosal invasion and lymph node metastasis. CONCLUSION: Our results suggest that patients with a Borrmann 3 or 4 lesion more than 5cm in maximal diameter, with serosal invasion and lymph node metastasis have thehighest risk for peritoneal recurrence. These patients could be considered as candidates for a treatment modality such as intraperitoneal chemotherapy or hyperthermic chemotherapy.
Drug Therapy ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*

PURPOSE: This study was designed to investigate the correlation between the clinicopathologic characteristics and the recurrence pattern of gastric cancer and to define survival difference according to treatment modality after diagnosis of recurrence. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 4184 patients who had undergone radical surgery for primary gastric cancer from 1986 through 1996. Clinicopathologic factors were analyzed for the relationship of each factor with the pattern of recurrence. And the survival after diagnosis of recurrence was compared among the treatment modalities. RESULTS: Recurrence pattern was confirmed in 1141 patients. Loco-regional recurrence occurred in 291 patients (20.1%), peritoneal recurrence in 383 (26.5%), distant recurrence in 290 (20.1%), and mixed recurrence in 177 (12.3%), respectively. Early recurrence (less than 2 years) occurred in 767 (69.3%), intermediate recurrence (2~5 years) in 286 (25.8%), and late recurrence (more than 5 years) in 54 (4.9%). In multivariate analysis, T stage, N stage, size of tumor and perineural invasion were independent prognostic factors for recurrence. Median survival from diagnosis of recurrence was 24.2 months in the curative operation group, 7.7 months in the chemotherapy group, 7.1 months in the non-curative operation group and 3.3 months in the conservative treatment group, respectively (p=0.000). CONCLUSION: The clinicopathological analysis of recurrent gastric cancer showed recurrent patterns and prognostic factors. Curative resection is suggested to have survival benefit in recurrent gastric cancer patients, although it was possible in patients with limited extent of disease.
Diagnosis ; Drug Therapy ; Humans ; Medical Records ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

Endocardial fibroelastosis (EFE) is characterized by deposition of collagen and elastin leading to ventricular hypertrophy and diffuse endocardial thickening. Here we report (for the first time in Korea) the case of a EFE presenting with heart failure. The patient was a 57-year-old woman who had complained of dyspnea on exertion {New York Heart Association (NYHA) functional class 3} and abdominal distension at the time of hospital admission. Echocardiography showed severe diastolic dysfunction with normal systolic function. On MRI, the contrast-enhanced delayed myocardial image demonstrated hyperenhancement in the endocardium. Owing to progressive heart failure, the patient was transplanted. Histological examination of the explanted heart showed irregularly thickened endocardium with fibrosis and elastosis in the both ventricles, compatible with the diagnosis of EFE.
Cardiomyopathy, Restrictive ; Collagen ; Dyspnea ; Echocardiography ; Elastin ; Endocardial Fibroelastosis ; Endocardium ; Female ; Fibrosis ; Heart ; Heart Failure ; Heart Transplantation ; Humans ; Hypertrophy ; Middle Aged ; Transplants