No abstract available.
Child* ; Heart Septal Defects, Ventricular* ; Humans

No abstract available.
Shoulder*

No abstract available.
Achilles Tendon*

No abstract available.
Tendons*

PURPOSE: Options for BRCA mutation carriers include close surveillance, chemoprevention, and risk-reducing surgery (RRS) for breast and ovarian cancer. However, chemoprevention and RRS for cancer prevention are not widely performed in Korea. The aim of this study was to investigate the usage patterns of surveillance, chemoprevention and RRS of breast and ovary in Korean BRCA mutation carriers. METHODS: We retrospectively reviewed the medical record of 67 women who were diagnosed with BRCA1 or BRCA2 mutation between January 2005 and May 2009 at Seoul National University Bundang Hospital. RESULTS: Mean age was 46 years old (range, 27-73 years), and median follow-up period was 10 months. The numbers of affected and unaffected carriers were 50 (74.6%) and 17 (25.4%). In 47 women affected with breast cancer excluding 3 cases of concurrent breast/ovarian cancers, 42 (89.4%) have received intensive surveillance only, 2 (4.3%) have taken tamoxifen for chemoprevention, and 3 (6.4%) have undergone contralateral prophylactic mastectomies to prevent breast cancer. For ovarian cancer prevention, risk reducing salpingo-oophorectomy was performed in 11 (24.4%) of 45 affected carriers excluding 5 patients who had bilateral salphingo-oophorectomy previously. In 17 unaffected carriers, chemoprevention and RRS were not performed. Only 4 (23.5%) of these unaffected carriers have chosen surveillance for breast or ovarian cancer. Old age and no family history are related to the poor compliance (no follow-up) of the carriers only in the univariate analysis but not in the multivariate analysis. CONCLUSION: Most of the Korean affected BRCA mutation carriers in our study chose intensive surveillance rather than chemoprevention or RRS. We should take special effort to follow and educate unaffected carriers, especially for those with old age or no family history.
Female ; Humans ; Breast Neoplasms ; Ovarian Neoplasms

No abstract available.
Cicatrix* ; Contracture* ; Neck* ; Thyroidectomy*

Eosinophils are only a small minority of peripheral blood leucocytes and, in normal subjects, most are found in the tissues of the lung and gastrointestinal tract. Peripheral blood eosinophilia is occurred by various causes, allergic diseases, parasite infection, clonal disorder, and drug. Moderate to severe eosinophilia may be caused by the idiopathic hypereosinophilic syndrome (HES), but the commonest cause of eosinophilia worldwide is helminthic infection and, in industrialized nations, atopic disease. Whatever the cause for the eosinophilia, in certain circumstances the eosinophils produce damage to various organs by activation of eosinophils, thrombotic events, release of eosinophil granule contents, and deposition of eosinophil proteins. Clinical manifestations are characterized by thromboembolic events of the involved organ, such as the heart, lungs, or nervous system. To our knowledge, the association between hypereosinophilia and intraabdominal multivessel (portal, splenic and superior mesenteric vein) thrombosis has never previously been reported. Thus, we report a case with portal, splenic and superior mesenteric venous thrombosis simultaneously with disseminated intravascular coagulapathy in the patient with hypereosinophilia.
Developed Countries ; Eosinophilia ; Eosinophils ; Gastrointestinal Tract ; Heart ; Helminths ; Humans ; Hypereosinophilic Syndrome ; Lung ; Mesenteric Veins* ; Necrosis* ; Nervous System ; Parasites ; Portal Vein* ; Splenic Vein* ; Thrombosis* ; Venous Thrombosis

Gonadotropin-releasing hormone (GnRH) agonist has been used in the treatment of a wide variety of sex-hormone-related diseases, as the administration of GnRH agonist can alter the secretion of gonadotropin and sex hormones. Recently, we found that the long-acting GnRH agonist aggravated hyperthyroidism and induced painless thyroiditis. This is the first report to demonstrate the association of thyroid dysfunction with GnRH agonist injection in Korea. Here, we report three cases and emphasize the clinical importance of this aggravating factor in autoimmune thyroid disease.
Gonadal Steroid Hormones ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Graves Disease ; Hyperthyroidism ; Korea ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

PURPOSE: To improve survival and/or to avoid radiotherapy, high dose chemotherapy (HDCT) with autologous peripheral blood stem cell transplantation (PBSCT) was given to patients with recurrent or high risk medulloblastoma (MB)/primitive neuroectodermal tumor (PNET) as well as patients younger than 3 years of age. METHODS: Six patients (3 recurrent, 1 high risk, 2 younger than 3 years; 5 MBs and 1 PNET) received single or double HDCT and PBSCT with or without immunotherapy using interleukin-2. Chemotherapeutic regimen in the first HDCT included cyclophosphamide (1,500 mg/m2/ day for 4 days) and melphalan (60 mg/m2/day for 3 days). Chemotherapeutic regimen in the second HDCT included carboplatin (400 mg/m2/day for 3 days), thiotepa (250 mg/ m2/day for 3 days), and etoposide (200 mg/m2/day for 3 days). RESULTS: Nine HDCTs were applied in 6 patients. Three double HDCTs were rescued with peripheral blood stem cells collected during single round leukapheresis. Rapid hematologic recovery occurred in 4 patients. Engraft failure occurred in 1 patient and delayed granulocyte recovery and platelet engraft failure occurred in 1 patient. Three patients who had minimal disease before HDCT had event free survival for 7~18 months after HDCT. Tumor relapsed 8 and 12 months after single HDCT in 2 patients among 3 patients with recurrent MB/PNET. One patient with recurrent MB died due to engraft failure and sepsis. CONCLUSION: HDCT with autologous PBSCT is expected to improve survival of patients with poor prognosis MB/PNET including younger patients less than 3 years. Subsequent trials with larger number of patients and long-term follow-up are needed.
Blood Platelets ; Carboplatin ; Cyclophosphamide ; Disease-Free Survival ; Drug Therapy* ; Etoposide ; Follow-Up Studies ; Granulocytes ; Humans ; Immunotherapy ; Interleukin-2 ; Leukapheresis ; Medulloblastoma ; Melphalan ; Neural Plate* ; Neuroectodermal Tumors* ; Neuroectodermal Tumors, Primitive ; Peripheral Blood Stem Cell Transplantation* ; Prognosis ; Radiotherapy ; Sepsis ; Stem Cells ; Thiotepa

Postoperative biliary stricture is a relatively rare but serious complication of biliary surgery. Although Rouxen-Y hepaticojejunostomy or choledochojejunostomy are well-established and fundamental therapeutic approaches, their postoperative morbidity and mortality rates have been reported to be up to 33% and 13%, respectively. Recent studies suggest that percutaneous transhepatic intervention is an effective and less invasive therapeutic modality compared with traditional surgical treatment. Compared with fluoroscopic intervention, percutaneous with cholangioscopy may be more useful in biliary strictures, as it can provide visual information regarding the stricture site. We recently experienced two cases complete membranous occlusion of the bilioenteric anastomosis and successfully treated both patients using percutaneous transhepatic cholangioscopy.
Choledochostomy ; Cholestasis ; Constriction, Pathologic ; Humans ; Postoperative Complications