No abstract available.
Vesicovaginal Fistula*

Most colonic multiple mucosa-associated lymphoid tissue (MALT) lymphomas are confirmed with a histologic and immunohistochemical staining of the mucosal biopsy specimen obtained during colonoscopic examinations. Endoscopically, colonic MALT lymphomas frequently appear as protruding and/or ulcerative lesions, and there are not so many reports of colonic MALT lymphoma as compared to the frequent reports of MALT lymphoma of stomach. We report a unique case of colonic MALT lymphoma presenting as a simple reddish discoloration of mucosa; this presentation has never been describe before. Our patient was a 47-yr-old male who suffered from tenesmus and mucoid stool. A colonoscopy was accomplished, followed by a histologic examination and we diagnosed a colonic MALT lymphoma. Staging of the disease was done because this was necessary for choosing the modality of treatments. The patient was then treated with polychemotherapy in conjunction with radiation therapy.
Colonic Neoplasms/*pathology ; Colonoscopy ; Color ; Humans ; Intestinal Mucosa/*pathology ; Lymphoma, Mucosa-Associated Lymphoid Tissue/*pathology ; Male ; Middle Aged

PURPOSE: The purpose of this study is to evaluate the usefulness of computed tomography (CT) for spiral tibia shaft fracture by analyzing associated distal tibia intra-articular fractures diagnosed by CT only which met the indication of surgical fixation and were fixed. MATERIALS AND METHODS: Ninety-five spiral tibia shaft fractures with preoperative ankle plain radiographs and CT were analyzed retrospectively. The incidence and type of associated distal tibia articular fractures were evaluated by reviewing ankle plain radiography and CT. The number of fractures diagnosed by CT that correspond with the indication of fixation and that were actually fixed were analyzed. RESULTS: Among 95 spiral tibia shaft fractures, 62 cases (65.3%) were associated with distal tibia intra-articular fracture. There were 37 cases of posterior malleolar fracture, 5 cases of avulsion fracture of the distal anterior tibiofibular ligament, 5 cases of medial malleolar fracture, and 15 cases of complex fracture. Among 52 posterior malleolar fractures including complex fracture, 20 cases were diagnosed by ankle plain radiograph. Of these 20 cases, 16 posterior malleolar fractures (80.0%) met the indication of surgical fixation, and 14 cases were actually fixed with a screw. Among 32 posterior malleolar fractures diagnosed by CT only, 26 cases (81.3%) met the indication of surgical fixation and 18 cases (56.3%) were fixed by screw. CONCLUSION: Approximately 50% of associated fractures were diagnosed by CT only and more than 80% of associated posterior malleolar fractures met the indication of surgical fixation and among these fractures, 18 cases (56.3%) were actually fixed by screw. This result suggests that CT is useful in diagnosis and treatment of distal tibia intra-articular fracture associated with spiral tibia shaft fracture.
Ankle ; Ankle Fractures ; Diagnosis ; Incidence ; Intra-Articular Fractures* ; Ligaments ; Radiography ; Retrospective Studies ; Tibia*

Triple antiplatelet therapy has been known to be superior to the conventional dual regimen for preventing stent thrombosis after coronary stenting, and the addition of oral anticoagulation to antiplatelet therapy is also considered an option. However, the risks and benefits of a triple antiplatelet regimen plus additional oral anticoagulation must be taken into account. Here, we report a case of fatal renal bleeding in a patient treated with triple antiplatelet plus oral anticoagulant therapy for the prevention of recurrent stent thrombosis.
Coronary Thrombosis ; Drug Combinations ; Drug-Eluting Stents ; Hemorrhage ; Humans ; Risk Assessment ; Stents ; Thrombosis

No abstract available.
Adult* ; Humans

To determine the status of Enterobius vermicularis infection among children living on western and southern coastal islands of the Republic of Korea, children (3-10 years) in 39 kindergartens and primary schools were examined using the cello-tape anal swab method, during July and August 2000. Of 1, 661 children examined, 307 (18.5%) were found to be positive for E. vermicularis eggs. The highest infection rate (59.3%) was found in a kindergarten and a branch school of Shinyang primary school on Chujado, Jeju-do (Province). Remarkable differences in egg positive rates were observed in different localities. The egg positive rate for boys (21.3%) was significantly higher than that of girls (15.4%) (P = 0.02). However, positive rates were not significantly dependent on age. The results of the present study show that E. vermicularis infection is highly prevalent among pre-school and primary school children living on the western and southern coastal islands of the Republic of Korea, and indicate the need for efforts to control this infection.
Prevalence ; Parasite Egg Count ; Male ; Korea/epidemiology ; Humans ; Geography ; Female ; Feces/parasitology ; Enterobius/*isolation & purification ; Enterobiasis/*epidemiology/parasitology ; Child, Preschool ; Child ; Animals

PURPOSE: To analyze the causes of vocal cord fixation in laryngeal cancer and to demonstrate its spiral CT findings. MATERIALS AND METHODS: We retrospectively applied the five pathologic mechanisms of vocal cord fixationto spiral CT findings and evaluated mechanisms of fixed vocal cord in 16 patients with laryngeal cancer of T3 or more on staging. CT findings of another six patients (T2) showing one or more suspicious mechanisms of vocal cord fixation in conventional CT were compared with those of the 16 patients (T3 or more). RESULTS: In 16 patients with laryngeal cancer of T3 or more, the most common finding of vocal cord fixation was the complete replacement of the true vocal cord (including the thyroarytenoid and vocalis muscle) by the tumor and tumor invasion of the paralaryngeal space (n = 16). Other findings were tumor invasion and fixation of the cricoarytenoid joint (n = 9), interference with cord mobility by the bulky mass (n = 6), tumor invasion of the thyroid cartilage, with vocalcord fixation (n = 4) and subglottic tumor spread (n = 3). In another six patients (T2) with suspicious vocal cordfixation, conventional CT showed partial vocal cord invasion and intact or minimal invasion of the paralaryngeal space (n = 3), a bulky mass without vocal cord invasion (n = 1) and subglottic extension but movable vocal cord (n= 2). CONCLUSION: Although the cause of vocal cord fixation from laryngeal cancer may be due to one of five patterns of cancer spread, or to a combination of these, the most common spiral CT finding is complete replacement of true vocal cord by the cancer and tumor invasion of the paralaryngeal space. Accurate evaluation of vocal cord fixation and the extent of the tumor could be evaluated with spiral CT using the breathing technique.
Humans ; Joints ; Laryngeal Neoplasms* ; Respiration ; Retrospective Studies ; Thyroid Cartilage ; Tomography, Spiral Computed* ; Vocal Cords*

Mesenchymal stem cells (MSCs) are present in diverse tissues and organs, including bone marrow, umbilical cord, adipose tissue, and placenta. MSCs can expand easily in vitro and have regenerative stem cell properties and potent immunoregulatory activity. They inhibit the functions of dendritic cells, B cells, and T cells, but enhance those of regulatory T cells by producing immunoregulatory molecules such as transforming growth factor-beta, hepatic growth factors, prostaglandin E2, interleukin-10, indolamine 2,3-dioxygenase, nitric oxide, heme oxygenase-1, and human leukocyte antigen-G. These properties make MSCs promising therapeutic candidates for the treatment of autoimmune diseases. Here, we review the preclinical studies of MSCs in animal models for systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease, and experimental autoimmune encephalomyelitis, and summarize the underlying immunoregulatory mechanisms.
Adipose Tissue ; Arthritis, Rheumatoid ; Autoimmune Diseases* ; B-Lymphocytes ; Bone Marrow ; Crohn Disease ; Dendritic Cells ; Dinoprostone ; Encephalomyelitis, Autoimmune, Experimental ; Heme Oxygenase-1 ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-10 ; Leukocytes ; Lupus Erythematosus, Systemic ; Mesenchymal Stromal Cells* ; Models, Animal* ; Nitric Oxide ; Placenta ; Stem Cells ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Umbilical Cord

BACKGROUND AND OBJECTIVES: Medullary thyroid carcinoma (MTC) accounts for about 5-10% of all thyroid cancers worldwide, but only for 2-4% in Korea. Its prognosis is relatively poorer than well-differentiated thyroid carcinoma (WDTC). We performed this study to find the adequate treatment methods through the analysis of clinical features and treatment process of 12 MTC cases. MATERIALS AND METHODS: We conducted retrospective chart review about 12 cases of pathologically proven MTC treated from 1991 to 1996 at the department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital. We analyzed their clinical features, treatment modalities and treatment outcomes. RESULTS: Male/female ratio was 1:1 (6:6) with the mean age of 46.2 (19-73) years. Mean follow-up periods were 26.8 (3-48) months and MTC accounted for 2.7% of all thyroid cancers during the period of 1991 to 1996. We performed surgical procedures in all cases. In 5 cases of disease-free status, complete surgical removal of tumor was performed in the first operation, and no recurrence occurred during the follow-up period. In the other 5 cases, incomplete surgical removal was inevitable due to carotid artery invasion or mediastinal extension, etc. These patients received many additional surgery and radiotherapy, but their condtion did not improve. In one case, we performed complete excision but he expired with double primary cancer: one other case who was confirmed as MEN type 2b had been suspicious of recurrence, but she was lost during the follow-up period. CONCLUSION: We confirmed that MTC has relatively poorer prognosis than WDTC, and completeness of surgical excision is important. Persistent tumor is a major cause of mortality, and the tumor is unable to remove through the other methods. So early diagnosis and treatment is the most important prognostic factor. We recommend that aggressive and meticulous surgical removal is important in MTC management.
Calcitonin ; Carotid Arteries ; Early Diagnosis ; Follow-Up Studies ; Humans ; Korea ; Male ; Mortality ; Neck ; Prognosis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms*

Despite the recent increase in the use of complementary and alternative medicine (CAM) among the general population and patients, little is known about Korean physicians' attitudes about and interest in CAM. We conducted a web-based survey of knowledge, attitude, and experience in CAM among primary care physicians (PCPs) and academic physicians (APs) in Korea. A total of 826 physicians (341 PCPs and 485 APs) responded. Respondents in both groups felt that they were not sufficiently knowledgeable about CAM. PCPs, however, had a significantly higher composite index score in CAM knowledge than that of APs. Although APs were more skeptical about the scientific evidence of CAM than PCPs, both groups had a positive attitude toward CAM. The level of experience in utilizing CAM in their practice was 23.2% among PCPs, which was much higher than that among APs (2.7%). Experience rates of referring patients to CAM were 11.7% in PCPs and 4.5% in APs (P<0.001). Despite the discrepant rates in CAM education between the two groups (58.7% in PCPs and 26.0% in APs, P<0.001), the majority of doctors in both groups (85.0% in PCPs and 70.0% in APs) expressed an intention to participate in authorized CAM coursework. In conclusion, despite the lack of scientific evidence, both PCPs and APs have an interest in incorporating CAM into their conventional medical practices. To meet physicians' increasing needs for CAM the Korean medical societies should promote education and research about CAM in the conventional medical system.
Complementary Therapies ; Humans ; Intention ; Korea ; Physicians, Primary Care ; Primary Health Care ; Societies, Medical ; Surveys and Questionnaires