BACKGOUND: Pulsed dye laser (PDL) is recommended as a good treatment for scars and keloids. However, there has been no absolute indications and standard laser parameters. Some proposed that only hypertrophic and atrophic/flat scars were effectively treated, but others reported that all scars and even keloids responded well to PDL treatment. OBJECTIVE: To determine whether 595nm PDL treatment is effective for scars and keloids, and if so, which group responds better to treatment between the atrophic/flat scars group and hypertropic scars/keloids group. METHOD: Twenty-two patients (skin types III-V) with scars and keloids were treated with 595nm PDL (0.45 or 1.5 msec, 4-8J/cm(2), 7mm spot size). Eleven patients had hypertrophic scars/keloids (6 had hypertropic scars, 5 had keloids), and eleven patients had atrophic/flat scars. After several treatments of each lesion, the results were evaluated by extent of the patient's satisfaction and comparision of pre-and post-laser photography and divided into the four categories: excellent, good, fair and poor. RESULTS: The clinical improvement and patient's satisfaction were better in the atrophic/flat scars group than the hypertrophic scars/keloid group. With keloid potients, the result of treatment were found to be particularly poor. CONCLUSION: From our results, only atrophic/flat scars respond well to 595nm PDL treatment, and hypertrophic scars and keloids should be excluded from this treatments method.
Cicatrix* ; Cicatrix, Hypertrophic ; Humans ; Keloid* ; Lasers, Dye* ; Photography

Transarterial chemoembolization (TACE) is the worldwide procedure performed for patients with various stage hepatoceullar carcinoma (HCC), but is not yet considered as curative treatment because of relatively high local recurrence rate. Moreover, many clinicians frequently experience treatment failure (incomplete necrosis or stage progression etc.) after repeated TACE, but no clear guidelines have been recommended about salvage treatment modalities for this situation. Recently, studies for combination of radiation therapy and TACE for HCC with TACE refractoriness have been tried and reported better therapeutic efficacy. Based on above suggestions, we herein offer our experience of a patient with macrovascular invasion developed after repeated TACE that achieve complete remission by stereotactic body radiation therapy. Further study, maybe regarding a combination of locoregional and systemic therapy, is necessary on how to manage HCC patients with TACE refractoriness.
Carcinoma, Hepatocellular* ; Humans ; Necrosis ; Recurrence ; Salvage Therapy ; Treatment Failure

Percutaneous endoscopic gastrostomy (PEG) has widely accepted for providing safe, long-term enteral nutrition for patients with swallowing disabilities. Though safe and technically simple, this procedure is often associated with some complications, such as wound infection, bleeding, stroma leaks and tube transposition. Major complications are rare and these include aspiration pneumonia, perforations, peritonitis and necrotizing fasciitis. We report here on a patient who developed extensive subcutaneous emphysema with hemoperitoneum and peritonitis following PEG. Medical treatment without removal of the PEG led to resolution of the emphysema and the peritonitis and successful PEG feeding.
Deglutition ; Emphysema ; Enteral Nutrition ; Fasciitis, Necrotizing ; Gastrostomy ; Hemoperitoneum ; Hemorrhage ; Humans ; Peritonitis ; Pneumonia, Aspiration ; Subcutaneous Emphysema ; Wound Infection

PURPOSE: Recurrent colorectal cancers have important and difficult diagnostic and treatment problems. The purpose of this study is to evaluate the rationale and the efficacy of surgical re-treatment for patients with recurrence following curative surgery for colorectal cancer. METHODS: From January 1991 to December 2002, we experienced 60 (20.9%) patients with recurred colorectal cancer among 287 patients who had curative operations in our hospital. These 60 patients were divided into three groups. Patients in group 1 had curative-intent resections, patients in group 2 had palliative resections, and patients in group 3 had conservertive treatment. The groups consisted of 17 (28.3%), 10 (16.7%) and 33 (55.0%) patients, respectively. We analyzed retrospectively those groups for any recurrence pattern and for survival. RESULTS: Of the 60 patients with recurrent colorectal cancer, in 20 (33.3%) patients the cancer recurred in the colon, and in 40 (66.7%) it recurred in the rectum. Local recurrence was seen in 9 (15.0%) patients, liver metastasis in 25 (41.7%), and pulmonary metastasis in 13 (21.7%). The 1- and 3-, and 5-year survival rates were 86.5%, 31.7%, and 15.9%, respectively, for group 1, 33.3%, 0%, and 0% for group 2, and 28.9%, 4.4%, and 4.4% for group 3. The median survival period was 31 months for group 1, 8 months for group 2, and 7 months for group 3. CONCLUSIONS: Although evaluation was difficult owing to the small number of patients with recurrent colorectal cancer, a significant difference in survival rates was observed between the treatment groups. On the basis of these results, we think that curative-intent aggressive surgery for recurrent colorectal cancer in appropriately selected cases can clearly prolong survival when compared with palliative resections and conservative treatment.
Colon ; Colorectal Neoplasms* ; Humans ; Liver ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate

The purpose of this study was to evaluate feasibility of Vertical Multileaf Collimator for determination of irradiation size using Vertical Multileaf Collimator and lead block to determine 4 different irradiation shape in case of Co-60 gamma-ray and 6 MV X-ray. We chose ion chamber, glass dosimeter and EBT chromic film to compare with Vertical Multileaf Collimator results and lead block results. In case of Co-60 gamma-ray and 6 MV X-ray, the central axis point dose normalized at reference field of lead block with ion chamber results for Vertical Multileaf Collimator were estimated higher than lead block about 5.1%, 4.2%. In case of Co-60 gamma-ray, the central axis point dose normalized at reference field of lead block with glass dosimeter results for Vertical Multileaf Collimator were estimated higher than lead block about 2.2%, 7.8%, 7.2%, 4.0% for reference, circle, triangle, cross field, respectively. In case of 6 MV X-ray, the central axis point dose normalized at reference field of lead block with glass dosimeter results for Vertical Multileaf Collimator were estimated higher than lead block about 6.7%, 6.2%, 3.8%, 6.2% for reference, circle, triangle, cross field, respectively. The results of EBT chromic film, Vertical Multileaf Collimator of penumbra size for all irradiation shape was smaller than lead block of those size that 2.0~3.5 mm for Co-60 gamma-ray, 0.5~1.0 mm for 6 MV X-ray. The results from this study, radiation treatment volume that results in shielding block can be minimized. In addition, during radiation treatment for 2, 3-dimensional radiation therapy using a Vertical Multileaf Collimator of this survey can be used to determine variety of irradiation fields.
Axis, Cervical Vertebra ; Feasibility Studies ; Glass

No abstract available.
Child* ; Humans ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Vesico-Ureteral Reflux*

Infiltrative hepatocellular carcinoma (HCC) patients have a poor prognosis because most patients present with advanced disease. Although tumor size is small, ablation therapy is difficult because it is difficult to delineate tumor boundary and tumor often combined vascular invasion. Therefore many clinicians still try locoregional therapy (LRT) such as transarterial chemoembolization (TACE), radiation therapy (RT), or combination with LRT and sorafenib in this situation. Stereotactic body radiation therapy (SBRT) is new technology providing very highly conformal ablative radiation dose and is expected to salvage modality for HCC showed incomplete response of TACE due to combined arteriovenous (AV) shunts. Based on above suggestions, we herein offer our experience of a complete remission of tumor by combination of SBRT and TACE in a patient with infiltrative HCC. Further study, maybe regarding a combination of locoregional and systemic therapy is necessary on how to manage infiltrative HCC with AV shunts.
Carcinoma, Hepatocellular* ; Humans ; Prognosis

BACKGROUND: During the past two decades, laser treatments have been increasingly performed by various personnel in Korea. However, as a result, adverse events related to laser treatments have also increased. OBJECTIVE: This study aimed to characterize cutaneous adverse events associated with laser treatments in Korea and to consider feasible ways to minimize possible laser-associated adverse events. METHODS: Adverse event reports after laser treatments were collected from the members of the Korean Dermatological Association. A retrospective analysis of clinical data was performed regarding the pre-treatment lesion, specific laser type applied, personnel who performed the procedure, and consequences in terms of treatmentrelated complications. RESULTS: A total of 69 reported cases of adverse events associated with laser treatment were collected. The most frequently reported adverse event was postinflammatory dyspigmentation, followed by secondarily induced dermatological disease, treatment-inflicted burn, and residual scar. CONCLUSION: Both expected and unexpected adverse events occur after laser treatments. Most adverse events are not serious, but proper dermatological attention should be given to avoid complications. It should be noted that the safest and the most successful laser treatment can be provided only by qualified personnel.
Burns ; Cicatrix ; Hyperpigmentation ; Korea ; Laser Therapy ; Retrospective Studies

Background and Objectives: Flavonoids form the largest group of plant phenols and have various biological and pharma-cological activities. In this study, we investigated the effect of a flavonoid, 3, 4’-dihydroxyflavone (3, 4’-DHF) on osteogenic differentiation of equine adipose-derived stromal cells (eADSCs). Methods: and Results: Treatment of 3, 4’-DHF led to increased osteogenic differentiation of eADSCs by increasing phosphorylation of ERK and modulating Reactive Oxygen Species (ROS) generation. Although PD98059, an ERK inhibitor, suppressed osteogenic differentiation, another ERK inhibitor, U0126, apparently increased osteogenic differentiation of the 3, 4’-DHF-treated eADSCs, which may indicate that the effect of U0126 on bone morphogenetic protein signaling is involved in the regulation of 3, 4’-DHF in osteogenic differentiation of eADSCs. We revealed that 3, 4’-DHF could induce osteogenic differentiation of eADSCs by suppressing ROS generation and co-treatment of 3, 4’-DHF, U0126, and/or N-acetyl cysteine (NAC) resulted in the additive enhancement of osteogenic differentiation of eADSCs. Conclusions Our results showed that co-treatment of 3, 4’-DHF, U0126, and/or NAC cumulatively regulated osteo-genesis in eADSCs, suggesting that 3, 4’-DHF, a flavonoid, can provide a novel approach to the treatment of osteoporosis and can provide potential therapeutic applications in therapeutics and regenerative medicine for human and companion animals.

PURPOSE: We investigated the clinical outcome of bone marrow (BM) involvement in patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based therapy. MATERIALS AND METHODS: A total of 567 consecutive patients with newly diagnosed DLBCL treated with rituximab-CHOP (RCHOP) between November 2001 and March 2010 were included in the current study. All of the patients underwent a BM study at the initial staging and the clinical characteristics and prognosis of these patients with or without BM involvement were analyzed retrospectively. RESULTS: The total cohort included 567 patients. The overall incidence of BM involvement was 8.5%. With a median follow-up duration of 33.2 months (range, 0.1 to 80.7 months) for patients who were alive at the last follow-up, the five-year overall survival (OS) and event-free survival (EFS) rate in patients without BM involvement (76.3% and 67.5%, p<0.001) was statistically higher than that in patients with BM involvement (44.3% and 40.1%, p<0.001). In multivariate analysis, among total patients, BM involvement showed a significant association with OS and EFS. In univariate and multivariate analyses, even among stage IV patients, a significant association with worse EFS was observed in the BM involvement group. CONCLUSION: BM involvement at diagnosis affected the survival of patients with DLBCL who received RCHOP. Although use of RCHOP can result in significant improvement of the therapeutic effect of DLBCL, BM involvement is still a negative prognostic factor of DLBCL patients in the era of rituximab.
Antibodies, Monoclonal, Murine-Derived ; B-Lymphocytes ; Bone Marrow ; Cohort Studies ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Lymphoma, B-Cell ; Multivariate Analysis ; Prognosis ; Rituximab