Objective: The aim of this study was to investigate the prognostic value of the maximum standardized uptake value (SUVmax) measured while restaging with F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/ CT) to predict the 3-year post-recurrence survival (PRS) in patients with recurrent gastric cancer after curative surgical resection. Materials and Methods: In total, 47 patients with recurrent gastric cancer after curative resection who underwent restaging with 18F-FDG PET/CT were included. For the semiquantitative analysis, SUVmax was measured over the visually discernable 18F-FDG-avid recurrent lesions. Cox proportional-hazards regression models were used to predict the 3-year PRS. Differences in 3-year PRS were assessed with the Kaplan–Meier analysis. Results: Thirty-nine of the 47 patients (83%) expired within 3 years after recurrence in the median follow-up period of 30.3 months. In the multivariate analysis, SUVmax (p = 0.012), weight loss (p = 0.025), and neutrophil count (p = 0.006) were significant prognostic factors for 3-year PRS. The Kaplan–Meier curves demonstrated significantly poor 3-year PRS in patients with SUVmax > 5.1 than in those with SUVmax ≤ 5.1 (3-year PRS rate, 3.5% vs. 38.9%, p < 0.001). Conclusion High SUVmax on restaging with 18F-FDG PET/CT is a poor prognostic factor for 3-year PRS. It may strengthen the role of 18F-FDG PET/CT in further stratifying the prognosis of recurrent gastric cancer.

No abstract available.
Closing Volume* ; Humans ; Posture* ; Pulmonary Ventilation*

No abstract available.
Adult* ; Humans ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: P53 and cyclin D1 have been evaluated as a prognostic marker in papillary thyroid carcinoma (PTC). However, the relationship between p53/cyclin D1 and PTC prognosis has not yet been confirmed. Therefore, we investigated the relationship between p53/cyclin D1 and PTC prognostic factors. METHODS: 919 patients with PTC were enrolled. Immunohistochemistry slides were reviewed for p53 and cyclin D1 immunoreactivity. Patients were classified into two groups according to the p53 and cyclin D1 grade: negative for < or =5% and positive for >5%. Medical records were reviewed to evaluate the prognostic factors, lymph node metastatic ratio (LNMR), and MACIS score. We analyzed patients based on p53/cyclin D1(-/-), p53/cyclin D1(-/+), p53/cyclin D1(+/-), p53/cyclin D1(+/+) separately for evaluation of independent effect of p53 and cyclin D1. RESULTS: Mean age of the patients was 49.73 years (range 15~87), and tumor size was 1.19 cm (range 0.1~5.0). P53 was positive in 809 (88.0%) and cyclin D1 was positive in 748 (81.4%). Positivity of p53 and cyclin D1 were correlated (r=0.448). There was no statistical significance in MACIS score. Positivity of p53 and cyclin D1 were related with larger tumor size, older age, early T stage, more tumor capsulation, and female. LNMR was higher in p53/cyclin D1(+/-) than p53/cyclin D1(-/-) (P=0.036), p53/cyclin D1(-/+) than p53/cyclin D1(-/-) (P=0.034), and p53/cyclin D1(+/+) than p53/cyclin D1(-/-) (P=0.007). CONCLUSION: There was no consistent relationship between p53/cyclin D1 and worse prognostic factors of PTC. However, LNMR was higher in p53(+) and cyclin D1(+) cases independently, much more in p53/cyclin D1(+/+) than p53/cyclin D1(-/-).
Cyclin D1* ; Cyclins ; Female ; Humans ; Immunohistochemistry ; Lymph Nodes ; Medical Records ; Prognosis ; Thyroid Neoplasms*

PURPOSE: Laparoscopic appendectomy isused as a three port technique for appendectomy. In children, single port laparoscopic appendectomy is difficult because they have a small peritoneal cavity for manipulation of laparoscopic instruments. We performed transumbilical laparoscopic assisted single port appendectomy (hybrid appendectomy) in children. METHODS: From March 2010 to July 2012, we performed transumbilical laparoscopic assisted single port appendectomy in 53 children. We made a vertical incision to the umbilicus approximately 1.5 cm, and a wound retractor (Applied Medical Resources Co., Ltd., Rancho Santa Margarita) was placed in the umbilical incision, and appendix exteriorized the extraperitoneum through the wound retractor. Appendectomy was performed conventionally. We had no conversion cases for laparotomy. RESULTS: A total of 53 patients, 29 females and 24 males, with a mean age of 8.5+/-2.0 years were enrolled in this retrospective study. The mean operative time was 29.4+/-9.4 minutes. There was no occurrence of complication or mortality. BMI was 17.8+/-4.9 kg/m2. And mean hospital stay was 3.2+/-1.0 days. CONCLUSION: In children, transumbilical single port laparoscopic appendectomy is technically difficult because they have a small peritoneal cavity. However, transumbilical laparoscopic assisted single port appendectomy (hybrid appendectomy) appearsto be a safe and effective technique for use in children, which allows for achievement of nearly scarless surgery.
Achievement ; Appendectomy ; Appendix ; Child ; Female ; Humans ; Laparoscopy ; Length of Stay ; Male ; Operative Time ; Peritoneal Cavity ; Retrospective Studies ; Umbilicus

On ultrasonography, medullary thyroid carcinoma (MTC) shows hypoechogenicity, an irregular margin, a predominantly solid composition, and microcalcifications, similar to those observed in papillary thyroid carcinoma (PTC). MTC presenting as a cystic lesion is rare, and endoscopic thyroidectomy can be performed for benign thyroid masses and early stage PTC, however it is inappropriate for MTC regardless of cystic change. The authors report a case of cystic MTC found after endoscopic thyroid lobectomy and provide a review of the literature on this topic.
Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography

Osteosarcomas are highly malignant bone tumors which commonly affect metaphyseal portions of long bones and those of the skull are distinctly rare as primary neoplasm. We report a case of recurrent osteosarcoma originated from the skull base which destructed sphenoid bone in two months. The CT and MR images of 28 years old man with headache, dizziness, and loss of touch sense in right buccal area showed 3-cm sized homogenously well-enhancing mass with internal small cystic portions. Craniotomy and mass excision was done and chemotherapy was combined for 1 month. After about 2 month, follow up MR images showed larger recurrent mass in original site and confirmed as the same osteosarcoma after 2nd operation.
Adult ; Craniotomy ; Dizziness ; Drug Therapy ; Follow-Up Studies ; Headache ; Humans ; Osteosarcoma* ; Skull Base* ; Skull* ; Sphenoid Bone

Osteosarcomas are highly malignant bone tumors which commonly affect metaphyseal portions of long bones and those of the skull are distinctly rare as primary neoplasm. We report a case of recurrent osteosarcoma originated from the skull base which destructed sphenoid bone in two months. The CT and MR images of 28 years old man with headache, dizziness, and loss of touch sense in right buccal area showed 3-cm sized homogenously well-enhancing mass with internal small cystic portions. Craniotomy and mass excision was done and chemotherapy was combined for 1 month. After about 2 month, follow up MR images showed larger recurrent mass in original site and confirmed as the same osteosarcoma after 2nd operation.
Adult ; Craniotomy ; Dizziness ; Drug Therapy ; Follow-Up Studies ; Headache ; Humans ; Osteosarcoma* ; Skull Base* ; Skull* ; Sphenoid Bone

BACKGROUND: Reperfusion of ischemic myocardium is clinically encountered during thrombolytic therapy of acute myocardial infarction, percutaneous transluminal coronary angioplasty(PTCA), and coronary artery bypass graft(CABG). Reperfusion results in endothelial dysfunction characterized by a reduced release of endothelium-derived relaxing factor(EDRF) in animal studies. Studies with experimental animals have emphasized the role of oxygen free radicals and lipid peroxidation in pathophysiology of reperfusion injury and myocardial stunning. The object of this study is to determine whether endothelial dysfunction was developed after open heart surgery and to evaluated the role of oxygen free radical and lipid peroxidation in reperfusion injury. METHODS: The study group was comprised 13 patients who underwent open heart surgery(male/female : 2/11, mean age : 43+/-4 year, Atrial septal defect in 4, Ventricular septal defect in 1, Mitral regurgitation in 2, Tetralogy of Fallot in 1, and Aortic stenosis and Regurgitation with Mitral stenosis in 5 patients). The endothelial function was evaluated with the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the continous infusion of acetylcholin, from 10(-9) to 10(-6) molar concentration to the coronary artery and intracoronary injection of 200microg nitroglycerin after acetylcholine infusion. The infusion study was performed before and 10 days after surgery. For analysis of the role of oxygen free radical and lipid peroxidation in reperfusion injury, blood samples for malondialdehyde and neutrophil respiratory burst test(hydrogen peroxide amount of neutrophils) were obtained in pre-declamping of aorta and 5 min, 10 min, and 20 min after declamping of aorta from coronary sinus. RESULTS: 1) The vasoconstrictor response to acetylcholine, 10(-9) to 10(-6)M concentration, at proximal and distal left anterior descending coronary artery, were increased significantly in post-operation infusion study but there was no singnificant difference in vasodilator response to nitroglycerin. 2) The mean absorbance value of malondialdehyde(MDA) in pre-declamping and 5min, 10min, and 20min after reperfusion were 96+/-12, 73+/-12, 89+/-11 and 77+/-12, respectively. There was no significant difference in plasma MDA level and hydrogen peroxide amount of neutrophils after reperfusion(aortic declamping). CONCLUSION: These data suggest that endothelium dependent vascular relaxation is impaired in patients with open heart surgery and post-ischemic reperfusion injury may be responsible for the abnormal response. But we did not determine the role of lipid peroxidation and oxygen free radical in reperfusion injury.
Acetylcholine ; Animals ; Aorta ; Aortic Valve Stenosis ; Coronary Artery Bypass ; Coronary Sinus ; Coronary Vessels ; Endothelium ; Free Radicals ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hydrogen Peroxide ; Lipid Peroxidation* ; Malondialdehyde ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Molar ; Myocardial Infarction ; Myocardial Stunning ; Myocardium ; Neutrophils ; Nitroglycerin ; Oxygen* ; Plasma ; Relaxation ; Reperfusion Injury* ; Reperfusion* ; Respiratory Burst ; Tetralogy of Fallot ; Thoracic Surgery* ; Thrombolytic Therapy

BACKGROUND: Reperfusion of ischemic myocardium is clinically encountered during thrombolytic therapy of acute myocardial infarction, percutaneous transluminal coronary angioplasty(PTCA), and coronary artery bypass graft(CABG). Reperfusion results in endothelial dysfunction characterized by a reduced release of endothelium-derived relaxing factor(EDRF) in animal studies. Studies with experimental animals have emphasized the role of oxygen free radicals and lipid peroxidation in pathophysiology of reperfusion injury and myocardial stunning. The object of this study is to determine whether endothelial dysfunction was developed after open heart surgery and to evaluated the role of oxygen free radical and lipid peroxidation in reperfusion injury. METHODS: The study group was comprised 13 patients who underwent open heart surgery(male/female : 2/11, mean age : 43+/-4 year, Atrial septal defect in 4, Ventricular septal defect in 1, Mitral regurgitation in 2, Tetralogy of Fallot in 1, and Aortic stenosis and Regurgitation with Mitral stenosis in 5 patients). The endothelial function was evaluated with the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the continous infusion of acetylcholin, from 10(-9) to 10(-6) molar concentration to the coronary artery and intracoronary injection of 200microg nitroglycerin after acetylcholine infusion. The infusion study was performed before and 10 days after surgery. For analysis of the role of oxygen free radical and lipid peroxidation in reperfusion injury, blood samples for malondialdehyde and neutrophil respiratory burst test(hydrogen peroxide amount of neutrophils) were obtained in pre-declamping of aorta and 5 min, 10 min, and 20 min after declamping of aorta from coronary sinus. RESULTS: 1) The vasoconstrictor response to acetylcholine, 10(-9) to 10(-6)M concentration, at proximal and distal left anterior descending coronary artery, were increased significantly in post-operation infusion study but there was no singnificant difference in vasodilator response to nitroglycerin. 2) The mean absorbance value of malondialdehyde(MDA) in pre-declamping and 5min, 10min, and 20min after reperfusion were 96+/-12, 73+/-12, 89+/-11 and 77+/-12, respectively. There was no significant difference in plasma MDA level and hydrogen peroxide amount of neutrophils after reperfusion(aortic declamping). CONCLUSION: These data suggest that endothelium dependent vascular relaxation is impaired in patients with open heart surgery and post-ischemic reperfusion injury may be responsible for the abnormal response. But we did not determine the role of lipid peroxidation and oxygen free radical in reperfusion injury.
Acetylcholine ; Animals ; Aorta ; Aortic Valve Stenosis ; Coronary Artery Bypass ; Coronary Sinus ; Coronary Vessels ; Endothelium ; Free Radicals ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hydrogen Peroxide ; Lipid Peroxidation* ; Malondialdehyde ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Molar ; Myocardial Infarction ; Myocardial Stunning ; Myocardium ; Neutrophils ; Nitroglycerin ; Oxygen* ; Plasma ; Relaxation ; Reperfusion Injury* ; Reperfusion* ; Respiratory Burst ; Tetralogy of Fallot ; Thoracic Surgery* ; Thrombolytic Therapy