OBJECTIVES: The purposes of this clinical study were 1) to assess 5-year survival rates in 195 patients with locally invasive cervical cancer(stage Ia-IIb) treated by surgery, neoadjuvant chemotherapy+surgery and postoperative radiation in selected cases, 2) to evaluate the prognostic factors affecting the survival rate, and 3) to get helpful information for the better treatment. METHODS: A retrospective analysis was conducted of 195 patients. They were diagnosed and operated on during the period of Jan. 1988 - Dec. 1993 in Dept. of OB/Gyn, Pusan Paik Hospital, Inje Medical School. The 5-year survival rates were estimated using the Kaplan-Meier method, and prognostic factors were assessed using Wilcoxon test. RESULTS: The 5-year survival rates for FIGO stages Ia, Ib, IIa, and IIb were 100, 86.1, 76.9, and 81.1%, respectively. Factors that affect the 5-year survival rates were clinical stage(P=0.0001), cell type(small cell vs other, P=0.0001), depth of invasion(< or = 5 mm vs >5 mm, P=0.0013), tumor size(< or = 3 cm vs >3cm, P=0.0035), and lymph node metastasis(0 vs 1 vs more than 2, P=0.0001). There was no difference in 5-year survival rates between without neoadjuvant chemotherapy group and with neoadjuvant chemotherapy group which had poor prognostic factors. The predicted recurrence rate of the postoperative radiation group showed a lower 5-year survival rate than the no postoperative radiation group(P=0.0001). CONCLUSIONS: We conclude that the factors affecting the prognosis were FIGO stage, cell type, depth of invasion, tumor size, and lymph node metastasis, and speculated that the survival rates could be improved by using neoadjuvant chemotherapy for more advanced locally invasive cases properly.
Busan ; Drug Therapy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Schools, Medical ; Survival Rate ; Uterine Cervical Neoplasms

A 3,480 g male neonate showed tachypnea symptom with a serum ionized calcium level of 0.66 mmol/L by routine clinical analysis. He was injected calcium gluconate intravenously through femoral vein catheter to treat the hypocalcemia. On second day after the injection, he started to show erythema in the flank area. The lesion became firm and changed into whitish crust consist of small crystals. Abdominal X-ray and ultrasonography showed the accumulation of calcium deposit in the subcutaneous layer of the lesion. Surgical debridement was performed to remove the crust with calcium deposit and acellular fish skin graft rich in omega-3 (Kerecis) was applied to the defect site for secondary intention of the defect wound. After 2 months, the skin and soft tissue defect were fully covered with healthy normal skin without depression or contracture. This report is a first case of iatrogenic calcinosis cutis without extravasation symptom.

Cholangiocarcinoma is a form of adenocarcinoma arising from the intrahepatic or extrahepatic biliary epithelium. Apparent predisposing factors include some chronic hepatobiliary parasitic infsttations, congenital anomalies with ectatic ducts, sclerosing cholangitis and chronic ulcerative colitis and occupational exposure to possible biliary tract carcinogens. Patients with cholangiocarcinoma usually present with biliary obstruction, painless jaundice, pruritus, weight loss and acholic stools. Because the obstructing process is gradua1, the cholangiocarcinoma is often far advanced by the time it presents clinically. The diagnosis is most frequently made by cholangiography following ultrasound demonstration of dilated intrahepatic bile ducts. We report a case of common bile duct cancer spreading to gallbladder and common hepatic duct along the biliary mucosal epitherium and submucosal tissue in 68-year-old female patient along with a review of literature.
Adenocarcinoma ; Aged ; Bile Ducts, Intrahepatic ; Biliary Tract ; Carcinogens ; Causality ; Cholangiocarcinoma ; Cholangiography ; Cholangitis, Sclerosing ; Colitis, Ulcerative ; Common Bile Duct* ; Diagnosis ; Epithelium ; Female ; Gallbladder* ; Hepatic Duct, Common* ; Humans ; Jaundice ; Occupational Exposure ; Pruritus ; Ultrasonography ; Weight Loss

Schwannomas are benign nerve sheath tumors that can originate at any anatomic sites. These tumors are usually soitary, benign, and slow-growing masses attached to large nerve trunks. These tumors have been described as arising in the pelvic retroperitoneum. We present two cases of pelvic retroperitoneal Schwannomas with a brief review of literatures.
Nerve Sheath Neoplasms ; Neurilemmoma*

Malignant fibrous histiocytoma is a rare malignant tumor of probably histiocytic origin. It is more common in soft tissue than bone. Usually it involves metaphysis or diaphysis of long bone. Primary spinal malignant fibrous histiocytoma is exceedingly rare. Authors report a case of primary malignant fibrous histiocytoma which showed rapid spinal cord compression in thoracic spine with review of literatures.
Diaphyses ; Histiocytoma, Malignant Fibrous* ; Spinal Cord Compression ; Spine*

Rectosigmoid vaginoplasty is a frequently used surgical method in male-to-female sex reassignment surgery. However, severe side effects, such as sepsis, may occur owing to stricture, mucorrhea, and rectovaginal fistula. Herein, we present the case of a 29-yearold patient who underwent complete reconstruction of an obstructed rectosigmoid vaginal orifice. The patient had undergone male-to-female sex reassignment surgery with rectosigmoid vaginoplasty 8 years previously. The vaginal introitus was completely obstructed, and mucous secretions of the rectum remained in the blind pouch. Therefore, she developed several complications, including panperitonitis, sepsis, and repeated obstruction. We performed complete resection of the scar and reconstructed the orifice of the neovagina using a pudendal thigh island flap. The patient’s lifethreatening condition subsided with the successful release of the vaginal orifice. Vaginal orifice stricture is a frequent complication of rectosigmoid vaginoplasty. A pudendal thigh flap can be used to effectively and safely release this stricture and reconstruct the neo-orifice of the rectosigmoid vagina without recurrence.

PURPOSE: Thoracic ultrasonography (US) is an emerging tool for diagnosing pneumothorax (PTX), and the possible application of color Doppler to ultrasonography is another new development. The aim of this study is to analyze the possible contribution of color Doppler to thoracic US and to the estimation of pneumothorax volume. METHODS: Patients who were admitted to emergency department underwent chest X-ray and thoracic US with color Doppler. They were also evaluated by computed tomography, if needed, US was performed at four chest sites by emergency medicine faculty and resident, and concordance between color Doppler and lung sliding was analyzed. The number of sites with abnormal findings was correlated with the volume of PTX at each sites. Statistical analysis was performed with Pearson correlation. RESULTS: Sixty-three of 151 PTX cases were included in our study. The sensitivity of US was for PTX detection was 92.1% (58 of 63), and the concordance between color Doppler and lung sliding was 99.4%. The number of sites per patient with abnormal findings increased with the average volume of the PTX. The average PTX volume in the 5 cases with normal findings was 7.0%, which is a smallsized PTX. CONCLUSION: The use of color Doppler is not more accurate than lung sliding, but it may helpful in diagnosing PTX. The volume of a PTX is proportional to a patient's number of sites with abnormal US findings.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Lung ; Pneumothorax* ; Thorax ; Ultrasonography

No abstract available.

No abstract available.
Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia* ; Respiratory Sounds*

BACKGROUND: Increasing degrees of medullary hyperemia induced by ischemia reperfusion injury were associated with renal dysfunction. A possible mechanism may be that ischemia causes alterations in the structure and function of vascular membranes which leads to an aggregation of red blood cells in the medullary vessel. It has been shown that heparin prevents postischemic endothelial cell dysfunction. Aim of this study was to evaluate heparin effects on renal hyperemia induced by ischemia reperfusion injury. METHOD: In this study, fifteen rabbits were randomized to either heparin treatment group(500 IU/kg IV bolus 10 minutes before renal artery occlusion, n=8) or control group(n=7). One side kidney underwent 60 minutes ischemia only by clamping renal pedicle and after that kidney tissue sample was obtained for histologic evaluation. The other side of kidney were permitted 60 minutes ischemia following 60 minutes reperfusion and after that kidney tissue sample was obtained for histologic evaluation. RESULTS: There was significant difference in the degree of congestion(2.6+/-0.2 vs 1.1+/-0.3, P<0.05) between outer medulla of control and heparin treatment group. CONCLUSION: Heparin significantly attenuated outer medullary congestion induced ischemic injury.
Constriction ; Endothelial Cells ; Erythrocytes ; Estrogens, Conjugated (USP) ; Heparin* ; Hyperemia ; Ischemia* ; Kidney ; Membranes ; Rabbits ; Renal Artery ; Reperfusion Injury ; Reperfusion*