No abstract available.
Estrogen Replacement Therapy* ; Estrogens* ; Female ; Gonadotropins* ; Humans ; Ovariectomy*

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

Screw fixation of the tibial component offers advantages in initial fixation in cementless total knee replacement. But the high incidence of screw related osteolysis was reported. The purpose of this study is to evaluate clinical results of cementless total knee replacement and to look for radiographic changes at the screw-bone interface. From January 1988 to December 1991, primary cementless total knee replacements with Miller Galante I (Zimmer, Warsaw. IN) were performed to 53 knees at Kyung Hee university hospital. Among them, 21 cases which could be followed-up for more than 4 years were studied retrospectively about the clinical and radiographic results. The mean follow-up period was 5.5 years(ranged from 4.2 years to 8 years). At the last follow-up period, knee scores of Hospital for Special Surgery were improved from mean 56 points to 90 points and the range of motion from 72 degrees to 110 degrees. In the last follow-up radiographs, osteolysis around screw was classified as linear(type I ), cystic(type II ) and cavitary(type III ) according to the width of the lucency around screws. Among 21 cases, radiographic findings of osteolysis around screw were detected in 10 cases but not in 11 cases. But clinical results were similar between these two groups. Among the total 84 screws(4 screws in each case), 21 screws(25%) showed screw related osteolysis typed as I in 13 screws(15.4%), II in 4 screws(4.8%) and III in 4 screws(4.8%). Among the 13 cases that followed-up more than 6 years, 20 screws(38%) showed screw related osteolysis typed as in 11 screws(21.2%), I in 5 screws(9.6%) and II in 4 screws(7.8%). The most frequently involved site of screw was anteromedial(33.3%). In conclusion, after mean 5.5 year follow-up, the clinical results were satisfactory but the development of osteolysis around screw might be an indicator of the implant failure.
Arthroplasty, Replacement, Knee* ; Follow-Up Studies ; Incidence ; Knee ; Osteolysis* ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: Extra-thyroidal extension has been recognized as a poor prognostic factor for increased regional recurrence risk in papillary thyroid carcinoma, and is known to require treatment that is more aggressive. In the recent UICC TNM 6th Classification, an extra-thyroidal extension was divided into a minimal extra-thyroidal extension (T3) and a massive extra-thyroidal extension (T4). The aim of this study was to investigate the clinical effect of a minimal extra-thyroidal extension of a papillary carcinoma for the recurrence of regional cervical lymph nodes. METHODS: We retrospectively studied 154 patients with papillary thyroid carcinoma where a thyroidectomy was performed from Feb. 2003 to May. 2006 at the Department of Surgery, with the exclusion of 6 patients with a massive extra-thyroidal extension. We divided the cases into a no extra-thyroidal extension group and a minimal extra-thyroidal extension group according to the grading of the extra-thyroidal extension. The grading of the extra-thyroidal extension was based on both pathological findings and intraoperative surgical findings. Clinicopathological factors associated with each group were analyzed by univariate and multivariate analysis. We divided the cases into two groups according to age (<45 yrs, > or =45 yrs) and lymph node status (positive, negative), and compared each group with regards to disease free survival according to the grading of the extra-thyroidal extension. RESULTS: By univariate analysis, a minimal extra-thyroidal extension was related to lymph node metastasis, tumor size, mutifocality (P<0.05), and was not related to cervical lymph node recurrence statistically (P=0.108). Cervical lymph node recurrence was related to being male, lymph node metastasis and tumor size (P<0.05). By multivariate analysis, a minimal extra-thyroidal extension was independently related to tumor size, multifocality, and lymph node metastasis (P<0.05). In both groups with regards to age and lymph node status, a minimal extra-thyroidal extension was not statistically related to disease free survival (P>0.05). CONCLUSION: We need to downstage to less than T3 for a minimal extra-thyroidal extension because there is no significant difference in disease free survival according to the grading of an extra-thyroidal extension in patients with papillary thyroid carcinoma.
Carcinoma, Papillary ; Classification ; Disease-Free Survival ; Humans ; Lymph Nodes* ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: The development of publicized screening methods for breast carcinoma detection has led to a marked increase in the discovery of ductal carcinoma in situ (DCIS) or DCIS with microinvasion (DCIS-MI). Axillary lymph node status has been believed to be not only an indicator of prognosis, but also a direction of adjuvant therapy. But the incidence of axillary metastasis in DCIS or DCIS-MI has diversely found in from 0% to 20%. This study was performed to analyze the incidence of axillary metastasis and the predictive factors associated with axillary lymph node metastasis in DCIS or DCIS-MI. METHODS: Patients with DCIS or DCIS-MI and axillary lymph node dissection from 1987 to 2004 were selected from Korea University Medical Center. We reviewed their medical records for age, palpability and size of the tumor, histolgic subtype, nuclear grade, hormone receptor status, and pathologic slides. RESULTS: Fifty two patients in DCIS and Thirty eight patients in DCIS-MI were included in the study. Axillary lymph node metastases were identified in 2 patients (3.8%) in DCIS and 4 patients (10.5%) in DCIS-MI. Tumor size and nuclear grade in DCIS had a borderline significance in association with microinvasion. We could not be able to find any predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. CONCLUSION: Axillary lymph node metastasis in DCIS or DCIS-MI appeared to be not low and there was no predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. But DCIS patients with large tumor size and poor nuclear grade have the high possibility associated with microinvasion, therefore, in that cases, there is a need to consider the possibility of axillary metastasis.
Academic Medical Centers ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Mass Screening ; Medical Records ; Neoplasm Metastasis* ; Prognosis

PURPOSE: To assess the accuracy of intraocular lens (IOL) power prediction for cataract surgery with open angle glaucoma (OAG) and to identify preoperative angle parameters correlated with postoperative unpredicted refractive errors. MATERIALS AND METHODS: This study comprised 45 eyes from 45 OAG subjects and 63 eyes from 63 non-glaucomatous cataract subjects (controls). We investigated differences in preoperative predicted refractive errors and postoperative refractive errors for each group. Preoperative predicted refractive errors were obtained by biometry (IOL-master) and compared to postoperative refractive errors measured by auto-refractometer 2 months postoperatively. Anterior angle parameters were determined using swept source optical coherence tomography. We investigated correlations between preoperative angle parameters [angle open distance (AOD); trabecular iris surface area (TISA); angle recess area (ARA); trabecular iris angle (TIA)] and postoperative unpredicted refractive errors. RESULTS: In patients with OAG, significant differences were noted between preoperative predicted and postoperative real refractive errors, with more myopia than predicted. No significant differences were recorded in controls. Angle parameters (AOD, ARA, TISA, and TIA) at the superior and inferior quadrant were significantly correlated with differences between predicted and postoperative refractive errors in OAG patients (-0.321 to -0.408, p<0.05). Superior quadrant AOD 500 was significantly correlated with postoperative refractive differences in multivariate linear regression analysis (β=-2.925, R²=0.404). CONCLUSION: Clinically unpredicted refractive errors after cataract surgery were more common in OAG than in controls. Certain preoperative angle parameters, especially AOD 500 at the superior quadrant, were significantly correlated with these unpredicted errors.
Biometry ; Cataract* ; Glaucoma, Open-Angle* ; Humans ; Iris ; Lenses, Intraocular ; Linear Models ; Myopia ; Refractive Errors* ; Tomography, Optical Coherence

PURPOSE: The incidence of secondary malignancies in hematologic patients is known to be higher than it is in other patients. However, the characteristics of secondary malignancy and surveillance have not yet been established for colorectal cancer in leukemic patients. METHODS: From 1995 to 2007, 6,030 patients who were diagnosed with acute myeloid leukemia (AML), acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML), chronic lymphoid leukemia (CLL), and multiple myeloma (MM) were enrolled in this study. Among them, 9 patients were diagnosed with colorectal cancer at St. Mary's Hospital and were analyzed retrospectively. RESULTS: Three of the 2,570 patients with AML, 1 of the 1,158 patients with CML, 2 of the 83 patients with CLL, 2 of the 422 patients with MM, and none of the 1,797 patients with ALL were found to have colorectal cancer. There were no operative mortalities, but 2 patients refused to have surgery. The ratio of observed to expected subsequent colorectal cancer in CLL was higher than it was in the other groups, indicating that the relative risk of colorectal cancer is higher in patients with CLL. CONCLUSION: Compared to the Surveillance, Epidemiology and End-Result (SEER) program at the National Cancer Institute (NCI) in the United State, we have the same high relatively risk in CLL patients. Careful attention should be paid to the possibility of colorectal cancer in CLL patients.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Hematologic Diseases ; Humans ; Incidence ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Multiple Myeloma ; National Cancer Institute (U.S.) ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) has been well controlled with otolith reposition therapy. Posterior canal is known as the most common site of BPPV. The purpose of this study was to study the therapeutic result of reposition therapy in posterior canal BPPV, to investigate the unusual cases such as recurred cases and type changed cases during the reposition maneuver, and to figure out the therapeutic strategy. MATERIALS AND METHODS: One hundred and ten patients diagnosed posterior canal BPPV were included in this study. Epley maneuver was performed once a day until nystagmus disappeared. We analyzed the number of treatment, changing type, recurrence and the relationship between recurrence and age or sex of patients. RESULT: All cases except 2 were recovered by Epley maneuver. In 11 cases, the type of disease was changed, and the treatment of these cases were changed according to new type and origin. Overall recurrence rate was 15%, and they were completely treated with reposition therapy. There was no correlation between recurrence and age, sex of patients. CONCLUSION: All most cases were cured with Epley maneuver. The type of the disease was possibly changeable. Recurrence rate was relative high, and close follow up was required.
Follow-Up Studies ; Humans ; Otolithic Membrane* ; Recurrence ; Semicircular Canals* ; Vertigo

The role of the donor and recipient gender have been a controversial point in the outcome of renal transplantation and the pathophysiologic mechanisms are not understood clearly. In order to evaluate the effect of gender on the renal graft survival, we reviewed our 400 consecutive living donor renal transplantation. The patients were divided into four groups, Group 1; male donor and male recipient(n=152), Group 2; female donor and male recipient(n=61), Group 3; male donor and female recipient(n=135), and Group 4; female donor and female recipient(n=52). To estimate the transplant outcome between the groups, we analyzed patient and graft survival, acute tubular necrosis, BUN, creatinine and rejection episode for maximum 5 years after transplantation. The level of BUN(34.7+/- 26.4, 19.8+/- 6.4, 30.5+/- 14.6, 23.1+/- 10.5 in group 1,2,3,4 respectively) and serum creatinine(2.62+/- 2.3, 1.48+/- 1.1, 2.24+/- 1.2, 1.65+/- 0.9 in group 1,2,3,4 respectively) were higher in male recipient groups regardless of donor gender. However, donor and recipient gender had no influence on post-graft blood pressure and acute tubular necrosis(p>0.05). Acute rejection episode was predominent at female donor graft than male donor graft(36.4% vs 30.1%). The 5 year graft survival in group 1,2,3,4 were 67.8, 67.2, 60.1, 72.7% and patient survival were 76.9, 75.6, 72.6, 80.5% in their orders. These results suggest that donor and recipient gender might play a role in the outcome of renal transplantation. The mechanism of these results must be analyzed by further evaluation using larger patient group.
Allografts* ; Blood Pressure ; Creatinine ; Female ; Graft Survival ; Humans ; Kidney Transplantation ; Living Donors ; Male ; Necrosis ; Tissue Donors* ; Transplants

The role of the donor and recipient gender have been a controversial point in the outcome of renal transplantation and the pathophysiologic mechanisms are not understood clearly. In order to evaluate the effect of gender on the renal graft survival, we reviewed our 400 consecutive living donor renal transplantation. The patients were divided into four groups, Group 1; male donor and male recipient(n=152), Group 2; female donor and male recipient(n=61), Group 3; male donor and female recipient(n=135), and Group 4; female donor and female recipient(n=52). To estimate the transplant outcome between the groups, we analyzed patient and graft survival, acute tubular necrosis, BUN, creatinine and rejection episode for maximum 5 years after transplantation. The level of BUN(34.7+/- 26.4, 19.8+/- 6.4, 30.5+/- 14.6, 23.1+/- 10.5 in group 1,2,3,4 respectively) and serum creatinine(2.62+/- 2.3, 1.48+/- 1.1, 2.24+/- 1.2, 1.65+/- 0.9 in group 1,2,3,4 respectively) were higher in male recipient groups regardless of donor gender. However, donor and recipient gender had no influence on post-graft blood pressure and acute tubular necrosis(p>0.05). Acute rejection episode was predominent at female donor graft than male donor graft(36.4% vs 30.1%). The 5 year graft survival in group 1,2,3,4 were 67.8, 67.2, 60.1, 72.7% and patient survival were 76.9, 75.6, 72.6, 80.5% in their orders. These results suggest that donor and recipient gender might play a role in the outcome of renal transplantation. The mechanism of these results must be analyzed by further evaluation using larger patient group.
Allografts* ; Blood Pressure ; Creatinine ; Female ; Graft Survival ; Humans ; Kidney Transplantation ; Living Donors ; Male ; Necrosis ; Tissue Donors* ; Transplants