No abstract available.
Aneurysm, False* ; Arteries* ; Fractures, Bone*

No Abstract Available.

Neoplastic polyps of colon are one of the most risky factors for colorectal cancer. Particularly villous adenomas have more malignant potential than other neoplastic polyps. The preoperative detection of malignant change in villous adenoma is very important to determine treatment modality of patients. We conducted that total twenty-four cases of villous adenoma who were diagnosed and treated at our institution between January 1990 and December 1995 were reviewed retrospectively. The peak incidence of age was 7th decades. And male to female ratio was 2 : 1. Size of the adenoma ranged from 1.2 to 10.7 cm with a mean diameter of 3.9 cm. Five cases(20.8%) were between 1 and 2 cm, 10(41.7%) between 2 and 4 cm, and 9(31.5%) greater than or equal to 4 cm. Location of the adenoma were 10 cases(41.7%) in upper rectum, 8(33.3%) in rectosigmoid, and 6(25.0%) in lower rectum respectively. Pathologic examination of the resected specimen were diagnosed 9(37.5%) as benign villous adenomas, 10(41.7%) as in situ carcinoma, and 5(20.8%) as invasive carcinoma. The diagnostic accuracy to detect in situ carcinoma or invasive carcinoma was endoscopic examination in 66.7 percent and digital examination in 86.7 percent. The grade of in situ carcinoma had not significantly relationship with the size of the adenoma on our study. However, invasive carcinoma was significantly related to adenoma size(P<0.05) as following results zero percent between 1 and 2 cm, 20 percent between 2 and 4 cm, and 33.3 percent greater than or equal to 4 cm. In conclusion, the larger villous adenoma has higher malignant potential, especially greater than or equal to 4 cm in size. Added, the clinical impression of the malignancy on digital examination can be more accurate than preoperative endoscopic examination on our study.
Adenoma ; Adenoma, Villous* ; Colon ; Colorectal Neoplasms ; Female ; Humans ; Incidence ; Male ; Polyps ; Rectum ; Retrospective Studies

No abstract available.
C-Reactive Protein* ; Chorioamnionitis* ; Female ; Humans ; Membranes* ; Pregnancy ; Rupture*

Programmed death-1 (PD-1) is a strong negative regulator of T lymphocytes in tumor-microenvironment. By engaging PD-1 ligand (PD-L1) on tumor cells, PD-1 on T cell surface inhibits anti-tumor reactivity of tumor-infiltrating T cells. Systemic blockade of PD-1 function using blocking antibodies has shown significant therapeutic efficacy in clinical trials. However, approximately 10 to 15% of treated patients exhibited serious autoimmune responses due to the activation of self-reactive lymphocytes. To achieve selective activation of tumor-specific T cells, we generated T cells expressing a dominant-negative deletion mutant of PD-1 (PD-1 decoy) via retroviral transduction. PD-1 decoy increased IFN-γ secretion of antigen-specific T cells in response to tumor cells expressing the cognate antigen. Adoptive transfer of PD-1 decoy-expressing T cells into tumor-bearing mice potentiated T cell-mediated tumor regression. Thus, T cell-specific blockade of PD-1 could be a useful strategy for enhancing both efficacy and safety of anti-tumor T cell therapy.
Adoptive Transfer ; Animals ; Antibodies, Blocking ; Autoimmunity ; Cell- and Tissue-Based Therapy ; Humans ; Lymphocytes ; Mice ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic* ; Zidovudine

Hallux valgus has been defined as a static subluxation of the first metatarsophalangeal joint with lateral deviation of the proximal phalanx on the first metatarsal head from the longitudinal axis of the first metatarsal with medial deviation of the first metatarsal. And first-second metatarsal angle is increased as well as bursal hypertrophy over the medial eminence of the first metatarsal head. Many procedures have been reported for the treatment of the hallux valgus ranging from resection arthroplasty to distal first metatarsal or basal first metatarsal osteotomy. Of these, Johnson and Corless have required sufficiently good results in the modifying Mitchell osteotomy into Chevron osteotomy. The Chevron procedure is an osteotomy involving the distal portion of the first metatarsal, lateral displacement of the metatarsal head with exostosectomy, and tightening of the medial capsular structures. Authors studied 17 cases in 10 patients with the hallux valgus deformity treated by Chevron osteotomy at the Department of Orthopedic Surgery, Capital Armed Forced General Hospital from September 1987 to September 1989. The results were as follows; 1. Seven patients (12 cases) were male and three patients (5 cases) were female. All patients had bilateral hallux valgus deformity. 2. The average first-second intermetatarsal angle was 11 degrees and average valgus angle was 32 degrees, preoperatively. They were corrected to 9 degrees and 14 degrees respectively. 3. The metatarsalgia of the great toe was subsided in all cases and they were satisfied with the result of their operations in respect to cosmetically and functionally. Avascular necrosis of capital fragment, nonunion, and dorsal angulation were not developed in any case. But, one case had marginal skin necrosis, presumably due to excessive compressive dressing. 4. Chevron osteotomy is a technically easy procedure and it can be obtained early bone healing with less complication.
Arm ; Arthroplasty ; Bandages ; Congenital Abnormalities ; Female ; Hallux Valgus ; Hallux ; Head ; Hospitals, General ; Humans ; Hypertrophy ; Male ; Median Eminence ; Metatarsal Bones ; Metatarsalgia ; Metatarsophalangeal Joint ; Necrosis ; Orthopedics ; Osteotomy ; Skin ; Toes

PURPOSE: To improve survival and/or to avoid radiotherapy, high dose chemotherapy (HDCT) with autologous peripheral blood stem cell transplantation (PBSCT) was given to patients with recurrent or high risk medulloblastoma (MB)/primitive neuroectodermal tumor (PNET) as well as patients younger than 3 years of age. METHODS: Six patients (3 recurrent, 1 high risk, 2 younger than 3 years; 5 MBs and 1 PNET) received single or double HDCT and PBSCT with or without immunotherapy using interleukin-2. Chemotherapeutic regimen in the first HDCT included cyclophosphamide (1,500 mg/m2/ day for 4 days) and melphalan (60 mg/m2/day for 3 days). Chemotherapeutic regimen in the second HDCT included carboplatin (400 mg/m2/day for 3 days), thiotepa (250 mg/ m2/day for 3 days), and etoposide (200 mg/m2/day for 3 days). RESULTS: Nine HDCTs were applied in 6 patients. Three double HDCTs were rescued with peripheral blood stem cells collected during single round leukapheresis. Rapid hematologic recovery occurred in 4 patients. Engraft failure occurred in 1 patient and delayed granulocyte recovery and platelet engraft failure occurred in 1 patient. Three patients who had minimal disease before HDCT had event free survival for 7~18 months after HDCT. Tumor relapsed 8 and 12 months after single HDCT in 2 patients among 3 patients with recurrent MB/PNET. One patient with recurrent MB died due to engraft failure and sepsis. CONCLUSION: HDCT with autologous PBSCT is expected to improve survival of patients with poor prognosis MB/PNET including younger patients less than 3 years. Subsequent trials with larger number of patients and long-term follow-up are needed.
Blood Platelets ; Carboplatin ; Cyclophosphamide ; Disease-Free Survival ; Drug Therapy* ; Etoposide ; Follow-Up Studies ; Granulocytes ; Humans ; Immunotherapy ; Interleukin-2 ; Leukapheresis ; Medulloblastoma ; Melphalan ; Neural Plate* ; Neuroectodermal Tumors* ; Neuroectodermal Tumors, Primitive ; Peripheral Blood Stem Cell Transplantation* ; Prognosis ; Radiotherapy ; Sepsis ; Stem Cells ; Thiotepa

Dural carotid-cavernous fistula (CCF) is characterized by arteriovenous communications between the meningeal branches of the internal or external carotid arteries and the cavernous sinus. Although the triad of chemosis, proptosis, and ocular bruit has been regarded as a classic sign of CCF, dural CCF often lacks these features. Dural CCF is a rare cause of ophthalmoplegia, and so it may be overlooked when the classic symptoms are absent. We report herein a case of bilateral dural CCF that presented as unilateral isolated abducens nerve palsy.
Abducens Nerve ; Abducens Nerve Diseases ; Carotid Artery, External ; Cavernous Sinus ; Caves ; Diplopia ; Exophthalmos ; Fistula ; Ophthalmoplegia

BACKGROUND: After an esophageal resection for an esophageal disease, the stomach becomes the most common organ for a substitute. The stomach has the advantages of being simple with fewer complications when used properly. The complications of an esophageal reconstruction using the stomach as the substitute are assessed and discussed. MATERIAL AND METHOD: Between 1990 and 1998, 44 patients who underwent esophagogastric anastomosis were treated in the department of Thoracic and Cardiovascular Surgery of Yongdong Severance Hospital, Seoul, Korea. RESULT: The rate of postoperative complications and mortality in these 44 patients were 70.5% and 13.6%, respectively. The major complications in our series involved the stricture of anastomosis(13.6%), pneumonia(11.4%), and wound infection(9.1%). The most frequent causes of postoperative deaths were pulmonary complications and sepsis(6.8%). CONCLUSION: Anastomotic leakage is no longer a major complication of an esophagogastrostomy. Most postoperative stricture can be overcome with frequent esophageal dilations. Postoperative pulmonary infection, nutrition, and physiotherapy are very important in reducing the rate of pulmonary morbidity and mortality.
Anastomotic Leak ; Constriction, Pathologic ; Esophageal Diseases ; Humans ; Korea ; Mortality* ; Postoperative Complications ; Seoul ; Stomach ; Wounds and Injuries

No abstract available.