OBJECTIVE: This study is aimed to analyze the results of follow up after conization and to determine the value of repeat conization for treatment of cervical intraepithelial neoplasia (CIN) III. METHODS: Between March 1998 and February 2002, 241 women were underwent knife conization due to CIN III of the uterine cervix. After knife conization, follow-up visits were scheduled at 2 weeks interval during the first 3 months for cervical inspection only, then at every 3 months for the first year, every 6 months for the second year, and then annually for pelvic examination and Papanicolaou smears. Among 241 patients, 71 women were suspected of residual or recurrent lesions by cytology and colposcopy. Among 71 patients with residual or recurrent lesions, 37 patients received simple hysterectomy and 34 patients received repeat conization. RESULTS: The mean age of the patients was 36.4 years (range 27-64) and mean parity was 2 (range 0-6). The mean follow-up duration was 25.4 months (range 14-51) after conization. The results of repeat conization (n=34) were as follows; no residual lesion in 7 patients, CIN III in 15 patients, and lower grade neoplasia in 12 patients. Two patients were margin positive; 1 patient with CIN III, 1 patient with lower grade neoplasia. The outcomes of simple hysterectomy (n=37) were as follows; no residual lesion in 8 patients, CIN III in 18 patients, and lower grade neoplasia in 11 patients. Resection margin negative rates of repeat conization and simple hysterectomy were 94.1% and 100%, respectively (p>0.05). CONCLUSION: This study suggests that less invasive technique such as repeat conization might be an alternative method instead of hysterectomy in selected patients with recurrent or residual lesions who wish to preserve fertility.
Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Colposcopy ; Conization* ; Female ; Fertility ; Follow-Up Studies* ; Gynecological Examination ; Humans ; Hysterectomy ; Papanicolaou Test ; Parity

Calcific tendinitis of hand and foot is rare and frequently misdiagnosed because of its rare incidence and its similar clinical presentation to other conditions such as infection. Awareness of the typical location as well as familiarity with the imaging findings is essential for making a correct diagnosis of this rare condition. We report four cases of calcific tendinitis of hand and foot, occurring in the flexor hallucis brevis, abductor digiti minimi, and abductor pollicis brevis.
Foot ; Hand ; Incidence ; Recognition (Psychology) ; Tendinopathy ; Tendons

PURPOSE: A laparoscopic appendectomy is now commonly performed. The push in recent years toward reducing the number of ports required to perform this surgery has led to the development of a single-port laparoscopic appendectomy (SPA). We compared postoperative pain after an SPA using a glove port with a percutaneous organ-holding device (group 1) with that of an SPA using a commercially-available multichannel single-port device (group 2). METHODS: Between March 2010 and July 2011, a retrospective study was conducted of a total of 77 patients who underwent an SPA by three surgeons at department of surgery, Kangbuk Samsung Medical Center. Thirty-eight patients received an SPA using a glove port with a percutaneous organ-holding device. The other 39 patients received an SPA using a commercially-available multichannel single port (Octo-Port or SILS Port). Operative details and postoperative outcomes were collected and evaluated. RESULTS: There were no differences in the mean operative times, times to pass gas, postoperative hospital stays, or cosmetic satisfaction scores between the two groups. The pain score in the first 24 hours after surgery was higher in group 2 than group 1 patients (P < 0.001). Furthermore, the trocar used in group 2 was more expensive than that used in group 1. CONCLUSION: An SPA using a glove port with a percutaneous organ-holding device was associated with a lower pain score during the first 24 hours after surgery because of the shorter fascia incision length and a cheaper cost than an SPA using a commercially-available multichannel single-port device.
Appendectomy* ; Fascia ; Humans ; Length of Stay ; Operative Time ; Pain, Postoperative ; Retrospective Studies ; Surgical Instruments

BACKGROUND: Multiple system atrophy (MSA) and idiopathic Parkinson's disease (IPD) are two common neurodegenerative disorders presenting with parkinsonism. Since a brain MRI study is an available method for differentiating MSA from IPD, we tried to find further values of brain MRI studies in differentiating MSA from IPD. METHODS: We measured anteroposterior and transverse diameters (AD and TD, respectively) of the brain stem of T2-weighted axial images. We graded the severity of atrophy (grade 0: none; grade 1: mild; grade 2: moderate; and grade 3: severe) of cerebellar vermis and hemispheres on the midsagittal and parasagittal planes. RESULTS: There were 36 patients with probable MSA and 40 patients with IPD. We calculated a parameter multiplying AD of the midbrain by TD of the midbrain. The mean of the AD x TD of the midbrain was 1007.5 +/- 161.8 mm2 in patients with MSA, and it was significantly smaller than that of those with IPD (1113.3 +/- 118.7 mm2). When the cut off value was decided as 1050 mm2, the sensitivity of the parameter for the diagnosis of MSA was 83.3% and specificity was 80%. The frequency of cerebellar atrophy was 72.2% in patients with MSA, and it was significantly higher than that of those with IPD (37.5%). CONCLUSIONS: Measurements of the brain stem, particularly the midbrain, and cerebellum areas on brain MRI are helpful methods for the differential diagnosis of patients with MSA from those with IPD.
Atrophy ; Brain Stem* ; Brain* ; Cerebellum* ; Diagnosis ; Diagnosis, Differential* ; Humans ; Magnetic Resonance Imaging* ; Mesencephalon ; Multiple System Atrophy* ; Neurodegenerative Diseases ; Parkinson Disease* ; Parkinsonian Disorders ; Sensitivity and Specificity

OBJECTIVE: Although alcohol dependence is associated with a wide range of cognitive impairment, working memory function of alcohol dependence has not been well studied. The aim of this study was the assessment of working memory in alcohol dependence, the comparison of verbal and visuo-spatial working memory, and the examination of the correlations between working memory and clinical parameters. METHODS: A sample of 18 sober alcohol-dependent participants was compared with a sample of 19 controls on verbal and visuo-spatial working memory test using "2-back" system. RESULTS: Alcohol dependent participants showed the increased errors of verbal working memory. The amount of alcohol consumption during problem alcohol drinking period was correlated significantly with false positive error of verbal working memory. CONCLUSION: These results demonstrated that alcohol dependence impairs verbal working memory despite no impairment of intelligence. This study suggested the relationship between verbal working memory impairment and the amount of alcohol consumption.
Alcohol Drinking ; Alcoholism* ; Humans ; Intelligence ; Memory, Short-Term*

PURPOSE: BRAF mutation and expression of extracellular signal regulated kinase (ERK) are linked with colorectal carcinogenesis through the serrated pathway. BRAF and ERK1/2 play important roles in the activation of mitogen-activated protein (MAP) kinase signaling pathways. The present study investigated the clinicopathologic outcomes of BRAF mutation and ERK1/2 expression in patients with colorectal cancer (CRC) and the possibility of using them as prognostic indicators. METHODS: Dual-priming oligonucleotide-based multiplex polymerase chain reaction for BRAF(V600E) mutation and immunohistochemical analysis of ERK1/2 were performed using 65 formalin-fixed, paraffin-embedded samples from patients with CRC. We analyzed the dependences of the clinicopathologic features on BRAF mutation and ERK1/2 expression. RESULTS: Out of 65 samples from CRC patients, BRAF mutation was detected in 3 (4.6%). The 3 patients with BRAF mutation presented with T3 CRC with lymph node metastasis (stage III) showing moderately or poorly differentiated histology. ERK1 and ERK2 were positively detected in 73.8% and 15.4% of the patients with CRC, respectively. ERK1 expression was significantly correlated with lymph node metastasis (P = 0.049). ERK2 expression was significantly correlated with tumor emboli (P < 0.05), tumor invasion (P = 0.035), lymph node metastasis (P = 0.017), and stage (P = 0.02). CONCLUSION: BRAF mutation and ERK1/2 expression may be associated with advanced or more aggressive CRC. These molecular markers might play prognostic roles in CRC developed through the serrated pathway.
Adenocarcinoma* ; Carcinogenesis ; Colorectal Neoplasms ; Humans ; Lymph Nodes ; Multiplex Polymerase Chain Reaction ; Neoplasm Metastasis ; Phosphotransferases*

Subcutaneous panniculitic T-cell lymphoma(SPTCL) is a rare subtype of peripheral T-cell lymphoma that clinically and histologically mimics benign panniculitis. It represents subcutaneous nodules predominatly on extremities and trunk and hemophagocytic syndrome almost leading to death. A 29-year-old women presented with multiple tender subcutaneous nodules on lower abdomen and extremities for 6 months often with fevers and chills. There was no hepatosplenomegaly or lymphadenopathy. Skin biopsy specimen showed dense diffuse infiltration of atypical lymphocytes in the subcutis, with extensive fat necrosis and karyorrhexis. The immunophenotypic studies showed a cytoxic T-lymphocyte profile, i.e., LCA+, UCHL+, CD8+, CD20-, CD30-, and CD56-. In immunohistochemical studies for the Ebstein-Barr virus resulted in a negative finding. On the basis of the clinical and histological finding, we established the diagnosis of SPTCL.
Abdomen ; Adult ; Biopsy ; Chills ; Diagnosis ; Extremities ; Fat Necrosis ; Female ; Fever ; Humans ; Lymphatic Diseases ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Peripheral ; Panniculitis ; Skin ; T-Lymphocytes*

OBJECTIVE: This study was designated to determine the effect of cord blood cell transplantation in ischemic injury model. METHODS: In this study, we administered human umbilical cord blood (hUCB)-derived CD34(+) cells into the lateral ventricle or directly into the striatum and assessed cell migration in mice with cryoinjury and behavioral recovery in rats with transient middle cerebral artery occlusion (MCAo). CD34(+) cells were isolated by magnetic cell sorting using CD34-microbeads and labeled with CM-Dil. RESULTS: When CD34(+) cells were injected into mice brain with cryoinjury, cells were migrated into a injury site after one week of injection. Similarly, injected CD34(+) cells were migrated into the periphery of infarcted area in rats with transient MCAo. When spontaneous activity was measured using a modified neurological severity score (mNSS), it was found that functional recovery was significantly higher when CD34(+) human umbilical cord blood cell (hUCBC) was transplanted 24 hours after stroke compared with phosphate buffered saline (PBS)-injected or CD34(-) transplanted, stroked animals (P<0.05). Although only small portion of transplanted cells were differentiated into neural lineages, CD34(+) hUCBC transplantation increased Brdu incorporation and recruitment of doublecortin (DCX) (+) cells in ischemic boundary zone. CONCLUSION: These results suggest that hUCBC transplantation may be an effective treatment for brain injuries, such as stroke, or neurodegenerative disorders by promoting endogenous repair process of the brain.
Animals ; Brain ; Brain Injuries ; Bromodeoxyuridine ; Cell Movement ; Cell Transplantation ; Fetal Blood ; Humans ; Infarction, Middle Cerebral Artery* ; Lateral Ventricles ; Mice ; Middle Cerebral Artery* ; Neurodegenerative Diseases ; Rats* ; Stroke ; Transplants

PURPOSE: Laparoscopy-assisted gastrectomy (LAG) is considered an alternative treatment option for gastric cancer. LAG is safe, however the long-term oncologic efficacy and survival of patients including those with advanced gastric cancer have not been assessed. The aim of this study was to evaluate long-term outcomes and survival of patients with gastric cancer, including advanced cases, who underwent LAG performed by a single surgeon. METHODS: Between January 2006 and December 2010, 161 patients with gastric cancer underwent LAG performed by a single surgeon. Clinicopathological data were collected retrospectively along with data on survival and prognosis. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method. RESULTS: A total of 161 patients diagnosed with gastric cancer underwent LAG. Postoperative morbidity occurred in 12 patients. The median OS was 67.0 months (range, 1.0~97.0 months), and the median DFS was 67.0 months (range, 1.0~97.0 months). T stage, N stage, TNM stage, lymphatic invasion, and venous invasion influenced overall survival and disease recurrence. The OS rates according to N stage were 96.8% for N0, 94.4% for N1, 45.5% for N2, and 42.9% for N3. CONCLUSION: The current study showed that LAG for gastric cancer, including advanced gastric cancer, is technically feasible with acceptable long-term oncologic outcomes.
Disease-Free Survival ; Gastrectomy* ; Humans ; Laparoscopy* ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: Titanium silicate (TS)-1 chemotherapy has been widely used against gastric cancer in Japan. The aim of the present study was to assess the efficacy and hematological safety of TS-1 as treatment for advanced and recurrent gastric cancer. METHODS: From September 2006 to February 2011, 51 advanced or recurrent gastric cancers were treated with TS-1. One course of treatment consisted of 40, 50, or 60 mg/m2 of TS-1 twice a day for 28 days, followed by withdrawal for two weeks. The primary end point was progression-free survival (PFS), and the secondary end point was overall survival (OS). RESULTS: The disease control rate was 39.2% (complete response, 0/51; partial response, 6/51; stable disease, 14/51; progressive disease, 23/51; not evaluable, 8/51). The median PFS was 4.0 months (95% confidence interval [CI], 2.2 to 5.7); the median PFS of the advanced group was 6.0 months (95% CI, 2.8 to 9.1), and the median PFS of the recurrent group was 3.0 months (95% CI, 1.8 to 4.1). The median OS was 11.0 months (95% CI, 6.3 to 15.6); the median OS of the advanced group was 10.0 months (95% CI, 4.9 to 15.0), and the median OS of the recurrent group was 14.0 months (95% CI, 4.1 to 23.8). Grade 3 or 4 hematological toxicity occurred in three patients (5.9%), anemia occurred in two patients (3.9%), and thrombocytopenia occurred in one patient (2%). CONCLUSION: TS-1 chemotherapy was safe and effective, with relatively long PFS and OS in patients with advanced and recurrent gastric cancers.
Anemia ; Disease-Free Survival ; Humans ; Japan ; Silicates ; Stomach Neoplasms ; Thrombocytopenia ; Titanium