Although intraocular involvement in Hodgkin's disease is infrequent, there were reported iridocyclitis, exudative retinal detatchment, retinal hemorrhage, necrotizing retinitis, anterior and posterior uveitis, perivascular chorioretinitis. We report a 61 years old male patient with Hodgkin's disease who developed retinal lesion with decreased visual acuity in his right eye during a period of quiscence in his disease, 10 months since diagnosed. On first ophthalmic examination, best corrected vision of right eye was 0.6 and 1.0 on left eye. Fundus examination of the left eye was normal; however, the right eye revealed cotton wool patches, retinal edema, and intraretinal hemorrhage along the superior temporal venules. Fluorescein angiography showed blockage of choroidal flush in early phase and focal area of hyper fluorescence with perivascular leakage of dye in late phase. The results of TORCH test were negative, and the patient didn't have hypertension, diabetes mellitus, and bleeding tendency. Therefore we this case presumed perivascular retinitis associated with Hodgkin's disease.
Chorioretinitis ; Choroid ; Diabetes Mellitus ; Fluorescein Angiography ; Fluorescence ; Hemorrhage ; Hodgkin Disease* ; Humans ; Hypertension ; Iridocyclitis ; Male ; Middle Aged ; Papilledema ; Retinal Hemorrhage ; Retinaldehyde ; Retinitis* ; Uveitis, Posterior ; Venules ; Visual Acuity ; Wool

Esophageal duplication is the congenital developmental anomaly manifestated as cystic or tubular type. The tubular esophageal duplication found at adult is extremely rare. A patient with tubular esophageal duplication is reported. A 37 years old male developed epigastric pain aggravated at hunger state from 2 monthes before administration. Gastrofiberscopy was done, and we could found the tubular esophageal duplication at 25 cm from incisiors. Esophagogram exposed the tunnel communicated with right anterior side of normal esophagus at upper and lower part of the tubular pathway with the length of 6 cm at T4-5 level. The microscopic finding of the tubular lumen revealed normal esophageal wall structure involving the outer part of muscle layer. Surgical resection was not done for the lesion was small and no symptom due to esophageal duplication was present. And so, the authors report this case as a tubular esophageal duplication with a literature review.
Adult ; Esophagus ; Humans ; Hunger ; Male

This phase II study aimed to assess the clinical activity and toxicity of ifosfamide based regimen in patients with epithelial ovarian cancer, relapsed or refractory to cisplatin-containing combination chemotherapy. From July 1991 to June 1993, 18 patients with epithelial ovarian cancer, relapsed or refractory to cisplatin were treated as follows. Relapsed cases were treated with IP(ifosfamide 4,0g/m2 intravenously and cisplatin 60mg/m2 intravenously on day 1) regimen every 3-4 weeks. The regimen used in refractory cases was Et-I(etoposide 100mg/m2 intravenously on days 1 to 3 and ifosfamide 1.0g/m2 intravenously on days 1 to 5) regimen every 3 or 4 weeks. The uroprotectant mesna was concomitantly used. Responses and toxicities were evaluated according to the WHO Criteria. The overall response rate was 27.8%(5/18), including 2 complete response and 3 partial response. There were four episodes(22.2%) of grade 3, 4 myelosuppression, but no other grade 3, 4 non-hematologic toxicity. Salvage therapy with ifosfamide based regimen is a useful and well tolerated treatment strategy in selected patients with relapsed ovarian cancer.
Cisplatin ; Drug Therapy, Combination ; Humans ; Ifosfamide ; Mesna ; Ovarian Neoplasms* ; Recurrence ; Salvage Therapy

PURPOSE: Transurethral resection of prostate(TURP) is the gold standard for the treatment of benign prostate hyperplasia(BPH) at the present. But many attempts have been made to develop minimally invasive method. We studied the efficacy of transurethral needle ablation(TUNA) of prostate for treatment of BPH. MATERIALS AND METHODS: We performed TUNA in 20 BPH patients including 13 patients with acute urinary retention. Preoperatively all patients were evaluated using urinary flow rates, International Prostate Symptom Score(1-PSS), Quality of life and cystoscopic examination. The urinary flow rates, 1-PSS and Quality of life were checked at 1, 3 and 6 months after TUNA in all patients. RESULTS: The average value of peak flow rate of the patients with urinary retention were 10ml/sec, 12ml/sec and 13ml/sec at 1, 3 and 6 months follow-up. The average value of Qmax of the patients without urinary retention were 9ml/sec preoperatively and increased to 13ml/sec, 13ml/sec and 14ml/sec at 1, 3 and 6 months postoperatively. 1-PSS of patients with urinary retention improved from average 26 at preoperation to 14, 13, 10 at 1, 3 and 6 months postoperatively. Quality of life of patients with urinary retention improved from average 5 at preoperation to 2, 2, 2 at 1, 3 and 6 months postoperatively. The average value of patients without urinary retention improved from average 26, 5 at preoperation to 14, 11, 11 and 2, 2, 2 at 1, 3 and 6 months follow-up. No patients complained of erectile dysfunction and retrograde ejaculation postoperatively. CONCLUSIONS: The result of our preliminary study suggest that TUNA can be considered to be a simple, safe and efficacious procedure for the treatment of BPH including urinary retention.
Ejaculation ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Needles* ; Prostate ; Quality of Life ; Tuna ; Urinary Retention

PURPOSE: This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. METHODS: This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. RESULTS: Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. CONCLUSION: To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.
Animals ; Animals, Wild ; Bites and Stings ; Child ; Child Health ; Health Personnel ; Humans ; Isothiocyanates ; Medical Records ; Post-Exposure Prophylaxis ; Rabies ; Vaccination

No abstract available.
Vesico-Ureteral Reflux*

Anophthalmos or microphthalmos is a rare congenital anomaly in which there is an absence of ocular tissue or small eyeball. This anomaly results in a small bony orbit and deformity of the asssociated skeletal, and soft tissues. Conventional management of the anophthalmic or microphthalmic orbit is started with the intraorbital placement of progressively increasing conformers as early as possible without enucleation. If an early treatment was not started, there could be retardation of growth of bony orbit and ipsilateral facial hypoplasia which is a necessity of more complex, disappointing application of three dimensional expansion osteotomy and socket reconstruction. The goal of treatment is the insertion of a comfortable prosthesis with good cosmesis. We treated 3 microphthalmic patients, who could not insert prosthesis on the first visit. We inserted an acrylic conformer into the orbit and then exchanged at interval of 6-8 weeks in order to expand the orbit. We obtained good cosmetic results. and the parents of patients were pleased with the appearance of their children fitting prosthesis.
Anophthalmos ; Child ; Congenital Abnormalities ; Humans ; Microphthalmos* ; Orbit ; Osteotomy ; Parents ; Prostheses and Implants

PURPOSE: To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery. MATERIALS AND METHODS: Between October 1998 and August 2010, 19 patients with stage I-III uterine carcinosarcoma received curative hysterectomy and bilateral salpingo-oophorectomy with or without PORT at Seoul National University Hospital. Their hospital medical records were retrospectively reviewed. PORT and non-PORT groups included 11 and 8 patients, respectively. They were followed for a mean of 22.7 months (range, 7.8 to 126.6 months). RESULTS: At 5 years, the overall survival rates were 51.9% for entire, 61.4% for PORT, and 41.7% for non-PORT groups, respectively. There was no statistical difference between PORT and non-PORT groups with regard to overall survival (p = 0.682). Seven out of 19 (36.8%) patients showed treatment failures, which all happened within 12 months. Although the predominant failures were distant metastasis in PORT group and loco-regional recurrence in non-PORT group, there was no statistically significant difference in loco-regional recurrence-free survival (LRRFS) (p = 0.362) or distant metastasis-free survival (DMFS) (p = 0.548). Lymph node metastasis was found to be a significant prognostic factor in predicting poor LRRFS (p = 0.013) and DMFS (p = 0.021), while the International Federation Gynecology and Obstetrics (FIGO) stage (p = 0.043) was associated with LRRFS. CONCLUSION: Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients.
Carcinosarcoma ; Gynecology ; Humans ; Hysterectomy ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Obstetrics ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterus

OBJECTIVE: To evaluate the efficacy and safety of concurrent chemotherapy of paclitaxel and carboplatin with standard pelvic radiotherapy as adjuvant therapy after primary surgery in high-risk cervical cancer. METHODS: Twenty-eight patients with FIGO stage IB1-IIB cervical cancer who received adjuvant concurrent chemoradiotherapy with paclitaxel and carboplatin from February 2000 to November 2001 were analyzed retrospectively in this study. Adjuvant chemoradiotherapy was done if there were lymph node involvement or at least 2 positive findings among following risk factors; lymphovascular space invasion, full- thickness involvement of cervix and tumor size larger than 4 cm in diameter. Two cycles of paclitaxel 135 mg/m2, followed by carboplatin with AUC of 4.5 were administered intravenously with an interval of at least 4 weeks. The radiotherapy was initiated concurrently at the first day of chemotherapy. The therapeutic results were evaluated by pelvic examination, Pap smear, SCCA (Squamous cell carcinoma antigen) and computed tomography (CT). The toxicities of the treatment were evaluated and graded by NCI-CTC version 2.0. RESULTS: Total 56 cycles of paclitaxel/carboplatin chemotherapy with concomitant pelvic radiotherapy was delivered. None of the patients had a progressive or recurrent disease during the follow-up period ranging from 6 to 33 months (median: 12.5 months). Neutropenia was the most common and concerned toxicity. Fifteen cases of grade 3 and 4 neutropenia (26.8%) were observed. Non-hematologic toxicities were mild and mainly related to neurologic or gastrointestinal symptoms. Eight cases of grade 1 and 2 neurotoxicity were observed (14.3%). CONCLUSION: The adjuvant chemoradiotherapy with paclitaxel and carboplatin seems to be effective and well-tolerated for the treatment of high risk group cervical cancer after primary surgical therapy. But a large randomized study with longer duration of follow-up is needed to justify this conclusion.
Area Under Curve ; Carboplatin* ; Cervix Uteri ; Chemoradiotherapy* ; Chemoradiotherapy, Adjuvant ; Drug Therapy ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Lymph Nodes ; Neutropenia ; Paclitaxel* ; Radiotherapy ; Retrospective Studies ; Risk Factors ; Uterine Cervical Neoplasms*

OBJECTIVE: To evaluate effects of subacromial bursa injection with steroid according to dosage and to investigate whether hyaluronidase can reduce steroid dosage. METHODS: Thirty patients with periarticular shoulder disorder were assigned to receive subacromial bursa injection once a week for two consecutive weeks. Ten patients (group A) underwent subacromial bursa injection with triamcinolone 20 mg; another group of ten patients (group B) with hyaluronidase 1,500 IU and triamcinolone 20 mg; and the other ten patients (group C) with triamcinolone 40 mg. We examined the active range of motion (AROM) of the shoulder joint, visual analogue scale (VAS), and shoulder disability questionnaire (SDQ) at study entry and every week until 1 week after the 2nd injection. RESULTS: All groups showed statistically significant improvements in VAS after 1st and 2nd injections. When comparing the degree of improvement in VAS, there were statistically significant differences between groups C and A or B, but not between groups A and B. SDQ was statistically significantly improved only in groups B and C, as compared to pre-injection. There were statistically significant differences in improvement of SDQ after the 2nd injection between groups C and A or B. Statistically significant improvements in AROM were shown in abduction (groups B and C) and in flexion (group C only). CONCLUSION: Repeated high-dose (40 mg) steroid injection was more effective in terms of pain relief and functional improvements of shoulder joint than medium-dose (20 mg) steroid injection in periarticular disorder. Hyaluronidase seems to have little additive effect on subacromial bursa injection for reducing the dosage of steroid.
Humans ; Hyaluronoglucosaminidase* ; Range of Motion, Articular ; Shoulder ; Shoulder Impingement Syndrome ; Shoulder Joint ; Triamcinolone ; Surveys and Questionnaires