PURPOSE: We performed this study to define the characteristic mammographic and ultrasonographic findings in lower risk lesions of fibrocystic change and also tried to evaluate the role of both modalities in planning the treatment of these lesions. MATERIALS AND METHODS: We retrospectively reviewed 38 cases of mammography and 46 cases of ultrasonography in biopsy proven 55 cases of fibrocystic change, histologically showing the nonproliferative pattern or proliferative pattern without atypia. We analyzed the mammographic and ultrasonographic findings, final assessments, and compared the effectiveness of each modality. RESULTS: On mammography, there were no abnormalities in 20 cases(53%), nodules or masses in 9 cases(24%), microcalcifications in 6 cases(16%) and asymmetric density in 5 cases(14%). On ultrasonography, there were 40 cases(87%) of focalsonographic abnormality and no abnormality in 6 cases(13%). Most focal sonographic abnormalities were smooth(40cases, 93%), well-defined(21 cases, 49%) or ill-defined(22 cases, 51%) round or oval(36 cases, 84%) shaped, homogeneous(31 cases, 67%), hypoechoic(30 cases, 65%) lesions. Final assessment revealed that only 7 cases(18%) of mammography and 8 cases(18%) of ultrasound examinations were included into the category of indeterminate and malignancy groups which were recomended biopsy. Mammography was excellent to demonstrate the microcalcifications and ultrasonography was effective in depiction of the focal lesions. CONCLUSION: The mammography and ultrasonography findings were not specific in diagnosing lower risk group of fibrocystic change. But complementary study of both modalities in conjunction with clinical findings will be helpful in making decinion amary biopsy, fine needle aspiration, and simple close follow up of the lesions.
Biopsy ; Breast* ; Mammography ; Needles ; Retrospective Studies ; Ultrasonography

PURPOSE: This study was performed to identify the characteristic findings of miliary pulmonary tuberculosis on HRCT and to evaluate the usefulness of HRCT by compareson with chest radiographs. MATERIAL AND METHODS: High resolution CT, chest radiographs and medical records were retrospectively reviewed in 10 patients with miliary pulmonary tuberculosis. We analysed the size, distribution and margin of nodules, reticular or ground-glass density, parenchymal lesion, mediastinal lymphadenopathy and pleural effusion on HRCT which were compared with chest radiographic findings. RESULTS: On HRCT, characteristic 1--2mm sized sharp or ill-defined nodular densities were randomly distributed throughout both lungs in all cases. In seven cases, the nodules were evenly scattered, but slightly more in upper lung zone in two cases, and in lower in one case. Only three cases revealed somewhat large and abundant nodules in posterior lung zone. There were findings of ill-defined margin of nodules in three cases, reticular densities in three cases and ground-glass opacity in two cases, all of which were observed within 4 weeks after onset of symptom. In one case, HRCT scan revealed a micronodular pattern in the lung parenchyma, even though chest radiographs of 2 days before were not obviously abnormal. HRCT was better to evaluate the margin of nodule and distribution than chest radiographs in four cases. Focal parenchymal lesion (n=5), pleural effusion(n=4), mediastinal lymphadenopathy(n=6) and ARDS(n=I) were also associated. CONCLUSION: HRCT could suggest a more specific diagnosis of miliary pulmonary tuberculosis with the above characteristic findings in appropriate clinical setting and normal or interstitial pattern of chest radiographs.
Diagnosis ; Humans ; Lung ; Lymphatic Diseases ; Medical Records ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis, Pulmonary*

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.
Gastric Stump*

To assess the change of nitric oxide(NO) concentration according to photorefractive keratectomy(PRK) depth and the role of NO in cataractohenesis after excimer laser PRK. The treated 36 rabbits were divided into 12 groups according to PRK depth(-3.0, -7.0, -11.0 diopter [0]), the dates of sampling(the 1st day and the 7th day after PRK), and reatment of NOS inhibitor (NG-nitro-L-arginine methylester, L-NAME). NO concentration and superoxide dismutase(SOD) activity in the aqueous humor and malondialdehyde(MDA) concentration in the lens were measured. Changes of lens epithelium were examined by eletron microscopy on the 3rd day and the 6th day after -11.0D of PRK. The NO and MDA concentration in the group without L-NAME treatment on the 1st day after -11.0D of PRK were significantly higher than those in the L-NAME treated group and control group. The activity of SOD increased in all of the PRK treated group on the 1st day and was even higher on the 7th day. The histopathological changes of lens epithelium on the 3rd day after PRK were compatible with cellular necrosis and those of the 6th day after PRK were compatible with cellular reparing. The results suggested that the toxicity of NO after PRK correcting over -11.0D may a role in cataractogenesis, but the progress could be suppressed by treatment of NOS inhibitor.
Aqueous Humor ; Epithelium ; Lasers, Excimer ; Malondialdehyde ; Microscopy ; Necrosis ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Photorefractive Keratectomy* ; Rabbits ; Superoxide Dismutase ; Superoxides

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

PURPOSE: The placement of a ureteral stent following a ureteroscopy (URS) with a stone extraction is routine. However, many patients complain of stent pain and urinary symptoms in the postoperative period. Reducing the frequency of stenting would decrease the need for re-instrumentation, reduce costs, and increase patient satisfaction provided that the efficacy and safety are not compromised. In order to evaluate the necessity of stenting, a comparison of patients with and without stenting after URS for ureteral calculi is reported. MATERIALS AND METHODS: 45 patients with ureteral calculi amenable to ureteroscopic management were prospectively randomized into stented (23 patients) and unstented (22 patients) groups. Standard ureteroscopic basketing and lithotripsy were performed with a ureteroscope (8.5Fr) with or without ureteral dilatation. Postoperative symptom questionnaires were obtained from each patient. Radiographic follow-up to assess the stone-free rate and evidence of obstruction was performed in all patients. RESULTS: There was no statistically significant difference in the age, stone size, operation time, and hospital stay, between the unstented and stented groups (p>0.05). In addition, there was no statistically significant difference in the flank pain and urinary symptoms (p>0.05), except for hematuria between the 2 groups. Hematuria was more severe and long standing in the stent group (p=0.001). CONCLUSIONS: Uncomplicated ureteroscopy for calculus retrieval can safely be performed without the placement of a postoperative stent. Considering its complications and side effects, we do not believe that a routine placement of a ureteral stent following an uncomplicated ureteroscopy for a stone is necessary.
Calculi ; Dilatation ; Flank Pain ; Follow-Up Studies ; Hematuria ; Humans ; Length of Stay ; Lithotripsy ; Patient Satisfaction ; Postoperative Period ; Prospective Studies ; Surveys and Questionnaires ; Stents* ; Ureter* ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy*

No abstract available.
Vesico-Ureteral Reflux*

OBJECTIVE: Although surgical resection is used to treat meningeal hemangiopericytoma (MHPC), there is a high risk of subsequent recurrence. This study investigated factors associated with treatment outcomes and recurrence in patients who had undergone surgical resection of intracranial MHPC. METHODS: Fifteen patients underwent surgical treatments performed by one senior neurosurgeon between 1997 and 2013. Clinical data, radiologic images, surgical outcomes, recurrence, and other relevant characteristics were reviewed and analyzed. RESULTS: Fifteen patients were included in the analysis, 12 (80%) of whom had tumors in the supratentorial region, and 3 (20%) of whom had tumors in the infratentorial region. Complete resection was achieved in all 15 patients, and 3 (20%) patients were administered radiosurgery and conventional radiotherapy after surgery as adjuvant radiotherapy. Three patients developed recurrence, 2 of whom had not received adjuvant radiotherapy. In 1 of the patients who had not received adjuvant radiotherapy, recurrence developed at the original tumor site, 81 months after surgery. The other 2 recurrences occurred at other sites, 78 and 41 months after surgery. The 5- and 10-year overall survival rates were 88.3%, while the 5- and 10-year recurrence-free survival rates were 83% and 52%, respectively. Additionally the mean Ki-67 index differed significantly between patients who did and did not develop recurrence (43% vs. 14%; p=0.001). CONCLUSION: Because of the high risk of MHPC recurrence, MHPC tumors should be completely resected, whenever feasible. However, even when complete resection is achieved, adjuvant radiotherapy might be necessary to prevent recurrence.
Hemangiopericytoma* ; Humans ; Radiosurgery ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence* ; Retrospective Studies* ; Survival Rate

OBJECTIVES: Since the 1990s, drug-resistant bacteria have become common pathogens of hospital-acquired infections. In recent years, healthcare-associated infections have come to the fore, and it is reported that distribution rates of these bacteria are comparable to those of hospital-acquired infections. However, there have been few studies on differences in resistant bacteria depending on the size of hospitals. Thus, the authors studied differences in drug-resistant bacteria between a tertiary hospital and smaller medical institutions. METHODS: We retrospectively analyzed the clinical findings and sputum culture results of patients transferred from tertiary hospitals (group A, n=74) and those transferred from smaller medical institutions (group B, n=65). RESULTS: The number of patients with malignancy was higher in group A than in group B. The length of intensive care unit stay was longer in group A than in group B. Antibiotic therapy and mechanical ventilation were more frequently used in group A than in group B. There were no significant differences between the 2 groups in bacterial species (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) and their resistance rates to carbapenem, while there were significant differences between the 2 groups in the bacterial species (Acinetobacter baumannii) and its resistance rate to carbapenem. CONCLUSION: In this study, there were significant differences between the 2 groups in the bacterial species and resistance rates to carbapenem for A. baumannii infection unlike other bacterial infections. Further studies on risk factors and patient classification are needed to confirm our results.
Acinetobacter baumannii ; Bacteria ; Bacterial Infections ; Drug Resistance, Bacterial* ; Escherichia coli ; Humans ; Intensive Care Units ; Klebsiella pneumoniae ; Pseudomonas ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers*