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*

No abstract available.
Gastric Stump*

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

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*

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

No abstract available.
Vesico-Ureteral Reflux*

BACKGROUND: Small deep cerebral infarct can be associated with small-vessel occlusive disease, largevessel disease, low-flow or thrombo-embolic mechanism. This study is designed to investigate ralationship between symptomatic single small deep infarcts ahd vascular diseases. METHODS: We studied 154 patients who had symptomatic, small-sized(<20 mm), single, subcortical infarction(basal ganglia, corona rediata, centrum semiovale) who were admitted to our hospital from jund, 1996 to September, 1999. They were evaluated about the lesion site and vascular status of the carotid system and middle cerebral artery, using MRI, MRA and cervical duplex sonography or conventional angiography. RESULTS: Among 154 patients with single small deep infarction, 100 were related with small artery disease(64.9%), 38 with middle cerebral artery disease(26.7%) and 16 with carotid artery disease(10.4%). The basal ganglia or basal ganglia with corona radiata area were more frequently responsible lesion sites in both small artery disease(n=59, 59%) and middle cerebral artery disese(n=28, 73.7%) than in carotid artery disease(n=1, 6.3%). The centrum ovale or centrum ovale with corona radiata area were frequently involved lesion sites in carotid artery disease (n=10, 67.5%). CONCLUSION: Single small deep infarcts of th basal ganglia with corona radiata were mostly seen in the middle cerebral artery disease or small artery disease, and small deep infarcts of the centrum semiovale with corona radiata were usually assoicated with internal carotid artery disease. In occurrence of single small deep infarcts, middle cerebral artery disease was more frequent than carotid artery disease, which might be associated with intracranial occlusive disease known to be more common in Asians than in Caucasians.
Angiography ; Arteries ; Asian Continental Ancestry Group ; Basal Ganglia ; Carotid Arteries ; Carotid Artery Diseases ; Carotid Artery, Internal ; Cerebral Infarction* ; Ganglia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Vascular Diseases

The overall prognosis of gastric cancer has gradually improved over the past decades with growing awareness of potential carcinogens, surveillance programs and early diagnosis, as well as advances in surgical techniques and multimodality treatments. Nevertheless, the outcome of advanced stage disease still remains poor with currently available treatments, and a worldwide consensus on the standard management thereof has not been established. To improve prognosis and quality of life in gastric cancer patients, both standardization and individualization of managements are imperative. Diagnostic tests and surgical procedures need to be further sophisticated and standardized based on more recent evidences from ongoing and future randomized controlled trials, while comprehensive management should be individualized to each patient. Future challenges lie with how to optimize personalized therapies by deciphering biological complexity of gastric cancer and incorporating molecular biomarkers in clinical practice to forecast prognosis and to guide targeted therapeutics in adjunct to current standards of care.
Disease Management ; Gastrectomy ; Humans ; Lymph Node Excision ; Stomach Neoplasms/*diagnosis/drug therapy/etiology/surgery