A 68-year-old male patient visited our clinic complaining of a single skin lesion on the left shoulder for 5 months. The lesion was a bluish to pigmented, bean-sized nodule. No subjective symptoms and signs accompanied it. Histologically, the tumor mass was composed tumor emboli in the vessels and moderately differentiated neoplastic glands lined by anaplastic cells. These findings were consistent with the metastatic adenocarcinoma. Abdominal sonography and CT scanning showed a mass at the tail of the pancreas. Therefore, we diagnosed this skin lesion as a metastatic adenocarcinoma originating from the pancreatic tail. We report herein a rare case of skin metastasis from pancreatic tail cancer, in which the cutaneous involvement was the first sign of the internal malignancy.
Adenocarcinoma ; Aged ; Humans ; Male ; Neoplasm Metastasis* ; Pancreas ; Pancreatic Neoplasms ; Shoulder ; Skin* ; Tail* ; Tomography, X-Ray Computed

Malignant germ cell tumors occur in children and young women in reproductive age, of all the germ cell malignancies, only pure dysgerminomas had a high cure rate prior to 1970. This was due to the exquisite radiosensitivity of these tumors. Multiple-agent chemotherapy has dramatically improved the pmgnosis of patients with malignant ovarian germ cell tumors. Clinicopathological analysis was performed on 21 cases of malignant germ cell tumors of the ovary, 9 cases at the department of Obstetrics & Gynecology, Kyung-pook National University Hospital, 4 cases, at the department of Obstetrics and Gynecology, Dong-guk University Kyungju Hospital and 8 cases, at the department of Obstetrics and Gynecology, Dae-gu Fatima Hospital during the period 10 years from July. 19S8 to June. 1997 The results were summarized as follows: 1. The mean age of the patients was 21.8 years old, ranging from 10 to 61 years old. 2. Main initial symptoms were abdominal distension(33.3%), abdominal mass palpation(33.3%), abdominal pain(28.6%), amenorrhea(4.8%) in order. 3. Histologically, the tumors were classified as immature teratoma(57.1%), dysgerminoma(19%), mixed germ cell tumor(9.5%), endodermal sinus tumor(9.5%), embryonal cell carcinoma(4.8%). 4, According to FIGO classification Stage I was the most prevalent(57.1%) at the time of diagnosis while Stage III was forward in 48.6%, Stage II in 9.5%, and no Stage IV, 5. The 5-year survival rate was 80.4% and three patients have died of malignancy and the other 18 patients live without disease from 11 to 102 months, with a median follow-up of 34.2 months. 6. Prognostic factors of malignant germ cell tumors in this study were the clinical stage, the presence of ascites and the residual tumor mass.
Ascites ; Child ; Classification ; Daegu ; Diagnosis ; Drug Therapy ; Dysgerminoma ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gyeongsangbuk-do ; Gynecology ; Humans ; Middle Aged ; Neoplasm, Residual ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Radiation Tolerance ; Survival Rate

No abstract available.
Cholestasis, Intrahepatic*

BACKGROUND: The purpose of this study was to investigate AIDS-specific knowledge, attitudes, and behaviors of auxiliary police on duty in Seoul and to provide basic data for use in AIDS prevention education for auxiliary police. METHODS: In November 2008, we questioned 402 auxiliary police in the Mobile Police Force located in Seoul by using a self-administered questionnaire containing 39 items. RESULTS: Of the respondents, 98.5% were unmarried and scored, on average, 2.95+/-0.98 out of 4 with respect to their knowledge about the transmission routes of HIV infection. Approximately 70.6% of the respondents were sexually active in the past year and 6.3% were diagnosed with or treated for a venereal disease within the past year. Approximately 42.5% of the respondents had sex with someone other than their steady partner and 35.5% of these respondents did not use condom during sexual intercourse. Approximately 77% of the respondents were willing to be anonymously tested for HIV infection that may have been acquired because of unprotected sexual activity during the past year (P=0.018). CONCLUSION: Providing assertive education, as well as additional support and instructions, is necessary to raise awareness about the prevention of AIDS among auxiliary police.
Acquired Immunodeficiency Syndrome ; Anonyms and Pseudonyms ; Coitus ; Condoms ; Surveys and Questionnaires ; HIV Infections ; Humans ; Police ; Sexual Behavior ; Sexually Transmitted Diseases ; Single Person

No abstract available.
Meningitis

BACKGROUND: The purpose of this study was to evaluate the efficacy of suction drain use following arthroscopic rotator cuff repair by comparing early pain score and range of motion (ROM) between groups with and without suction drains. METHODS: The study included 153 patients with rotator cuff tears who underwent arthroscopic repairs at our clinic from April 2014 to March 2015. Following surgery, a suction drain was used in 85 patients (group D) and not used in 68 patients (group ND). There was no statistical difference between the groups in terms of age, gender, or total operation time. The clinical outcome with regard to pain (assessed by pain scores and analgesic requests) and passive ROM was assessed preoperatively and postoperatively. RESULTS: Immediate postoperative analgesic requirement was significantly higher in group D (p=0.001), although there was no difference in pain outcomes between the groups during the 3-month follow-up period. A statistically significant difference in passive ROM was observed at the postoperative 2- and 6-week follow-ups (p=0.036, 0.035, and 0.034 in forward elevation (FE), external rotation at the side (ER) and 90 ER at weeks 2, respectively; 0.045 and 0.009 in FE and ER at weeks 6, respectively); however no significant difference was observed at the end of 3 months. During the study period, no complication was reported in either group. CONCLUSIONS: Use of suction drains after arthroscopic rotator cuff repair provided little benefit in terms of ROM or pain in the early postoperative period (up to 3 months).
Arthroscopy ; Follow-Up Studies ; Humans ; Postoperative Period ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder ; Suction* ; Tears

No abstract available.
Acetabulum* ; Arthroplasty, Replacement, Hip*

Disparity among cholangiograms is rarely observed. The causes of disparity include spontaneous disappearance of gall stone, incomplete filling of smaller branch, technical problems, interpretative errors, and overriding of evidence. 5pontaneous disappearance of gall stone is rare but has been well documented in both radioligic and clinical literatures. Recently we have experienced spontaneous disappearance of a large stone in the common bile duct and this formsthe basis of the present case report. The patient, 53-year-old female, was admitted on January 18, 1982 to 5t. Mary's Hospital, Catholic Medical College because of repeated episodes of pain in the epigastrium and the right upper quadrant for the past 2 months. On admission, physical examination revealed tenderness in the epigastrium and the right μpper quadrant. Laboratory tests revealed bilirubin 2.2 mgfdl and alkaline phosphatase 76 .5 KA/dl. A percutaneous transhepatic cholagiogram(PTC} performed 2 days later revealed a large stone measuring 16 × 26mm in size in the distal CBD. The CBD and CHD proximal to the stone were moderately dilated. Most of the intrahepatic ducts were well delineated without fi lJ ing defect or evidence of stone. However, the in ferior segment of the posterior branch of the right intrahepatic duct (IPRH) was not delineated. The ending of the nonvisualized segment was rather abrupt. The patient suffered severe abdominal pain 2 days after PTC, and was treated with Buscopanø compositum. The attack ceased 20 hours after the onset of colicky abdominal pain. An operation was performed 4 days after PTC. To our surprise there was no stone in the distal CBD. The gallbladder was resected and a T-tube has been placed. A table cholangiogram confirmed disappearance of the stone, but IPRH was agin not opacified except for a short ditance just after bifurcation from the main branch. Eight days after surgery a follow-up T-tube cholangiogram was performed. No residual stone was found in the extrahepatic bile duct. However, IPRH which was not opacifled until then became distinctly visualized demonstrating multiple intra-ductal radiolucent stones, There was a diaphragm-like structure obstructing the lumen and confining the stones located proximally to the site obstructed in the precedent cholangiograms, The radiologic and clinical importances of our observation in this case are four fold: 1. Gall stone up to the diameter of 14 × 23mm can pass through the papilla spontaneously, 2. Repeat diagnostic imaging is imperative when patient became asymptomatic after severe colicky abdominal pain before the intended operation, 3. Without optimal delineation of intrahepatic biliaη radicles, residual stone or stones cannot be exciuded in the cholangiograms, 4. And finally, to avoid misdiagnosis a comprehensive knowledge of normal anatomy of cholangiogram is required.
Abdominal Pain ; Alkaline Phosphatase ; Bile Ducts, Extrahepatic ; Bilirubin ; Common Bile Duct ; Diagnostic Errors ; Diagnostic Imaging ; Diaphragm ; Female ; Follow-Up Studies ; Gallbladder ; Gallstones ; Humans ; Middle Aged ; Physical Examination

After a lobectomy the apearance of the chest roentgenogram may return so nearly to normal that it isfrequently very difficult to tell which lobe has been moved without refering to the thoracic surgeon's record. Thereriew of literature failed to disclose previous articles concerning the differential diagnosis between upper andlower lobectomy. Clues of a lobectomy may be found in the rib cage, hilar shadows, pleura and disphragms, but they do not specifically incidate which lobe has been removed. In the present study we anlaysed anatomico-spatialchanges of the pulmonary basal arteries, hilar point, vascular redistribution, diaphragm and rib cage on the plainchest films taken before and after a lobectomy in 33 cases seen at the Dept. of Radiology, St. Mary's Hospoital, Catholic Medical College. Firstly we observed the pulmonary basal artery after a lobectomy on plain chest film. In 12 cases of upper lobectomy the pulmonary basal artery was easily identified in every case. However in all of 21cases of lower lobectomy, the pulmonary basal artery was not identified. Next, a shift of the hilar point waschecked after a lobectomy. Regarding to vascular redistribution, the blood vessels was counted at upper and lowerlung fields by simon's method before and after a lobectomy, respectively. Finally, the level of the diaphragm wascompared in the pre. and post-opeative films and resected rib was scrutinized. The present study revealed that themost reliable sign to indicate specifically which lobe has been resected is persistence or disappearance of thepulmonary basal artery. Then i.e. in upper lobectomy the pulmonary basal artery was easily identified, but inlower lobectomy the pulmoanry basal artery was not dectable. Other findings such as vascular redistribution,elevated diaphragm and resected rib were not specific.
Arteries ; Blood Vessels ; Diagnosis, Differential ; Diaphragm ; Methods ; Pleura ; Ribs ; Thorax

The authors analysed the CT findings in 75 cases diagnosed as gastric carcinoma by U.G. I.S. or endoscopy in a 3)1, year period. The comparative analysis betw~en CT findings and surgical pathologic findings was done in 55 cases who underwent surgery. 20 cases could not be operated upon because of distant metastasis. The gastric carcinoma was devided into 4′ stages according to the staging system of the American joint Committee on Cancer. The CT findings were then compared and the following results noted : 1. The relationship with gastric wall thickening and penetratioil degree of tumori no thickening (Iesser than 1.0 cm) of 3 cases showed all of T1, 11 of localized thickening (1. 0.1 .5cm) showed 7 of T2, 38 of localized thickening (more than 1.5 cm) showed 37 of T3 and 3 of diffuse thickening showed all of T4a. 2. The accuracy of Iymph node detection by CT scan, 1) Regionaf tymph node showed 86% in operative f in ding and 73% in pathologic. 2) Extragastric Iymph node showed 87% in operative finding and 89% in pathologic. 3) Retro-peritoneallymph node showed 96% in operative finding and 95% in pathologic. ic. 3. In operated cases, there was one case of false positive distant metastasis and three false negative cases. 20 cases of non-operated cases showed distant metastasis such as liver, lung or kidney. 4. 55 cases were classified as stage 1 in 4 cases, 11 in 18, 111 in 23 and IV in 10 by pathologic findings, and 1 in 3, 11 in 24, 111 in 19 and IV in 9 by CT. The overall accuracy by CT stagi ng is 75%. 5. Among a total of 75 cases, there were 46 operable cases by CT finding an d 43 operabl e cases by pathologic staging. There we re 29 inoperable cases by CT finding and 27 cases by pathologic staging. Therefore, there was a 93% overall accuracy by CT stagi ng in terms of determination of operability. 6. The accuracy of adhesion into adjacent structure by CT finding was 69%. compared with operable finding.
Endoscopy ; Joints ; Kidney ; Liver ; Lung ; Neoplasm Metastasis ; Tomography, X-Ray Computed