No abstract available.
Histiocytoma, Malignant Fibrous* ; Maxillary Sinus* ; Nasal Cavity*

Undifferentiated sarcoma is one of the rare primary malignant tumor of the liver typically occur ring in later childhood. It has also been referred to embryonal sarcoma or malignant mesenchymoma. In Korea, three child and two adult cases have been reported to date in liter ature. We experienced a case of undifferentiated sarcoma in a 65- year- old female who presented with abdominal pain and right upper quadrant mass . Contrast-enhanced abdominal CT scan revealed a well demarcated mass with low at tenuation and sept ation at left lobe of the liver and the mass showed hypovas cular pattern on hepatic angiography. On cross section, the tumor was well demarcated from the adjacent liver by afibr ouspseudocapsule and showed cystic degener ation. Pathologically, the tumor was consistent with an undifferentiated sarcoma of the liver.
Abdominal Pain ; Adult* ; Angiography ; Child ; Female ; Humans ; Korea ; Liver* ; Mesenchymoma ; Sarcoma* ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Cases of small hepatocellular carcinoma (HCC) have been increasing with the progress of diagnostic methods . In this study the screening methods for early diagnosis of HCC were re-evaluated, and comparative therapeutic analyses were perfomed. METHODS: A total of 110 patients with small HCC (< 5 cm and < 4 nodules ) were retrospectively analyzed. The patients were divided into four treatment groups ; unt reated group (No T x, n=12), transarterial-oily-chemoembolization group (TOCE, n=43), combined treatment group of percutaneous ethanol injection and TOCE (CEI, n=22), OP group ( OP, n=33). RESULTS: Small HCC occupied 22.6% of total HCC cases. Only one third of small HCC cases were detected during the regular screening. In this group, Alpha-fet oprotein as say provided a diagnostic clue in 50% of cases, ultras onography in 71%, and the combination of both in 88%. Five year survival rate and 5-year non-recurrence rate in small HCC was 29% and 37% respectively. Comparative therapeutic analys es showed t hat CEI and OP gave a better survival than TOCE in Child grade A. CEI prolonged survival in Child grade B wher eas TOCE did not. Only TOCE was tried and did not improve the survival in Child grade C. CONCLUSION: 1) A more strict screening is needed in high risk group of HCC. 2) As a first line of treatment in small HCC, OP or CEI can be selected in Child grade A, and CEI in Child grade B. In Child grade C, a less invasive treatment (PEIT , microwave coagulat ion therapy) should be investigated.
Carcinoma, Hepatocellular* ; Child ; Diagnosis ; Early Diagnosis ; Ethanol ; Humans ; Mass Screening ; Microwaves ; Prognosis ; Retrospective Studies ; Survival Rate

Acute pancreatitis in cancer patients can be secondary to the malignant process itself or a complication of antineoplastic agent administration. However, acute pancreatitis caused by metastatic carcinoma of the pancreas is an uncommon condition with a poor prognosis. We report a case of a 63-year-old man with small cell carcinoma of the lung, who developed acute pancreatitis lately. Thirteen months earlier, he developed small cell carcinoma of the lung and received 6 cycles of chemotherapy. Abdominal CT scan showed swelling of the pancreas with multiple masses. The patient was managed conservatively and pancreatitis subsided. This case indicates that metastasis induced acute pancreatitis can be a manifestation of lung cancer, especially in small cell carcinoma.
Carcinoma, Small Cell/secondary* ; Carcinoma, Small Cell/radiography ; Carcinoma, Small Cell/pathology ; Case Report ; Human ; Lung Neoplasms/radiography ; Lung Neoplasms/pathology* ; Male ; Middle Age ; Pancreatic Neoplasms/secondary* ; Pancreatitis/radiography ; Pancreatitis/pathology* ; Tomography, X-Ray Computed

PURPOSE: With recent developments in endoscopic surgery for thyroid tumors, several approaches have been applied to endoscopic neck surgery. Gasless endoscopic thyroidectomy has some advantages over gas insufflating surgery. We evaluated the role of gasless endoscopic thyroidectomies on various thyroid tumors including malignant thyroid tumors. METHODS: We performed thyroidectomies for a total of 195 patients who were admitted to Uijongbu St. Mary's Hospital from November 1999 to February 2002. We compared the clinical data of 100 patients who received gasless endoscopic thyroidectomies with the data of 95 patients who underwent conventional thyroidectomies. Furthermore, we subclassified the 100 patients who received a gasless endoscopic thyroidectomy into two groups, before and after the start of 2001. RESULTS: The analysis of the clinical data showed that an endoscopic thyroidectomy gave superior results with respect to the time of postoperative recovery and cosmetic results. Also, the patients in the second half group showed significantly shorter operation times reduced from 153.4 min. to 128.6 min. and length of hospital stay similarly reduced(3.55 days vs. 5.35 days). CONCLUSION: A gasless endoscopic thyroidectomy is a safe and technically feasible alternative to a conventional thyroi-dectomy in benign and early malignant tumors, and provides good cosmetic results.
Humans ; Length of Stay ; Neck ; Thyroid Gland ; Thyroidectomy*

OBJECTIVE: Helicobacter pylori(H. pylori) infection plays an importanat role in the pathophysiology of gastrointestinal diseases, and its diagnosis is crucial in clinical practice. Currently many diagnostic methods are introduced for its simple, and accurate diagnosis. 13C urea breath test(13C-UBT) is a convenient, non-invasive and reliable test for the diagnosis of H. pylori infection. To assess the clinical value of the 13C-UBT, we examined the sensitivity, specificity of 13C-UBT with regard to other tests. METHODS: A prospective multicenter study was done in 107 subjects(mean age 36 years, 55 males, 52 females) presenting for endoscopy from three university hospitals. We tested for H. pylori infection by 13C-UBT, serum IgG antibody level, and multiple biopsies for rapid urease testing and histology. Either a positive histology result or a combined positive CLO test and IgG ELISA in the presence of a negative histology results, was interpreted as a positive finding for H. pylori infection. 13C-UBT was performed after 4hrs fast. Breath samples were collected at 0 and 30 minutes after giving 75mg 13C-urea. RESULTS: Results were analysed by isotope ratio mass spectrometry and expressed as units of delta( 13C, 13CO2 /12CO2) and considered as positive for H. pylori if delta value was greater than 4.0. Sensitivity and specificity of 13C-UBT were 94.5%, and 100% respectively. No significant adverse events were noted. CONCLUSIONS: The 13C-UBT offers an easy, safe and accurate approach to the diagnosis of H. pylori infection in routine clinical practice
Biopsy ; Breath Tests* ; Diagnosis* ; Endoscopy ; Enzyme-Linked Immunosorbent Assay ; Gastrointestinal Diseases ; Helicobacter pylori* ; Helicobacter* ; Hospitals, University ; Humans ; Immunoglobulin G ; Male ; Mass Spectrometry ; Prospective Studies ; Sensitivity and Specificity ; Urea* ; Urease

BACKGROUND: Recent studies showed that non-steroidal antiinflammatory drug may reduce the risk of colorectal cancers. So its potential target, cyclooxygenase (COX)-2 in colorectal cancers has been widely investigated. However, the rate and patterns of COX-2 expression in colorectal polyps have been quite variable among study groups. Furthermore, its role has not been established. The study aim is to investigate the expressions of COX-2 and vascular endothelial growth factor (VEGF) and to evaluate the role of COX-2 in colorectal polyps. METHODS: Fifty-seven colorectal polyps from endoscopic polypectomy or surgical resection were enrolled. Polyps were as follows; 9 were hyperplastic polyps, 14 mild, 26 moderate dysplasia, 8 high grade adenomas (5 severe dysplasia, a carcinoma in situ, and two intramucosal carcinomas). They were stained for COX-2 and VEGF by immunohistochemistry. The intensity of staining according to histologic grades and size of polyp was semi-quantitatively assessed. RESULTS: COX-2 was expressed in 18 cases (31.8%) by dysplastic epithelium and 29 cases (50.9%) by interstitial cells. Epithelial COX-2 expressions were significantly related to histologic grades and size, and begun at moderate dysplasia actually. Interstitial COX-2 was little related to histologic grades and size. VEGF was expressed in 35 cases (61.4%). There was close relationship between epithelial COX-2 and VEGF expressions. CONCLUSION: COX-2 is expressed both in dysplastic epithelium and interstitial cells of colorectal polyps. Our results suggest that epithelial COX-2 expression may be playing a role in tumorigenesis of colorectal polyp, possibly involved in angiogenesis with VEGF.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Colorectal Neoplasms ; Cyclooxygenase 2* ; Endothelial Growth Factors ; Epithelium ; Immunohistochemistry ; Polyps* ; Prostaglandin-Endoperoxide Synthases ; Vascular Endothelial Growth Factor A*

OBJECTIVES: Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. METHODS: The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. RESULTS: Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. CONCLUSIONS: Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.
Adoption ; Confidentiality ; Delivery of Health Care ; Electronic Health Records ; Hospital Information Systems ; Information Systems ; Management Information Systems ; Quality of Health Care ; Radiology Information Systems ; Referral and Consultation