PURPOSE: PET developed on the basis of biochemical characteristics of malignant tissues where the increase in glucose metabolism. Therefore, early and accurate detection of primary or metastatic lesion can be expected. This study is to compare PET and other traditional methods in detection of primary breast carcinoma and metastatic lesion, and to find the advantage of PET. MATERIALS AND METHODS: We compared and analysed the results of PET, US, mammogr aphy, bone scan, CT and biopsy reports of the 46 patients who were examined in our hospital from September 1, 19094 to July 31, 1995. PET Trace 200 cyclotron and PET Advanced Scenner were used for FDG synthesis and imaging respectively. RESULTS: 10 of the 12 cases who had preoperative PET were consistent with the results of mammography and ultrasound and 9 of the 10 cases were consistent with the pathologic results. In one case, which did mammography and PET after excis ional biopsy, PET gaves a false positive result. In the detection of axilliary node metastasis, PeT after excisional biopsy, PET gaves a false positive result. In the detection of axilliary node metastasis, PET shows 100% sensitivity and specificity but bone scan shows 100%, 72.2% respectively. CONCLUSION: PET is useful for diagnosis of primary breast cancer and is superior to bone scan in specificity for diagnosis of bone metastasis and in early detection of response to treatment. Because PET cannot exclude false (+) in inflamm atory lesion, continuous investigation is needed for establishment of indication and reduction of false (+), false (-).In spite of high cost, PET may become a new and useful diagnostic tool.
Biopsy ; Breast Neoplasms* ; Breast* ; Cyclotrons ; Diagnosis* ; Electrons* ; Glucose ; Humans ; Mammography ; Metabolism ; Neoplasm Metastasis ; Positron-Emission Tomography* ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: To evaluate the usefulness of flexible covered stent in the treatment of acute colorectalobstruction secondary to colorectal carcinoma. MATERIALS AND METHODS: Flexible covered stents were placed in 11patients with clinical and radiologic signs of acute colonic obstruction secondary to colorectal carcinoma. Thepurposes of stent insertion were pre-operative bowel preparation in seven patients and palliative treatment infour. A fistula was present in two;in one this was between the proximal jejunum and colon, and the other wasrectovaginal. The usefulness of stent insertion for the purpose of preoperative bowel preparation was evaluatedaccording to the feasability and status of bowel preparation, as decided by the operator. Palliative treatment forthe relief of symptoms of acute bowel obstruction was evaluated according to the number and amount of defecation,bowel dilatation in simple abdomen radiography, and the presence of complications. RESULT: Bowel preparation forthe purpose of preoperative bowel cleansing was easy in seven patients;the fecal materials remaining in the colonpresented no problems during surgery. In one of four patients palliative treatment involved a colostomy;this wasdue to recurrent stent obstruction by fecal materials after three months, and in two other patients there wasstent obstruction after two and five months, respectively. The stent in one of four patients who underwentpalliative treatment was removed because of stent migration three days after insertion;the stents in two patientswith fistulas covered the fistulas successfully. Complications after stent insertion were anal pain in threepatients, anal bleeding in three and stent migration in one. CONCLUSION: The flexible covered stent was aneffective device for the relief of acute colonic obstruction secondary to malignant rectosigmoid neoplasia. Itallowed for single-stage operation and covered the fistula. We believe however that for further evaluation of theusefulness of this type of stent in long-term palliative treatment, a larger-scale study is needed.
Abdomen ; Colon ; Colorectal Neoplasms ; Dilatation ; Fistula ; Hemorrhage ; Humans ; Jejunum ; Palliative Care ; Radiography ; Stents*

A wedge-shaped anterior hairline extension is a very rare skin manifestation usually associated with congenital anomalies including a Tessier number 10 cleft. Other associated conditions are the Tessier number 9 cleft, the Fraser syndrome, and the Manitoba oculotrichoanal syndrome (MOTA syndrome). The Tessier number 10 cleft features include a coloboma of the middle third of the upper eyelid, and an eyebrow divided into two portions. The medial eyebrow portion may be absent and the lateral portion is angulated vertically, joining the hairline of the scalp. This creates a wedge-shaped anterior hairline extension. Herein we report on a case of a wedge-shaped anterior hairline extension associated with the Tessier number 10 cleft.
Abnormalities, Multiple ; Anal Canal ; Coloboma ; Eyebrows ; Eyelids ; Fraser Syndrome ; Hypertelorism ; Manitoba ; Scalp ; Skin Manifestations

PURPOSE: The purpose of this pilot study was to evaluate the association between adenosine triphosphate-based chemotherapy response assays (ATP-CRAs) and subsets of tumor infiltrating lymphocytes (TILs) in gastric cancer. MATERIALS AND METHODS: In total, 15 gastric cancer tissue samples were obtained from gastrectomies performed between February 2007 and January 2011. Chemotherapy response assays were performed on tumor cells from these samples using 11 chemotherapeutic agents, including etoposide, doxorubicin, epirubicin, mitomycin, 5-fluorouracil (5-FU), oxaliplatin, irinotecan, docetaxel, paclitaxel, methotrexate, and cisplatin. TILs in the tissue samples were evaluated using antibodies specific for CD3, CD4, CD8, Foxp3, and Granzyme B. RESULTS: The highest cancer cell death rates were induced by etoposide (44.8%), 5-FU (43.1%), and mitomycin (39.9%). Samples from 10 patients who were treated with 5-FU were divided into 5-FU-sensitive and -insensitive groups according to median cell death rate. No difference was observed in survival between the two groups (P=0.216). Only two patients were treated with a chemotherapeutic agent determined by an ATP-CRA and there was no significant difference in overall survival compared with that of patients treated with their physician's choice of chemotherapeutic agent (P=0.105). However, a high number of CD3 TILs was a favorable prognostic factor (P=0.008). Pearson's correlation analyses showed no association between cancer cell death rates in response to chemotherapeutic agents and subsets of TILs. CONCLUSIONS: Cancer cell death rates in response to specific chemotherapeutic agents were not significantly associated with the distribution of TIL subsets.
Adenosine ; Adenosine Triphosphate ; Antibodies ; Cell Death ; Cisplatin ; Doxorubicin ; Drug Screening Assays, Antitumor ; Drug Therapy ; Epirubicin ; Etoposide ; Fluorouracil ; Gastrectomy ; Granzymes ; Humans ; Lymphocytes, Tumor-Infiltrating* ; Methotrexate ; Mitomycin ; Paclitaxel ; Pilot Projects* ; Stomach Neoplasms*

Granular parakeratosis is a recently recognized disorder of keratinization that is usually confined to intertriginous areas. The histopathologic features are distinctive and diagnostic. Rarely, histopathologic variants such as follicular granular parakeratosis and granular parakeratosis of eccrine ostia have been described. In this report, we describe a rare case of granular parakeratosis mostly confined to eccrine ostia.
Eccrine Glands ; Keratins ; Neck ; Parakeratosis

No abstract available.
Asian Continental Ancestry Group* ; Humans ; Lasers, Solid-State* ; Skin*

No abstract available.
Asian Continental Ancestry Group* ; Humans ; Lasers, Solid-State* ; Skin*

Emphysematous pyelonephritis is an uncommon, but life-threatening necrotizing inflammation of renal parenchyme and perinephric tissue by gas-forming organisms. This disease is encountered mainly in patients with uncontrolled diabetes mellitus and/or urinary tract obstruction etc. Though the pathogenesis of this diseases is still poorly understood, radiographic demonstration of gas shadow in renal parenchyme and peri-nephric tissue establishes the diagnosis of emphysematous pyelonephritis. The identification of this finding has been believed to consider incision and drainage or nephrectomy in addition to medical treatment, because of high mortality rate of this disease in spite of vigorous medical management. We report two cases of emphysematous pyelonephritis complicated in 62-year-old female and 48- year-old male patients with diabetes mellitus. Nephrectomies were not performed because of bilateral emphysematous pyelonephritis in one patient and of refusal of nephrectomy by the other patient. But patients were recovered completely on medical management.
Diabetes Mellitus ; Diagnosis ; Disulfiram ; Drainage ; Female ; Humans ; Inflammation ; Male ; Middle Aged ; Mortality ; Nephrectomy ; Pyelonephritis* ; Urinary Tract

OBJECTIVE: To compare the clinical outcomes following conservative treatment and arthroscopic repair in patients with a rotator cuff tear. METHODS: In this retrospective study, patients aged >50 years with a symptomatic rotator cuff tear were reviewed. The rotator cuff tendons were evaluated using ultrasonography, shoulder magnetic resonance imaging or MR arthrography, and the patients with either a high-grade partial-thickness or small-to-medium-sized (≤3 cm) full-thickness tear were included in this study. The primary outcome measures were a pain assessment score and range of motion (ROM) at 1-year follow-up. The secondary outcomes were the rate of tear progression or retear along with the rate of symptom aggravation after the treatments. RESULTS: A total of 357 patients were enrolled, including 183 patients that received conservative treatment and 174 patients who received an arthroscopic repair. The pain assessment score (p<0.001) and the ROM in forward flexion (p<0.001) were significantly improved in both groups. The ROM in internal rotation did not significantly change after conservative treatment and arthroscopic repair. The pain assessment score and ROM were not significantly different between the two groups. Retear was observed in 9.6% of patients who had an arthroscopic repair and tear progression was found in 6.7% of those who underwent conservative treatment. The proportion of aggravation for pain and ROM did not significantly differ between the two groups. CONCLUSION: The effectiveness of conservative treatment is not inferior to arthroscopic repair for patients >50 years old with a less than medium-sized rotator cuff tear in a 1-year follow-up period. Further study is warranted to find the optimal combination of conservative treatment for a symptomatic rotator cuff tear.
Arthrography ; Arthroscopy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Observational Study* ; Outcome Assessment (Health Care) ; Pain Measurement ; Range of Motion, Articular ; Retrospective Studies* ; Rotator Cuff* ; Shoulder ; Tears* ; Tendon Injuries ; Tendons ; Treatment Outcome ; Ultrasonography

PURPOSE: This study comparedthe effectiveness and safety of laparoscopic adrenalectomy with conventional open adrenalectomy for the treatment of pheochromocytoma. METHODS: Medical records of 100 patients who underwent surgical removal of pheochromocytoma (open adrenalectomy, n=59; laparoscopic adrenalectomy, n=39) at Samsung Medical Center from June 1995 to August 2007 were retrospectively reviewed. RESULTS: To draw an appropriate comparison, patients with a tumor less than 7 cm in size were evaluated (open adrenalectomy, n=23; laparoscopic adrenalectomy n=31). No statistically significant differences were evident according to age, gender and tumor size. The mean operating time was 158 min for the open surgery group and 114 minfor the laparoscopic group (P<0.01). The mean postoperative hospital stay was 10.4 days following open surgery and 5.6 days following laparoscopic surgery (P<0.01). The mean volume of the estimated blood loss for the laparoscopic surgery group (482 ml) was less than for the open surgery group (mean 229 ml) (P=0.06), and the time to first oral intake was 1.7 days after laparoscopic adrenalectomy and 3.5 days after open surgery (P<0.01). The frequency of using analgesics for postoperative pain after laparoscopic adrenalectomy was markedly lower than following conventional open adrenalectomy. There was no recurrence or complications during the follow-up periods (mean: 30 months). CONCLUSION: Laparoscopic adrenalectomy offers advantages of less postoperative pain, shorter operative time and a shorter hospital stay as compared with conventional open adrenalectomy. Laparoscopic adrenalectomy for treating pheochromocytoma is a minimally invasive alternative to conventional open adrenalectomy.
Adrenalectomy* ; Analgesics ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Medical Records ; Operative Time ; Pain, Postoperative ; Pheochromocytoma* ; Recurrence ; Retrospective Studies