PURPOSE: To evaluate the characteristics of magnetic resonance (MR) images in Peyronie's disease and to assess the usefulness of post-erection penile MRI. MATERIALS AND METHODS: We retrospectively reviewed the MR images of seven patients in whom Peyronie's disease was clinically suspected. All seven underwent pre- and post-erectile MRI. After the aquisition of erectile MRI, three patients also underwent contrast-enhanced MRI. We compared image quality and the rate of detection of penile plaque between pre-erectile and post-erectile images. In three patients who underwent contrast- enhanced MRI, we assessed correlation between the contrast enhancement pattern, as seen on MRI, of the plaque and corpus cavernosa and clinical inflammatory signs such as painful erection. RESULTS: In the seven patients, all post-erectile MRI images showed localized thickening and irregularities of the tunica albuginea and the septum penis, suggesting penile plaque. On pre-erectile MRI, however, plaque was detected in five cases. In six of seven cases, plaque as seen on T2-weighted images (T2WI) showed low signal intensity similar to that of the tunica albuginea, and as seen on T1-weighted images (T1W1), a signal intensity of signal intensity similar to or similar to or slightly higher than that of the tunica albuginea. In one case, plaque showed high signal intensity on both T1WI and T2WI. On T1WI, the corpus cavernosa showed homogeneous medium-signal intensity on all pre- and post-erectile MR images. On pre-erectile T2WI, the corpus cavernosa of six patients showed heterogeneous high signal intensity, whereas on post-erectile T2WI the corpus cavernosa of all patients showed homogeneous high signal intensity. Due to the enlarged penis and homogeneous signal intensity of the corpus cavernosa, the image quality of post-erectile images was superior to that of pre-erectile imjages. The images of two of three patients who underwent contrast enhanced MRI showed strong enhancement of the plaque and adjacent corpus cavernosa, while in one case, no enhancement was noted. Independently of the enhancement pattern, these three patients had no active inflammatory clinical signs such as painful erection. CONCLUSION: In Peyronie's disease, all plaque is clearly, visualized on MRI. In terms of image quality and plaque detection, post-erectile penile MR imaging is superiou to pre-erectile imaging.
Humans ; Magnetic Resonance Imaging* ; Male ; Penile Induration* ; Penis ; Retrospective Studies

OBJECTIVE: To prospectively evaluate the feasibility, safety, and survival of laparoscopic surgical staging in patients with locally advanced cervical cancer. METHODS: From Oct 2001 to Jul 2006, a total of 83 consecutive patients were eligible for inclusion and underwent laparoscopic surgical staging. RESULTS: Three patients with intraoperative great vessel injury and 1 patient in whom the colpotomizer was unable to be inserted were excluded. Laparoscopic surgical staging was feasible in 95.2% (79/83). Immediate postoperative complications were noted in 12 (15.2%) patients. Prolonged complications directly related to operative procedures numbered 2 (2.5%), and were trocar site metastases. The mean time from surgery to the start of radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) was 11 (5-35) days. All patients tolerated the treatment well and completed scheduled RT or CCRT without disruption of treatment and additional admission. The rate of modification of the radiation field after surgical staging was 8.9% (7/79). Five-year progression-free survival and overall survival (OS) rates were 79% and 89%, respectively. The OS of patients with microscopic lymph node metastases, which were fully resected, were comparable to those of patients without lymph node metastasis. However, the OS of patients with macroscopic lymph node metastases that were fully resected were poorer compared with those of patients without lymph node metastasis. CONCLUSION: Pretreatment laparoscopic surgical staging is a feasible and safe treatment modality. However the survival benefit of debulking lymph nodes or full lymph node dissection is not clear.
Chemoradiotherapy ; Disease-Free Survival ; Glycosaminoglycans ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Postoperative Complications ; Prospective Studies ; Surgical Instruments ; Surgical Procedures, Operative ; Uterine Cervical Neoplasms

BACKGROUND/AIMS: The catheter probe endoscopic ultrasonography (EUS) system is widely used to evaluate upper gastrointestinal tract lesions. The depiction of the esophageal wall by probe EUS remains problematic due to the difficulty of the filling of water in the esophageal lumen. In addition, filling the esophagus with water can be associated with an increased risk of aspiration. To resolve such problems, we recently applied the use of probe EUS with the jelly-filled method for the evaluation of subepithelial lesions. The procedure is characterized by filling the esophageal lumen with jelly. In this study, we evaluated the efficacy of probe EUS by using the jelly-filled method for esophageal subepithelial lesions. METHODS: We analyzed the records of the patients with suspected subepithelial lesions at the time of endoscopy that was performed from November 2005 to June 2007. Esophageal subepithelial lesions with both EUS findings and pathological reports were retrospectively compared. RESULTS: The study included 181 patients (96 males, 85 females), with an average age of 55.5 years (age range, 29~78 years). Sixty-eight patients had lesions in the upper esophagus, 60 patients had lesions in the middle esophagus and 53 patients had lesions in the lower esophagus. Secondary layers of esophageal lesions were predominant (91/181) in the cases. Pathological findings were available for 34 patients. Compared with the pathological findings, the diagnostic accuracy of EUS was 91.1%. CONCLUSIONS: Probe EUS by using the jelly-filled method is convenient and safe to perform and provides clear and full-circumferential imaging of a lesion. It is an alternative method to use in place of previously used probe-EUS procedures for the assessment of esophageal subepithelial lesions.
Catheters ; Endoscopy ; Endosonography ; Esophagus ; Humans ; Hypogonadism ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Retrospective Studies ; Upper Gastrointestinal Tract

BACKGROUND/AIMS: The use of self-expandable metal stents (SEMS) is a safe and efficacious method for palliating malignant gastric outlet obstruction. However, few reports have assessed clinical outcome after the insertion of SEMS for malignant gastric outlet obstruction caused by stomach cancer. The aim of this study was to assess the usefulness of uncovered SEMS in patients with malignant gastric outlet obstruction caused by stomach cancer. METHODS: We evaluated 62 patients with gastric outlet obstruction caused by stomach cancer treated by the implantation of uncovered SEMS. A total of 62 patients (43 males, 19 females) were treated between August 2000 and March 2007. A scoring system was used to grade the ability to eat. RESULTS: Stent implantation was successful in 61 (98.4%) patients. Relief of obstructive symptoms was achieved in 49 (80.3%) patients. The mean survival duration was 143 days. The mean stent patency time was 103.5 days. An improvement in the ability to eat using the scoring system was statistically significant (p<0.05). CONCLUSIONS: Endoscopic placement of uncovered SEMS is a safe and effective treatment for the palliation of patients with inoperable malignant gastric outlet obstruction caused by stomach cancer.
Gastric Outlet Obstruction ; Humans ; Male ; Stents ; Stomach ; Stomach Neoplasms

There have been ongoing social discussions on revision of the abortion law since the Constitutional Court ruled it nonconformity to the constitution on April 11, 2019. Thus, Korean Society of Obstetrics and Gynecology, Korean Society of Maternal Fetal Medicine, Korean College of Obstetricians and Gynecologists, and Korean Association of Obstetricians and Gynecologists organized 'special committee for abortion law' to support social discussion on the revision of the abortion law, and they prepared official opinions of obstetrics for medical issues including doctors' right to refuse abortion. In the future, the committee will continue to adapt to changes of medical environment especially after the revision of the abortion law by collecting its members' feedbacks.

There have been ongoing social discussions on revision of the abortion law since the Constitutional Court ruled it nonconformity to the constitution on April 11, 2019. Thus, Korean Society of Obstetrics and Gynecology, Korean Society of Maternal Fetal Medicine, Korean College of Obstetricians and Gynecologists, and Korean Association of Obstetricians and Gynecologists organized 'special committee for abortion law' to support social discussion on the revision of the abortion law, and they prepared official opinions of obstetrics for medical issues including doctors' right to refuse abortion. In the future, the committee will continue to adapt to changes of medical environment especially after the revision of the abortion law by collecting its members' feedbacks.