OBJECTIVE: The aims of this study were to analyze the natural history of patients with pseudomyxoma peritonei originated from mucinous ovarian tumor, evaluate clinical and pathologic variables, and review our experience with available therapeutic modalities. METHODS: Six patients were treated for pseudomyxoma peritonei originating from mucinous ovarian tumor at Severance Hospital between 1990 and 1998. The data were collected retrospectively and all charts were reviewed RESULTS: The mean age at diagnosis was 51 years, and most common symptoms were abdominal distension. Pseudomyxoma peritonei was found in association with five mucinous ovarian tumors of borderline malignancy, and one ovarian mucinous adenoma. All patients underwent surgical staging and cytoreduction, three patients received postoperative adjuvant chemotherapy and, of these, two developed recurrence. With respect to survival, all patients were alive, four were alive and free of disease, two were alive with disease at the end point of study. CONCLUSION: Pseudomyxoma peritonei is commonly associated with borderline mucinous ovarian tumors, and is a frequently relapsing and protracted disease. But aggressive and repeated debulking surgery is recommended for long survival.
Adenoma ; Chemotherapy, Adjuvant ; Diagnosis ; Humans ; Mucins* ; Natural History ; Pseudomyxoma Peritonei* ; Recurrence ; Retrospective Studies

No abstract available.
Humans ; Plasma* ; Tranexamic Acid* ; Urticaria*

PURPOSE: This study was undertaken to correlate the CT and histopathologic findings of abscess wall. MATERIALS AND METHODS: The CT findings of 12 patients with pathologically proven brain abscess were retrospectively analyzed with particular attention to the thickness, smoothness and uniformity of enhancing abscess wall, and the results were correlated with histopathologic findings. RESULTS: Two patients with acute cerebritis showed an isodense ring on non-contrast CT(NCCT), but a true capsule formation could not be identified at pathologic examination. Six other patients with isodense ring on NCCT consisted of early to late cerebritis(3 cases), late cerebritis to early capsule(1 case), early capsule(1 case), and late capsule(1 case). These 6 cases showed ring enhancement on contrast enhanced CT(CECT) and true capsule formation pathologically. There was no isodense ring on NCCT in the remaining four patients. They consisted of early to late cerebritis(2 cases), late cerebritis(1 case), and late cerebritis to early capsule formation(1 case). These also showed ring enhancement on CECT and true capsule formation pathologically. CONCLUSION: We found that it is difficult to predict the exact stage of brain abscess on preoperative CT findings. It is suggested that clinical findings and sequential dynamic CT may provide more detailed informations for evaluation of abscess staging.
Abscess ; Brain Abscess* ; Brain* ; Humans ; Retrospective Studies

BACKGROUND: The implementation of intraoperative normovolemic hemodilution is a strategy used in an attempt to diminish the need for or obviate allogeneic transfusion and to avert the potential complications. The goal of this study was to evaluate the safety and efficacy of moderate intraoperative normovolemic hemodilution. METHODS: Fifteen patients scheduled for posterolateral spinal fusion underwent intraoperative normovolemic hemodilution with 10% pentastarch to a target hematocrit level of 25% (hemodilution group). All units of blood procured by hemodilution and additional allogeneic blood was transfused in the perioperative period to maintain the hematocrit level of>25%. We investigated the effect of hemodilution on whole blood coagulation as measured by the thromboelastography and, evaluated its efficacy of decreasing the need for allogeneic blood transfusion as compared to the nonhemodilution group, retrospectively. RESULTS: Hemodilution with pentastarch caused a decrease in response and coagulation time (p<0.01) but did not influence on the alpha angle and maximum amplitude on thromboelstogram. Amount of transfusion of allogeneic blood was 4.1 1.7 units for the hemodilution group and 5.0 1.5 units for the nonhemodilution group. Net red blood cell volume ""saved"" from hemodilution was about 120 ml. CONCLUSION: Moderate intraoperative normovolemic hemodilution with pentastarch does not affect the coagulability of whole blood. But its efficacy of decreasing the need for allogeneic blood transfusion is minimal.
Blood Coagulation ; Blood Transfusion ; Erythrocytes ; Hematocrit ; Hemodilution* ; Humans ; Hydroxyethyl Starch Derivatives ; Perioperative Period ; Retrospective Studies ; Spinal Fusion* ; Thrombelastography

PURPOSE:Ghrelin is an endogenous ligand of the growth hormone secretagogue receptor, and stomach is the major site of ghrelin secretion. The purpose of this study is to compare the serum ghrelin concentrations between patients with type 2 diabetes mellitus (DM) and normal adults. We studied also whether serum ghrelin levels in the patients with type 2 DM are correlated with body mass index (BMI), serum insulin, lipid profiles, and creatinine levels. METHODS:Forty patients with type 2 DM and forty normal adults were included in this study. We measured heights and weights of the subjects and calculated their BMIs. Blood samples were obtained to measure the ghrelin concentration and their sera were stored at -20degreeC until used. In all subjects, serum ghrelin levels were measured using the commercially available Ghrelin(human) EIA kit. RESULTS:No differences of mean values were detected between the control group and the type 2 diabetic group for age, body weight, BMI, and the levels of serum total cholesterol, triglyceride, HDL cholesterol, and creatinine. But ghrelin level of the type 2 diabetic group (71.1+/-30.5 ng/L) was significantly lower than the control group (139.7+/-36.9 ng/L). In the control group, the ghrelin level showed positive correlation with HDL cholesterol (Pearson's correlation coefficient=0.37, P<0.05). In the diabetic group, the ghrelin level showed weakly positive correlation with insulin concentration. However, there was no significant relationship between serum ghrelin and various parameters in the diabetic patients group. CONCLUSION: In this study, ghrelin concentration in type 2 diabetic patients was lower than that in the control group. In the control group, serum ghrelin concentrations were positively correlated with HDL cholesterol. In the type 2 diabetic group, there was no significant correlation between insulin and ghrelin concentrations.
Adult ; Body Mass Index ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Ghrelin* ; Humans ; Insulin ; Receptors, Ghrelin ; Stomach ; Triglycerides ; Weights and Measures

Complications of penile prosthesis include malfunction, infection and patient dissatisfaction. Herein, a rare complication of a retained reservoir having eroded into the bladder after the removal of the penile components of a three-piece penile prosthesis, is reported. A 39-year-old man complained of irritative voiding symptoms. The symptoms had developed 4 years after the removal of the penile components of the prosthesis. The erosion of the reservoir into the bladder was discovered incidentally during the treatment of bladder calculi. The reservoir was removed by an open vesicolithotomy.
Adult ; Calculi ; Cytochrome P-450 CYP1A1 ; Humans ; Penile Prosthesis* ; Prostheses and Implants ; Urinary Bladder Calculi* ; Urinary Bladder*

Whiplash injury in low-speed traffic accidents are not objectively verified by medical equipment, thereby creating scope for misuse, which has resulted in huge social losses worldwide. The aim of this study was to examine the influence of low-speed vehicular rear-impact collisions on middle-aged men, and to analyze the head and neck injury criteria for the symptomatic human volunteers. Data was examined from the results of 50 dynamic sled tests, originally performed by Hong et al. (2012). In the previous tests, 50 men aged 30~50 years were exposed to an impulse equivalent to a bumper-to-bumper rear collision under medical supervision, and no resulting whiplash injury was identified. In this study, for 6 subjects who experienced dull aches over their bodies, head injury criteria (HIC15) and neck injury criteria (N(km)) were calculated according to the accelerations, forces, and moments at the occipital condyle measured by motion capture system. Although there were no changes in magnetic resonance imaging findings in all subjects at the pre-/post-test orthopedic examination, 6 subjects revealed mild aches around the shoulder, back, or lumbar area, and their symptoms disappeared within 2 days. The head and neck injury criteria, HIC15 (3.086 +/- 2.942) and N(km) (0.077 +/- 0.064) were obtained, and the maximum HIC15 and N(km) were found to be significantly lower than the critical injury assessment reference values (HIC15: 700, N(km): 0.3). Moreover, even though 2 subjects were exposed to the same level of change of velocity (7.9 km/h), each N(km) was significantly different (0.179, 0.057). One can therefore conclude that N(km) can vary according to voluntary movements in the human subject.
Acceleration ; Accidents, Traffic ; Aged ; Automobiles ; Craniocerebral Trauma ; Head ; Human Experimentation ; Humans ; Magnetic Resonance Imaging ; Male ; Neck ; Neck Injuries ; Organization and Administration ; Orthopedics ; Reference Values ; Shoulder ; Whiplash Injuries

Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

Benign ductal or glandular neoplasms of the esophagus unrelated to Barrett esophagus are extremely rare. Only 9 cases have been reported in the English language literature. We now report a case of esophageal gland duct adenoma incidentally found in a 73-year-old man. A 0.8 cm-sized, polypoid submucosal lesion in the distal esophagus was removed. Histologically, the lesion was well circumscribed and consisted of several ducts or cysts with focal papillary configurations. Interstitial lymphocytic infiltration with germinal centers was also observed. The lining cells of ducts or cysts were composed of two layers: an inner intensely eosinophilic luminal duct cell layer and an outer myoepithelial cell layer that was accentuated by alpha-smooth muscle actin. There was no significant nuclear atypia or mitosis. Mucin production was occasionally observed in a few goblet cells. To the best of our knowledge, this is the first case of benign ductal or glandular neoplasm of the esophagus among Koreans.
Actins ; Adenoma ; Aged ; Barrett Esophagus ; Eosinophils ; Esophagus ; Germinal Center ; Goblet Cells ; Humans ; Mitosis ; Mucins ; Muscles ; Neoplasms, Glandular and Epithelial ; Phenobarbital

PURPOSE: To evaluate anatomic variations and pitfalls of the labral-capsular-ligamentous complex in the shoulder joint for the proper interpretation of magnetic reasonance arthrographic images. MATERIALS AND METHODS:To determine the presence of sublabral sulci, undercutting of the base of the glenoid labrum by the articular cartilage, and the proximity of the middle glenohumeral ligament to the anterior glenoid labrum, 56 MR arthrograms of 41 asymptomatic volunteers were prospectively evalvated for labral shape and capsular insertion. We also evaluated the axillary fold, which was often confused with a loose body. RESULTS: The anterior and posterior parts of the labra, varied but their shape showed several dominant features; triangular(72%, 36%, respectively), rounded(13%, 35%), cleaved(8%, 1%), notched(2%, 0%), flat(5%, 24%), and absent(0%, 4%). Anterior capsular insertion was type 1 in 82% of cases, type 2 in 13% and type 3 in 5%, whereas posterior insertion was type 1 in 62%, type 2 in 36% and type 3 in 2%. We could also detect many pitfalls, such as undercutting of the base of theglenoid labrum by the articular cartilage(29%), sublabral sulci(25%), a prominent axillary fold(38%), and the middle glenohumeral ligament in proximity to the anterior labrum(5%). CONCLUSION: Our study revealed wide variability in the MR arthrographic appearance of the labral-capsular-ligamentous complex in asymptomatic shoulders. A good understanding of normal variation and pitfalls of the normal shoulder may be helpful pathologic condition in case of glenouhumeral instability.
Arthrography* ; Cartilage, Articular ; Ligaments ; Prospective Studies ; Shoulder ; Shoulder Joint ; Volunteers