No abstract available.

Breast thermography produces a picture of the heat emitted from the surface of the breast. And abnormal temperature over the breast has been suggested as an indicator of malignancy. The mechanisms for the heat production at the area of the skin over the breast are suggested hypermetabolism, hypervascularization, and hyperfusion of the affected regions of the breast. The purpose of this study was to evaluate the diagnostic accuracy of breast thermography in breast cancer. One hundred thirty breast cancers and one hundred ten benign breast masses were examined by a digital infrared thermographic system (NEC San-ei, Therm Tracer 6T67) between January 1991 and December 1995. In this study, thermograms were classified as normal (Th-1), equivocal (Th-2), or abnormal (Th-3). Normal thermograms were those with normal symmetric vascularity, equivocal thermograms were those with only heat in the area of mass, and abnormal thermograms were those with heat and increased vascularity in the area of mass. Among the 110 benign breast masses, there were 98 Th-1 cases (89.1%), 2 Th-2 cases (1.8%) and 10 Th-3 cases (9.1%). Among the 130 breast cancers, there were 98 Th-3 cases (75.4%), 20 Th-2 cases (16.2%), and 12 Th-1 cases (9.2%). The sensitivity of the breast thermograms was 90%, the specificity 89.1%, and the diagnostic accuracy 89.6%. A thermal difference(deltaT) of less than 1oC was seen in 10 cases (7.7%) of breast cancer, and a deltaT of more than 1oC was seen in 120 cases (92.3%). Among the latter of a deltaT of more than 3oC was seen in 67 cases(51.4%). The correlation of the breast-cancer tumor size with deltaT was highly significant(p<0.0001). The classification of the thermographic diagnosis was found to be statistically correlated with tumor size (p<0.0001), axillary node status (p<0.001) and nuclear grade (p<0.05), but not with the presence or abscence of estrogen receptor. These results suggest that thermography is useful as a diagnostic tool for breast cancer. And that a deltaT of more than 2oC of on a breast thermogram strongly suqqests a malignancy.
Breast Neoplasms* ; Breast* ; Classification ; Diagnosis* ; Estrogens ; Hot Temperature ; Sensitivity and Specificity ; Skin ; Thermogenesis ; Thermography*

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

No abstract available.

No abstract available.

Ectopic paragonimiasis has been diagnosed in many organs such as the mesentery, ovary, pleura, central nervous system, subcutis and very rarely in the liver. However, simultaneous involvement of the colon and liver, which mimics colonic cancer with liver metastasis, is quite unusual, and to our knowledge has never been reported. Our case is a 63 year old woman who visited our hospital because of upper abdominal pain. Radiologically, space occupying lesions were detected in the transverse colon, mesocolon and left hepatic lobe. After the radical presection, they were proved to be an ectopic paragonimiasis forming multiple cavitary parasitic granulomas with Charcot-Leyden crystals and degenerating eggs.
Abdominal Pain ; Central Nervous System ; Colon* ; Colon, Transverse ; Colonic Neoplasms ; Eggs ; Female ; Granuloma ; Humans ; Liver* ; Mesentery ; Mesocolon ; Middle Aged ; Neoplasm Metastasis ; Ovary ; Ovum ; Paragonimiasis* ; Pleura

We report here on a rare case of a ruptured basilar tip aneurysm that was successfully treated with coil embolization in the bilateral cervical internal carotid artery (ICA) occlusions with abnormal vascular networks from the posterior circulation. A 43-year old man with a familial history of moyamoya disease presented with subarachnoid hemorrhage. Digital subtraction angiography demonstrated complete occlusion of the bilateral ICAs at the proximal portion and a ruptured aneurysm at the basilar artery bifurcation. Each meningeal artery supplied the anterior cranial base, but most of both hemispheres were supplied with blood from the basilar artery and the posterior cerebral arteries through a large number of collateral vessels to the ICA bifurcation as well as the anterior cerebral and middle cerebral arteries. The perfusion computed tomography (CT) scans with acetazolamide (ACZ) injection revealed no reduction of cerebral blood flow and normal cerebrovascular reactivity to ACZ. An abdominal CT aortogram showed no other extracranial vessel abnormalities. A ruptured basilar tip aneurysm was successfully treated with coil embolization without complications. Endovascular embolization may be a good treatment option with excellent safety for a ruptured basilar tip aneurysm that accompanies proximal ICA occlusion with vulnerable collateral flow.
Acetazolamide ; Aneurysm ; Aneurysm, Ruptured ; Angiography, Digital Subtraction ; Basilar Artery ; Carotid Artery, Internal ; Collateral Circulation ; Glycosaminoglycans ; Meningeal Arteries ; Middle Cerebral Artery ; Moyamoya Disease ; Perfusion ; Posterior Cerebral Artery ; Skull Base ; Subarachnoid Hemorrhage

OBJECTIVE: The aim of this study was to determine the role of intra-arterial (IA) nimodipine injections for cerebral vasospasm secondary to ruptured subarachnoid hemorrhage (SAH) and to investigate the factors that influence vasodilation and clinical outcomes. METHODS: We enrolled 29 patients who underwent aneurysm clipping for ruptured cerebral aneurysms between 2009 and 2011, and who received IA nimodipine after subsequently presenting with symptomatic vasospasm. The degree of vasodilation shown in angiography was measured, and the correlation between the degree of vasodilation and both the interval from SAH to cerebral vasospasm and the interval from clipping to cerebral vasospasm was determined. The change in blood flow rate after IA injection was assessed by transcranial Doppler ultrasound. Multiple clinical parameters were completed before and after IA nimodipine injection to evaluate any improvements in clinical symptoms. RESULTS: For eight patients, Glasgow Coma Scale (GCS) scores increased by two or more points. The regression analysis demonstrated a positive correlation between the change in GCS scores after IA nimodipine injection and the change in blood vessel diameter (p=0.025). A positive correlation was also observed between the interval from SAH to vasospasm and the change in diameter (p=0.040); and the interval from clipping to vasospasm and the change in diameter (p=0.022). CONCLUSION: IA nimodipine injection for SAH-induced vasospasm led to significant vasodilation in angiography and improvement in clinical symptoms without significant complications. Our findings suggest that IA nimodipine injection should be utilized when intractable vasospasm develops despite rigorous conservative management.
Aneurysm ; Aneurysm, Ruptured ; Angiography ; Blood Vessels ; Glasgow Coma Scale ; Glycosaminoglycans ; Humans ; Injections, Intra-Arterial ; Intracranial Aneurysm ; Nimodipine ; Subarachnoid Hemorrhage ; Vasodilation ; Vasospasm, Intracranial

PURPOSE: There has been considerable controversy over the prognosis of gastric signet ring cell carcinoma (SRC). To clarify the biologic behavior of SRC, we evaluated the clinicopathologic features and the prognosis of SRC. METHODS: A total of 3,104 patients with a gastric carcinoma who had undergone a gastrectomy from 1987 to 1995 were analyzed retrospectively. Among them, 556 patients with SRC were compared to 2,548 patients with non-SRC. RESULTS: Patients with SRC were younger than those with non-SRC, and female were prevalent. Incidence of EGC were higher in patients with SRC. EGC with SRC had a larger proportion of mucosa-confined lesions and a lower rate of lymph node metastasis than EGC with non-SRC. Multivariate analysis showed that SRC was a negative inde pendent risk factor for lymph node metastasis. Among advanced gastric cancers SRCs showed a higher prevalence of large-sized lesions, Borrmann type IV lesions, and advanced nodal stage, as well as a higher rate of peritoneal metastasis. The 5-year survival rate of EGC with SRC (93.8%) was higher than that of non-SRC (91.2%). However, the prognosis of advanced SRC (49.0%) was poorer than that of non-SRC (53.5%). CONCLUSION: A female preponderance, a younger age, and a higher proportion of early gastric cancer characterized the peculiar biologic behavior of gastric signet ring cell carcinoma. In addi tion, the prognosis of SRC was poor once invasion had gone beyond the submucosa. These findings suggest that signet ring cell carcinoma of the stomach should be regarded as a distinct type of gastric cancer.
Carcinoma, Signet Ring Cell* ; Female ; Gastrectomy ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prevalence ; Prognosis* ; Retrospective Studies ; Risk Factors ; Stomach ; Stomach Neoplasms ; Survival Rate

PURPOSE: An abridged 5-item version of the 15-item International Index of Erectile Function (IIEF) was developed and its validity has been proven in the western medical community. This study was designed to assess the validity of the abbreviated Korean version of the IIEF as a diagnostic tool for ED. MATERIALS AND METHODS: Patients who visited the Andrology Clinic of the Asan Medical Center with a chief complaint of ED fall into the patient group. Patients who visited the Family Medicine Clinic of the same hospital with chief complaints other than ED, and checked no ED in the self-assessment questionnaire, fall into the control group. Patients, both of the patient group and control group, were asked to fill out the self-administered IIEF-5 and the questionnaire asking the severity of the ED. RESULTS: Collected questionnaires from a total of 309 subjects (the patient group: 149; the control group: 160) were used for statistical analysis. Mean ages were 43 and 52 for the control group and the patient group, respectively. A Receiver Operating Characteristics (ROC) Curve analysis indicated that there is a close correlation between IIEF-5 total scores and the presence of ED (area under the ROC curve=0.961). The most appropriate cutoff score between ED and no ED was 17 (sensitivity=91.3%, specificity=86.3%). Substantial consistency existed between the predicted and the patient-answered ED severity levels (Weighted Kappa=0.681). CONCLUSIONS: The Korean version of IIEF-5 is highly effective in detecting the presence and assessing the severity of ED. The result of our study supports its validity as a diagnostic instrument in the clinical setting.
Andrology ; Chungcheongnam-do ; Diagnosis ; Erectile Dysfunction* ; Humans ; Male ; Surveys and Questionnaires ; ROC Curve ; Self-Assessment