A patient with extraskeletal cervical epidural Ewing's sarcoma who presented with cervical radiculopathy is reported. A 58-year-old woman presented with right posterolateral neck pain and upper extremity radiculopathy. The computed tomography myelography showed epidural and paravertebral masses on right side, with widening of the ipsilateral neural foramina at the C2-C3 level. On magnetic resonance images, the mass was isointense to soft tissue on T1-weighted images, hyperintense on T2-weighted images, and showed diffuse enhancement on GdTA enhanced T1-weighted images. The staged, combined posterior and anterior approach were done and the tumor mass was subtotally removed. During postoperative adjuvant chemotherapy with Cytoxane, Adriamycin, Vincristine, Prednisolone regimen, the patient died of severe compression of upper cervical cord by recurrent, extended tumor mass in the spinal canal.
Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Middle Aged ; Myelography ; Neck Pain ; Prednisolone ; Radiculopathy ; Sarcoma, Ewing* ; Spinal Canal ; Upper Extremity ; Vincristine

We encountered a rare condition of rice body in subacromial and subdeltoid spaces in a patient with unremarkable medical history. Although it is uncommon, there have been continued reports on its formation in certain type of infective and inflammatory arthritis. However, except for a traumatic event, evaluation yielded no known and conceivable cause for his chronic inflammatory bursitis. Relatively typical findings for rice body on magnetic resonance imaging have been described, and in our case the imaging prompted us to schedule early removal, which is generally accepted as the management of choice to prevent further progression of symptoms. The symptoms of the shoulder showed significant improvement, and a close follow-up schedule has been recommended for observation of recurrence and development of any foreseeable underlying cause.
Appointments and Schedules ; Arthritis ; Bursitis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Shoulder ; Shoulder Joint

Shoulder kinematics is important, as it is associated with shoulder arthropathy and pain mechanisms. Various static and dynamic analysis methods are prevalent for shoulder kinematics. These include 2-dimensional plane x-ray, computed tomography, and magnetic resonance imaging, cadaver study, electromagnetic motion analysis, transcortical bone pins technique, and in vivo 3-dimensional motion analysis. Although these methods provide the value of the shoulder kinematics angle, they are unable to explain why such changes occur. Since each method has its pros and cons, it is important to understand all factors accurately, and to choose a method that best meets the purpose of the researcher.
Biomechanical Phenomena* ; Bone Nails ; Cadaver ; Magnetic Resonance Imaging ; Magnets ; Methods ; Shoulder*

No abstract available.
Pancreatic Pseudocyst*

PURPOSE: Although influenza is regarded as one of the major causes of morbidity and mortality in children with cancer, the actual vaccine coverage remains poor. We conducted evaluation of immunogenicity and safety of influenza vaccine in children with cancer. METHODS: In this study, 25 children with cancer who received influenza vaccine (SK influenza IX vaccine(R)) at the Korea Cancer Center Hospital between October and December 2009 were analyzed. Blood samples of patients were collected twice (at the beginning of this study and at 30th day after vaccination) and their antibody titers were measured using the hemagglutination-inhibition (HI) assay. Immunogenicity of the influenza vaccine was assessed by seroprotection rate on days 0 and 30, seroconversion rate on day 30, and mean fold increase (MFI) of geometric mean titer (GMT) of HI between days 0 and 30. RESULTS: Any of the subjects in our study did not experienced serious adverse events after influenza vaccination. Seroprotection rates were 68% for H1N1, 40% for H3N2, and 36% for B. Seroconversion rates were 12% for H1N1, 16% for H3N2, and 20% for B. MFIs were 0.9 for H1N1, 1.2 for H3N2, and 1.8 for B. CONCLUSION: In the study, we found a limited protective immune response to influenza vaccine, among subjects with cancer. However, some subjects showed seroconversion, and there were no severe adverse events among all subjects, supporting the recommendation of annual influenza vaccination in children with cancer.
Child ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Vaccination

Primary tumors of the heart are rare, three quarter of the tumors are benign, and nearly half of the benign heart tumors are myxomas. Cardiac myxoma usually originate in the left atrium about 75 percent, however, only 3 to 4 percent of myxoma are detected in the left ventricle. We report on a 32 years old woman with left ventricular myxoma who presented with shortness of breath, chest tightness, and general weakness. Acute pulmonary embolism and left ventricular myxoma were found on a perfusion lung scan and echocadiogram. A mass located on septal wall of left ventricle was excised en bloc. The patient recovered uneventfully and careful follow up has be performed periodically.
Adult ; Dyspnea ; Female ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Lung ; Myxoma* ; Perfusion ; Pulmonary Embolism* ; Thorax

PURPOSE: The treatment of choice for well-differentiated thyroid cancer is surgical excision. However, the operation method is still controversial. Also, the operation method has been changing gradually. Thus, we reviewed the records of patients with well-differentiated thyroid cancer who had received operations in our hospital to assess the trend in surgical procedure, and to determine the proper procedure, method, considering both recurrence and complications. METHODS: We retrospectively analyzed the cases of 452 patients with differentiated thyroid cancer who had received operations from January 1989 to December 1998. We divided the 10 years into two periods; period I was from 1989 to 1993 (254 patients) and period II was from 1994 to 1998 (198 patients). We analyzed recurrences and complications according to the operation method, including neck lymph-node dissection. The incidences and locations of lymph- node metastasis were taken into account, too. The statistical analysis was done by using the Fisher's exact test. RESULTS: In period I, 147 patients (58%) received a total thyroidectomy, and in period II, all patients received total thyroidectomy. In period I, 24 patients (9.4%) had a recurrence, and in period II, 13 patients (6.6%) had a recurrence. In period I, 55 patients (21.7%) had postoperative hypoparathyr oidism, and in period II, 38 patients (19.2%) had postoperative hypoparathyroidism. In period I, 15 patients (5.9%) had postoperative hoarseness, and in period II, 7 patients (3.5%) had postoperative hoarseness. Two hundred eighty-one patients (62.2%) had lymph-node metastasis, and the anterior neck region was the most common site of metastasis (60.2%). CONCLUSION: In the operation method for differentiated thyroid cancer, the trend is toward a total thyroidectomy away from a lobectomy. Also, a skillful and experienced surgeon can reduce the incidence of postoperative complications. Thus the best operation method for differentiated thyroid cancer is a total thyroidectomy, including a preventive anterior-neck lymph-node dissection, which is done by a skillful and experienced surgeon.
Hoarseness ; Humans ; Hypoparathyroidism ; Incidence ; Neck ; Neoplasm Metastasis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

In this retrospective study, 412 patients who had a curative resection with a lymph node dissection of higher level than D2 for gastric cancer at the Kwangju Christian Hospital from 1985 to 1991 were reviewed to analyze the dependence of their survival rate on lymph node metastasis results obtained by evaluating various metastatic patterns and on the spectrum of tumors(location, depth of invasion, size, and histologic type). The results are as follows: 1) Positive metastatic lymph nodes were found in 258(62.6%) of the 412 patients. When it came to the metastatic frequencies of each lymph node, No. 6 was involved in 40% of the cases(165 cases), No. 4 in 21.6%(87 cases), No. 3 in 20.1%(83 cases), No. 5 in 15%(62 cases), No. 8 in 14.3%(59 cases), No. 1 in 9.7%(40 cases), No. 7 in 8.9%(37 cases), and No. 9 in 8.2%(34 cases), which shows relatively higher metastatic frequencies for the perigastric lymph nodes than for the others. The 5-year survival rates for metastasis of various lymph nodes were 33.3% for No. 10, 20.4% for No. 3, 20% for No. 2, 20% for No. 13, 17.5% for No. 6, 16.6% for both No. 12 and 15, 15.7% for N0. 4, 12.9% for No. 5, 11.7% for N0. 9, 10.8% for No. 7, 8.4% for No. 8, 10% for both No. 1 and No. 11, 5.5% for No. 14 and 0% for No. 16. 2) When it came to the dependence of the metastatic frequencies of lymph nodes on the location of the gastric cancer, cancers in the lower third of the stomach showed the highest metastatic frequency in No. 6(39%), followed by No. 3(16.8%) and No. 4(16.2%) in that order. In the case of gastric cancer in the middle of the stomach, No. 6 showed the highest frequency at 48.6% followed by No. 3(26.3%), No. 4(23.6%), No. 5(17.1%), No. 8(17.1%), and No. 9(9.2%) in that order. In the case of gastric cancer in the upper third of the stomach, No. 3 showed the highest frequency at 47.6% followed by No. 1(47.6%), No. 4(38%), No. 6(23.8%), No. 5(19%), and No. 7(9.5%) in that order. This showed that in all lacations of gastric cancer, lymph node metastases were primarily observed among the perigastric N1 node group. 3) As the tumor invasion into the stomach wall grew deeper, metastases of the lymph nodes of N2 or higher groups increased. There was a significant difference in the metastatic frequencies of the lymph nodes between the proper muscle and the serosal layer. The survival rate dropped to a remarkable degree when the tumor invasion was deeper than the serosal layer. 4) Poorly differentiated adenocarcinomas were more frequently metastasized to the regional lymph nodes than well differentiated ones, and the metastasis extended to nonperigastric lymph nodes. The poorer the differentiation was, the lower the survival rate became. 5) The larger the size of the tumors was, the higher the lymph node metastatic frequency grew, reducing the survival rate. 6) When patients were in advanced stages of gastric cancer, the survival rate dropped considerably. 7) Based on the results mentioned above in which tumor invasion into the lymph nodes of N2 or higher groups were often observed and in which there were significant differences in the prognosis, we conclude that a gastrectomy with extensive lymphadenectomy at least up to the second node group(D2) might be the procedure of choice for advanced gastric cancer in order to improve the survival rate.
Adenocarcinoma ; Gastrectomy ; Gwangju ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate*

In this retrospective study, 412 patients who had a curative resection with a lymph node dissection of higher level than D2 for gastric cancer at the Kwangju Christian Hospital from 1985 to 1991 were reviewed to analyze the dependence of their survival rate on lymph node metastasis results obtained by evaluating various metastatic patterns and on the spectrum of tumors(location, depth of invasion, size, and histologic type). The results are as follows: 1) Positive metastatic lymph nodes were found in 258(62.6%) of the 412 patients. When it came to the metastatic frequencies of each lymph node, No. 6 was involved in 40% of the cases(165 cases), No. 4 in 21.6%(87 cases), No. 3 in 20.1%(83 cases), No. 5 in 15%(62 cases), No. 8 in 14.3%(59 cases), No. 1 in 9.7%(40 cases), No. 7 in 8.9%(37 cases), and No. 9 in 8.2%(34 cases), which shows relatively higher metastatic frequencies for the perigastric lymph nodes than for the others. The 5-year survival rates for metastasis of various lymph nodes were 33.3% for No. 10, 20.4% for No. 3, 20% for No. 2, 20% for No. 13, 17.5% for No. 6, 16.6% for both No. 12 and 15, 15.7% for N0. 4, 12.9% for No. 5, 11.7% for N0. 9, 10.8% for No. 7, 8.4% for No. 8, 10% for both No. 1 and No. 11, 5.5% for No. 14 and 0% for No. 16. 2) When it came to the dependence of the metastatic frequencies of lymph nodes on the location of the gastric cancer, cancers in the lower third of the stomach showed the highest metastatic frequency in No. 6(39%), followed by No. 3(16.8%) and No. 4(16.2%) in that order. In the case of gastric cancer in the middle of the stomach, No. 6 showed the highest frequency at 48.6% followed by No. 3(26.3%), No. 4(23.6%), No. 5(17.1%), No. 8(17.1%), and No. 9(9.2%) in that order. In the case of gastric cancer in the upper third of the stomach, No. 3 showed the highest frequency at 47.6% followed by No. 1(47.6%), No. 4(38%), No. 6(23.8%), No. 5(19%), and No. 7(9.5%) in that order. This showed that in all lacations of gastric cancer, lymph node metastases were primarily observed among the perigastric N1 node group. 3) As the tumor invasion into the stomach wall grew deeper, metastases of the lymph nodes of N2 or higher groups increased. There was a significant difference in the metastatic frequencies of the lymph nodes between the proper muscle and the serosal layer. The survival rate dropped to a remarkable degree when the tumor invasion was deeper than the serosal layer. 4) Poorly differentiated adenocarcinomas were more frequently metastasized to the regional lymph nodes than well differentiated ones, and the metastasis extended to nonperigastric lymph nodes. The poorer the differentiation was, the lower the survival rate became. 5) The larger the size of the tumors was, the higher the lymph node metastatic frequency grew, reducing the survival rate. 6) When patients were in advanced stages of gastric cancer, the survival rate dropped considerably. 7) Based on the results mentioned above in which tumor invasion into the lymph nodes of N2 or higher groups were often observed and in which there were significant differences in the prognosis, we conclude that a gastrectomy with extensive lymphadenectomy at least up to the second node group(D2) might be the procedure of choice for advanced gastric cancer in order to improve the survival rate.
Adenocarcinoma ; Gastrectomy ; Gwangju ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate*

BACKGROUND: Papillary thyroid cancer has a high frequency of lymph-node metastasis, but the methods for detecting and treating of lymph-node metastases remains controversial. We reviewed clinical analyses for lymph-node metastases. METHODS: Were retrospectively reviewed charts of 120 patients with papillary thyroid cancer who were treated from July 1994 to February 1997. Clinical aspects and the relationship between age, sex, tumor size, extracapsular invasion, multicentricity of the tumor and lymphadenopathy and the rate of lymph-node metastasis were investigated. RESULTS: Modified neck dissection was done in 97 patients, and lymph node metastases were detected in 72 patients (74.2%). Lymph-node meatastases were detected in 3 patients during routine central compartment neck dissection. The overall lymph-node metastasis was 62.5% (75 of 120). The mean number of metastastic nodes was 5.67, and the most frequent site was level VI. Lymph-node metastases were more frequent at a young age and for large sized tumors, extracapsular invasion and preoperatively palpable lymphadenopathy. CONCLUSIONS: The lymph-node metastatic rate is high for preoperatively palpable lymph node, tumor sizes over 4 cm, and extracapsular invasion (p<0.05). To reduce the recurrence rate, the surgeon shoud do a modified neck dissection on such above patients.
Humans ; Lymph Nodes* ; Lymphatic Diseases ; Neck Dissection ; Neoplasm Metastasis* ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms*