As flow cytometric analysis using paraffin-embedded tissue was developed by Hedley et al in 1983, retrospective study with large amount of archival material was possible. Many literatures reported that the result of paraffin embedded tissue was compatible with that of fresh tissue. We compared the DNA histograms of 26 cases of colorectal adenocarcinoma in which the analysis was done in both fresh and paraffin-embedded tissues. Aneuploidy in fresh and paraffin-embed-ded tissues was 73.0% and 50.0%, respectively. The concordance rate of fresh and paraffin-em-bedded tissues was 76.8% and six interpreters were agreed in 73.0% of the cases. Because flow cytometric DNA analysis using fresh tissues can detect more aneuploid population than in paraffin-embedded tissue, the former is strongly recommeded in DNA ploidy study. Also careful observation using standard criteria may improve the interpretation of DNA histogram.
Adenocarcinoma

Hematoma of gastric wall is very rare, and occasionally associated with coagulopathy, trauma, peptic ulcer disease, and therapeutic endoscopy. Ischemic gastric necrosis is also rare because of the abundant anastomotic supply to the stomach, and it is usually associated with surgery and disruption of the major vessels. Endoscopic submucosal injection of hypertonic saline-epinephrine (HS-E) is a safe, cost-effective, and widely used therapy for hemostasis but it may cause tissue necrosis and perforation. We describe a case of gastric wall hematoma with oozing bleeding after endoscopic gastric mucosa biopsy in 71-year old woman with chronic renal failure and angina pectoris undergoing anti-platelet medication. We injected a small dose of HS-E (7ml) for controlling oozing bleeding. Two days later, endoscopy showed huge ulcer with necrotic tissue at the site of previously hematoma. Therefore we should pay particular attention for hematoma and mucosal necrosis when performing endoscopic procedure in a patients with high bleeding and atherosclerotic risk.
Angina Pectoris ; Biopsy ; Endoscopy ; Female ; Gastric Mucosa ; Hematoma ; Hemorrhage ; Hemostasis ; Humans ; Kidney Failure, Chronic ; Necrosis ; Peptic Ulcer ; Stomach ; Ulcer

Osteogenesis imperfecta is one of the groups of hereditary disorders of connective tissue which includes the Ehlers-Danlos syndrome, the Marfan syndrome, pseudoxanthoma elasticum, and Hurler syndrome. While cardiovascular involvement is associated with each of these disorders, it is least common in osteogenesis imperfecta and is overshadowed by the bony, ocular, otologic, cutaneous, and dental manifestations that are characteristic of the disorder. In evaluating patients with osteogenesis imperfecta, careful attention should be paid to cardiovascular findings and if valvular lesions are noted, patients should be instructed regarding the need for antibiotic prophylaxis for dental and surgical procedures. We report a case of osteogenesis imperfecta associated with aortic regurgitation.
Antibiotic Prophylaxis ; Aortic Valve Insufficiency* ; Connective Tissue ; Ehlers-Danlos Syndrome ; Humans ; Marfan Syndrome ; Mucopolysaccharidosis I ; Osteogenesis Imperfecta* ; Osteogenesis* ; Pseudoxanthoma Elasticum

OBJECTIVE: To review the current applications of robotics in spinal surgery. METHODS: We reviewed the literature on robotic surgery identified by searching Pubmed. Articles reporting clinical results of robotic surgeries using the da Vinci surgical system(R) were analyzed. Descriptions of our trials and comparisons with the conventional techniques were added to the review. RESULTS: Several surgical robots have been developed however, most of the robots are currently unavailable for practical use. Most of publications regarding spinal surgical robots merely suggested its feasibility. The da vinci surgical system(R) is the popular robotic system designed for use in various surgical fields. However, clinical applications of this innovative instrument in spinal surgery seem to be in the experimental phase. According to our research, the advantages of robotic surgery using the da Vinci surgical system(R) were maximized in cases of paravertebral or presacral tumors however, its use in other types of spinal surgeries such as the transoral craniovertebral junction approach andanterior lumbar interbody fusion will be feasible in the near future despite the current limitations. CONCLUSION: Clinical application of robotic surgery in the spinal surgical field is currently confined to the treatment of some specific diseases or procedures however, robotic surgery is expected to play a practical future role as a minimally invasive surgical instrument in spinal surgery.
Robotics ; Spine ; Surgical Instruments ; Surgical Procedures, Minimally Invasive

Benign fibrous mesothelioma of the pleura is a relatively rare neoplasm originated from pleural mesothelial cell, often asymptomatic or presenting with a specifical sign. One of the main problems, concerns the preoperative differential diagnosis, mainly because it is difficult to differentiate between benign and malignant type. A 62-year old woman presented with recurrent chest pain. The chest radiography in a patient was suspected localized pleural mesothelioma. The chest computed tomography scan showed that mass like lesion of well marginated ovoid shape with homogenous attenuation on anterior-basal segment of right lower lobe. After resection of a pleural mass by thoracoscopic extirpation from right hemithorax, Localized benign fibrous mesothelioma of the pleura was confirmed by pathology and immunohisto-chemical staining. We report here one case of pleural benign fibrous mesothelioma with some considerations on its diagnosis and treatment.
Chest Pain ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Mesothelioma ; Middle Aged ; Pathology ; Pleura* ; Radiography ; Solitary Fibrous Tumor, Pleural* ; Thorax

Splenic marginal zone lymphoma (SMZL) is a rare type of non-Hodgkin's lymphoma (NHL). We report here on a patient who displayed the synchronous occurrence of SMZL and early gastric cancer (EGC). The patient was a 74 year-old male with liver cirrhosis. An EGC in the gastric antrum was diagnosed and the preoperative abdomen computed tomography scan revealed splenomegaly and intra-abdominal lymphadenopathy. We performed subtotal gastrectomy and the postoperative pathologic examination revealed adenocarcinoma limited to the gastric mucosa and SMZL in the lymph nodes. The patient recovered from the surgery without complications and is now awaiting chemotherapy. SMZL has an indolent clinical course with good long-term survival and so there is the possibility of the occurrence of a second primary malignancy. Rare cases of a second primary malignancy being diagnosed along with SMZL have been described in the literature. Patients with SMZL should be carefully followed after treatment to detect the possible occurance of a second primary malignancy.
Abdomen ; Adenocarcinoma ; Gastrectomy ; Gastric Mucosa ; Humans ; Liver Cirrhosis ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Non-Hodgkin ; Male ; Pyloric Antrum ; Splenomegaly ; Stomach Neoplasms

PURPOSE: To identify candidate genes related with urolithiasis, the vitamin D receptor (VDR) gene polymorphisms were searched. MATERIALS AND METHODS: Between July 2002 and June 2003, 212 healthy subjects, used as normal controls, and 155 patients with urolithiasis were examined. The control volunteers had no histories of urolithiasis, familial stone disease or osteoporosis. The patients underwent a stone metabolic study and stone analysis. 49 patients received a stone analysis, of which, 45 had calcium stones. Using a polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) analysis of peripheral blood, the association between the VDR gene BsaM I polymorphism and urolithiasis was evaluated. The polymorphism was divided into three groups: excisable (C/C), unexcisable (T/T) and heterozygote (C/T). RESULTS: For the VDR gene BsaM I polymorphism, there was no statistically difference between the control and the urolithiasis groups. The distribution of VDR genotypes in the 155 patients with urolithiasis was as follows: C/C, 139 (89.7%); C/T, 12 (7.7%) and T/T, 4 (2.6%), which was not significantly different from that in the 212 control subjects: C/C, 195 (92.0%); C/T, 14 (6.6%) and T/T, 3 (1.4%). The frequencies of VDR genotypes in the 45 patients with calcium stone were: C/T (13.3%) and T/T (6.7%), and that of the T allele 13.3%, which were significantly different from those of the controls: C/T (6.6%) and T/T (1.4%) and that of the T allele, 4.7% (p<0.05). CONCLUSIONS: VDR BsaM I polymorphism appears to be a good candidate for a genetic marker in calcium stone disease. The T allele especially may be in charge of the pathogenesis of calcium stones. Further analysis and case accumulation are required to identify the genetic marker of urolithiasis. (Korean J Urol 2004;45:1143-1147)
Alleles ; Calcium* ; Genetic Markers* ; Genotype ; Heterozygote ; Humans ; Osteoporosis ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitriol* ; Urolithiasis ; Vitamin D* ; Vitamins* ; Volunteers

PURPOSE: To identify candidate genes related with urolithiasis, the vitamin D receptor (VDR) gene polymorphisms were searched. MATERIALS AND METHODS: Between July 2002 and June 2003, 212 healthy subjects, used as normal controls, and 155 patients with urolithiasis were examined. The control volunteers had no histories of urolithiasis, familial stone disease or osteoporosis. The patients underwent a stone metabolic study and stone analysis. 49 patients received a stone analysis, of which, 45 had calcium stones. Using a polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) analysis of peripheral blood, the association between the VDR gene BsaM I polymorphism and urolithiasis was evaluated. The polymorphism was divided into three groups: excisable (C/C), unexcisable (T/T) and heterozygote (C/T). RESULTS: For the VDR gene BsaM I polymorphism, there was no statistically difference between the control and the urolithiasis groups. The distribution of VDR genotypes in the 155 patients with urolithiasis was as follows: C/C, 139 (89.7%); C/T, 12 (7.7%) and T/T, 4 (2.6%), which was not significantly different from that in the 212 control subjects: C/C, 195 (92.0%); C/T, 14 (6.6%) and T/T, 3 (1.4%). The frequencies of VDR genotypes in the 45 patients with calcium stone were: C/T (13.3%) and T/T (6.7%), and that of the T allele 13.3%, which were significantly different from those of the controls: C/T (6.6%) and T/T (1.4%) and that of the T allele, 4.7% (p<0.05). CONCLUSIONS: VDR BsaM I polymorphism appears to be a good candidate for a genetic marker in calcium stone disease. The T allele especially may be in charge of the pathogenesis of calcium stones. Further analysis and case accumulation are required to identify the genetic marker of urolithiasis. (Korean J Urol 2004;45:1143-1147)
Alleles ; Calcium* ; Genetic Markers* ; Genotype ; Heterozygote ; Humans ; Osteoporosis ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitriol* ; Urolithiasis ; Vitamin D* ; Vitamins* ; Volunteers

Toxoplasmosis of the central nervous system occurs in 3 to 40 percent of all patients with the acquired immunodeficiency syndrome (AIDS), and it is the most common opportunistic infection to cause encephalitis or focal intracerebral lesions. We experienced two cases of cerebral toxoplasmosis in AIDS patients presenting as high fever, seizure and general weakness.
Acquired Immunodeficiency Syndrome ; Central Nervous System ; Encephalitis ; Fever ; Humans ; Opportunistic Infections ; Seizures ; Toxoplasmosis ; Toxoplasmosis, Cerebral*

OBJECTIVE: The purpose of this study was to analyze the clinical and radiological outcomes of dynamic stabilization with DIAM implants. METHODS: We evaluated 24 cases in which lumbar decompressive surgery was performed with dynamic stabilization using DIAM and having more than 24 months of follow up. Indications consisted of spinal stenosis with or without a herniated disc and transition level stenosis of the instrumented fusion segment. Operative data, clinical outcome, and plain and flexion/extension radiographs were obtained and compared to preoperative and postoperative data. RESULTS: The mean age at operation was 56.2 years(range 47-68); the mean follow-up duration was 28.4 months(range 24-37 months).The mean pain and function scores improved significantly from baseline to follow-up, as follows: back pain VAS score from 6.2 to 2.5, leg pain VAS score from 7.2 to 2.4, and Prolo's economic and functional rating score from 5.8 to 8.2. Radiological data demonstrated that the heights of the intervertebral foramen and the posterior disc increased significantly after the procedure. There were no implant-associated complications except for two spinous process fractures which occurred during DIAM insertion, and one case of wound infection. Flexion instability and spondylolisthesis occurred in two cases during the follow-up period. CONCLUSION: These mid-term results suggest that DIAM is a safe and effective alternative surgical option in the treatment of degenerative lumbar stenosis without flexion instability. Careful follow-up is needed to watch for the development of flexion instability and spondylolisthesis.
Back Pain ; Constriction, Pathologic ; Follow-Up Studies ; Intervertebral Disc Displacement ; Leg ; Spinal Stenosis ; Spondylolisthesis ; Wound Infection