No abstract available.
Hernia*

BACKGROUND: The purpose of this study was to determine the accuracy and the reliability in diagnosing breast cancer. METHODS: This clinical study was performed on 132 patients with palpable breast masses who had been diagnosed with excisional biopsy from August 1997 to July 1998 at the Department of Surgery, Seoul Adventist Hospital. Among the 132 patients, the mammographs were taken for 65 patients, ultrasonographs for 83 patients, and fine needle aspiration biopsies (FNAB) for 72 patients. The results of the three diagnostic procedures were compared with the postexcisional histologic diagnosis. RESULTS: 1) Mammography discovered breast cancer with an accuracy of 70.8%, a false positive fraction of 6.8%, a false negative fraction of 76.2%, a sensitivity of 23.8%, a specificity of 93.2%, and a positive predictive value of 62.5%. 2) Ultrasonography detected breast cancer with an accuracy of 74.7%, a false positive fraction of 6.9%, a false negative fraction of 68.0%, a sensitivity of 32.0%, a specificity of 93.1%, and a positive predictive value of 66.7%. 3) Among the 72 aspirates, 7 (9.7%) aspirates had a technically unsatisfactory aspiration cytology. 4) Of the 65 technically satisfactory cytologies, the diagnosis was malignant in 16 cases, suspicious for malignancy in 6 cases, and benign in 43 cases. 5) Aspiration cytology detected breast cancer with an accuracy of 90.8%, a false positive fraction of 4.9%, a false negative fraction of 16.7%, a sensitivity of 83.3%, a specificity of 95.1%, and a positive predictive value of 90.9%. CONCLUSIONS: The fine needle aspiration biopsy was more reliable than either mammography or ultrasonography. Also, as an initial diagnostic method, fine needle aspiration biopsy had a high degree of accuracy in diagnozing palpable breast masses.
Biopsy* ; Biopsy, Fine-Needle* ; Breast Neoplasms* ; Breast* ; Diagnosis* ; Humans ; Mammography* ; Sensitivity and Specificity ; Seoul ; Ultrasonography ; Ultrasonography, Mammary*

To assess the role of anorectal physiologic study for the diagnosis of chronic idiopathic constipation. METHODS: A retrospective study of 81 constipated patients (23 male, 58 female) of mean age 48 16.6 (16~83) years who had no abnormalities in colonoscopy, barium enema, and rectal exam was done. 81 patients underwent defecography and cine-defecography, of which 66 patients underwent anal manometry, 52 patients underwent colonic transit time study (CTT), and 27 patients underwent anal plug electromyography (EMG). RESULTS: Nonrelaxing puborectalis syndrome (NRPR), rectocele, rectal intussusception, anal dyschezia, and sigmoidocele were observed in 27 (33.3%), 26 (32.1%), 14 (17.3%), 3 (3.7%), and 2 (2.5%) of the patients, respectively. Normal cinedefecography finding was observed in 21 (25.9%) patients. More than one abnormal finding was found in 11 (13.6%) patients. Abnormal findings included colonic inertia in 6 (11.5%) patients and pelvic outlet obstruction in 2 (3.8%) patients. Normal colon transit time was observed in 44 (84.6%) patients. Anal hypertonia was observed in 23 (34.8%) patients by anal monometry, of which 3 patients were diagnosed with anal dyschezia in cinedefecography. 13 (48.1%) patients were diagnosed with NRPR in anal plug EMG. The correlation rate between cinedefecography/EMG, defecography/CTT, and CTT/EMG were 81.5%, 61.5%, and 51.9% respectively in the diagnosis of NRPR. Sensitivities of the three tests were 72.7% for cinedefecography, 66.7% for EMG, and 7.7% for CTT in diagnosing NRPR (p<0.05). Positive predictive values of the three tests were 80% for anal plug EMG, 72.7% for cinedefecography, and 50% for CTT in the diagnosis of NRPR. CONCLUSIONS: Defecography and EMG were complements each of the other in diagnosis of pelvic outlet obstruction especially NRPR, but CTT has no role.
Barium ; Colon ; Colonoscopy ; Complement System Proteins ; Constipation* ; Defecography ; Diagnosis* ; Electromyography ; Enema ; Humans ; Intussusception ; Male ; Manometry ; Rectocele ; Retrospective Studies ; Time and Motion Studies

PURPOSE: To assess the effectiveness of cinedefecography (CD), anal electromyography (EMG), and anal manometry (ARM) for the diagnosis of non-relaxing puborectalis syndrome (NRPR) and to compare the outcomes for patients after biofeedback therapy (BF). METHODS: The clinical criteria used in this study for NRPR included straining, incomplete evacuation, tenesmus, and the need for enemas, suppositories, or digitation. Patients who satisfied the clinical criteria were evaluated by use of anorectal physiology tests: CD, EMG, and ARM. The EMG criteria included failure to achieve a significant decrease in the electrical activity of the puborectalis (PR) during attempted evacuation. The ARM criteria included failure to achieve a significant decrease in intra-anal pressure during attempted evacuation. The CD criteria included either paradoxical contraction or failure of the PR to relax together with incomplete evacuation. Other possible etiologies for incomplete evacuation, such as rectal intussusception or rectocele, were excluded in all cases. Fifty-eight constipated patients diagnosed as having NRPR by at least one of anorectal physiolosic tests had more than one BF session. The outcomes for fifty-one patients (mean age, 44.8 years; male-to-female ratio, 22:29) were reported as either improved or unimproved at a mean follow-up of 12.7 (range, 2~30) months. The sensitivities, the specificities, and the positive and negative predictive values for the CD, EMG, and ARM diagnoses of NRPR were calculated to assess the diagnostic accuracy of each test and to identify predictors associated with the outcome of BF. RESULTS: The sensitivities of EMG, CD, and ARM were 96%, 89%, and 85%, respectively (P>0.05). The positive predictive values of the three tests were 63% for EMG, 52% for ARM, and 51% for CD (P>0.05). The negative predictive values of the three tests were 90% for EMG, 43% for ARM, and 25% for CD (P<0.05). The specificities of the three tests were 38% for EMG, 13% for ARM, and 2% for CD (P<0.05). The positive predictive values the two-study-positive groups and the three-study-positive group were 63% for the EMG- and ARM-positive group, 61% for the CD- and EMG-positive group, 51% for the CD- and ARM-positive group, and 61% for the three-study- positive group (P>0.05). CONCLUSIONS: A combination of the CD and the EMG tests is suggested for the diagnosis of NRPR.
Arm ; Biofeedback, Psychology ; Diagnosis* ; Electromyography ; Enema ; Follow-Up Studies ; Humans ; Intussusception ; Manometry ; Physiology ; Rectocele ; Suppositories

BACKGROUND: Kurt Semm, a German gynecologist, was first to describe a laparoscopic appendectomy for an incidental appendectomy in gynecologic surgery. At that time, it was limited to an incidental appendectomy performed during gynecologic surgery. The development of laparoscopic instruments and more experience has allowed surgeons to perform laparoscopic surgery easier than before. Nowadays, laparoscopy allows surgeons to perform appendectomies in a safe and effective way, and it reduces the risk of performing unnecessary appendectomies. METHODS: We reviewed the records of 201 patients who had an appendectomy at our hospital from February 1997 to December 1997. A laparoscopic appendectomy was carried out in 51 cases, and an open appendectomy was carried out in the others. RESULTS: 1) There was not a significant difference between the two groups in regard to age and sex. The male-to-female ratios were 1.32:1 in laparoscopic appendectomy group and 1.17:1 in the open appendectomy group. The mean ages were 30.3 years in laparoscopic appendectomy group and 29.7 years in open appendectomy group. 2) There was not a significant difference in pathologic severity between the two groups. The majority had suppurative appendicitis in both groups. Postoperative complications were less frequent in the open appendectomy group. 3) The mean operative times were 55.6 minutes in the laparoscopic appendectomy group and 42 minutes in the open appendectomy group. 4) The mean hospital stays were 4.69 days in the laparoscopic appendectomy group and 6.96 days in the open appendectomy group. 5) The mean postoperative periods until normal activity were 8.79 days in the laparoscopic appendectomy group and 12.85 days in the open appendectomy group. 6) The postoperative use of analgesics was less frequent in the laparoscopic appendectomy group. 7) Conversion to an open laparotomy occurred in 3 cases. CONCLUSIONS: We think that a laparoscopic appendectomy is a safer, more effective, more cosmetic, and less invasive procedure than an open appendectomy.
Analgesics ; Appendectomy* ; Appendicitis ; Female ; Gynecologic Surgical Procedures ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Operative Time ; Postoperative Complications ; Postoperative Period

Neurilemmoma, like other non-epithelial tumors, seldom occurs in the thyroid gland. We present a case of a 61-year-old woman with a neurilemmoma of her left thyroid lobe. She was clinically and biochemically euthyroid, and underwent a left thyroid lobectomy without complications. The tumor was an encapsulated solid mass, 34x23x1 5mm in size and was diagnosed as neurilemmoma. Neurilemmoma of the thyroid gland tends to develop in the right lobe, but this case was in the left.
Female ; Humans ; Middle Aged ; Neurilemmoma* ; Thyroid Gland*

An appendicocolic fistula is a rare disease. It seems likely that the appendix becomes adherent to the viscus either before or after its perforation due to appendicitis, so surgeons may become confused when an emergency appendectomy in done. We report one case of an appendicocolic fistula to draw attention to the importance of this fistula and to describe the clinical, the diagnostic, and the therapeutic aspects of the disease.
Appendectomy ; Appendicitis ; Appendix ; Emergencies ; Fistula* ; Rare Diseases

We conducted this study to investigate the synergistic effect of human urine-derived stem cells (USCs) and surface modified composite scaffold for bladder reconstruction in a rat model. The composite scaffold (Polycaprolactone/Pluronic F127/3 wt% bladder submucosa matrix) was fabricated using an immersion precipitation method, and heparin was immobilized on the surface via covalent conjugation. Basic fibroblast growth factor (bFGF) was loaded onto the heparin-immobilized scaffold by a simple dipping method. In maximal bladder capacity and compliance analysis at 8 weeks post operation, the USCs-scaffold(heparin-bFGF) group showed significant functional improvement (2.34 ± 0.25 mL and 55.09 ± 11.81 microL/cm H2O) compared to the other groups (2.60 ± 0.23 mL and 56.14 ± 9.00 microL/cm H2O for the control group, 1.46 ± 0.18 mL and 34.27 ± 4.42 microL/cm H2O for the partial cystectomy group, 1.76 ± 0.22 mL and 35.62 ± 6.69 microL/cm H2O for the scaffold group, and 1.92 ± 0.29 mL and 40.74 ± 7.88 microL/cm H2O for the scaffold(heparin-bFGF) group, respectively). In histological and immunohistochemical analysis, the USC-scaffold(heparin-bFGF) group showed pronounced, well-differentiated, and organized smooth muscle bundle formation, a multi-layered and pan-cytokeratin-positive urothelium, and high condensation of submucosal area. The USCs seeded scaffold(heparin-bFGF) exhibits significantly increased bladder capacity, compliance, regeneration of smooth muscle tissue, multi-layered urothelium, and condensed submucosa layers at the in vivo study.
Adult Stem Cells/cytology/metabolism/*transplantation ; Animals ; Biocompatible Materials/chemistry ; Cell Differentiation ; Fibroblast Growth Factor 2/administration & dosage ; Heparin/administration & dosage ; Humans ; Materials Testing ; Models, Animal ; Poloxamer ; Polyesters ; Rats ; Reconstructive Surgical Procedures ; Regeneration ; Tissue Engineering/*methods ; Tissue Scaffolds/chemistry ; Urinary Bladder/anatomy & histology/physiology/*surgery ; Urine/*cytology

BACKGROUND: Research into the Baumann skin type (BST) has recently expanded, with growing interest in the development of an efficient and effective skin type classification system for better understanding of this skin condition. OBJECTIVE: We aimed to identify male-specific skin type characteristics with investigation into the distribution of BST by age and region in the Korean male population and to determine the intrinsic and extrinsic factors related to skin type. METHODS: A questionnaire was administered to collect information about age, region, working behavior, drinking behavior, smoking behavior, usual habit of sun protection, medical history, and the BST which consisted of four parameters; oily (O) or dry (D), sensitive (S) or resistant (R), pigmented (P) or non-pigmented (N), and wrinkled (W) or tight (T). RESULTS: We surveyed 1,000 Korean males aged between 20 and 60 years who were divided equally by age and region. Of the total respondents, OSNW type accounted for the largest percentage and ORPW type the lowest. In terms of Baumann parameters, O type was 53.5%, S type was 56.1%, N type was 84.4% and W type was 57.5%. Several behavioral factors were found to have various relationships with the skin type. CONCLUSION: The predominant skin type in the Korean male respondents was OSNW type, and the distribution of skin types with regards to age and region was reported to be distinct. Therefore, skin care should be customized based on detailed skin types considering the various environmental factors.
Classification ; Drinking Behavior ; Humans ; Male ; Skin Care ; Skin ; Smoke ; Smoking ; Solar System ; Surveys and Questionnaires

BACKGROUND AND PURPOSE: Nonmotor symptoms (NMS) in Parkinson's disease (PD) have multisystem origins with heterogeneous manifestations that develop throughout the course of PD. NMS are increasingly recognized as having a significant impact on the health-related quality of life (HrQoL). We aimed to determine the NMS presentation according to PD status, and the associations of NMS with other clinical variables and the HrQoL of Korean PD patients. METHODS: We surveyed patients in 37 movement-disorders clinics throughout Korea. In total, 323 PD patients were recruited for assessment of disease severity and duration, NMS, HrQoL, and other clinical variables including demographics, cognition, sleep scale, fatigability, and symptoms. RESULTS: In total, 98.1% of enrolled PD subjects suffered from various kinds of NMS. The prevalence of NMS and scores in each NMS domain were significantly higher in the PD group, and the NMS worsened as the disease progressed. Among clinical variables, disease duration and depressive mood showed significant correlations with all NMS domains (p<0.001). NMS status impacted HrQoL in PD (rS=0.329, p<0.01), and the association patterns differed with the disease stage. CONCLUSIONS: The results of our survey suggest that NMS in PD are not simply isolated symptoms of degenerative disease, but rather exert significant influences throughout the disease course. A novel clinical approach focused on NMS to develop tailored management strategies is warranted to improve the HrQoL in PD patients.
Cognition ; Demography ; Humans ; Korea ; Movement Disorders* ; Parkinson Disease* ; Prevalence ; Quality of Life*