PURPOSE: This prospective study was performed to evaluate the usefulness of preoperative radioimmu-noscintigraphy and intraoperative scintimetric examination (radioimmunoguided surgery: RIGS) using (99m)Tc-anti-CEA F(ab')(2), fragment. MATERIALS AND METHODS: Nineteen patients with rectal cancer underwent preoperative whole body planar scintigraphy at 4 hours after injection of (99m)Tc-anti-CEA F(ab')(2), fragment and SPECT imaging at 18 hours. Surgical operation was performed at 24 hours after injection. During laparotomy, radioactivities from intraabdominal viscera were measured by gamma probe. The radioac-tivities from excised tumor and lymph nodes were also measured and compared with pathology. RESULTS: All nineteen patients were confirmed to have adenocarcinomas in the rectum. Twenty-seven of 97 excised lymph node groups had metastasis and 2 patients had liver metastasis in pathology. Preoperative radioim- munoscintigraphy detected primary tumors in 11 patients (sensitivity 55%) and it couId not detect any lymph nodes or liver metastasis. All patients showed high radioactivity in the kidneys, liver, spleen, and major vessels in intraoperative measurement by gamma probe, and tumor activity was not discriminated from background activity. However, ra4ioactivity from excised tumor was higher than normal rectum (T/B ratio; 3.47+/-2.25). When excised lymph node activity/background activity ratio > 1,5 was considered as positive criteria of metastasis, sensitivity, specificity, positive and negative predictive values were 78.6%, 73.9%, 55.0% and 89.5%, respectively. CONCLUSION: Radioimmunoscintigraphy using (99m)Tc-anti-CEA F(ab')(2). has no additional value for preoperative staging and use of early RIGS using (99m)Tc-anti-CEA F(ab')(2)is inappropriate. For early RIGS using (99m)Tc labeled antibodies in rectal cancer patients, further development of more specific antibodies and methods to reduce background activity are needed.
Adenocarcinoma ; Antibodies ; Humans ; Kidney ; Laparotomy ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Pathology ; Pilot Projects* ; Prospective Studies ; Radioactivity ; Radioimmunodetection* ; Radionuclide Imaging ; Rectal Neoplasms* ; Rectum ; Sensitivity and Specificity ; Spleen ; Tomography, Emission-Computed, Single-Photon ; Viscera

As a result of advanced surgical techniques, arthroscopy for shoulder surgery is becoming more common.Although serious complications from the absorption of fluid during shoulder arthroscopy are rare, significant absorption of irrigation fluid does occur during the procedure.This report describes a case of severe neck edema and pleural effusion following shoulder arthroscopy in a patient who received a large amount of arthroscopy fluid for irrigation.
Absorption ; Arthroscopy ; Edema ; Humans ; Neck ; Pleural Effusion ; Shoulder

As a result of advanced surgical techniques, arthroscopy for shoulder surgery is becoming more common.Although serious complications from the absorption of fluid during shoulder arthroscopy are rare, significant absorption of irrigation fluid does occur during the procedure.This report describes a case of severe neck edema and pleural effusion following shoulder arthroscopy in a patient who received a large amount of arthroscopy fluid for irrigation.
Absorption ; Arthroscopy ; Edema ; Humans ; Neck ; Pleural Effusion ; Shoulder

PURPOSE: Tumor suppressor gene called PTEN has been localized to 10q23 in 1997 and its mutation has been implicated in some malignancies. Loss of the PTEN gene has been clinically associated with unfavorable histology and influencing tumor staging and recurrence in the determination of a prognosis in patients suffering from other cancers, its role in colorectal cancers is inconclusive as of yet. The purpose of this study is shed light on PTEN expression in colorectal cancer and its significance associated with pathological findings and clinical findings. METHODS: A total of 217 patients who had been diagnosed with colorectal cancer, had undergone radical colectomy from October of 1993 to December of 2000, and for whom follow-up was possible were selected for this study. Their clinical records were analyzed and specimens were stained immunohistochemically RESULTS: In comparing the PTEN positive group (48 patients, 22.1%) with the negative group (171 patients, 77.9%), there was a significantly (P=0.021) higher frequency of recurrence in the negative group (29.0%) than in the positive group (12.5%), and an especially higher frequency of distant metastasis in the negative group (18.3%) than in the positive group (4.2%), with P=0.010. Although there was no meaningful difference in the overall five year survival rate, the five year disease free survival rate was significantly (P=0.029) higher in the positive group. CONCLUSIONS: The results of this study reveal the possibility of using PTEN as a prognostic indicator in colorectal cancer.
Colectomy ; Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Genes, Tumor Suppressor ; Humans ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Recurrence ; Survival Rate

As the outbreak of coronavirus disease 2019 continues and the number of confirmed cases requiring isolation increases, there is a need for a safe and efficient system to assess patients' condition. We developed and evaluated a self-assessment questionnaire consisting of 23 symptoms with linear-scale scores from 0 to 10. Patients were asked to indicate their worst score for each symptom daily, and medical personnel assessed clinical improvement or deterioration based on the changes in scores. Focused communication on severity of specific symptoms was the primary advantage for the clinicians, and a thorough check for their symptoms was helpful for patients.