A case of adenocarcinoma of cystic duct associated with GB empyema is presented. A 72 year old male was admitted to Kwangju Christian hospital because of abdominal pain in right upper quadrant for 4 days. He underwent explolaparotomy under the impression of GB empyema or GB cancer. For seeking causative factor of GB empyema, serial sections of cystic duct and mapping were performed. We can find adenocarcinoma of cystic duct in the specimen removed at cholecystectomy. The criteria for disgnosis of cystie duct carcinoma which was outlined by Farrar. These criteria are; 1) The growth must be restricted to the cystic duct, 2) There is no neoplastic process in the gall bladder, hepatic and common bile duct. 3) Histopathological examination must be comfirm carcinoma. Here we report a case of adenocarcinoma of cystic duct associated with GB empyema with brief review of Literature.
Abdominal Pain ; Adenocarcinoma* ; Aged ; Cholecystectomy ; Common Bile Duct ; Cystic Duct* ; Empyema* ; Gwangju ; Humans ; Male ; Urinary Bladder

No abstract available.
Child* ; Eosinophils* ; Humans ; Immunoglobulin E* ; Skin Tests* ; Skin*

No abstract available.
Child* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

No abstract available.
Humans ; Twins*

PURPOSE: The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER). METHODS: The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records. RESULTS: Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA (chi2=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance. CONCLUSION: Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.
Critical Pathways ; Electronics ; Electrons ; Emergencies ; Hematologic Tests ; Humans ; Length of Stay ; Neurology ; Stroke

Sine 1976, 2380 eases of ERCP were performed at the Kwangju Chrietian Hospital. Nighty eight patients with periampullary choledochaduodenal fistula diagnosed at ERCP were revewed, Following result were obtained 1) Cases were most commonly noted from fifth decade to seventh decade, and sex distribution was similar. 2) Right upper quadrant abdominal was most common clinical manifestation, and duration of illness prior to diagnosis were from 2 months to 20 years. Several weeks or days before ERCP, sudden disappearance of pain suggeeted spontaneous extrustion of a stone from the common bile duct to the duodenum with resultant PACD formation. 3) On past history, various types biliay operations had carried out in 26 patients. Subtotal gastrectomy with gastrojejunostomy in 1 patients, operation for CBD ascaris removal in 1 patient. 4) Most PACDF had finding formed recently on ERCP and fibrosis, inflamation, granulation, atrophic change, adhesive stenosis were noted additionally. 5) Most common cause of PACD by ERCP was biliary teact stone. 6) Endoscopic sphincteropapillotomy(EST) were performed in 39 patients with PACDF due to CBD stone and surgical intervention were done in 36 patients due to CBD stone also. It was interesting that EST were performed in 3 patients with old stenotic fistula.
Adhesives ; Ascaris ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Constriction, Pathologic ; Diagnosis ; Duodenum ; Fibrosis ; Fistula* ; Gastrectomy ; Gastric Bypass ; Gwangju ; Humans ; Sex Distribution

BACKGROUND AND OBJECTIVES: Ultrasonography is the most useful tool for detecting extrathyroidal extension, which is the deciding factor in surgical extension of papillary thyroid carcinoma. However, there are few studies on pre-operative ultrasonographic findings about extrathyroidal extension. This research thus evaluates a predictive sonographic index of extrathyroidal extension. SUBJECTS AND METHOD: 265 patients with papillary thyroid carcinoma who underwent preoperative sonography and surgery were respectively reviewed. Sonographic findings were compared with pathological results. RESULTS: There were no differences among the patents in terms of calcification and echo texture, whereas significant differences were observed in terms of mass size, lymph node metastasis, capsule contact, and degree of capsule contact. These four factors were weighted according to the degree of severity and defined the extrathyroidal index as the total of these scores. The index had high sensitivity, specificity and predictability. CONCLUSION: We suggest that the extrathyroidal extension index with sonography is helpful for drawing pre-operative sonographic diagnosis.
Diagnosis ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms* ; Ultrasonography*

BACKGROUND AND OBJECTIVES: To investigate the effectiveness of fine needle aspiration (FNA) conducted by the otolaryngologists, we compared the ultrasound (US)-guided FNA results conducted by a radiologist (RD-US), the US-guided FNA results (ENT-US), and the palpation guided FNA results (ENT-palpation) conducted by an otolaryngologist. SUBJECTS AND METHOD: 1646 patients who underwent FNA were classified according to the site and periods of investigation (2007-2015), and their sampling adequacy was retrospectively reviewed. They were also divided into three groups (ENT-US, ENT-palpation, and RD-US); each group was then investigated for sampling adequacy. Results of further surgical excisional biopsy were compared with the those of the FNA results to investigate the diagnostic accuracy of all three groups. RESULTS: The sampling adequacy identified by the groups showed the result of ENT-US at 87.9%, ENT-palpation at 87.1% and RD-US at 91.3%. The periodical inadequacy rate failed to show any significant differences between the groups. The sensitivity of ENT-palpation was lower than other two groups. Diagnostic accuracy identified by the groups showed the result of ENT-US at 95.2%, ENT-palpation at 93.6%, and RD-US at 97.4%. CONCLUSION: FNA performed by otolaryngologists demonstrates the effectiveness of diagnosis and treatment, and that doing so would improve economic efficiency. Therefore, it is recommended that well-trained otolaryngologists conduct FNA actively.
Biopsy ; Biopsy, Fine-Needle* ; Diagnosis ; Humans ; Methods ; Palpation ; Retrospective Studies ; Ultrasonography

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

The establishment of DNA microarray technology has enabled high-throughput analysis and molecular profiling of various types of cancers. By using the gene expression data from microarray analysis we are able to investigate diagnostic applications at the molecular level. The most important step in the application of microarray technology to cancer diagnostics is the selection of specific markers from gene expression profiles. In order to select markers of immortalization and transformation we used c-myc and H-ras(V12) oncogene-transfected NIH3T3 cells as our model system. We have identified 8751 differentially expressed genes in the immortalization/transformation model by multivariate permutation F-test (95% confidence, FDR <0.01). Using the support vector machine algorithm, we selected 13 discriminative genes which could be used to predict immortalization and transformation with perfect accuracy. We assayed H-ras(V12)-transfected "transformed" cells to validate our immortalization/transformation classification system. The selected molecular markers generated valuable additional information for tumor diagnosis, prognosis and therapy development.
Classification ; Diagnosis ; Gene Expression ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Prognosis ; Transcriptome ; Support Vector Machine