No abstract available.
Endometrial Stromal Tumors* ; Lung* ; Neoplasm Metastasis* ; Uterus*

Although intramedullary nailing is mostly used in the management of fractures in the long bone shaft, plate fixation is still alternative option in periprosthetic or metaphyseal fractures. For the rigid fixation during plating, sometimes we need wiring. Many surgeons experience slippage of wire resulting in loss of rigid fixation because plate and wire is so slippery and the diameter of bone is changing by level especially in the metaphyseal area. Wiring plate(CHO plate) was designed to prevent slippage. This plate has transverse holes for wires between screw holes on traditionally used dynamic compression plate. Sixteen fractures of long bone shaft were fixed with wiring plate and 11 cases which were followed up for more than one year were evaluated. There were periprosthetic fractures(4 cases), spiral or butterfly fractures(4 cases) and fractures of poor bone quality(two cases of malignancy and one case of osteoporosis). Nine cases were successfully reduced and the healed without loss of fixation. In two cases, delayed union and nonunion were observed due to wire breakage with plate loosening. Preliminarily, wiring plate fixation can be used for the periprosthetic fracture and one of alternative option in butterfly or spiral fracture and fracture in osteoporotic bone or pathologic fracture.
Butterflies ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Periprosthetic Fractures

No abstract available.
Carcinoid Tumor*

No abstract available.
Gastric Stump*

Building a database file in the medical literature using personal computer enables individualized computer user to search with a small amount of time and effort. We developed a computer program for searching medical literature. This program was developed with Clipper database language, and runs on IBM-PC-compatible computers. The data is based on the Index of Korean Journal of Urology which was revised in 1991. The program is focused on the function of retrieving and printing of keywords, authors and titles, etc. We expect more advanced and beneficial program for searching of medical literature based on this program.
Microcomputers ; Urology*

Granular cell tumor (GCT) of the breast is a rare clinical entity, and is believed to be of schwannian origin and to follow a benign clinical course. A 50-year-old woman presented with a slowly growing mass in the right breast. Fine needle aspiration cytology revealed a cellular smear containing isolated or clustered cells showing round to oval nuclei with abundant oncocytic granular cytoplasm. Nuclei showed a fine granular chromatin pattern and occasional small single nucleoli. Cell boundaries were poorly defined, and naked nuclei were frequently found. Histologically, the tumor showed features of typical GCT, and immunohistochemical staining findings strongly supported the diagnosis. The present study demonstrates that GCT of the breast can mimic malignant lesions of breast both clinically and radiologically. The recognition of its cytologic features and suspicion of this lesion would undoubtedly aid the correct diagnosis of mammary GCT.
Biopsy, Fine-Needle* ; Breast* ; Chromatin ; Cytoplasm ; Diagnosis ; Female ; Granular Cell Tumor* ; Humans ; Middle Aged

There are few reports in the literature of complete obstruction of the vertebral artery (VA) due to an electric screw driver bit penetration through the neural foramen into the spinal canal with Brown-Sequard syndrome (BSS). A 25-year-old man was admitted to the emergency department with a penetrated neck injury by an electric screw driver bit after a struggle. The patient presented the clinical features of BSS. Computed tomography scan revealed that the electric screw driver bit penetrated through the right neural foramen at the level of C3-4, and it caused an injury to the right half of the spinal cord. Emergent angiography revealed VA dissection, which was managed by immediate coil embolization at both proximal and distal ends of the injury site. After occlusion of the VA, the electric screw driver bit was extracted under general anesthesia. Bleeding was minimal and controlled without difficulties. No postoperative complications, such as wound dehiscence, CSF leakage, or infection, were noted. Endovascular approaches for occlusion of vertebral artery lesions are safe and effective methods of treatment.
Adult ; Anesthesia, General ; Angiography ; Brown-Sequard Syndrome* ; Cervical Vertebrae ; Embolization, Therapeutic ; Emergencies ; Female ; Hemorrhage ; Humans ; Methods ; Neck Injuries ; Postoperative Complications ; Spinal Canal ; Spinal Cord ; Vertebral Artery Dissection ; Vertebral Artery* ; Wounds and Injuries ; Wounds, Penetrating

The prognoses for the gastric cancer patients treated with total gastrectomies are known to be unsatisfactory due to the low survival rates, the high frequency of postoperative mortality or morbidity, and long-term complications such as nutritional deficiency. The authors evaluated the 5-year survival rates and analyzed the prognostic factors in 557 patients with gastric cancer who underwent total gastrectomies during the period between Jan. 1987 and Dec. 1993. The overall 5-year survival rate was 49.7%, and the survival rates according to the stage were stage Ia, 92.0%; Ib, 85.5%; II 64.1%; IIIa 55.0%; IIIb 26.5%; and stage IV, 6.3%. Postoperative mortality rate was 1.1%. By using univariate analysis to evaluate the prognostic factors, factors such as age, depth of invasion, extent of lymph node metastasis (according to the Japanese rule), number of involved nodes, lymph node ratio, distant metastasis (peritoneal and/or hepatic), size of the tumor, gross type, histological type, the surgical curability and the TNM stage were found to be related with the survival of the patients. In a multivariate analysis using 11 variables, the TNM stage was the single most significant prognostic factor. Besides the TNM, depth of invasion (ratio of risk (R.R)=1.50), extent of lymph node metastasis (R.R=1.83), number of involved nodes (R.R=1.64), lymph node ratio (R.R=1.91), and peritoneal metastasis (R.R=3.11) were found to be independent prognostic factors influencing survival. It was thought that the radicality of surgery could be reflected in the number of removed nodes per specimen. In this study, the average number of removed nodes was 42.3 per case. Hence, it may be said that adequate lymphadenectomy was performed for almost all the grossly curable cancers. The 5-year survival rate in stage IV patients with tertiary node (N3) metastasis and no peritoneal or hepatic metastasis was 16.8%; in patients with peritoneal or hepatic metastasis, the survival rate was 0%. There was a significant survival difference between these two groups (p<0.05). This result suggests that the tertiary node metastasis is a potentially curable factor, and that it should be classified differently in the current TNM system. In conclusion, the overall survival rates in the patients treated with total gastrectomies were favorable compared with the results in other reports. Depth of invasion, extent of lymph node metastasis, number of involved nodes, lymph node ratio were important prognostic factors for survival after a total gastrectomy. The current TNM staging system appears to be a reasonable one, except that the probable curability of tertiary node metastasis may need to be taken into consideration.
Asian Continental Ancestry Group ; Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Malnutrition ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms* ; Survival Rate

Neuromyelitis optica (NMO) is a demyelinating disease of the central nervous system that is characterized by severe episodes of transverse myelitis and optic neuritis. Aquaporin-4-specific autoantibody (NMO IgG) is the marker of NMO. We report herein a 28-year-old woman with systemic lupus erythematosus (SLE) that manifested with bilateral optic neuritis. She had NMO IgG in addition to clinical and serologic characteristics of SLE. This is the first report of a patient with SLE and NMO IgG that manifested with sequential bilateral optic neuritis.
Adult ; Central Nervous System ; Demyelinating Diseases ; Female ; Humans ; Immunoglobulin G ; Lupus Erythematosus, Systemic ; Myelitis, Transverse ; Neuromyelitis Optica ; Optic Neuritis

PURPOSE: The association of the tetralogy of Fallot(TOF) with the complete form of atrioventricular septal defect(AVSD) is rare cardiac malformation.The predominant clinical findings in both groups of cases were those associated with tetralogy of Fallot, but certain features need to be emphasized, however. METHODS: Forteen(2%) out of 659 patients with tetralogy of Fallot seen at the department of pediatrics, Seoul National University Hospital from January 1986 to June 1994, were associated with the complete form of AVSD. We reviewed clinical records, echocardiographic findings, angiographic findings and operative findings of patients. Our diagnostic criteria for TOF with complete AVSD are as follows. 1) Anterosuperior displacement of infundibular septum and RVOT obstruction. 2) Large (nonrestrictive) VSD and an overriding aorta. 3) Primum ASD with common AV valve.Goose-neck deformity of LVOT. RESULTS: 1) Only 14 cases(2%) of the 659 TOF patients were associated with complete AVSD. 2) The male to female ratio was 1:2.5. 3) The predominant features were those associated with TOF, but 9 patients(64.4%) had Down's syndrome. 4) The electrocardiogram showed left axis deviation except 2 patients. 5) Most common type among 14 patients with complete AVSD defect was Rastelli type C(78.5%). 6) Associated cardiovascular anomaly included PDA, ASD of secundum type, right aortic arch, left superior vena cava. 7) Among 12 patients who underwent operations, 9 patients are still alive and followed up. CONCLUSIONS: TOF associated with complete AV septal defect was a rare disease. There was a clinical difference between TOF and AVSD combined groups of case. The presence of Down's syndrome or left-axis deviation with TOF increases the likelihood of associated complete AVSD.Careful preoperative evaluation of these patient is essential to their management and successful operative treatment.
Aorta ; Aorta, Thoracic ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Down Syndrome ; Echocardiography ; Electrocardiography ; Endocardial Cushion Defects ; Female ; Humans ; Male ; Pediatrics ; Rare Diseases ; Seoul ; Tetralogy of Fallot* ; Vena Cava, Superior