No abstract available.
Aneurysm, False* ; Blood Pressure Monitors* ; Blood Pressure* ; Compression Bandages* ; Humans ; Radial Artery*

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

PURPOSE: This study was tried to evaluate the potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate, overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. MATERIAL AND METHODS: Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200cGy) radiation therapy alone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940 cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months. RESULTS: Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group (25% vs. 47%). The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting (22% vs. 6%) and bone marrow toxicities (25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. CONCLUSION: The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.
Bone Marrow ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin ; Follow-Up Studies ; Humans ; Incidence ; Nausea ; Neoplasm Metastasis ; Pulmonary Fibrosis ; Survival Rate ; Survivors ; Vomiting

BACKGROUND: Manifestations of gastroesophageal reflux disease(GERD) range from mild episodes of heartburn and acid regurgitation to chronic mucosal inflammation with esophagitis. It has been suggested that elderly patients may present symptoms in a slightly different manner from younger patients. The aim of the present study was to compare symptoms and clinical characteristics of elderly patients to that of younger patients in a population with endoscopially GERD. METHODS: Three hundred sixty two patients with diagnosed GERD who underwent esophagogastroduedenoscopy were enrolled. Patients were divided into two groups according to age(<65 years, n=181 and> or =65 years, n=181). Esophageal and other symptoms and clinical parameters including the status of endoscopic findings, Helicobacter pylori infection and pathologic findings. RESULTS: Among esophageal symptoms, heartburn is less frequent in elderly group(21.5% vs. 31.5%, p=0.032). Dyspepsia is most common symptom in both group and more frequent in elderly group(42.5% vs. 32.0%, p=0.039). Other symptoms showed no differences between two groups. The prevalence of H. pylori infection, hiatal hernia and nonerosive GERD also showed no significant differences. CONCLUSION: Elderly patients with GERD presented a higher frequency of atypical symptoms. Intensive history taking for atypical symptoms was needed in elderly patients with suspected GERD.
Aged ; Dyspepsia ; Esophagitis ; Gastroesophageal Reflux ; Heartburn ; Helicobacter pylori ; Hernia, Hiatal ; Humans ; Inflammation ; Korea ; Prevalence

Purpose: Surgery is prioritized for a splenic injury when the patient is hemodynamically unstable or the injury is severe and there is an increased risk of bleeding. This study aimed to examine the outcomes of splenectomies where a surgical stapling device was used to reduce operation time and rapidly control bleeding. Methods: This retrospective study included 53 patients who underwent a splenectomy for traumatic splenic injury at Chosun University Hospital between 2012 and 2017. Clinical outcomes including operation time (duration), blood transfusion amount (number of units), length of hospital stay, length of intensive care unit stay, and mortality rate were compared between patients who received conventional ligation [conventional group (CG)] and patients who received a splenectomy where a surgical stapling device was used [stapling group (SG)]. Results: The SG showed an average operation time of 17 minutes less than the CG, although the reduction was not statistically significant. No significant differences in estimated blood loss and blood transfusion amount were determined between the 2 groups, although the SG received 1 more unit of red blood cells for transfusion in the 48-hour post-operative period compared with the CG. One case of pancreatic fistula as a postoperative complication was reported in the SG. Conclusion The use of a surgical stapling device in a splenectomy may be considered for a hemodynamically unstable patient with splenic injury which caused severe anatomical damage.

Purpose: Surgery is prioritized for a splenic injury when the patient is hemodynamically unstable or the injury is severe and there is an increased risk of bleeding. This study aimed to examine the outcomes of splenectomies where a surgical stapling device was used to reduce operation time and rapidly control bleeding. Methods: This retrospective study included 53 patients who underwent a splenectomy for traumatic splenic injury at Chosun University Hospital between 2012 and 2017. Clinical outcomes including operation time (duration), blood transfusion amount (number of units), length of hospital stay, length of intensive care unit stay, and mortality rate were compared between patients who received conventional ligation [conventional group (CG)] and patients who received a splenectomy where a surgical stapling device was used [stapling group (SG)]. Results: The SG showed an average operation time of 17 minutes less than the CG, although the reduction was not statistically significant. No significant differences in estimated blood loss and blood transfusion amount were determined between the 2 groups, although the SG received 1 more unit of red blood cells for transfusion in the 48-hour post-operative period compared with the CG. One case of pancreatic fistula as a postoperative complication was reported in the SG. Conclusion The use of a surgical stapling device in a splenectomy may be considered for a hemodynamically unstable patient with splenic injury which caused severe anatomical damage.

PURPOSE: We evaluated whether Cyberknife radiosurgery is an effective and safe method of therapy for medically intractable trigeminal neuralgia (TN). MATERIALS AND METHODS: We retrospectively analyzed the outcome of 26 patients, who failed to surgery or were not suitable candidates for invasive intervention and were treated by Cyberknife radiosurgery between March 2004 and May 2005. Radiosurgery doses of 60~64 Gy were delivered to the 80% isodose line prescribed to an 6 mm length of the nerve, sparing the most proximal 3 mm away from the trigeminal nerve root entry zone (median dose: 64 Gy). RESULTS: Follow-up period was 3~15 months (median follow-up period: 9 months) Preliminary results from a cohort of 26 patients undergoing Cyberknife radiosurgery for TN showed that pain relief was achieved in 50% (13/26) of patients within the first 24 hrs after treatment. At last follow-up, 96.2% (25/26) of patients reported early pain relief within 7 days. Treatment failure developed in 2 of 26. Poor response occurred in one patient and relapse was observed in the other patient. 3 patients had hypoesthesia (11.5%), which was the only complication observed with any of our patients. CONCLUSION: With these results, authors assumed that Cyberknife radiosurgery for TN could be one of safe and effective therapeutic methods.
Cohort Studies ; Follow-Up Studies ; Humans ; Hypesthesia ; Radiosurgery* ; Recurrence ; Retrospective Studies ; Treatment Failure ; Trigeminal Nerve ; Trigeminal Neuralgia*

A prominent crista terminalis is a normal anatomic variant which consist of thick muscular bridge within the right atrium. However, it could be often misdiagnosed with an abnormal mass on the transthoracic echocardiography. The case report presented here, describe the findings of transthoracic echocardiography that suggested a right atrial mass in patients with pulmonary embolism. However, subsequent transesophageal echocardiography and cardiac computed tomography/magnetic resonance imaging differentiated a true right atrial mass from a prominent crista terminalis.
Echocardiography ; Echocardiography, Transesophageal ; Heart Atria ; Humans ; Pulmonary Embolism

Hamstring injuries are common forms of muscle strains in athletes but a complete rupture of a proximal hamstring origin is rare. Often there is a considerable delay in diagnosis and stringent treatment because of its rarity, difficulty in clinical diagnosis, and initial attempts of conservative care. We report two cases of acute complete rupture of the proximal hamstring tendons treated with early surgical repair. The diagnosis and treatment of this unusual injury are discussed.
Acute Disease ; Adolescent ; Adult ; Football/*injuries ; Humans ; Male ; Martial Arts/*injuries ; Rupture ; Tendon Injuries/diagnosis/*surgery ; Thigh ; Young Adult