No abstract available.
Adult* ; Atherosclerosis* ; Cholesterol* ; Humans ; Korea*

No abstract available.
Humans ; Siblings*

BACKGROUND: Phantom limb sensation is an unusual position sense of the extremity during nerve block that the position of extremity is misinterpreted as being flexed, or elevated, when actually they are in neutral position. Whether it is from the fixation of proprioceptive input at the time of motor blockade or from unmasking of the pattern which has been already present in the CNS is still controversial. We perfomed this study under the assumption that phantom limb sensation can still be reproduced without the influence of position at the time of nerve blockade. METHODS: Thirty-six patients scheduled for elective orthopedic surgery were randomly assigned. For 26 patients, spinal anesthesia was performed with hyperbaric 0.5% tetracaine or bupivacaine at lateral decubitus position and the position was changed to supine immediately. Existence of phantom limb sensation and the level of anesthesia was recorded at 10 and 20 minutes after injection of local anesthetics. For 10 patients, same local anesthetics were injected after patient's legs were straightened in lateral decubitus position. RESULTS: Forteen out of 26 patients whose position were changed to supine immediately after the injection of local anesthetics experienced phantom limb sensations. Five out of 10 patients whose legs were kept straight before the injection of local anesthetics experienced phantom limb sensations. Previous history of trauma was positively related to the expression of phantom limb sensation. CONCLUSION: Our data showed that the expression of phantom limb sensation is reproducible. And this was not related to the position at the time of spinal anesthesia. Trauma seems to be an important factor related to the expression of phantom limb sensation.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine ; Extremities ; Humans ; Leg ; Nerve Block ; Orthopedics ; Phantom Limb* ; Proprioception ; Sensation* ; Tetracaine

BACKGROUND: One of the most important prognostic factors in colorectal cancer is lymph node metastasis, which predicts a reduced survival time. Although lymph node metastases were not detected by a conventional hematoxylin-eosin stain technique, 20 to 30 percent of patients fail long-term survival on account of a local or systemic recurrence. Recurrent disease in these patients is believed to develop from occult tumor in lymph nodes. PURPOSE: The authors have conducted an immunohistochemical study with two different antibodies against cytokeratin to identify occult micrometastases in lymph nodes which were diagnosed as tumor negative by conventional histopathology. METHODS: Paraffin blocks of sixty-five patients with colorectal cancer (T2/3, N0, M0) after a curative resection between January 1991 and December 1993 at Kyung-Hee University Hospital were stained with avidin-biotin-peroxidase complex technique using two monoclonal antibodies (anti-cytokeratin AE1/AE3 and anti-cytokeratin No. 20, DAKO, Hamburg, Germany). To assess the clinical correlation between micrometastasis in lymph node and patients survial, 5-year disease-free survival rates were calculated by Kaplan-Meier method and the significance of the differences was estimated by the log-rank test. P values <0.05 were taken to be significant. RESULTS: Of the sixty-five patients with 1133 lymph nodes, tumor cells detected by anti-cytokeratin AE1/AE3 and anti-cytokeratin No. 20, were 2.4 percent (27/1133) and 3.4 percent (38/1133), respectively. Micrometastases were detected in twenty-six patients (40.0 percent). The histologic stage of four cytokeratin positive cases was upstaged from T2, N0, M0 to T2, N1/2, M0, and twenty-two of T3, N0, M0 to T3, N1/2, M0. Cytokeratin-positive cases showed statistically significant recurrence rate (42.3 percent) compared to that of cytokeratin -negative cases (17.9 percent)(x2 test, p=0.032). With the median follow-up of 62 months, 5-year disease-free survival rates of the micrometastses negative and positive cases were 81.7 percent and 61.3 percent, respectively (p=0.0438). CONCLUSIONS: In conclusion, immunohistochemical technique to identify the occult micrometastases in lymph nodes overlooked in conventional histopathology is a useful staging method to anticipate a recurrence and a prognosis more precisely.
Antibodies ; Antibodies, Monoclonal ; Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Keratins ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Paraffin ; Prognosis ; Recurrence

BACKGROUNDS/AIMS: MRI performed preoperatively for Hepatocellular Carcinoma(HCC) not only detects and provides information on the tumor characteristics but can also be used as a noninvasive method via MR-angiogram. MR-angiogram can reconstruct the tumor and its relation to vessels in three dimension. Therefore, it has the advantage of presenting the exact relations of the tumor and the intrahepatic vessels. Recently, preoperative imaging in HCC has become more complex. The invasive angiography is at the center of these various, complex tests and there is a tendency for unnecessary, repeated testing. The cost of these complex tests is hard to ignore. The purpose of this study was to compare single preoperative MRI with other tests and weigh the advantages. METHODS: The subjects were thirty-nine patients who underwent surgery for HCC from November, 1997 through October, 1998. Ten of these patients who had HCC with the diameter of less than 5cm, were evaluated with MRI and when necessary MR angiogram only. The control group were eleven patients with tumor of the same size as above but whom were evaluated with abdominal CT + Hepatic angiogram + Transcatheter arterial chemoembolization(TACE) + lipodol CT, abdominal CT + Hepatic angiogram + CT - AP + TACE + lipodol CT or abdominal CT + Hepatic angiogram + CT - AP + TACE during the identical period. RESULTS: The average cost of preoperative testing was lowest with MRI only. There were no deaths in either group and complication occured in one case of each group. Comparison of the duration of admission between these groups showed a statistically significant difference(p=0.003). The MRI only group with an average of 22.5 days and the control group of 30.8 days. This was due to shortening of the preoperative testing time. Another point worth noting is that patients who underwent MRI alone complained less of discomfort. CONCLUSION: MRI alone group was comparable to control group in providing of preoperative anatomical information. Not performing angiography did not increase risks technically during operation. The authors suggest that MRI as the single preoperative imaging test can be in alternative to the various preoperative imaging test.
Angiography ; Carcinoma, Hepatocellular* ; Humans ; Magnetic Resonance Imaging* ; Tomography, X-Ray Computed

There have been a growing numbers of patients diagnosed with malignancy and coronary artery disease simultaneously or serially. In the era of percutaneous coronary intervention (PCI), stent thrombosis has been a rare but challenging problem. Recently, we experienced two unique cases of acute stent thrombosis in patients with malignancy. The first case showed acute and subacute stent thrombosis after PCI. The second case revealed simultaneous thromboses in stent and non-treated native coronary artery. We believe that we need rigorous precautions in the treatment of patients with coronary artery disease and malignancy, especially with regards to deciding how and whether to revascularize, as well as which anti-platelet agents to select.
Coronary Angiography ; Coronary Artery Disease ; Coronary Thrombosis ; Coronary Vessels ; Humans ; Lung Neoplasms ; Pancreatic Neoplasms ; Percutaneous Coronary Intervention ; Stents ; Thrombosis

Primary paraganglioma of the liver is a very rare disorder, and radiologic findings have not yet been described. We report a case of this entity in which the US, CT, MRI and 131I-MIBG scan findings are described.
Liver* ; Magnetic Resonance Imaging ; Paraganglioma*

A murime monoclonal antibody (mAb) specific for the envelope glycoprotein gp120 of human immunodeficiency virus type-I (HIV-1) was chemically coupled to pokeweed antiviral protein (PAP) from Phytolacca americana. The immunotoxin was purified by FPLC using 5200 colum. The purified immunotoxin efficiently bound to HIV-infected T cells as evidenced by fluorescence-activated cell sorter analysis. The immunotoxin selectively killed human T lymphoid lines infected with HIV-lIIIB at less than 250 pM of the immunotoxin cells, while PAP or mAb alone did not have any significant effect on infected cells. The uninfected control T cell lines were not affected. Human cells infected with HIV-2 or other HIV-1 strains were not killed, suggesting that the killing depends completely on the antibody used for coupling. These in vitro results suggest that the PAP-mAb conjugate may be used to selectively remove cells expressing viral antigens from individuals infected with HIV.
Antigens, Viral ; Cell Line ; Glycoproteins ; HIV ; HIV-1 ; HIV-2 ; Homicide ; Humans* ; Immunotoxins ; Phytolacca americana* ; T-Lymphocytes*

The survey was undertaken among the 105 ostomates who attended the 2nd Workshop for Stoma Rehabilitation on Aug. 30th, 1997 by the Department of Surgery, Kyung-Hee University Hospital to assess the physical, psychosocial and sexual problems with a stoma. The 97% of ostomates had permanent colostomies following abdominoperineal resection. The 67% of ostomates had one or more physical problems caused by stoma. Frequent bowel movement (94.3%), impairment of irrigation (64.6%), unpleasant odor (27.3%), and urinary frequency (21.3%) were common problems encountered by ostomates. Concerning the psychosocial problems, 3.8% of them suffered from profound restriction of social activities and 1.9% of them had psychologic problems such as depression. 42 of 58 ostomates (72.4%) who were employed before operation returned to their work. Among 71 men, 44 (62%) were impaired by sexual function. Most ostomates suffered physical, social, psychologic and sexual problems in their daily life and needed helps of experts such colorectal surgeons, enterostomal therapists, and ostomy association. Attention is needed more to improve the quality of life for the ostomates.
Colostomy ; Depression ; Education ; Humans ; Male ; Odors ; Ostomy ; Quality of Life ; Rehabilitation

PURPOSE: To determine the characteristics of benign breast calcifications on mammogram. MATERIALS AND METHODS: Benign breast calcifications on mammograms of 25 patients, which were confirmed by needle localization and excisional biopsy(15 cases), cytology(1 case), or follow-up study(9 cases), were retrospectively analysed according to size, shape, number, distribution, and density. RESULTS: The size of benign breast calcifications was uniform in 4 cases (16%), and variable in 21 cases (84%). The shape of calcifications was round or oval in 18 cases(72%), linear or branching pattern in 6 cases (24%), and irregular in 1 case(4%). The number of calcifications was 2-5 in 7 cases(28%), and over 6 in 12 cases(48%). The distribution of calcifications was focal in 13 cases(52%) and diffuse in 12 cases(48%). The density of calcification was homogenous in all 25 cases(100%). CONCLUSION: Analysis of number, shape, size, and distribution is helpful for the diagnosis of benign breast calcifications. However the homogenous density of the calcification is suggested to be the most helpful criterion for the diagnosis of benign breast calcifications.
Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Needles ; Retrospective Studies