No abstract available.
Arteriovenous Fistula*

No abstract available.
Pulmonary Edema*

An accurate preoperative evaluation of lymph nodes(LNs) in gastric cancer is a prerequisite for successful surgery and favorable prognosis. We retrospectively analyzed the Ct accuracy in perigastric LN localization and LN staging of gastric cancer as well as the size criteria for the metastasized LN in 64 patients who hed undergone a surgery for gastric cancer. The results of perigastric LNs evaluation by CT are as follows; sensitivity 67%(64/95), specificity 90%(839/929), accuracy 88%(903/1024). Of 95 pathologically metastasized LN groups, 66 could be retrospectively identified on Ct scans(69%). In LN staging, CT was correct in 60%(38/64), overstaged in 32%(21/64), and understaged in 8%(5/64). The perigastric LN groups which were easily localized on CT were #3, 7, 8, and 13. The mean size of metastasized LNs on CT according to the I.N group was #3 (13mm), #4(9mm), #6 (10mm), #7(10.5mm), #8 (10mm), #9 (11mm), #13 (9mm).
Humans ; Lymph Nodes* ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms*

Pre-surgical and post-surgical change in adult clef lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft sites in dental radiograph and then the prosthetic treatment to the missing teeth was done.
Adult ; Bone and Bones ; Cicatrix ; Esthetics ; Fistula ; Humans ; Lip ; Maxilla ; Nasal Septum ; Osteotomy ; Palate ; Tooth ; Transplants

PURPOSE: A recent study analyzing several cytokines reported that long cardiopulmonary bypass (CPB) time and long aortic cross clamp (ACC) time were accompanied by enhanced postoperative inflammation, which contrasted with the modest influence of the degree of hypothermia. In this present study, we aimed to examine the effect of CPB temperature on the clinical outcome in infants undergoing repair of isolated ventricular septal defect (VSD). METHODS: Of the 212 infants with isolated VSD who underwent open heart surgery (OHS) between January 2001 and December 2010, 43 infants were enrolled. They were classified into 2 groups: group 1, infants undergoing hypothermic CPB (26degrees C-28degrees C; n=19) and group 2, infants undergoing near-normothermic CPB (34degrees C-36degrees C; n=24). RESULTS: The age at the time of the OHS, and number of infants aged<3 months showed no significant differences between the groups. The CPB time and ACC time in group 1 were longer than those in group 2 (88 minutes vs. 59 minutes, P=0.002, and 54 minutes vs. 37 minutes, P=0.006 respectively). The duration of postoperative mechanical ventilation was 1.6 days in group 1 and 1.8 days in group 2. None of the infants showed postoperative neurological and developmental abnormalities. Moreover, no postoperative differences in the white blood cell count and C-reactive protein levels were noted between two groups. CONCLUSION: This study revealed that hypothermic and near-normothermic CPB were associated with similar clinical outcomes and inflammatory reactions in neonates and infants treated for simple congenital heart disease.
C-Reactive Protein ; Cardiopulmonary Bypass* ; Cytokines ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Humans ; Hypothermia ; Infant* ; Infant, Newborn ; Inflammation ; Leukocyte Count ; Respiration, Artificial ; Thoracic Surgery

Left ventricular-right atrial shunt is a relatively uncommon defect, which permits as communication between the left ventricle and right atrium. This paper is fifth case report in our country. This patient was noted to have congenital heart disease in two years old. The pathology of this lesion was classified into four types by Perry. The type C is compatible with this case. The first successful surgical correction was made by Kirby in 1957. The pathology of this lesion was classified into four types by Perry. The type C is compatible with this case. The first successful surgical correction was made by Kirby in 1957. In 12 years old boy, we have experienced a case of left ventricular-right atrial shunt. In selective left ventricular angiocardiography, we found opacification to right atrium and main pulmonary artery simultaneously, and also opacified right ventricle later. Operation was performed during cardiopulmonary bypass. We opened right atrium and found out a defect just below the annulus of the tricuspid valve. The defect measuring 6mm in diameter communicate the left ventricle with right atrium through a segment of the septal leaflet fused to the margins of the septal defect. In the tricuspid valve, a cleft, 4mm in length and a isolated perforation(2mm in diameter) were found in the septal leaflet. Associated cardiac anomaly was a non-functioning patent foramen ovale. The recovery was uneventful and discharged healthily on fourteenth day after operation.
Angiocardiography ; Cardiopulmonary Bypass ; Child ; Foramen Ovale, Patent ; Heart Atria ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Male ; Pathology ; Pulmonary Artery ; Tricuspid Valve

PURPOSE: The aim of this study is to analysis of survival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. METHODS AND MATERIALS: From January 1981 to December 1998, eight-hundred twenty-seven uterine cervical cancer patients were treated with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (521 patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were performed with the Kaplan-Meier method and the Cox hazard model, respectively. Median follow-up was 38.6 months. RESULTS: On the radiation therapy only group, 314 patients (60%) achieved complete response (CR), 47 patients (9%) showed local recurrence (LR), 78 patients (15%) developed distant metastasis (DM). On the postoperative radiation therapy group, showed 276 patients (85%) CR, 8 patients (2%) LR, 37 patients (11%) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality ( p=0.0010), recurrence ( p=0.0001), Pap smear ( p=0.0329), CEA ( p=0.0001) and SCC antigen ( p= 0.0001). CONCLUSION: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.
Carcinoma, Squamous Cell ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Proportional Hazards Models ; Recurrence ; Survival Rate ; Uterine Cervical Neoplasms*

PURPOSE: To evaluate the merits of this technique and to provide a standard for comparison with futuretreatment alternatives. MATERIALS AND METHODS: We retrospectively reviewed the records of 52 patients withdirect CCF treated at the Yonsei Medical Center between 1983 and 1997 by transarterial or transvenous embolizationusing detachable balloon(s) and/or coils. RESULTS: Among the 52 cases, 51 were traumatic in origin, while onlyone was the result of a ruptured aneurysm. The three most common presentations were chemosis, bruit, andpulsatile proptosis. Forty-five patients were successfully treated with detachable balloon(s) and/or coils andinternal carotid blood flow was preserved in 35. When coils were used (1993-7), the ICA preservation rate washigher than when they were not used (1983-92). To confirm statistical significance, however, more studies areneeded. Four patients who initially presented with incomplete occlusion showed spontaneous occlusion on follow upangiography. In two patients, surgical ligation was performed because embolization failed and there was incompleteocclusion of the fistula. We experienced complications such as transient 3rd and 6th cranial nerve palsy,migration of deflated balloons and coils to the lung, and loss of vision. CONCLUSION: Transarterial andtransvenous embolization with detachable balloon(s) and/or coils provides a high rate of fistula obliteration withlow morbidity. In particular, the use of coils led to an increased rate of ICA preservation, thus and isconsidered as a good treatment modality for CCF obliteration.
Aneurysm, Ruptured ; Cranial Nerves ; Exophthalmos ; Fistula* ; Humans ; Ligation ; Lung ; Retrospective Studies

PURPOSE: Steroid 5-alpha reductase type 2 (SRD5A2) modifies testosterone to dihydrotestosterone (DHT) in the prostate. Single-nucleotide polymorphisms (SNPs) of the SRD5A2 gene might affect DHT. We sought to understand the relationship of SRD5A2 SNPs to prostate cancer in the Korean population. MATERIALS AND METHODS: Twenty-six common SNPs in the SRD5A2 gene were assessed in 272 prostate cancer cases and 173 controls. Single-locus analyses were conducted by using conditional logistic regression. Additionally, we performed a haplotype analysis for the SRD5A2 SNPs tested. RESULTS: Among the 20 SNPs and 4 haplotypes, there were no statistically significant results in the prostate cancer patients and the controls. In the logistic analysis of SRD5A2 polymorphisms with prostate-specific antigen (PSA) criteria, two SNPs (rs508562, rs11675297) and haplotype 1 displayed significant results (odds ratio [OR], 1.76; p=0.05; OR, 1.88-2.02; p=0.01-0.04; OR, 0.59; p=0.02, respectively). rs508562, rs11675297, rs2208532, and haplotype 1 (OR, 1.49; p=0.05; OR, 2.02; p=0.05; OR, 2.01; p=0.04; OR, 0.56-0.64, p=0.03-0.04, respectively) had significant associations with Gleason score. rs508562, rs11675297, and haplotype 1 (OR, 1.41-2.34; p=0.004-0.05; OR, 1.74-1.82; p=0.03-0.05; OR, 0.42-0.67; p=0.0005-0.03, respectively) were significantly associated with clinical stage. CONCLUSIONS: We conclude that there was no significant association between SRD5A2 SNPs and the risk of prostate cancer in the Korean population. However, we found that some SNPs and 1 haplotype influenced PSA level, Gleason score, and clinical stage.
3-Oxo-5-alpha-Steroid 4-Dehydrogenase/*genetics ; Aged ; Case-Control Studies ; Dihydrotestosterone/metabolism ; Genetic Predisposition to Disease ; Genotype ; Haplotypes ; Humans ; Logistic Models ; Male ; Membrane Proteins/*genetics ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Odds Ratio ; Polymorphism, Single Nucleotide ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/epidemiology/*genetics ; Republic of Korea/epidemiology ; Risk Factors ; Testosterone/genetics

PURPOSE: Maxillary sinus cancers are usually locally advanced, and involve the structures around sinus, but the regional lymphatic spread is uncommon. Therefore, the local control of these cancers is important for their cure. We reviewed our experience of 55 patients with squamous cell carcinomas of the maxillary sinus, treated with radiation therapy, and looked for the role of radiation therapy in maxillary sinus cancers. MATERIALS AND METHODS: Between November 1982 and October 1999, 55 patients with squamous cell carcinomas of the maxillary sinus underwent either radiation therapy only, or combined with surgery or with concurrent chemoradiation therapy. All patients were restaged according to the 1997 AJCC staging systems. The T classifications of the tumors of the patients were as follows:1.8% (1/55) for T2, 81.8% (45/55) for T3 and 16.4% (9/55) for T4. Thirteen patients were diagnosed with lymph node involvement. With the surgical procedures, 12 patients were managed by biopsy only, 21 were resected by FESS (functional endoscopic sinus surgery) and 22 by partial/medial/total maxillectomies. The details of the treatments were as follows:8 patients were treated with radiation therapy only, 17 with a combination of FESS and radiation therapy, 22 with a combination of a maxillectomy and radiation therapy, 4 with a combination of preoperative radiation therapy and surgery, and 4 with concurrent chemoradiation therapy. The mean follow-up for all patients was 25 months, ranging from 2.8 to 125 months. RESULTS: The 4-year local control and survival rates for all patients were 45.5 and 33.3%, respectively. The 4-year local control and survival rates, due to the extent of surgery, were as follows:32.1, and 21.4 % for biopsy; 41.9, and 31.7% for FESS; and 56.8, and 52.7% for maxillectomy, respectively. Twenty-nine (52.7%) patients were not cured, and of these 29 patients, 23 (79.3%) patients had a local recurrence following treatment. CONCLUSION: This study has shown that the major failure sites following treatment to be the local regions, and that the completeness of surgery was important for improving the local control and survival of patients with squamous cell carcinoma of the maxillary sinus.
Biopsy ; Carcinoma, Squamous Cell* ; Classification ; Follow-Up Studies ; Humans ; Lymph Nodes ; Maxillary Sinus Neoplasms ; Maxillary Sinus* ; Recurrence ; Survival Rate