No abstract available.
Breast Neoplasms* ; Breast*

PURPOSE: This study was undertaken to evaluate the clinical results of pars plana vitrectomy on posterior segment complications in posterior uveitis. METHODS: We reviewed the records of 20 eyes of 19 uveitis patients who were followed up for 6 months or more after vitrectomy. RESULTS: The mean follow-up period was 20 months. Final visual acuity improved in 10 eyes (50%), was maintained in 6 (30%), and decreased in 4 (20%). The mean improvement of vision was 1.6 lines (p=0.019). Detached retina was reattached in 8 (80%) among the 10 eyes with primary surgery. Postoperative complications were cataract (7 eyes), macular degeneration (2 eyes), retinal detachment (2 eyes), and recurrence (1 eye). CONCLUSIONS: These results suggest that pars plana vitrectomy may be a safe and effective treatment for posterior segment complications in posterior uveitis, but that early and complete vitrectomy should be considered for a better visual prognosis.
Cataract ; Follow-Up Studies ; Humans ; Macular Degeneration ; Postoperative Complications ; Prognosis ; Recurrence ; Retina ; Retinal Detachment ; Uveitis ; Uveitis, Posterior* ; Visual Acuity ; Vitrectomy*

PURPOSE: Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. METHODS AND MATERIALS: Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcioma in situ (38 cases), severe dysplasia(2), myoma(6), uterine bleeding (4), uterine prolapse (2), and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy form August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients reveived ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. RESULTS: Overall 5-year survival rate and relapse-free survival rate were 83.8%, 86.9% respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were 90.9%, 88.8%, 38.4%, and 100% respectively. There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cncer (stage IA) had no treatment related failure. Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. CONCLUSION: Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy. Survivals for patients with gross disease remained after inappropriate hysterectomy was poor. So, early cancer detection and proper management with precise pretreatment staging is necessary to avoid inadherent hysterectomy especially in the cases of gross residual disease.
Carcinoma in Situ ; Cervix Uteri ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Node Excision ; Myoma ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms ; Uterine Hemorrhage ; Uterine Prolapse

Acute panautonomic neuropathy characterized by selective involvement of sympathetic and parasympathetic nerves with complete or relative sparing of somatic motor and sensory functions was first described by Young et al in 1969. We experienced acute pandysautonomia with peripheral neuropathy. The serial electrophysiologic studies revealed progressive periphear axonal polyneuropathy. Autonomic function test suggested dysautonomia of selective postganglionic lesion in 1 case and pandysautonomia in 3 cases. Our four cases wree Acute panautonomic neuropathies which simultaneously developed sensorimotor polyneuropathy. All Laps were normal except elevated CSF protein without pleocytosis. Recovery was poor in general, but 34-years-old female patient was markedly improved after plasmapheresis. Therefore we recommend immunologic treatment such as plasmapheresis or pulse therapy in early stage of progressive pandysautonomia.
Axons ; Female ; Humans ; Leukocytosis ; Peripheral Nervous System Diseases ; Plasmapheresis ; Polyneuropathies ; Primary Dysautonomias ; Sensation

Female ; Follow-Up Studies ; Headache ; Humans ; Incidence ; Neck ; Neck Pain ; Shoulder Pain ; Temporomandibular Joint

BACKGROUND AND OBJECTIVES: The odorant confusion matrix (OCM) odor identification test is a kind of suprathreshold odor identification test using 10 synthetic odorants as stimuli and confusion matrix consisted of closed alternatives. This test is known to have an advantage in qualitative diagnosis of olfactory dysfunction by analyzing mis-identification of odorants at specific nerve dysfunctions. The aim of this study is whether we can use this OCM odor identification test for comparing normals with patients with olfactory disturbance. MATERIALS AND METHODS: The OCM odor identification test using 10 synthetic odorants familiar to Korean was applied to 40 normals and 32 patients who showed decreased sense of smell without sinonasal diseases. Percent-corrects of normals were compared with patients and with olfactory thresholds by a modified ascending method of limits (CCCRC) test using successively diluted 1-butanol. RESULTS: Percent-corrects of normals in the OCM odor identification test was higher than those of patients with statistical significance (p<0.001), and the results of OCM odor identification test was well correlated with those of the CCCRC olfactory threshold test (r=0.77). CONCLUSION: The OCM odor identification test exhibited no problems in discriminating patients from normals and can be used in clinical contexts.
1-Butanol ; Diagnosis ; Humans ; Odors* ; Olfaction Disorders ; Smell

PURPOSE: To evaluate the response and survival rate after three-dimensional conformal radiation therapy (3D-CRT) of patients with a solitary sternal relapse of breast cancer. MATERIALS AND METHODS: Seventeen patients between May 1996 and June 2005 were evaluated with the salvage 3D-CRT treatment of a solitary sternal relapse of breast cancer. The treatment fields included the gross tumor volume with 2 cm margins. The total radiation dose was 35.0~61.5 Gy (biologic effective dose of 43.7 ~76.9 Gy(10) using an alpha/beta ratio of 10 Gy), with a daily dose of 1.8~3.0 Gy. The tumor response was evaluated by the change in maximum tumor size via follow up CT scans 1~3 months after the completion of treatment. RESULTS: An objective tumor response was achieved in all patients, with a complete response in 5 patients and a partial response in 12 patients. The 5-year overall survival rate was 51.9% (median survival time: 27 months), and the most important factor affecting overall survival was the disease-free interval (interval from primary surgery of breast cancer to the development of sternal metastasis): The 5-year overall survival rate was 61.8% for patients with a disease-free interval > or =12 months and 0.0% for patients with disease-free interval <12 months (p=0.03). CONCLUSION: The response to 3D-CRT was good in patients with solitary sternal relapse of breast cancer. Particularly, patients with long disease-free interval from primary surgery survived significantly longer than patients with short disease-free interval from primary surgery.
Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Recurrence ; Survival Rate ; Tumor Burden

BACKGROUND: Body fat distribution, rather than the level of obesity per se, appears to be a strong predictor of abnormalities in metabolic complication. Visceral fat accumulation is significantly correlated with glucose intolerance and constitutes as an independent risk factor for the diabetes mellitus. METHODS: We investigated the impact of body fat distribution on the glucose, lipid metabolism and growth hormone secretion in obese subjects with varying glucose tolerance and lean controls matched with sex and age. 69 obese Koreans (34 men, 35 women; 43.8 yrs) and 21 lean Koreans (10 men, 11 women; 40.8 yrs) were recruited. Anthropometric measurement and impedence for measurement of total body fat, and computed tomography for visceral and subcutaneous fat area at umbilicus level were performed. All subjects underwent a standard oral glucose tolerance test and GH stimulation test by L-dopa. RESULTS: The results are summarized as follows. 1. Obese patients had greater ideal body weight (%, IBW) and lean body mass (LBM) than lean controls. But no significant differences were found in IBW and LBM between 3 obese groups. 2. The 25 obese NIDDM had the highest FFA-AUC during OGTI and the lowest GH-AUC to L-Dopa stimulation test. The insulin-AUC during OGTT was the highest in 24 obese subjects with normal glucose tolerance. 3. All male groups have VSR of more than 0.4, which has been designated visceral fat obesity. In contrast all female groups have VSR of lesser than 0.4 but obese DM subjects have the highest VSR. Visceral fat area per body weight ratio(VWR) showed increasing tendency in obese, IGT, and DM group. 4. Waist circumference and VWR showed strong correlation with metabolic parameters among anthropometric parameters. They were positively correlated with FFA-AUC during OGTT and negatively correlated with GH-AUC to L-dopa stimulation. CONCLUSION: Visceral fat accumulation are associated with insulin resistance, dyslipidemia and impairment of growth hormone secretion via increase of free fatty acid. The simple waist circumference may provide a more practical indicator that correlated with aMominal fat distribution and metabolic complications associated with obesity.
Adipose Tissue* ; Body Fat Distribution ; Body Weight ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Glucose Intolerance ; Glucose Tolerance Test ; Glucose* ; Growth Hormone ; Humans ; Ideal Body Weight ; Insulin Resistance ; Intra-Abdominal Fat ; Levodopa ; Lipid Metabolism* ; Male ; Obesity* ; Risk Factors ; Subcutaneous Fat ; Umbilicus ; Waist Circumference

We describe two cases of post-radiation sarcoma after breast cancer treatment. The first patient was a 61-year-old woman who underwent partial mastectomy of the right breast and adjuvant whole breast irradiation 7 years previously. Subsequently, a rapidly growing mass from the anterior arc of the right fifth rib was incidentally detected on an abdomino-pelvic computed tomography scan. The second patient was a 70-year-old woman who received neoadjuvant chemotherapy and a partial mastectomy of the left breast 9 years ago. Adjuvant irradiation was delivered to the whole breast and supraclavicular region. Subsequently, an approximate 8 cm mass developed in the left axillary area. Both patients received wide excision of the tumor with negative resection margins. The pathological diagnoses were osteosarcoma and undifferentiated pleomorphic sarcoma, respectively. Although post-radiation sarcomas are rare complications with a poor prognosis, enhanced awareness and early detection by clinicians are essential to improve outcomes via curative surgical resection.
Aged ; Breast ; Breast Neoplasms ; Female ; Humans ; Mastectomy, Segmental ; Middle Aged ; Neoplasms, Radiation-Induced ; Osteosarcoma ; Prognosis ; Ribs ; Sarcoma

We experienced a case of 67-year-old female with leiomyoma of the urinary bladder accompanied with voiding difficulty. Patient evaluation included IVP, ultrasound, pelvic CT scan and cystoscopy with biopsy. She had a tumor at anterior wall of the urinary bladder and the mass lesion of left ovary. The urinary bladder tumor was removed by partial cystectomy and the mass of left ovary was removed by total abdominal hysterectomy and lect salpingooophorectomy, simultaneously. Microscopically, the tumor of the urinary bladder had spindle shaped nucleus, polychromasia without mitotic figure, and was confirmed as the benign leiomyoma. The tumor of the left ovary was diagnosed as the thecoma on its histologic examination. The leiomyoma is an uncommon benign tumor of the urinary bladder. We report a case of leiomyoma of the urinary bladder with review of the literature.
Aged ; Biopsy ; Cystectomy ; Cystoscopy ; Female ; Humans ; Hysterectomy ; Leiomyoma* ; Ovary ; Thecoma ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Bladder*