There has been no adequate diagnostic method for the diagnosis of intrascrotal lesions until recent days. Butafter the development of radionuclide testicular scan, early and relatively accurate diagnosis of the testicularlesions are possible. So the authors analyzed the 32 cases of patients who were examined by testicular scan andconfirmed by follow up study or operation, and the results are as follows; 1. These 32 cases consists of 13 casesod epididymitis, 7 cases of testicular torsion, 4 of cryptorchism, 2 of testicular tumor and etc. The over alldiagnostic accuracy is about 69%. 2. In epididymitis, the diagnostic accuracy is 85%(11/13) and the findings ofscan are increased perfusion in radionuclide angiogram and hot activity noted mainly in peripheral portion of thetesticle in static image. 3. In cases o testicular torsion, diagnostic accuracy is 86%(6/7). Acute torsion showsnormal perfusion in angiogram and round cold area instatic image. But in missed torsion, perfusion is increasedand round cold area wit surrounding hyperemia is noted in static image. Radionuclide testicular scan seems to benoninvasive, inexpensive, easily available and simple to perform with low gonadal radiation dose. So it can bevery useful as the first study in patients with acute testicular symptoms.
Cryptorchidism ; Diagnosis ; Epididymitis ; Follow-Up Studies ; Gonads ; Humans ; Hyperemia ; Male ; Methods ; Perfusion ; Spermatic Cord Torsion

It is well known that halogenated anesthetics have been mainly used for inhalation anesthesia these days. However many controversies still exist concerning hepatic cellular damage after halothane anesthesia. Although several articles have been issued concerning the effects of halogenated anesthetics for hepatitis B surface antigen positive patients, a study of frequent research and strict case collections is meaningful. The authors observed the effects of enflurane anesthesia on 15 HBsAg positive patients who had not recognized themselves whether they had hepatitis symptoms or were carriers. During the period of study, all groups(enflurane study group and enflurane and halothane control groups) did not experience any difficulty with the anesthesia, blood transfusion, and jaundice, etc. The comparative data of liver function tests did not show great differences during the convalescent period. According to this and other recent studies, we can positively conclude that halogenated anesthetics, especially enflurane, may favorably be used to administer HBsAg positive patients, unless any undesirable problems related to anesthesia exist.
Anesthesia* ; Anesthesia, Inhalation ; Anesthetics ; Anesthetics, Inhalation ; Blood Transfusion ; Enflurane* ; Halothane ; Hepatitis ; Hepatitis B Surface Antigens* ; Humans ; Jaundice ; Liver Function Tests

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

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

Classification ; Consensus ; Diagnosis ; Hematologic Neoplasms ; Hematology ; Lymphoid Tissue

BACKGROUND: Multi-loculated empyema makes treatment difficult, and more so when thoracentesis or chest tube drainage fails. MATERIALS AND METHODS: From December 1991 to December 1997, we performed closed rib resectional drainage for 18 cases of loculated empyema on the fibrinopurulent or early chronic phase. RESULTS: Surgery was performed on patients with loculated empyema complaining of persistent symptoms due to failure of treatment by thoracentesis (8 cases) or chest tube drainage (10 cases). Predisposing factors of empyema were pneumonia in 13 cases, clotted hemothorax in 3 cases, cholecystectomy, and tuberculous pleurisy in 1 case. Causal organisms were cultured in 8 cases (42.1%), and methicillin-resistant staphylococcus aureus was found in 3 cases, pseudomonas aeruginosa in 2 cases, and enterococcus aerogens, alpha-hemolytic streptococcus, and acinetobacter baumannii were found in 1 case. Size of loculations was various, and computed chest tomogram showed multiple loculations of empyema numbering 1~4 (mean 1.78+/-1.00). Operating time was relatively short, about 55~140 mins (mean 102.8+/-30.8). All toxic symptoms including fever disappeared postopratively and general conditions improved very quickly in all patients. Length of chest tube indwelling time and hospital stay after surgery were 3~42 days (mean 11.4+/-11.5) and 6~36 days (mean 12.9+/-8.1), respectively. Complications of prolonged drainage occurred in 2 cases and no death occurred. There were no recurrences and chest x-rays taken 3~6 months after surgery showed normal findings in 14 cases and slight pleural thickening in 4 cases. CONCLUSIONS: Closed rib resectional drainage requires very simple techniques and has excellent outcomes and little complications, therefore, we think that it is the choice of operation for patients with loculated empyema on the fibrinopurulent or early chronic phase.
Acinetobacter baumannii ; Causality ; Chest Tubes ; Cholecystectomy ; Drainage* ; Empyema* ; Enterococcus ; Fever ; Hemothorax ; Humans ; Length of Stay ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pseudomonas aeruginosa ; Recurrence ; Ribs* ; Streptococcus ; Thorax ; Tuberculosis, Pleural

PURPOSE: The aim of this study was to assess the clinicopathological characteristics and prognosis of colorectal mucinous carcinomas. METHODS: 1, 809 patients who underwent curative resection, between January 1989 and December 1999, for colorectal carcinomas, were enrolled in this study. Of these, 128 patients had more than 50% mucin secreting acini that could be classified as the mucinous type. These mucinous carcinoma patients were compared with 1, 681 non-mucinous carcinoma patients, in order to evaluate differences in their clinicopathological characteristics, recurrence pattern and prognosis. RESULTS: The incidence of mucinous carcinomas was 7.1%. The mean age of the mucinous carcinoma patients was younger than the non-mucinous carcinoma patients (P=0.001). The mucinous carcinomas occurred in the right colon more frequently than non-mucinous carcinoma, and the size of the tumor was larger (P<0.001). There were no significant differences in the loco-regional and systemic recurrence rates, but the systemic recurrence pattern of the mucinous carcinomas was different from those of the non-mucinous carcinomas. With a mucinous carcinoma, the most common site for systemic recurrence was the peritoneal metastasis, whereas in a non-mucinous carcinoma, was the liver. There was no significant difference in the 5-year survival rate between the two groups. CONCLUSION: In a mucinous carcinoma, the most common pattern of treatment failure was a peritoneal recurrence. The hepatic recurrence rate of the mucinous carcinomas was less than that of the non-mucinous carcinoma. Therefore, more aggressive diagnostic and therapeutic approaches, under the consideration of peritoneal recurrence in mucinous carcinomas, will be required.
Adenocarcinoma, Mucinous* ; Colon ; Colorectal Neoplasms ; Humans ; Incidence ; Liver ; Mucins* ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Survival Rate ; Treatment Failure

BACKGROUND: The purpose of this study was to evaluate the gender-related changes in the function and distribution of alpha1-adrenoceptors in the distal mesenteric artery of streptozotocin (STZ)-induced diabetic rats at the level of alpha1-adrenoceptor subtypes. METHODS: Diabetes was induced by intravenous injection of STZ in a dose of 60 mg/kg through the tail vein in 8 week-old male or female Sprague-Dawley rats (n = 13/group). Age-matched normal rats (n = 15) were used as a control group. Four weeks after STZ injection, the change in mean arterial pressure caused by a 45degrees tilting was recorded. The alpha1-adrenoceptor subtypes mediating contractions of the distal mesenteric artery were investigated using the agonist, phenylephrine as well as subtype-selective antagonists including prazocin, 5-methylurapidil, and BMY 7378. The expression of alpha1-adrenoceptor subtypes of each artery was examined by immunofluorescence staining and western blotting using subtype selective antibodies. RESULTS: Compared with normal male rats, the contractile response to phenylephrine was decreased in the distal mesenteric artery in normal female rats. Moreover, a decrease in contractile force was observed in STZ-induced diabetic rats compared with age-matched controls. Western blotting revealed that there was the difference between normal male and female rats in manifestation of the alpha1D-adrenoceptor. In STZ-induced male and female diabetic rats, all alpha1-adrenoceptor subtypes were decreased in distal mesenteric arteries, compared with normal rats. CONCLUSIONS: There was the gender-related functional difference of alpha1-adrenoceptors in normal rats. In both male and female rats, diabetes decreased the contractile response in mesenteric arteries, which might be caused by the overall change in alpha1-adrenoceptor.
Animals ; Arterial Pressure ; Arteries ; Blotting, Western ; Contracts ; Diabetes Mellitus, Experimental ; Female ; Fluorescent Antibody Technique ; Humans ; Injections, Intravenous ; Male ; Mesenteric Arteries ; Negotiating ; Phenylephrine ; Piperazines ; Rats ; Rats, Sprague-Dawley ; Receptors, Adrenergic, alpha-1 ; Streptozocin ; Veins

Neurofibromatosis 1(NF-1, Von Recklinghausen disease) and Neurofibromatosis 2(NF-2, bilateral acoustic neurinoma) have been established as distinct disorders by the National Institutes of Health(NIH) Consensus Development Conference in 1988. We recently have encountered a patient of NF-2 who develop multiple intracranial and spinal tumors 12 years after the surgical treatment of Schwannoma of lumbar nerve roots. The tumors were right acoustic neurinoma, left cerebellopontine angle(CPA) meningioma, multiple intracranial meningiomas, intraorbital glioma, multiple ependymomas of the brain stem and cervical spinal cord, and meningiomas of cervical nerve roots. We present this case with a review of reported cases of neurofibromatosis.
Academies and Institutes ; Acoustics ; Brain Stem ; Ependymoma ; Glioma ; Humans ; Meningioma ; Neurilemmoma ; Neurofibromatoses* ; Neurofibromatosis 2* ; Neuroma, Acoustic ; Spinal Cord

Since the epidural catheterization has been widely used for the purpose of anesthesia, diagnosis and pain control, there are various undesirable complications and hazards through the technical procedure or catheterization itself. Authors have experienced several hazards of location of the epidural catheter tip which were detected by epidurography performed the 1st. or 2nd. postoperative day with 50% Angiograffin. Hazards were as follows; 1) Single air bubble in the epidural space. 2) Inappropriate placement of the catheter tip. 3) Kinking of catheter in the epidural space. 4) Intravascular placement of the catheter.
Anesthesia ; Catheterization* ; Catheters* ; Diagnosis ; Epidural Space