PURPOSE: We performed a retrospective study to compare the accuracy between conventional CT staging and intraoperative staging for advanced gastric cancer. MATERIALS AND METHODS: Sixty patients with advanced gastric cancer were included in this study during the recent 2 year-period. All were pre- and posto- peratively diagnosed as advanced gastric cancer. CTwas performed with G E 9800 and Somatom DR3 under conventional technique in 50 and with others in 10 referred patients. The CT staging for T and N category with emphasis on incurable factor, if not resacted, were performed. And we compared the accuracy between conventional CT and intraoperative staging. The final histo-pathologic staging was used as a gold standard. RESULTS: Accuracy of CT and operation for T4(n=l7) factor is 76.9 % and 86.2 % respectively. Overestimation rate for T4 was 9.3 % by CT and 6.1% by operation, and underestimation rate for was 13.8 % and 7.7 % respectively. Accuracy of CT and operation for N (n=60) factor was 50 % and 60 % respectively. Overestimation rate for N factor was 18.3 % by CT and 18.3 % by operation, and underestimation rate for N factor was 31.7 % and 21.7 % respectively. Correct Tand IM staging was possible only in 33% by CT and 38% by intraoperative assessment. CONCLUSION: Conventional CT and intraoperative staging for incurable T/N factor in advanced gastric cancer have a potential limitations, especially for N factor. Therefore, more reliable modality or technique such as dynamic scanning by spiral CT, transabdominal or endoscopic ultrasonography should be preoperatively performed to complement infrequent errors in intraoperative staging. Furthermore, a histology-oriented surgical approach seems essential in selecting the most appropriate surgical procedure.
Complement System Proteins ; Endosonography ; Fibrinogen ; Humans ; Retrospective Studies ; Stomach Neoplasms* ; Tomography, Spiral Computed

PURPOSE: To investigate the changes in postural balance before and after total hip arthroplasty (THA) using computerized dynamic posturography MATERIALS AND METHODS: This was a prospective study of 18 patients undergoing total hip arthroplasty. We evaluated each patient's postural balance prior to, and at least 12 months after, total hip arthroplasty by using computerized dynamic posturography. We compared the preoperative equilibrium scores with the postoperative equilibrium scores. Clinical results were assessed for all patients preoperatively and postoperatively using the Harris hip scoring system. We investigated whether postural balance improves, and what factors were related to this parameter. RESULTS: Patients showed significant improvement in postural balance by means of proprioception after total hip arthroplasty (p<0.05). We found, during intercepting visual compensation, that an increase in the Harris hip score was correlated with an improvement in balance (p<0.01, r = 0.649). CONCLUSION: Patients with Total hip arthroplasty showed improvement in dynamic postural balance through proprioceptive recovery, and balance improved as the Harris hip score increased. This resulted in decreased pain, recovery of articular function, enhancement of physical activity, and ultimately improvement in postural balance by means of total hip arthroplasty.
Arthroplasty ; Compensation and Redress ; Hip ; Humans ; Motor Activity ; Postural Balance ; Proprioception ; Prospective Studies

Since the publication of the first edition of Korean clinical practice guidelines of secondary stroke prevention, encouraging data from recent large clinical trials and meta-analysis have led us to consider many therapeutic options in the treatment of symptomatic extracranial carotid stenosis. Accordingly, the writing group of Clinical Research Center for Stroke decided to provide recent views on the therapeutic revascularization of extracranial carotid stenosis, and timely evidence-based recommendations. In this updated version, new evidences about carotid angioplasty/stenting, treatment timing, and perioperative preparation are given, and qualifying conditions for operator are elucidated. This refinement was based on current consensus between Korean Society of Intravascular Neurosurgery, Korean Society of Interventional Neuroradiology, and Korean Society of Cerebrovascular Surgery and approved by Korean Stroke Society, Korean Neurological Association, and Korean Society of Geriatric Neurology. These recommendations are subject to future correction based on new evidences from ongoing and future studies.
Carotid Arteries ; Carotid Stenosis ; Consensus ; Endarterectomy, Carotid ; Neurology ; Neurosurgery ; Publications ; Secondary Prevention ; Stroke ; Writing

Since the release of first Korean Clinical Practice Guideline of Stroke in 2009, many important new evidences have emerged in the field of thrombolytic therapy. Among the recent developments are the extended therapeutic time window of intravenous (IV) tissue plasminogen activator (tPA) up to 4.5 hours after onset, and the efforts for the wider application of IV thrombolysis to patients with minor stroke and elderly patients over 80 years old. Debates about the optimal dose of IV tPA according to the ethnic population is still ongoing. Further evidences for the efficacy of intra-arterial thrombolysis have also accumulated, including the application of various novel mechanical devices with promising results. Thus update of guideline became necessary and we revise the acute stroke management guideline, focusing on the thrombolytic therapy.
Aged ; Humans ; Stroke ; Thrombolytic Therapy ; Tissue Plasminogen Activator