No abstract available.
Colorectal Neoplasms* ; Humans* ; Oncogenes* ; Point Mutation* ; Polymerase Chain Reaction*

OBJECTIVE: The authors reviewed experience with patients harboring intracerebral hematoma (ICH) treated by stereotactic computed tomography (CT) guided thrombolysis and aspiration and evaluated feasibility, safety and prognostic factors of this procedure. METHODS: One hundred and ten patients with supratentorial ICH >25 ml without underlying structural etiology or coagulopathy were recruited. The patients with Glasgow Coma Scale (GCS) <5 were excluded. A catheter was directed stereotactically into the ICH under CT guidance. Hematoma aspiration was followed by instillation of urokinase. This was repeated every 6 hours until less than half of its initial volume remained. For analysis of prognostic factors, we classified them into two groups;good (Glasgow Outcome Scale (GOS) > or =4) and bad (GOS<4) prognosis group, and performed comparative analysis between two groups. RESULTS: Mean age was 59.8 years. The baseline hematoma size ranged from 15 to 72 mL. ICH volume reduced by an average of 74.2%. At 6 months after the procedure, 56 patients had achieved a good recovery, 29 patients were dependent, and 10 remained vegetative. Fifteen patients died in hospital. The main good prognostic factors were young age, small ICH volume, high GCS, absence of rebleeding, underlying disease and complications. CONCLUSION: CT-guided thrombolysis and aspiration appears safe and effective in the reduction of ICH volume. Patients of ICH presenting with bad prognostic factors should require frequent radiological investigation and more meticulous procedure. Further studies are needed to assess optimal thrombolytic dosage and must include controlled comparisons of mortality, and disability outcome.
Catheters ; Glasgow Coma Scale ; Hematoma* ; Humans ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator

No abstract available.
Pregnancy* ; Ultrasonography*

Cutaneous metastases from internal carcinomas are relatively rare, especially from pancreatic carcinoma. Pancreatic carcinomas are usually adenocarcinomas which arise in the head of the gland, and are known to rapidly metastasize to the lymphatic system by permeation and embolization. We report a case of cutaneous metastasis from pancreatic adenocarcinoma. in 74-year-old male patient who have two pea sized, slight erythematous nodules on the lower abdomen and posterior side of the neck.
Abdomen ; Adenocarcinoma* ; Aged ; Head ; Humans ; Lymphatic System ; Male ; Neck ; Neoplasm Metastasis* ; Peas

The symptoms of the rheumatoid arthritis are variable enough to be ranged from mild to severe case. Synovectomy, fusion, and total knee replacement are to be applied according to the site and degree of involvement as surgical treatments. In the analysis, we compare the result of PCL retention TKR patients with those of PCL sacrificing TKR patients and of cemented TKR patients with those of cementless TKR patients. Function of the knee was evaluated using the knee score system of the Hospital for Special Surgery. From Nov, 1982 to Nov. 1990, total knee replacment was performed on 128 knees in 77 patients with rheumatoid arthritis at the Kyung Hee University Hospital and were followed for from two to ten years(average, four years eleven months). 1. The age at operation was ranged from 21 years to 72 years(average 53.2 years). There were seventy one female and six male patients. 2. The cruciate sacrificing prosthesis(group I ) were 42 cases and cruciate retention prosthesis(group II) were 86 cases. 3. The average preoperative range of motion was 85. 5 degree and the average post-operative range of motion was 107. 7 degree. Group I changed from 74. 7 degree to 105. 8 degree and Group II changed from 90. 5 degree to 108. 5 degree. 4. The average preoperative flexion contracture was 28. 7 degree and average post-operative flexion contracture was 7.8 degree. Group I changed from 37 degree to 8.4 degree and Group II changed from 24. 7 degree to 7. 5 degree. 5. The average preoperative tibiofemoral angle was varus 7. 4 degree in 69 cases and valgus 7. 6 degree in 59 cases. The average postoperative tibiofemoral angle was valgus 7. 2 degree. 6. The average preoperative knee Rating Score was 35. 2 point and the average postoperative score improved to 82. 7 point. Group I changed from 31. 3 point to 79. 4 point and Group II changed from 37 point to 84. 2 point. 7. 107 cases were cemented TKR and the 21 cases were cementless. There was no significant difference in those groups. 8. Additional operations were THR in eight cases, TER in five cases, TAR in four cases, TSR in one case, TWR in one case, Swanson prosthesis in one case, knee synovectomy in two cases, elbow synovectomy in three cases, and wrist synovectomy in two cases. 9. Complication included loosening in one case, partial ankylosis in three cases, and deep infection in one case.
Ankylosis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Elbow ; Female ; Humans ; Knee ; Male ; Prostheses and Implants ; Range of Motion, Articular ; Wrist

The combination of an intradermal nevus with epidermal cyst or other adnexal tumors has often been described since 1952. Most of these reports have involved the coexistence of common epidermal cysts and melanocytic nevi. Herein, we report a 21-year-old Korean male, who initially presented to our department with a rapidly enlarging preexisting nevus on his back. The mass was surgically excised and histopathologically showed intradermal nevus combined with epidermal cyst.
Epidermal Cyst ; Humans ; Male ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented ; Young Adult

No abstract available.
Breast Neoplasms* ; Tamoxifen*

PURPOSE: While the safety and efficacy of laparoscopic adrenalectomy are relatively well documented, this procedure remains challenging for pheochromocytoma. The purpose of our investigation was to assess the perioperative profiles of laparoscopic adrenalectomy (LA) with those of open adrenalectomy (OA) in patients with pheochromocytoma. MATERIALS AND METHODS: Between January 1997 and October 2005, 31 patients with pheochromocytoma underwent surgical removal, including 15 LA and 16 OA. The LA was performed via a lateral decubitus transperitoneal approach. The mean tumor size was similar in both groups (LA 6.0cm vs. OA 5.7cm). All patients underwent extensive preoperative medical preparation with alpha-blockers. The intraoperative hemodynamic instabilities and perioperative profiles were retrospectively analyzed. RESULTS: No conversion to open surgery was required with either procedure and no mortality was observed. Hypertensive crisis (systolic blood pressure>200mmHg) and severe tachycardia (heart rate>100/min) were more common in the OA group (LA 13.3 and 26.7% vs. OA 56.3 and 62.5%). The mean operating times for both groups were similar (LA 182.0+/-47.0 min vs. OA 183.1+/-66.5 min), but the duration of hospitalization was shorter in the LA group (LA 5.3+/-2.2 days vs. OA 6.8+/-1.0 days). The estimated blood loss was greater in the OA group (LA 103.3+/-44.2ml vs. OA 159.4+/-66.8ml). Intravenous morphine was needed in 56.3% of the OA, but in only 13.3% of the LA group. There were no significant differences in the postoperative complications between the two groups. CONCLUSIONS: The laparoscopic resection of pheochromocytomas can be accomplished safely and effectively. A short hospital stay, with minimal perioperative morbidity and the eradication of endocrinopathy, support the minimally invasive approach for adrenalectomy in patients with pheochromocytoma.
Adrenalectomy* ; Conversion to Open Surgery ; Hemodynamics ; Hospitalization ; Humans ; Laparoscopy ; Length of Stay ; Morphine ; Mortality ; Pheochromocytoma* ; Postoperative Complications ; Retrospective Studies ; Tachycardia

No abstract available.
Adrenocortical Carcinoma* ; Stomach Neoplasms*

BACKGROUND: To determine whether multiple short-term surveillances are as effective as long-term surveillance for estimating the incidence rates of nosocomial infections (NIs), we prospectively performed 9-month surveillance in four intensive care units (ICUs). METHODS: NI surveillance was performed prospectively from November 2002 through July 2003, with long-term surveillance performed over the 9-month period, and short-term surveillance performed during the middle 3 weeks of each calendar quarter. The incidence rate of NIs or device-associated infections was calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: We observed no significant differences between the incidence rates of total NIs determined from these two methods (9.6 [CI95 8.2-11.3] vs 10.4 [CI95 7.5-14.4], P=.66). In addition, these two methods did not differ significantly in estimating the rates of ventilator-associated pneumonia (5.1 [CI95 3.4-7.6] vs 7.5 [CI95 3.8-15.0], P=.35), catheter-associated urinary tract infection (2.4 [CI95 1.7-3.4] vs 1.7 [CI95 0.7-4.1], P=.47), and central line-associated bloodstream infection (2.2 [CI95 1.4-3.4] vs 3.7 [CI95 1.9-7.4], P=.21). Plotting of the NI rates showed that the trends in multiple short-term surveillances were similar to those in long-term surveillance, except in one ICU. CONCLUSION: Our findings suggest that multiple short-term surveillances could replace long-term surveillance in estimating the baseline incidence rates of NIs in the circumstances of the relatively large number of patients in the ICUs, which would be especially useful in countries with limited resources.
Cross Infection* ; Epidemiology ; Humans ; Incidence ; Infection Control ; Intensive Care Units ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Urinary Tract Infections