PURPOSE: To evaluate the effects and complications of self-expandable metallic stent for the treatment of malignant esophagogastric strictures. MATERIALS AND METHODS: From September 1991 to March 1995, 110 stents were placed under fluoroscopic guidance in 103 patients. Of the 103 patients, there were 73 patients with esophageal cancer, 14 patients with gastric cancer, 12 patients with recurrence after surgery, three patients with esophageal compression by metastatic mediastinal lymphadenopathy, and one patient with esophageal invasion by lung cancer. Seventeen patients had esophagorespiratory fistulas. Under fluoroscopic guidance, 113 self-expandable metallic stents (99 Song stents, 14 Strecker stents) were placed in 103 patients. RESULTS: After stent placement, 68 (66%) of the patients could ingest solid food, 26 (25.2%) could ingest soft food, whereas three (2.9%) were not able to have food. Esophagorespiratory fistulas were occluded immediately after stent insertion. All stents were placed without any technical failures or procedural morbidity or mortality. Complications included restenosis in 13, gastroesophageal reflux in 11, stent tube migration in eight, massive bleeding in four, delayed esophageal perforation in one, stent obstruction by food impaction in one patient. CONCLUSION: Self-expandable metallic stent seems to be relatively safe and effective procedure in the palliative treatment of malignant esophagogastric stricture.
Constriction, Pathologic* ; Esophageal Neoplasms ; Esophageal Perforation ; Fistula ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Lung Neoplasms ; Lymphatic Diseases ; Mortality ; Music ; Palliative Care* ; Recurrence ; Stents* ; Stomach Neoplasms

BACKGROUND AND OBJECTIVES: Sudden deafness, an important disease characterized by abrupt sensorineural hearing loss, is rare in children and the prognosis in children is accepted to be worse than that in adults. However, clinical studies are not sufficient to define the clinical characteristics and prognosis of sudden deafness in children. The author analyzed clinical manifestation of sudden deafness in children and compared the treatment results of children with those of adults. SUBJECTS AND METHOD: A retrospective analysis was performed in 25 patients (29 ears) who were treated for sudden deafness from January 1993 to May 2008. RESULTS: 1) The overall hearing recovery rate (79%) was significantly higher in adults (53.7%). The prognosis in children less than 10 years old (73%) was also higher than that in adults. 2) The rate of complete recovery (61%) was higher in children than in adults (38.5%). CONCLUSION: The sudden deafness in children has unique clinical characteristics and the recovery rate is more favorable than in adults.
Adult ; Child ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Prognosis ; Retrospective Studies

PURPOSE: To evaluate and compare effectiveness of single acquisition CT and conventional angiography (CA) in grading stenosis in an artery of the lower extremity . MATERIALS AND METHODS: CA and CTA were performed in 12 patients with acclusive arterial disease of the lower extremity. CA extended from the bifurcation site of the abdominal aorta to the popliteal artery, 25-30 seconds after the injection of 120-150ml contrast media by a power injector at the rate of 2.5-3ml/sec via the antecubital vein. Using SSD and MIP methods, the data was reconstructed three-dimensionally. The artery was divided into five segments and the degree of lesion was definedas normal or mild (1-49%), moderate (50-74%), or severe stenosis (75-99%), or occlusion (100%). We retrospectively evaluated and compared the effectiveness of CTA and CA in the detection of each vessel and the grading ofstenosis. RESULTS: Although 11 segments were graded by CA as occluded, only five of these were similarly graded by CTA, and the remaining six were undergraded. The ratio of consistency for grading was 88.5% (46/52) in less thanmild stenosis, and 63.6% (7/11) in moderate or severe stenosis ; if the 11 segments detected only by CTA wereexcluded, the ratio of consistency for occlusion was 100%. Overall diagnostic accuracy was 84.2% (85/101) and whenthe 11 segments were excluded, this was 88.9% (80/90). Because of the capacity of CTA to distinguish vessles with greater than 50% stenosis from those with less than mild stenosis, sensitivity of 86.0%, specificity of 93.2% and accuracy of 89.1% were recorded. If the 11 vessels detected only by CTA were excluded, sensitivity and accuracy would be 91.3% and 92.2%, respectively. CONCLUSION: For detecting and grading stenosis in an artery of the lowerextremity, single acquisition CTA is more accurate than its conventional counter part, and we believe that CTA is a useful modality in the planning and follow-up of treatment.
Angiography* ; Aorta, Abdominal ; Arterial Occlusive Diseases* ; Arteries ; Constriction, Pathologic ; Contrast Media ; Follow-Up Studies ; Humans ; Lower Extremity* ; Popliteal Artery ; Retrospective Studies ; Sensitivity and Specificity ; Silver Sulfadiazine ; Tomography, Spiral Computed* ; Veins

BACKGROUND: Telomere shortening is thought to be involved in the pathophysiology of myeloid malignancies, but telomere lengths (TL) during interphase and metaphase in hematopoietic malignancies have not been analyzed. We aimed to assess the TLs of interphase and metaphase cells of MDS and telomerase activity (TA) and to find out prognostic significances of TL and TA. METHODS: The prognostic significance of TA by quantitative PCR and TL by quantitative fluorescence in situ hybridization (QFISH) of interphase nuclei and metaphase chromosome arms of bone marrow cells from patients with MDS were evaluated. RESULTS: MDS patients had shorter interphase TL than normal healthy donors (P<0.001). Average interphase and metaphase TL were inversely correlated (P=0.013, p arm; P=0.029, q arm), but there was no statistically significant correlation between TA and TL (P=0.258). The progression free survival was significantly shorter in patients with high TA, but the overall survival was not different according to average TA or interphase TL groups. Multivariable Cox analysis showed that old age, higher International Prognostic Scoring System (IPSS) subtypes, transformation to AML, no history of hematopoietic stem cell transplantation and short average interphase TL (<433 TL) as independent prognostic factors for poorer survival (P=0.003, 0.001, 0.005, 0.005, and 0.013, respectively). CONCLUSIONS: The lack of correlation between age and TL, TA, and TL, and the inverse relationship between TL and TA in MDS patients reflect the dysregulation of telomere status and proliferation. As a prognostic marker for leukemia progression, TA may be considered, and since interphase TL has the advantage of automated measurement by QFISH, it may be used as a prognostic marker for survival in MDS.
Arm ; Bone Marrow Cells ; Disease-Free Survival ; Fluorescence ; Hematologic Neoplasms ; Hematopoietic Stem Cell Transplantation ; Humans ; In Situ Hybridization ; Interphase ; Leukemia ; Metaphase ; Myelodysplastic Syndromes* ; Polymerase Chain Reaction ; Prognosis ; Telomerase* ; Telomere Shortening ; Telomere* ; Tissue Donors

PURPOSE: To determine the time of magnetic resonance(MR) signal intensity changes in denervated skeletal muscle and to compare MR imaging with electromyography(EMG) in the evaluation of peripheral nerve injury. MATERIALS AND METHODS: We evaluated MR imagings of denervated muscles after experimental transection of the sciatic nerve in five rabbits using 1.0T MR unit. MR imaging and EMG were performed 3 days and 1, 2 and 3 weeks after denervation. T1-weighted images(T1-WI), T2-WI and Short Tau Inversion Recovery(STIR) images were obtained. The signal intensity (SI) of muscles in the denervated and normal sides were visually and quantitatively compared. After measuring the SI of the normal and abnormal areas, the time of SI change was determined when there was significant difference (P<0.05) of SI between the normal and denervated sides. RESULTS: On STIR images, two of the five rabbits showed significant SI changes at the third day(P<0.05) and all showed significant changes(P<0.05)at the first week. On T2-WI, one rabbit showed significant SI changes at the third day, and all showed significant SI changes at the first week. On T1-WI, significant SI changes were seen in one rabbit at the second week and in one at the third. One week after denervation, all showed denervation potential on EMG. CONCLUSION: This study suggests that MR imaging using STIR images is a useful method in the evaluation of denervated muscle, and that MR signal changes of denervated muscle may precede EMG changes after denervation. To localize and to determine the severity of the peripheral nerve injury, future analysis of the distribution of abnormal MR SI in denervated muscles would be helpful.
Denervation ; Magnetic Resonance Imaging* ; Muscle, Skeletal* ; Muscles ; Peripheral Nerve Injuries ; Rabbits* ; Sciatic Nerve

PURPOSE: To evaluate percutaneous nephrostomy and ureteral stent placement in patients with postoperative ureteral injury. MATERIALS AND METHODS: Percutaneous nephrostomy and antegrade ureteral stent placement we reattempted in 12 patients with postoperative ureteral injuries. The previous operations which caused ureteral injuries included ureteroscopic extraction of ureteral stones(7), total abdominal hysterectomy due to uterinemyoma(2), ureteroscopic biopsy in a patient with ureteral tuberculosis(1), open ureteroplasty due to retroperitoneal fibrosis(1), and ureterocystostomy during renal transplantation(1). After percutaneousnephrostomy, a 7.0 F ureteral stent was inserted in each patient. The stent was removed under cystoscopic guidancefour to six weeks after this procedure. Urinalysis was performed to evaluate the presence of urinary tractinfection after ureteral stent placement. Ultrasonography and/or intravenous urography were performed three weeksafter stent placement, and every six months after the stent removal. RESULTS: Percutaneous nephrostomy andplacement of an antegrade ureteral stent were successfully performed in all 12 patients. In three patients, the diagnosis of ureteral injuries was made immediately and in nine was delayed for between two and nineteen days. Theureteral stents remained in position for 25-95 days (average, 51) ; no evidence of urine leakage or ureteralstricture was seen on the follow-up examinations carried out from six months to several years after removal of thestent and no case required reintervention. CONCLUSION: Percutaneous nephrostomy and antegrade ureteral stentingare easy to perform, provide for the drainage of urine, cause no significant complication and show a successful therapeutic effect, and are this effective non-operative interventional techniques for patients with postoperative ureteral injury.
Biopsy ; Drainage ; Follow-Up Studies ; Humans ; Hysterectomy ; Nephrostomy, Percutaneous* ; Stents* ; Ultrasonography ; Ureter* ; Urinalysis ; Urography

The cytogenetic analysis of mesenchymal stromal cells (MSCs) is essential for verifying the safety and stability of MSCs. An in situ technique, which uses cells grown on coverslips for karyotyping and minimizes cell manipulation, is the standard protocol for the chromosome analysis of amniotic fluids. Therefore, we applied the in situ karyotyping technique in MSCs and compared the quality of metaphases and karyotyping results with classical G-banding and chromosomal abnormalities with fluorescence in situ hybridization (FISH). Human adipose- and umbilical cord-derived MSC cell lines (American Type Culture Collection PCS-500-011, PCS-500-010) were used for evaluation. The quality of metaphases was assessed by analyzing the chromosome numbers in each metaphase, the overlaps of chromosomes and the mean length of chromosome 1. FISH was performed in the interphase nuclei of MSCs for 6q, 7q and 17q abnormalities and for the enumeration of chromosomes via oligo-FISH in adipose-derived MSCs. The number of chromosomes in each metaphase was more variable in classical G-banding. The overlap of chromosomes and the mean length of chromosome 1 as observed via in situ karyotyping were comparable to those of classical G-banding (P=0.218 and 0.674, respectively). Classical G-banding and in situ karyotyping by two personnel showed normal karyotypes for both cell lines in five passages. No numerical or structural chromosomal abnormalities were found by the interphase-FISH. In situ karyotyping showed equivalent karyotype results, and the quality of the metaphases was not inferior to classical G-banding. Thus, in situ karyotyping with minimized cell manipulation and the use of less cells would be useful for karyotyping MSCs.
Azure Stains ; Chromosome Banding/*methods ; Humans ; In Situ Hybridization, Fluorescence/*methods ; Karyotyping/*methods ; Mesenchymal Stromal Cells/*cytology