Marchiafava-Bignami disease (MBD) is characterized by cerebral white matter lesions associated with chronic alcoholism. Premortem diagnosis of MBD is usually based on history and clinical manifestations. We report a case of acute MBD in which diffusion-weighted MRI (DWI) showed high signal intensities along the white matter including the corpus callosum. DWI may be useful in premortem diagnosis of acute MBD.
Alcoholism ; Corpus Callosum ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Humans ; Leukoencephalopathies ; Marchiafava-Bignami Disease

PURPOSE: The aim of this study was to evaluate the effectiveness and indication of radiofrequency ablation(RFA) using renal VX2 tumors by implantation of VX2 tumor cells under the renal capsule in rabbits. MATERIALS AND METHODS: Ten rabbits were injected with 30-40microliter VX2 tumor cells(1.2x10(7) viable cells/ml) under the renal capsule of the right kidney by right subcostal incision. On the 14th day after the tumor cells were implanted, we checked for the development of renal tumors, and the sizes and shapes(exophytic or central) of the tumors by the use of computed tomography. We performed RFA in the renal VX2 tumors with a 17G StarBurst electrode through kidney exposure. After the first and third day following RFA, renal function was checked. On the third day, we performed CT and harvested the kidneys for gross and microscopic evaluation. RESULTS: We confirmed the development of renal VX2 tumors in nine cases. Tumor shapes were exophytic in seven cases and central in two cases; the mean size of the tumors was 2.1 cm(range, 1.1-3.8cm). In all tumors, RFA was performed. From the use of enhanced CT after RFA on the third day, all of the lesions treated with RFA showed no enhancement. From the pathological findings, coagulative necroses were seen on all of the lesions treated with RFA. The necrotized tumor size after RFA was not different statistically as measured by CT and a pathological examination (p=0.833) CONCLUSIONS:: In centrally located renal tumors, we experienced thermal injury in pelvocalyceal systems. RFA is an effective method for nephron sparing surgery as the tumor cells completely disappear and there is preserved renal function and the procedure is easy to apply. We suggest that the RFA method for exophytic renal tumors is more effective than other procedures.
Rabbits ; Animals

BACKGROUND AND OBJECTIVES: Previous studies have shown that uptake of 18Fluoro-2-deoxy-glucose in head and neck cancer, as determined by the standardized uptake value (SUV) on positron emission tomography scan (PET scan), is associated with the biology of tumor. The aims of this study were to confirm the association with the biology of tumor and to establish whether a high SUV had prognostic significance. MATERIALS AND METHOD: Thirty patients with the head and neck cancer diagnosed as squamous cell carcinoma underwent a PET scan before treatment. SUVs were analyzed for possibility correlated with diseasefree survival. RESULTS: In univariate survival analysis, when patients were divided into two groups based on the SUV cut-off value of 8, the group whose SUV was greater than 8 in the pre-treatment PET scan showed significantly worse outcome (p=0.029). Correlation analysis demonstrated that SUV provided prognostic information independent of the tumor size, pathologic differentiation and stage. CONCLUSION: We conclude that high FDG uptake on PET (SUV >8 in pre-treatment PET scan) is an important prognostic indicator for poor outcome. Identified patients are thought to require intensive treatment protocol and more careful follow up.
Biology ; Carcinoma, Squamous Cell ; Head and Neck Neoplasms* ; Head* ; Humans ; Positron-Emission Tomography*

PURPOSE: We wanted to clinically evaluate the antibiotic therapy used from pre- to postlaparoscopic cholecystectomy along with the improved surgical techniques and instruments and the patient nutrition. METHODS: We prospective studied 105 patients who were treated with laparoscopic cholecystectomy for acute and chronic cholecystitis at Busan St. Mary Hospital from March 2007 to January 2008. The two groups were divided as follows: (A) the group was not injected with antibiotics, and the other group (B) was injected with antibiotics. We did not used antibiotics when the patient had no acute aggravating symptoms, and we exclude the patients with old age (<70 years), a past history of diabetes mellitus (DM) or hypertension (HTN), and a past operation history. RESULTS: Between the two group, there was no difference when they were compared for age, BMI (Body Mass Index), the operation time (minute) and the length of the hospital stay: (A) Group 49.3+/-13.0 years, 24.4+/-3.2 kg/m2, 37.9 +/- 10.0 minute and 4.6 +/- 1.3 days, respectively, and (B) Group 55.9+/-15.6 years, 23.5+/-3.5 kg/m2, 43.2 +/- 23.8 minute and 5.5 +/- 2.5 days, respectively. There was a significant different in the leukocyte count and the % of neutrophils: (A) Group 6396microliter(-1) and 53.4%, respectively and (B) Group 9354microliter(-1) and 66.6%, respectively. In (B) group, there were 2 cases of atrial fibrillation, 1 case of diarrhea and 1 case of wound seroma. There were no surgical related complications in group (A). CONCLUSION: For the well nourished chronic cholecystitis patients, the use of the prophylatic antibiotics may be less effective because of the many drug-induced side effects. More studies about the use of prophylactic antibiotics are needed.
Anti-Bacterial Agents ; Atrial Fibrillation ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Diabetes Mellitus ; Diarrhea ; Humans ; Hypertension ; Leukocyte Count ; Prospective Studies ; Seroma

OBJECTIVE: To retrospectively evaluate the intermediate results of radiofrequency ablation (RFA) of small renal masses (SRMs). MATERIALS AND METHODS: Percutaneous or laparoscopic RFA was performed on 48 renal tumors in 47 patients. The follow-up studies included a physical examination, chest radiography, creatinine level, and contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 35 patients underwent a follow-up biopsy. Recurrence was defined as contrast enhancement on imaging studies after 3 months, lesion growth at subsequent imaging, or viable cancer cells on follow-up biopsy. RESULTS: Technical success was achieved in 43 (89.6%) of 48 renal tumors. The mean tumor size was 2.3 cm and the mean follow-up period was 49.6 months. Repeated RFA was necessary in 5 tumors due to incomplete ablation. The overall complication rate was 35.8%, of which 96.2% were mild complications. Serum creatinine levels at 12 months after RFA did not differ from those before RFA (1.28 vs. 1.36 mg/dL). Four patients were found to have recurrence at various follow-up intervals, and distant metastasis was not found in any cases. CONCLUSION: RFA appears to be a useful treatment for selected patients with SRMs. Our 4-year follow-up results disclose an excellent therapeutic outcome with RFA, while achieving effective local tumor control.
Adult ; Aged ; Catheter Ablation/*methods ; Contrast Media/diagnostic use ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms/*surgery ; Laparoscopy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Complications ; Radiography, Thoracic ; Reoperation ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVE: Speedy surgical orthodontics (SSO), an innovative orthodontic treatment, involves the application of orthopedic forces against temporary skeletal anchorage devices following perisegmental corticotomy to induce movement of specific dental segments. Herein, we report the biological effects of SSO on the teeth and periodontal structures. METHODS: Five beagle dogs were divided into 2 groups and their 6 maxillary incisors were retracted en masse by applying 500 g orthopedic force against a single palatal mini-plate. Retraction was performed without and with perisegmental corticotomy in groups I and II, respectively. All animals were killed on the 70th day, and their periodontal structures were processed for histologic analyses and scanning electronic microscopy (SEM). The linear distance between the third maxillary incisor and canine was used as a benchmark to quantify the retraction amount. RESULTS: Retraction was markedly faster and retraction amount greater in group II than in Group I. Surprisingly, Group II did not show any root resorption despite extensive retraction, while Group I showed prominent root surface irregularities. Similarly, SEM showed multiple resorption lacunae in Group I, but not in Group II. CONCLUSIONS: SSO is an effective and favorable orthodontic approach for major en masse retraction of the maxillary anterior teeth.
Animals ; Dogs ; Electronics ; Electrons ; Incisor ; Microscopy ; Orthodontics ; Orthopedics ; Root Resorption ; Tooth

BACKGROUND AND OBJECTIVES: Differentiated thyroid carcinoma (DTC) is a known malignant tumor arising from the follicular epithelium in thyroid gland. Although the prognosis for patients with DTC is generally good, appropriate surgical management can further reduce recurrence and cancer death rates significantly. The therapeutic methods performed are total thyroidectomy plus radioactive iodine (131I) therapy and life-long thyroid-stimulating hormone (TSH) suppression. Histopathologically, DTC contains papillary and follicular adenocarcinoma. In numerous studies, staging systems-AMES, AGES, MACIS, etc-have been created to evaluate prognostic outcome. By applying staging systems, we have treated 394 patients with DTC since 1998. The purpose of our study was to analyze characteristics of recurrent cases and evaluate remission rates of recurrent cases according to diagnostic methods. MATERIALS AND METHOD: From January 1998 to December 2001, we performed 630 thyroidectomies and 487 malignant tumors (421 papillary, 28 follicular, 20 medullary, 12 undifferentiated carcinoma and 6 other malignant tumors). We analyzed 394 DTC cases; excluding other malignancy, 65 cases were recurrent cancer (58 papillary and 7 follicular carcinoma). The medical records of 394 patients with DTC treated at our hospital were reviewed retrospectively. We analyzed impact of primary surgery on recurrence in 65 recurrent patients and compared the remission rates of those patients using physical examination with those using laboratory tests and imaging studies. RESULTS: 347 patients with DTC were treated initially in our hospital and 18 patients showed recurrence. Among them, lobectomy was performed as a primary surgery in 69 patients of whom one (1.4%) had recurrence. Forty-seven patients with DTC treated initially in other hospitals were referred to our hospital. Lobectomy was performed as a primary surgery in 23 patients (54.7%). Recurrence of 32 patients was detected by palpation. Of these patients, the remission rate was 25.0%, whereas patients diagnosed by laboratory tests and imaging systems showed 53.3% remission rate (p=0.056). CONCLUSION: The extent of primary thyroid resection appeared to have significant impact on the recurrence of DTC. In view of this, we should apply staging system strictly in treating DTC-total thyroidectomy and central neck dissection in high-risk groups. In following up patients, we should check the thyroglobulin level and use image tests like computed tomography and positron emission tomography to detect recurrence earlier.
Adenocarcinoma, Follicular ; Adenocarcinoma, Papillary ; Carcinoma ; Epithelium ; Humans ; Iodine ; Medical Records ; Mortality ; Neck Dissection ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Palpation ; Physical Examination ; Positron-Emission Tomography ; Prognosis ; Recurrence* ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin

Case 1: A 39-year-old man underwent orthotopic heart transplantation on November 1994 for dilated cardiomyopathy. His postoperative course was unevenful and medications included daily cyclosporin A, Immuran and prednisone. On December 13.1994, he developed cough and sore throat. Chest radiographs revealed multiple patch growing lesions. Sputum fungus culture revealed Aspergillus Fumigatus. The patient was treated with daily infusion of amphotericin B. He remains well without evidence of relapse of Aspergillus, Case 2: This 39-year-old man had undergone orthotopic heart transplantation on November 16 1994 for dilated cardiomyopathy. In December 7.1994. he developed recurrent syncope. Chest radiographs revealed fungus ball like lesion on right lung field. On open lung biopsy and wedge resection of the mass was performed. Aspergillosis and CMV infection was demonstrated in the biopsy specimen. The patient was treated with conventional amphotericin B therapy for over 7weeks and Ganciclovir for over 2weeks. At the end of therapy chest X-ray showed only small residual scar in the area of previous mass.
Adult ; Amphotericin B ; Aspergillosis* ; Aspergillus ; Aspergillus fumigatus ; Azathioprine ; Biopsy ; Cardiomyopathy, Dilated ; Cicatrix ; Cough ; Cyclosporine ; Fungi ; Ganciclovir ; Heart Transplantation* ; Heart* ; Humans ; Lung ; Pharyngitis ; Prednisone ; Radiography, Thoracic ; Recurrence ; Sputum ; Syncope ; Thorax

PURPOSE: To assess the usefulness of implanted fiducial markers in the setup of hypofractionated radiotherapy for prostate cancer patients by comparing a fiducial marker matched setup with a pelvic bone match. MATERIALS AND METHODS: Four prostate cancer patients treated with definitive hypofractionated radiotherapy between September 2009 and August 2010 were enrolled in this study. Three gold fiducial markers were implanted into the prostate and through the rectum under ultrasound guidance around a week before radiotherapy. Glycerin enemas were given prior to each radiotherapy planning CT and every radiotherapy session. Hypofractionated radiotherapy was planned for a total dose of 59.5 Gy in daily 3.5 Gy with using the Novalis system. Orthogonal kV X-rays were taken before radiotherapy. Treatment positions were adjusted according to the results from the fusion of the fiducial markers on digitally reconstructed radiographs of a radiotherapy plan with those on orthogonal kV X-rays. When the difference in the coordinates from the fiducial marker fusion was less than 1 mm, the patient position was approved for radiotherapy. A virtual bone matching was carried out at the fiducial marker matched position, and then a setup difference between the fiducial marker matching and bone matching was evaluated. RESULTS: Three patients received a planned 17-fractionated radiotherapy and the rest underwent 16 fractionations. The setup error of the fiducial marker matching was 0.94+/-0.62 mm (range, 0.09 to 3.01 mm; median, 0.81 mm), and the means of the lateral, craniocaudal, and anteroposterior errors were 0.39+/-0.34 mm, 0.46+/-0.34 mm, and 0.57+/-0.59 mm, respectively. The setup error of the pelvic bony matching was 3.15+/-2.03 mm (range, 0.25 to 8.23 mm; median, 2.95 mm), and the error of craniocaudal direction (2.29+/-1.95 mm) was significantly larger than those of anteroposterior (1.73+/-1.31 mm) and lateral directions (0.45+/-0.37 mm), respectively (p<0.05). Incidences of over 3 mm and 5 mm in setup difference among the fractionations were 1.5% and 0% in the fiducial marker matching, respectively, and 49.3% and 17.9% in the pelvic bone matching, respectively. CONCLUSION: The more precise setup of hypofractionated radiotherapy for prostate cancer patients is feasible with the implanted fiducial marker matching compared with the pelvic bony matching. Therefore, a less marginal expansion of planning target volume produces less radiation exposure to adjacent normal tissues, which could ultimately make hypofractionated radiotherapy safer.
Enema ; Fiducial Markers ; Glycerol ; Humans ; Incidence ; Pelvic Bones ; Prostate ; Prostatic Neoplasms ; Rectum

BACKGROUND AND ackground and Objectives: Smoking has been reported as an important risk factor of laryngeal cancer. Cytochrome P450 1A1 (CYP1A1) and glutathione S-transferase P1 (GSTP1) are genes that encode enzymes which are involved in the metabolism of carcinogens in cigarette smoke. In this study, we statistically tested the significances of smoking and genotypes of CYP1A1 and GSTP1 as risk factors of laryngeal cancer. MATERIALS AND METHOD: In this case-control study, 84 pathologically proven laryngeal cancer patients and 168 age- and sex-matched controls were included as the study subjects. Information on smoking habit was collected using a self-administered questionnaire, and CYP1A1 and GSTP1 genotypes were analyzed using PCR-RFLP method. Chi-square test, Student's t-test and conditional logistic analysis were used to test statistical significance. RESULTS: Smoking was turned out to be a significant risk factor of laryngeal cancer both in univariate and multivariate analyses. The CYP1A1 Ile/Ile genotype was significant in the univariate test, but the statistical significance disappeared in the multivariate conditional logistic model including smoking. The odds ratio (95% confidence interval) of GSTP1 A/A genotype for laryngeal cancer was 0.71 (0.38, 1.33), which was not statistically significant. CONCLUSION: Smoking is the most potent risk factor among the three factors, and the genotypes of CYP1A1 and GSTP1 would not be major risk factors for laryngeal cancer in Koreans.
Carcinogens ; Case-Control Studies ; Cytochrome P-450 CYP1A1* ; Cytochrome P-450 Enzyme System ; Genotype ; Glutathione Transferase ; Humans ; Laryngeal Neoplasms* ; Logistic Models ; Metabolism ; Multivariate Analysis ; Odds Ratio ; Polymorphism, Genetic* ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Tobacco Products