No abstract available.
Biopsy* ; Neoplasm Metastasis* ; Prostate* ; Prostatic Neoplasms*

PURPOSE: Only a few reports have been published describing the mid-term results of posterior intravaginal slingplasty(IVS). We analyzed the efficacy and complications of this procedure. MATERIALS AND METHODS: We analyzed the treatment outcomes of 95 patients who underwent posterior IVS due to uterine(n=59) and vaginal vault(n=36) prolapse. The degrees of prolapse were classified according to pelvic organ prolapse quantification(POPQ) of the International Continence Society(ICS), and posterior IVS was conducted for cases above stage 2. Polypropylene tape was used for all 95 patients. On the postoperative evaluation, stage 0 was regarded as a complete remission, stage 1 as an improvement and above stage 2 as a failure. RESULTS: Among the patients operated on for uterine and vaginal vault prolapse, 48(81.4%) and 30(83.3%) patients were cured, and 8(13.6%) and 6(16.7%) patientsshowed improvement, and 3(5.1%) and 0(0%) patients showed failure, respectively. The mean hospitalization was 3.3 and 3.8 days, the mean operative time was 37.4 and 36.7 minutes, and the mean bleeding volume was 91 and 102ml in the uterine prolapse group and the vaginal vault prolapse group, respectively. The mean follow-up time was 27.3 months(2-40). Identified complications were tape erosion in 9 cases(9.5%), hemorrhage that needed transfusion in 3 cases(3.2%), and recurrent prolapse in 3 cases(3.2%). CONCLUSIONS: Posterior IVS proved to be a highly effective therapeutic method for uterine and vaginal vault prolapse, with a low surgical risk and less discomfort to the patients. Tape erosion was a relative frequent complication of this operation.
Follow-Up Studies ; Hemorrhage ; Hospitalization ; Humans ; Operative Time ; Pelvic Organ Prolapse* ; Polypropylenes ; Prolapse ; Treatment Outcome ; Uterine Prolapse

PURPOSE: We evaluated the ability of endo-rectal coil MRI (ER-MRI) to predict the local pathological stage of prostate cancer prior to radical prostatectomy and compared the results with those of transrectal ultrasonography (TRUS). MATERIALS AND METHODS: ER-MRI using high field magnets (1.5 Tesla) were performed in 22 patients (mean age 62.8 years, range 51-73) with clinically localized prostate cancer before radical prostatectomy. Of the 22 patients, 17 patients were also assessed by TRUS. The results of the imaging techniques were compared with the post-operative histopathological findings. As one patient with pelvic lymph node metastasis, which was detected on frozen-section examination during surgery, was spared radical prostatectomy, the final evaluation included 21 patients. RESULTS: DSeven of the 21 patients (33%) were found to have extraprostatic extension (EPE), and 5 had seminal vesicle invasion (SVI). The sensitivity and specificity for diagnosing EPE using ER-MRI were 62.5% and 84.6%, respectively, and 16.7% and 100% with TRUS. The sensitivity and specificity for diagnosing SVI were 80.0% and 93.8%, respectively with ER-MRI, and 0% and 92.3% with TRUS. The accuracy of predicting SVI was 90.5% with ER-MRI compared to 70.6% with TRUS. CONCLUSIONS: ER-MRI was significantly better than TRUS for determining the local extent of prostatic cancer and for prediction of SVI in the preoperative staging of clinically localized prostate cancer.
Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Seminal Vesicles ; Sensitivity and Specificity ; Ultrasonography

No abstract available.

BACKGROUND: Intraoperative collection of bile and a bile culture are of use in predicting bacterial infection in the biliary system. The aim of this study was to identify chronological changes in the bacteriology of the bile in the age and sex distributions for biliary tract disease of the patients. METHODS: We retrospectively reviewed the clinical records of 722 patients who had been operated on for biliary tract disease at the Department of Surgery Ewha Womans University Hospital, from Jan. 1979 to July 1998 and on whom intraoperative bile culture had been performed. We divided the 722 patients into two group based on the time of their treatment, period A being 1979-1988 and period B being 1989-1998. The statistical analysis was done by using the Mantel-Haenszel Chi-Square test. RESULTS: The overall bile culture positive rate was 56% (404 cases), and the male-to-female ratio was 1:1.64. There was no significant statistical difference in the sex ratio between the two periods (period A: 1:1.78, period B: 1:1.55) (p>0.05). Overall, the most commonly isolated organism in the bile was Escherichia coli (137 cases, 30%). Comparing the two periods, we found that the Enterococcus species was an organism found increasingly in biliary tract infections (period A: 0%; period B: 17%) whereas infection by Escherichia coli was significantly decreased in the latter period (period A: 43%; period B: 28%) (p<0.05). The sixth decade (29.1%) was the most prevalent age overall. The age distribution for period A showed no statistical difference between the 5th (21.58%) and the 7th decades (21.94%), but there was significant difference between the 7th (29.95%) and the 5th decades (16.89%) in the age distribution for period B (p<0.05). CONCLUSIONS: According to the above results, we concluded that there were significant chronological changes in the bacteriology of the bile & in the age distributions between the two periods, but no such difference was observed between the sex distribution.
Age Distribution ; Bacterial Infections ; Bacteriology* ; Bile* ; Biliary Tract ; Biliary Tract Diseases ; Enterococcus ; Escherichia coli ; Female ; Humans ; Retrospective Studies ; Sex Distribution ; Sex Ratio

No abstract available.
Alcoholics* ; Erythrocyte Indices* ; Humans

PURPOSE: Pelvic ring fractures amount to 1.5% of all joint fractures. The most frequent causes of pelvic trauma are related to car accidents (50~60%) and car-pedestrian crashes (24~28%). The incidence and severity according to the types of acetabular fractures are not known well. We wanted to evaluate the clinical characteristics of acetabular fractures. METHODS: We reviewed the medical records and radiographic findings of 46 cases of the acetabular fractures in patients who suffered motor vehicle accidents during a 2 year period (from March 2007 to April 2009). RESULTS: The proportion of acetabular fractures was 35.7% of all the pelvic bone fractures due to motor vehicle accidents. The males made up 65.0% of the patients. The mean patient age was 44 year old. The majority of cases were driver-accidents (37.0%). As basis on Tile's grouping, the anterior fracture was the most common type (45.6%). The initial ISS score was higher for anterior fracture than that for the other types of acetabular fractures. Surgical operations were performed for 59.0% of the study patients. When the operative intervention was performed within 3 days, the ICU stay of the patients was much longer. Early surgical intervention could not reduce the development of late complications or improve the overall clinical outcomes. CONCLUSION: Acetabular fractures are not a rare type of pelvic bone injury in patients who are injured in motor vehicle accidents. Anterior fracture was the most common type and it showed a poor prognosis. Early surgical intervention cannot reduce the length of the hospital stay of patients with acetabular fractures or the development of late complications.
Acetabulum ; Fractures, Bone ; Humans ; Incidence ; Injury Severity Score ; Joints ; Length of Stay ; Male ; Medical Records ; Motor Vehicles ; Pelvic Bones ; Prognosis

Choroidal metastatic carcinoma is very rare. We recently experienced a case of lung adenocarcinoma which presented to the clinic with ocular symptoms. This 57-year-old Korean male patient visited the department of ophthalmology due to decreased visual acuity and pain of the left eye. On MRI scan, a nodule was attached to the retina of the left eyeball. On simple chest radiograph, a large amount of pleural effusion was noted in the left pleural cavity. Emergency enucleation of the left eyeball was done with an impression of malignant melanoma causing an intractable ocular pain. Grossly, the lesion in the eyeball was rising from the choroid. On histologic examination, tumor cells formed many irregular, small gland-like structures. The tumor cells showed alcian blue-positive mucin in the cytoplasm and glandular lumens and were positive for CEA. Chest CT scan was performed postoperatively and showed a huge mass in the left lower lobe and multiple nodular opacities in both lung fields. Bronchoscopic biopsy revealed moderately differentiated adenocarcinoma similar to that of the eyeball.
Adenocarcinoma* ; Biopsy ; Choroid* ; Cytoplasm ; Emergencies ; Humans ; Lung Neoplasms ; Lung* ; Magnetic Resonance Imaging ; Male ; Melanoma ; Middle Aged ; Mucins ; Neoplasm Metastasis* ; Ophthalmology ; Pleural Cavity ; Pleural Effusion ; Radiography, Thoracic ; Retina ; Tomography, X-Ray Computed ; Visual Acuity

PURPOSE: This study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers. MATERIALS AND METHODS: From 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10). RESULTS: Spine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, alpha/beta = 10 Gy) was 52 Gy10 (range, 37.5 to 76.8 Gy10) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 Gy10 and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, p = 0.041). CONCLUSION: HT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (alpha/beta = 10 Gy) higher than 57 Gy10 could improve local control.
Disease-Free Survival ; Gastrointestinal Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Radiotherapy, Intensity-Modulated ; Recurrence ; Spinal Cord ; Spine ; Treatment Outcome ; Tumor Burden

No abstract available.
Hypersensitivity, Delayed* ; Ranitidine* ; T-Lymphocytes*