No abstract available.
Dogs ; Animals

No abstract available.
Angioplasty* ; Budd-Chiari Syndrome* ; Heart Ventricles* ; Stents*

PURPOSE: This study aimed to evaluate the preliminary treatment results of fractionated stereotactic radiotherapy (FSRT) for metastatic brain tumors. MATERIALS AND METHODS: Between August 1997 and December 1998, frameless FSRT was performed in 11 patients with metastatic brain tumor (1S lesions). Primary sites were lung in 7 patients, breast in 2, stomach in 1, and malignant melanoma in 1, All patients received 30-36 Gy/10-20 fx external beam irradiation to whole brain. Eight patients received FSRT for 1 lesion, one for 2 lesions, and two for 4 lesions. Fractionation schedule was 25 Gy/5 fx in 11 lesions, 18 Gy(1 fx in 3, 30 Gy/5 fx in 2, 15 Gy/5 fx in 1. Mean tumor volume was 7.0 cc (0.39~55.23 cc). Multiple-arc FSRT was delivered to 16 lesions and conformal FSRT through irregular ports shaped to tumor profile to 2 lesions. RESULTS: No patient experienced any acute side reaction from FSRT. Follow-up radiologic evaluation was available in 9 patients. Six of nine patients achieved the complete response, but two showed the partial response and one showed no response on follow-up radiologic studies. Among six patients with complete response, 5 patients survived from 5 to 15 months and showed no evidence of metastatic brain d#isease clinically and/or radiologically at last follow-up. Among two patients who did not have radiologic evaluation, one showed clinically complete response until death and the other died just after FSRT caused by intercurrent disease. One patient with no response radiologically survived 7 months and showed nearly complete disappearance of clinical symptom with stable status radiologically, CONCLUSION: Initial experience in this study suggests that the external beam irradiation to whole brain with 30 Gy/10 fx followed by FSRT with 20~30 Gy/5~6 fx could be the good treatment option to the patients with metastatic brain tumor. This study suggests that the fractionation schedule for FSRT should be determined in consideration of performance status, number of metastasis, tumor volume, location, presence of extracranial disease, and age.
Appointments and Schedules ; Brain Neoplasms* ; Brain* ; Breast ; Follow-Up Studies ; Humans ; Lung ; Melanoma ; Neoplasm Metastasis ; Radiotherapy* ; Stomach ; Tumor Burden

A 40-year-old female patient who had tethered spinal cord with intraspinal lipoma and intractable pain of the lower leg and foot is reported. The pain started 5 years ago and exaggerated recently. A pea-size mass had been noted since birth at sacral region, which was excised 2 months prior to admission at the other clinic. Neurological examination revealed diffuse muscular wasting of the left foot, especially the sole, hypesthesia of the left sole with dysesthesia, bilaterally increased knee jerks, and absent left ankle jerk. The patient underwent L5 laminectomy, subtotal removal of extradural, intradural and intramedually lipoma with dural repair, and dorsal rhizotomy of ipsilateral L5 and S1 roots. At surgery, the neural elements were untethered with mass removal, adhesiolysis, and division of thickened arachnoid septum. The pain improved much after and was tolerable with some analgesics.
Adult* ; Analgesics ; Ankle ; Arachnoid ; Female ; Foot* ; Humans ; Hypesthesia ; Knee ; Laminectomy ; Leg ; Lipoma* ; Neurologic Examination ; Pain, Intractable* ; Paresthesia ; Parturition ; Rhizotomy ; Sacrococcygeal Region ; Spinal Cord*

BACKGROUND: Many implants are being used for the reconstruction of orbital wall fractures. The effect of the choice of implant for the reconstruction of an orbital wall fracture on the surgical outcome is under debate. The purpose of this article is to compare the outcomes of orbital wall reconstruction of small orbital wall fractures on the basis of the implants used. METHODS: The authors conducted a retrospective study using electronic databases. Between March 2001 and December 2012, 461 patients with orbital wall fractures were included in this study. Among them, 431 patients in whom the fracture size was less than 300 mm2 were analyzed. The fracture size was calculated using computed tomography scans of the orbit in the sagittal and coronal images. Cases in which the fracture size was less than 300 mm2 were included in this study. RESULTS: One hundred and twenty-nine patients were treated with silastic sheets; 238 patients were treated with titanium meshes; and absorbable meshes were used in the case of 64 patients. Overall, 13 patients required revision, and the revision rate was 3.0%. The revision rate of the silastic sheet group was 5.4%. In the multivariable analysis, the revision rate of the group reconstructed with silastic sheets was highly statistically significant (P=0.043, odds ratio=3.65). However, other factors such as age, sex, fracture type, and fracture size were not significant. CONCLUSIONS: Reconstruction of orbital wall fractures with silastic sheets may cause more complications than that with other materials such as titanium meshes and absorbable meshes.
Humans ; Orbit* ; Orbital Fractures ; Retrospective Studies ; Silicones ; Titanium

BACKGROUND: Rotational atherectomy has been shown to be safe and efficient for the treatment of ISR, but the recurrence rate is still high. Intracoronary-irradiation after rotational atherectomy may be a reasonable approach to prevent recurrent ISR. SUBJECTS & METHODS: Fifty consecutive patients with diffuse ISR (length > 10 mm) in native coronary arteries underwent rotational atherectomy and adjunctive balloon angioplasty followed by beta irradiation using a 188Re-MAG3-filled balloon catheter. The radiation dose was 15 Gy at 1.0 mm deep into vessel wall. RESULTS: Mean length of the lesion and irradiated segment was 25.6 +/- 12.7 mm and 37.6 +/- 11.2 mm, respectively. The radiation was delivered successfully to all patients, with a mean irradiation time of 201.8 61.7 seconds. No adverse event including myocardial infarction, death, or stent thrombosis occurred during the follow-up period (mean 10.3 +/- 3.7 months) and non-target vessel revascularization was needed in one patient. Six-month binary angiographic restenosis rate was 10.4 % and loss index was 0.17 +/- 0.31. CONCLUSIONS: beta irradiation using 188Re-MAG3-filled balloon following rotational atherectomy is safe and feasible for patients with diffuse ISR, and it may improve the clinical and angiographic outcomes. Further prospective randomized trials are warranted to evaluate the synergistic effect of debulking and irradiation in patients with diffuse ISR.
Angioplasty, Balloon ; Atherectomy, Coronary* ; Catheters ; Coronary Vessels ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Recurrence ; Stents ; Thrombosis

Pancreatic fistulae follows pancreatic duct disruption and may develop as a complication of pancreatic disease or injury. The escaping fluid may be walled off by the surrounding viscera to form a pseudocyst or an abscess. Fistulae may drain spontaneously into adjacent hollow viscera or communicate with the body surface externally. Although internal pancreatic fistulas that communicate with adjacent internal organs are much less common, vascular communication with the pancreatic ductal system is especially unusual and generally represents a serious clinical situation. We experienced one case of pancreatic duct-portal vein fistula in a patient with pancreatic cancer. Endoscopic retrograde cholangiopancreatography revealed a large vascular structure representing the portal vein filled at the time of the contrast injection, indicating the presence of a pancreatic duct-portal vein fistulae.
Abscess ; Cholangiopancreatography, Endoscopic Retrograde ; Fistula* ; Humans ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Fistula ; Pancreatic Neoplasms* ; Portal Vein ; United Nations ; Veins* ; Viscera

BACKGROUND: This study presents a biomechanical and histometric comparison of bone response to implants with various area of hydroxyapatite(HA) coating. METHODS: The implants were placed in the tibia of 10 rabbits weighing 2.5-3.5kg. The control group had a machined surface, the experimental group 1 had 50micrometer thick HA coated in a band form, and the experimental group 2 had 50micrometer thick HA coated on the entire surface. 8 weeks after implantation, the animals were sacrificed. Removal torque was measured and histologic preparation was also performed for histologic and histometric analysis. Bone to implant contact as well as percentage of bone area inside threads were measured. ANOVA post hoc, and t-test were used for statistical analysis with p-value p<0.05. RESULTS: 1. The removal torques were 9.36 +/- 5.64 Ncm, 48.40 +/- 16.66 Ncm, and 82.37 +/- 22.56 Ncm for the control, exp. 1, and exp. 2 group respectively. Statistically significant difference were found among all the groups(p<0.05). 2. Bone to implant contact in the cortical bone were 38.94 +/- 10.9 %, 66.90 +/- 14.1 %, 73.00 +/- 19.4 %, in the marrow bone, 8.30 +/- 5.4 %, 14.59 +/- 5.9 %, 18.54 +/- 11.8 %, and in total, 22.40 +/- 10.1 %, 31.19 +/- 7.5 %, 41.41 +/- 12.2 % for the control, exp.1, and exp. 2 group respectively . In the cortical bone, exp. 1, and exp. 2 group showed statistically significantly higher contact compared to control group. Total contact and in the marrow bone, only exp. 2 group showed statistically significantly higher contact compared to control group(p<0.05). In all the groups significantly higher contact were observed in the cortical bone compared to the marrow bone(p<0.05). 3. Percentage of bone area inside threads in the cortical bone were 55.68 +/- 7.25 %, 55.19 +/- 13.19 %, 57.04 +/- 13.33 %, in the marrow bone, 12.34 +/- 14.61 %, 17.56 +/- 20.04 %, 20.26 +/- 12.83 %, and in total, 30.30 +/- 12.46 %, 31.57 +/- 15.15 %, 34.25 +/- 12.56 % for the control, exp.1, and exp. 2 group respectively. There was no statistical difference among the groups. In all the groups significantly higher bone area were observed in the cortical bone compared to the marrow bone(p<0.05)
Animals ; Bone Marrow ; Durapatite* ; Rabbits ; Tibia* ; Torque*

PURPOSE: Brain metastases are present in approximately 10-16% of small cell lung cancer patients at diagnosis. Brain metastasis is an important clinical problem associated with increasing the survival rate, with a cumulative incidence of up to 80% in patients surviving 2 years. Prophylactic cranial irradiation(PCI reduces the incidence of brain matastasis and may prolong survival in patients with limited small-cell lung cancer who achieved complete remission. This study was performed to analyze the incidence of brain metastasis, survival and clinical aspects after PCI in patients with limited small-cell lung cancer who achieved complete remission. METHODS: Between 1989 and 1999, forty-two patients with limited small-cell lung cancer who achived achieved complete remission after therapy were enrolled into this study retrospectively. All patients received etoposide and cisplatin(VPP) alternating with cytoxan, adriamycin, and vincristine(CAV) every 3 weeks for at least 6 cycles initially. All patients received thoracic radiotherapy:concurrent(38.1%) and sequentia(61.9%). All patients received late PCI. RESULTS: Most patients(88.1%) were men, and the median age was 58 years. The median follow-up duration was 18.1 months. During the follow-up period, 57.1% of the patients developed relapse. The most frequent site of relapse was chest(35.7%), followed by brain(14.3%), liver(11.9%), adrenal gland(4.4%), and bone(2.2%). With the Kaplan-Meier method, the average disease-free interval was 1,090 days(median 305 days). The average time to development of brain relapse after PCI and other sites relapse(except brain) were 2,548 days and 1,395 days(median 460 days), respectively. The average overall survival was 1,233 days(median 634 days, 21.1 months), and 2-year survival rates was 41.7%. The average overall survival in the relapse group was 642 days(median 489 days) and in the no relapse group was 2,622 days(p<0.001). The average overall survival in the brain relapse guoup was 928 days(median 822 days) and in the no brain relapse group was 1,308 days(median 634 days)(p=0.772). In most patients(85.7%), relepse(expect brain) or systemic disease was the usual cause of death. Brain matastasis was the cause of death in 14.3% of the cases. CONCLUSIONS: We may conclude that PCI reduces and delays brain metastasis in patients with limited small-cell lung cancer who achieved complete remission. We found decreased survival in relapse group but, no significant survival difference was noted according to brain matastasis. And relapse(except brain) or systemic disease was the usual cause of death. In order to increase survival, new treatment strategies for control methods for relapse and systemic disease are required.
Brain* ; Cause of Death ; Cranial Irradiation* ; Cyclophosphamide ; Diagnosis ; Doxorubicin ; Etoposide ; Follow-Up Studies ; Humans ; Incidence* ; Lung Neoplasms* ; Lung* ; Male ; Neoplasm Metastasis* ; Recurrence ; Retrospective Studies ; Small Cell Lung Carcinoma ; Survival Rate

Primary hepatic neuroendocrine cell carcinoma is a very rare tumor. We experienced a 75-year-old woman with primary hepatic neuroendocrine carcinoma presenting with pyogenic liver abscess. Abdominal CT scan revealed a multiseptated liver abscess and an enlarged lymph node in portocaval portion. We performed percutaneous drainage of the liver abscess, but the amount of drained pus did not decrease after 20 days. The follow-up abdominal CT scan showed that the cystic portion of liver abscess had been replaced by the solid tumor. Microscopic examination of the tumor tissue showed nests of epithelial cells with uniform round hyperchromatic nuclei and high nuclear to cytoplasmic ratio. Immunohistochemical staining was strongly positive for synaptophysin and chromogranin A.
Adenine/analogs & derivatives/therapeutic use ; Antiviral Agents/*adverse effects/therapeutic use ; Drug Eruptions/diagnosis/*pathology ; Female ; Hepatitis B, Chronic/*drug therapy ; Humans ; Ichthyosis/chemically induced/pathology ; Lamivudine/*adverse effects/therapeutic use ; Middle Aged ; Phosphonic Acids/therapeutic use