PURPOSE: The clinical significance of preoperative serum levels of CEA and CA19-9, levels of CEA and CA19-9 in peritoneal washing fluid and free cancer cells in peritoneal washing fluid in gastric cancer patients were evaluated in this study. MATERIALS AND METHODS: Serum and peritoneal levels of CEA and CA19-9 and peritoneal washing cytology in 115 patients with gastric cancer were analyzed with respect to the prognostic factors using univariate and multivariate analysis. RESULTS: Positive rate of serum CEA and CA19-9 was 16.5%, 13.0%. And that of peritoneal washing CEA, CA19-9 and cytology was 15.7%, 7.8% and 9.6%. A univariate analysis showed that tumor markets in serum and peritoneal washing fluid and peritoneal washing cytology had significant correlations with the progression of the tumors, and patients with positive serum or peritoneal tumor markers had poorer survival after operation than did the patients with negative tumor markers. But in a multivariate analysis showed that only peritoneal CA19-9 was an independent risk factor. And combination of these five markers provided rnore predictable prognostic informations in a multivariate analysis. CONCLUSION: Combination of serum or peritoneal levels of CEA, CA19-9 and washing cytology appeared to be a useful marker for managing gastric cancer patients.
Humans ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Biomarkers, Tumor

Malignant skin tumors, including squamous cell carcinoma and malignant melanoma, have occurred in tattoos. Seven documented cases of basal cell carcinoma associated with tattoos have also been reported in the medical literature. We encountered a patient with basal cell carcinoma in a tattooed eyebrow. We report on this case as the eighth reported case of a patient with basal cell carcinoma arising in a tattooed area.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Eyebrows ; Humans ; Melanoma ; Skin

Hereditary spastic ataxia is a familial neurological disorder which exhibit the features of a progressive combined pyramidal tract and cerebellar deficiency. The main features are progressive gait disturbance, incoordination, nystagmus, visual impairment, hyperreflexia, extensor plantar response, peripheral neuropathy, and pes cavus. A 27-year-old male patient with spastic ataxic gait was evaluated. He showed characteristic features of hereditary spastic ataxia. There were another twelve affected members in four generations of his family which may be inherited by autosomal dominant pattern. One of them is reported with review of the literature on familial spastic ataxia.
Adult ; Ataxia* ; Family Characteristics ; Foot Deformities ; Gait ; Humans ; Male ; Muscle Spasticity* ; Nervous System Diseases ; Peripheral Nervous System Diseases ; Pyramidal Tracts ; Reflex, Abnormal ; Reflex, Babinski ; Vision Disorders

The spontaneous hematomyelia is an uncommon event and its predisposing conditions are vascular malformation, syringomyelia, pregnancy and delivery, angioma, hemophilia, anticoagulant therapy, etc. We have recently experienced the patient with spontaneous onset and resolving hematomyelia in the cervical spinal cord. A 30-year-old male patient with non-traumatic spinal shock was evaluated. On MRI, a hematomyelia along cervical spi-nal cord was revealed. A suspicious AV malformation was noticed at C3-4 level. Fol-low-up MRIs showed spontaneous resolution of the hematoma.
Adult ; Hemangioma ; Hematoma ; Hemophilia A ; Humans ; Magnetic Resonance Imaging ; Male ; Pregnancy ; Shock ; Spinal Cord ; Spinal Cord Vascular Diseases* ; Syringomyelia ; Vascular Malformations

Bell's palsy is a relatively common, unilateral facial paralysis of unknown etiology. The purpose of this study was to evaluate the prognostic value of several electrophysiologic tests in Bell's palsy. Blink reflex (BR), side-to-side compound muscle action potential (CMAP) amplitude comparison, and side-to-side nerve excitability test (NET) threshold differ once have been studied during the first 2 weeks in 66 patients with Bell's palsy. According to the early response of BR(Rl), the patients were divided into 3 groups: Rl< or = 13ms(17cases) ; Rl>13ms(22cases), and absent BR(27cases). There was a remarkable tendency towards a satisfactory recovery from paralysis if BR occurred during the first 2 weeks from onset(p<0.001). In patients with normal BR, 88.2% had a satisfactory recovery, when the reflex was absent a bad prognosis was given in 59.3% of the patients. According to side-to-side CMAP amplitude comparison, the patients were divided into 2 groups; CMAP amplitude comparison > or = 25% (35cases), and CMAP amplitude comparison <25% (31cases). There was a tendency towards a satisfactory recovery from paralysis if side-to-side CMAP amplitude comparison was more than 25% (p < 0,003). In patients with more than 25% of CMAP amplitude comparison, 82.9% of the patients had a satisfactory recovery, but in patients with less than 25% of CMAP amplitude comparison, 51.6% of the patients had a bad prognosis. According to side-to-side NET threshold difference, the patients were divided into 2 groups, NET threshold difference < or = 3.5mA(43cases), and NET threshold difference >3.5mA (23cases). When the threshold of electrical excitability on both sides differs 3.5mA or more an unsatisfactory recovery has strongly to expected(p<0.001). In patients with less than 3.5mA of NET threshold, 81.4% had a satisfactory recovery, but in patients with more than 3.5mA of NET threshold, 60.9% had a bad prognosis. BR, side-to-side CMAP amplitude comparison, and side-to-side NET threshold difference seem to be useful independent indices for predicting the prognosis an early stage of the paralysis.
Action Potentials ; Bell Palsy* ; Blinking ; Facial Paralysis ; Humans ; Paralysis ; Prognosis ; Reflex

BACKGROUND: There have been many changes to the social and medical environment in Korea over the last 30 years. Therefore, we presume that distribution and incidence of skin tumors might have changed. This is the first report to analyse skin tumors in the Jeonbuk province over the past 27 years (1978~2004). OBJECTIVE: To investigate the incidence and distribution of skin tumors among people of the Jeonbuk province. METHODS: A total of 4,037 cases of skin tumor were obtained from surgical pathology specimen at Department of Dermatology in Chonbuk National University Hospital. RESULTS: Among the 4,037 cases of skin tumors, 2,856 cases (70.8%) were benign tumors, 841 cases (20.8%) were malignant tumors, and 340 cases (8.4%) were premalignant lesions. The most common benign skin tumor was melanocytic nevi with 402 cases, followed by 299 cases of seborrheic keratosis, 298 cases of epidermal cyst, and 136 cases of nevus sebaceus. Among the 841 cases of malignant skin tumors, there were 309 cases of basal cell carcinoma, 192 cases of squamous cell carcinoma, 66 cases of malignant melanoma, and 55 cases of malignant lymphoma. Of the premalignant lesions, there were 271 cases of actinic keratosis, 67 cases of Bowen's disease and 2 cases of lentigo maligna. The predilection sites of melanocytic nevi were the face (50.0%), trunk (13.9%), scalp (11.0%), foot (9.5%), and those of seborrheic keratosis were the face (37.5%), followed by the scalp (23.1%). The predilection site of basal cell carcinoma, squamous cell carcinoma and actinic keratosis was the face (86.9%, 57.8%, 82.3%). Over the past 10 years (1994~2004), benign tumors, malignant tumors and premalignant lesions have occurred with a ratio of 58.4%, 68.7%, and 77.2% respectively. 220 patients with malignant tumors were transferred for treatment or evaluation to other departments or hospitals. Form these, the most common type of tumor was basal cell carcinoma (56 cases), followed by squamous cell carcinoma (44 cases). CONCLUSION: We reviewed 4,037 cases of skin tumor, confirmed histopathologically within at the Department of Dermatology at the Chonbuk National University Hospital between 1978 and 2004. This data will be made available for the study of skin tumors in Korea.
Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidermal Cyst ; Foot ; Humans ; Hutchinson's Melanotic Freckle ; Incidence ; Jeollabuk-do* ; Keratosis, Actinic ; Keratosis, Seborrheic ; Korea ; Lymphoma ; Melanoma ; Nevus ; Nevus, Pigmented ; Pathology, Surgical ; Scalp ; Skin*

Carcinoid tumors are well-differentiated epithelial neoplasms that usually can be diagnosed without difficulty based on their distinctive histologic patterns. These tumors are composed of variable numbers of calls that contain endocrine secretory granules in their cytoplasm, which can be identified by histochemistry, immunohistochemistry, and electron microscopy, Carcinoid tumors of the duodenum are relatively rare, the reported incidence being 2.0-8.9% of all gastrointestinal carcinoid tumors dianosed in Western countries. The rate of occurrence among all duodenal tumors is 3-5.5%. We experienced a case of carcinoid tumor of the duodenum in a 53 year-old male patient. He was admitted to our hospital because of epigastric pain. On the gastrofiberscopic examination, 0.7 cm sized Yamada type II polyp with central ulceration was noticed on the duodenal bulb. The biopsy specimen revealed carcinoid tumor. He was treated with polypectomy.
Biopsy ; Carcinoid Tumor* ; Cytoplasm ; Duodenum ; Humans ; Immunohistochemistry ; Incidence ; Male ; Microscopy, Electron ; Middle Aged ; Neoplasms, Glandular and Epithelial ; Polyps ; Secretory Vesicles ; Ulcer

Annuloaortic ectasia, cystic medial degeneration of the afflicted aortic wall leading to progressive dilatation, is often accompanied by Marfan's syndrome. Some portions of intimal flap is commonly demonstrated along the aorta in the noninvasive diagnosis of aortic dissection. We report the first case of circumscribed aortic dissection developed in a 28 year old obese non-Marfanoid patient. He was transferred after thrombolytic therapy at a community hospital because of severe chest pain and ST segment elevation. Transthoracic echocardiography showed markedly dilated aortic root, moderate amount of pericardial effusion, mild aortic regurgitation in spite of normal regional wall motion of left ventricle. Intimal flap, characteristic of aortic dissection, was not seen with computed tomography. Intimal tear was demonstrated just above aortic valve only by transesophageal echocardiography. Two parallel intimal tear and small circumscribed dissection was demonstrated by autopsy.
Adult ; Aorta ; Aortic Valve ; Aortic Valve Insufficiency ; Autopsy ; Chest Pain ; Diagnosis ; Dilatation ; Dilatation, Pathologic* ; Echocardiography ; Echocardiography, Transesophageal ; Heart Ventricles ; Hospitals, Community ; Humans ; Marfan Syndrome ; Pericardial Effusion ; Thrombolytic Therapy

PURPOSE: To evaluate the outcomes of Ahmed valve implantation in neovascular glaucoma patients who received intraoperative mitomycin C (MMC) and postoperative 5-fluorouracil (5-FU) after 24 months of follow-up. METHODS: A total of 40 eyes from 40 patients with neovascular glaucoma who received antiglaucomatous medication without previous glaucoma surgery were included in the present study. The patients were divided into 2 groups. The control group (20 eyes) underwent Ahmed valve implantation only and the study group (20 eyes) underwent Ahmed valve implantation and received intraoperative MMC and postoperative 5-FU. Failure was defined as the first occurrence of any of the following: 1) the first of 3 consecutive visits where intraocular pressure (IOP) was over 18 mmHg; 2) 20% IOP reduction from baseline; 3) the final number of topical medications was not reduced by at least two from baseline; 4) the need for additional surgery; or 5) the occurrence of a serious complication. RESULTS: In the control group, the cumulative success rate was 19.1% at 24 months. The cumulative success rate in the study group was 43.7% at 24 months. Serious complications such as endophthalmitis, valve exposure, or prolonged hypotony were not observed. CONCLUSIONS: The adjunctive use of intraoperative MMC and postoperative 5-FU with Ahmed valve implantation resulted in a high success rate and good IOP control and did not cause serious complications during the follow-up period.
Endophthalmitis ; Eye ; Fluorouracil ; Follow-Up Studies ; Glaucoma ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Mitomycin

OBJECTIVE: To clarify the relationship of skin temperature changes to clinical, radiologic, and electrophysiological findings in unilateral lumbosacral radiculopathy and to delineate the possible temperature-change mechanisms involved. METHODS: One hundred and one patients who had clinical symptoms and for whom there were physical findings suggestive or indicative of unilateral lumbosacral radiculopathy, along with 27 normal controls, were selected for the study, and the thermal-pattern results of digital infrared thermographic imaging (DITI) performed on the back and lower extremities were analyzed. Local temperatures were assessed by comparing the mean temperature differences (DeltaT) in 30 regions of interest (ROIs), and abnormal thermal patterns were divided into seven regions. To aid the diagnosis of radiculopathy, magnetic resonance imaging (MRI) and electrophysiological tests were also carried out. RESULTS: The incidence of disc herniation on MRI was 86%; 43% of patients showed electrophysiological abnormalities. On DITI, 97% of the patients showed abnormal DeltaT in at least one of the 30 ROIs, and 79% showed hypothermia on the involved side. Seventy-eight percent of the patients also showed abnormal thermal patterns in at least one of the seven regions. Patients who had motor weakness or lateral-type disc herniation showed some correlations with abnormal DITI findings. However, neither pain severity nor other physical or electrophysiological findings were related to the DITI findings. CONCLUSION: Skin temperature change following lumbosacral radiculopathy was related to some clinical and MRI findings, suggesting muscle atrophy. DITI, despite its limitations, might be useful as a complementary tool in the diagnosis of unilateral lumbosacral radiculopathy.
Electrodiagnosis ; Humans ; Hypothermia ; Incidence ; Lower Extremity ; Magnetic Resonance Imaging ; Muscular Atrophy ; Radiculopathy ; Skin ; Skin Temperature ; Thermography