Gestational trophoblastic tumors including choriocarcinoma bave become one of the most curable human malignancies with an overall cure rate exceeding 90%. Although systemic chemotherapy is the initial treatment for chorio- carcinoma, some patients with chemotherapy-resistant choriocarcinorna can be treated by integration of cbemotherapy, surgery and radio- therapy. We report two cases of persistent localized choriocarcinoma which was treated by surgical intervention.
Choriocarcinoma* ; Drug Therapy ; Female ; Humans ; Neoplasm Metastasis ; Pregnancy ; Trophoblastic Neoplasms

No abstract available.
Bandages*

Background: Brain MRI may unexpectedly display abnormalities in splenium of the corpus callosum (SCC). However, the clinical implications of this lesion are unclear and are not always consistent with ischemic infarctions. We performed this study to clarify the clinical and radiological implications in patients with SCC lesions. Methods: We retrospectively reviewed consecutive patients with MRIreported SCC changes between 2009 and 2012. We analyzed clinical and radiological findings, etiologies, cognitive impairment, and clinical outcomes. Results: We found 30 patients (16 females; mean 50.5 years) who had SCC lesions on MRI. Confusion was the most common clinical finding in 50% of cases. Cerebral infarction was the most common etiology (50%). The most consistent SCC changes on MRI were low signal in T1WI, high signal on T2WI and FLAIR, and high signal on DWI. We classified SCC lesions into in situ SCC lesions (SCC only) and multiple (SCC plus) lesions for patients with multiple lesions. The clinical symptoms of SCC only lesions were relatively mild. Cognitive functions were evaluated by Mini Mental State Examination (MMSE) and clinical dementia rating (CDR) scale at the time of discharge and patients with SCC only lesions showed less impaired cognition compared with those with SCC plus lesions. Clinical outcomes were evaluated by the modified Rankin scale at 1 month and patients with SCC only lesions revealed good clinical outcomes compared with those with SCC plus lesions. Conclusions: MRI-reported SCC lesions may have heterogeneous etiologies and present with various symptoms. The clinical course and outcome are relatively good, particularly in small isolated and oval shaped SCC lesions.

BACKGROUND: Coronary arteriovenous(AV) fistula is a rare congenital disease, and seldom produce symptoms during childhood. However late complications can occur including congestive heart failure, myocardial ischemia, and bacterial endocarditis. Therefore surgical repair is recommended even if the patients are asymptomatic. In these days many investigators are interested in transcatheter embolization because of high procedural success rate without risks and morbidity associated with cardiac surgery. METHODS: Five patients(4 females and 1 male) of coronary AV fistula were treated with transcatheter coil embolization. All had symptom of chest pain. In coronary angiograms fistulous tracts were originated from left anterior descending artery(LAD) and drained to main pulmonary artery(MPA) in 4 cases. The other case had abnormal vessel from left circumflex artery(LCX) to bronchial artery. Transcatherter coil embolization were done with Judkins left guiding catheter, 018 inch Tracker or 3F Microferret catheter, and 018 inch coils. RESULTS: The fistula tracts were completely occluded in 3 cases after coil emboilzation. In 2 cases with multiple fistular vessels, major fistula were occluded, but minor vessels remained. There were no procedure related complications. CONCLUSION: Transcatheter coil embolization may be an effective treatment modality in coronary AV fistula with excellent result and minimal complications.
Arteriovenous Fistula* ; Bronchial Arteries ; Catheters ; Chest Pain ; Embolization, Therapeutic* ; Endocarditis, Bacterial ; Female ; Fistula ; Heart Failure ; Humans ; Myocardial Ischemia ; Research Personnel ; Thoracic Surgery

Airway foreign body aspiration in children can lead to accidental death, due to the foreign body itself or the removal procedure. Depending on its location, removal of the foreign body can be challenging. Here, we present a case of successful removal of a foreign body from the left upper lobar bronchus via ventilating bronchoscopy with a rigid bronchoscope and Fogarty arterial embolectomy catheter. Tracheobronchial foreign bodies in locations that are difficult to reach with forceps, due to an acute angle or the small diameter of the pediatric bronchial tree, can be effectively removed with a Fogarty arterial embolectomy catheter.

Background and Objectives: Tracheostomy lead to persistent bacterial colonization of the respiratory tract. Surgical site infection and restenosis by the pathogenic bacteria is the most fatal complication after open airway surgery. The aim of this study is to describe the culture results of larynx and tracheostoma in patients with tracheostomy and the preoperative, intraoperative culture results in patients underwent open airway surgery.Materials and Method A retrospective review was performed on 18 patients who underwent culture between 2017 and 2019. Results: Pseudomonas or antibiotic resistance bacteria were identified in 11 patients out of 18 patients (61.1%); Ceftriaxone-resistant Streptococcus (38.9%), Pseudomonas (33.3%), Methicillin- resistant Staphylococcus aureus (16.7%), extended-spectrum β-lactamases (ESBL) producing Klebsiella pneumoniae (11.1%). Among 18 patients, 6 patients showed the different culture result between larynx and tracheostoma. In 4 out of 10 patients who underwent open airway surgery, the bacteria were not identified before surgery, but the bacteria were isolated in the intraoperative culture. In one patient, the bacteria detected intraoperatively were different from those detected before surgery. Conclusion Preoperative respiratory tract culture and usage of perioperative antibiotics according to the culture are necessary. It is crucial to verify the bacterial culture in both tracheostoma and larynx. And it should be performed immediately before open airway surgery.

Background and Objectives: Tracheostomy lead to persistent bacterial colonization of the respiratory tract. Surgical site infection and restenosis by the pathogenic bacteria is the most fatal complication after open airway surgery. The aim of this study is to describe the culture results of larynx and tracheostoma in patients with tracheostomy and the preoperative, intraoperative culture results in patients underwent open airway surgery.Materials and Method A retrospective review was performed on 18 patients who underwent culture between 2017 and 2019. Results: Pseudomonas or antibiotic resistance bacteria were identified in 11 patients out of 18 patients (61.1%); Ceftriaxone-resistant Streptococcus (38.9%), Pseudomonas (33.3%), Methicillin- resistant Staphylococcus aureus (16.7%), extended-spectrum β-lactamases (ESBL) producing Klebsiella pneumoniae (11.1%). Among 18 patients, 6 patients showed the different culture result between larynx and tracheostoma. In 4 out of 10 patients who underwent open airway surgery, the bacteria were not identified before surgery, but the bacteria were isolated in the intraoperative culture. In one patient, the bacteria detected intraoperatively were different from those detected before surgery. Conclusion Preoperative respiratory tract culture and usage of perioperative antibiotics according to the culture are necessary. It is crucial to verify the bacterial culture in both tracheostoma and larynx. And it should be performed immediately before open airway surgery.

OBJECTIVE: This study was to evaluate the correlation of clinical symptoms and physical signs with electrodiagnostic findings in carpal tunnel syndrome (CTS), and to increase the usefulness of clinical symptoms and physical signs in the diagnosis of CTS. METHOD: We prospectively identified 322 hands from 172 subjects clinically from 5 tertiary hospitals. All subjects completed 6 clinical symptoms and 6 physical signs including 3 provocative tests. Each symptoms and signs were divided motor and sensory symptoms and signs, and the correlation between symptoms and signs and the results of motor and sensory conduction studies and needle electromyography were evaluated. The sensitivity and specificity of each valuable symptoms and signs for electrodiagnostic results were also assessed. RESULTS: Tingling sensation, nocturnal pain, worsening, and Phalen sign were correlated with motor conduction study, and falling tendency, abductor pollicis brevis weakness and atrophy, tingling sensation, hypoesthesia, and Tinel and Phalen signs were correlated with needle electromyography. The Phalen sign had the best sensitivity and specificity for median motor conduction study, and the best sensitive physical sign for needle electromyography. CONCLUSION: Motor and sensory symptoms and signs were not correlated with motor and sensory conduction studies, but motor symptoms and signs were correlated with needle electromyography. The Phalen test was the most useful evaluating tool to diagnose CTS.
Atrophy ; Carpal Tunnel Syndrome* ; Diagnosis ; Electrodiagnosis ; Electromyography ; Hand ; Hypesthesia ; Needles ; Prospective Studies ; Sensation ; Sensitivity and Specificity ; Tertiary Care Centers

BACKGROUND: The prevalence of obesity is increasing year after year in Korean; and gastroesophageal reflux disease(GERD) is increasing in this population as well. The aim of this study is to assess the association between age, body mass index(BMI) and GERD in healthy Korean adults. METHODS: Analysis was done on 1,016 subjects who had not had malignancy, uncontrolled metabolic disease, enteric surgery and organic esophageal disease. They completed a questionnaire that included past history and reflux symptoms. Endoscopy was performed by two gastroenterologists who were not given any patient information. Existence of GERD was determined by the esophageal syndrome criteria of the Montreal guidelines. Subjects were categorized by BMI, initially as: underweight, normal(18.5< or =BMI<25), overweight(25< or =BMI<30) and obese by the WHO criteria, and then as: underweight, normal(18.5< or =BMI<23), overweight(23< or =BMI<25) and obese by the Asian-Pacific criteria. RESULTS: The overall[is this correct] prevalence of GERD in our subjects was 15.5%. Age and sex were not correlated factors for GERD. By the WHO and the Asian-Pacific criteria, GERD was present in underweight(10.0%, 12.1%), normal(13.9%, 14.4%), overweight(18.6%, 13.0%) and obese groups(21.0%, 18.8%). No meaningful association was seen between BMI and GERD in either of the classified groups. Erosive GERD was seen in 83 subjects (8.2%) on endoscopy. The obese(BMI> or =25) group(12.1%) showed a meaningful increment in the prevalence of erosive GERD compared to the non-obese(BMI<25) group(6.2%)(p value 0.002). CONCLUSION: The prevalence of GERD in healthy Korean adult subjects was not closely associated with obesity and age[according to BMI]; however, erosive GERD was found to have a strong association with obesity.
Adult ; Body Mass Index ; Endoscopy ; Esophageal Diseases ; Gastroesophageal Reflux ; Humans ; Metabolic Diseases ; Obesity ; Prevalence ; Surveys and Questionnaires ; Thinness

No abstract available.
Dogs ; Animals