No abstract available.
Cell Line* ; Dimethyl Sulfoxide* ; Intercellular Signaling Peptides and Proteins* ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: This study was performed to identify the characteristic findings of miliary pulmonary tuberculosis on HRCT and to evaluate the usefulness of HRCT by compareson with chest radiographs. MATERIAL AND METHODS: High resolution CT, chest radiographs and medical records were retrospectively reviewed in 10 patients with miliary pulmonary tuberculosis. We analysed the size, distribution and margin of nodules, reticular or ground-glass density, parenchymal lesion, mediastinal lymphadenopathy and pleural effusion on HRCT which were compared with chest radiographic findings. RESULTS: On HRCT, characteristic 1--2mm sized sharp or ill-defined nodular densities were randomly distributed throughout both lungs in all cases. In seven cases, the nodules were evenly scattered, but slightly more in upper lung zone in two cases, and in lower in one case. Only three cases revealed somewhat large and abundant nodules in posterior lung zone. There were findings of ill-defined margin of nodules in three cases, reticular densities in three cases and ground-glass opacity in two cases, all of which were observed within 4 weeks after onset of symptom. In one case, HRCT scan revealed a micronodular pattern in the lung parenchyma, even though chest radiographs of 2 days before were not obviously abnormal. HRCT was better to evaluate the margin of nodule and distribution than chest radiographs in four cases. Focal parenchymal lesion (n=5), pleural effusion(n=4), mediastinal lymphadenopathy(n=6) and ARDS(n=I) were also associated. CONCLUSION: HRCT could suggest a more specific diagnosis of miliary pulmonary tuberculosis with the above characteristic findings in appropriate clinical setting and normal or interstitial pattern of chest radiographs.
Diagnosis ; Humans ; Lung ; Lymphatic Diseases ; Medical Records ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis, Pulmonary*

PURPOSE: There are many prognostic factors in the recurrence and the progression of T1 superficial bladder cancer. Among these factors, microstaging evaluation in T1 bladder cancer may be of important value in patients with T1 superficial bladder cancer. To evaluate the usefulness of microstaging evaluation, we analyzed the microstage in T1 superficial bladder cancer and analyzed the recurrence rate and the progression rate of each microstage. MATERIALS AND METHODS: A retrospective analysis was done on 87 patients with T1 primary superficial bladder cancer managed in our hospital between January 1992 and April 1998. Microstages were assigned according to the following system: pT1a, invasion of lamina propria: pT1b, invasion to the level of the muscularis mucosa; pT1c, invasion through the muscularis mucosa but superficial to the muscularis propria. We analyzed the relationship between the microstage and the grade, the relationship between the recurrence or the progression of diseases and the grade of the tumor, the relationship between the grade or the microstage and the recurrence of diseases. All specimens were obtained from transurethral resection. RESULTS: The recurrence rates of pT1a, pT1b and pT1c were 9.1%(3/33), 40%(8/33) and 64.7%(22/33) respectively(p<0.001). The progression rates of pT1a, pT1b and pT1c were 0%(0/33), 10%(2/20) and 20.6%(7/34) respectively(p=0.005). The recurrence rates of grade I, grade II and grade III were 23.1%(3/13), 26.7%(12/45) and 62.1%(18/29) respectively(p=0.002). The progression rates of grade I, grade II and grade III were 7.7%(1/13), 4.4%(2/45) and 20.7%(6/29) respectively(p=0.062). pT1a, pT1b and pT1c were 21.2%(7/33), 20%(4/40) and 5.9%(2/34) in the patients of the grade I. pT1a, pT1b and pT1c were 69.7%(23/33), 50%(10/20) and 35.3%(12/34) in the grade II. pT1a, pT1b and pT1c were 9.1%(3/33), 30%(6/20) and 58.8%(20/34) in the grade III. Thus the relationship between the grade and the microstage was statistically significant(p=0.001). The recurrece rates of pT1a in the grade I, pT1b in the grade I and pT1c in the grade I were 14.3%(1/7), 0%(0/4) and 100%(2/2). The recurrence rates of pT1a in the grade II , pT1b in the grade II and pT1c in the grade II were 8.7%(2/23), 40%(4/10) and 50%(6/12). The recurrence rates of pT1a in the grade III, pT1b in the grade III and pT1c in the grade III were 0%(0/3), 66.7%(4/6) and 77.8%(14/20)(p=0.176). The progression rates of pT1a in the grade I, pT1b in the grade I and pT1c in the grade I were 0%(0/7), 0%(0/4) and 50%(1/2). The progression rates of pT1a in the grade II, pT1b in the grade II and pT1c in the grade II were 0%(0/23), 10%(1/10) and 8.3%(1/12). The progression rates of pT1a in the grade III, pT1b in the grade III and pT1c in the grade III were 0%(0/3), 16.7%(1/6) and 25%(5/20)(p=0.526). CONCLUSIONS: Microstaging in T1 superficial bladder cancer appears to be a significant prognostic factor in the recurrence and the progression of the diseases.
Humans ; Mucous Membrane ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Gastric Stump*

We report a case of 41-year-old male with pulmonary metastasis from a recurrent intracranial malignant meningioma, which had two more recurrence, multiple intracranial metastasis. Pulmonary metastasis was developed five years after resection of primary lesion. The metastatic routes and treatment of pulmonary metastatic malignant meningiomas were described.
Adult ; Humans ; Male ; Meningioma* ; Neoplasm Metastasis* ; Recurrence

PURPOSE: Appendicitis is the most common abdominal surgical emergency. The diagnosis of appendicitis can be difficult, occasionally taxing the diagnostic skills of even the most experienced surgeon, and especially for diagnosing reproductive women. This study was designed to evaluate the various pathologies of the appendix and the other intraabdominal organs in patients who were preoperatively diagnosed with acute appendicitis, and we wanted to analyze the difference of the perioperative results between the reproductive women and the other patients. METHODS: The study was a retrospective analysis of 1,108 appendectomies that were performed from September 2003 to August 2006. The data were analyzed for the following parameters: the age-related and sex-related incidence of acute appendicitis, the rates of negative appendectomy, negative operation and appendicular perforation, and the incidence of other encountered pathologies. In addition, we present the clinical results of the reproductive women. RESULTS: The diagnostic accuracy for acute appendicitis was 87.2%. The negative appendectomy rate was 11.6% and it was significantly higher (20.8%) in the reproductive women than in the male patients of the same age (P=0.001). On the clinical analyses of the reproductive aged appendicitis group showed they a shorter pain duration and a higher WBC count, and more frequent epigastric discomfort, nausea, vomiting and RLQ tenderness (P< 0.05). CONCLUSION: We noted a high rate of negative appendectomy among reproductive female patients, so more care should be taken to diagnose these patients.
Appendectomy ; Appendicitis* ; Appendix ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Female ; Humans ; Incidence ; Male ; Nausea ; Pathology ; Retrospective Studies ; Taxes ; Vomiting

The incidence of heterotopic gastric mucosa located in the submucosa in resected stomach specimens has been reported to be 3.0 to 20.1%. Heterotopic gastric mucosa is thought to be a benign disease, which rarely becomes malignant. Heterotopic gastric mucosa exists in the gastric submucosa, and gastric cancer rarely occurs in heterotopic gastric mucosa. Since tumors are located in the normal submucosa, they appear as submucosal tumors during endoscopy, and are diagnosed through endoscopic biopsies with some difficulty. For such reasons, heterotopic gastric mucosa is mistaken as gastric submucosal tumor. Recently, two cases of early gastric cancer arising from heterotopic gastric mucosa in the gastric submucosa were treated. Both cases were diagnosed as submucosal tumors based on upper gastrointestinal endoscopy, endoscopic ultrasound, and computed tomography findings, and in both cases, laparoscopic wedge resections were performed, the surgical findings of which also suggested submucosal tumors. However, pathologic assessment of the surgical specimens led to the diagnosis of well-differentiated intramucosal adenocarcinoma arising from heterotopic gastric mucosa in the gastric submucosa.
Adenocarcinoma ; Biopsy ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastric Mucosa ; Incidence ; Stomach ; Stomach Neoplasms

PURPOSE: In spite of a very poor prognosis for primary gastric cancer invading neighboring organs, combined resection of the involved adjacent organ may improve. Whether pancreaticoduodenectomy in advanced distal gastric cancer improves the survival is controversial. We conducted this study to evaluate the results of pancreaticoduodenectomy in advanced distal gastric cancer. METHODS: We retrospectively analysed 29 patients who underwent surgery at the Department of Surgery, Yonsei University College of Medicine, between January 1994 and December 2001. Patients included in this study had locally advanced distal gastric cancer, without evidence of distant metastases, which had invaded to the duodenum and/or pancreas head, or conglomerated infrapyloric lymph nodes. Patients were divided into two groups: pancreaticoduodenectomy (PD) (n=12), or palliative subtotal gastrectomy (PSTG) (n=17). We compared the clinicopathologic features, operative outcomes, recurrence and survival between these two groups. RESULTS: There were no differences in clinicopathologic features between the two groups. Operation time, incidence and amount of perioperative transfusion, postoperative hospital stay and morbidity were greater in the PD group than in the PSTG group. However, there was no postoperative mortality in either group. Five patients had systemic recurrence (liver, lung, and paraaortic LN metastases) in the PD group, while most patients experienced regional disease progression in the PSTG group. The survival of the PD group was significantly better than that of the PSTG group (P=0.0006). CONCLUSION: Pancreaticoduodenectomy can be safely performed and improves the prognosis for patients with locally far advanced distal gastric cancer that is associated with invasion into the duodenum and/or pancreas head, or conglomerated infrapyloric lymph nodes.
Disease Progression ; Duodenum ; Gastrectomy ; Head ; Humans ; Incidence ; Length of Stay ; Lung ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Pancreas ; Pancreaticoduodenectomy* ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

A 5-year-old girl was admitted because of an acute onset of weakness in her extremities. She had experienced a similar episode before but had recovered spontaneously. She had previously been diagnosed with distal renal tubular acidosis(RTA) at the age of 2 months. During the period of acute paralysis, her serum potassium level was 1.8 mmol/L and the muscle enzymes were markedly raised suggesting massive rhabdomyolysis. Although hypokalemia is common in renal tubular acidosis, acute paralytic presentation is uncommon and is rarely described in children. We report a case of distal RTA complicated with hypokalemic paralysis with a brief review of related literatures.
Acidosis, Renal Tubular* ; Child ; Child, Preschool ; Extremities ; Female ; Humans ; Hypokalemia ; Paralysis* ; Potassium ; Rhabdomyolysis

Congenital cysts of the gallbladder are extremely rare, hence only a few ciliated foregut cysts of gallbladder have been reported. We report a case of a 20-year-old woman presenting with mild right upper quadrant abdominal discomfort, with normal levels of serum bilirubin and liver function tests. Abdominal ultrasonography revealed a well-defined cystic mass measured about 2 cm attached to the neck of gallbladder, with internal echogenic debris suggesting a complicated cyst, such as a hemorrhagic cyst. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed similar findings. Laparoscopic cholecystectomy showed a slightly distended gallbladder. The size of cyst on the neck was 1.6x1.2 cm, and it contained mucosa lined by ciliated pseudostratified columnar epithelium and underlying smooth muscle layers. Histopathology identified a ciliated foregut cyst of gallbladder.
Abdomen/diagnostic imaging ; Cholangiopancreatography, Magnetic Resonance ; Cholecystectomy, Laparoscopic ; Cysts/diagnostic imaging/pathology/surgery ; Female ; Gallbladder/pathology/surgery ; Gallbladder Diseases/*diagnosis ; Humans ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult