The purpose of this study was to access the effect of TMJ arthrocentesis in locking 8 patients with anterior distal displacement without reduction ( 'closed lock' ). TMJ Arthrocentesis was defined as needle puncture of the joint space and usually combined with lavage. After lavage, the mandible is gently manipulated to evaluate the movement. Arthrocentesis with irrigation has been used successfully with few complications and low morbidity. Postoperative therapy requires repetitive opening and excursive exercises to maintain and improve the function. The mean follow-up period was 17.1 months(range, 8 to 30months). Preoperative and postoperative mean maximal interincisal opening(MIO) was 25.4mm preoperatively and 39.8mm postoperatively. The pain was reduced in 7 out of 8(87.5%) patients with limited mouth opening. The result of this study indicate that TMJ arthrocentesis is an effective means of controlling pain and improving jaw movement in patients with closed lock.
Exercise ; Follow-Up Studies ; Humans ; Jaw ; Joints ; Mandible ; Mouth ; Needles ; Punctures ; Temporomandibular Joint* ; Therapeutic Irrigation

PURPOSE: The association between the margin status and the risk of a local recurrence (LR) after breast conservation therapy (BCT) is controversial. In addition, the width of the resection margin that minimizes the risk of LR is unknown. This study examined the interaction between the margin width, tumor characteristics, and adjuvant systemic therapy on the risk of LR after BCT. METHODS: The records of 348 women with T1 and T2 breast cancers, who were treated with BCT between 1997 and 2004, were reviewed. Patients who underwent a re-excision with a positive margin were excluded. The margin was classified as close (< or =5 mm tumor-free margin) or negative (>5mm tumor-free margin). Various clinical and pathologic factors were analyzed as potential prognostic factors for LR in addition to the margin width. RESULTS: The rate of LR for all patients after a mean follow-up of 37.2 months was 3.7% (13/348). The LR rates were significantly associated with young age (<40 years, P=0.009), high nuclear grade (P=0.032), large tumor size (>2 cm, P=0.021) and negative hormone receptor (P=0.032). A positive axillary lymph node, the presence of EIC, high histological tumor grade, high proliferative index (Ki-67), the presence of lymphovascular invasion, the over-expression of c-erbB2 and the expression of p53 was not significant. Systemic adjuvant therapy was not associated with a lower rate of LR in both groups. The final resection margins were close in 30 patients (8.6%) and negative in 318 patients (91.4%). The rates of LR by the margin width were 6.7% (2/30) for close margins and 3.5% (11/318) for negative margins. There were no significant differences in the rate of LR according to the margin width. The rate of LR in patients with a 1 mm tumor-free margin width was 13.3% (2/15). Moreover, there is a tendency for an increase in the LR with a 1 mm tumor-free margin than with a margin width >1 mm (P=0.046). CONCLUSION: According to this study, if the margin is tumor-free, a close resection margin (< or =5 mm) is not associated with an increased rate of LR in BCT. However, a high rate of LR can be expected in patients with 1 mm margins.
Breast Neoplasms ; Breast* ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Recurrence*

PURPOSE: This study was performed to determine the incidence of BMM and to correlate the presence of these micrometastases with prognosis and othet clinicopathologic features. Materials AND Methods: BMM was evaluated in 220 breast cancer patients between July, 1991 and January, 1997, using mouse monoclonal antibody (AE1/AE3) against cytokeratin in an immunofluorescent assay. RESULTS: Of the 220 patients, 71 (32.3%) were positive for BMM. There were no association between bone marrow positivity and nodal status, TNM stage, known histopathologic parameters, and hormona1 receptor. Median follow-up for 220 patients was 41.6 month. The relapse rate was 16.8% (37/220). Twenty-four (33.8%) of 37 patients were positive for BMM and 13 (8.7%) were negative (p<0.05). Bone metastasis occurred in 16 cases, and was more common in BMM positive patients (14 of 24, 54.2%, versus 2 of 13, 15.4%, p < 0.05). Twenty-six patients were died of relapsed breast cancer. In overall survival, patients who was negative for BMM showed higher survival rate (p<0.05). CONCLUSION: BMM was a good predictor for distant metastasis, especially bone metastasis, and for poor prognosis. But no association was found between bone marrow positivity and tumor size, nodal status, stage, histologic parameter and hormonal receptor status.
Animals ; Bone Marrow* ; Breast Neoplasms* ; Breast* ; Fluorescent Antibody Technique ; Follow-Up Studies ; Humans ; Incidence ; Keratins ; Mice ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Prognosis ; Recurrence ; Survival Rate

Background: Retzius-sparing robot-assisted radical prostatectomy (rsRARP) is a surgical procedure that can minimize the resection of surrounding prostate tissue by enabling access through the anterior surface of the Douglas pouch. We reported our initial experiences with rsRARP compared to conventional robot-assisted radical prostatectomy (RARP). Methods: Retrospective data were collected from March 2019 to June 2022, including 69 patients who underwent robotic radical prostatectomy for localized prostate cancer. The operations were performed at a single center, and we alternated between the two methods. Perioperative characteristics and oncologic and functional outcomes were analyzed. Results: In total, 35 patients underwent RARP and 34 patients underwent rsRARP. The preoperative characteristics of the patients were similar. Oncologic and functional parameters were analyzed postoperatively. Except for early recovery of urinary incontinence (immediate, 1 month, 3 months, 6 months: p<0.001, p=0.002, p=0.004, and p=0.014, respectively), there were no significant differences between the two groups. We also analyzed trends in operation time and oncologic and functional outcomes according to the progression of rsRARP cases. Conclusions rsRARP has the major advantage of enabling an early recovery from urinary incontinence after surgery, and it is also a good surgical approach that shows oncologically similar results to the conventional approach. It is also highly reproducible and can be recommended to surgeons new to robotic radical prostatectomy.

Cysts of the spleen are uncommon disease entities and can be classified as either primary (true) or secondary (pseudo-) depending on the presence of a true epithelial lining. True nonparasitic cysts of spleen are very rare, and the majority of the cases are classified as epidermoid cysts. True splenic cysts were found in three children during the last eleven years (1989~1999) in Yeungnam University Hospital. Two of the children were girls and one was boy. The age at diagnosis ranged from 7 to 15 years. Abdominal ultrasonography was utilized to the initial diagnosis, and computerized tomography was done for the detailed studies. Radionuclide scanning was performed in a patient. Surgical resection (one partial splenectomy and two total splenectomies) was performed. The cysts were from 4cm to 9cm in maximum diameter. Pathologic finding was epidermoid cyst of the spleen.
Child ; Diagnosis ; Epidermal Cyst ; Female ; Humans ; Male ; Spleen ; Splenectomy ; Ultrasonography

Background and Objectives: In South Korea, neck ultrasonography (US) has been used widely at 1- or 2-year intervals to detect recurrence after thyroidectomy. The aim of this study is to assess the prevalence and pattern of recurrence and to establish a proper frequency of follow-up neck US after thyroid lobectomy for papillary thyroid microcarcinoma (PTMC). Materials and Methods: We retrospectively reviewed 262 consecutive patients who had undergone thyroid lobectomy for PTMC from January 2005 to October 2009. They were divided into two groups based on the presence of recurrence (240 patients in group 1 and 22 patients in group 2). The comparison between the two groups involved clinical and pathological characteristics. Results: Recurrences were found in 22 (8.4%) of 262 patients with 132.5 months follow-up (range, 120-180 months). There was a significant difference in the mean number of follow-up neck US after 5 years postoperatively, shortened interval, total number of follow-up neck US (p=0.002, p＜0.001, p＜0.001). All recurrences were found between 2-3 to 11-12 years. Recurrences after 5 years were found in 16 (72.7%) of 22 patients. Conclusion Recurrence after thyroid lobectomy for PTMC occurred with various times during follow up. The minimum frequency of follow-up neck US was not enough for detecting tumor recurrence, especially after 5 years postoperatively. Our results suggest that annual neck US may be appropriate between 3 to 12 years after thyroid lobectomy for PTMC.

OBJECTIVES: The standard metrics used to monitor the progression of acute kidney injury (AKI) include markers such as serum creatinine, blood urea nitrogen, and estimated glomerular filtration rate (eGFR). Moreover, neutrophil gelatinase-associated lipocalin (NGAL) expression has been reported to modulate oxidative stress. METHODS: We aimed to evaluate the usefulness of serum NGAL levels for monitoring renal function after radical nephrectomy (RN). We prospectively collected data from 30 patients who underwent RN. We analyzed serum NGAL and creatinine at 6 time points: preoperative day 1, right after surgery, 6 hours after surgery, postoperative day (POD) 1, POD 3, and POD 5. We compared these measurements according to the eGFR values (classified as chronic kidney disease stage III; CKD III or not) using data obtained 3 months after surgery. RESULTS: The mean age was 65.5 years (range, 45–77 years), and the male-to-female ratio was 2:1. At the last follow-up examination, there were 12 patients (40%) with CKD III. Using receiver operating characteristic analysis, we found that serum creatinine on POD 5 (area under the curve [AUC], 0.887; P= 0.000) and NGAL at 6 hours after LRN (AUC, 0.743, P= 0.026) were significant predictors of CKD III. The development of CKD III after LRN was associated with the serum creatinine level on POD 5 and the NGAL at 6 hours after surgery. CONCLUSIONS: Compared to serum creatinine, serum NGAL enabled earlier prediction of postoperative CKD III. Therefore, serum NGAL measured 6 hours after surgery could be a useful marker for managing patients after RN.
Acute Kidney Injury ; Blood Urea Nitrogen ; Creatinine ; Early Diagnosis* ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kidney ; Lipocalins* ; Nephrectomy* ; Neutrophils* ; Oxidative Stress ; Prospective Studies ; Renal Insufficiency, Chronic ; ROC Curve

PURPOSE: The purpose of this study was to evaluate the characteristics of patients who received primary androgen deprivation therapy (PADT) for clinically localized prostate cancer and the clinical efficacy of this treatment. MATERIALS AND METHODS: Between January 1998 and August 2007, patients who underwent PADT for clinically localized prostate adenocarcinoma were analyzed. The patients studied could not receive definitive therapy owing to old age or medical comorbidities. All patients' Gleason score, pretreatment prostate-specific antigen (PSA) value, time to PSA progression, and D'Amico's risk criteria were analyzed. RESULTS: A total of 72 patients were analyzed. The patients' mean age was 75.29 years (range, 57-92 years) and their median pretreatment PSA was 13.52 ng/ml (range, 1.27-74.82 ng/ml). The median follow-up duration was 39 months (range, 18-115 months). Thirteen patients (18.57%) had PSA progression after reaching a PSA nadir. The mean time to PSA progression was 14 months (range, 7-55 months). Among these 13 patients, 2 patients had low-risk prostate cancer and 11 patients had high-risk prostate cancer by D'Amico's risk criteria. Three of the 13 patients are now receiving chemotherapy, 2 patients died from cancer progression, 3 patients died of a non-cancer cause, and 5 patients are now being conservatively managed. Of the total 72 patients, 70.83% of the patients are still receiving PADT. A total of 11 patients died; however, only 2 deaths were caused by prostate cancer. CONCLUSIONS: In patients with localized prostate cancer who could not receive definitive therapy for several reasons, the cancer-caused death rate was very low, even in patients with PSA progression. PADT is an effective therapeutic option in patients with localized prostate cancer.
Adenocarcinoma ; Androgens ; Comorbidity ; Follow-Up Studies ; Humans ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms

PURPOSE: The aim of this study was to evaluate the risk factors for cervical lymph node (LN) metastasis and the clinical role of internal jugular LN (IJLN) sampling in patients with papillary thyroid carcinoma (PTC) and who had a preoperatively undetected cervical LN. METHODS: One-hundred sixty-three patients with PTC (1 cm in diameter) without clinical evidence of cervical LN involvement were entered the study. All patients the received central compartment node dissection (CCND) and IJLN sampling after total thyroidectomy. We retrospectively analyzed the correlation between the metastatic rate of IJLN and the known risk factors for cervical LN metastasis in the PTC patients. The correlation between the status of the central compartment LN and IJLN metastasis was analyzed. RESULTS: The overall metastatic rate of the central compartment LN and the IJLN was 74.8% and 50.3%, respectively. The metastatic rate of the IJLN was significantly associated with the male gender (P=0.046), primary tumor size (>2 cm, P=0.003) and multiplicity (P=0.006) of the PTC. A young patient age, bilaterality and extracapsular invasion did not achieve statistical significance (P>0.05). The presence of central compartment LN metastasis was a statistically significant risk factor for IJLN metastasis, especially when the rate of central compartment LN metastasis was higher than 50% in the individual patients. CONCLUSION: According to our study, male gender, a large tumor size (>2 cm), multiplicity and the presence of central compartment LN metastasis is considered to be important risk factors for IJLN metastasis in PTC patients. IJLN sampling might be proposed as a relevant tool for making the decision to perform lymphadenectomy in PTC patients with a preoperatively undetected cervical LN.
Humans ; Lymph Node Excision ; Lymph Nodes* ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: Since the publication of the 5th edition of the AJCC cancer staging manual in 1997 (old stage), significant developments have occurred in the field of breast cancer diagnosis and management; therefore, it was revised at 2002 (new stage). There are few reports comparing the changes in prognosis in relation to the changes in the staging system. The aims of this study were to evaluate the changes in patient distribution and prognosis according to the changes in the staging system and to elucidate the efficacy of new staging system. METHODS: The records of 1, 275 patients who underwent an operation for breast cancer at Yeung-Nam University Hospital between 1987 and 2003 were reviewed. The pathological stage was assigned retrospectively according to the 5th and the 6th AJCC staging criteria. The patient distributions by stage, nodal status, 5-year relapse free survival (RFSR) and overall survival rates (OSR) were retrospectively compared. RESULTS: Five hundred and five of 616 stage II patients according to the 1997 classification system were also stage II according to the 6th AJCC staging system. The number of patients with stages IIA and IIB decreased from 370 and 246 (old stage) to 342 and 165 (new stage), respectively. Conversely, the number of patients with stage III increased from 158 (old stage) to 271 (new stage). The five-year RFSR for patients with stage I, IIA, IIB, and IIIA were 94.2, 87.1, 74.3, and 48.8% according to the old stage (P<0.0001), and 95.2, 87.8, 81.7, and 66.8%, respectively, according to the new stage (P<0.0001). The five-year OSR for patients with stage I, IIA, IIB, and IIIA were 98.7, 94.3, 86.1, and 63.5% according to the old stage (P<0.0001), and 98.7, 95.7, 96.5, and 72.9%, respectively, according to the new stage (P<0.0001). The RFSR and OSR for stage IIIC were 42.0 and 59.5%, respectively. There was significant difference in the five-year OSR for stages IIB and IIIA (P=0.0308 and P=0.0132, respectively). CONCLUSION: In our study, the 6th AJCC staging system shifted poorer prognostic cohort of each stage toward a higher stage compared to the 1997 version. Therefore, the survival rate for any one stage assigned by 2002 staging system was also improved. In conclusion, it is imperative that careful attention is devoted to this effect so that accurate conclusions regarding the efficacy of new treatment can be drawn.
Breast Neoplasms* ; Breast* ; Classification ; Cohort Studies ; Diagnosis ; Humans ; Joints* ; Neoplasm Staging ; Prognosis ; Publications ; Recurrence ; Retrospective Studies ; Survival Rate