Most of the breast cancer revealed mass and/or microcalcifications on mammography. We analyzed morphologic characteristics of the masses and microcalcifications on mammography which confirmed as breast cancer pathologically. Of all 54 cases, 4 patients (7%) showed microcalcification only, 27 patients (50%), mass only, and the other 23 patients (43%), both microcalcification and mass on the mammography. The margin of the breast mass were ill-defined in 37 cases, well-defined in 8 cases, and well-defined with surrounding infiltration in 5 cases. The morphologic characteristics of the microcalcification were punctate-linear-V shape in 11 patients, punctate-linear shape in 9 patients, and punctate shape in 7 patients.
Breast Neoplasms* ; Breast* ; Humans ; Mammography

Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in serious long-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severe hypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followed by acute lung injury during general anesthesia induction. A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was no sign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspiration occurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemia with hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results became stable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeal life support can have survival benefits.
Acute Lung Injury ; Anesthesia* ; Anesthesia, General ; Anoxia ; Blood Gas Analysis ; Extracorporeal Membrane Oxygenation* ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Intubation, Intratracheal ; Laparoscopy ; Middle Aged ; Mortality ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach Neoplasms

No abstract available.
Fetal Blood* ; Humans ; Infant, Newborn* ; Phenotype

PURPOSE: To compare the corneal power (K) measured by different methods in the patients who underwent photorefractive keratectomy (PRK) or laser in situ keratomilieusis (LASIK) METHODS: Fifty-four patients who had undergone PRK or LASIK from December 1999 to December 2000 and followed for 3 months or longer were selected for this study. The corneal power was measured by five different methods in 35 eyes(18 patients) of PRK group and in 70 eyes (36 patients) of LASIK group: calculation method (C-K), hard contact lens method (H-K), autorefractokeratometer (A-K), manual keratometer (M-K) and topography (T-K). RESULTS: Preoperative mean corneal power was 43.41+/-1.06 D in PRK group and 43.75+/-1.03 D in LASIK group. Postoperative corneal power in PRK group showed following Results: C-K, 40.94+/-1.51 D; H-K, 41.04+/-1.23 D; A-K, 41.18+/-1.29 D; M-K, 41.38+/-1.33 D; T-K, 41.67+/-1.26 D. In LASIK group, the results were: C-K, 38.64+/-2.25 D; H-K, 39.29+/-1.66 D; A-K, 39.53+/-1.61 D; M-K, 39.85+/-1.54 D; T-K, 40.36+/-1.26 D. The corneal power of calculation method was lowest in both groups. Each corneal power was not different statistically from the others in PRK group(p=0.16). However, C-K was significantly lower than A-K (p=0.02), M-K (p=0.00) or T-K (p=0.00) in LASIK group. Also, H-K or AK was lower than T-K statistically in LASIK group (p=0.00, p=0.02). CONCLUSIONS: The corneal power was lowest when measured by calculation method after refractive surgery. In LASIK group, there were statistical differences among the corneal powers by each method.
Humans ; Keratomileusis, Laser In Situ ; Photorefractive Keratectomy ; Refractive Surgical Procedures*

PURPOSE:To report the change of corneal asphericity and the relationship between asphericity and visual acuity after wearing the reverse-geometry lens. METHODS: The authors reviewed out-patient records of 37 consecutive patients wearing reverse-geometry lenses. The patients were followed up from July 2004 to December 2007. The unaided visual acuity (VA), spherical equivalent (SE) and asphericity before and after wearing the lens were compared. The relationship of SE and final VA, initial astigmatism and final VA, and asphericity and final VA was also analyzed. In addition, the relationship between the increment of VA and asphericity was determined. RESULTS: VA and SE improved and the asphericity decreased after wearing the lens (p<0.05). There was high correlation between the spherical equivalent and final visual acuity (p<0.001), and no correlation between asphericity and final visual acuity (p=0.358) was observed. However, the lower the initial asphericity, the greater the increment of visual acuity observed (p=0.048). CONCLUSIONS: Initial corneal asphericity can be a predictor of increment of VA after wearing reverse-geometry lenses.
Astigmatism ; Humans ; Outpatients ; Visual Acuity

PURPOSE: We developed an inverse technique for tissue morcellation by modifying the conventional upward technique and then examined its safety and efficiency. MATERIALS AND METHODS: From July 2008 to December 2010, a total of 389 consecutive patients treated with holmium laser enucleation of the prostate (HoLEP) were enrolled in this study. For tissue morcellation, we used an upward technique for an initial series of 84 patients and an inverse technique for a consecutive series of 305 patients. We compared efficiency and safety between the inverse technique and the upward technique. RESULTS: There were no significant differences in mean age or prostate volume between the two groups. The mean morcellation efficiency was higher in the inverse technique group. The incidence of severe bladder injury was significantly higher in the upward technique group. Regarding the site of bladder injury, 7 and 4 cases of bladder injury occurred in the bladder dome and posterior wall, respectively, in the upward technique group. In the inverse technique group, however, the site of bladder injury was limited to the trigone. We divided our clinical series of patients into the upward technique group and three inverse technique groups on the basis of the timing. The mean morcellation efficiency was significantly higher in all three inverse technique groups than in the upward technique group. However, there was no significant difference in mean morcellation efficiency between the three inverse technique groups. CONCLUSIONS: In conclusion, the inverse technique might be a more effective, safer, and more excellent method of morcellation than the conventional upward technique.
Holmium ; Humans ; Incidence ; Lasers, Solid-State ; Prostate ; Urinary Bladder

PURPOSE: We developed an inverse technique for tissue morcellation by modifying the conventional upward technique and then examined its safety and efficiency. MATERIALS AND METHODS: From July 2008 to December 2010, a total of 389 consecutive patients treated with holmium laser enucleation of the prostate (HoLEP) were enrolled in this study. For tissue morcellation, we used an upward technique for an initial series of 84 patients and an inverse technique for a consecutive series of 305 patients. We compared efficiency and safety between the inverse technique and the upward technique. RESULTS: There were no significant differences in mean age or prostate volume between the two groups. The mean morcellation efficiency was higher in the inverse technique group. The incidence of severe bladder injury was significantly higher in the upward technique group. Regarding the site of bladder injury, 7 and 4 cases of bladder injury occurred in the bladder dome and posterior wall, respectively, in the upward technique group. In the inverse technique group, however, the site of bladder injury was limited to the trigone. We divided our clinical series of patients into the upward technique group and three inverse technique groups on the basis of the timing. The mean morcellation efficiency was significantly higher in all three inverse technique groups than in the upward technique group. However, there was no significant difference in mean morcellation efficiency between the three inverse technique groups. CONCLUSIONS: In conclusion, the inverse technique might be a more effective, safer, and more excellent method of morcellation than the conventional upward technique.
Holmium ; Humans ; Incidence ; Lasers, Solid-State ; Prostate ; Urinary Bladder

Urachal anomalies are very rare. The umbilicus and the structures which lead to its formation rarely cause trouble except in patients with an error. Embryologically, the urachus represents the vestigial remnant of the allantois which, in the fetus, communicates with the cloaca. The patent urachus results from failure of luminal closure of the urachus Herein a case of congenital patent urachus reported with a brief review of literatures.
Allantois ; Cloaca ; Fetus ; Humans ; Phenobarbital ; Umbilicus ; Urachus*

PURPOSE: Many patients presenting with headache also complain of constipation; the relationship between these two symptoms has not been explored in detail. The aim of this study was to investigate the association between primary headache and constipation. METHODS: This retrospective study included all children who attended the Inje University Sanggye Paik Hospital complaining of headache, and who had been followed up for at least 100 days. Patients were divided into 2 groups: group A, in whom the headache improved after treatment for constipation, and group B, in whom headache was not associated with constipation. RESULTS: Of the 96 patients with primary headache, 24 (25.0%) also had constipation (group A). All 24 received treatment for constipation. Follow-up revealed an improvement in both headache and constipation in all patients. Group B contained the remaining 72 children. Comparison of groups A and B indicated a significant difference in sex ratio (P=0.009, chi-square test). Patients with probable tension-type headache were more likely to be in Group A (P=0.006, chi-square test). CONCLUSION: Resolution of constipation improves headache in many patients diagnosed with primary headache, especially those with probable tension-type headache. We suggest that either constipation plays a key role in triggering headache, or that both constipation and headache share a common pathophysiology.
Adolescent* ; Child* ; Constipation* ; Follow-Up Studies ; Headache* ; Humans ; Migraine Disorders ; Pediatrics ; Retrospective Studies ; Sex Ratio ; Tension-Type Headache

PURPOSE: Pelvic floor muscle exercise (PFME) is a therapeutic option for urinary incontinence (UI). However, studies of the efficacy of PFME on UI in patients with cognitive impairment (CI) are lacking. Therefore, we evaluated the effect of PFME on UI in elderly women with mild CI. METHODS: A total of 150 women with mild CI or Alzheimer disease and UI were screened using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Cognitive function and behavioral symptoms were evaluated by the Mini-Mental State Examination and Barthel's Activities of Daily Living. The patients were randomly divided into a control group (n=46) and a PFME group (n=52, 6 sessions of PFME for 12 weeks). The primary outcome was the change in UI episodes measured with a frequency volume chart (FVC). The secondary outcomes were other FVC parameters and the ICIQ-SF scores. RESULTS: A total of 82 women (control group: 40 and PFME group: 42) completed the study. After 12 weeks of PFME, the mean number of UI episodes per 24 hours decreased by 1.6 (from 3.3 to 1.7) in the PFME group and by 0.5 (from 3.4 to 2.9) in the control group (P < 0.001 between groups). The mean number of micturition episodes and total ICIQ-SF scores improved in the PFME group to a significantly greater extent than in the control group (P<0.001). CONCLUSIONS: Supervised PFME can be a good therapeutic option for improving UI in elderly women with CI.
Activities of Daily Living ; Aged* ; Alzheimer Disease ; Behavioral Symptoms ; Cognition ; Cognition Disorders* ; Female ; Humans ; Pelvic Floor* ; Urinary Incontinence* ; Urination