No abstract available.
Teratoma* ; Uterus*

PURPOSE: Hydroxychloroquine has been used as the antimalarial agent and drug of the treatment for autoimmune disease such as rheumatoid arthritis. Hydroxychloroquine retinopathy can cause serious visual disturbance although the incidence is low. This report is to describe a case of Hydroxycholoroquine retinopathy on 73 year old female. CASE SUMMARY: A 73 year old female patient presented our clinic with complaints of visual disturbance for several months. She had taking 400 mg/day (8.8 mg/kg of lean body weight/day) of hydroxychloroquine for 2 years. The best corrected visual acuity was 20/30 in both eyes. Bull's eye maculopathy was observed on her fundus examination and Humphrey Automated Visual Field 24-2 showed central scotoma in both eyes. Parafoveal thinning of photoreceptor layers, loss of the inner and outer segment junction and external limiting membrane was observed on spectral domain Optical Coherence Tomography. Window defect was visible at the parafoveal area on fluorescein angiography. Electroretinogram revealed subtle dysfunction of cone cell and multifocal ERG trace array showed decreased amplitudes at the parafoveal area. Electrooculogram showed decreased Arden ratio. CONCLUSIONS: We strongly advise that all patients taking Hydorxycholoroquine therapy have a regular examination to find hydroxychloroquine retinopathy in early stage especially in the patients having high risk factors.
Arthritis, Rheumatoid ; Autoimmune Diseases ; Electrooculography ; Eye ; Female ; Fluorescein Angiography ; Humans ; Hydroxychloroquine ; Incidence ; Membranes ; Risk Factors ; Scotoma ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields

PURPOSE: To compare the postoperative results between the patient group which used bioabsorbable interference screw and metallic interference screw during ACL reconstruction surgery. MATERIAL AND METHODS: Out of 105 patients for whom the postoperative follow-up was possible for one year, authors took 80 patients who underwent arthroscopic ACL recostruction with bone-patellar tendon-bone autograft between December of 1996 and December of 2000. 60 patients fell into group 1 where the patients received bioabsorbable interference screw for fixation at femur and tibia, and 20 patients were classified as group 2 where the patients received metallic interference screw on both the femur and tibia. KT 2000 arthrometer was performed and Lysholm knee score was taken before and after the operation, and the patients underwent the same examination at 6 weeks. 3 months, 6 months, and 1 year after the operation, and the results were compared. RESULT: The average Lysholm knee score of group 1 was 59, and 57 for group 2. During the final follow up examination, the average score improved to 90 for group 1, and group 2. Compared to the healthy side, KT 2000 arthrometer showed the average in group 1 was 6.9 mm and 7.2 mm in group 2 preoperatively, at the final follow up visit after the operation, the value improved to 3.0 mm for both group 1 and 2. Unlike group 2, there were statistically significant relaxation symptoms in group 1 when the exams were performed up until 6 weeks after the operation(P<0.05). CONCLUSION: The usage of bioabsorbable interference screw has many advantages. However, unlike metallic interference screw, it shows laxity within 3 months after the operation. Therefore, when using bioabsorbable interference screw, one has to consider the patients'activity, occupation, or life-style.

No abstract available.
Endocardial Cushion Defects* ; Endocardial Cushions* ; Ultrasonics*

PURPOSE: Laparoscopic radical nephrectomy (LRN) is more challenging with increases in body mass index (BMI). Several recent studies have shown, however, that LRN can be safely performed even in obese patients. The influence of obesity on the perioperative outcomes of LRN has not been well elucidated for large renal tumors (>7 cm), however. We estimated the impact of obesity on LRN for stage T1 and T2 renal cell carcinoma (RCC). MATERIALS AND METHODS: From January 2004 to March 2011, 266 patients underwent LRN (T1: 195, T2: 71). These patients were subdivided into the following two groups according to BMI: the nonobese group (BMI less than 25 kg/m2) and the obese group (BMI greater than 25 kg/m2). Perioperative outcomes were retrospectively compared between these two groups in T1 and T2 RCC patients. RESULTS: There were no significant differences in perioperative outcomes between the obese and nonobese groups of T1 RCC patients. However, in T2 RCC patients, operative time and complication rate were significantly increased in the obese group. CONCLUSIONS: Our results suggest that LRN can be safely performed in Korean patients with T1 RCC regardless of obesity. In T2 RCC patients, however, LRN may become more difficult with increasing BMI considering a longer operation time as well as a higher complication rate. We suggest that LRN for obese patients with T2 RCC be carefully considered.
Body Mass Index ; Carcinoma, Renal Cell ; Humans ; Nephrectomy ; Obesity ; Operative Time ; Retrospective Studies

BACKGROUND: American Heart Association (AHA) defined 7 cardiovascular health metrics for the general population to improve cardiovascular health in 2010: not smoking; having normal blood pressure; being physically active; normal body mass index, blood glucose, and total cholesterol levels; and eating a healthy diet. To investigate trends in cardiovascular health metrics in Korea, we used data from the third and fourth Korean National Health and Nutrition Examination Surveys. METHODS: We defined seven cardiovascular health metrics similar to the one defined by AHA but physical activity, body mass index, and healthy diet were properly redefined to be suited for the Korean population. We compared each cardiovascular health metric and calculated the sum of cardiovascular health metrics after dichotomizing each health metric to ideal (scored 1) and poor (scored 0). RESULTS: Health metric scores of smoking in males (P value for trend < 0.001), physical activity both in males and females (P-value for trend < 0.001 both), body mass index in females (P-value for trend = 0.030), and blood pressure both in males and females (P-value for trend < 0.001, both) were improved. On the other hand, health metric scores of healthy diet in males (P-value for trend = 0.002), and fasting blood glucose both in males and females (P-value for trend < 0.001 both) got worse. The total scores of seven health metrics were stationary. CONCLUSION: Total scores were not changed but each metric showed various trends. A long-term study is necessary for analyzing exact trends.
Adult* ; American Heart Association ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Diet ; Eating ; Fasting ; Female ; Hand ; Humans ; Korea ; Male ; Motor Activity ; Smoke ; Smoking

Successful management of patients with persistent or recurring pain after lumbar disc surgery requires comprehensive evaluation to accurately localize the anatomic sources of pain. The results of reoperation for recurrent disc herniation are uniformly good, whereas those of reoperation for scar tissue are poor. There have been few studies comparing the ability of enhanced MRI and CT/discography to distinguish between scar tissue and recurrent disc herniation. We evaluated 23 patients with recurring pain after lumbar disc surgery. Two neurosurgeons independently reviewed CT/discography and MRI of each patient before and after gadolinium enhancement. To determine the accuracy, sensitivity, and specificity of each test, responses were compared with surgical findings and CT/discography was found to be more sensitive and specific in distinguishing between scar and recurrent disc herniation. Characteristics associated with recurrent disc herniation include nonenhanced or rim-enhanced abnormality surrounding a low signal on enhanced MRI. and extension of contrast into the epidural space on CT/discography. For determining the need to repeat open disc surgery, combined MRI and CT/discography is more accurate and sensitive than either test alone.
Cicatrix ; Epidural Space ; Gadolinium ; Humans ; Magnetic Resonance Imaging ; Reoperation ; Sensitivity and Specificity

The objectives of this study were to characterize the alterations of 3p and 9p in sporadic renal cell carcinomas (RCC) and to assess the relationship between the clinical stages or tumor size and the alteration of these chromosomes. Thirty eight archival, paraffin embedded tissue sections from 38 patients with RCC were analyzed for loss of heterozygosity (LOH) at 3p and 9p with 11 microsatellite markers. LOH was detected in 81.6% (31/38) and 37.8% (14/37) at 3p and 9p, respectively. The frequencies of LOH at VHL and FHIT locus were 75.6% and 72.2%, respectively. Twelve cases out of 38 showed LOH at both 9p21 and 3p. The loss of 3p in the samples tested was not related to clinical stages and tumor size, but that of 9p21 was significantly associated with advanced stage and larger tumor size. These results support that 3p deletion, including VHL and FHIT gene, play a critical role in the tumorigenesis of sporadic RCC, especially at early stage, and that 9p21 may contribute to the progression of sporadic RCC.
Carcinogenesis ; Carcinoma, Renal Cell* ; Humans ; Loss of Heterozygosity* ; Microsatellite Repeats ; Paraffin

BACKGROUND: We determined the effect of spinal cord injury (SCI) on sevoflurane requirements and stress hormone responses, and sevoflurane concentration to block autonomic hyperreflexia (AHR) in SCI patients. METHODS: In the first series, sevoflurane concentrations to maintain bispectral index score (BIS) at 40-50 and stress hormone response were examined in 27 SCI patients undergoing surgery below the level of injury.Fifteen patients without SCI served as control.Measurements included end-tidal sevoflurane concentrations (ET(SEVO)), systolic blood pressure (SBP), heart rate (HR), catecholamines, vasopressin, and cortisol concentrations.In the second series, sevoflurane concentration to block AHR was examined in 31 SCI patients undergoing transurethral litholapaxy.When a patient developed an episode of AHR, the target sevoflurane concentration was maintained for 10 min, and then the procedure was repeated.Each target concentration was determined by up-down method based on SBP. RESULTS: During surgery, SBP, HR, and BIS were comparable between SCI and control.However, ETSEVO was significantly smaller in the SCI than the control.Plasma concentrations of norepinephrine, epinephrine and cortisol were significantly lower in the SCI than the control.SBP rose by 67 +/- 31 mmHg, whereas HR fell by 13 +/- 8 bpm during the 1st trial in the SCI (P < 0.01).Hypertensive events were associated with increases of norepinephrine concentrations.ETSEVO required to prevent AHR were 3.12% in 50% of patients, 3.83% in 95% of patients. CONCLUSIONS: SCI reduces the anesthetic requirement by 39%, and decreases stress hormone responses during surgery below the level of injury.To prevent AHR in 95% of SCI patients undergoing litholapaxy, ETSEVO 3.83% may be required.
Autonomic Dysreflexia ; Blood Pressure ; Catecholamines ; Epinephrine ; Heart Rate ; Humans ; Hydrocortisone ; Lithotripsy ; Methyl Ethers ; Mustard Compounds ; Norepinephrine ; Spinal Cord Injuries ; Vasopressins

PURPOSE: Previous studies examining the relationship between time to treatment and survival outcome in breast cancer have shown inconsistent results. The aim of this study was to analyze the overall impact of delay of treatment initiation on patient survival and to determine whether certain subgroups require more prompt initiation of treatment. MATERIALS AND METHODS: This study is a retrospective analysis of stage I-III patients who were treated in a single tertiary institution between 2005 and 2008. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of interval between diagnosis and treatment initiation in breast cancer and various subgroups. RESULTS: A total of 1,702 patients were included. Factors associated with longer delay of treatment initiation were diagnosis at another hospital, medical comorbidities, and procedures performed before admission for surgery. An interval between diagnosis and treatment initiation as a continuous variable or with a cutoff value of 15, 30, 45, and 60 days had no impact on disease-free survival (DFS). Subgroup analyses for hormone-responsiveness, triple-negative breast cancer, young age, clinical stage, and type of initial treatment showed no significant association between longer delay of treatment initiation and DFS. CONCLUSION: Our results show that an interval between diagnosis and treatment initiation of 60 days or shorter does not appear to adversely affect DFS in breast cancer.
Breast Neoplasms* ; Breast* ; Comorbidity ; Diagnosis ; Disease-Free Survival ; Humans ; Retrospective Studies ; Survival Rate ; Time-to-Treatment ; Triple Negative Breast Neoplasms