No abstract available.
Dermoscopy ; Hemangioma* ; Lasers, Dye

OBJECTIVE: Self-expanding stents are increasingly used for the treatment of complex intracranial aneurysms. The purpose of this study was to evaluate the usefulness and safety of a self-expanding nitinol stent (Enterprise) in the treatment of wide-necked intracranial aneurysms. METHODS: This was a retrospective study of 39 patients with 40 wide-necked intracranial aneurysms who were enrolled in a single-center registry of patients treated with the Enterprise between June 2009 and December 2011. Thirty patients were asymptomatic, four had cerebrovascular accident sequelae, and five had suffered subarachnoid hemorrhage. One aneurysm had reopened after prior coil embolization, while 39 had not been treated. Clinical charts, procedural data, and angiographic results, including both immediate post-procedural angiograms and follow-up imaging, were reviewed. RESULTS: The mean neck size of the aneurysms was 5.58 mm (range 3-15.1 mm). Embolization was successful in all patients. There were five procedure-related events. There were no fatalities, but one procedure-related morbidity was noted. The immediate angiographic results included eight complete occlusions (20%), six remnant necks (15%), and 26 remnant sacs (65%). At angiographic follow-up (mean: 11.3 months), out of 18 of the aneurysms treated with stent-assisted coiling, there were 13 (72.2%) complete occlusions, four (22.2%) remnant necks, and one recanalization (5.6%). CONCLUSION: Stent-assisted coiling using the Enterprise is effective for the treatment of wide-necked intracranial aneurysms. Further angiographic and clinical follow-up investigation will be needed for evaluation of the long-term outcomes.
Aneurysm* ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Neck ; Retrospective Studies ; Stents* ; Stroke ; Subarachnoid Hemorrhage

PURPOSE: A lateral thoracodorsal fasciocutaneous flap (LTFF) is a local fasciocutaneous flap that has been used in breast reconstructions since the 1980s. Although the LTFF is a wellstudied reconstruction procedure after radical surgery in Western countries, there is no report in Korea. By introducing the LTFF procedure, we suggest an easy reconstruction technique that can be performed by the breast surgeon directly. METHODS: Patients with lateral breast cancer and redundant lateral thoracic region might be candidates for this procedure. The flap consists of the lateral and dorsal extensions of the inframammarian fold as well as an extended line from the anterior axillary line. A quadrantectomy is performed through a planned skin incision, and an axillary lymph node dissection can be performed simultaneously if the sentinel lymph node is positive. The skin and subcutaneous fat with the fascia of the serratus anterior and latissimus dorsi muscle should be dissected carefully. A wedge-shaped flap can be acquired successfully. The lateral breast defect is then reconstructed by a rotation of the flap. The axis of the flap is drawn following the inframammarian fold so that the final scar would be under the brassiere line. RESULTS: Nineteen patients were treated with the LTFF after breast conserving surgery. All tumors were located in lateral breast regions. Seroma occurred in three and partial fat necrosis and partial flap necrosis were observed in each one. The cosmetic result based on four-point scoring system of breast cosmesis showed excellent in seventeen and good in two. CONCLUSION: Despite its long scar line, with appropriate patient selection, a LTFF might be a useful method for breast reconstructions.
Axis, Cervical Vertebra ; Breast Neoplasms ; Breast* ; Cicatrix ; Fascia ; Fat Necrosis ; Female ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes ; Mammaplasty* ; Mastectomy, Segmental ; Necrosis ; Patient Selection ; Seroma ; Skin ; Subcutaneous Fat ; Superficial Back Muscles

OBJECTIVES: This study investigates the effects of using customized walking aids individualized for stroke patients by measuring the effects of different cane lengths to determine the ideal length of walking aids for stroke patients. METHODS: Cane lengths were determined from the greater trochanter with walking aids measured 5cm below, at the greater trochanter and 5cm above. All patients walked for ten meters with each cane length to measure speed. Then, we measured the opto gait, timed up go test, and electromyography three times each. Statistical analysis was performed using a linear mixed model, and in the case of significance, the p-value was corrected using the Bonferroni method. RESULTS: There was a statistically significant differences in time up and go test(TUGT), 10m walking, stride and speed between the groups. CONCLUSIONS: Long cane length increases body symmetry, stride, increasing muscle activity, and short cane length increases balance and walking.
Canes* ; Cerebrovascular Disorders ; Electromyography ; Femur ; Gait ; Humans ; Methods ; Stroke* ; Walking*

PURPOSE: The purpose of this study was to analyze the results of an immediate and mid-term angiographic and clinical follow-up of endovascular treatment for paraclinoid aneurysms. MATERIALS AND METHODS: From January 2002 to December 2012, a total of 113 consecutive patients (mean age: 56.2 years) with 116 paraclinoid saccular aneurysms (ruptured or unruptured) were treated with endovascular coiling procedures. Clinical and angiographic outcomes were retrospectively evaluated. RESULTS: Ninety-three patients (82.3%) were female. The mean size of the aneurysm was 5.5 mm, and 101 aneurysms (87.1%) had a wide neck. Immediate catheter angiography showed complete occlusion in 40 aneurysms (34.5%), remnant sac in 51 (43.9%), and remnant neck in 25 (21.6%). Follow-up angiographic studies were performed on 80 aneurysms (69%) at a mean period of 20.4 months. Compared with immediate angiographic results, follow-up angiograms showed no change in 38 aneurysms, improvement in 37 (Fig. 2), and recanalization in 5. There were 6 procedure-related complications (5.2%), with permanent morbidity in one patient. CONCLUSION: Out study suggests that properly selected patients with paraclinoid aneurysms can be successfully treated by endovascular means.
Aneurysm* ; Angiography ; Catheters ; Female ; Follow-Up Studies ; Humans ; Neck ; Retrospective Studies

The development of primary squamous cell carcinoma in the endometrium is extremely rare. In 1928 Fluhmann proposed three criteria to establish the diagnosis: (1) no coexisting endometrial adenocarcinoma, (2) no connection between the endometrial tumor and the squamous epithelium of the cervix and (3) no squamous cell carcinoma of the cervix present. More recently, the World Health Organization (WHO) updated Fluhmann's criteria by adding that the tumor must contain clear evidence of squamous differentiation, such as the presence of intercellular bridges and/or keratin. We have experienced a case of primary endometrial squamous cell carcinoma which fulfills Fluhmann's criteria and WHO's. In this report, we present the clinical and pathological findings of a case of a primary endometrial squamous cell carcinoma of a 62-year-old patient with a review of the concerned literatures.
Adenocarcinoma ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Diagnosis ; Endometrium ; Epithelium ; Female ; Humans ; Middle Aged ; World Health Organization

BACKGROUND/AIMS: Hyperplastic polyps (HPs) are the most common cause of all benign epithelial gastric polyps, constituting 30 to 93%. Although gastric HPs are usually considered as benign lesions compared with adenoma, neoplastic transformation has been known to occur rarely. We aimed to identify the clinical factors of gastric HPs predicting for neoplastic transformation. METHODS: Between January 2002 to August 2010, a total of 274 gastric HPs, which had been removed by endoscopic polypectomy or surgical resection from 210 patients, were analyzed retrospectively. RESULTS: Neoplastic transformation was found in 15 cases (5.5%) of 274 HPs including 10 cases of low grade dysplasia (3.7%), 2 cases of high grade dysplasia (0.7%) and 3 cases of adenocarcinoma (1.1%). Neoplastic transformations were significantly associated with >1 cm in size (n=10 [66.7%] vs. n=91 [35.1%], p=0.024), with pedunculated shape (n=9 [60.0%] vs. n=62 [23.9%], p=0.002), with previous history of gastrectomy (n=3 [20.0%] vs. n=3 [1.2%], p=0.002) and with synchronous neoplastic lesions occurring elsewhere in the gastric mucosa (n=5 [33.3%] vs. n=31 [12.0%], p=0.021). However, no significant difference was found between HPs with and without neoplastic transformation in terms of age, sex, number of polyps detected per patient, location, macroscopic appearance such as erosion, hyperemia. CONCLUSIONS: Neoplastic transformation of gastric HPs had significant relationships with >1 cm in size, pedunculated shape, postgastectomy state, and synchronous neoplastic lesion. Therefore, endoscopic polypectomy should be considered in these HPs to avoid the risk of missing HPs with neoplastic potential.
Adenocarcinoma/*pathology/surgery ; Age Factors ; Aged ; Cell Transformation, Neoplastic ; Female ; Gastroscopy ; Humans ; Hyperplasia ; Male ; Middle Aged ; Polyps/*pathology/surgery ; Predictive Value of Tests ; Retrospective Studies ; Sex Factors ; Stomach Neoplasms/*pathology/surgery

OBJECTIVES: Extension of the standard model while retaining compliance with it is a challenging issue because there is currently no method for semantically or syntactically verifying an extended data model. A metadata-based extended model, named CCR+, was designed and implemented to achieve interoperability between standard and extended models. METHODS: Furthermore, a multilayered validation method was devised to validate the standard and extended models. The American Society for Testing and Materials (ASTM) Community Care Record (CCR) standard was selected to evaluate the CCR+ model; two CCR and one CCR+ XML files were evaluated. RESULTS: In total, 188 metadata were extracted from the ASTM CCR standard; these metadata are semantically interconnected and registered in the metadata registry. An extended-data-model-specific validation file was generated from these metadata. This file can be used in a smartphone application (Health Avatar CCR+) as a part of a multilayered validation. The new CCR+ model was successfully evaluated via a patient-centric exchange scenario involving multiple hospitals, with the results supporting both syntactic and semantic interoperability between the standard CCR and extended, CCR+, model. CONCLUSIONS: A feasible method for delivering an extended model that complies with the standard model is presented herein. There is a great need to extend static standard models such as the ASTM CCR in various domains: the methods presented here represent an important reference for achieving interoperability between standard and extended models.
Compliance ; Health Records, Personal* ; Humans ; Methods ; Semantics

OBJECTIVES: Klinefelter syndrome is the most common genetic cause of male infertility and presents with 47, XXY mainly or 46, XX/47, XXY mosaicism. It is characterized by hypogonadism and azoospermia due to testicular failure, however, sporadic cases of natural pregnancies have been reported. With the development of testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI), sperm can be retrieved successfully and ART is applied in these patients for pregnancy. It has been suggested that the risk of chromosome aneuploidy for both sex chromosome and autosome is increased in the sperms from 47, XXY germ cells. Considering the risk for chromosomal aneuploidy in the offspring, preimplantation genetic diagnosis (PGD) could be applied as a safe and more effective treatment option in Klinefelter syndrome. The aim of this study is to assess the outcome of PGD cycles by using FISH for sex chromosome and autosome in patients with Klinefelter syndrome. MATERIALS AND METHODS: From Jan. 2001 to Dec. 2003, PGD was attempted in 8 cases of Klinefelter syndrome but TESE was failed to retrieve sperm in the 3 cases, therefore PGD was performed in 8 cycles of 5 cases (four 47, XXY and one 46, XY/47, XXY mosaicism). In one case, ejaculated sperm was used and in 4 cases, TESE sperm was used for ICSI. After fertilization, blastomere biopsy was performed in 6~10 cell stage embryo and the chromosome aneuploidy was diagnosed by using FISH with CEP probes for chromosome X, Y and 17 or 18. RESULTS: A total of 127 oocytes were retrieved and ICSI was performed in 113 mature oocytes. The fertilization rate was 65.3+/-6.0% (mean+/-SEM) and 76 embryos were obtained. Blastomere biopsy was performed in 61 developing embryos and FISH analysis was successful in 95.1% of the biopsied blastomeres (58/61). The rate of balanced embryos for chromosome X, Y and 17 or 18 was 39.7+/-6.9%. The rate of aneuploidy for sex chromosome (X and Y) was 45.9+/-5.3% and 43.2+/-5.8% for chromosome 17 or 18, respectively. Embryo transfer was performed in all 8 cycles and mean number of transferred embryos was 2.5+/-0.5. In 2 cases, clinical pregnancies were obtained and normal 46, XX and 46, XY karyotypes were confirmed by amniocentesis, respectively. Healthy male and female babies were delivered uneventfully at term. CONCLUSION: The patients with Klinefelter syndrome can benefit from ART with TESE and ICSI. Considering the risk of aneuploidy for both sex chromosome and autosome in the sperms and embryos of Klinefelter syndrome, PGD could be offered as safe and more effective treatment option.
Amniocentesis ; Aneuploidy ; Azoospermia ; Biopsy ; Blastomeres ; Chromosomes, Human, Pair 17 ; Embryo Transfer ; Embryonic Structures ; Female ; Fertilization ; Germ Cells ; Humans ; Hypogonadism ; Infertility, Male ; Karyotype ; Klinefelter Syndrome* ; Male ; Mosaicism ; Oocytes ; Pregnancy ; Preimplantation Diagnosis* ; Prostaglandins D ; Sex Chromosomes ; Sperm Injections, Intracytoplasmic ; Spermatozoa

No abstract available.
Female ; Hysterectomy, Vaginal* ; Uterine Prolapse*