Closed loop onstruction represent a surgical emergency, because this lesion leads to small boweel infarction, perforation, and peritonitis if not treated in time. We analyzed the CT and ultrasonographic findings of 4 patients prospectively and 2 patients retrospectively with surgically proven closed loop obstruction of the small boweel to evaluate the characteristic findings, the cause of the closed loop obstruction and predictive criteria for the viablity of the involved bowel loop. The characteristic CT and sonographic features of the closed loop obstruction of the small bowel included; dilated fluid-filled bowel loops, the thickened bowel wall, absence of peristalsis, and ascites. In one case, closed loop obstructio originating from umbilical hernia was documented by CT and sonography. The possible criteria for the gangrenous changes could be the maximal thickness of bowel more than 7mm, and infiltration in the mesentery/omentum.
Ascites ; Emergencies ; Hernia, Umbilical ; Humans ; Infarction ; Peristalsis ; Peritonitis ; Prospective Studies ; Retrospective Studies ; Ultrasonography*

The purpose of this study is to report our 5-year experience with fluoroscopic removal of blunt esophageal foreign body or impacted food in 15 consecutive patients who were referred by endoscopists because they couldn's remove it endoscopically. The foreign body or impacted food was a pieced of meat, a bean, a badug stone or a beef bone. Thirteen patients had underlying disease(11 of corrosive stricture, 2 of postoperative stricture) but 2 patients did not. We removed the object using one of the following 4 techniques: Basket extraction technique, Foley catheter technique, single balloon technique (dilatation of stenosis for passing the food into the stomach and for the treatment of the stricture as well), double balloon technique(removal of the foreign body by trapping it with two valvuloplasty balloons). Removal was successful in all patients. Esophageal perforation occurred in one patient using the single balloon technique, who treated nonoperatively by means of fasting, antibiotics and parenteral alimentation. No procedure related death occurred in these series. In conclusion, fluoroscopic removal of blunt esophageal foreign bodies of impacted food with various techniques is promising alternative to esophagoscopic removal.
Anti-Bacterial Agents ; Catheters ; Constriction, Pathologic ; Esophageal Perforation ; Fasting ; Foreign Bodies* ; Humans ; Meat ; Red Meat ; Stomach

PURPOSE: To evaluate the significance of fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) images for the diagnosis of intracranial tumors. MATERIALS AND METHODS: MR imaging was used to study15 patients with various intracranial tumors and were compared the findings according to fast spin echo and fast FLAIR images. RESULTS: In 12 of 15 patients, tumor signal intensities on FLAIR images were consistent with those shown on T2-weighted (T2W) images. In seven of eight patients who had cystic or necrotic components within the mass, FLAIR images showed isosignal intensity and in the other patient, high signal intensity was seen. There was variation in the signal intensity from cerebrospinal fluid (CSF). In 12 of 13 patients in whom edema was associated with tumor, FLAIR images were clearer than T2W images as their signal intensity was brighter. In eight patients, however, FLAIR and T2W images provided a similar definition of the margin between edema and tumor. In six patients with intratumoral hemorrhage, FLAIR and T2W images showed the same signal intensities at all stages of the hemorrhage except the chronic cystic stage. CONCLUSION: We concluded that in the diagnosis of intracranial tumors, FLAIR images can supplement conventional spin-echo images.
Cerebrospinal Fluid ; Diagnosis ; Edema ; Hemorrhage ; Humans ; Magnetic Resonance Imaging

PURPOSE: To evaluate the clinical usefulness of 2-D Cine PC (phase contrast) technique in visualizing the pattern and the site of abnormal CSF flow and to assess the effect of a third ventriculostomy in patients with hydrocephalus. MATERIALS AND METHODS: The study group consisted of three normal controls and 13 patients with hydrocephalus, as shown on CT or MRI, and two patients who had undergone their third ventriculostomy. The technique was EKG-gated 2-D Cine PC MRI with velocity encoding 5cm/sec, TR 80msec, TE 12.3-15msec, and flip angle 15-60 degrees. Image quality was analyzed for variable sequences, and CSF flow was observed along the CSF flow pathway. We analyzed continuity and intensity of the CSF flow signal, and obstruction site and flow velocity degree were then defined. RESULTS: Systolic high and diastolic low signal intensity along the CSF flow-pathway, with normal asynchronicity and continuation, were clearly seen in normal controls. In three patients, there was obstruction at the ventricular level while others were either normal or showed a normal pattern with a weak signal. 'Normal' was defined as noncommunicating hydrocephalus and the latter as communicating hydrocephalus. In the two patients who had undergone ventriculostomy, a signal was in one case detected at the site of the third operation. CONCLUSION: A 2-D Cine PC CSF flow study enables us to see CSF flow signals noninvasively and to detect the site of obstruction of a CSF flow-pathway. It can therefore be useful for determining the application of a ventriculoperitoneal shunt and assessing the effect of a third ventriculostomy.
Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Ventriculoperitoneal Shunt ; Ventriculostomy

No abstract available.
Acute Kidney Injury* ; Hemoglobinuria, Paroxysmal*

PURPOSE: To analyze the location of microcalcifications present on pathologic specimens and the relationshipbetween the shape of clustered microcalcifications seen on mammogram and the location of these microcalcificationson pathologic specimen. MATERIALS AND METHODS: In 84 female patients aged 25-68, we analysed the location ofmicrocalcifications seen on pathologic speciments. In 65 cases, the shape of these microcalcifications correlatedwith their location. These shapes, as seen on mammograms, were classified as granular, linear, or branching ; thelocation of microcalcifications was difined as intraductal, stromal, lobular, or a mixture of the three. Todetermine the difference, if any, between pathologic diagnosis and pathological location and shape as seen onmammograms, statistical analysis using the Chi-square test was performed. RESULT: Among 84 cases, 51 were benignand 33 cases were malignant. In both types of disease, in 45% and 58% of cases, respectively, microcalcificationswere located intraductally. There was no statistically significant difference between pathologic diagnosis andpathologic locations (p = 0.191) ; analysis of the relationship between shape of microcalcification andpathological location similarly revealed no statistically significant difference ( p > 0.05 ) . In four of 33cases of malignant disease(12 %), there was microcalcification not only of the tumor itself but also of theadjacent non-tumorous region. CONCLUSION: Regardless of whether the disease was benign or melignant,microcalcifieations were most commonly intraductal. The relationship between shape and location ofmicrocalcifications seen on pathologic specimens demonstrated no statistical significance.
Diagnosis ; Female ; Humans

The research of p53 is being conducted to find the mechanisms of tumorigenesis and to treat various cancers. Homeodomain-interacting protein kinase2 (HIPK2) is an important factor to regulate p53 and to increase the stability of p53. Activation of HIPK2 leads to the selective phosphorylation of p53, resulting in growth arrest and the enhancement of apoptosis. In this study, the canine HIPK2 cDNA fragments were obtained, and their overlapping regions were aligned to give a total sequence of 3489 bp. The canine HIPK2 cDNA (GenBank accession number; AY800385) shares 93% and 90% sequence identity with those of human and mouse HIPK2, respectively. The canine HIPK2 cDNA contains an open reading frame encoding 1163 amino acid residues and the predicted amino acid sequence has 98% and 96% identity with those of human and mouse, respectively. The deduced amino acid sequence of canine HIPK2 has also all domains' sites compared with human and mouse HIPK2. Therefore, these structural similarities suggested that the canine HIPK2 shares the basic biological functions that HIPK2 exhibit in other species.
Amino Acid Sequence ; Animals ; Base Sequence ; Cloning, Molecular ; DNA, Complementary/chemistry/genetics ; Dogs/metabolism/*physiology ; Male ; Molecular Sequence Data ; Polymerase Chain Reaction/veterinary ; Protein-Serine-Threonine Kinases/*genetics ; Sequence Alignment ; Sequence Analysis, DNA

OBJECTIVES: The aim of this study was to identify influences of stress, anxiety, depression, and personality trait on nausea, vomiting, and retching of breast cancer patients perceiving chemotherapy. METHODS: Breast cancer patients who were admitted to Ewha Womans University Cancer Center for women to receive chemotherapy participated in the study. In addition to sociodemographic and clinical factors, self-reported questionnaires, including Type D personality Scale 14, Hospital Anxiety and Depression Scale, and Global Assessment of Recent Stress scale were used to evaluate psychological factors of the subjects. For examination of anticipatory and post chemotherapy nausea, vomiting, and retching, the subjects filled out the Rhodes Index of Nausea, Vomiting, and Retching and Visual Analogue Scale. RESULTS: No significant influence of type D personality, anxiety, or depression on nausea, vomiting, and retching was observed. If the patient experienced more severe stress, higher scores for anticipatory and post chemotherapy nausea, vomiting, and retching were recorded. The tendency was retained after adjusting for the cycle number of chemotherapy, the emetic risk of the chemotherapy regimen, type D personality, anxiety, and depression. Specifically, financial problems, unusual happenings, ordinary daily stress, and general stress were significantly related to nausea, vomiting, and retching. CONCLUSION: Assessment of life stress, especially for financial problems, unusual happenings, and ordinary daily stress of patients receiving cancer chemotherapy can be used as an effective way to reduce the risk of nausea, vomiting, and retching related during chemotherapy.
Anxiety* ; Breast Neoplasms* ; Breast* ; Depression* ; Drug Therapy* ; Female ; Humans ; Nausea* ; Surveys and Questionnaires ; Stress, Psychological ; Vomiting* ; Vomiting, Anticipatory

Recent research suggests that a small group of cells, named cancer stem cells (CSCs), is responsible for initiating tumor formation, recurrence, and metastasis. c-Yes, a proto-oncogene that is a subfamily of Src family kinase, is often activated in human colon cancer; this implicates c-Yes in the onset and progression of the disease. The objective of this study was to investigate the correlation between c-Yes and CSCs. We performed a sphere formation assay and reverse transcription-polymerase chain reaction for studying the differentiation of HT-29 human colon CSCs. To demonstrate the specific role of c-Yes in CSCs, we performed live cell microscopy and a cell cycle assay. These study shows, for the first time, that c-Yes is enriched in CD133+ CSCs, compared to their CD133− counterparts, and that c-Yes depletion in CD133+ cells induces cell differentiation. Moreover, c-Yes depletion was found to elongate the midbody and increase the proliferation doubling time. This also suggested that the misregulation of microtubules during chromosomal separation causes aneuploidy. Our results suggest that c-Yes may play a crucial role in initiating, maintaining, and driving the tumorigenic property of colon cancer.
Aneuploidy ; Cell Cycle ; Cell Differentiation ; Colon* ; Colonic Neoplasms* ; Humans* ; Microscopy ; Microtubules ; Neoplasm Metastasis ; Neoplastic Stem Cells ; Phosphotransferases ; Proto-Oncogenes ; Recurrence ; Stem Cells*

PURPOSE: The aim of this study was to determine the rate of lymph node (LN) micrometastasis in patients with stage I and II rectal cancer.METHODS: One hundred eighty patients with either stage I or II rectal carcinoma who underwent curative resection between 1995 and 2010 were included. Forty-eight patients received neoadjuvant chemoradiotherapy. Two sections from each LN were stained with hematoxylin and eosin (H&E) and with CK20 by immunohistochemistry (IHC), respectively.RESULTS: A total of 2,257 LNs with a median of 12.5 LNs per patient were examined. For IHC staining, CK20-positive neoplastic cells were found in 4 of the 2,257 LNs (0.2%) from 3 of the 180 patients (1.7%), and all corresponding H&E re-stained sections confirmed that these neoplastic cells were present. Three of four neoplastic cells were micrometastasis, and one was macrometastasis. All occult neoplastic cells were found in 3 of the 85 patients (3.5%) with stage II disease.CONCLUSION: We observed a 3.5% rate of occult neoplastic cells in stage II rectal cancer. Interestingly, the results of IHC staining corresponded with those of H&E re-stained sections, suggesting that the examination of H&E stained section by a competent pathologist may replace IHC staining.
Chemoradiotherapy ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Immunohistochemistry ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Micrometastasis ; Rectal Neoplasms