PURPOSE: We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. MATERIALS AND METHODS: The first postoperative diagnostic and post-therapy radioiodine scans of one hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of 3.7~9.3 GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10 ng/ml) during serum TSH elevation. RESULTS: Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stunning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/143) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. CONCLUSION: There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine.
Eating ; Humans ; Neoplasm Metastasis ; Reference Values ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

OBJECTIVE: The purpose of this project was to suggest guidelines for management of Low grade Squamous Intraepithelial Lesion(LSIL) by evaluating natural course of LSIL of the uterine cervix. MATERIAL & METHODS: Among the women who visited Korea University Kuro Hospital from Jan. 1993 to Oct. 1998, One hundred fifty eight patients who were diagnosed as LSIL with colposcopy directed biopsy were followed up by colposcopy and/or cytology, HPV DNA test every 3 months. RESULT: In I58 patients who were diagnosed as LSIL, colposcopic examination confirmed progression to high grade intraepithelial lesion(HSIL) in 17(10.7%) patients, persistence of LSIL in 87(55%) patients, regression to normal in 54(34.2%) patients during the 3 year follow-up period. In prediction of LSIL subgroup, abnormal Pap test is 39%, 64%, 71% and abnormal HPV test is l6%, 29%, 65% in regression, persistent and progression group respectively. The shortest time of transition from minor lesion(LSIL) to high grade lesion was 12 months (the range, 12-51). CONCLUSION: Of the patients who were diagnosed as LSIL and monitored by colposcopy for 60 months, 34% had disease that regressed, 55% had persistent disease, and 11% had progressive disease. HPV DNA test(p=0.002) is more informative than pap test(p=0.567) in prediction of disease progression.
Biopsy ; Cervix Uteri ; Colposcopy ; Disease Progression ; DNA ; Female ; Follow-Up Studies ; Human Papillomavirus DNA Tests ; Humans ; Korea ; Natural History

PURPOSE: Kawasaki disease is notorious for coronary arterial complication which is usually developed as a febrile disease in early childhood. Increased polymorphonucleus(PMN) cell levels in acute phases may be associated with the pathophysiology of Kawasaki disease. We studied the relationship between coronary arterial dilatation and elastase activity which was excreted from PMN cell and roles as an important factor for vasculitis. METHODS: Ten patients diagnosed with Kawasaki disease in Yonsei University Medical Center were examined between November, 2001 and January, 2002. In addition, 15 patients with other febrile diseases were also examined. Echocardiography was done in patients with Kawasaki disease on the first day of admission and four weeks after the onset of the disease. At each time, venous samples were drawn and separated into plasma and leukocytes. In patients with other febrile disease, samples were drawn on admission. Elastase activities in plasma and neutrophil extracts were measured. RESULTS: The significant increased plasma elastase activity, 6.19+/-0.74 U/mL, found in Kawasaki disease patients compared with the other febrile disease patients, 4.86+/-1.17 U/mL(P<0.05). And there was no significance between the above two diseases in terms of the elastase activity in neutrophil extracts. The relationship between initial elastase activity and the coronary arterial complication which was shown in subacute phase wasn't significant. CONCLUSION: Plasma elastase activity was increased in Kawasaki disease significantly, but the initial plasma elastase activity in the acute phase could not reflect the range of coronary arterial complication.
Academic Medical Centers ; Dilatation* ; Echocardiography ; Humans* ; Leukocyte Elastase* ; Leukocytes ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils* ; Pancreatic Elastase ; Plasma ; Vasculitis

OBJECTIVE: To compare dysphagia between infratentorial stroke patients and supratentorial stroke patients. METHODS: Subjects of this study were patients with post-stroke dysphagia (PSD) who were admitted to our medical institution between May 2014 and June 2017. We evaluated a total of 64 patients with PSD. A videofluoroscopic swallowing study (VFSS) was performed to determine dysphagia severity. We measured the following parameters: pharyngeal transit time (PTT), post-swallow pharyngeal remnant, Penetration Aspiration Scale (PAS) scores, and Functional Dysphagia Scale (FDS). We analyzed patient's results from VFSS performed at admission. All VFSS images were recorded using a camcorder running at 30 frames per second. An AutoCAD 2D screen was used to measure post-swallow pharyngeal remnant. RESULTS: In this study, PTT and FDS were similar (p>0.05) between infratentorial stroke patients and supratentorial stroke patients. However, there were significant differences in pharyngeal remnant and PAS scores between the two groups (p<0.01 and p<0.05, respectively). CONCLUSION: Both pharyngeal remnant and PAS score registered higher levels from VFSS test for infratentorial stroke patients than those for supratentorial stroke patients. This suggests greater chances of problems occurring with swallowing, the major functions of pons. Thus, clinicians should pay particular attention to active dysphagia evaluation and treatment in PSD of infratentorial stroke patients.
Deglutition ; Deglutition Disorders ; Fluoroscopy ; Humans ; Pons ; Running ; Stroke

OBJECTIVES: Early diagnosis of intrauterine growth retardation is important to ensure optimal monitoring and delivery with the introduction of real-time and Doppler ultrasound systems, a noninvasive method of measuring human fetal blood flow has become available. The aim of this study is to compare blood flow velocity waveforms at the fetal descending aorta and umbilical artery in normal and in patients with pregnancy induced hypertension. METHODS: Using a combination of linear array real-time and pulsed Doppler ultrasound, blood flow velocity measurements were carried out at the fetal descending aorta and umbilical artery in 35 normal pregnancies and 18 cases of pregnancy induced hypertensive patients. RESULTS: The mean systolic/diastolic ratio of umbilical artery and aorta was significantly higher in PIH patients than in normal pregnancies(3.8 +/- 0.81 versus 2.97 +/- 0.52, p<0.05) and to predict perinatal morbidity, umbilical velocimetry is more sensitive than that of descending thoracic aorta. CONCLUSION: This study suggests that umbilical artery velocimetry could be used as a marker to predict adverse perinatal outcome.
Aorta ; Aorta, Thoracic* ; Blood Flow Velocity ; Early Diagnosis ; Female ; Fetal Blood ; Fetal Growth Retardation ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Rheology* ; Ultrasonography ; Umbilical Arteries

To identify significant prognostic factors in patients undergoing simple hysterectomy in the presence of invasive cervical cancer, the records of 45 patients who had taken such a procedure between 1993 and 1997 were reviewed. Overall relapse-free survival and 5-year survival rates were 91.1 and 92.1%, respectively. Factors found to be significantly related to survival were the retrospectively determined stage(p=0.0000), the presence of residual disease(p=0.0001), and cell type(p=0.0000). By multivariate analysis, factor emerging as significantly detrimental to survival was the cell type. The presence of residual disease was a marginally significant factor(p=0.067). The expectations for survival of patients with residual tumor mass and/or with adenocarcinoma after simple hysterectomy appear to be markedly worse than those with others, so radical reoperation should be considered in those patients.
Adenocarcinoma ; Humans ; Hysterectomy* ; Multivariate Analysis ; Neoplasm, Residual ; Reoperation ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

Frequency of fracture of the acetabulum is becoming increasingly with the increase of automobile accident. If fractures are not accurately evaluated, classified and reduced anatomically, major sequelae and complications such as traumatic arthritis, joint instability and avascular necrosis of the femoral head were highly developed. The principles of treatment are to restore the fractured acetabulum to its normal anatomy, to maintain and/or restore function, and accordingly early joint motion to promote healing and to prevent joint adhesion. However, the treatment of displaced fracture of the acetabulum has been controversial: that is, should these fractures be treated by closed or open method? Judet et al(1964), Pennal(1980) and Matta et al(1986) advocated open reduction and internal fixation for displaced fractures of the acetabulum. Especially, Matta et al reported that displaced fracture must be reduced to a displacement of 3mm or less, in addition to congruent reduction of the femoral head with weight-bearing dome of the acetabulum, to achieve a satisfactory clinical result. However, some authors reported that, if closed reduction such as traction was used, good result could be obtained. We analysed 42 cases of acetabular fractures to compare the results of closed treatment with that of open treatment as well as its complication after each treatment. All were treated at Kang-Nam St. Marys Hospital from June 1981 to June l86. The complications were' developed in 7(29.2%) out of 24 cases of conservatively treated group, and 5 (27. 8 %) of 18 cases of surgically treated group. However, 7 (70%) of 10 conservatively treated cases of displaced fracture developed complication. In all conservatively treated cases, traumatic arthritis was developed. Five of 18 surgically treated patients developed complications, such as deep wound infection in two cases, traumatic arthritis in two cases, and avascular necrosis in one case. The causes of complication in 5 surgically treated cases were wrong surgical approach by wrong classification in three cases, failure of internal fixation in a case and inevitable avascular necrosis in a case, respectively. Thus, anatomical restoration of the joint surface offered the best chance for a symptom free hip and reduced the complication such as traumatic arthritis. Even though traumatic arthritis and avascular necrosis may develop later by other causes, total hip replacement surgery will be much eased, if the nor mal joint anatomy is restored at initial treatment. Proper selection of the best suited surgical approach analysing the type fracture to minimize the sequelae is mandatorily stressed when surgical treatment is indicated.
Acetabulum ; Arthritis ; Arthroplasty, Replacement, Hip ; Automobiles ; Classification ; Head ; Hip ; Humans ; Joint Instability ; Joints ; Methods ; Necrosis ; Traction ; Weight-Bearing ; Wound Infection

No abstract available.
Leukemia, Myelomonocytic, Juvenile* ; Xanthogranuloma, Juvenile*

No abstract available.
Mediastinum*

Aneurysms of the coronary arteries are rare. They may be due to atheroselerosis, mucocutaneous lymph node syndrome, mycotic emboli, syphilis or trauma and occasionally they are congenital. The prognosis appears to be poor and death can occur suddenly from rupture of the aneurysm, peripheral coronary embolism or bacterial endocarditis. Recently surgical treatment has been successful. In a 5 year old patient with ventricular septal defect, two aneurysmal sacs located at the cardiac crux and just posterior to it was proved by coronary angiography and MRI, and successfully excised at operation.
Aneurysm* ; Child, Preschool ; Coronary Angiography ; Coronary Vessels* ; Embolism ; Endocarditis, Bacterial ; Heart Septal Defects, Ventricular ; Humans ; Magnetic Resonance Imaging ; Mucocutaneous Lymph Node Syndrome ; Prognosis ; Rupture ; Syphilis