PURPOSE: The status of the pelvic lymph node provides important information with respect to the choice of therapy and prognosis in patients with prostate cancer. we evaluated the clinical effectiveness and safety of laparoscopic pelvic lymph node dissection in 7 patients with prostate cancer. MATERIALS AND METHODS: From July 1996 to December 1997, 7 patients whose mean age was 67.7year (range 56-73) underwent transperitoneal laparoscopic pelvic lymph node dissection as a staging procedure for prostatic cancer. We evaluated the clinical stage, Gleason score, PSA, number of harvested lymph nodes, operative time, postoperative hospital stay, and complications. RESULTS: Clinical stage was T1c-T2c, and mean Gleason score was 7.6(range 6-10). Mean preoperative PSA was 35.3ng/ml(range 19-56.2). The mean number of removed lymph nodes was 8.4(range 5-12) and lymph node metastases were noted in 2 patients. Mean operative time was 180.7minutes (range 140-260). Mean postoperative hospital stay was 2.1 days(range 2-3). Conversion from the laparoscopic procedure to open surgery was not required. Subcutaneous emphysema occurred in 2 patients and was conservatively managed. CONCLUSIONS: Our preliminary experience suggests that laparoscopic pelvic lymph node dissection could be performed safely and efficiently to detect the pelvic lymph node metastasis in patients with prostate cancer with a short hospital stay and a low morbidity, though being more time-consuming.
Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision* ; Lymph Nodes* ; Neoplasm Grading ; Neoplasm Metastasis ; Operative Time ; Prognosis ; Prostate* ; Prostatic Neoplasms* ; Subcutaneous Emphysema

The survey was undertaken among the 105 ostomates who attended the 2nd Workshop for Stoma Rehabilitation on Aug. 30th, 1997 by the Department of Surgery, Kyung-Hee University Hospital to assess the physical, psychosocial and sexual problems with a stoma. The 97% of ostomates had permanent colostomies following abdominoperineal resection. The 67% of ostomates had one or more physical problems caused by stoma. Frequent bowel movement (94.3%), impairment of irrigation (64.6%), unpleasant odor (27.3%), and urinary frequency (21.3%) were common problems encountered by ostomates. Concerning the psychosocial problems, 3.8% of them suffered from profound restriction of social activities and 1.9% of them had psychologic problems such as depression. 42 of 58 ostomates (72.4%) who were employed before operation returned to their work. Among 71 men, 44 (62%) were impaired by sexual function. Most ostomates suffered physical, social, psychologic and sexual problems in their daily life and needed helps of experts such colorectal surgeons, enterostomal therapists, and ostomy association. Attention is needed more to improve the quality of life for the ostomates.
Colostomy ; Depression ; Education ; Humans ; Male ; Odors ; Ostomy ; Quality of Life ; Rehabilitation

PURPOSE: The purpose of this study was to evaluate the accuracy of contrast enhanced magnetic resonance angiography (CE-MRA) in the visualization of the renovascular anatomy for the preoperative evaluation of living renal donors. MATERIALS AND METHODS: Thirty-one consecutive potential living renal donors were investigated. Ten patients underwent both digital subtraction angiography (DSA) and CE-MRA, and twenty-one underwent CE-MRA alone before the donor nephrectomy. The intraoperative findings on the number of renal vessels were compared with those of the DSA and CE-MRA. RESULTS: DSA and CE-MRA showed 100% agreement in identifying the main renal arteries, accessory renal artery, and renal veins before surgery. In the DSA and CE-MRA group (n=10), the accuracy relative to the intraoperative findings was 92.3% (12/13) for the renal artery and 100% (10/10) for the renal vein. In the CE-MRA alone group (n=21), 93.3% (28/30) accuracy was shown for the renal artery and 91.3% (21/23) for the renal vein compared with the intraoperative findings. CONCLUSIONS: CE-MRA showed similar agreement and accuracy to DSA. As a minimally invasive technique, CE-MRA has the potential to replace DSA.
Angiography, Digital Subtraction ; Humans ; Magnetic Resonance Angiography* ; Nephrectomy ; Renal Artery ; Renal Veins ; Tissue Donors* ; Transplantation

We sought to gain insights on the prevalence of psychiatric disorders, the risk and protective factors and the prevention and intervention programs of mental health problems among disaster workers. The prevalence of Posttraumatic Stress Disorder (PTSD) among disaster workers was higher than that of the general population and lower than that of disaster survivors. They might suffer from various mental health problems and comorbid disorders. Those mental problems could affect not only their physical health but also self-medication, life satisfaction, and job functioning. Heterogeneous and various factors were positively and negatively associated with psychiatric problems. Prevention and intervention programs were summarized for PTSD among disaster workers. Self-help technique 'RESCUE' and cognitive behavior therapy, developed especially for disaster workers was introduced. Future research and directions were suggested.
Cognitive Therapy ; Disasters* ; Humans ; Mental Health* ; Prevalence ; Stress Disorders, Post-Traumatic ; Survivors

Lymphoceles are the most frequent surgical complications following kidney transplantation. Symptomatic lymphoceles following kidney transplantation are managed best by surgical marsupialization with intraperitoneal drainage. We performed laparoscopic intraperitoneal drainage in a patient with a large lymphocele and secondary hydronephrosis following a kidney transplant.
Drainage* ; Humans ; Hydronephrosis ; Kidney Transplantation ; Kidney* ; Laparoscopy ; Lymphocele* ; Transplantation

BACKGROUND: The management of blood program is difficult, because there is no comprehensive data collection system in place that gathers data about blood and blood components (blood) usage in Korea. To provide basic data for estimating future blood needs and thereby adjusting the blood program to those needs, data of blood usage in ten Korean university hospitals was analyzed. METHODS: The amount of blood used in Korea from 1995 to 2004 was estimated from the data of the Korean Red Cross Blood Centers (KRCBC) and from blood collection data of hospitals. Ten top ranking hospitals regarding blood usage were selected based on a previous report, and the data for blood usage in these hospitals were evaluated. RESULTS: About 20% of red blood cells (RBC) including whole blood > or =40% of platelets (PLT), > or =30% of plasma products (Plasma), and > or =70% of single donor apheresis platelets (SDP) transfused in Korea were used in ten University hospitals. The pattern of blood utilization in ten hospitals was different from that in total hospitals in Korea. The mean units of blood transfused per 1000 admitted patients in these ten hospitals increased steadily until 2000, but from 2001 the amount of blood transfused reached a plateau until 2004, although variations between hospitals is noticed, it seems to be stabilized. About 35% of RBC, 33% of Plasma and 27% of PLT were transfused for patients aged 60 years or more, and the transfusion rate for RBC was between 5% and 17% showing an increasing tendency proportional to patients age in two hospitals. CONCLUSION: This study provides baseline data for planning a blood program, and for a blood monitoring program a continuous and comprehensive data collection system for blood supply and blood demand needs to be established at a National level.
Blood Component Removal ; Data Collection ; Erythrocytes ; Hospitals, University* ; Humans ; Korea* ; Plasma ; Red Cross ; Tissue Donors

Angiosarcomas are extremely rare in the nasal cavity and para-nasal sinus. Upto the present only nineteen cases have been reported in the literature. A 31-year-old male presented with right facial swelling and large oral cavity mass. He was treated with wide excision of the tumor by radical maxillectomy. The tumor was diagnosed as angiosarcoma by immunohistochemical staining with factor VIII-reactive antigen. No adjuvant radiotherapy after surgery was done. After 9 montbs from surgery, the tumor recurred in the primary sites of oral cavity and right maxillary sinus and metastasized to the both lungs. He was treated with palliative chemotherapy and showed a stable disease in follow-up magnetic resonance image of para-nasal sinus and simple chest X-ray after second cycle of chemotherapy. He is undergoing further chemotherapy without any problems. We report first in Korea a case of primary angiosarcoma of the right maxillary sinus in a 31-year-old male.
Adult ; Drug Therapy ; Follow-Up Studies ; Hemangiosarcoma* ; Humans ; Korea ; Lung ; Male ; Maxillary Sinus* ; Mouth ; Nasal Cavity ; Radiotherapy, Adjuvant ; Thorax

PURPOSE: We tried to identify the overall incidence of microsatellite instability (MSI) and the utility of mismatch repair (MMR) protein expression in sporadic colorectal cancers in Korean. We also investigate the role of angiogenesis in colorectal cancers by MSI status. METHODS: A total 85 resected colorectal cancers were submitted for MSI study using PCR methods with 5 markers and immunohistochemistry (IHS) for hMLH1 and hMSH2. Expression of COX-2 and iNOS and microvessel density by IHS were correlated with various clinicopathologic prognostic factors. RESULTS: Among 85 cases of sporadic colorectal cancers, MSI was observed in 11 cases (12.9%) including 10 MSI-H and 1 MSI-L cases. Patients with MSI (+) showed female prevalence (1.75 : 1), low Dukes stage, mucinous histologic type, and Crohn-like lymphoid reaction than those with MSS. Overall sensitivity of hMLH1 and/or hMSH2 expression was 98.6% and specificity was 72.7%. iNOS expression was significantly correlated with COX-2 expression in tumor cells (P=0.006), however, they were not correlated with MSI status. High microvessel density was correlated with hMLH1 expression (P=0.025), COX-2 expression (P= 0.05), and Crohn-like lymphoid reaction (P=0.041). CONCLUSIONS: IHS for MMR proteins is a valuable substitute of MSI status and COX-2 related neoangiogenesis is thought to be related to inhibition of microsatellite unstable colorectal cancer progression via decreased microvessel density.
Colorectal Neoplasms* ; DNA Mismatch Repair ; Female ; Humans ; Immunohistochemistry ; Incidence ; Microsatellite Instability* ; Microsatellite Repeats* ; Microvessels* ; Mucins ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity

Primary frontal sinus lymphoma is a very uncommon disease. In all the previously reported cases, the presenting symptoms have been due to the tumor mass effect. We present an unusual case report of an immunocompetent patient who presented with facial palsy, and then progressively developed other cranial nerve palsies over several months. He was later diagnosed with diffuse large B cell lymphoma originating from the frontal sinus. The patient underwent chemotherapy, but eventually had to receive autologous peripheral blood stem cell transplantation. He is currently disease-free. The clinical course, diagnostic workup, and therapeutic outcome are described.
Adult ; Cranial Nerve Diseases/*diagnosis/pathology ; Frontal Sinus/*pathology ; Humans ; Lymphoma/*diagnosis/pathology ; Male

PURPOSE: Women with breast cancer diagnosed at an age of 40 years or younger have a greater prevalence of germline BRCA1 and BRCA2 mutations than the prevalence of women with breast cancer diagnosed at older ages. Several immunohistochemical characteristics have been identified in breast cancers from studies of Caucasian women with BRCA1/2 mutations having familial or early-onset breast cancers. The aim of this study is to determine whether early-onset breast cancer in BRCA1 or BRCA2 mutation carriers, who were not selected from a family history, could be distinguished by the use of immunohistochemical methods and could be distinguished from breast cancer in women of a similar age without a germline BRCA1 or BRCA2 mutation. We also analyzed the prognostic difference between BRCA1/2 related and BRCA1/2 non-related patients by the use of univariate and multivariate analysis. MATERIALS AND METHODS: Breast cancer tissue specimens from Korean women with early-onset breast cancers were studied using a tumor tissue microarray. Immunohistochemical staining of estrogen receptor (ER), progesterone receptor (PR) and HER-2, as well as the histology and grade of these specimens, were compared. The prognostic impact of immunohistochemical and histological factors as well as the BRCA1/2 mutation status was investigated separately. RESULTS: There were 14 cases and 16 deleterious BRCA1/2 mutations among 101 patients tested. A family history (4/14) and bilateral breast cancers (3/9) were high risk factors for BRCA1/2 mutations. BRCA1/2- associated cancers demonstrated more expression of ER-negative (19.4% versus 5.1%, p=0.038) and HER-2 negative than BRCA1/2 negative tumors, especially for tumors with BRCA1 tumors The BRCA1/2 mutation rate for patients with triple negative tumors (negative expression of ER, PR and HER-2) was 24.2%. Tumor size, nodal status, and HER-2 expression status were significantly associated with disease free survival, as determined by univariate and multivariate analysis, but the BRCA1/2 status was not a prognostic factor. CONCLUSION: Breast cancer that occurs in women with a germline BRCA1 or BRCA2 mutations have recognizable immunohistochemical features, which may be useful in identifying individuals that are more likely to carry germline mutations. Although the BRCA1/2 mutation status was not a prognostic factor in Korean women with early-onset breast cancer, more cases with a longer follow-up period are needed for further study.
Female ; Humans ; Risk Factors ; Breast Neoplasms