No abstract available.
Graves Disease* ; Humans ; Thyroid Gland*

Xanthelasma palpebrum is the most common type of xanthoma that develops mainly on the inner epicanthus of upper eyelids with symmetrical distribution. The lesion tends to be permanent, progressive and cosmetically disfiguring. The recommended treatment has been surgical excision, local treatment with chemicals, and carbon dioxide laser. All of the mentioned treatment have some disadvantages including scarring, pigmentary change and need for local anesthesia. We describe the treatment of xanthelasma palpebrum with the pulsed dye laser which coagulates the hyperpermeable vessels so that the lipid leakage could be blocked and prevent recurrence and further progression.
Anesthesia, Local ; Cicatrix ; Eyelids ; Lasers, Dye* ; Lasers, Gas ; Recurrence ; Xanthomatosis

PURPOSE: To evaluate the predictive value of the early response of 18F-flurodeoxyglucose positron emission tomography (FDG PET) during concurrent chemoradiotherapy (CCRT) for locally advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: FDG PET was performed before and during CCRT for 13 NSCLC patients. Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured and the changes were calculated. These early metabolic changes were compared with the standard tumor response by computed tomograms (CT) one month after CCRT. RESULTS: One month after the completion of CCRT, 9 patients had partial response (PR) of tumor and 4 patients had stable disease. The percent changes of SUVmax (%DeltaSUVmax) were larger in responder group than in non-responder group (55.7% +/- 15.6% vs. 23.1% +/- 19.0%, p = 0.01). The percent changes of SUVmean (%DeltaSUVmean) were also larger in responder group than in non-responder group (54.4% +/- 15.9% vs. 22.3% +/- 23.0%, p = 0.01). The percent changes of MTV (%DeltaMTV) or TLG (%DeltaTLG) had no correlation with the tumor response after treatment. All the 7 patients (100%) with %DeltaSUVmax > or = 50% had PR, but only 2 out of 6 patients (33%) with %DeltaSUVmax < 50% had PR after CCRT (p = 0.009). Likewise, all the 6 patients (100%) with %DeltaSUVmean > or = 50% had PR, but only 3 out of 7 patients (43%) with %DeltaSUVmean < 50% had PR after CCRT (p = 0.026). CONCLUSION: The degree of metabolic changes measured by PET-CT during CCRT was predictive for NSCLC tumor response after CCRT.
Carcinoma, Non-Small-Cell Lung* ; Chemoradiotherapy* ; Glycolysis ; Humans ; Lung Neoplasms ; Positron-Emission Tomography ; Tumor Burden

No abstract available.
Lipoma* ; Scalp*

PURPOSE: Endobronchial tuberculosis and bronchogenic cancer are common causes of atelectasis or obstructive pneumonitis in Korea. Differntiation between endobronchial tuberculosis and bronchogenic carcinoma is important for the treatment and prognosis but it is sometimes difficult to differentiate these two lesions with radiologic examinations. The purpose of this study was to find the differential points between endobronchial tuberculosis and bronchogenic carcinoma associated with atelectasis or obstructive pneumonitis. MATERIALS AND METHODS: Forty patients in whom atelectasis or obstructive pneumonitis was detected on chest radiographs comprised the study. A definite mass opacity was not observed on chest radiographs in all patients. In these patients, the causes of obstruction were endobronchial tuberculosis (n=20) and bronchogenic cancer (n=20) which were microbiologically or pathologically confirmed. RESULTS: Double obstructive lesions were more frequently found in endobronchial tuberculosis (8/20) than in bronchogenic cancer (1/20). Multiple calcifications along the bronchial wall and severe distortion of bronchi were observed only in endobronchial tuberculosis (4/20) and associated low density mass at obstruction site was only observed in bronchogenic cancer (6/20). Bronchial dilatation (11/20) and parenchymal calcifications (14/20) distal to obstruction site, air containing bronchogram at post obstructive bronchus (14/20) were more frequently found in endobronchial tuberculosis. Contour bulging at obstruction site (14/20), and only mucus bronchogram at post obstructive bronchus (14/20) were more frequently found in bronchogenic carcinoma. CONCLUSION: In patients with atelectasis or obstructive pneumonitis, endobronchial tuberculosis is characterized by double obstructive lesion, multiple calcifications at the bronchial wall, and severe distortion of the bronchi. Endobronchial carcinoma is characterized by a low density mass at the obstructive site.
Bronchi ; Carcinoma, Bronchogenic* ; Dilatation ; Humans ; Korea ; Mucus ; Pneumonia* ; Prognosis ; Pulmonary Atelectasis* ; Radiography, Thoracic ; Tuberculosis*

Neuroleptic malignant syndrome is a rare, but potentially life-threatening adverse event associated with the use of neuroleptic agents. We describe the case of a 47-year-old schizophrenic woman who was treated with clozapine for years. The patient developed acute renal failure with pulmonary edema, and underwent mechanical ventilation and hemodialysis.
Acute Kidney Injury ; Antipsychotic Agents ; Clozapine* ; Female ; Humans ; Middle Aged ; Neuroleptic Malignant Syndrome* ; Pulmonary Edema ; Renal Dialysis ; Respiration, Artificial ; Rhabdomyolysis

Gastrocelic fistula of malignant origin is a rare complication, usually due to gastric or colon cancer. Possible other etiologic factors resulting in gastrocolic fistula are peptic ulcer, trauma, carcinoid tumor, intestinal tuberculosis, Crohn's disease, lymphoma, intraabdominal abscess, diverticulitis and etc. At the present, earlier diagnosis and treatment of gastric and colon cancer may explain the low frequency of malignant gastrocolic fistula than the past but the review of Korean literatures revealed only two reports of gastrocolic fistula secondary to gastric cancer and another from benign gastric ulcer. Yet, there has been no report of fistula due to colon cancer. We experienced a case of colon cancer with postural dizziness, fecal eructation who was diagnosed as gastrocolic fistula by endoscopy, barium enema, UGI series and finally underwent operation. Therefore, we report this case with the review of literatures.
Abscess ; Barium ; Carcinoid Tumor ; Colon* ; Colonic Neoplasms* ; Crohn Disease ; Diagnosis ; Diverticulitis ; Dizziness ; Endoscopy ; Enema ; Eructation ; Fistula* ; Lymphoma ; Peptic Ulcer ; Stomach Neoplasms ; Stomach Ulcer ; Tuberculosis

Gastrocolic fistula is a rare lesion which is caused most commonly by carcinoma of colon or stomach. The less common causes of gastrocolic fistula are follows: trauma, faulty gastrocolic anastomosis during gastrectomy, benign gastric ulcer, syphilis, carcinoid tumor, tuberculosis, intraperitoneal abscess, lymphoma, perforated diverticulum of colon, and ulcerative colitis. The locations of fistulae are mostly between greater curvature of stomach and distal half of the transverse colon. In the case of penetrating benign gastric ulcer and gastrcolic fistula, it is usually associated either with asipirin or with prolonged steroid administration. A 36-year-old male who had an unusual gastrocolic fistula secondary to non-surgically treated benign gastric ulcer is presented. The exitence of a gastrocolic fistula was dernonstrated by radiological examination of the colon and the stomach. In this patient, the colonoscope passde through the fistula and the stomach could be examined. Careful preparation was carried out preoperatively with intravenous fluids and blood transfusions. Resection of the distal stomch, fistulous tract, and segment of the transverse colon was then accamplished.
Abscess ; Adult ; Blood Transfusion ; Carcinoid Tumor ; Colitis, Ulcerative ; Colon ; Colon, Transverse ; Colonoscopes ; Diverticulum ; Fistula* ; Gastrectomy ; Humans ; Lymphoma ; Male ; Stomach ; Stomach Ulcer* ; Syphilis ; Tuberculosis

PUPOSE: The superficial spreading type of early gastric cancer has different clinicopathologic features from other types of early gastric cancer in terms of its invasiveness and lymph-node metastases. Therefore, we attempted to elucidate the pathological features, surgical procedures and patients prognoses. MATERIALS AND METHODS: Clinical information was reviewed for patients who had undergone a gastrectomy for gastric cancer during an 8-year period (1995~2002) at Dankook University Hospital and Ulsan University, with an average follow-up of 48 months. Three hundred (300) superficial spreading lesions were analyzed with respect to macroscopic type, lymph-node (LN) metastasis, recurrent pattern, survival rate and method of surgical operation. In addition, the clinicopathological features of the superficial spreading type were compared with those of 739 other patients with small-sized cancer. RESULTS: In both groups, the IIc-type macroscopic lesion, the elevated subtype to be more specific, occurred most frequently. There was no significant difference in the method of surgery between the groups. The submucosal invasion was 39.8% in small-sized cancer, and 61.7% in superficial spreading cancer (P=0.005). The incidence of LN metastasis was 11.3% in early gastric cancer, 7.8% in small-sized cancer and 20.0% in superficial spreading cancer (P=0.005). The incidence of lymphatic invasion was 4.6% in small-sized cancer and 13.0% in superficial spreading cancer (P=0.009). The incidence of recurrence was 1.4% in small-sized cancer and 3.6% in superficial spreading cancer. The overall 5-year survival rate was 84.8% in superficial spreading cancer and 93.0% in small-sized cancer (P=0.052). The 5-year disease- free survival rate was 94.7% in superficial spreading cancer and 87.5% in small-sized cancer (P=0.053). CONCLUSION: The superficial spreading type of early gastric cancer tends to be more invasive and to show a higher incidence of lymph-node metastasis than small-sized early gastric cancer. A wide resection with extensive lymph-node dissection seems to be an appropriate treatment for a superficial spreading type of early gastric cancer.
Follow-Up Studies ; Gastrectomy ; Humans ; Incidence ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Stomach Neoplasms* ; Survival Rate ; Ulsan

Since nationwide compulsory health insurance started in 1977, shortage of hospital beds has become apparent and this is related in part to the length of hospital stay. To determine the factors which affect the length of stay a total of 1,003 in-patients medical records for appendectomy, cholecystectomy, and Cesarean section discharged in 1965, 1970, 1975 and 1980 from a university hospital were studied. The major findings are as follows; The average length of stay showed a statistically significant difference by year among the cholecystectomy and Cesarean section patients. For the appendectomies no statistically significant difference was found. Complications after surgical operation explained the length of stay mostly in all three procedures; the next factors were age, character of surgery, day of the week of surgery, and multiple diagnoses in this order for appendectomy; day of the week of surgery, age, type of accommodation, route of admission in this order for cholecystectomy; and day of the week of surgery, multiple diagnoses, residential area and type of accommodation in Cesarean section respectively.
Adolescent ; Adult ; Age Factors ; Child ; Hospitals, Teaching/utilization* ; Hospitals, University/utilization* ; Human ; Korea ; Length of Stay* ; Regression Analysis