No abstract available.
Breast* ; Silicon* ; Silicones*

PURPOSE: Colorectal obstruction develops most frequently by carcinoma, and 7%–30% of these colorectal carcinomas are acute cases. The oncologic safety of self-expanding metal stent (SEMS) insertion as a bridge to surgery has not yet been established. Thus, we investigated the oncologic safety of SEMS insertion as a bridge to surgery in patients with obstructive colorectal cancer.METHODS: This retrospective had 56 patients enrolled requiring emergency management for obstructive colorectal cancer at stage II or III, who had undergone curative surgery between July 2008 and June 2011. These subjects were divided into two groups: patients who had undergone emergency surgery without SEMS insertion (non-stent group) and those who had undergone elective surgery after preoperative decompression with SEMS insertion (stent group). The two groups were compared for clinicopathologic characteristics, postoperative complications, and survival rate.RESULTS: Enterostomy was performed in 25 patients (100.0%) in the non-stent group and 1 patient (3.2%) in the stent group; laparoscopic surgery was carried out in 7 patients (28.0%) in the non-stent group and 19 patients (61.29%) in the stent group, each showing statistically significant differences. There was no statistically significant difference in postoperative complications and 5-year disease-free survival rate (72% vs. 74.19%, P=0.87, respectively).CONCLUSION: In treatment of malignant colorectal obstruction, elective operation after stent insertion had similar oncologic outcomes compared with emergency operation. Preoperative stent insertion not only lowers the incidence of enterostomy but also makes laparoscopic surgery possible, thereby enhancing patients' quality of life. Therefore, preoperative stent insertion is a useful method that may replace emergency surgery in treatment of malignant colorectal obstruction.
Colorectal Neoplasms ; Decompression ; Disease-Free Survival ; Emergencies ; Enterostomy ; Humans ; Incidence ; Intestinal Obstruction ; Laparoscopy ; Methods ; Postoperative Complications ; Quality of Life ; Retrospective Studies ; Stents ; Survival Rate

The criteria for the evaluation of spinal impairment are diverse, complex, and have no standardized form. This makes it difficult and somewhat troublesome to accurately evaluate spinal impairment patients. A standardized guideline was studied for the evaluation of spinal impairment, based on the American Medical Association (AMA) Guides and the McBride method. This guideline proposal was developed by specialty medical societies under the Korean Academy of Medical Sciences. In this study, the grades of impairment were assessed by dividing patients into three different categories: spinal cord impairment, spinal injury impairment and spinal disorder impairment. The affected regions of the spine are divided into three: the cervical region, the thoracic region, and the lumbosacral region. The grade of impairment was differentially evaluated according to the affected region. The restricted range of motion was excluded in the evaluation spinal impairment because of low objectivity. Even though the new Korean guideline for the evaluation of spinal impairment has been proposed, it should be continuously supplemented and revised.
*Disability Evaluation ; Humans ; Korea ; Program Development ; Severity of Illness Index ; Spinal Cord Injuries/classification/diagnosis ; Spinal Diseases/classification/*diagnosis

OBJECTIVE: This study was performed to evaluate the overall survival and the change in treatment modalities in patients with uterine endometrial cancer in Korea. METHODS: From January 1990 to March 2005, medical records of 740 patients with endometrial cancer in nine hospitals were reviewed. The overall survival was determined supported by the death statistics of Korea National Statistical Office. RESULTS: The mean age of patients was 51.5 years (range: 21-82 years). The mean gravidity and parity were 3.3 and 2.1 (range: 0-18, 0-9), respectively. The most common stage, grade and histological type at diagnosis were FIGO stage I, grade 1 and endometrioid adenocarcinoma (76.5%, 56.4% and 87.2%), respectively. The main treatment modalities was surgery on stage I (59.8%), surgery-adjuvant radiotherapy on stage II (55.1%), surgery-adjuvant radiotherapy or surgery-adjuvant chemoradiation on stage III (38.3%) and surgery-adjuvant chemotherapy on stage IV (55.6%). The preferred treatment modality was surgery only on grade 1 (69.0%) and surgery-adjuvant radiotherapy on grade 2-3 (43.4% and 53.2%). Surgery had been the most common method of therapy before 1998 but its prevalence gradually decreased. As a result, surgery-adjuvant radiotherapy and surgery-adjuvant chemotherapy were most widely performed in 2004-2005 and surgery-adjuvant chemoradiation also increased more than a twofold. The overall 5 years survival rate (5YSR) for all 740 patients was 81.3%. The overall 5YSR of stage I was 89.0%. The overall 5YSR of grade 1, grade 2, grade 3 were 96.0%, 92.0%, 80.0%. Before 1998, the survival rate was 77.0%. Since then it increased to 83-88% and in 2000-2001 it increased to 88.0%, and it was the highest survival rate. CONCLUSION: The survival rate of endometrial cancer has been improving for the past 15 years and the method of treatment is also being changed currently. In order to improve the survival rate of endometrial cancer, a close investigation including genetic and environmental factors of the pathophysiology of endometrial cancer along with the epidemiology of risk factors, should be carried out.
Carcinoma, Endometrioid ; Diagnosis ; Drug Therapy ; Endometrial Neoplasms* ; Epidemiology ; Female ; Gravidity ; Humans ; Korea* ; Medical Records ; Parity ; Prevalence ; Radiotherapy ; Risk Factors ; Survival Rate

PURPOSE: To evaluate the sonographic findings of calcific tendinitis around the hip. MATERIALS and METHODS: Ten patients (7 women and 3 men; mean age, 42 years; age range, 34-52 years) with a diagnosis of calcific tendinitis around the hip were evaluated. All the patients underwent radiography and sonography (color Doppler sonography in 6 patients). The sonographic findings were analyzed to determine the level of tendon thickening compared with the contralateral side as well as the shape and posterior acoustic shadowing of the calcification, and vascularity on color Doppler sonography. RESULTS: In all cases, sonography showed a thickening of the tendon compared with the contralateral normal tendon as well as hyperechoic calcific shadows within the thickened tendon. Intratendinous calcifications were mainly observed as a homogeneous ovoid hyperechoic shadow with or without acoustic shadowing. Color Doppler sonography showed increased vascularity within or around the thickened tendon in four of the six patients. CONCLUSION: Sonography is effective in detecting a thickening of the tendon as well as intratendinous calcification, and can be used to diagnose calcific tendinitis around the hip.
Acoustics ; Diagnosis ; Female ; Hip* ; Humans ; Male ; Radiography ; Shadowing (Histology) ; Tendinopathy* ; Tendons ; Ultrasonography*

PURPOSE: Catheter directed thrombolytic dissolution (CDT) of deep vein thrombus (DVT) is in widespread use, yet the complications especially pulmonary embolism (PE), associated with the procedure remains ill defined. To assess the incidence of PE we reviewed the clinical course of acute DVT patients treated by CDT. METHOD: From January 2000 to September 2003, 25 patients were treated by CDT. To define the new development of PE, patients had a technetium 99m lung scan before and just after CDT-, and clinical symptoms were recorded. All patients underwent ascending venogram and CT scan initially to define DVT extension. CDT with urokinase was done by a the same intervention radiologist. RESULT: Proximal thrombus extension level was the femoral vein in 8 patients, iliac vein in 12-, and inferior vena cava (IVC) in 5. Complete thrombolysis was achieved in 16 patients, partial lysis in 2 and no lysis in 7. PE was detected in 7 patients with initial lung scan whose thrombus proximal level was IVC 2, iliac vein 4, femoral vein 1 in each, and no changes in lung scan after CDT. In 17 patients with normal findings at intial lung scan, there were also no changes after CDT. One patient with normal lung scan showed high probable scan defects in lung scan after CDT. Because he also complained of sudden onset dyspnea with cough, we diagnosed him as newly developed, PE-related CDT. CONCLUSION: Only one (4%) case of PE was developed in our study. No prediction factor of PE such as CDT results, or thrombus proximal extent could be defined. These findings suggest that routine usage of temporary IVC filter is unnecessary during CDT.
Catheters* ; Cough ; Dyspnea ; Femoral Vein ; Humans ; Iliac Vein ; Incidence ; Lung ; Pulmonary Embolism* ; Technetium ; Thrombosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Inferior ; Venous Thrombosis*

We report radiologic findings in a case of chest wall parachordoma in a 32-year-old male with right upper back pain. The plain radiograph and CT scan of the chest revealed a soft tissue mass in the right lateral chest wall with rib erosion. En-bloc surgical resection with chest wall reconstruction was performed.
Adult ; Back Pain ; Humans ; Male ; Ribs ; Thoracic Wall* ; Thorax* ; Tomography, X-Ray Computed

Estrogen is a sex steroid hormone which is known to be helpful in preventing aging process in various ways. It is frequently used in hormone replacement therapy (HRT). Basically wound healing is likely to have same process on the view of cell proliferation and extracellular matrix formation. However, it is not determined yet whether estrogen up-regulates or down-regulates wound healing. This study was designed to determine the effect of estrogen on proliferation of human dermal fibroblasts and collagen synthesis in vitro which are most important in wound healing. Fibroblasts were isolated from the dermis of adults and cultivated in the presence of either one of 5 concentrations of estrogen(0, 0.01, 0.1, 1.0, 10microgram/ml). The fibroblasts were seeded at 5.0x103cell/well in Dulbecco's Modified Eagle's Medium/Ham's F-12 nutrient including 10% fetal bovine serum with either one of 5 different concentration of estrogen in 96-well plates. The cells were incubated for 3 days. For fibroblast proliferation MTT assay method was used. To measure the production of collagen, the collagen type I carboxy- terminal propeptide enzyme immunoassay was carried out. All concentrations of estrogen stimulated the proliferation of fibroblasts. The best proliferation and maximum stimulation of collagen synthesis was seen at supplementation of 1.0microgram/ml of estrogen. The collagen synthesis per cell was also maximal at concentration of 1.0microgram/ml estrogen. These results demonstrate that estrogen influences human dermal fibroblast proliferation and the estrogen concentration is critically important factor in vitro.
Adult ; Aging ; Cell Proliferation ; Collagen Type I ; Collagen* ; Dermis ; Estrogens* ; Extracellular Matrix ; Fibroblasts* ; Hormone Replacement Therapy ; Humans ; Immunoenzyme Techniques ; Wound Healing

PURPOSE: We report our early experience, and the feasibility, of an endovascular technique for treating iliac vein compression syndrome, which is known to be caused by a chronic pulsating irritation of the iliac artery. METHODS: Five patients presented with acute deep vein thromboses in their left legs, diagnosed by computed tomography (CT), and treated with a catheter-directed thrombolysis. The residual stenosis was treated by angioplasty, followed by stent placement. The results were evaluated, followed with duplex ultrasound. RESULTS: The CT scan of the left iliac vein was compressed by the right iliac artery, with the thrombosis shown distal of the venous segment of the crossover point in all five cases. Success with the endovascular technique was achieved in all 5 patients. In the follow up, the duplex scan stent site and patency were examined. During the follow up period all the stents were patent, and no thrombosis recurred. CONCLUSION: A CT scan is helpful in diagnosing iliac vein compression syndrome, with a thrombosis. The endovascular approach for its treatment should be considered affirmative due to its safety and simplicity.
Angioplasty ; Constriction, Pathologic ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Iliac Artery ; Iliac Vein* ; Leg ; May-Thurner Syndrome* ; Stents ; Thrombosis* ; Tomography, X-Ray Computed ; Ultrasonography ; Venous Thrombosis

Generally, absolute alcohol embolization has been commonly used for treatment of arteriovenous malformation (AVM) because complete surgical extirpation of AVM can be an extremely hazardous and difficult. Even if absolute alcohol is safe embolic agent, it can result in pain, pulmonary hypertension, pulmonary embolism and post-embolization syndrome such as nausea, vomiting, hemolysis and myoglobinuria. So, general anesthesia is needed for alcohol embolization. In this case, anesthesia was induced with intravenous (IV) propofol 110 mg and succinylcholine 60 mg and maintained with propofol and vecuronium. The pulmonary artery pressure was monitored with a Swan-Ganz catheter. After alcohol injectons, systolic pulmonary artery pressure was increased, ranging 35-40 mmHg. And cola-colored urine was noticed. For treatment of pulmonary hypertension, nitroglycerine was given IV. The IV fluid rate was increased and furocemide was given IV to increase the urine output. After general anesthesia, the patient was awake but appeared to be alcohol-intoxicated. Blood alcohol level was 42 mg/dl. Urinalysis showed large amounts of myoglobin, hemoglobin and albumin. So, anesthesiologists have to keep in mind of such complications when absolute alcohol embolization is done.
Anesthesia ; Anesthesia, General ; Arteriovenous Malformations* ; Catheters ; Ethanol* ; Hemolysis ; Humans ; Hypertension, Pulmonary ; Myoglobin ; Myoglobinuria ; Nausea ; Nitroglycerin ; Propofol ; Pulmonary Artery ; Pulmonary Embolism ; Succinylcholine ; Urinalysis ; Vecuronium Bromide ; Vomiting