ABSTRACT
OBJECTIVE: We aimed to investigate the associations of post-stroke emotional incontinence (PSEI) with various psychiatric symptoms and quality of life independent of potential covariates in survivors of acute stroke. METHODS: A total of 423 stroke patients were assessed within 2 weeks of the index event. Psychiatric symptoms were assessed by the Symptom Checklist-90-Revised (SCL-90-R), which has nine domains comprising Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, and Psychoticism. Quality of life was measured using the World Health Organization Quality of Life abbreviated form (WHOQOL-BREF), which has four domains related to physical factors, psychological factors, social relationships, and environmental context. Associations of PSEI with scores on the SCL-90-R and WHOQOL-BREF were investigated using pairwise logistic regression model adjustment for potential sociodemographic and clinical covariates. RESULTS: PSEI was present in 51 (12.1%) patients. PSEI was associated with the Obsessive-Compulsive, Interpersonal Sensitivity, and Hostility symptom dimensions of the SCL-90-R and with the psychological factors and social relationships domains of the WHOQOL-BREF independent of important covariates including previous stroke, stroke severity, and physical disability. CONCLUSION: PSEI causes some aspects of psychiatric distress and negatively affects psychological and interpersonal quality of life. For patients with PSEI, special attention to psychiatric comorbidity and quality of life is needed, even in the acute stage of stroke.
Subject(s)
Humans , Anxiety , Comorbidity , Depression , Hostility , Logistic Models , Psychology , Quality of Life , Stroke , Survivors , World Health OrganizationABSTRACT
No abstract available.
ABSTRACT
PURPOSE: Laparoscopic sleeve gastrectomy (LSG) is rapidly gaining ground as one of the surgical procedures in bariatric surgery with emerging long-term follow-up data. The aim of the present study was to report our initial experience of LSG in morbidly obese patients. METHODS: Sixty-four consecutive patients underwent LSG from April 2009 to July 2010 at our bariatric surgery center. Patients eligible for LSG were those with a body mass index (BMI) of >37 kg/m2, and >32 kg/m2 with co-morbidities. LSG was performed using 5 trocars and endo-staplers with guidance of 34 Fr bougie. Perioperative management was standardized. The clinical data were prospectively collected and retrospectively analyzed. RESULTS: Among 64 patients, 19 were male and 45 were female, mean age was 35 years (range 20~57), mean preoperative BMI was 38.8 kg/m2 (range 32~57), and mean preoperative body weight was 108 kg (range 75~164). Mean operative time was 118 minutes (range 65~340) and mean length of hospital stay was 3.4 days (range 1~82). Staple line leak occurred in 1 patient, kinking of the gastric tube occurred in 2 patients. There was no open conversion and no postoperative mortality. After 170 days of follow-up, 24.4 kg of body weight loss and 52.7% of excess weight loss (%EWL), on average, was noted. CONCLUSION: Though long-term follow-up is needed, our early operative outcome was satisfactory in terms of %EWL and safety of the procedure. LSG was a safe and effective treatment strategy for morbidly obese patients.
Subject(s)
Female , Humans , Male , Bariatric Surgery , Body Mass Index , Body Weight , Follow-Up Studies , Gastrectomy , Length of Stay , Obesity, Morbid , Operative Time , Prospective Studies , Retrospective Studies , Surgical Instruments , Weight LossABSTRACT
PURPOSE: A molecular magnetic resonance (MR) imaging technique using superparamagnetic iron oxide (SPIO) nanocrystals was developed for monitoring stem cells noninvasively. This study was performed to investigate whether the presence of transplanted human mesenchymal stem cells in the penile cavernosum of a diabetic rat model could be evaluated noninvasively using molecular MR imaging. MATERIALS AND METHODS: SPIO nanocrystals (Feridex; AMI, Cambridge, USA) were transferred to human mesenchymal stem cells (hMSCs) using GenePORTER. The SPIO-transferred hMSCs were examined with Prussian blue staining. SPIO-labeled hMSCs were transplanted to the penile cavernosum of a diabetic rat model and MR images were examined in vivo using 1.5 T MR. RESULTS: SPIO was transferred to hMSCs successfully. MR signal intensity at the areas of the SPIO-transferred hMSCs decreased in the penile cavernosum of the diabetic rat model. SPIO particles were confirmed in the transplanted penile cavernosum with Prussian blue staining. CONCLUSIONS: The SPIO-labelled hMSCs in the penile cavernosum of a diabetic rat model can be monitored noninvasively using molecular MR imaging.
Subject(s)
Animals , Humans , Rats , Diabetes Mellitus , Ferric Compounds , Ferrocyanides , Iron , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Magnetics , Magnets , Mesenchymal Stem Cells , Nanoparticles , Stem Cells , TransplantsABSTRACT
Natural orifice transluminal endoscopic surgery (NOTES) is the new therapeutic technique. This procedure stands on the cutting edge of minimal invasive surgery that accesses the abdominal cavity through a natural orifice under the endoscopic image. There have been many animal experiments, and clinical trials of NOTES. We performed a transgastric endoscopic cholecystectomy of a pig using conventional endoscopic instruments through a natural orifice and the assistance of a 5mm laparoscopic trocar.
Subject(s)
Abdominal Cavity , Animal Experimentation , CholecystectomyABSTRACT
PURPOSE: Molecular magnetic resonance (MR) imaging techniques using superparamagnetic iron oxide nanocrystals (SPIO) have been developed for noninvasively monitoring stem cells. This study was performed to investigate if the presence of transplanted human mesenchymal stem cells in the liver, kidney, bladder and penile cavernosum can be evaluated noninvasively with using molecular MR imaging. MATERIALS AND METHODS: SPIO (Feridex; AMI, Cambridge, USA) were transferred to the human mesenchymal stem cells (hMSCs) using GenePORTER. The labeling viability, efficiency and differentiation of the SPIO transferred hMSCs were examined with Tripan blue, Von Kossa, alkaline phosphatase, toluidine blue, oil red O and Prussian blue staining. The SPIO labelled hMSCs were transplanted to the liver, kidney, bladder and penile cavernosum of rats, and the MR images were examined in vitro or in vivo using 1.5 T MR. RESULTS: The viability and efficiency of the SPIO transferred hMSCs were good. Osteogenic, chondrogenic or adipogenic differentiation from the SPIO transferred hMSCs was observed. A decrease of the MR signal intensity of the SPIO transferred hMSCs with using GenePORTER was found in vitro. A decrease of the MR signal intensity was found at concentrations that were more than 1x10(5) hMSCs in vitro. The MR signal intensity at the areas of the SPIO transferred hMSCs decreased in the liver, kidney, bladder and penile cavernosum. The intracellular SPIOs were confirmed in the SPIO labelled hMSCs that were transplanted in the liver, kidney, bladder and penile cavernosum with Prussian blue staining. CONCLUSIONS: The SPIO labelled hMSCs in the liver, kidney, bladder and penis can be evaluated noninvasively by using molecular MRI.
Subject(s)
Animals , Humans , Male , Rats , Alkaline Phosphatase , Iron , Kidney , Liver , Magnetic Resonance Imaging , Mesenchymal Stem Cells , Nanoparticles , Penis , Stem Cells , Tolonium Chloride , Urinary BladderABSTRACT
PURPOSE: Monitoring the biological changes in transplanted stem cells is important. Molecular magnetic resonance (MR) imaging using superparamagnetic iron oxide nanocrystals(SPIO) has been developed for noninvasive monitoring of stem cells. This study was performed to investigate whether the biological status of transplanted human mesenchymal stem cells(hMSCs) in the rabbit penis can be monitored noninvasively using molecular MR imaging. MATERIALS AND METHODS: SPIO(Feridex; AMI, Cambridge, MA, USA) were transferred into hMSCs using GenePORTER. The labeling efficiency, viability, and differentiation of the SPIO-containing hMSCs were examined with Trypan blue, Von Kossa, alkaline phosphatase, toluidine, blueoil red O, and Prussian blue staining. SPIO-labeled hMSCs were transplanted into the rabbit penis, and MR images of them were examined in vitro or in vivo using 1.5 T MR. Histologic examination was performed. RESULTS: The viability and efficiency of the SPIO-transferred hMSCs were good. Osteogenic, chondrogenic and adipogenic differentiation from SPIO-containing hMSCs were found. A decrease in MR signal intensity in the SPIO-containing hMSCs was found in vitro. MR signal intensity in the areas of the SPIO-transferred hMSEc in the rabbit penis decreased and were confined locally. Intracellular SPIO were confirmed in the hMSCs transferred into penis. CONCLUSIONS: SPIO-labeled hMSCs in the rabbit penis can be evaluated noninvasively using molecular MR imaging.
Subject(s)
Humans , Male , Alkaline Phosphatase , Iron , Magnetic Resonance Imaging , Mesenchymal Stem Cells , Penis , Stem Cells , Trypan Blue , Urinary BladderABSTRACT
PURPOSE: Monitoring the biological changes in transplanted stem cells is important. Molecular magnetic resonance (MR) imaging using superparamagnetic iron oxide nanocrystals(SPIO) has been developed for noninvasive monitoring of stem cells. This study was performed to investigate whether the biological status of transplanted human mesenchymal stem cells(hMSCs) in the rabbit penis can be monitored noninvasively using molecular MR imaging. MATERIALS AND METHODS: SPIO(Feridex; AMI, Cambridge, MA, USA) were transferred into hMSCs using GenePORTER. The labeling efficiency, viability, and differentiation of the SPIO-containing hMSCs were examined with Trypan blue, Von Kossa, alkaline phosphatase, toluidine, blueoil red O, and Prussian blue staining. SPIO-labeled hMSCs were transplanted into the rabbit penis, and MR images of them were examined in vitro or in vivo using 1.5 T MR. Histologic examination was performed. RESULTS: The viability and efficiency of the SPIO-transferred hMSCs were good. Osteogenic, chondrogenic and adipogenic differentiation from SPIO-containing hMSCs were found. A decrease in MR signal intensity in the SPIO-containing hMSCs was found in vitro. MR signal intensity in the areas of the SPIO-transferred hMSEc in the rabbit penis decreased and were confined locally. Intracellular SPIO were confirmed in the hMSCs transferred into penis. CONCLUSIONS: SPIO-labeled hMSCs in the rabbit penis can be evaluated noninvasively using molecular MR imaging.
Subject(s)
Humans , Male , Alkaline Phosphatase , Iron , Magnetic Resonance Imaging , Mesenchymal Stem Cells , Penis , Stem Cells , Trypan Blue , Urinary BladderABSTRACT
PURPOSE: Cystic neoplasms in the liver are rarely seen tumors. Biliary cystadenoma and cystadenocarcinoma constitute less than 5% of intrahepatic cysts originating from the bile duct. The clinicopathologic and radiologic findings are important to arrive at the proper diagnosis and treatment of intrahepatic biliary cystadenoma and cystadenocarcinoma. The aims of this study were to characterize the clinical and pathologic aspects of these lesions, and also to discuss the treatment and prognosis of biliary cystadenoma and cystadenocarcinoma. METHODS: We reviewed the clinical records of six patients who had intrahepatic biliary cystadenoma and cystadenocarcinoma and who had undergone operations from January, 1986 to June, 2002 at Hanyang University Hospital. RESULTS: Primary biliary cystadenoma and cystadenocarcinoma of the intrahepatic biliary systems are rarely seen tumors. Biliary cystadenoma mainly affected women, and this was a different gender preponderance than was seen for biliary cystadenocarcinoma. We found no signs or symptoms that were specific for either of these tumors, and the diagnoses were usually made by abdominal CT and abdominal ultrasonography. These tumors were usually large, multilocular and cystic in appearance. The pathologic findings revealed multiple cystic masses lined with cuboidal to columnar epithelium. The nature of the cystic fluid was usually the mucous type. Of the 6 patients in whom the lesions were completely excised, 4 of the patients are alive. The other 2 patients died of old age and distant metastasis, respectively. CONCLUSION: Surgical resection of the tumor, including a margin of surrounding normal liver parenchyma, was the only curative method. If the tumor is confined in the liver, complete surgical excision yields an excellent prognosis. Complete resection of a biliary cystadenoma and radical resection of a biliary cystadenocarcinoma seem to offer these patients a chance for long-term survival.
Subject(s)
Female , Humans , Bile Ducts , Biliary Tract , Cystadenocarcinoma , Cystadenoma , Diagnosis , Epithelium , Liver , Neoplasm Metastasis , Prognosis , Tomography, X-Ray Computed , UltrasonographyABSTRACT
Carcinoid tumors are derived from Kultschitzky cells, and often found in the appendix, ileum, rectum and bronchus, but those of the biliary tract are rare. Here, the case of a 59-year-old man, unexpectedly found to have a carcinoid tumor obstructing the common bile duct, is reported. A gallbladder carcinoid tumor was also found incidentally during a planned subtotal gastrectomy operation. The literature on carcinoid tumors of the extrahepatic bile duct and gall bladder is also reviewed.
Subject(s)
Humans , Middle Aged , Appendix , Bile Ducts, Extrahepatic , Biliary Tract , Bronchi , Carcinoid Tumor , Common Bile Duct , Gallbladder , Gastrectomy , Ileum , Rectum , Urinary BladderABSTRACT
PURPOSE: Molecular magnetic resonance(MR) imaging technique using the superparamagnetic iron oxide nanocrystals(SPIO) are developed for the monitoring the stem cells noninvasively. This study was performed to monitor the transplanted SPIO labelled human mesenchymal stem cells(hMSCs) with the molecular MR imaging and histologically in the rat bladder. MATERIALS AND METHODS: SPIO(Feridex; AMI, Cambridge, MA, USA) were labelled to hMSCs using GenePORTER. The labeling viability, efficiency of the SPIO labelled hMSCs were examined with tripan blue, prussian blue staining. SPIO labelled hMSCs are transplanted to the bladder in rats and MR images of them were examined using 1.5 T MR. Histologic examination of the SPIO labelled hMSCs transplanted bladder was performed with H&E and prussian blue staining. RESULTS: The viability, efficiency of the SPIO labelled hMSCs were good. MR signal intensity at the areas of the SPIO labelled hMSCs in the bladder decreased after transplantation of 1x10(6) SPIO labelled hMSCs and were confined locally. Intracellular SPIO were confirmed in the hMSCs transplanted bladder up to 5 weeks. CONCLUSION: The SPIO labelled hMSCs in the bladder can be monitored using the molecular MR imaging and SPIO labelled hMSCs were found in the transplanted bladder.
Subject(s)
Animals , Humans , Rats , Iron , Magnetic Resonance Imaging , Mesenchymal Stem Cells , Stem Cells , Urinary BladderABSTRACT
Breast metastases from extramammary primary tumors are uncommon, accounting for approximately 1.3~6.6% of all malignant mammary tumors. Apart from hematopoietic neoplasms, malignant melanoma is one of the most common neoplasms with which secondary involvement of the mammary parenchyme is known. Although they are so rare, breast metastases from such neoplasms can mimic primary breast carcinoma clinically and on imaging studies. Approximately 20% of the patients affected by malignant melanoma will develop metastases, the commonest sites being liver, lung, and brain; metastases to the breast from malignant melanoma are rare, and in about 40% of the patients affected the breast lesion is the first manifestation of disease. Correct management of metastatic disease to the breast can prevent unnecessary mutilation; in fact, in the majority of patients so far widespread metastases have appeared rapidly despite various systemic treatments, showing that major surgery gives very poor results in terms of controlling the disease. In this paper, we present the case of a 49-year-old woman with a history of a malignant cutaneous melanoma of nasal cavity that had been surgically excised in 2004. She was admitted to our Breast Division 6 months later because a screening mammogram and anultrasound evaluation had revealed the presence of a nodular opacity in the both breast, without any clinical manifestations. For this reason, in September 2004 the patient underwent a simple mastectomy of both breasts.
Subject(s)
Female , Humans , Middle Aged , Brain , Breast Neoplasms , Breast , Hematologic Neoplasms , Liver , Lung , Mass Screening , Mastectomy, Simple , Melanoma , Nasal Cavity , Neoplasm MetastasisABSTRACT
Multiple primary tumors are defined as cases involving primary malignant tumors of different histologic origins in one person. The absolute number of reported cases of double primary malignant tumors has increased in recent years diagnostic procedures. Primary adenocarcinoma of duodenum is a rare disease and represents less than 0.5% of all gastrointestinal malignancies. Therefore, synchronous multiple primary cancers of the stomach and duodenum are very rare. Recently, we experienced a case of triple primary malignant tumors of different site originating from the stomach, duodenum and cervix in 71- year-old woman. She had had radiation therapy and chemotherapy for squamous cell carcinoma of the uterine cervix 8 years previously. We performed subtotal gastrectomy and pancreaticoduodenectomy with radical lymph node dissection. She remained healthy without any evidence of recurrence 12 months after the operation.
Subject(s)
Female , Humans , Adenocarcinoma , Carcinoma, Squamous Cell , Cervix Uteri , Drug Therapy , Duodenal Neoplasms , Duodenum , Gastrectomy , Lymph Node Excision , Pancreaticoduodenectomy , Rare Diseases , Recurrence , Stomach , Stomach Neoplasms , Uterine Cervical NeoplasmsABSTRACT
Transsexualism is a variety and complexity of conditions to the desire for sex change and may require medical treatments over psychological evaluations in some patients. Consequently, there is a potential confusion in the determination of anatomical sex in transsexuals arising from administration of hormone and/or sex reassignment surgery. In this article, we represent a case of a 52-year-old "woman"found dead on the road-side. "She"was naked on the scene and supposed to be murdered by strangulation of he neck. Surprisingly, autopsy findings as well as DNA typing revealed that "she"was transsexual once a man. We discuss medicolegal problems posed by medico-surgical treatment in transsexuals.
Subject(s)
Female , Humans , Middle Aged , Autopsy , DNA Fingerprinting , Homicide , Neck , Sex Reassignment Surgery , TranssexualismABSTRACT
Mass disasters usually include transportation accidents (aircraft, train or bus), structural failures of bridges and buildings, structural fires and industrial accidents. These often result in extensive damage of property and the loss of life. For the effective restoration and management of the situation, a well-organized operational plan is essential. Such a plan must consider facilities, specified personnel, administrative assistance and law enforcement. Recently, we experienced an aircraft accident leaving 128 people dead or missing. KDMORT (Korea Disaster Mortuary Operational Team) was tasked to perform the medicolegal investigations and identification. Difficulties were encountered during the procedures. In this article, we discuss some problems in the mass disaster operational system of Korea.
Subject(s)
Humans , Accidents, Occupational , Administrative Personnel , Aircraft , Disaster Planning , Disasters , Fires , Korea , Law Enforcement , TransportationABSTRACT
A 27-year-old woman with a 4-month history of right upper quadrant dull pain and normal blood pressure was admitted in May 2001. Abdominal ultrasonography and abdominal computed tomography revealed a huge retroperitoneal mass with hepatic nodules. Histologic diagnosis was paraganglioma based on gun biopsy. Hormonal study for pheochromocytoma was negative. I-metaiodobenzylguanidine (MIBG) scintigraphy and angiography were performed for operation. The tumor was removed en bloc with part of the pancreas, spleen and hepatic mass. Pathologic examination with immunohistochemical staining revealed a malignant pheochromocytoma growing exophytically from the left adrenal and metastasizing to the liver. The postoperative course has been uneventful and no recurrence has been noted over a 2-months follow-up period.
Subject(s)
Adult , Female , Humans , Angiography , Biopsy , Blood Pressure , Diagnosis , Follow-Up Studies , Liver , Neoplasm Metastasis , Pancreas , Paraganglioma , Pheochromocytoma , Radionuclide Imaging , Recurrence , Spleen , UltrasonographyABSTRACT
PURPOSE: Whole liver transplantation, an effective therapy for many inherited and acquired hepatic disorders, has limitations including donor shortage and fatal surgical complications. Hepatocyte transplantation, which is simpler and less expensive than whole liver transplantation, allows the use of living related donors, permits the use of a single donor organ for multiple recipients, and makes possible the cryopreservation of hepatocytes for future use. However, choosing a proper scaffold for hepatocytes hampers wide use of hepatocyte transplantation. We performed hepatocyte transplantation using biodegradable injectable polymers, fabricated form poly (lactide-co-glycolide) (PLGA) microspheres, as scaffolds to evaluate their effectiveness. METHODS: Female, five week old FVB mice, were prepared for donors, and four male, five week old nude mice, were used for recipients. Liver cells were isolated from FVB donors. The cell viability exceeded 95% as assessed by trypan blue exclusion method. For three nude mice, 2X10(6) cells resuspended in 200micro liter medium were mixed with 200micro liter PLGA microspheres, and were injected into the peritoneal cavity of each mouse. One nude mouse was transplanted with 2X10(6) cells resuspended in 200micro liter medium only, and it served as a negative control. Specimens were retrieved at one week, and histological and immunohistochemical analyses were performed. RESULTS: In the negative control, all transplanted hepatocytes disappeared at one week. In mice transplanted both microspheres and hepatocytes, conglomerates, which contained hepatocytes, were observed in the peritoneal cavity, The hepatocytes were identified by H and E staining and immunohistochemistry using anti- hepatocyte antibody. CONCLUSION: In this preliminary study, stable hepatocyte engraftment was achieved in hepatocyte transplantation with PLGA microspheres, but not in hepatocyte transplantation only. More studies on comparison between sponge-type scaffolds and injectable scaffolds would be necessary. Improvement on both initial vascularization and proliferation of transplanted hepatocytes is a target of our future work.
Subject(s)
Animals , Female , Humans , Male , Mice , Cell Survival , Cryopreservation , Hepatocytes , Immunohistochemistry , Liver , Liver Transplantation , Mice, Nude , Microspheres , Peritoneal Cavity , Polymers , Tissue Donors , Trypan BlueABSTRACT
The diagnosis of gastric cancer in young age group was sometimes missed .The operative risk in senile age group was high because of combined other organ diseases. We tried to determine the difference in their correct clinicopathologic features and the prognosis of young and senile patients with gastric cancer. Clinicopathologic characteristics and surgical results were compared in 40 senile gastric cancer patients who were aged 65 years or above, and in 48 young gastric cancer patients who were aged 40 years or less. In clinicopathologic features, the senile group was characterized by a high incidence of well differentiated adenocarcinoma and intestinal type by Lauren classification. The young age group was characterized by high incidence of undifferentiated type adenocarcinoma and diffuse type by Lauren classification . The others were unremarkable. When the survival rate was compared in all cases between young and senile group, the young age group showed a more favorable prognosis than the senile group, but without statistical difference ( P=0.0058 ) . Also, the survival rate according to UICC stage showed no statistical difference when the same stage of the two different groups were compared . Both group showed better survival in curative surgery cases than in noncurative surgery cases.Our findings ruled out any relationships between age and length of survival time in patients undergoing curative gastrectomy for gastric cancer.