Sacral Herpes Simplex Infection Mimicking as Herpes Zoster in the Immune-Competent Patient

No abstract available.

Utiliy of Breast Sentinel Lymph Node Biopsy Using the Day-Before or the Same-Day Subareolar Injection of (99m)Tc-Tin Colloid / 한국유방암학회지

PURPOSE: The aims of this study were to examine the feasibility of sentinel lymph node (SLN) biopsy using the day-before-surgery or the same-day subareolar injection of (99m)Tc-Tin colloid, and to evaluate the accuracy of performing intraoperative multiple frozen section diagnosis of the SLN for breast cancer. METHODS: From Jul. 2003 to Feb. 2004, a total of 81 women with clinically node negative breast cancer underwent SLN biopsy and this was followed by axillary lymph node dissection at the Korea Cancer Center Hospital. 2-2.5mCi of (99m)Tc-Tin colloid was injected intradermally in the outer upper edge of the areola on the day before or the same day of surgery, and lymphoscintigraphy was then obtained. The time interval between the injection of tracer and SLN biopsy varied from 1 hour to 20 hours. Intraoperatively, the status of the SLNs was examined by multiple frozen section diagnosis and all the SLNs were subjected to serial sectioning for Hematoxylin-eosin staining and immunohistochemical staining for cytokeratin. After removal of the SLNs, standard level I and II axillary dissection was performed in all patients. RESULTS: In 26 patients (32.1%), the SLNs were positive for tumor cells among these 26 patients. 16 patients (61.5%) results showed that the SLNs were the only metastatic nodes. Two cases of false negative findings were identified. The sensitivity and specificity were 92.9% and 100% respectively. In the second half of this study, no false-negative cases were found in 41 consecutive patients. CONCLUSION: The results of SLN biopsy using the day-before-surgery or same-day subareolar injection of (99m)Tc-Tin colloid were excellent for identification of the SLNs. This technique does not interfere with effective treatment in the operating room because the time interval between the injection and surgery did not affect the results of SLN biopsy. Intraoperative multiple frozen section diagnosis of SLNs was readily available, and this was highly accurate for assessing the status of SLNs

Meconium Peritonitis: 15 Cases Studies

PURPOSE: Meconium peritonitis is a form of aseptic, chemical peritonitis that results from a perforation of the gut during the intrauterine or perinatal period. The rarity of the disease resulted in few survivors up to the 1950's. However, the constantly increasing survival rate has followed an aggressive surgical management, along with a more thorough understanding of the etiological and pathological variations likely to be encountered. This study was performed to analyze our past 10 years' experience with meconium peritonitis. METHODS: The hospital records of 15 patients treated between January 1991 to December 2000 were retrospectively reviewed. RESULTS: The male to female sex ratio was 2:1, and the age at surgery varied from at the time of birth to 48 days. The clinical manifestations included marked abdominal distension (13 cases), respiratory distress (8 cases), billous vomiting (5 cases) and scrotal swelling (1 case). Radiological findings included air-fluid level (7 cases), calcification (4 cases) and pneumoperitoneum (3 cases). The prenatal ultrasonography demonstrated dilated loops of bowel, septated fetal ascites and calcification. The leading cause of perforation was small bowel atresia (8 cases). A primary end-to-end anastomosis was performed in 10 cases. Generalized type (8 cases) was the most common finding of meconium peritonitis. 86% of patients survived without long-term complications. CONCLUSION: Early recognition and proper management offer the greatest opportunity for survival in cases of meconium peritonitis.

The Prognostic Factors in the Survival of Adult CAPD Patients / 대한신장학회잡지

As a single CAPD center in Korea, we, at the department of internal medicine, Seoul National University Hospital, conducted a retrospective study in CAPD patients for the causes of death, patient survival rate, technique success rate, and risk factors. We enrolled in our study 167 patients who had began CAPD as an initial replacement therapy for end stage renal disease from March 1992 to July 1997 and survived for more than 2 months. As the prognostic factors of patient survival and technique success, we analyzed demographic features, clinical features including comorbid conditions at the beginning of CAPD, and laboratory findings at the beginning and 6 months after the start of CAPD. The mean age of patients was 49.8 12.5, and sex ratio was 1.4: 1(M: F). The mean follow-up period was 24.0 +/- 14.4 months. Cerebrovasular accident(CVA), the patient giving up on the treatment, cardiac dis- eases and peritonitis were the main causes of death in CAPD patients. Among the causes of death, although CVA and the patient giving up on the treatment were relatively important, the most im- portant causes of death were cardiovascular diseases. The 2 year survival rate and 4 year survival rate of CAPD patients were 89.4% and 55.579o respectively ; the 2 year technique success rate and 4 year technique success rate of CAPD were 87.37% and 63.18% respectively ; and the mean survival period and technique success period were 50.57 +/- 2.42 and 49.37 +/- 2.85 rnonths, respectively. We determined the independent prognostic factors for patient survival to be diabetes mellitus(p=0.0004, relative risk=5.9263) and liver cirrhosis(p=0.0032, RR=5.3211) using multivariate analysis with Cox proportional hazard model. Although the results were statistically insignificant, the patients with cardiac diseases(p=0.0961, RR= 2.0116) and older patients who were over 60 years old(p=0.1312, RR=1.8431) had a poor prognosis. The probable prognostic factors for 2 year survival of patients, considered marker of risk factors for early death, were DM, liver cirrhosis, and cardiac diseases, though statistically insignificant, and they were similar to prognostic factors for the patient survival during the entire period. The independent prognostic factor of technique failure of CAPD was DM(p= 0.0150, RR=2.6762). The patient survival rate and technique success rate of CAPD patients were similar to the outcomes reported in other countries. However, the fact that liver cirrhosis was included as one of the independent prognostic factors seems to reflect a disease characteristic of Korean population in whom chronic liver diseases are prevalent. Due to ever increasing pro- portions of DM, cardiac diseases, and older patients in CAPD patients and the prevalence of liver cirrhosis in Korea, more intensive management is necessary for CAPD patients with these disorders/ conditions.