Conventional Angiogram versus Multi-detector Row Helical Computed Tomography Angiogram for Preoperative Diagnostic Imaging in Low Extremity Arterial Surgery

PURPOSE: We performed this study to assess the suitability of conventional angiography (CA) vs. multi-detector row helical CT angiogram (MD-CTA) as a method of preoperative diagnostic imaging for low extremity arterial surgery. METHODS: From February 2004 to September 2006, 23 patients (4 claudicants, 19 limb-threatening ischemia) were studied with CA and MD-CTA preoperatively. The site and degree of stenotic or occlusive lesions in arterial segments from the renal artery to the dorsalis pedis artery were compared with both methods. We also compared the surgical inflow and outflow site changes in preoperative planning based on CA and MD-CTA and the final outcome. Additional diagnostic value and test-related complications were also analyzed. RESULTS: The median age of patients was 68 years old (range: 43~89 years), with a male to female ratio of 1.3:1. Twenty-three patients had CA after an MD-CTA scan. One hundred fifty lesions were detected in these patients. The total ratio of consistency for occlusion in CA vs. MD-CTA was 69.6%. Three patients received amputation treatment and eleven patients received a bypass operation. The agreement between the preoperative plan based on MD-CTA and the final operation was 100%, even in critical limb ischemia. There were no serious complications related to the tests. CONCLUSION: These findings suggest that MD-CTA is an adequate preoperative imaging study of infrainguinal arterial surgery and may be substituted for conventional angiography without any serious complications.

Expression of RUNX3 in Human Gastric Cancer

PURPOSE: RUNX3, a novel tumor suppressor, is frequently inactivated in gastric cancer. In the present study, we examined the pattern of RUNX3 expression in gastric cancer cells from gastric cancer specimens and the impact of its alteration on clinical outcome. MATERIALS AND METHODS: A total of 124 samples of both gastric cancer and normal tissue were obtained from 124 patients who underwent curative gastrectomy at the Seoul Medical Center from January 2001 to December 2005. RUNX3 expression was determined by immunohistochemical staining, and the results were analyzed. Statistical analysis wabased on clinicopathological findings and differences in survival rates. RESULTS: The mean age of the patients was 61 years, and the male:female ratio was 1.9:1. The expression rate of RUNX3 was 59.7% (74/124). The expression rate was higher in differentiated gastric cancers (nucleus: 9.1%, cytoplasm: 57.6%) than in the undifferentiated types (nucleus: 5.2%, cytoplasm: 46.6%) (P=0.133). The 5-year survival rates according to RUNX3 expression determined from cancer tissue were 88.9% for the nucleus +/- cytoplasm(+) group of patients, 76.1% for the cytoplasm only (+) group of patients, and 65.3% for the RUNX3 negative expression group of patients (P=0.626). Only UICC TNM staging showed statistical significance related to the survival rate, as determined by multivariate analysis. CONCLUSION: The RUNX3 expression rate was higher in differentiated gastric cancer than in the undifferentiated types without significance. Although RUNX3 expression predicted better survival, based on multivariate analysis, the finding was not statistically significant. More cases should be further evaluated.

Surgical Treatment for Obstructing Carcinomas of the Left Colon and Rectum

PURPOSE: There have been many different kinds of operations for obstructing left colon (distal to splenic flexure) cancer and rectal cancer because immediate resection and anastomosis was known to cause many complications. We performed this study to analyse operative cases and evaluate which procedure had the better result. METHODS: Thirty-six cases of left colon cancer and rectal cancer with complete obstruction were analysed from April 1990 to January 2001 and those cases were divided into two groups, the group of staged procedure and the group of primary resection. 28 cases were curative operations and 8 cases were palliative operations. RESULTS: The group of staged procedures had 17 cases of curative operations with 1st. stage-colostomy and 2nd. stage-cancer resection. And the group of primary resection had 11 cases of curative operations, 6 cases of Hartmann's procedures, 2 cases with intraoperative colonic lavage and resection and 3 cases with cancer resection, anastomosis and proximal colostomy. There were no differences in the distribution of age and cancer stage between two groups. In both groups, the sigmoid colon was the most prevalent obstruction site. The staged procedure group had higher operative mortality (25%) than the primary resection group (8%). And 5-year survival rate of the primary resection group was higher than that of the staged procedure group (45%: 33%), but there was no statistical significance. CONCLUSIONS: We think that the primary resection is the better surgical procedure because of shorter hospital stay and fewer operations in the treatment of obstructing left colon and rectal cancer.

A Clinical Analysis of the Breast Masses by Biopsy

BACKGROUND : A discussion of the chronologic trends of operative indications of breast masses for proper management of breast masses is desirable. METHODS : A retrospective analysis of 882 patients with breast masses who underwent operations at Kangnam General Hospital from January 1986 to December 1997 was done. All the lesions were classified according to for age, size of the mass, and the pathologic result. Concurrently, the distributions of the different masses were retrospectively analyzed for each one-year time period. RESULTS : The most prevalent age group was the third decade (28.6%) followed by the fourth decade (25.3%) and the fifth decade (24.4%). The most common lesion was fibroadenoma (38.7%), followed by mammary dysplasia (22.6%) and malignancy (18.3%). In fibroadenoma, the most common pathologic type was intracanalicular (34.9%), and the juvenile type occurred in significantly younger patients compared to other types (19.2 vs 29.2 years of age). In mammary dysplasia, the most common pathologic type was fibrous (74.4%), and the epithelial hyperplasia and adenosis types were occurred in older patients compared to the other types (39.1 and 41.0 vs 33.5 and 35.4 years of age). As the chronologically changing pattern of the pathologic types, the number of mammary dysplasia had a decreasing tendency and fibroadenoma had a relatively increasing one, and the reason may be the effect of fine-needle aspiration cytology. CONCLUSIONS : The result of this study shows that the distribution of the disease in terms of age and frequency is almost the same as that of other reported results. The trend of the disease types in terms of the time period shows that the operation rate for fibroadenomas is increasing while the rate for mammary dysplasia is decreasing. This tendency might come from the decreasing use of surgical biopsy for mammary dysplasia.

Clinical review of vreast cancer

No abstract available.

A clinical analysis of T-tube choledochostomy

No abstract available.

The diagnostic value of fine needle aspiration cytology of neck masses

No abstract available.