ABSTRACT
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by overproduction of myeloid white blood cells. Philadelphia chromosome is an essential finding for CML diagnosis. Generally, a clinical diagnosis of essential thrombocythemia (ET) can be established from isolated marked thrombocytosis in peripheral blood. However, Philadelphia chromosome-positivity or bcr/abl rearrangement with isolated thrombocytosis should be diagnosed as CML, not ET, according to World Health Organization diagnostic criteria. Therefore, CML should not be excluded before confirming the presence of the Philadelphia chromosome or bcr/abl rearrangement in cases of isolated thrombocytosis in peripheral blood. We report a case of CML with clinical features of ET in a patient successfully treated with imatinib.
Subject(s)
Humans , Bone Marrow , Diagnosis , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Leukocytes , Philadelphia Chromosome , Thrombocythemia, Essential , Thrombocytosis , World Health Organization , Imatinib MesylateABSTRACT
Most patients with familial adenomatous polyposis (FAP) undergo prophylactic colectomy. As a result, extracolonic manifestations including benign and malignant tumors are more common in patients with FAP, and duodenal cancer is now the main cause of death. However, duodenal adenomas and carcinomas are detected less frequently in Korea and Japan than in Western countries, and gastric cancer is more prevalent than in Western countries. In the present case, a 63-year-old man, who had undergone a total colectomy and an ileostomy 14 years previously, presented at our outpatient clinic complaining of discomfort at the ileostomy site. The patient had adenomas in the gallbladder and ileum, and adenocarcinomas in the duodenum and stomach. The interval between development of duodenal cancer and stomach cancer was only 4 months. Therefore, we suggest that more frequent endoscopic surveillance may be needed for these cases.
Subject(s)
Humans , Adenocarcinoma , Adenoma , Adenomatous Polyposis Coli , Ambulatory Care Facilities , Cause of Death , Colectomy , Colon , Duodenal Neoplasms , Duodenum , Gallbladder , Ileostomy , Ileum , Japan , Korea , Stomach , Stomach NeoplasmsABSTRACT
A 73-year-old woman presented with intermittent abdominal pain and weight loss of 15 kg for 2 years. Colonoscopy revealed an erythematous polypoid tumor with a long and wide stalk in the cecum, but with air inflation, it abruptly went away through the ileocecal valve (ICV). An abdominal computed tomography showed a well-demarcated pedunculated subepithelial mass of 2.6x2.7 cm size with fat attenuation in the terminal ileum. It was an intussusceptum of the ileal lipoma through the ICV. This ileal lipoma was causing her symptoms because repeated ileocolic intussusceptions resulted in intermittent intestinal obstructions. In order to avoid surgical sequelae of ileal resection, snare polypectomy using cap-assisted colonoscopy technique was performed within the ileum without complications. The histopathology report confirmed it as a subepithelial lipoma. After endoscopic resection of the ileal lipoma, the patient has been free of symptoms and was restored to the original weight.
Subject(s)
Female , Humans , Abdominal Pain , Cecum , Colonoscopy , Ileocecal Valve , Ileum , Inflation, Economic , Intestinal Obstruction , Intussusception , Lipoma , SNARE Proteins , Weight LossABSTRACT
Aspiration of the upper airway tract occurs most commonly in infants and children as a result of immature interaction between deglutition musculature and incomplete laryngeal reflex. Typically, the presence of a foreign body in the airway can cause difficulty in phonation, acute respiratory distress, and chronic airway infection. However, rarely, a foreign body lodged in the esophagus may also cause these problems. Although acute airway obstruction due to foreign body aspiration to the airway sometimes occurs in adults, cases involving these symptoms caused by the presence of a foreign body in the esophagus are very rare, and no such cases have been reported in Korea to date. The authors report a case of acute respiratory distress, during improving from an underlying alcoholic dilated cardiomyopathy. Stridor was observed on auscultation due to upper respiratory obstruction caused by an orthodontic prosthesis lodged within the upper esophagus.
Subject(s)
Adult , Child , Humans , Infant , Airway Obstruction , Alcoholics , Auscultation , Cardiomyopathy, Dilated , Deglutition , Esophagus , Foreign Bodies , Korea , Phonation , Prostheses and Implants , Reflex , Respiratory SoundsABSTRACT
Stress-induced cardiomyopathy is characterized by transient wall-motion abnormalities involving the left ventricular apex. Emotional or physical stress might play a key role in this reversible form of cardiomyopathy, but the etiology remains unclear. Clinical features of stress-induced cardiomyopathyare similar to those of acute coronary syndrome, but there is no significant stenosis in the coronary arteries. Recently, transient mid-ventricular ballooning syndrome, a variant form of stress-induced cardiomyopathy in which only the mid-ventricle is affected, has been reported. Here, we report a case of a 42-year-old female patient who developed transient mid-ventricular ballooning syndrome after cardiac arrest during autologous fat transplantation.
Subject(s)
Adult , Female , Humans , Acute Coronary Syndrome , Cardiomyopathies , Constriction, Pathologic , Coronary Vessels , Heart Arrest , Takotsubo Cardiomyopathy , TransplantsABSTRACT
PURPOSE: The prevalence of prostate cancer is increasing in the general population. This study aimed to evaluate the epidemiologic characteristics of the prostate cancer detection rate. MATERIALS AND METHODS: We analyzed data from patients who underwent transrectal ultrasound-guided prostate biopsy and who were newly diagnosed with prostate cancer from 2005 to 2006 in Korea. These data were based on National Health Insurance statistics. We also analyzed the data of patients who underwent transrectal ultrasound-guided prostate biopsy and were newly diagnosed with prostate cancer in our institution from 2005 to 2007. RESULTS: According to the data of the National Health Insurance, the detection rates of prostate cancer were 45.8% in 2005 and 43.1% in 2006. These results were not actual cancer detection rates. According to the data from our institution, the cancer detection rate ranged from 24.8% to 25.9% compared with the 15.5% to 23% cancer detection rate reported by other Korean studies. We analyzed the reasons for this difference in detection rates and suggest that the difference is because a suggestive diagnosis is useful and is unchanged until the diagnosis is confirmed. CONCLUSIONS: The prevalence of prostate cancer is increasing more rapidly than that of other major cancers. The detection rate of prostate cancer in Korean patients who underwent transrectal ultrasound-guided prostate biopsy was inferior to that in Caucasians. Also, some patients were detected without proper screening or biopsy and were thus diagnosed as having advanced or metastatic prostatic cancer. We need a good corelationship between National Health Insurance and the cancer registration project for real detection of prostate cancer.
Subject(s)
Humans , Biopsy , Early Detection of Cancer , Korea , Mass Screening , National Health Programs , Prevalence , Prostate , Prostatic NeoplasmsABSTRACT
PURPOSE: Prostatic manipulation and surgery have been shown to increase serum prostate-specific antigen (PSA). We studied the effect of ejaculation on the serum PSA levels. MATERIALS AND METHODS: We evaluated 131 men(16 to 64 years old) who had no history of surgery or inflammatory disease of the urogenital tract. The total serum PSA, free PSA, serum total testosterone, free testosterone, luteinizing hormone(LH), and follicular stimulating hormone(FSH) were evaluated 1 hour after ejaculation. RESULTS: A PSA level was detected in all the men. There were statistically significant changes of the serum PSA level before and after ejaculation. We compared the parameters between increased PSA group and the decreased PSA group. There were significant differences between the two groups on comparison of the total prostate volume(25.4+/-3.6g vs 15.1+/-4.2g, respectively) and the transition zone volume(7.1+/-2.7g vs 5.3+/-1.1g, respectively). CONCLUSIONS: Based on our data, ejaculation affects the serum PSA concentration in young men, and there seems to be a physiological relationship between ejaculation and the PSA level. The larger the prostate volume, the more ejaculation has an effect on the serum PSA level.
Subject(s)
Humans , Male , Ejaculation , Lutein , Prostate , Prostate-Specific Antigen , TestosteroneABSTRACT
The posterior cruciate ligament(PCL) is one of the most important structures in the knee joing because it provides about 94% of the total restraint to posterior displacement of the tibia & posterior stability of the knee joint. If the posterior instability persisted, rotational instability, injury to meniscus and degenerative change develop within several years. The purpose of this study is to know the result of the posterior cruciate ligament reconstruction using semitendinosus tendon and to know the factors which affected to good result. During the period from January 1989 to December 1994, 16 cases with posterior cruciate ligament reconstruction using semitendinosus tendon were evaluated clinical and radiological results retrospectively and performed stastical analysis using the SPSS. The results were as follows; 1. The average preoperative posterior laxity was 14.1 mm and average postoperative laxity was 6.3 mm. It was improved 7.8 mm. 2. In other associated injured ligament group with or without fracture, above good was in 8 cases and below fair in 6 cases, but there was no significant difference between the two (X²=9.8, df=1, P>0.05). 3. In the poor result group, mean body weight was 80(±13.23)kg and there was significant difference between poor group & fair, good, excellent group(F=3.52, P < 0.05). From these results it would be suggested that PCL reconstruction using semitendinosus tendon is more effective in relatively light weighted group than heavier group.
Subject(s)
Body Weight , Knee , Knee Joint , Ligaments , Posterior Cruciate Ligament , Retrospective Studies , Tendons , TibiaABSTRACT
Birth injury is defined as any condition that affects the fetus adversely during the labor or delivery. Clavicle fracture during the delivery can be found in 0.49-0.95% if all living newborns. The objectives of this study were to identify and prevent the contribution facture during delivery. We obtained 98 patients of the clavicle fracture among the 13,698 neonates delivered at P.M.C from March. 1991 to Feb. 1994. We analysed the 98 patients of the clavicle fracture with 857 control group according to neonatal factors, maternal factors and methods of delivery. The results were as follows ; 1. Of all the cases of the clavicle fracture, the site of the fracture was middle 1/3 of the clavicle and majority of the fracture were displaced(82.5%). 2. Birth injuries which were associated with clavicle fracture were increased than those without clavicle fracture in brachial plexus injuries, scalp and intracranial hemorrhage, and skull fracture. 3. Contributing factors which were increased the fracture of the clavicle during the delivery were as follows; i) Maternal age over 37 years and below 24 years. ii) Gestational age over 40 weeks (especially over 42 weeks) iii) Birth weight over 3500kg. 4. The proportion of the vacuum extraction during the delivery was nearly double times in patient group than in control group.
Subject(s)
Humans , Infant, Newborn , Birth Injuries , Birth Weight , Brachial Plexus , Clavicle , Fetus , Gestational Age , Intracranial Hemorrhages , Maternal Age , Scalp , Skull Fractures , VacuumABSTRACT
We reviewed thrity-one cases of unstable tibial fractures treated with Ilizarov method from January 1991 to December 1992. We attained satisfactory bony union in all cases without bone graft(Average time 19.2 weeks). There were numbers of complications, but its were soluble and careful management & numbers of minor surgery were needed to prevent & solve such complications. Post-op immediate weight bearing and ROM exercise were possible and showed no difficulty in getting mainteance of reduction & fracture healing, and serious joint ankylosis was not developed. In conclusions, Ilizarov method is an excellent treatment in getting reduction, maintenance of reduction, early ambulation and fracture healing in the cases of unstable tibia fractures.
Subject(s)
Ankylosis , Early Ambulation , Fracture Healing , Ilizarov Technique , Joints , Minor Surgical Procedures , Tibia , Tibial Fractures , Weight-BearingABSTRACT
In general, satisfactory results can be obtained by nonoperative means in the management of proximal femoral shaft fracture in children. Howerver, it is sometimes difficult to maintain the fracture alignment by the nonoperative means because of different muscle pulls in the thigh. The proximal fragment tend to be displaced and roentgenograms are difficult to be taken during traction. These problems have led some authors to advocate open reduction and internal fixation which facilitate overall care. We report our experiences on nonoperative and.operative treatment for proximal femoral fracture at the Chon-ju Presbyterian Medical Center from February 1987 to January 1991. The results are as follows ; 1. There were 20 cases in male, 7 cases in female. Average age at injury was 6.9 years (range, 6 months to 12 years and 8 months). Traffic accident was the most common cause (70.3%). 2. Average immobillization time was 9.2 weeks (range, 6.0 weeks to 12.1 weeks) in the nonoperative treatment group(17 cases), while 8.1 weeks(range, 6.1 weeks to 11.4 weeks) in the operative treatment group (10 cases). 3. Average bony union time was 9.6 weeks (range, 6.3 weeks to 12.5 weeks) in the nonoperative treatment group(17. cases) and 11.2 weeks (range, 9.0 weeks to 13.4 weeks) in the operative treatment group (P < 0.05). 4. Average overgrowth of femur was 3.3mm(range,
Subject(s)
Child , Female , Humans , Male , Accidents, Traffic , Clinical Study , Femoral Fractures , Femur , Protestantism , Thigh , TractionABSTRACT
No abstract available.
ABSTRACT
No abstract available.
Subject(s)
Cerebral Palsy , Clubfoot , Congenital Abnormalities , Muscle SpasticityABSTRACT
No abstract available.
ABSTRACT
In recent years, there has been a tendency to advocate operative treatment as the method of choice for certain fractures of the proximal humerus. But the management of this fracture is still under debate, especially in the elderly patients. Seventy eight patients with displaced fractures of the proximal humerus were reviewed, and the results were as follows ; l. Among the 78 patients, the ratio of males and females was 44:34 and the highest incidence was between the ages of 40 and 49 years. 2. The most common cause of injuries was traffic accident (57.7%), and falling or slipped down was in 33.3%. 3. According to the classificatoin of Neer, the commonest type was two part fracture (60.3%). 4. Fifty-three cases were treated conservatively, and surgical treatment was done at 25 cases. At old age, or patients with severe associated injury, external fixation was done (12 cases), and one case of four-part fracture was treated by prosthetic replacement. 5. The results were analyzed according to Neer's criteria, and 38 cases (48.7%) showed good, 25 cases (32.1%) was fair, and 15 cases (19.2%) was poor. 6. Total cases with complication were 19 (24.4%), and joint stiffness was most common (10 cases). 7. At elderly patient above 50 years old, the result of surgical treatment was satisfactory in 72.7%, and 58.8% was so when treated conservatively. And the external fixation showed slightly better result than that of internal fixation.
Subject(s)
Aged , Female , Humans , Male , Accidental Falls , Accidents, Traffic , Clinical Study , Humerus , Incidence , Joints , MethodsABSTRACT
Treatment by External Fixation with External Compression Device was used for the displaced fractures of the proximal humerus. Especially in the old aged patient and patient with severe associated injury, this method was excellent for the early, painless motion of the shoulder and then good functional result. This experimental treatment was performed in 8 patients, and its merits were as follows: 1. The technique of operation was relatively easy, and was possible within a short time with minor injury. 2. The quality of reduction was good in all cases. 3. By the compression effect on the fracture site and firm maintenance of reduction during the treatment, solid healing as in internal fixation was possible. 4. Firm maintenance of reduction & minimal injury of soft tissue made possible early painless and wide ROM exercise, and then good functional result.
Subject(s)
Humans , Humerus , Methods , ShoulderABSTRACT
Since January 1988 a group of 54 patients presenting with stone in the lower third of the ureter have been treated with rigid ureteroscope. In 47 cases(87 per cent) the stone was removed successfully. The associated number of complication was low, with most patients being treated conservatively. Our results confirm the safety and efficiency of ureteroscopy to manage the lower ureteral stones.