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1.
Clinical Endoscopy ; : 478-484, 2018.
Article in English | WPRIM | ID: wpr-716588

ABSTRACT

BACKGROUND/AIMS: Since population-based screening for gastric cancer in Korea was implemented, endoscopic treatment of early gastric cancer has become increasingly popular. This study investigates factors affecting endoscopic curative resection of early gastric cancer in population-based screening for gastric cancer. METHODS: We retrospectively reviewed data of patients with newly diagnosed gastric cancer who underwent treatment at Seoul St. Mary’s Hospital. All patients completed questionnaires about clinical information, including interval between surveillance tests for gastric cancer. RESULTS: Of 469 gastric cancer patients, 147 (31.3%) had undergone curative endoscopic resection, 260 (55.4%) had undergone curative surgical resection, and 62 (13.3%) underwent non-curative resection or were in an inoperable state. Patients with curative endoscopic resection had fewer alarm symptoms/signs than other groups. In multivariate analysis, regular surveillance endoscopy was the only factor predicting curative endoscopic resection (odds ratio [OR], 6.099; 95% confidence interval [CI], 2.532–14.933). In addition, patients undergoing gastric cancer screening had a significantly higher rate of endoscopic curative resection compared with subjects who had never been screened. (1-year interval: OR, 49.969; 95% CI, 6.340–393.827, 2-year interval: OR, 15.283; 95% CI, 1.833–127.406, over 2-year interval: OR, 10.651; 95% CI, 1.248–90.871). Shorter screening test intervals were associated with higher rates of endoscopic curative resection. CONCLUSIONS: Regular surveillance testing was the independent factor predicting curative endoscopic resection of gastric cancer.


Subject(s)
Early Detection of Cancer , Endoscopy , Humans , Korea , Mass Screening , Multivariate Analysis , Retrospective Studies , Seoul , Stomach Neoplasms
2.
Journal of Rhinology ; : 43-46, 2018.
Article in Korean | WPRIM | ID: wpr-714404

ABSTRACT

Solitary fibrous tumor is a rare spindle cell neoplasm of mesenchymal origin that occurs most commonly in the pleura. This tumor can be found in various extrathoracic sites that contain soft tissue. There are few reports of solitary fibrous tumors in the head & neck and only 5 cases of solitary fibrous tumors of the cheek have been reported. A 53-year-old man visited our department complaining of a firm mass in the left cheek. We suspected a schwannoma originating from the infraorbital nerve. The mass was removed via a gingivobuccal approach and was diagnosed as a solitary fibrous tumor.


Subject(s)
Cheek , Head , Humans , Middle Aged , Neck , Neurilemmoma , Pleura , Solitary Fibrous Tumors
3.
Article in English | WPRIM | ID: wpr-139835

ABSTRACT

We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery.


Subject(s)
Foreign Bodies , Hemorrhage , Humans , Lung Injury , Lung , Pneumonectomy , Thoracotomy , Thorax , Tuberculosis, Pulmonary , Wounds, Penetrating
4.
Article in English | WPRIM | ID: wpr-139834

ABSTRACT

We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery.


Subject(s)
Foreign Bodies , Hemorrhage , Humans , Lung Injury , Lung , Pneumonectomy , Thoracotomy , Thorax , Tuberculosis, Pulmonary , Wounds, Penetrating
5.
Article in English | WPRIM | ID: wpr-118267

ABSTRACT

In the embryo, the thymus originates from the third and fourth pharyngeal pouches and migrates from the superior neck to the mediastinum. Ectopic cervical thymoma (ECT) is an extremely rare tumor that originates from ectopic tissue, and is caused by the aberrant migration of the embryonic thymus. Our patient was a 30-year-old woman who had a nodular lesion in the neck for several years. Ultrasonography and computed tomography were performed. She underwent surgery, and a histological examination resulted in a diagnosis of type AB thymoma. Herein, we report a case of ECT that was resected through a transcervical approach.


Subject(s)
Adult , Choristoma , Diagnosis , Embryonic Structures , Female , Humans , Mediastinum , Neck , Thymectomy , Thymoma , Thymus Gland , Ultrasonography
6.
Article in English | WPRIM | ID: wpr-10928

ABSTRACT

BACKGROUND: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. METHODS: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients. Trauma factors included sternal fracture, flail chest, diaphragm injury, traumatic aortic dissection, combined cardiac injury, pulmonary contusion, pneumothorax, hemothorax, hemopneumothorax, abbreviated injury scale score, thoracic trauma severity score, and injury severity score. RESULTS: Forty-six patients (45.5%) had at least 1 episode of VAP, 10 (21.7%) of whom died in the ICU. Of the 55 (54.5%) patients who did not have pneumonia, 9 (16.4%) died in the ICU. Using logistic regression analysis, we found that VAP was associated with severe lung contusion (odds ratio, 3.07; 95% confidence interval, 1.12 to 8.39; p=0.029). CONCLUSION: Severe pulmonary contusion (pulmonary lung contusion score 6–12) is an independent risk factor for VAP in ventilated trauma patients with multiple rib fractures.


Subject(s)
Abbreviated Injury Scale , Contusions , Diaphragm , Flail Chest , Hemopneumothorax , Hemothorax , Humans , Injury Severity Score , Intensive Care Units , Logistic Models , Lung , Lung Injury , Mortality , Pneumonia , Pneumonia, Ventilator-Associated , Pneumothorax , Retrospective Studies , Rib Fractures , Ribs , Risk Factors , Thoracic Injuries , Wounds and Injuries
7.
Article in Korean | WPRIM | ID: wpr-651630

ABSTRACT

BACKGROUND AND OBJECTIVES: Oroantral fistula is an epithelialized communication between the oral cavity and the maxillary sinus. The aim of this study is to investigate the clinical characteristics and treatment of oroantral fistula. SUBJECTS AND METHOD: Patients who have undergone treatment for oroantral fistula between May 1995 and December 2015 were enrolled in this study. The demographic data of these patients and characteristics of oroantral fistula were analyzed. Patients with oroantral fistula were initially administered oral antibiotics for 3 weeks. If fistula persists in spite of the medication, surgery (soft tissue flap with or without bone graft) was performed. The surgical results according to the presence of bone graft were compared. RESULTS: Twenty-two patients were in accordance with the inclusion criteria. The male to female ratio of patients was 12:10, with the mean age of 47.9±13.4 years. The main complaint of patients was pus discharge from the fistula. Two patients were successfully treated with antibiotics whereas 20 patients underwent surgery. Recurrence occurred in 3 patients, who were treated with soft tissue flap, but no recurrence developed in the patients treated with soft tissue flap and bone graft. Although dehiscence of soft tissue flap occurred in one patient treated with bone graft, it was successfully treated by secondary intention without an additional surgery. CONCLUSION: Bone graft bears the negative pressure of the oral cavity and the weight of secretions including the blood. In addition, it induces secondary intention for the dehiscence of the flap. In this regard, bone graft seems to contribute to the surgical success of oroantral fistula.


Subject(s)
Anti-Bacterial Agents , Bone Transplantation , Female , Fistula , Humans , Intention , Male , Maxillary Sinus , Methods , Mouth , Oral Surgical Procedures , Oroantral Fistula , Recurrence , Suppuration , Surgical Flaps , Transplants
8.
Article in English | WPRIM | ID: wpr-30191

ABSTRACT

OBJECTIVES: To evaluate the factors that limit post-cochlear implantation (CI) speech perception in prelingually deaf children. METHODS: Patients with CI were divided into two groups according to Category of Auditory Performance (CAP) scores 3 years post-CI: the poor performance group (poor performance group, CAP scores≤4, n=41) and the good performance group (good performance group, CAP scores≥5, n=85). The distribution and contribution of the potential limiting factors related to post-CI speech perception was compared. RESULTS: Perinatal problems, inner ear anomalies, narrow bony cochlear nerve canal (BCNC), and intraoperative problems was significantly higher in the poor performance group than the good performance group (P=0.010, P=0.003, P=0.001, and P=0.045, respectively). The mean number of limiting factors was significantly higher in the poor performance group (1.98±1.04) than the good performance group (1.25±1.11, P=0.001). The odds ratios for perinatal problems and narrow bony cochlear nerve canal in the poor performance group in comparison with the good performance group were 4.878 (95% confidence interval, 0.067 to 0.625; P=0.005) and 4.785 (95% confidence interval, 0.045 to 0.972; P=0.046). CONCLUSION: This study highlights the comprehensive prediction of speech perception after CI and provides otologic surgeons with useful information for individualized preoperative counseling of CI candidates.


Subject(s)
Child , Cochlear Implantation , Cochlear Implants , Cochlear Nerve , Counseling , Deafness , Ear, Inner , Hearing Loss, Sensorineural , Humans , Language Development , Odds Ratio , Prognosis , Speech Perception , Surgeons
9.
Neurointervention ; : 10-17, 2016.
Article in English | WPRIM | ID: wpr-730293

ABSTRACT

PURPOSE: The purpose of this study was to assess the safety and early outcomes of the Pipeline device for large/giant or fusiform aneurysms. MATERIALS AND METHODS: The Pipeline was implanted in a total of 45 patients (mean age, 58 years; M:F=10:35) with 47 large/giant or fusiform aneurysms. We retrospectively evaluated the characteristics of the treated aneurysms, the periprocedural events, morbidity and mortality, and the early outcomes after Pipeline implantation. RESULTS: The aneurysms were located in the internal carotid artery (ICA) cavernous segment (n=25), ICA intradural segment (n=11), vertebrobasilar trunk (n=8), and middle cerebral artery (n=3). Procedure-related events occurred in 18 cases, consisting of incomplete expansion (n=8), shortening-migration (n=5), transient occlusion of a jailed branch (n=3), and in-stent thrombosis (n=2). Treatment-related morbidity occurred in two patients, but without mortality. Both patients had modified Rankin scale (mRS) scores of 2, but had an improved mRS score of 0 at 1-month follow-up. Of the 19 patients presenting with mass effect, 16 improved but three showed no changes in their presenting symptoms. All patients had excellent outcomes (mRS, 0 or 1) during the follow-up period (median, 6 months; range, 2-30 months). Vascular imaging follow-up (n=31, 65.9%; median, 3 months, range, 1-25 months) showed complete or near occlusion of the aneurysm in 24 patients (77.4%) and decreased sac size in seven patients (22.6%). CONCLUSION: In this initial multicenter study in Korea, the Pipeline seemed to be safe and effective for large/giant or fusiform aneurysms. However, a learning period may be required to alleviate device-related events.


Subject(s)
Aneurysm , Carotid Artery, Internal , Follow-Up Studies , Humans , Korea , Learning , Middle Cerebral Artery , Mortality , Retrospective Studies , Thrombosis
10.
Article in Korean | WPRIM | ID: wpr-647784

ABSTRACT

Metastasizing pleomorphic adenoma is a rare condition of metastasis from a histologically benign pleomorphic adenoma of the salivary glands. The bones and lungs are the most common metastatic locations for metastasizing pleomorphic adenoma, suggesting hematogenous spread of the primary tumor. However, we observed a case of metastasizing pleomorphic adenoma presenting with cervical lymph node metastasis, suggesting metastasis through the regional lymphatic system, in a 37-year-old woman who underwent parotidectomy 14 years earlier. Herein, we report this rare case and review the relevant literature.


Subject(s)
Adenoma, Pleomorphic , Adult , Female , Humans , Lung , Lymph Nodes , Lymphatic System , Neoplasm Metastasis , Recurrence , Salivary Glands
11.
Article in English | WPRIM | ID: wpr-81049

ABSTRACT

Mediastinitis is a life-threatening disease, and effective drainage is needed to treat mediastinitis with abscess formation. We recommend an alternative drainage method using chest tube binding with a Silastic Penrose drainage tube. The use of a Silastic Penrose drainage tube may help to manage mediastinitis with abscess formation. This method facilitates effective draining and prevents tissue adhesion.


Subject(s)
Abscess , Chest Tubes , Drainage , Mediastinitis , Tissue Adhesions
12.
Article in Korean | WPRIM | ID: wpr-657017

ABSTRACT

The isolated unilateral aplasia of the submandibular gland (SMG) is an extremely rare condition, because most cases of congenital absence of the major salivary glands are associated with other anomalies and several major salivary glands. Worldwide, only 15 cases of isolated unilateral SMG aplasia have been reported. Here, we report a case of a 35-year-old woman with isolated unilateral SMG absence. The ipsilateral parotid gland was hypertrophied at the time of initial diagnosis, but this gland showed significant atrophy during the subsequent 3-year follow-up. This phenomenon may be associated with ipsilateral SMG aplasia, and we report this unique case along with a literature review in this paper.


Subject(s)
Atrophy , Female , Follow-Up Studies , Humans , Parotid Gland , Salivary Glands , Submandibular Gland
13.
Article in Korean | WPRIM | ID: wpr-647967

ABSTRACT

Although neurilemmomas can arise from all types of cranial nerves except the optic and olfactory nerves, a hypoglossal neurilemmoma is extremely rare. Furthermore, since this neurilemmoma usually develops in the intracranial portion of the hypoglossal nerve, a hypoglossal neurilemmoma in the submandibular region is unfamiliar even to head and neck surgeons. However, the preoperative diagnosis of hypoglossal neurilemmoma in the submandibular region is very important because of the possibility of sacrificing the hypoglossal nerve during surgery under the incorrect impression of a salivary gland tumor. Therefore, we report a case of hypoglossal nerve neurilemmoma occurring in the submandibular area with a review of the literature focusing on preoperative differential diagnosis.


Subject(s)
Cranial Nerves , Diagnosis, Differential , Head , Hypoglossal Nerve , Neck , Neurilemmoma , Olfactory Nerve , Salivary Glands , Submandibular Gland
14.
Article in English | WPRIM | ID: wpr-201026

ABSTRACT

Atherosclerotic vascular dysfunction is a chronic inflammatory process that spreads from the fatty streak and foam cells through lesion progression. Therefore, its early diagnosis and prevention is unfeasible. Reactive oxygen species (ROS) play important roles in the pathogenesis of atherosclerotic vascular disease. Intracellular redox status is tightly regulated by oxidant and antioxidant systems. Imbalance in these systems causes oxidative or reductive stress which triggers cellular damage or aberrant signaling, and leads to dysregulation. Paradoxically, large clinical trials have shown that non-specific ROS scavenging by antioxidant vitamins is ineffective or sometimes harmful. ROS production can be locally regulated by cellular antioxidant enzymes, such as superoxide dismutases, catalase, glutathione peroxidases and peroxiredoxins. Therapeutic approach targeting these antioxidant enzymes might prove beneficial for prevention of ROS-related atherosclerotic vascular disease. Conversely, the development of specific antioxidant enzyme-mimetics could contribute to the clinical effectiveness.


Subject(s)
Atherosclerosis , Catalase , Early Diagnosis , Foam Cells , Glutathione , Oxidation-Reduction , Peroxidases , Peroxiredoxins , Reactive Oxygen Species , Superoxides , Vascular Diseases , Vitamins
15.
Korean Journal of Medicine ; : 608-612, 2013.
Article in Korean | WPRIM | ID: wpr-80225

ABSTRACT

Prompt antibiotic treatment reduces the incidence of complications such as liver abscesses, pyelonephritis, and osteomyelitis in patients with typhoid fever. Renal or liver abscesses are especially rare in patients without underlying disease or predisposing factors. The occurrence of both renal and liver abscesses in a patient with typhoid fever has not been reported. Although the prevalence of typhoid fever in Korea has decreased, it is still an important disease owing to increased opportunities for the occurrence of waterborne diseases with climate warming and group feeding, and the increased numbers of tourists and foreigners visiting Korea. We present a patient with no underlying disease or predisposing factors who developed both renal and liver abscesses caused by nalidixic acid-resistant Salmonella typhi after a trip to Nepal. He was treated successfully with percutaneous drainage of the renal abscess and high-dose ciprofloxacin.


Subject(s)
Abscess , Ciprofloxacin , Climate , Drainage , Drug Resistance , Emigrants and Immigrants , Humans , Incidence , Korea , Liver , Liver Abscess , Nalidixic Acid , Nepal , Osteomyelitis , Prevalence , Pyelonephritis , Salmonella , Salmonella typhi , Typhoid Fever
16.
Article in Korean | WPRIM | ID: wpr-93447

ABSTRACT

Hepatitis viruses (hepatitis B virus (HBV) and hepatitis C virus) have been associated with development of inflammatory arthritis. Approximately 400 million people worldwide have chronic HBV infection. HBV infection is the one of the most common causes of liver disease, and the prevalence of HBV infection in Korea is almost 6%. Arthritis in patients with HBV can be encountered in two settings: as a rheumatoid arthritis (RA)-like, acute, self-limited polyarthritis during the pre-symptomatic phase of acute hepatitis B, or, more rarely, as arthritis occurring in the context of HBV-associated polyarteritis nodosa (PAN). In both cases, the pathogenesis of arthritis is attributed to the deposition of immune complexes containing viral antigens (HBsAg or HBeAg) and their respective antibodies (anti-HBs and anti-HBe) in synovial tissues. Here we report on a case of polyarthritis associated with reactivation of chronic hepatitis B virus infection with a review of the literature.


Subject(s)
Antibodies , Antigen-Antibody Complex , Antigens, Viral , Arthritis , Arthritis, Rheumatoid , Hepatitis B , Hepatitis B, Chronic , Hepatitis C , Hepatitis Viruses , Hepatitis, Chronic , Herpesvirus 1, Cercopithecine , Humans , Korea , Liver Diseases , Polyarteritis Nodosa , Prevalence , Viruses
17.
Article in Korean | WPRIM | ID: wpr-107355

ABSTRACT

Tumor necrosis factor (TNF)-alpha antagonist has been proven to have benefit for rheumatologic diseases. Because TNF-alpha is not only an important mediator of inflammation in human body, but plays many physiologic roles, it can cause unique adverse effects or complications related to these functions. Adverse effects involving neurological systems, such as Guillain-Barre syndrome, Chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy with conduction blocks (MMNCB), distal symmetric polyneuropathy, and small fibers neuropathy have been previously reported. However, only several cases of infliximab-associated MMNCB are reported. We report a case of MMNCB which developed while treating spondyloarthropathy with infliximab.


Subject(s)
Antibodies, Monoclonal , Guillain-Barre Syndrome , Human Body , Humans , Inflammation , Polyneuropathies , Spondylarthropathies , Tumor Necrosis Factor-alpha , Infliximab
18.
Article in Korean | WPRIM | ID: wpr-148153

ABSTRACT

BACKGROUND/AIMS: Only limited data are available on severe community-acquired pneumonia (severe CAP or SCAP) caused by Streptococcus pneumoniae in Korea. METHODS: All patients who were admitted to a tertiary hospital for CAP from January 2007 to December 2008 were reviewed retrospectively, and SCAP was defined by 2007 Infectious Disease Society of America/American Thoracic Society criteria. RESULTS: In total, 94 patients were diagnosed with SCAP (mean age, 73.5 +/- 14.3 years; male, 70). Among them, pneumococcal SCAP (P-SCAP) accounted for 24.5%, and non-P-SCAP accounted for 18.1% (four with Pseudomonas aeruginosa, [4.3%]; four with Staphylococcus aureus, [4.3%]), and no organisms were identified in 57.4% of the patients. A history of neoplasm was less frequent, and the incidence of shock and pneumonia severity index (PSI) scores were lower in patients with P-SCAP than in those with non-P-SCAP or with SCAP with no organism identified (p = 0.012, 0.023 and 0.007, respectively). Patients with P-SCAP had a lower rate of treatment failure (p = 0.048) and tended to have lower in-hospital and 30-day mortalities compared with those with non-P-SCAP. In a multivariate analysis, the history of neoplasm was the strongest independent factor for predicting 30-day mortality (odds ratio, 9.068; 95% confidence interval, 1.856-44.309). CONCLUSIONS: P-SCAP accounted for 24.5% of SCAP cases. P-SCAP was associated with lower disease severity and a tendency toward better hospital outcomes compared with non-P-SCAP.


Subject(s)
Communicable Diseases , Humans , Incidence , Intensive Care Units , Male , Multivariate Analysis , Pneumonia , Pseudomonas aeruginosa , Retrospective Studies , Shock , Staphylococcus aureus , Streptococcus pneumoniae , Tertiary Care Centers , Treatment Failure
19.
Kosin Medical Journal ; : 181-184, 2012.
Article in Korean | WPRIM | ID: wpr-115477

ABSTRACT

Multicentric reticulohistiocytosis (MRH) is a rare disease characterized by nodular skin lesions and severe erosive polyarthritis which is associated with malignancy in some cases. The diagnosis is confirmed by the presence of oncocytic histiocytes and multinucleated giant cells on histopathology of the cutaneous nodules and the synovial membrane. It usually remits spontaneously after 5-8 years but it can provoke destructive arthritis. We report a case of a 49-year-old female who presented with numerous nodules on the both hands, face and abdomen and progressive destructive polyarthritis of 3 years duration and has been diagnosed with rheumatoid arthritis. The lesion showed large histiocytes with ground-glass eosinophilic cytoplasm, typical of MRH. Clinical manifestation and radiological pattern of MRH may be misdiagnosed as other disease like rheumatoid arthritis and psoriatic arthritis, but histopathologic findings of our case can differentiate MRH from any other conditions.


Subject(s)
Abdomen , Arthritis , Arthritis, Psoriatic , Arthritis, Rheumatoid , Cytoplasm , Eosinophils , Female , Giant Cells , Hand , Histiocytes , Humans , Rare Diseases , Skin , Synovial Membrane
20.
Article in Korean | WPRIM | ID: wpr-13697

ABSTRACT

BACKGROUND/AIMS: Carcinoid tumors are often indolent asymptomatic tumors, however significant proportions are malignant. The patients with these tumors have usually been treated by radical excision. Recently, small gastrointestinal carcinoid tumors can be easily be detected with increasing use of endoscopy and surgical treatment has been questioned. We evaluate clinical characteristics of gastrointestinal carcinoid tumors and clinical usefulness of endoscopic resection in treatment of gastrointestinal carcinoid tumors. METHODS: We reviewed the medical records of 37 cases of gastrointestinal carcinoid tumors over the past three years in our instituide. RESULTS: The peak incidence was in the 5th decade and slight male predominance. The most comgastrointestinal carcinoid tumors were diagnosed by endoscopy with biopsy. Twenty-six cases of carcinoid tumors of size less than 15 mm have been safely treated with endoscopic resection. All of the patients are alive and clinically free of disease during 23 months after endoscopic resection. CONCLUSIONS: Recently, the detection of small carcinoid tumors in gastrointestinal tract, especially in rectum, is increasing with frequent use of endoscopy. Endoscopic resection was found to be useful and safe for treatment of small gastrointestinal carcinoid tumors.


Subject(s)
Biopsy , Carcinoid Tumor , Endoscopy , Gastrointestinal Tract , Humans , Incidence , Male , Medical Records , Rectum
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