We report a case of 50-year-old man with hyalinized hemangioma of the liver. This tumor was detected incidentally during surgical operation for gall stone and was preoperatively diagnosed as intrahepatic stone. A 2.5 2 cm sized gray to white hard mass was found in the left lobe of the liver. Histologically, the tumor was composed of dense collagenous tissue with marked hyalinization, calcification, and ossification admixed with scattered sclerotic vessels. Abundunt elastic fibers were noted in the hyalinized tissue. Totally hyalinized hemangioma is very uncommon and could be erroneously diagnosed as a malignant tumor by preoperative radiologic examination.
Collagen ; Elastic Tissue ; Gallstones ; Hemangioma* ; Humans ; Hyalin* ; Liver* ; Middle Aged

BACKGROUND: Rhinocerebral mucormycosis (RCM) is an uncommon and fatal clinical syndrome resulting from an opportunistic infection caused by a fungus of the order Mucorales in immunocompromized patients. The mortality and morbidity in the patients with intracranial involvement is invariably high, and it was reported that most survivors had early diagnosis and received aggressive treatment. Therefore, we retrospectively reviewed four patients of pathologically confirmed mucormycosis to find out the clues for early diagnosis of RCM and for prediction of fatal intracranial involvement. METHODS: The clinical, radiological features and histo-pathological involvement sites in the patients with intracranial involvement were compared to those without intracranial involvement. RESULTS: All the patients had uncontrolled diabetes and were admitted with orbital involvement. On the precise physical examination, mucosal involvement was found in all patients; three of them in only nasal mucosa and one in oral palatal mucosa. Despite the vigorous antifungal therapy, two patients had intracranial involvement and expired. MRI finding of extensive sphenoid sinusitis adjacent cavernous sinus preceded the intracranial involvement of RCM, which was not found in the patients without intracranial involvement. CONCLUSIONS: Our findings suggest that early observation of oral or nasal mucosal changes might be an important clinical clue for differentiation of RCM from other causes of rhino-oculo-cerebral symptoms in uncontrolled diabetic patients, and that extensive sphenoid sinusitis might be an important radiological feature for predicting the fatal intracranial involvement of RCM.
Cavernous Sinus ; Diabetes Mellitus ; Early Diagnosis* ; Fungi ; Humans ; Magnetic Resonance Imaging ; Mortality ; Mucorales ; Mucormycosis* ; Mucous Membrane ; Nasal Mucosa ; Opportunistic Infections ; Orbit ; Physical Examination ; Retrospective Studies ; Sphenoid Sinus ; Sphenoid Sinusitis ; Survivors

Purpose: Completion total gastrectomy (CTG) for remnant gastric cancer (RGC) is a technically demanding procedure and associated with increased morbidity. The present study aimed to evaluate postoperative complications and their risk factors following surgery for RGC after initial partial gastrectomy due to gastric cancer excluding peptic ulcer. Materials and Methods: We retrospectively reviewed the data of 107 patients who had previously undergone an initial gastric cancer surgery and subsequently underwent CTG for RGC between March 2002 and December 2020. The postoperative complications were graded using the Clavien-Dindo classification. Logistic regression analyses were used to determine the risk factors for complications. Results: Postoperative complications occurred in 34.6% (37/107) of the patients. Intraabdominal abscess was the most common complication. The significant risk factors for overall complications were multi-visceral resections, longer operation time, and high estimated blood loss in the univariate analysis. The independent risk factors were multivisceral resection (odds ratio [OR], 2.832; 95% confidence interval [CI], 1.094–7.333;P=0.032) and longer operation time (OR, 1.005; 95% CI, 1.001–1.011; P=0.036) in the multivariate analysis. Previous reconstruction type, minimally invasive approach, and current stage were not associated with the overall complications. Conclusions Multi-visceral resection and long operation time were significant risk factors for the occurrence of complications following CTG rather than the RGC stage or surgical approach. When multi-visceral resection is required, a more meticulous surgical procedure is warranted to improve the postoperative complications during CTG for RGC after an initial gastric cancer surgery.

Purpose: This study aimed to compare the long-term functional and patient-reported outcomes between intra-corporeal delta-shaped gastroduodenostomy and gastrojejunostomy after laparoscopic distal gastrectomy for gastric cancer. Materials and Methods: We retrospectively reviewed clinicopathological data from 616 patients who had undergone laparoscopic distal gastrectomy for stage I gastric cancer between January 2015 and September 2020. Among them, 232 patients who had undergone delta-shaped anastomosis and another 232 who had undergone Billroth II anastomosis were matched using propensity scores. Confounding variables included age, sex, body mass index, physical status classification, tumor location, and T classification. Postoperative complications, nutritional outcomes, endoscopic findings, and quality of life (QoL) were compared between the 2 groups. Results: No significant differences in postoperative complications or nutritional parameters between the two groups were observed. Annual endoscopic findings revealed more residual food and less bile reflux in the delta group (P<0.001) than in the Billroth II group. Changes of QoL were significantly different regarding emotional function, insomnia, diarrhea, reflux symptoms, and dry mouth (P=0.007, P=0.002, P=0.013, P=0.001, and P=0.03, respectively).Among them, the delta group had worse insomnia, reflux symptoms, and dry mouth within three months postoperatively. Conclusions Long-term nutritional outcomes and QoL were comparable between the delta and Billroth II groups. However, more residual food and worse short-term QoL regarding insomnia, reflux symptoms, and dry mouth were observed in the delta group. Longer fasting time before endoscopic evaluation and short-term symptom management would have been helpful for the delta group.

Purpose: This study evaluated real-world compliance with surgical treatment according to Korea's gastric cancer treatment guidelines. Materials and Methods: The 2018 Korean Gastric Cancer Treatment Guidelines were evaluated using the 2019 national survey data for surgically treated gastric cancer based on postoperative pathological results in Korea. In addition, the changes in surgical treatments in 2019 were compared with those in the 2014 national survey data implemented before the publication of the guidelines in 2018. The compliance rate was evaluated according to the algorithm recommended in the 2018 Korean guidelines. Results: The overall compliance rates in 2019 were 83% for gastric resection extent, 87% for lymph node dissection, 100% for surgical approach, and 83% for adjuvant chemotherapy, similar to 2014. Among patients with pathologic stages IB, II, and III disease who underwent total gastrectomy, the incidence of splenectomy was 8.08%, a practice not recommended by the guidelines. The survey findings revealed that 48.66% of the patients who underwent gastrectomy had pathological stage IV disease, which was not recommended by the 2019 guidelines. Compared to that in 2014, the rate of gastrectomy in stage IV patients was 54.53% in 2014. Compliance rates were similar across all regions of Korea, except for gastrectomy in patients with stage IV disease. Conclusions Real-world compliance with gastric cancer treatment guidelines was relatively high in Korea.

Purpose: The study aimed to investigate real-world surgical outcomes of minimally invasive surgery (MIS) for advanced gastric cancer using Korean Gastric Cancer Association (KGCA)-led nationwide data. Materials and Methods: A nationwide survey of patients who underwent surgical treatment for gastric cancer in 2019 was conducted by the KGCA. A total of 14,076 patients from 68 institutions underwent surgery, and 4,953 patients diagnosed with pathological stages IB-III gastric cancer were included. Among them, 1,689 patients who underwent MIS (MIS group) and 1,689 who underwent the open approach (open group) were matched using propensity score in a 1:1 ratio. Surgical outcomes were compared, and multivariate analysis was performed to identify the independent factors for overall morbidity. Results: The MIS group had a lower proportion of D2 lymphadenectomy, total omentectomy, and combined resection. However, the number of harvested lymph nodes was higher in the MIS group. Better surgical outcomes, including less blood loss and shorter hospital stay, were observed in the MIS group, and the overall morbidity rate was significantly lower in the MIS group (17.5% vs. 21.9%, P=0.001). The mortality rates did not differ significantly between the 2 groups. In the multivariate analysis, the minimally invasive approach was a significant protective factor against overall morbidity (odds ratio, 0.799; P=0.006). Conclusions Based on the Korean nationwide data, MIS for stage IB-III gastric cancer had better short-term outcomes than the open approach, including lower rates of wound complications, intra-abdominal abscesses, and cardiac problems.

No abstract available.
Embryonic Structures* ; Fluorescence* ; Humans* ; In Situ Hybridization* ; Preimplantation Diagnosis*

PURPOSE: The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. METHOD: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990), that was by Kim'(1997). RESULTS: In terms of the nurses knowledge of pain management, the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids, 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016), years of experiences(p=.002), experience of cancer pain education(p=.001). CONCLUSION: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.
Analgesics ; Analgesics, Opioid ; Classification ; Education ; Pain Management* ; Pain Measurement ; Seoul

PURPOSE: The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. METHOD: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990), that was by Kim'(1997). RESULTS: In terms of the nurses knowledge of pain management, the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids, 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016), years of experiences(p=.002), experience of cancer pain education(p=.001). CONCLUSION: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.
Analgesics ; Analgesics, Opioid ; Classification ; Education ; Pain Management* ; Pain Measurement ; Seoul

INTRODUCTION: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. MATERIALS AND METHODS: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). RESULTS: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. CONCLUSION: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.
Female ; Follow-Up Studies ; Head ; Humans ; Lip ; Male ; Mandible ; Medical Records ; Mouth Floor ; Mouth Mucosa ; Mouth Neoplasms ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Oropharynx ; Palate ; Recurrence ; Salivary Glands