The primary malignant melanoma arising in the leptomeninges of the central nervous system is extremely rare. We report a case of malignant melanoma, apparently thought to be originated from leptomeninges, with diffuse neoplastic process widely spreaded over the leptomeninges of 42 years old man, who had suffered severe headache, nausea and left hemiparesis. This patient is free of the symptoms for six months after operation. The literature on this subject is briefly reviewed.
Adult ; Central Nervous System ; Headache ; Humans ; Melanoma* ; Nausea ; Paresis

The use of osseointegrated implants is an accepted procedure for the treatment of Total, or partial edentulism and offers good predictability of long-term success. Osseointegration implies a firm and direct interlocking between vital bone and screw-shaped titanium implants. There should be not to interposed tissue between fixture and bone. This study was undertaken to assess the clinical condition, complication, and prosthodontic aftercare of different implant systems. One hundred fifty-nine patients treated with a total of 503 endosseous implants (364 Steri-oss threaded type, 69 Integral cylinder with HA coated type, 35 Steri-oss threaded with HA coated type, 21 Steri-oss cylinder with HA coated type and 14 3i implant type), Most of the implant were placed in type B and C bone quantity and type 2 and 3 bone quality according to Lekhorm and Zarb. The success rate of Steri-oss threaded type during healing and function was 92%, Steri-oss threaded type with hydroxyapatite coated was 91%, Steri-oss cylinder type with hydroxyapatite coated was 90%, Integral cylinder type with hydroxyapatite coated was 90% and 3i implant type was 93%. One hundred twenty-nine patients had been treated with implant prosthesis. 79 of these patients had received a fixed type prosthesis and 50 patients had received a removable type prosthesis. There were no differences between the implant systems with regard to age, gender. Failures were associated with poor bone quality, smaller implant sizes, a surgical installation technique and stress distribution when in function. Visual analgoue scales recorded as satisfied results functionally and esthetically, but 15% dissatified with chewing ability.
Aftercare ; Dental Implants* ; Durapatite ; Humans ; Mastication ; Mouth Rehabilitation* ; Mouth* ; Osseointegration ; Prostheses and Implants ; Prosthodontics ; Titanium ; Weights and Measures

We reviewed 36 patients with carcinoid tumors, which had been diagnosed at the St. Mary's hospital, Kangnam St. Mary's hospital and St. Vincent's hospital affiliated with Catholic Medical Center during 18 years from July 1978 to June 1996. The peak age group was the third decade (25%), and the sex ratio of males to females was 1.57 : 1 with an age range of 13 to 73 years. The most common location of the tumors was the bronchus, 11 cases; next were the rectum, 9 cases, and the appendix, 5 cases. These were followed by the stomach, the duodenum, the ovaries, the gallbladder, the thymus, the sigmoid colon, and the ascending colon. One of cases had such widespread metastases that its primary site of origin could not be determined. According to the embryological classification, the foregut was the most common site, 15 cases; next were the hindgut, 10 cases, and the midgut, 7 cases. The malignant potential is determined by the size, the histological feature of the tumor, and the status of the regional lymph nodes. Among these, the size of the tumor was the most important; the extent of the resection was usually determined by the size of the tumors.There were no cases of classic carcinoid syndrome, but two cases of rectal and duodenal carcinoid tumors had symptoms similar to those of the carcinoid syndrome. We experienced three synchronous carcinomas and one metachronous carcinoma of different sites on the carcinoid tumors.
Appendix ; Bronchi ; Carcinoid Tumor* ; Classification ; Colon, Ascending ; Colon, Sigmoid ; Duodenum ; Female ; Gallbladder ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Ovary ; Rectum ; Sex Ratio ; Stomach ; Thymus Gland

The Duhamel procedure has been the authors' treatment of choice for children with Hirschsprung's disease over the last 15 years. Owing to advancements in instrumentation and technique, laparoscopic correction of some congenital anomalies, including congenital megacolon, have become possible. In March and May of 1997, laparoscopic Duhamel procedures were performed on a girl and boy aged 7 months and 2 years and 9 months, respectively. The primary diagnosis in both patients was Hirschsprung's disease, which was confirmed by barium-enema and mucosal suction biopsy. The boy did not need construction of a loop colostomy, while the girl had a colostomy made neonatally. Using 4 trocars, the sigmoid colon, proximal rectum, and posterior rectal wall were mobilized laparoscopically. Immdeiately after severing the proximal resection line, the proximal end was pulled down posterior to the dentate line for side-to-side anastomosis with GIA and Endo-GIA staplers perineally. The colonic remnant was then resected with staplers and harvested through the right lower quadrent port site. Operative time was 210 minutes for the boy and 200 minutes for the girl. No perioperative complications were noted, and conversion to laparotomy was never required. Regular diet was resumed 4 days (boy) and 2 days (girl) after the operations. Postoperative hospital stay was 7 days in the two cases. We successfully performed laparoscopic Duhamel procedures for the first time in Korea, and think it feasible, safe, andminimally invasive owing to size reduction of the incision and avoidence of intraperitoneal opening of the bowel.
Biopsy ; Child ; Colon ; Colon, Sigmoid ; Colostomy ; Diagnosis ; Diet ; Female ; Hirschsprung Disease* ; Humans ; Korea* ; Laparoscopy ; Laparotomy ; Length of Stay ; Male ; Operative Time ; Rectum ; Suction ; Surgical Instruments

Burkholderia pseudomallei is a gram-negative opportunistic intracellular pathogen that causes an acute and fatal septicemic melioidosis in humans. The organism is mainly found in Southeastern Asia and Northern Australia. Recently, we encountered a case of melioidosis in a Korean patient and performed the laboratory diagnosis of melioidosis. As a result, a gram negative bacterium was isolated from a melioidosis patient, and it was identified as B. pseudomallei on DNA sequencing of 16S ribosomal RNA with 99.9% homology and biochemical examination of VITEK gram-negative identification card. Also, DNA from cultured bacteria was tested in multiplex PCR, a 245 bp fragment amplified from the metalloprotease gene and a fragment of variable size ranging from 400~700 bp resulting from amplification of the 10 bp repetitive element for B. pseudomallei were confirmed after electrophoresis. The bacterium was sensitive to ceftazidime, imipenem and meropenem but resistant to ticarcillin. So far, there are no domestic cases of melioidosis in Korea, however, due to the increase in international travelers, the incidence of melioidosis is likely to increase. We report a recent case of melioidosis in a Korean patient.
Asia, Southeastern ; Australia ; Bacteria ; Burkholderia pseudomallei ; Ceftazidime ; Clinical Laboratory Techniques ; DNA ; Electrophoresis ; Humans ; Imipenem ; Incidence ; Korea ; Melioidosis ; Multiplex Polymerase Chain Reaction ; RNA, Ribosomal, 16S ; Sequence Analysis, DNA ; Thienamycins ; Ticarcillin

BACKGROUND: In gastric cancer, lymph-node status is the most important discriminant of patient outcome. In spite of its prognostic importance, lymph-node status is usually examined by a routine histological examination using only one hematoxylin and eosin (H-E) section prepared from a representative cut surface of each lymph node. In order to overcome this drawback, new means based on the polymerase chain reaction (PCR) have recently developed to detect micrometastases in lymph nodes. METHODS: Gastric cancer tissues and lymph nodes were obtained from 9 primary gastric adenocarcinoma patients who underwent gastric resection. A total of 80 lymph nodes and 9 gastric cancer tissues were analyzed by both histologic and molecular examination of keratin 19 mRNA. Regional lymph nodes obtained from patients with benign peptic ulcer perforation were used as normal control lymph nodes. RESULTS: 1) Keratin 19 mRNA was expressed in all patients with gastric cancers, but in none of the 10 normal control lymph nodes. 2) Keratin 19 mRNA was detected in all of the 8 lymph nodes which were histologically metastasis-positive. Of the 72 lymph nodes which were histologically metastasis- negative, 67 were found not to express keratin 19 mRNA, but 5 were found to express keratin 19 mRNA. 3) Especially, of the 3 early gastric cancers which were histologically metastasis-negative, one was found not to express keratin 19 mRNA, but two were found to express keratin 19 mRNA. CONCLUSIONS: Keratin 19 reverse transcripture (RT)-PCR a more sensitive method than histological examination for the detection of gastric micrometastases in lymph nodes and may serve as a useful clinical factor in establishing accurate staging for prognosis and in planning optimum management.
Adenocarcinoma ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Keratin-19* ; Lymph Nodes* ; Neoplasm Micrometastasis* ; Peptic Ulcer Perforation ; Polymerase Chain Reaction ; Prognosis ; RNA, Messenger* ; Stomach Neoplasms*

Pneumoconiosis is fibrogenic disease, caused by inhalation of mineral dust. It is defined as the accumulation of dust in the lung and tissue reaction to its presence and the dust is considered to be an aerosal of solid and inanimate particles. It is among the most common and the most important occupational lung disease, especially in developing countries. It is required three prerequisites for making a clinical diagnosis of pneumoconiosis: 1) a full clinical and occupational history together with the result of physical examination; 2) previous X-ray for comparison; and 3) a clear understanding of the time scale involved in the progression of the diseases. Most pneumoconiosises are slow to evolve and changes in the appearances take many months -usually years- to occur. Pneumoconiosis is represented on a plain X-ray of the chest as multiple small round opacities, usually smaller than 1cm diameter. In 58 years old female patient, pneumoconiosis is manifested as 5 X 4 X 3cm sized solitary pulmonary nodule without any occupational history and past histoty of exposure of dust. so we treated this case with right upper lobectomy. Therefore we report this case with a brief review of literatures.
Developing Countries ; Diagnosis ; Dust ; Female ; Humans ; Inhalation ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Middle Aged ; Physical Examination ; Pneumoconiosis* ; Solitary Pulmonary Nodule* ; Thorax

BACKGROUND: There has been a general feeling among surgeons that recurrence or metastasis following a curative gastric resection is a hopeless surgical proposition. This study was conducted to evaluate the clinical features and significance of relaparotomy following a gastrectomy for gastric cancer. METHODS: Fifty-six cases of relaparotomies following resection for 53 gastric cancer patients, which were performed over a nine-year period, were investigated retrospectively. On preoperative diagnosis, there were 17 cases of remnant and anastomotic recurrence, 15 cases of intestinal obstruction, 7 cases of cholecystitis, 7 cases of rectosigmoid obstruction, 5 cases of E-loop obstruction and 5 cases of other diseases. RESULTS: Of all the laparotomies eleven cases (19%) were non-recurrence, benign diseases and forty-six (81%) were recurrence. In the 17 cases of remnant and anastomotic recurrence, re-resection was possible in 13 (76%) and major postoperative complications developed in 4 cases with 2 cases of death within one month. Also 6 of 7 re-resected cases which was stage I at first operation were still alive well. In 15 cases of mechanical obstruction, 5 cases were non-recurrence and 10 cases involved recurrence, of which 6 had a bypass or enterostomy and 4 an exploration only. All cholecystitis cases had a cholecystectomy; metastasis was found in 2 cases. Rectal obstruction and E-loop obstruction all involved recurrence and a palliative resection was possible in only one case of each type of obstruction. CONCLUSIONS: In a relaparotomy of remnant and anastomotic recurrence, most of the survival-improving re-resection cases were in stage I at the first operation. In late-onset cholecystitis tumor recurrence should be suspected and a relaparotomy of the malignant obstruction, with bypass and ostomy procedure, can be justified for symptomatic relief.
Cholecystectomy ; Cholecystitis ; Diagnosis ; Enterostomy ; Gastrectomy ; Humans ; Intestinal Obstruction ; Laparotomy ; Neoplasm Metastasis ; Ostomy ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: Dispatcher-assisted telephone instruction during cardiopulmonary resuscitation (CPR) improves the quality of CPR performed by laypersons. However, in Korea, CPR instruction guidelines for bystanders have not made. We therefore studied the effects of verbal instruction on the quality of chest compression. METHODS: Data from two randomized, double-blinded, controlled trials using identical methodology were combined to obtain 175 records for analysis. Subjects were randomized into either a "push as hard as you can and fast" (n=87) or "push down 5~6 cm, 100~120 rate/min" (n=88), verbal instructions in the 2011 Korea Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). Data were recorded via a Resusci(R) Anne SkillReporter(TM), Laerdal Medical mannequin. Primary outcome measures included chest compression depth and chest compression rate per minute. RESULTS: The average compression depth and speed of chest compressions did not significantly differ between the two verbal instructions. CONCLUSION: The verbal istructions provided by telephone based on the 2011 Korean Guidelines for CPR and ECC are not effective. The instructions for high quality CPR of layperson should therefore be studied.
Cardiopulmonary Resuscitation* ; Emergencies ; Heart Massage ; Korea ; Manikins ; Methods ; Outcome Assessment (Health Care) ; Telephone* ; Thorax ; Verbal Learning

Low grade fibromyxoid sarcoma is a recently recognized, uncommon soft tissue neoplasm. It has a tendency to develop in deep soft tissue of young adults and a possibility of local recurrence or distant metastasis. Diagnostic criteria have not been well defined and this tumor has not been accepted as a distinct entity. Histologically, it is characterized by the presence of bland spindle cells with mainly whorled pattern of growth, set in alternating areas with a myxoid or fibrous stroma. Careful consideration of the morphological and immunohistochemical features of this tumor permit a positive diagnosis of low grade fibromyxoid sarcoma and allow its distinction from a number of other benign and malignant soft tissue neoplasms. We experienced a low grade fibromyxoid sarcoma in chest wall and report this case with a review of the literature.
Diagnosis ; Humans ; Neoplasm Metastasis ; Recurrence ; Sarcoma* ; Soft Tissue Neoplasms ; Thoracic Wall* ; Thorax* ; Young Adult