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

PURPOSE: The purpose of this study was to evaluate the MR findings of calvarial eosinophilic granuloma. MATERIALS AND METHODS: We reviewed the MR imaging studies of nine patients [M:F=3:6, aged 6 -35 (mean, 20.5) years] with pathologically proven eosinophilic granuloma in the calvaria. The findings were evaluated for involvement of the diploic space, changes in adjacent bone marrow, distinction of the transitional zone, pattern of bone destruction, signal intensity and contrast enhancement of the tumor, and contrast enhancement of the adjacent dura. RESULTS: All lesions involved the diploic space, showed no change in adjacent bone marrow, and had a distinct transitional zone. In most (8/9) cases there was asymmetric bony destruction. On T1-weighted images, signal intensities of the tumors varied, while on T2-weighted images, hyperintensity was observed in seven cases, isointensity in one, and hypointensity in one. After the administration of contrast material, enhancement was homogeneous in four cases and inhomogeneous in five. Enhancement of the adjacent dura was demonstrated in all nine cases. CONCLUSION: The characteristic MR findings of calvarial eosinophilic granuloma are variable signal intensity on T1WI, high signal intensity on T2WI, and marked contrast enhancement; in addition, there is a distinct transitional zone, asymmetrical bony destruction, and associated dural enhancement.
Bone Marrow ; Eosinophilic Granuloma* ; Eosinophils* ; Histiocytosis ; Humans ; Magnetic Resonance Imaging ; Skull

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

Skeletal remains collected from the archaeological fields must be maintained carefully, for being used in scientific studies on the physical characteristics, health status, and pathological disease of the ancient or medieval human populations. Even if Joseon Dynasty Human Sample Collection might be a good example for such studies, few of bone collections predated the Joseon Age (e.g. Goryeo Dynasty) have been established until now, possibly owing to poor preservation condition of archaeological sites in Korea. In this study, we performed anthropological studies on a few cases of Goryeo skeletons, which have been rarely reported by anthropologists in Korea. Judging from the preservation status of bones found in various types of Goryeo graves (e.g. earthen- or stone-chambered tombs), many cases seem to be cremated in accordance with Buddhist funeral rites. Goryeo bone collections must be constructed with the bones identified in the earthen tombs, which were preserved much perfectly than those of any other types of Goryeo tombs.
Anthropology, Physical ; Archaeology ; Funeral Rites ; Humans ; Korea ; Skeleton

Laparoscopic techniques are being applied to the surgical management of the colorectal disease. Comparing our twenty-month experience in laparoscopic colectomy with that of the conventional (open) colectomy, we evaluate the efficacy and the safety of laparoscopic operations in colorectal disease. From April 1994 to December 1995, thirty-five patients underwent a colorectal surgery at St. Vincent's Hospital, The Catholic University of Korea, College of Medicine. Nineteen patients (5 males and 14 females; mean age 54.8 years) were included in the laparoscopic group and fourteen patients (5 males and 9 females; mean age 50.9) were included in the open group. Two conversion cases were excepted due to unfitness for comparison. Malignancy were 15 cases in the laparoscopic group and 9 cases in the open group. To estimate the general advantage of laparoscopic surgery, we compared durations of wound pain and ileus, postoperative hospital stays, and operative time between two groups. Then surgical margins and numbers of lymph nodes harvested were compared between two groups for an evaluation of radical curability of malignant disease. The operative procedures of two groups included abdominoperineal resection, anterior resection, low anterior resection, sigmoid colectomy, right hemicolectomy, and Hartmann's procedure. The conversion rate of laparoscopic colectomy was 9.5 % (2 of 21). In the laparoscopic group, we experienced some advantages in duration of pain and ileus, and postoperative hospital stays, even though there was no statistical significance. Comparable surgical margins and numbers of lymph nodes harvested proved the laparoscopic procedures to be worthy of radical surgery. Between the two groups, morbidity and mortality showed no difference. Although the operative time of the laparoscopic group was longer than that of the open group, it can be decreased with more experience, development of better instruments, and the specialization. Even if we require a long-term survival rate, our data suggest that the laparoscopic colectomy can be accomplished effectively and safely with the accumulation of experience and the advancement of equipments.
Colectomy* ; Colon, Sigmoid ; Colorectal Surgery ; Female ; Humans ; Ileus ; Korea ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Male ; Mortality ; Operative Time ; Surgical Procedures, Operative ; Survival Rate ; Wounds and Injuries

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