PURPOSE: Malignant disease of the anus is rare. Abdominoperineal resection was formerly considered to be the treatment of choice. But, in recent, less ablative and more effective combined therapeutic modalities have been developed. METHODS: we analyzed 33 patients who were diagnosed and treated as anal cancers at the Department of Surgery, Gospel Hospital, Kosin Medical Collage, from July 1, 1988 to Nov. 30, 1997. RESULTS: The ratio of male to female was 1.4:1 and mean age was 56.7 years old. Twenty-two (84.8%) of these cancers were located in the anal canal and 5 (15.2%) in the anal margin. Three main histologic types of the anal cancers were identified: squamous cell carcinoma was the most common lesion, accounted for 17 cases (51.1%), adenocarcinoma accounted for 8 cases (24.2%), malignant melanoma accounted for 8 cases (24.2%). The overall 3-year survival rate and 5-year survival rate of anal cancer were 54.1%, 41.7%. Eleven patients with squamous cell carcinoma were treated curatively: 6 patients were treated with chemoradiotherapy, 3 patients with abdominoperineal resection, one patient with chemoradiotherapy and abdominoperineal resection, one patient with local excision. CONCLUSION: In survival rate, there were no significant differences between chemoradiotherapy group and surgical treatment group. In squamous cell carcinomas, chemoradiotherapy had anal sparing benefit without loss of survival. On univariate analysis, T, N, type of treatment, histologic type had no statistical significances on survival. On multivariate analysis, location of lesion and distant metastasis had statistical significances.
Adenocarcinoma ; Anal Canal ; Anus Neoplasms* ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Female ; Humans ; Male ; Melanoma ; Multivariate Analysis ; Neoplasm Metastasis ; Survival Rate

No abstract available.
Intracranial Aneurysm*

No abstract available.
Humans ; Kidney Transplantation* ; Living Donors*

Endoscopic ACL reconstruction using bone-patellar tendon-bone has been considered the gold standard in the field of reconstructive ACL surgery. Technically, graft must be placed at isometric point. But it is difficult to evaluate the placement of graft postoperatively. The purpose of this study is to determine the radiological ideal position of graft by comparing postoperative results with the graft placement. Seventy cases of endoscopic ACL reconstruction were reviewed and classified according to the femoral and tibial graft position on radiologic imaging. The femoral graft position was classified in relation to angle of graft on anterior position view and distance from posterior margin of graft to the inner surface of posterior cortex on lateral view. The tibial graft position was classified in relation to intercondylar eminence on anterior posterior view and lateral view. Knee score (modified Marshall, Lysholum), manual anterior instability test (Lachman test, Pivot shift test) and arthrometer measurement were checked to evaluate postoperative results in each case. The results of this study implicate that knee joint in which femoral graft was oriented at direction of 11 o clock centring around 68 degree respect to tibial joint and placed within 3mm from posterior cortex showed higher knee score and lesser laxity. In cases of tibial side, the graft oriented to intercondylar eminence (AP view) and placed anterior to intercondylar eminence (lateral view) showed higher knee score and lesser laxity.
Joints ; Knee ; Knee Joint ; Patellar Ligament* ; Transplants

Familial adenomatous polyposis (FAP) is an hereditary autosomal dominant disease characterized by development of hundreds to thousands of adenomatous polyps in the colon and rectum. The common symptoms are bloody stool, diarrhea, and abdominal pain. The average age at onset of symptoms is 33 years. Because of inevitable progression to malignancy, it is necessary to remove the entire colonic and rectal mucosa. Current surgical options are total proctocolectomy with permanent ileostomy, trans-abdominal colectomy with ileorectal anastomosis (IRA), and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Recently IPAA can give optimum control of colorectal polyposis in FAP patients with an acceptable incidence of postoperative complications and satisfactory functional results. We experienced one case of FAP who had malignacy in the remained rectum after subtotal colectomy. IPAA was done and the result was satisfactory.
Abdominal Pain ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Colectomy* ; Colon ; Diarrhea ; Humans ; Ileostomy ; Incidence ; Mucous Membrane ; Postoperative Complications ; Proctocolectomy, Restorative ; Rectum*

Gardner's syndrome is a familial disease consisting of gastrointestinal adenomatous polyposis, osteomas of the mandible, skull, and long bones, and a variety of sol tissue lesions, including sebaceous cysts, fibromas, lipomas, and desmoid tumors. The colon is the most common site for polyposis, but the stomach, duodenum, small bowel, and periampullary area may also be involved. The diagnostic evaluation, malignant potential, and management is identical to that for familial adenomatous polyposis. The extracolonic manifestations of Gardner's syndrome are frequent and varied. Gardner's syndrome is inherited as autosomal dominant traits. Authors experienced one case that is a 32 year old female patient who had colonic and duodenal multiple polyposis, desmoid tumor in abdominal wall and right mesocolon and odontoma on mandible.
Abdominal Wall ; Adenomatous Polyposis Coli ; Adult ; Colon ; Duodenum ; Epidermal Cyst ; Female ; Fibroma ; Fibromatosis, Aggressive ; Gardner Syndrome* ; Humans ; Lipoma ; Mandible ; Mesocolon ; Odontoma ; Osteoma ; Skull ; Stomach

No abstract available.
Chordoma*

PURPOSE: This study is for the evaluation of low tesla(0.064T) MR imaging diagnostic accuracy in the internal derangement of the knee. MATERIALS AND METHODS: We retrospectively analysed the MR images of 36 injured knees of 35 patients. The presence of tear was determined by arthroscopy or surgery in all cases. RESULTS: The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of low tesla MRI for the diagnosis of anterior cruciate ligament injury were 83%, 88%, 86%, 77%, 91%, for the posterior cruciate ligament 75%, 95%, 86%, 92%, 83%, for the medial collateral ligament 83%, 96%, 92%, 91%, 92%, for the lateral collateral ligament 67%, 97%, 94%, 67%, 97%, for the menisci 75%, 93%, 89%, 75%, 93%. CONCLUSION: The low tesla MRI is an accurate method in detection and evaluation of the internal derangement of the knee.
Anterior Cruciate Ligament ; Arthroscopy ; Collateral Ligaments ; Diagnosis ; Humans ; Knee* ; Lateral Ligament, Ankle ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Carcinoembryonic Antigen ; Colorectal Neoplasms

No abstract available.
Carcinoembryonic Antigen ; Colorectal Neoplasms