Volvulus of the colon is a twisting of a redundant segment of the colon about it's narrow mesentery and sigmoid volvulus is the most common type. In many developing counteries this disorder is a common cause of obstruction of the intestine and in the western hemisphere it occurs in elderly patients who often have significant coexisting disease. This disorder may spontaneously reduce and recur as a chronic problem, but more frequently it becomes acute by obstruction, which may lead to strangulation and gangrene with high mortality if not treated promptly. Recently We have experienced 5 cases of signmoid volvulus, which were all in their twenties and had surgical operation. They had the triad of abdominal pain, distention, and absolute constipation. Plain abdominal roentgenogram was diagnostic in all cases The first line of treatment was nonoperative decompression with rigid sigmoidoscopy and successful in four of five. One Patient had emergency Hartman operation and other four had elective sigmoid resection with primary anastomosis.
Abdominal Pain ; Aged ; Colon ; Colon, Sigmoid* ; Constipation ; Decompression ; Emergencies ; Gangrene ; Humans ; Intestinal Volvulus* ; Intestines ; Male* ; Mesentery ; Mortality ; Sigmoidoscopy

Small round cell tumors such as neuroblastoma, rhabdomyosarcoma, Ewing's tumor, malignant lymphoma and small cell carcinoma are often confused clinically and histologically. To clarify the similarites and differences and to get more information on the histogenesis among the small round cell tumors, we examined histological, immunohistochemical and ultrastructural features of ten cases of neuroblastomas, twenty Ewing's tumors, ten embryonal rhabdomyosarcomas and twelve small cell carcinomas in children and young adults. Antibodies against desmin, vimentin, cytokeratin, neuron-specific enolase, synaptophysin, neurofilament, S-100 protein, chromogranin and HBA 71 were used in biotin streptavidin procedures. The results of the immunohistochemical and electron microscopical examinations yielded virtually identical findings in each group as followings. 1) Among the twenty cases of Ewing's tumors, eighteen cases were positive in staining for HBA-71. The staining for HBA-71 was negative in neuroblastoma, embryonal rhabdomyosarcoma and small cell carcinoma. 2) Neuroblastomas had marked interdigitating cytoplasmic processes containing many microtubules and dense-core secretory granules, however, they were sparse and rare in Ewing's tumor. 3) Embryonal rhabdomyosarcoma showed actin-myosin bundles. According to differentiation, well differentiated rhabdomyosarcoma exhibited Z-band materials and external lamina. 4) Neuroblastoma showed ultrastructural evidence of a neuronal differentiation, but neuronal differentration is a sparse and rare in Ewing's tumor. This ultrastructural feature strengthens the hypothesis that Ewing's tumor is derived not only from an undifferentiated neuroectodermal stem cell but from primitive cell of neuroectodermal origin.
Antibodies ; Biotin ; Carcinoma, Small Cell ; Child ; Cytoplasm ; Desmin ; Humans ; Immunohistochemistry ; Keratins ; Lymphoma ; Microtubules ; Neural Plate ; Neuroblastoma ; Neurons ; Phosphopyruvate Hydratase ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal ; S100 Proteins ; Sarcoma, Ewing ; Secretory Vesicles ; Stem Cells ; Streptavidin ; Synaptophysin ; Vimentin ; Young Adult

PURPOSE: We evaluated the correlation between the carcinogenesis of gallbladder and the expression of lysozyme, p53, c-erbB2 and CEA in gallbladder lesions. MATERIALS AND METHODS: Thirty cases of gallbladder lesions (containing 17 cases of GB carcinoma) were examined. We analyzed the clinicopathologic findings of the early (stage I & II) and advanced carcinoma (stage III, IV & V) and those of carcinoma with or without metaplasia in the tumor. We performed p53, c-erbB2 and CEA immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. We also performed lysozyme immunohistochemical staining and compared its finding with metaplastic and non-metaplastic lesions. RESULTS: There are two distinct genetic pathways in gallbladder cacinogenesis and metaplastic carcinoma was more frequent than non-metaplastic carcinoma. Metaplasia of gallbladder did not reveal any difference of the clinicopathologic findings and depth of invasion (Nevin stage). Lysozyme expression was found in all metaplastic lesions but non-expression did not indicate non-metaplastic lesions. p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively. The correlation of p53 and c-erbB2 expressions was found but which did not indicate that the co-expression was needed in the carcinogenesis. CEA immunohistochemical staining may be helpful in the differential diagnosis of benign lesions and precancerous and cancerous lesions of the gallbladder. CONCLUSION: These results suggest that p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively.
Carcinogenesis ; Diagnosis, Differential ; Gallbladder* ; Metaplasia* ; Mucous Membrane ; Muramidase

BACKGROUND: We analyzed the clinical characteristics of trauma involving the liver and/or the spleen to evaluate the safety of nonoperative management. METHODS: A retrospective study was conducted on 78 cases who were treated with operative (37 cases) and nonoperative (41 cases) management at Wonkwang University Hospital from January 1995 to June 1998. Nonoperative management was done in hemodynamically stable patients. RESULTS: Three cases in the operative group (OG) and 5 cases in the nonoperative group (NOG) were children. Causes of injury were traffic accidents (66.6%), falls (15.4%), penetrating injuries (11.4%), and assaults (6.4%). Associated intraabdominal injuries were renal contusions (42%), pancreatic injuries (18%), mesenteric tearing (12%), diaphragm ruptures (9%). Associated extraabdominal injuries were chest injuries (56.5%), long bone fractures (15.2%), pelvic bone fractures (9.8%), and CNS injuries (8.7%). Mean total blood requirements were 7.0 units in the OG and 1.2 units in the NOG. Complications were 35 cases in the OG (pleural effusion, 6 cases; intraabdominal abscess, 4 cases; pneumonia, 4 cases; biloma, 3 cases) and 15 cases in the NOG (pleural effusion, 5 cases; pneumonia, 5 cases; intraabdominal abscess, 2 cases). Causes of 8 delayed operations were bowel perforations (small bowel 2 cases, and colon, 1 case), bile peritonitis (2 cases), and hemodynamically instability (3 cases). The hospitalization period was 16 days in the OG and 14 days in the NOG. Six patients in the OG died and the causes were multiple organ failures (4 cases), hypovolemic shock (1 case), and ARDS (1 case). No patient died in the delayed operation cases and the NOG, even in major injury cases aquired respiratory distress syndrom. CONCLUSIONS: Nonoperative management of traumatic liver and/or spleen injury is safe and can be tried initially under the conditions of stable hemodynamics, feasible abdominal CT, and feasible immediate operation.
Abscess ; Accidents, Traffic ; Bile ; Child ; Colon ; Contusions ; Diaphragm ; Fractures, Bone ; Hemodynamics ; Hospitalization ; Humans ; Liver* ; Multiple Organ Failure ; Pelvic Bones ; Peritonitis ; Pneumonia ; Retrospective Studies ; Rupture ; Shock ; Spleen* ; Thoracic Injuries ; Tomography, X-Ray Computed

Clinical characteristics of papular-purpuric gloves and socks syndrome consist of a purpuric erythema affecting the hands and feet in a gloves and stocking distribution. It is sometimes associated with fever and oral lesions. The disease is self-limiting and resolves within 1 to 2 weeks. Serological studies have shown that there is an association with parvovirus B19 infection in most patients affected by this syndrome. We report a case of gloves and socks syndrome in a 21-year-old female. She had a 4-day history of papular-purpuric eruptions of the hands and feet in a gloves-and-socks distribution. She also complained of fever(up to 39C) during the first 2 or 3 days of clinical onset. The oral mucosa was normal and there were no palpable lymph nodes. Laboratory and histopathological findings were non-specific. However, human parvovirus B19 DNA was detected in the serum by a polymerase chain reaction. Systemic manifestations were transient and disappeared within a few days, whereas the skin lesions resolved gradually over a period of 2 weeks.
DNA ; Erythema ; Female ; Fever ; Foot ; Hand ; Humans ; Lymph Nodes ; Mouth Mucosa ; Parvovirus ; Parvovirus B19, Human ; Polymerase Chain Reaction ; Skin ; Young Adult

In 1952, Zoon described eight cases of benign circumscribed chronic balanitis characterized by an extensive infiltration of plasma cells with no evidence of dysplasia of the overlying epidermis. Plasma cell balanitis can often be confused clinically with other conditions, such as erythroplasia of Queyrat, fixed drug eruptions, secondary syphilis, candidiasis and Reiters disease. We report a case of plasma cell balanitis in a 65-year-old man. He complained of a single, red, shiny and smooth patch involving the glans penis and adjacent prepuce. This patch was unresponsive to systemic and topical steroid treatment. Laboratory studies were negative or within the normal range. Histopathological findings showed a band-like mainly plasmacytic inflammatory infiltrate of the upper dermis. This patient was treated once daily with 2% fusidic acid cream topically for 5 weeks. The lesions resolved and no recurrence was observed during 2 years of follow-up.
Aged ; Arthritis, Reactive ; Balanitis* ; Candidiasis ; Dermis ; Drug Eruptions ; Epidermis ; Erythroplasia ; Follow-Up Studies ; Furosemide* ; Fusidic Acid* ; Humans ; Male ; Penis ; Plasma Cells* ; Plasma* ; Recurrence ; Reference Values ; Syphilis

PURPOSE: The purpose of this study was to identify relationships between quality of sleep, symptom cluster, depression, environmental disorder, and quality of life among hospitalized cancer patients. METHODS: The subjects were 114 patients who underwent chemotherapy for colon cancer, gastric cancer, gynecologic cancer and breast cancer. They were recruited from the cancer center of a university hospital. Data were collected from August 4th to 30th, 2011. The questionnaires included the Korean sleep scale A (quality of sleep), MDASI-K (symptom cluster), the environmental sleep disturbing scale, Zung's depression scale, and the Korean version of EORTC QLQ-C30. The collected data was analyzed by t-test, ANOVA, multiple regression analysis using the SPSS 19.0 program. RESULTS: Functional QOL was negatively associated with symptom QOL (r=-.798, p<.001). Symptom cluster, depression, & spouse (46.3%) were the most powerful predictors for functional QOL (46.3%) and symptom QOL (53.4%). CONCLUSION: It is evident that oncology nurses need to evaluate two dimensions of quality of life for cancer patients, for example, functional and symptom QOL. We recommend nurses develop specific protocols for relieving physical symptoms and alleviating depression, and furthermore test the effectiveness of them.
Breast Neoplasms ; Colonic Neoplasms ; Depression ; Humans ; Quality of Life ; Spouses ; Stomach Neoplasms ; Surveys and Questionnaires

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

Arteiovenous malformation of the uterus is an extremely rare and becomes one of the causes of severe uterine bleeding. Because uterine bleeding can be aggravated with diagnostic dilatation and curettage, an accurate diagnosis should be achieved before the intervention. This malformation may be congenital or acquired. In the past, the diagnosis is usually made retrospectively after hysterectomy, however, recently it may be made before management by ultrasound, doppler ultrasound, pelvic angiography, magnetic resonance imaging, etc.. We have experienced one case of arteriovenous malformation of the uterus, which is presented with a brief review of the literatures.
Arteriovenous Malformations* ; Diagnosis ; Dilatation and Curettage ; Female ; Hysterectomy ; Magnetic Resonance Angiography ; Retrospective Studies ; Ultrasonography ; Uterine Hemorrhage ; Uterus*

OBJECTIVE: The purpose of this study was to determine the important factors affecting survival and pregnancy rate in frozen-thawed embryo transfer cycles. METHODS: we performed reprospective analysis in 738 cycles of frozen-thawed embryo transfers, in relation to the insemination methods, the freezing stage of embryo, patient's age, infertility factors and the origin of injected sperm in ICSI cycles. After conventional IVF or ICSI, the supernumerary PN stage zygotes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propandiol (PROH) as a cryoprotectant. RESULTS: The survival rates of thawed embryos were 69.3% (1585/2287) in conventional IVF group and 71.7&% (1645/2295) in ICSI group. After frozen-thawed embryo transfers, 27.0% (92/341) and 32.0% (109/341) of pregnancy rates were achieved in conventional IVF and ICSI group, respectively. There were no significant difference in the survival and pregnancy rates according to the insemination methods, the freezing stage and patient's age. However, the pregnancy rate (36.2%) of male factor infertility (22.9%). In ICSI group, the origin of injected sperm did not affect the outcome of frozen-thawed embryo transfer cycles. CONCLUSION: The present study demonstrates that acceptable clinical outcomes can be achieved after the transfer of frozen-thawed embryos regardless of the stage of embryos for freezing, the patient's age and the origin of injected sperm.
Embryo Transfer* ; Embryonic Structures* ; Freezing ; Humans ; Infertility ; Insemination ; Male ; Pregnancy Rate* ; Pregnancy* ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Survival Rate ; Zygote