We report a case of classic Kaposis sarcoma(KS) in a 74-year-old man who had asymptomatic red-dish-blue or dark-brown macules, papules and nodules on his bo hower extrimities. The biopsy specimen showed typical histopathologic features of FS including a highly vascularized lesion with a proliferation of spindle-shaped cells accompanied by etravasated erythrocytes and variable number of inflammatery cells. Many of the spindle-shaped cells associated with the proliferating vessels in KS lesion expressed factor VIII-related antigen. He was treated with 1500 cGy of radiation(300 cGy per day for 5 successive day. Four weeks after radiotherpy, gross and histopathologic findings were mucl improved and healed leaving hyperpigmentation.
Aged ; Biopsy ; Erythrocytes ; Humans ; Hyperpigmentation ; Radiotherapy* ; Sarcoma* ; von Willebrand Factor

No abstract available.
Hemodynamics* ; Nitroprusside*

No abstract available.
Fibronectins* ; Plasma* ; Pre-Eclampsia*

No abstract available.
Humans ; Poroma* ; Tissue Donors*

PURPOSE: A delta-shaped anastomosis (DA) is a widely accepted technique used for a totally laparoscopic distal gastrectomy (TLDG). Several studies have suggested various modifications to overcome the drawbacks of an original DA. We present our novel technique―a T-shaped modified delta anastomosis (TDA), and we report the early outcomes with its use in a case series. METHODS: We retrospectively reviewed the medical records of 40 patients who underwent a TLDG with TDA for early gastric cancer at OOO between February 2016 and May 2017. Perioperative outcomes, postoperative complications, and operating time were analyzed, and all data were expressed as means±standard deviation. RESULTS: We observed no major complications that required immediate postoperative intervention. Other minor and non-surgical complications were delayed gastric emptying (n=1), pneumonia (n=2), atelectasis (n=3), dumping symptom (n=1), and symptomatic bile reflux (n=1). No wound infection was reported in any patient. The total operative time was 206.5±25.4 min and the estimated blood loss was 27.8±33.5 ml. The mean time required to perform the anastomosis was 20.9±6.7 min, and the mean number of cartridges used during the operation was 4.78±0.66. CONCLUSION: We conclude that a TDA following a laparoscopic distal gastrectomy was successfully developed and showed acceptable clinical outcome.
Bile Reflux ; Gastrectomy ; Gastric Emptying ; Humans ; Laparoscopy ; Medical Records ; Operative Time ; Pneumonia ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Stomach Neoplasms ; Wound Infection

Purpose: Preoperative tumor size is associated with clinical stage, treatment plan and even survival rate of patient. We investigated the accuracy of tumor size estimation between magnetic resonance imaging (MRI) and ultrasonography (US) findings, comparing these with pathologic tumor size in the diagnosis of early breast carcinoma. Methods: Between 2011 and 2016, 136 patients with early breast cancer were analyzed and their tumor size on US and MRI findings were compared with their pathologic tumor size retrospectively. The background parenchymal enhancement of MRI was categorized as minimal, mild, moderate, and extreme. The patients who underwent neoadjuvant chemotherapy, had positive resection margins, underwent excisional biopsy for cancer diagnosis, and had non-mass lesions on MRI scans, were excluded. Results: In all, 83.1% of the cases showed concordance between MRI findings and pathologic tumor size within 0.5cm. MRI overestimated the findings by 10.3% and underestimated them by 6.6%; 78.7% showed concordance between US findings and pathologic tumor size within 0.5cm. US overestimated the findings by 5.9% and underestimated them by 15.4%. The tumor size on MRI (r=0.87) showed a stronger correlation to the pathologic tumor size than that on US (r=0.64) in early breast cancer patients. US had a tendency to underestimate the tumor size. The degree of breast parenchyma did not affect the accuracy of the measurement of preoperative tumor size. Conclusion MRI is relatively more accurate than US for assessing preoperative tumor size in breast cancer patients. US tends to underestimate tumor size.

PURPOSE: Despite modern pathologic techniques, GISTs pose a dilemma in nomenclature, cellular origin, diagnosis, classification, and prognostication. The authors attempted to elucidate the clinical applications of known prognostic factors at our hospital on the basis of CD34 or CD117 positivity. METHODS: Immunostaining was done on 24 cases of GI tract tumor including leiomyoma, leiomyosarcoma, and GISTs treated in our hospital between 1991 and 2000. 20 cases that showed positive reactivity to either CD34 or CD117 were chosen, and a retrograde evaluation of the clinical characteristics and pathological characteristics was done. RESULTS: 16 of 24 cases (66.7%) showed a positive reactivity to CD34, 18 cases (75%) to CD117, and 20 cases (83.3%) to both CD34 and CD117. Complete resection was performed on all, with exception of one in which intraperitoneal metastasis was detected. The mean age of the patients was 58.9 (19~74) years, the mean tumor size was 8.1 cm (3~20) and there was no significant difference between the sexes. The overall survival rate was 80%. The difference of cumulative survival rate was significant when tumor size was 10 cm or greater (p=0.0021), mitotic count was 5/50 HPF or over (p<0.0001), or severe cellularity (p=0.0001), invasion (p<0.0001), necrosis (p=0.0185) or atypism (p<0.0001) were accompanied. CONCLUSION: Authors defined GIST as those case that were immunohistochemically positive to either CD34 or CD117. The prognostic factors those affected 5-year survival rate were tumor size, mitotic count, intratumoral necrosis, severecellularity, atypism and invasion. Additionally, the surgical treatment for this condition should be a complete resection of macroscopically identified tumor with adequate margin secured. Finally, a long term follow-up for the recurrence should be carried out.
Classification ; Diagnosis ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Leiomyoma ; Leiomyosarcoma ; Necrosis ; Neoplasm Metastasis ; Recurrence ; Stomach* ; Survival Rate

OBJECTIVE: Traumatic brain injury has been shown to result in a decrease of the brain-free magnesium concentration that is associated with the development of neurologic deficits. However, changes in free magnesium homeostasis have not been characterized in other fluid compartments. We examine the ionized serum magnesium(Mg2+) and ionized serum calcium(Ca2+) in the moderate diffuse axonal injury of rat model. METHODS: We designed a study to determine whether ionized serum magnesium(Mg2+) and / or ionized serum calcium(Ca2+) levels correlate with moderate diffuse axonal injury(mDAI). A new ion-selective electrode was used to determine Mg2+ and Ca2+ level in the serum, prior to and following weight-drop induced mDAI. RESULTS: Serum Mg2+ remained significantly depressed to about 76% of preinjury values for 3 hours (0.73+/-0.01 mg/dL, 0.79+/-0.03 mg/dL, 0.84+/-0.03 mg/dL at 1, 2, 3 hours after trauma, respectively) compared to control group (1.07+/-0.03 mg/dL, p<0.05), but not in total serum magnesium(tMg). Mg2+/ tMg was shown a significant decrease for first 3 hours (49%, 53.4%, 56.4% at 1, 2, 3 hours after trauma respectively) compared to control group (70.9%, p<0.05). Head trauma resulted in small decrease of Ca2+, but there was a significant increase in the amount of Ca2+/ Mg2+(mean value in control group: in injured group for 3 hours after trauma = 4.65+/-0.012: 5.71+/-0.015, p<0.05). Apoptotic change was shown at 3 hours after mDAI and apoptotic index(AI) was significantly increased at 12 and 24 hours after trauma (54.8+/-1.7, 51.5+/-3.2 at 12, 24 hours, p<0.05). CONCLUSION: These findings suggest that the early decline in serum Mg2+ and increase in the amount of Ca2+/ Mg2+ following brain trauma may be a critical factor in the development of irreVersible tissue injury and early treatment with magnesium salt may be effective in histological changes following experimental traumatic brain injury in the rat.
Animals ; Apoptosis ; Axons ; Brain Injuries ; Calcium* ; Craniocerebral Trauma ; Diffuse Axonal Injury* ; Homeostasis ; Ion-Selective Electrodes ; Ions* ; Magnesium* ; Models, Animal ; Neurologic Manifestations ; Rats*

Tacrolimus(FK 506) is a powerful immunosuppressant. Recently, topical and systemic tacrolimus was known to have therapeutic effects in various dermatologic diseases such as atopic dermatitis, psoriasis, pyodema gangrenosum, and Beh et's disease. A 48-year-old woman presented with psoriasis of 40 years duration, which was recalcitrant to any therapies including topical steroids and calcipotriol, UVB, PUVA, acitretin, cyclosporine, and methotrexate. Therefore, systemic tacrolimus treatment, at a dose of 2 to 6 mg per day, was initiated, and complete resolution of the lesions was observed after 2 months. We report a case of recalcitrant psoriasis improved with tacrolimus.
Acitretin ; Cyclosporine ; Dermatitis, Atopic ; Female ; Humans ; Methotrexate ; Middle Aged ; Psoriasis* ; Steroids ; Tacrolimus*

Rheumatoid vasculitis usually occurs in patients with long standing, seropositive, erosive rheumatoid arthritis. It involves typically small to medium-sized vessels and is associated with peripheral neuropathy, digital gangrene, nail fold infarcts, livedo reticularis, and palpable purpura. Histologic examination of skin biopsy specimens usually shows leukocytoclastic vasculitis. We report a case of rheumatoid vasculitis developed on both extremities in a 63-year-old female with rheumatoid arthritis for 15 years.
Arthritis, Rheumatoid ; Biopsy ; Extremities ; Female ; Gangrene ; Humans ; Livedo Reticularis ; Middle Aged ; Peripheral Nervous System Diseases ; Purpura ; Rheumatoid Vasculitis* ; Skin ; Vasculitis